Substance P/calcitonin gene-related peptide and their receptors expression in human periodontal ligament after root canal preparation with five different systems.

AIM: The purpose of this study was to quantify the effect of five different root canal preparation instruments on Substance P (SP), Calcitonin gene-related peptide (CGRP) and their receptors expression in healthy human periodontal ligament. METHODOLOGY: STROBE guidelines were used to design a study using 60 periodontal ligament samples obtained from healthy lower premolars where extraction was indicated for orthodontic reasons. Prior to extraction 40 of these premolars were equally divided into four groups and root canals were prepared using different systems: Mtwo, Reciproc Blue, HyFlex EDM and Plex-V. Ten premolars were prepared with hand files and served as a positive control group. The remaining 10 premolars where extracted without treatment and served as a negative control group. All periodontal ligament samples were processed to measure the expression of SP, CGRP and their receptors by radioimmunoassay. Kruskal-Wallis and Duncan tests were performed to determine statistically significant differences between the groups for each variable. RESULTS: Greater expression of all the peptides measured were found in the hand-file preparation group, followed by the Reciproc Blue, Mtwo, HyFlex EDM and Plex-V groups. The lower SP, CGRP and their receptors values were for the intact teeth control group. Kruskal-Wallis test showed statistically significant differences amongst groups (p < .001). Dunn post-hoc tests showed statistically significant differences in SP, CGRP and their receptors expression between the intact teeth and the hand-file and Reciproc Blue groups. Hand-file group showed significant differences with the other groups, except with Reciproc Blue, where no differences were observed in any of the peptides measured. Finally, no differences were observed between Plex-V and HyFlex in any of the peptides measured. CONCLUSIONS: Root canal preparation with hand files and Reciproc Blue generates the highest expression of SP, CGRP, NK1 and CGRP1R in human periodontal ligament, whilst Plex-V and HyFlex maintain the basal expression of neuropeptides and their receptors. Mtwo showed intermediate results between Reciproc Blue and HyFlex.

On the relationships between auditory and visual factors in a residential environment context: A SEM approach.

To understand the effects of specific elements that may enhance or detract residents' well-being, it is important to explore the relationships between auditory and visual factors, based on people's sensory experiences. Although residential environments provide natural experimental conditions to observe these relationships, the complexity of measuring sensory perceptions and their subsequent interpretation constitutes a challenge. This study aims to identify the influence of socio-demographics and residential location characteristics on three latent variables: noise-Sensitivity, sound-Pleasantness, and visual-Liveability in a Latin American city. The methodology is replicable and relies on a digital survey that displays environments in 360-format video and uses sound immersion techniques; it was applied to a sample of household heads in Quito, Ecuador. Based on an efficient experimental design, we selected different residential environments according to acoustic-visual attributes and the proximity to residential, commercial, and recreational land uses. Structural Equation Models (SEM) were estimated using mediating variables. Our results reveal the influence of noise-Sensitivity on sound-Pleasantness and, indirectly, on visual-Liveability. Further analysis shows that the impact of sound and visual perception changes with different socio-demographics and residential location characteristics.

Use of scaffolds and regenerative materials for the treatment of immature necrotic permanent teeth with periapical lesion: Umbrella review.

