Frecuencia de Patologías y Condiciones de Lengua Observadas en Población Pediátrica

RESUMEN: Las patologías y condiciones linguales constituyen una proporción considerable del total de lesiones de la mucosa oral. Los estudios epidemiológicos que describen su frecuencia en la población pediátrica son escasos y variables. El objetivo de este estudio fue establecer la frecuencia de patologías y condiciones de lengua en niños atendidos en la Facultad de Odontología de la Universidad de Chile. Se realizó un estudio observacional, descriptivo y de corte transversal donde se examinaron pacientes pediátricos de 4 a 13 años de ambos sexos. De un total de 179 pacientes, un 53 % presentó al menos una patología o condición lingual. El rango etario de 11 a 13 años presentó un mayor OR de presentar lesiones y/o condiciones linguales al ser comparado con los otros rangos etarios (valor p<0,05). La patología o condición lingual más frecuente fue la lengua saburral (39 %), seguida por la lengua fisurada (15 %), la hipertrofia de papilas linguales (5 %) y la lengua geográfica (3 %). La ubicación más frecuente fue la base lingual con un 59 % del total de ubicaciones registradas. En base a la escasa evidencia que existe y a la alta frecuencia encontrada en esta investigación, se debe destacar la importancia del conocimiento de las patologías y condiciones linguales en niños. A través de este estudio, se sientan bases para futuras investigaciones que ayuden a odontólogos a reconocer, diagnosticar y tratar estas condiciones cuando sea necesario.

ABSTRACT: Lingual pathologies and conditions constitute a considerable proportion of the total lesions of the oral mucosa.The epidemiological studies that describe its frequency in the pediatric population are limited and variable. The objective of this study was to establish the frequency of pathologies and lingual conditions in children attended at the Faculty of Dentistry of the University of Chile. An observational, descriptive and cross-sectional study was carried out where pediatric patients between 4 and 13 years of both sexes were examined. Of a total of 179 patients, 53 % had at least one pathology or lingual condition. The age range of 11 to 13 years presented a higher OR of presenting lesions and/or lingual conditions when compared with the other age ranges (p value <0.05). The most frequent pathology or lingual condition was coated tongue (39 %), fast due to the fissured tongue (15 %), the hypertrophy of the lingual papillae (5 %) and the geographic tongue (3 %). The most frequent location was the lingual base with 59 % of the total frequency registered. Based on the little evidence that exists and the high frequency found in this research, the importance of knowledge of pathologies and lingual conditions in children should be highlighted. Through this study, foundations are laid for future investigations that help dentists recognize, diagnose, and treat these conditions when necessary.

A randomized study of botulinum toxin versus botulinum toxin plus physical therapy for treatment of cervical dystonia.

BACKGROUND: Physical therapy (PT) for cervical dystonia is not well studied, and the underlying physiological effects are not known. METHODS: We enrolled 26 subjects comprising of 16 cervical dystonia and 10 healthy controls for normative physiological data. We randomized cervical dystonia patients who reported suboptimal benefits on botulinum toxin (BoNT) injections to BoNT alone (BoNT arm) or BoNT plus PT (PT-BoNT arm). PT-BoNT arm received manual PT on the injection day followed by six weeks of home-exercise program. Home-exercise program comprised of stretching, range-of-motion and isometric exercises. The primary outcome was change from baseline in Toronto Western spasmodic torticollis rating scale (TWSTRS) that was recorded six weeks after exercise program. TWSTRS was video evaluated by blinded raters. We probed sensorimotor plasticity with transcranial magnetic stimulation (TMS) using a paired associative stimulation (PAS) paradigm. RESULTS: TWSTRS score improved (severity 31%, p = 0.002; pain 28%, p = 0.01) and PAS plasticity decreased (p = 0.01) in PT-BoNT arm compared to BoNT arm. PAS values for PT-BoNT arm were found to approach values of healthy control values. Change in PAS measure correlated significantly with TWSTRS change (severity, r = 0.56, p = 0.04; pain, r = 0.61, p = 0.03. TWSTRS disability score only approached significance (p = 0.14) when comparing the two treatment arms. CONCLUSION: PT is a potential adjunct in patients with cervical dystonia who report suboptimal benefits with BoNT therapy. PT related benefits in cervical dystonia are likely mediated through modulation of sensorimotor plasticity.

A Selection of Important Genes and Their Correlated Behavior in Alzheimer's Disease.

