Investigación clínica a largo plazo del tratamiento con implantes dentales / Long-term clinical research of treatment with dental implants

La implantología oral clínica ha evolucionado significativamente durante las últimas décadas. El desarrollo de los aspectos diagnósticos, quirúrgicos y prostodóncicos ha mejorado la predictibilidad de la oseointegración y los resultados clínicos a largo plazo del tratamiento con implantes. Además, algunos criterios de condiciones clínicas y radiográficas se han incorporado al concepto de éxito, como el nivel de los implantes, los tejidos periimplantarios, el nivel de la prótesis y el grado de satisfacción de los pacientes. La evidencia científica ha demostrado que el tratamiento con implantes es una excelente opción para la rehabilitación de los pacientes con parcial y total edentulismo. De hecho, los estudios a largo plazo reflejan el éxito de las rehabilitaciones fijas, sobredentaduras, puentes fijos y coronas unitaria. Sin embargo, algunas complicaciones biológicas y prostéticas han definido los conceptos diferentes de éxito y supervivencia de los implantes dentales. Conclusiones: Este trabajo indica que las restauraciones sobre implantes dentales en la rehabilitación de los pacientes parcial y totalmente edéntulos constituye un tratamiento odontológico con resultados clínicos a largo plazo con un elevado éxito. (AU)

Clinical implant dentistry has evolved significantly during last decades. The development of diagnostic, surgical and prosthetic aspects has improved the predictability of osseointegration and long-term clinical outcomes of the implant treatment. Moreover, several criteria of clinical and radiographic conditions have been incorporated in the concept of implant success, as implant level, peri-implant tissues, prosthetic level, and patient satisfaction. The scientific evidence of the literature demonstrates that implant treatment is an excellent option for the rehabilitation of patients with partial and total edentulism. In fact, long-term studies are reported the success of fixed total rehabilitation, overdentures, fixed bridges and single crowns. However, some biological and technical complications are defined the different concepts of success and survival of prosthetic and dental implants. Conclusions: This paper indicates that restorations with dental implants in the rehabilitation of partially and totally edentulous patients constitute a dental treatment with long-term clinical outcomes with a high success. (AU)

El tratamiento con implantes mediante la elevacion transalveolar del seno maxilar en pacientes geriatricos / Implant treatment by transalveolar maxillary sinus elevation in geriatric patients

Introducción: El objetivo del presente estudio era mostrar los resultados clínicos del tratamiento del maxilar superior posterior con implantes colocados mediante la técnica de elevación transalveolar del seno maxilar en pacientes geriátricos. Pacientes y Métodos: 24 pacientes geriátricos (15 hombres y 9 mujeres) con pérdidas dentales maxilares fueron tratados con 28 implantes diferentes colocados mediante la técnica de elevación sinusal transalveolar para su posterior rehabilitación prostodóncica. Los implantes fueron cargados después de un periodo de cicatrización de 6 meses. Resultados: Los hallazgos clínicos indican una supervivencia y éxito de los implantes del 96,4%. En un paciente de los 24 tratados (4,2%) se perdió un implante (3,6%). La altura ósea residual media fué de 6,38 ±1,10 mm (rango:5-10 mm). La ganancia media de hueso vertical fué de 4,40 ±1,15 mm (rango: 2-7 mm). 67,8% de los implantes se insertaron en localización molar y el 32,2% en la localización premolar. Se utilizaron biomateriales en el 97,8% de los implantes. Se realizaron coronas unitarias en 20 pacientes (83,3%), puentes fijos en 3 pacientes (12,5%) y una sobredentadura con bolas en un paciente (4,2%). El seguimiento medio de los pacientes estudiados ha sido de 64,2 ±8,6 meses con un rango entre 50 y 82 meses. Conclusiones: Este estudio indica que el tratamiento con implantes dentales mediante la elevación transalveolar del seno maxilar superior en pacientes geriátricos, constituye una terapéutica implantológica con una elevada tasa de éxito. (AU)

Introduction: The aim of this study was to report the clinical findings of treatment of posterior maxilla with dental implants inserted by transalveolar sinus elevation in geriatric patients. Patients and Methods: 24 geriatric patients (15 males and 9 females) with maxillary tooth loss were treated with 28 different implants placed by transalveolar sinus elevation for rehabilitation of posterior maxilla. Implants were loaded after a healing free-loading period of 6 months. Results: Clinical findings indicate a survival and success rate of implants of 96.4%. In one patient of 24 treated patients (4.2%), one implant was lost (3.6%). The mean residual height was 6.38 mm±1.10 mm (range: 5-10 mm). The mean elevation height was 4.40 mm±1.10 mm (range: 2-7 mm). 67.8% of implants were inserted in molar and 32.2% in premolar localization. Bone substitutes were used in 97.8% of implants. Twenty patients (83.3%) were restored with single crowns, 3 patients with fixed bridges (12.5%) and one patient (4.2%) with overdenture. The mean follow-up period of treated patients was 64.2 ±8.6 months (range: 50-82 months). Conclusions: This study indicates that treatment with dental implants placed by transalveolar sinus elevation in geriatric patients constitute an implant treatment with a high success rate. (AU)