BACKGROUND: Current treatment of immature necrotic permanent teeth with a periapical lesion is regenerative endodontics, which is based on tissue engineering under the triade of stem cells, scaffolds and bioactive molecules. OBJECTIVES: This Umbrella Review was aimed to evaluate the success of scaffold and regenerative materials used for the treatment of these teeth, in terms of apical closure, tooth length increase, widening of root canal walls, tissue vitality and periapical lesion repair. METHODS: An extensive literature research was carried out in the Medline, ISI Web of Science, and Scopus databases for relevant systematic reviews matching the keyword search strategy. Based on inclusion and exclusion criteria, reviewers independently rated the quality of each study to determine their level of evidence. Methodological quality assessment of each article was obtained using A Measurement Tool to Assess Systematic Reviews (AMSTAR)-2 tool, and risk of bias was assessed with the Risk of Bias in Systematic Reviews (ROBIS) tool. RESULTS: After removing duplicates, 155 articles were found; from which 133 were excluded for being non-relevant and 15 other due to exclusion criteria. One more was discarded after methodological quality evaluation, for a total of six articles remaining. The most common scaffold used was the blood clot, others used were poly lactic-co-glycolic acid and platelet-rich fibrin matrix. The most common regeneration material used was Mineral Trioxide Aggregate (MTA), followed by Biodentine. An increase in tooth length and widening of root canal walls were reported in all selected studies with different proportions, as well as periapical lesion repair. ROBIS analysis showed that only one article had low bias, two were classified as unclear bias, while the remaining three had high risk of bias. DISCUSSION: An exhaustive literature search was carried out applying language filters, high-quality indexed journals, year of publication, which ensures the best quality articles were included. Blood clot was the most used scaffold as is the most easy to place inside the canal and does not require to extract blood from the patient. The use of MTA and Biodentine as sealing materials has been associated with thickening of canal walls, apical closure and reduced signs and symptoms of apical periodontitis. However, most of the included reviews assessed were case reports and only in a few of them were clinical trials included. There is also a lack of risk of bias analysis in most reviews. CONCLUSION: The blood clot is the most common scaffold used for inducing regeneration during the treatment of immature necrotic teeth. Tooth length increase and widening of root canal walls are the most common criteria used in the studies as success indicators. MTA and Biodentine did not show differences in the results analysed. Quality assessment and bias risk evaluation showed that it is necessary to design better studies with rigorous methodology to recommend a trustable and predictable protocol for the treatment of immature necrotic permanent teeth with periapical lesions. REGISTRATION: International Prospective Register of Systematic Reviews (PROSPERO) CRD42021248404.

The path towards herd immunity: Predicting COVID-19 vaccination uptake through results from a stated choice study across six continents.

Despite unprecedented progress in developing COVID-19 vaccines, global vaccination levels needed to reach herd immunity remain a distant target, while new variants keep emerging. Obtaining near universal vaccine uptake relies on understanding and addressing vaccine resistance. Simple questions about vaccine acceptance however ignore that the vaccines being offered vary across countries and even population subgroups, and differ in terms of efficacy and side effects. By using advanced discrete choice models estimated on stated choice data collected in 18 countries/territories across six continents, we show a substantial influence of vaccine characteristics. Uptake increases if more efficacious vaccines (95% vs 60%) are offered (mean across study areas = 3.9%, range of 0.6%-8.1%) or if vaccines offer at least 12 months of protection (mean across study areas = 2.4%, range of 0.2%-5.8%), while an increase in severe side effects (from 0.001% to 0.01%) leads to reduced uptake (mean = -1.3%, range of -0.2% to -3.9%). Additionally, a large share of individuals (mean = 55.2%, range of 28%-75.8%) would delay vaccination by 3 months to obtain a more efficacious (95% vs 60%) vaccine, where this increases further if the low efficacy vaccine has a higher risk (0.01% instead of 0.001%) of severe side effects (mean = 65.9%, range of 41.4%-86.5%). Our work highlights that careful consideration of which vaccines to offer can be beneficial. In support of this, we provide an interactive tool to predict uptake in a country as a function of the vaccines being deployed, and also depending on the levels of infectiousness and severity of circulating variants of COVID-19.

Community Response to Noise from Hot-Spots at a Major Road in Quito (Ecuador) and Its Application for Identification and Ranking These Areas.

Environmental legislation in Ecuador is advancing with the legitimate aspiration of providing citizens with new standards of quality and environmental health. In the context of environmental noise, these legislative advances are based on the experience accumulated in other countries, which is an advantage that must be managed with caution by incorporating local factors into noise management procedures. This study advances two lines of work. The first is to survey the population about their attitude towards noise from a major road to try to detect local factors in the annoyance and sleep disturbances. The second uses this information to compare noise indicators for the detection and ranking of hot-spots from major roads. The interviewees exhibited a high level of annoyance and sleep disturbance due to noise compared with the results of other studies. Results show that there are small differences in the definition of hot-spots when using WHO's dose-response curves for Lden ≥ 68 dB for and for Lnight ≥ 58 dB, in comparison with the curves generated in this study (CS). Regarding the application of both dose-response curves (WHO vs. CS) to the estimation of the population at risk of the harmful effect of nighttime traffic noise (HSD), small oscillations are also observed even when Lnight ≥ 58 dB and Lnoche ≥ 60 dB are used.

Expression of substance P, calcitonin gene-related peptide and vascular endothelial growth factor in human dental pulp under different clinical stimuli.

