Characterization of patients with epithelial dysplasia and carcinoma in situ in the oral cavity, 2000 to 2014 / Caracterización de pacientes con displasia epitelial y carcinoma in situ en cavidad oral, entre 2000 y 2014

Objetive: To characterize patients diagnosed with oral epithelial dysplasia and carcinoma in situ, according to their severity, location, age, sex and smoking habits. Materials and Methods: A descriptive study, based on 126 histopathological reports of biopsies diagnosed with mild, moderate, severe epithelial dysplasia and carcinoma in situ, with information regarding anatomical location, age and gender of the patient, recorded in the biopsy reports of the histopathology services of the Faculty of Dentistry of Andrés Bello University and Major University, between the years 2000 and 2014. The dichotomous qualitative variables were described based on percentage and age using the Shapiro-Wilk test, presenting as average and standard deviation, in the STATA 12® program (StataCorpLP, Texas, USA). Result: A similar frequency was found for men and women diagnosed with OED, 53.17% and 46.83% respectively. A mild degree of OED was the most diagnosed in both sexes. The group most affected by OED was between 50 and 69 years old (57.94%) and the most frequent anatomic location was the lateral border of the tongue (34.13%). Conclusion: Most of the analyzed cases corresponded to mild degrees of dysplasia; however, it is important to always carry out a histopathological diagnosis of the lesion, patient follow-up and education regarding risk habits.

Objetivo: Caracterizar a pacientes con diagnóstico de displasia epitelial oral (DEO) y carcinoma in situ (CIS) según su severidad, localización, edad, género y hábito tabáquico. Materiales and Métodos: Se realizó un estudio descriptivo, en base a 126 informes histopatológicos de biopsias diagnosticadas con displasia epitelial leve, moderada, severa y carcinoma in situ, que contaban con información relativa a localización del diagnóstico, edad y género del paciente, registrados en los informes de biopsias de los servicios de histopatología de la Facultad de Odontología de la Universidad Andrés Bello y Universidad Mayor, entre los años 2000 y 2014. Las variables cualitativas dicotómicas se describieron en base a porcentaje y la edad mediante el test de Shapiro-Wilk, presentándose como media y desviación estándar, en el programa STATA 12 ® (StataCorpLP, Texas, USA). Resultados: Se encontró una frecuencia levemente aumentada de mujeres y hombres con diagnóstico de DEO, 67 (53,17%) y 59 (46,83%), respectivamente. El grado leve de DEO fue el más diagnosticado en ambos sexos. El grupo más afectado por DEO fue entre los 50 a 69 años (57,94%) y la localización anatómica más frecuente fue el borde lateral de la lengua (34,13%). Conclusión: La mayoría de los casos analizados correspondieron a grados leve de displasia; no obstante, es importante realizar siempre un diagnóstico histopatológico de la lesión, seguimiento al paciente y educación en cuanto a hábitos de riesgo.

Aspectos no clásicos del uso de metformina: ¿Qué hay de nuevo? / Non-classical uses of metformin: what's new?

Metformina, el antidiabético oral más usado, ha sido descrito últimamente en propiedades fuera de su acción como insulino sensibilizante para pacientes con diabetes mellitus. En esta revisión se presenta una actualización del uso de este fármaco en tres condiciones: síndrome de ovario poliquístico (SOP), esteatohepatitis no alcohólica (EHNA) y beneficios en algunos tipos de cáncer. Dada la relevancia de la insulino resistencia (IR) en la patogenia del SOP, la metformina es útil, ayudando a mejorar la fertilidad en mujeres con deseo de embarazo y mejorando la esfera endocrino-metabólica de estas. El grado de IR se ha reconocido como un factor importante en la gravedad de la EHNA, y la metformina podría frenar el avance de la enfermedad disminuyendo el grado de fibrosis hepática, además de disminuir la mortalidad general de estos pacientes. Por último, se observa que en pacientes diabéticos con algunos tipos de cáncer, el uso concomitante de metformina podría ser beneficioso en la morbimortalidad, si bien las vías de acción no están totalmente claras, hay ideas de cuales serían y en qué tipos de cáncer se podría ver algún beneficio.