El tratamiento con implantes insertados en localizaciones alveolares regeneradas con betafosfato tricalcico / Treatment with implants inserted in regenerated alveolar sites with beta-tricalcium phosphate

Introducción: El objetivo del presente estudio era mostrar los resultados del tratamiento con implantes dentales insertados en área regeneradas con betafosfato tricálcico. Métodos: 48 pacientes con pérdidas dentales parciales fueron tratados con 97 implantes Galimplant ® en área regeneradas con betafofato tricálcico Osteoblast ®. Diversas técnicas fueron realizadas (implantes inmediata en alveolos postextracción; expansión ósea con expansores u osteotomos y elevación transalveolar / lateral del seno maxilar). Los implantes fueron cargados después de un periodo de cicatrización de 6 meses. Resultados: 48 pacientes fueron tratados con implantes, con una edad media de 37,4 años (rango: 22-63 años). En 16 pacientes (33,3%) se realizó la inserción de implantes de forma inmediata en alveolos postextracción. En 9 pacientes (18,7%) se realizó la técnica de expansión ósea con expansores u osteotomos. En 10 pacientes (20,8%) se realizó la elevación transalveolar del seno maxilar. En 13 pacientes (27,1%) la elevación sinusal fué lateral. En la investigación realizada se perdieron 4 implantes de los 97 insertados (4,1%). 2 implantes fueron fracasos inmediatos o precoces (2,06%) ya que se perdieron, durante la fase de cicatrización, al no conseguir la oseointegración. Los 2 fracasos tardíos fueron por periimplantitis (2,06%). La pérdida media de hueso marginal fué de 1,34 ±1,19 mm. Se realizaron un total de 78 prótesis (100%), 61 coronas unitarias (78,2%) y 17 puentes fijos (21,8%). El periodo de seguimiento clínico ha sido de 5 años. Conclusiones: Este estudio indica que los implantes dentales pueden ser insertados con éxito en las áreas regeneradas con betafosfato tricálcico. (AU)

Introduction: The aim of this study was to report the outcome of treatment with dental implants inserted in regenerated sites with beta-tricalcium phosphate. Methods: 48 patients with partial tooth loss were treated with 97 Galimplant ® implants in regenerated sites with beta-tricalcium phosphate Osteoblast ®. Patients were treated with several surgical tecniques (immediate implants in fresh sockets, alveolar ridge expansion, transalveolar /lateral sinus elevation). Implants were loaded after a healing free-loading period of 6 months. Results: 48 patients were treated, with a mean age of 37.4 years (range: 22-63 yr), with 97 implants. Sixteen patients (33.3%) were treated with immediate implants in fresh sockets; in 9 patients (18.7%), alveolar ridge expansion were used; and 10 patients (20.8%) were treated with transalveolar or lateral sinus elevation (13 patients; 27.1%). 2 implants (2,06%) were lost during the healing period and two implant (2,06%) was lost by peri-implantitis. Marginal bone loss was 1.34 ±1.19 mm. A total of 78 prostheses were realized, 61 single crowns (78.2%) and 17 fixed bridges (21.8%). The follow-up period was of 5 years. Conclusions: This study indicate that dental implants can be inserted with success in regenerated sites with beta-tricalcium phosphate. Conclusions: This study indicates that treatment with dental implants placed by transalveolar sinus elevation in geriatric patients constitute an implant treatment with a high success rate. (AU)

La pérdida ósea marginal en la rehabilitación fija con implantes en pacientes edéntulos. Un estudio a 3 años / Marginal bone loss on fixed rehabilitation with implants in edentulous patients. A 3-year study