BACKGROUND: The aim of this study was to measure the dental pulp inflammatory response through neuropeptides (SP and CGRP) as a response to occlusal trauma, orthodontic movements and a combination of both, as well as the angiogenic defense mechanism through VEGF expression, which could be the initial step to mineralized tissue formation. METHODS: Forty human dental pulp samples were collected from healthy first premolars with extraction indicated due to orthodontic reasons from a sample of 20 patients. Patients were divided into four groups with 10 premolars each (1 mandibular and 1 maxillary premolar from each patient): healthy pulp control group, occlusal trauma group, moderate orthodontic forces group; and occlusal trauma plus moderate orthodontic forces group. Stimuli were applied for 24 h before tooth extraction in all experimental groups. All samples were processed, and SP, CGRP, and VEGF were measured by radioimmunoassay. The Kruskal-Wallis test was performed to assess significant differences among groups and Mann-Whitney's U post hoc pairwise comparisons were also performed. RESULTS: The highest increase in SP, CGRP, and VEGF expressions was found in the occlusal trauma plus orthodontic forces group, followed by the moderate orthodontic forces, the occlusal trauma and the control groups, with statistically significant differences between all groups for each of the 3 peptides analyzed (Kruskal-Wallis p < 0.001). All possible pairwise post-hoc comparisons were also significant for each peptide analyzed (Mann-Whitney's U p < 0.001). CONCLUSION: SP, CGRP, and VEGF expressions significantly increase in human dental pulps when stimulated by occlusal trauma combined with moderate orthodontic forces, as compared with these two stimuli applied independently. Name of the registry: Importance of Neurogenic Inflammation in the Angiogenic Response of the Dental Pulp as a Defensive Response. TRIAL REGISTRATION NUMBER: NCT03804034. Date of registration: 01/15/2019 Retrospectively registered. URL of trial registry record: https://clinicaltrials.gov/ct2/show/NCT03804034?term=NCT03804034&draw=2&rank=1 .

Expression of early angiogenesis indicators in mature versus immature teeth.

BACKGROUND: Proper oxygen balance in the dental pulp is essential for cell metabolism. Angiogenesis in the pulp is a constant process during the life of the tooth. Hypoxia indicators in a tissue, such as HIF-1α, as well as vascular destabilization markers, such as ANG2 and its receptor TIE2, are necessary for angiogenesis. Therefore the purpose of this study is to evaluate the expression of HIF-1α, ANG1, ANG2 and TIE2 in dental pulp as early angiogenesis indicators in teeth with complete and incomplete root development. METHODS: Forty human dental pulps were obtained from freshly extracted third molars divided into two groups: incomplete (n = 20) and complete (n = 20) root development. Dental pulps were stored at - 80 °C, defrosted in an ice bath and re-frozen with their respective thaws to disintegrate the tissue. Three sonication cycles were performed until the tissues were homogenized, then thaw were centrifuged and the supernatant was collected for the detection of the markers to be studied. The samples were processed for the ELISA test using the ELISA-sandwich principle. Student t and Mann-Whitney U tests were performed to determine statistically significant differences between groups. RESULTS: In the complete root development, HIF-1α, ANG1, ANG2 and TIE2 expressions were significantly higher than their expression in the incomplete root development group. CONCLUSIONS: The angiogenic process seems to be a physiological process in the dental pulp. Angiogenic activity is higher in teeth with mature than immature apex teeth.

Microalgal cultivation for biofertilization in rice plants using a vertical semi-closed airlift photobioreactor.

Nitrogen (N) is one of the most important limiting factors in conventional rice (Oryza sativa) production, which heavily relies on synthetic fertilizers. In this study, we researched on the development and use of a vertical semi-closed airlift photobioreactor (PBR) for microalgal cultivation and subsequently determined the efficacy of microalgae-based fertilizers to rice plant growth. The PBR system was developed to produce two strains of N2-fixing cyanobacteria (Anabaena sp. UTEX 2576, Nostoc muscorum UTEX 2209S), and a polyculture of Chlorella vulgaris (UTEX 2714) and Scenedesmus dimorphus (UTEX 1237). When these biofertilizers were evaluated for rice under the greenhouse conditions, results showed that the rice plant heights treated with polyculture-based microalgal biomass were similar to or better than the urea treatment. The effects of the inoculation of the N2-fixing cyanobacterial inoculation on seedling growth was not statistically significant. In conclusion, the vertical semi-closed system PBR cultivation method developed in this study proved to be a simple and effective method for cultivating microalgae. Demonstration of the reliable production system for N2-fixing cyanobacteria and chlorophytes at a medium scale could potentially open the future application of microalgal biofertilizers in rice production.