The most used oral antidiabetic, metformin, has recently been promoted for properties other than its insulin sensitizing action in diabetic patients. We review the current use of this medication in three conditions: polycystic ovary syndrome (POS), non-alcoholic steatohepatitis (NASH) and some types of cancer which appear to benefit. Given the relevance of insulin resistance in the pathogenesis of POS, metformin is useful, helping to improve fertility in women wishing to conceive and, at the same time, improving their endocrine-metabolic functioning. An important factor in the severity of NASH is the degree of insulin resistance, and metformin can slow the progression of the disease, lowering the degree of hepatic fibrosis as well as diminishing the general mortality of these patients. Lastly, the concomitant use of metformin in diabetics suffering some forms of cancer may reduce morbidity and mortality. Although its action mechanism is not yet clear, there are some preliminary ideas as to what this could be and which types of cancer it could help.

Calidad de sueño y rendimiento académico en alumnos de educación secundaria / Quality of sleep and academic performance in high school students

Background: Sleeping and studying are the day-to-day activities of a teenager attending school. Aim: To determine the quality of sleep and its relationship to the academic performance among students attending morning and afternoon shifts in a public high school. Material and Methods: Students of the first and second year of high school answered an interview about socio-demographic background, academic performance, student activities and subjective sleep quality; they were evaluated using the Pittsburgh Sleep Quality Index (PSQI). Results: The interview was answered by 322 first year students aged 15 ± 5 years attending the morning shift and 364 second year students, aged 16 ± 0.5 years, attending the afternoon shift. The components: sleep latency, habitual sleep efficiency, sleep disturbance, drug use and daytime dysfunction were similar and classified as good in both school shifts. The components subjective sleep quality and duration of sleep had higher scores among students of the morning shift. The mean grades during the first semester of the students attending morning and afternoon shifts were 5.9 and 5.8, respectively (of a scale from 1 to 7). Among students of both shifts, the PSQI scale was associated inversely and significantly with academic performance. Conclusions: A bad sleep quality influences academic performance in these students.

Daño endotelial y activación del sistema hemostático asociado al uso crónico de cocaína: estudios ex vivo e in vitro / Endothelial damage and activation of the haemostatic system associated to chronic use of cocaine: an ex vivo and in vitro study

Antecedentes: Usuarios crónicos de cocaína tienen riesgo aumentado de presentar infarto de miocardio, angina,muerte súbita y accidentes cerebrovasculares. Aunque la patogenia del daño vascular es mayormente desconocida, se ha encontrado arterioesclerosis prematura y formación de trombos intravasculares. Objetivo: Demostrar evidencia de daño endotelial y activación del sistema hemostático en usuarios crónicos de cocaína. Métodos: Un grupo de 23 pacientes con criterios de dependencia a cocaína DSM-IV; 19 hombres (edad promedio 32 a), con exposición a la droga dentro de 72 h del estudio. Disfunción endotelial se evaluó por enumeración de las células endoteliales circulantes (CEC) y nivel de sICAM . Para activación del sistema hemostático se incluyó: complejos trombina-antitrombina (TAT) y generación de trombina; NAP-2 y RANTES para activación plaquetaria. In vitro, CE en cultivo (HUVEC), se expusieron a plasma de consumidores o controles. Se midió factor von Willebrand (FVW) en el medio y expresión de FvW y factor tisular (FT) sobre las CE. Adhesión plaquetaria estática se evaluó por microscopía. Resultados: En usuarios de cocaína, con respecto a controles, las CEC estaban significativamente elevadas...

Background: chronic cocaine users have an increased risk of developing myocardial infarction, angina, suddendeath and stroke. Although the pathogenesis of this effect is not completely known, premature atheromatosis and intravascular thrombosis appear to be involved.Aim: to provide evidence for the presence of endothelial damage and activation of the haemostatic system in chronic cocaine users. Methods: 23 subjects (19males, overall mean age 32) with DSM-IV criteria for cocaine dependency and exposure to the drug within 72 hours were studied. Endothelial dysfunction was determined by circulating endothelial cell counts (CEC) and sICAM levels. Thrombin-antithrombin complexes (TAT) and thrombin generation were used to characterize haemostatic status. In vitro, platelet activation was studied by NAP-2 and RANTES. EC in culture (HUVEC) were exposed to plasma from cocaine users and controls. Von Willebrand factor was measured in the culture media as well as its expression along with that of tissue factor in EC. Platelet adhesion was evaluated by microscopy. Results: Compared to controls, EC were significantly increased in cocaine users...