Introducción: El objetivo del presente estudio era mostrar los resultados de la pérdida ósea marginal en el tratamiento con rehabilitación fija mediante implantes dentales en pacientes edéntulos totales. Material y Métodos: 24 pacientes edéntulos fueron tratados con 210 implantes KTX ® con superficie arenada y grabada para la rehabilitación total fija. Los implantes fueron cargados inmediatamente en el mismo día de la cirugía. El seguimiento clínico medio fue de 37,1 ±14,6 meses. Resultados: Los hallazgos clínicos indican una supervivencia y éxito de los implantes del 99,5%. Los pacientes fueron rehabilitados con 33 prótesis totales fijas atornilladas. Complicaciones biológicas fueron observadas en el 50% de los pacientes y las complicaciones prostodóncicas en el 4,2% de los pacientes. La pérdida ósea marginal fue de 1,33± 0,77 mm. La pérdida ósea marginal no estuvo relacionada significativamente con la edad, sexo, hábito de fumar, antecedentes médicos, tipos de prótesis y seguimiento clínico. Conclusiones: Este estudio indica que la rehabilitación fija mediante implantes dentales en pacientes edéntulos totales constituye una terapéutica con éxito con una pérdida ósea marginal frecuente. (AU)

Introduction: The aim of this study was to report the outcome of marginal bone loss in the treatment of fully edentulous patients with fixed prostheses supported with dental implants. Material & Methods: 24 edentulous patients were treated with 210 KTX ® sandblasted and acid surface implants for fixed maxilla/mandible rehabilitation. Implants were immediately loaded in the same day of the surgery. The mean follow-up was 37.1 ±14.6 months. Results: Clinical results indicate a survival and success rate of implants of 99.5%. One implant was lost during the follow-up period. The patients were restored with 33 screw fixed rehabilitations. Biological complications were observed in 50% of patients and technical complications in 4.2% of patients. Mean marginal bone loss was 1.33 ± 0. 77 mm. Marginal bone loss are not significantly related with age, gender, smoking, medical background, types of prostheses, and clinical follow-up. Conclusions: This study indicates that fixed rehabilitations by dental implants in totally edentulous patients constitute a successful treatment with a frequent marginal bone loss. (AU)

Pax3 loss of function delays tumour progression in kRAS-induced zebrafish rhabdomyosarcoma models.

Rhabdomyosarcoma is a soft tissue cancer that arises in skeletal muscle due to mutations in myogenic progenitors that lead to ineffective differentiation and malignant transformation. The transcription factors Pax3 and Pax7 and their downstream target genes are tightly linked with the fusion positive alveolar subtype, whereas the RAS pathway is usually involved in the embryonal, fusion negative variant. Here, we analyse the role of Pax3 in a fusion negative context, by linking alterations in gene expression in pax3a/pax3b double mutant zebrafish with tumour progression in kRAS-induced rhabdomyosarcoma tumours. Several genes in the RAS/MAPK signalling pathway were significantly down-regulated in pax3a/pax3b double mutant zebrafish. Progression of rhabdomyosarcoma tumours was also delayed in the pax3a/pax3b double mutant zebrafish indicating that Pax3 transcription factors have an unappreciated role in mediating malignancy in fusion negative rhabdomyosarcoma.

Long-term safety and efficacy of anacetrapib in patients with atherosclerotic vascular disease.

AIMS: REVEAL was the first randomized controlled trial to demonstrate that adding cholesteryl ester transfer protein inhibitor therapy to intensive statin therapy reduced the risk of major coronary events. We now report results from extended follow-up beyond the scheduled study treatment period. METHODS AND RESULTS: A total of 30 449 adults with prior atherosclerotic vascular disease were randomly allocated to anacetrapib 100 mg daily or matching placebo, in addition to open-label atorvastatin therapy. After stopping the randomly allocated treatment, 26 129 survivors entered a post-trial follow-up period, blind to their original treatment allocation. The primary outcome was first post-randomization major coronary event (i.e. coronary death, myocardial infarction, or coronary revascularization) during the in-trial and post-trial treatment periods, with analysis by intention-to-treat. Allocation to anacetrapib conferred a 9% [95% confidence interval (CI) 3-15%; P = 0.004] proportional reduction in the incidence of major coronary events during the study treatment period (median 4.1 years). During extended follow-up (median 2.2 years), there was a further 20% (95% CI 10-29%; P < 0.001) reduction. Overall, there was a 12% (95% CI 7-17%, P < 0.001) proportional reduction in major coronary events during the overall follow-up period (median 6.3 years), corresponding to a 1.8% (95% CI 1.0-2.6%) absolute reduction. There were no significant effects on non-vascular mortality, site-specific cancer, or other serious adverse events. Morbidity follow-up was obtained for 25 784 (99%) participants. CONCLUSION: The beneficial effects of anacetrapib on major coronary events increased with longer follow-up, and no adverse effects emerged on non-vascular mortality or morbidity. These findings illustrate the importance of sufficiently long treatment and follow-up duration in randomized trials of lipid-modifying agents to assess their full benefits and potential harms. TRIAL REGISTRATION: International Standard Randomized Controlled Trial Number (ISRCTN) 48678192; ClinicalTrials.gov No. NCT01252953; EudraCT No. 2010-023467-18.