Dentine sensitivity risk factors: A case-control study.

OBJECTIVE: To identify the clinical and psychological risk factors associated with dentine hypersensitivity (DH) in order to provide an early diagnosis and preventive therapy. MATERIALS AND METHODS: A nested case-control study was design between 2011 and 2012. A total of 61 DH cases and 122 controls participated in this investigation. Cases and controls were matched for sex, group of age and socioeconomic status in a ratio of 1:2. DH to different stimuli such as cold, heat, acid, and sweet was asked in patient interviews, and dental examinations were used to detect DH. Clinical and psychological risk factors such as dental hygiene, periodontal disease, acid diet, alcohol consumption, psychological stress, and psychopathological symptoms were inquired. Psychological stress was measured through the PSS-10 and psychopathological symptoms were evaluated by SCL-90-R in Spanish. Descriptive and univariate binary logistic regression analysis were performed to estimate the association between clinical and psychological risk factors and the presence of DH. RESULTS: Toothpaste abrasivity (odds ratio [OR] 1.881, 95% confidence interval [CI] 1.010-3.502, P = 0.045), gingival recession (OR 2.196, 95% CI 1.020-4.728, P = 0.041), and periodontal therapy (OR 5.357, 95% CI 2.051-13.993, P < 0.001) were associated with DH. Subjects with perceived stress (OR 1.211, 95%, CI 0.518-2.833, P = 0.658), obsessive-compulsive (OR 1.266, 95%, CI 0.494-3.240, P = 0.623) and hostility (OR 1.235, 95%, CI 0.507-3.007, P = 0.642) symptoms had a clinical greater odd of DH. CONCLUSION: Oral hygiene products and periodontal conditions are important risk factors for DH. Individuals with perceived stress, obsessive-compulsive, and hostility symptoms may increase a clinical risk for this entity. Targeting to dental counseling focused on oral hygiene products, periodontal therapy and a psychological evaluation may be promising in DH prevention.

Serological screening for cysticercosis in mentally altered individuals.

The parasitic infection neurocysticercosis may give rise to a variety of psychiatric manifestations that resemble, but are different from, primary psychiatric disorders. The aim of this study was to determine if among individuals from a neurocysticercosis-endemic area of Colombia who apparently had a psychiatric manifestation with associated neurological finding ('cases'), some could have been infected with Taenia solium cysticerci. This case-control study was done in individuals hospitalized in two mental institutions. The control-1 individuals were those classified with primary psychiatric disease, and the control-2 group consisted of healthy, non-hospitalized individuals. A serological test for cysticercosis was positive in 5/96 (5.1%) cases, 4/153 (2.6%) psychiatric controls, and 5/246 (2%) healthy controls. The data analysis indicated a weak association between the cases and a positive serology for neurocysticercosis (odds ratio > 2; P > 0.05). The lower education level of the cases influenced this association.

Ulceras trombóticas en miembros inferiores asociadas a síndrome de klinefelter: reportaje de un caso / Ulceras trombóticas in inferior members associated to syndrome of klinefelter: news article of a case

Realizamos el análisis de un caso de síndrome de klinefelter complicado con úlceras de miembros inferiores. Los estudios que relacionan estas variables (klinefelter y úlceras) desde hace 40 años dejan aún muchas interrogantes sin aclarar, sin embargo existen algunas teorías de interés para justificar dicha asociación que permanece abierta al aporte e interpretación.

Perforación intestinal por fiebre tifoidea

Fiebre tifoidea es una enfermedad aguda producida por la Salmonella typhi, aunque puede ser causa por otras tipos serotipos paratíficas; caracterizada por fiebre, cefalea, dolor abdominal, rash transitorio, esplemomegalia, leucopenia. Las principales complicaciones son la hemorragia y la perforación intestinal de ulceras localizadas en las placas de Peyer usualmente en el íleon terminal. El Cloranfenicol ha sido administrado en forma específica pero el uso de betalactámico, fluorquinolonas ha sido efectivo. El tratamiento quirúrgico esta indicado en los casos graves donde se practica sutura simple, lavado de cavidad, resección intestinal con amastomosis termino-terminal, últimamente hemos realizado la ilostomía...