In 2017, approximately 5 million Americans were living with Alzheimer's disease (AD), and it is estimated that by 2050 this number could increase to 16 million. In this study, we apply mathematical optimization to approach microarray analysis to detect differentially expressed genes and determine the most correlated structure among their expression changes. The analysis of GSE4757 microarray dataset, which compares expression between AD neurons without neurofibrillary tangles (controls) and with neurofibrillary tangles (cases), was casted as a multiple criteria optimization (MCO) problem. Through the analysis it was possible to determine a series of Pareto efficient frontiers to find the most differentially expressed genes, which are here proposed as potential AD biomarkers. The Traveling Sales Problem (TSP) model was used to find the cyclical path of maximal correlation between the expression changes among the genes deemed important from the previous stage. This leads to a structure capable of guiding biological exploration with enhanced precision and repeatability. Ten genes were selected (FTL, GFAP, HNRNPA3, COX1, ND2, ND3, ND4, NUCKS1, RPL41, and RPS10) and their most correlated cyclic structure was found in our analyses. The biological functions of their products were found to be linked to inflammation and neurodegenerative diseases and some of them had not been reported for AD before. The TSP path connects genes coding for mitochondrial electron transfer proteins. Some of these proteins are closely related to other electron transport proteins already reported as important for AD.

Anaerobic digestion of Brewery Spent Grains: Trace elements addition requirement.

The current study evaluates and compares the stability of anaerobic digestion of Brewery Spent Grains (BSG) with and without addition of nutrients. Based on the composition of the BSG two levels of nutrients addition were defined. Control reactor, without addition of nutrients, showed signs of instability after 3months of operation and collapsed. On the contrary, supplemented reactors led to a COD removal rate of 60% and a methane production of 280NLCH4.kg-1 VSadded. According to these results, it was possible to define an additive solution adapted to BSG degradation.

Occurrence of Dysphagia Following Botulinum Toxin Injection in Parkinsonism-related Cervical Dystonia: A Retrospective Study.

BACKGROUND: The aim was to compare the occurrence of post-injection dysphagia in parkinsonism-related cervical dystonia (PRCD) versus cervical dystonia (CD) of other etiologies (non-PRCD). A secondary objective was to explore potential clinical differences between PRCD and non-PRCD and their respective responses to botulinum toxin (BoNT). METHODS: A cross-sectional chart review was carried out of patients treated for CD with Onabotulinumtoxin A at the University of Florida. We collected demographic information, dose of BoNT injected, patient-reported presence of dysphagia as a side effect, patient-perceived duration of benefit and efficacy according to the Clinical Global Impression Scale (CGIS). RESULTS: Of the 144 patients included, 24 patients were diagnosed with PRCD and 120 were diagnosed as non-PRCD. Data analysis showed no significant differences in number of weeks of benefit from BoNT (PRCD 9.1±3.7 versus non-PRCD 9.4±3.7 weeks, p = 0.830), BoNT dosage (PRCD 235.0±95.6 versus non-PRCD 263.7±101.3 units, p = 0.181), median CGIS score (median = 2 or "much improved" for both groups, p = 0.88), or the presence of dysphagia after BoNT (PRCD 17% versus non-PRCD 19 %, p = 0.753, n = 132). In a subgroup analysis of the non-PRCD group, patients who experienced dysphagia were older than those who did not (63.9±8.9 years versus 58.1±14.4 years, p = 0.02). DISCUSSION: Despite an increased baseline risk of dysphagia in patients with PRCD, BoNT appears to be equally safe and equally beneficial in PRCD and non-PRCD patients.

Association between antidepressants and falls in Parkinson's disease.

Parkinson's disease (PD) patients have an increased risk of falls resulting in important social and economical consequences. Risk factors for falls include the use of psychotropic drugs, which are used for the treatment of PD neuropsychiatric symptoms. We aimed to determine the association between psychotropic drug use and falls in a PD cohort. A cross-sectional study from the NPF QII study UF site was conducted. Subjects reported presence and frequency of falls in the prior year. Frequency was scored from 0 (no falls) to 4 (falling daily). Antidepressants, antipsychotics, cognitive enhancers/stimulants, and benzodiazepines were considered psychotropics. Forty percent of the 647 subjects included had a fall in the previous year. Fallers were found to have clinical signs of a more advanced disease. After adjusting for confounding variables, the regression analysis showed that use of antidepressants alone (adjusted OR 2.2, CI 95 % 1.3-3.8, p = 0.04), benzodiazepines alone (adjusted OR 2.0, CI 95 % 1.1-3.5, p = 0.02), and the combination of antidepressants with benzodiazepines (adjusted OR 4.1, CI 95 % 2.0-8.3, p < 0.0001) were independently associated with the presence of falls. When comparing to those not on psychotropics, subjects on antidepressants alone had a significantly higher mean frequency of falls score (1.07 vs. 0.44, p < 0.0001). The use of antidepressants was independently associated with falls in our PD cohort after considering for confounding variables such as age and measures of disease progression. Other factors related to disease progression should be considered before claiming the use of psychotropic drugs as causative.