La eficacia clínica a largo plazo de los implantes con conexión interna y superficie arenada y grabada / Long-term clinical efficacy of implants with internal connection and sandblasted-acid-etched surface

Introducción: La implantología oral representa una opción importante en el tratamiento de los pacientes con pèrdida dental total y parcial. El estudio a largo plazo muestra la evaluación de los pacientes tratados mediante carga precoz de implantes con conexión interna y superficie arenada y grabada. Mètodos: 40 pacientes con pèrdidas dentales fueron tratados con implantes Frontier GMI ® con conexión interna y superficie arenada y grabada. Los implantes fueron cargados tras un periodo de tiempo de 6 semanas en la mandíbula y 8 semanas en el maxilar superior. Los hallazgos clínicos (implantológicos y prostodóncicos) se han seguido durante al menos 6 años. Resultados: 103 implantes fueron insertados en ambos maxilares, 46 implantes (44,7%) en el maxilar superior y 57 implantes (55,3%) en la mandíbula, para su rehabilitación prostodóncica. 37 implantes (35,9%) fueron insertados en el sector anterior y 66 implantes (64,1%) en el sector posterior. 70 implantes (68%) de forma sumergida (2 cirugías) y 33 implantes (32%) de forma no sumergida (una cirugía). Despuès de un seguimiento clínico de 92,2 meses, los resultados indican una supervivencia de los implantes del 96,2%; ya que se perdieron 4 implantes. La pèrdida ósea marginal fuè de 0,99 ± 0,84 mm. Las restauraciones prostodóncicas incluyeron 31 coronas unitarias, 15 puentes fijos, 5 sobredentaduras con bolas, 2 rehabilitaciones totales fijas y una rehabilitación completa híbrida. Las complicaciones tardías fueron 11 implantes (10,7%) con periimplantitis y 6 prótesis (11,1%) con complicaciones protèsicas. Conclusiones: Los hallazgos clínicos del estudio indican que el tratamiento con carga precoz mediante prótesis de los implantes con conexión interna y superficie arenada y grabada, representa una terapèutica odontológica con èxito. (AU)

Introduction: Implant dentistry constitute an important option in the prosthodontic treatment of patients with partial and total tooth loss. This long-term study reports the evaluation of patients treated by early loading of implants with internal connection and sandblasted-acidetched surface. Methods: 40 patients with tooth loss were treated with Frontier GMI ® sandblasted and acid-etched surface implants. Implants were loaded after a healing free-loading period of 6 weeks (mandible) and 8 weeks (maxilla). Clinical findings (implants and prosthodontics) were followed during at least 6 years. Results: 103 implants were inserted (46 maxillary (44.7%), and 57 mandibular (55.3%)) for prosthodontic rehabilitation. 37 implants (35.9%) were inserted in anterior sites and 66 implant (64.1%) in posterior sites. Seventy implants (68%) were placed submerged (two stages) while that 33 implants (32%) were placed nonsubmerged (one stage). After at a mean follow-up of 92.2 months, clinical results indicate a survival rate of implants of 96.2%. Four implants were lost during the treatment. Mean marginal bone loss were 0.99 ± 0.84 mm. Prosthodontic restorations included 31 single crowns, 15 fixed bridges, 5 overdentures, 2 fixed totally rehabilitation and an hybrid full rehabilitation. Delayed complications include 11 implants (10.7%) with peri-implantitis and 6 prostheses (11.1%) with technical complications. Conclusions: Clinical results of this study indicate that prosthodontic rehabilitation by early loading of internal connection and sandblasted and etched- implants can be a successful dental treatment. (AU)

QSAR and molecular docking modelling of anti-leishmanial activities of organic selenium and tellurium compounds.

Leishmaniasis affects mainly rural areas and the poorest people in the world. A computational study of the antileishmanial activity of organic selenium and tellurium compounds was performed. The 3D structures of the compounds were optimized at the wb97xd/lanl2dz level and used in the quantitative structure-activity relationship (QSAR) analysis. The antileishmanial activity was measured by L. donovani ß carbonic anhydrase inhibition (Ki) and the half-maximal inhibitory concentration (IC50) against L. infantum amastigotes. The dataset was divided into training (75%) and test sets (25%) by using a k-means clustering algorithm. For pKi prediction, model M3 with seven 3D topographic descriptors was characterized by the following statistical parameters: r 2 = 0.879, Q 2 LOO = 0.822, and Q 2 ext = 0.840. For pIC50 prediction, model M12 with six attributes was characterized by the following statistical parameters: r 2 = 0.907, Q 2 LOO = 0.824, and Q 2 ext = 0.795. Both models met all the requirements of Tropsha´s test, which implies predictions of pIC50 and pKi activities with high accuracy. Concomitantly, favourable interactions of the sulphonamide group with the Zn atom in the protein were revealed by the docking analysis.