An Optimization-Driven Analysis Pipeline to Uncover Biomarkers and Signaling Paths: Cervix Cancer.

Establishing how a series of potentially important genes might relate to each other is relevant to understand the origin and evolution of illnesses, such as cancer. High-throughput biological experiments have played a critical role in providing information in this regard. A special challenge, however, is that of trying to conciliate information from separate microarray experiments to build a potential genetic signaling path. This work proposes a two-step analysis pipeline, based on optimization, to approach meta-analysis aiming to build a proxy for a genetic signaling path.

Determining the coping strategies of individuals with epilepsy.

PURPOSE: The purpose of the present study was to determine whether the coping styles of patients with epilepsy are associated with certain demographic, clinical, and psychosocial variables. METHODS: A survey of 200 patients using several tests including the Brief-COPE was conducted. RESULTS: Nine subscales of the Brief-COPE achieved acceptable internal consistency and were employed in study analysis. Using principal component analysis, six subscales correlated well with one another, representing engagement-type coping strategies. The other three also correlated well, representing disengagement-type strategies. As a group, our patients favored engagement-type strategies. On univariate analysis, increased age, being African-American, receiving disability benefits, and work status were associated with the use of engagement-type strategies, while on multiple linear regression, only age and race were independently associated. Low BMQ-S scores, low income level, and not driving were associated with the use of disengagement-type strategies both on univariate and multivariate analyses. CONCLUSION: Among patients with epilepsy, certain demographic and psychosocial variables are associated with particular coping styles.

Effects of antiepileptic drug characteristics on medication adherence.

PURPOSE: To determine whether antiepileptic drug (AED) characteristics are associated with medication adherence. METHODS: We reviewed pharmacy and clinical records of 108 patients with epilepsy from the indigent care program at Shands-Jacksonville. We calculated the mean medication possession ratio (MMPR) for each AED. Using univariate analysis, we determined whether differences exist in the MMPR of various AEDs. We also determined whether the MMPR differs accordingly to the use of mono- or combination therapy, dosing frequency, release-type, or brand-name formulation. We employed multivariable analysis to determine if these differences persisted in the context of other demographic and clinical variables. RESULTS: Mean medication possession ratio was higher (better) when using older AEDs, in monotherapy, and with more frequent dosing intervals. These variables remained significant on multivariable analysis. CONCLUSION: Our findings contradict some commonly held beliefs on medication adherence and suggest that specific AED characteristics may be superseded by factors such as overall patient satisfaction with the drug regimen.

Modulation of elevated plus maze behavior after chronic exposure to the anabolic steroid 17alpha-methyltestosterone in adult mice.

Exposure to supraphysiological doses of androgens may disrupt affective components of behavior. In this study, behavior of adult C57Bl/6 male mice was studied after exposure to the anabolic androgenic steroid (AAS) 17alpha-methyltestosterone (17alpha-meT; 7.5 mg/kg) via a subcutaneous osmotic pump for 17 days. Controls received vehicle implants (0.9% NaCl + 30% cyclodextrine). On day 15, experimental animals were challenged with an ethanol (EtOH) injection (i.p.; 1 g/kg) while controls received saline injections. Five minutes after the injection, animals were tested in an automated elevated plus maze (EPM) or in automated activity chambers. In addition, injection-free animals were tested for ethanol consumption on day 16 after an overnight water deprivation period. Whereas chronic exposure to 17alpha-meT did not modulate open arm behavior, EtOH-exposed animals made more entries into the open arms than controls (P < 0.05). A significant reduction of risk assessment behaviors (rearing, flat approach behavior, and stretch attended posture) over the EPM was noted for EtOH-exposed animals whereas a reduction in stretch attended postures was observed among 17alpha-meT-exposed animals. Locomotor activity, and light-dark transitions in activity chambers remained unaltered. Exposure to AAS did not modulate EtOH consumption. Our data suggest that exposure to a supraphysiological dose of 17alpha-meT has minimal effects on exploratory-based anxiety.