Natural Time Analysis of Seismicity within the Mexican Flat Slab before the M7.1 Earthquake on 19 September 2017.

One of the most important subduction zones in the world is located in the Mexican Pacific Coast, where the Cocos plate inserts beneath the North American plate. One part of it is located in the Mexican Pacific Coast, where the Cocos plate inserts beneath the North American plate with different dip angles, showing important seismicity. Under the central Mexican area, such a dip angle becomes practically horizontal and such an area is known as flat slab. An earthquake of magnitude M7.1 occurred on 19 September 2017, the epicenter of which was located in this flat slab. It caused important human and material losses of urban communities including a large area of Mexico City. The seismicity recorded in the flat slab region is analyzed here in natural time from 1995 until the occurrence of this M7.1 earthquake in 2017 by studying the entropy change under time reversal and the variability ß of the order parameter of seismicity as well as characterize the risk of an impending earthquake by applying the nowcasting method. The entropy change ΔS under time reversal minimizes on 21 June 2017 that is almost one week after the observation of such a minimum in the Chiapas region where a magnitude M8.2 earthquake took place on 7 September 2017 being Mexico's largest quake in more than a century. A minimum of ß was also observed during the period February-March 2017. Moreover, we show that, after the minimum of ΔS, the order parameter of seismicity starts diminishing, thus approaching gradually the critical value 0.070 around the end of August and the beginning of September 2017, which signals that a strong earthquake is anticipated shortly in the flat slab.

El efecto de la fatiga cíclica sobre los pilares de implantes dentales / The effect of the cyclic fatigue in dental implant abutments

INTRODUCCIÓN: La conexión implante-pilar ha sido sugerida como crucial para el éxito a largo plazo de las restauraciónes sobre implantes oseointegración y para prevenir futuras complicaciónes biológicas y mecánicas. El objetivo de este estudio fué evaluar la influencia del test de fatiga cíclica en el comportamiento de las conexiones internas implante-pilar. MÉTODOS: 36 pilares mutiposición de implantes de titanio de conexión interna fueron divididos en 2 grupos: 18 pilares slim o curvos y 10 pilares rectos con diferentes alturas. Los pilares fueron apretados con una llave de torque a 30 Ncm. Una carga cíclica entre 175 N y 100 N fué aplicada con 30º de inclinación axial al sistema de implantes durante 5 millones de ciclos. RESULTADOS: Los tests biomecánicos muestran una fractura de los implantes y de los tornillos de retención a una carga límite de 100 N de los pilares slim curvos y de 130 N en los pilares rectos. La fracturas aparecieron en la zona de unión entre el cuello y el cuerpo del implante y en los tornillos protéscios. No se han encontrado fracturas en los pilares multiposición. CONCLUSIONES: Este estudio indican que los tests de fatiga cíclica son importantes para analizar la respuesta biomecánica de los diferentes pilares en las conexiones implante-pilar de los sistemas de implantes

INTRODUCTION: The connection implant-abutment has been suggested to be crucial for the long-term success of implant restorations and to prevent future biological and mechanic complications. The aim of this study was to evaluate the influence of fatigue cyclic test in the behavior of internal connection implant-abutments. METHODS: Thirty six titanium abutments of internal connection implants were divided in two groups: 18 slim and 18 right multiunit abutments with different length. Abutments were tightened to 30 Ncm with a torque controller. A cyclic load between 175 N and 100 N according to different implant abutments at a 30-degree angle to the long axis was applied to the implants for a 5 million cycles. RESULTS: Biomechanical testing showed implant and screw retention fracture in a limit load of 100 N of slim implant abutments and 130 N of right implant abutments. Fracture cracks were located in the area between neck and body of implants and screw retention. No abutment fractures were found. CONCLUSIONS: This study indicate that fatigue cyclic test are very important to analize the biomechanical behavior of different abutments in connection implant-abutment of implants systems

La respuesta tisular a implantes dentales con plataforma reducida (platform switching) / Tissue response to dental implants with platform switching

La evolución en los diseños de los sistemas de implantes y en la configuración de los pilares protésicos ha desarrollado el concepto de plataforma reducida que comprende la colocación de un pilar más estrecho que la plataforma del implante para aumentar su distancia de la interfase hueso-implante. La plataforma reducida es considerada un factor importante para preservar la estabilidad del hueso crestal y de los tejidos blandos y asegurar el éxito de los implantes dentales a largo plazo. La plataforma reducida reduce las fuerzas oclusales y la contaminación bacteriana en la interfase entre el hueso crestal y el implante. Los estudios experimentales en animales y clínicos en pacientes muestran su eficacia para prevenir la pérdida ósea y de los tejidos blandos periimplantarios

The evolution of designs of implant systems and abutments configurations has developed the concept of platform-switching that involves the connection of a narrower abutment to the platform implant to allow horizontal distance of the interface bone-implant. Platform-switching is considered an important factor to preserve the stability of crestal bone and soft tissue ensuring the success of dental implants in the long-term follow-up. Platform-switching reduces the forces of occlusal loading and bacterial contamination in the interface between the crestal bone and the implant. Experimental studies in animals and clinical studies in patients showed that implants with platform-switching have demonstrated the effectiveness to prevent peri-implant bone loss and subsequent soft tissue los

Evaluación de la función muscular del cuádriceps en pacientes con EPOC modera-severa / Evaluation of quadricep muscle function in patients with moderate-severe COPD

Objetivo: el objetivo del estudio fue evaluar la función muscular periférica de pacientes con EPOC moderadasevera, mediante la medición de la fuerza muscular isométrica e isotónica del cuádriceps y la masa muscular mediante ecografía. Método: fueron incluidos pacientes con EPOC moderada-severa estables, remitidos a Rehabilitación Respiratoria. En la extremidad dominante, se midió la fuerza isométrica (dinamómetro hidráulico), test 1RM y se realizó una ecografía para obtener el área transversal y dimensiones de diversas secciones musculares. Resultados: participaron 34 pacientes con EPOC estable: GOLD 2 (n = 11), GOLD 3 (n = 12) y GOLD 4 (n = 11) Los GOLD 4 tenían un IMC P50 (P25 - P75) 25,3 (22,5 - 28,8), significativamente menor que los GOLD 3: 32,0 (27,5 - 34,0); p = 0,025. Se evidenció debilidad del cuádriceps (1RM/peso <0,60 1RM/IMC <120%), de forma global: 0,33 (0,22 - 0,41) y 93% (61 - 112) respectivamente, y en cada grupo, sin diferencias significativas entre ellos. Tampoco hubo diferencias significativas entre los grupos en las mediciones de ecografía muscular. La fuerza isotónica (1RM) se correlacionó con el grosor del cuádriceps QT (r = 0,529; p = 0,003) y el grosor del músculo vasto intermedio Q1(r = 0,514; p = 0,004) La fuerza isométrica se correlacionó con el QT (0,621; p <0,001), Q1 (0,441; p = 0,009) y el área transversal AQ (r = 0,587; p <0,001) Para cada grupo, el QT y la fuerza isométrica se correlacionaron significativamente. Conclusión: en nuestra serie de pacientes se demuestra la existencia de debilidad muscular del cuádriceps, independientemente del grado de severidad de la enfermedad y en estrecha relación con la masa muscular de dicho músculo. Palabras clave: disfunción muscular, fuerza isotónica, 1RM, fuerza isométrica, ecografía muscular

Objective: The objective of this study was to evaluate peripheral muscle function in patients with moderate-severe COPD by measuring isometric and isotonic muscular strength of the quadriceps and muscle mass through ultrasound. Method: This study included stable patients with moderate-severe COPD who were referred to pulmonary rehabilitation. In the dominant extremity, isometric strength (hydraulic dynamometer) and the 1RM test were measured and an ultrasound was done to determine the transversal area and dimensions of different sections of muscle. Results: 34 stable patients with COPD participated: GOLD 2 (n = 11), GOLD 3 (n = 12) and GOLD 4 (n = 11). GOLD 4 patients had a BMI P50 (P25 - P75) 25.3 (22.5 - 28.8), which was significantly lower than GOLD 3 patients: 32.0 (27.5 - 34.0); p = 0.025. Weakness in the quadriceps was observed (1 RM/weight <0.60; 1 RM/BMI <120%) overall: 0.33 (0.22 - 0.41) and 93% (61 - 112), respectively, and in each group, without significant differences between groups. There were also no significant differences between groups for ultrasound muscle measurements. Isotonic strength (1 RM) correlated to quadricep thickness QT (r = 0.529; p = 0.003) and vastus intermedius muscle thickness Q1(r = 0.514; p = 0.004). Isometric strength correlated to QT (0.621; p <0.001), Q1 (0.441; p = 0.009) and transversal area AQ (r = 0.587; p <0.001). QT and isometric strength were significantly correlated in each group. Conclusion: In our study, patients showed muscular weakness in the quadriceps, regardless of the degree of disease severity and this weakness was closely related to the mass of said muscle

Mexican oregano (Lippia graveolens) essential oil-in-water emulsions: impact of emulsifier type on the antifungal activity of Candida albicans.

This study examined the impact of emulsifier type on the physicochemical characteristics and antifungal capacity of oregano oil-in-water emulsions: Tween 80, hydroxylated soy lecithin, and gum arabic. GC/MS analysis showed that the major components of the Lippia graveolens essential oils were thymol (31.7%), p-cymene (18.7%), and carvacrol (14.6%). The oil-in-water emulsions were made using ultrasonic technology in which thymol and carvacrol quantities were 12.26-13.67 g/L and 5.6-6.2 g/L, respectively. The droplet size of the emulsions followed the next descendent order: gum arabic > lecithin > T80. The zeta potential of the emulsions favored the stability against coalescence. Finally, the antifungal activity of the emulsions was evaluated, in which, 30 µL/mL of gum arabic or hydroxylated soy lecithin emulsions inhibited the growth of Candida albicans. The result suggests that Mexican oregano essential oil emulsions can be used as an antifungal against of C. albicans.

Podocyte GSK3 is an evolutionarily conserved critical regulator of kidney function.

Albuminuria affects millions of people, and is an independent risk factor for kidney failure, cardiovascular morbidity and death. The key cell that prevents albuminuria is the terminally differentiated glomerular podocyte. Here we report the evolutionary importance of the enzyme Glycogen Synthase Kinase 3 (GSK3) for maintaining podocyte function in mice and the equivalent nephrocyte cell in Drosophila. Developmental deletion of both GSK3 isoforms (α and ß) in murine podocytes causes late neonatal death associated with massive albuminuria and renal failure. Similarly, silencing GSK3 in nephrocytes is developmentally lethal for this cell. Mature genetic or pharmacological podocyte/nephrocyte GSK3 inhibition is also detrimental; producing albuminuric kidney disease in mice and nephrocyte depletion in Drosophila. Mechanistically, GSK3 loss causes differentiated podocytes to re-enter the cell cycle and undergo mitotic catastrophe, modulated via the Hippo pathway but independent of Wnt-ß-catenin. This work clearly identifies GSK3 as a critical regulator of podocyte and hence kidney function.

Métodos estadísticos alternativos y su aplicación a la investigación en Cuidados Intensivos / Alternative statistical methods and their application to research in intensive care setting

En los estudios de casos y controles anidados, el muestreo de los controles se hace habitualmente por densidad de incidencia y mediante emparejamiento. Con respecto a los casos control clásicos, son más eficientes, permiten el cálculo de la incidencia de la enfermedad y cuentan con más validez interna por la menor presencia de sesgo. Las técnicas de riesgos competitivos pueden usarse si se estudian diferentes tipos de eventos y nos centramos en el tiempo y el tipo del primer evento. El particionamiento recursivo es un tipo de análisis multivariante cuyo propósito es la construcción de algoritmos de clasificación, especialmente útiles cuando hay un gran número de variables predictoras con relaciones complejas con el evento objeto de estudio

In nested case-control studies, sampling of controls is usually done by density of incidence and pairing. With regard to the classic control cases studies, nested ones are more efficient, allow the calculation of the incidence of the disease and they have more internal validity due to the lower presence of bias. Competitive risks techniques can be used if we study different types of events and focus on the time and type of the first event. Recursive partitioning is a type of multivariate analysis whose purpose is the construction of classification algorithms, and it is especially useful when there are a large number of predictive variables with complex relationships with the event

La oseointegración de implantes de titanio con diferentes superficies rugosas / Osseointegration of titanium implant with several rough surfaces

La superficie de los implantes es muy importante para conseguir la oseointegración. Existen muchos tipos de superficies en los implantes dentales. La investigación en superficie de implantes comienza con la superficie mecanizada. La superficie rugosa incrementa la adherencia celular y muestra una mayor área de contacto hueso-implante. El recubrimiento con plasma de titanio e hidroxiapatita fueron métodos comunes para modificar la rugosidad de la superficie. Más recientemente, el arenado (ej. alúmina) y el grabado ácido (ej. chorhídrico, sulfúrico, nítrico) son otros procesos que pueden incrementar la superficie rugosa de los implantes. Más recientemente, la tecnología ha comenzado en la implantología oral con el desarrollo de superficies porosas que manifiestan una mejor respuesta osteogénica e incrementa la unión mecánica hueso-titanio. La oseointegración parece estar influenciada por los modelos de especies animales. En el conejo el proceso es más rápido que en el perro, y en el perro es más rápido que en el hombre. La incorporación de nuevos materiales y procesos técnicos en la investigación sobre superficies de implantes ofrecen nuevas posibilidades de mejorar su respuesta tisular y su potencial óseo regenerativo. Conclusiones: El tratamiento de la superficie de los implantes constituye un importante campo en futuras investigaciones de la implantología oral mediante los estudios de experimentación

Implant surface is very important for enhance the osseointegration. They are many types of dental implant surfaces. Implant surface research begins with machined surface. Roughened surface titanium increase cell adhesion and exhibit stronger bone-implant contact area. Plasma-spray and hydroxyapatite coating were common methods for rough surface modification. Most recently, blasting (i.e. alumina) and acid-etching (i.e. hydrochloric, sulphuric and nitric) are another process by which surface roughness can be increased. Most recently, technology begins in implant dentistry with the development of porous surfaces that manifest better osteogenic response and increase bone-titanium mechanical interlocking. Osseointegration appeared to be strongly influenced by the animal species model. The rabbit model was faster compared to the dog model, and the dog model was faster the human model. The introduction of new materials and new technical process in dental surfaces research offering new possibilities for better tissue response and bone regenerative potential. Conclusions: The surface modifications of titanium constitute an important field for future research of implant dentistry by experimental studies

El tratamiento con implantes mediante la elevación transcrestal del seno maxilar. Un estudio a 3 años / Implant treatment by transcrestal maxillary sinus elevation. A 3-year follow-up study

Introducción: El objetivo del presente estudio era mostrar los resultados del tratamiento con implantes dentales insertados mediante la técnica de elevación transcrestal en el maxilar superior. Pacientes y Metodos: 47 pacientes (18 hombres y 29 mujeres) con pérdidas dentales maxilares fueron tratados con 60 implantes IPX ® Galimplant con conexión interna y superficie arenada y grabada fueron insertados mediante la técnica de elevación sinusal transcrestal para la rehabilitación del maxilar posterior. Los implantes fueron cargados después de un periodo de cicatrización de 6 meses. Resultados: Los hallazgos clínicos indican una supervivencia y éxito de los implantes del 100%. La ganancia media de hueso vertical fué de 4,8 mm (rango: 2-6,5 mm). 46,7% de los implantes se insertaron en localización molar y el 53,3% en la localización premolar. Biomateriales fueron utilizados en el 91,7% de los implantes. Después de un periodo medio de carga funcional de 37,6 meses (rango: 24-52 meses), no ha habido complicaciones tardías. El 70% de los implantes fueron rehabilitados con coronas unitarias y el 30% con puentes fijos. Conclusiones: Este estudio indica que el tratamiento con implantes dentales mediante su inserción con elevación transcrestal del seno maxilar superior constituye una terapéutica implantológica con éxito

Introduction: The aim of this study was to report the outcome of treatment with maxillary dental implants inserted by transcrestal sinus elevation. Patients and Methods: 47 patients (18 males and 29 females) with maxillary tooth loss were treated with 60 IPX ® Galimplant internal connection and sandblasted and acid-etched surface implants inserted by transcrestal sinus elevation for rehabilitation of posterior maxilla. Implants were loaded after a healing free-loading period of 6 months. Results: Clinical results indicate a survival and success rate of implants of 100%. The mean elevation height was 4.8 mm (range: 2-6.5 mm). 46.7% of implants were inserted in molar and 53.3% in premolar localization. Bone substitutes were used in 91.7% of implants. After a mean functioning period of 37.6 months (range: 24-52 months), no late complications were reported. 70% of implants were restored with single crowns and 30% with fixed bridges. Conclusions: This study indicate that treatment with dental implants inserted in maxilla by transcrestal sinus elevation constitute a successful implant treatment

Alternative statistical methods and their application to research in intensive care setting. / Métodos estadísticos alternativos y su aplicación a la investigación en Cuidados Intensivos.

In nested case-control studies, sampling of controls is usually done by density of incidence and pairing. With regard to the classic control cases studies, nested ones are more efficient, allow the calculation of the incidence of the disease and they have more internal validity due to the lower presence of bias. Competitive risks techniques can be used if we study different types of events and focus on the time and type of the first event. Recursive partitioning is a type of multivariate analysis whose purpose is the construction of classification algorithms, and it is especially useful when there are a large number of predictive variables with complex relationships with the event.