Determining Factors in the Success of Direct Pulp Capping: A Systematic Review.

AIM: To elucidate the factors that determine the success of direct pulp capping (DPC) in permanent teeth with pulp exposure due to dental caries. MATERIALS AND METHODS: A comprehensive electronic search from 1980 to 2023 across PubMed, Scopus, and ISI Web databases was conducted using specific keywords and MeSH terms in Q1 or Q2 journals. Only prospective/retrospective clinical studies in English on 15 or more human permanent teeth with carious pulpal exposure treated with DPC agents-mineral trioxide aggregate (MTA), Biodentine, or calcium hydroxide with a rubber dam and minimum 1-year follow-up, were considered. The factors retrieved and analyzed were based on study design, patient age, sample size, type of cavity, exposure size and location, pulp diagnosis, solutions to achieve hemostasis, hemostasis time, capping material, restoration type, follow-up period, methods of evaluation, and overall success. REVIEW RESULTS: Out of 680 articles, only 16 articles were selected for the present systematic review on application of the selection criteria. A wide age range of patients from 6 to 88 years were considered among these studies with sample sizes ranging from 15 to 245 teeth with reversible pulpitis being the predominant diagnosis of the cases. Mineral trioxide aggregate as a capping material was evaluated in 4 studies as a lone agent, while compared with other capping agents such as biodentine or calcium hydroxide in 7 studies. The follow-up period ranged from 9 days to nearly 80 months. While both clinical and radiographic evaluation was carried out in all studies, cold testing dominated the clinical tests while IOPR was the common radiograph considered. Mineral trioxide aggregate success rate was higher and similar to biodentine than calcium hydroxide. CONCLUSION: Direct pulp capping has a high and predictable success rate in permanent teeth with carious exposure to reversible and irreversible pulpitis. Currently, mineral trioxide aggregate and biodentine have better long-term results in DPC than calcium hydroxide, hence, they should be used as an alternative to calcium hydroxide. Definitive restoration within a short period improves long-term prognosis. CLINICAL SIGNIFICANCE: The significance of this review lies in its provision of evidence-based information on the effectiveness of DPC and the factors that influence its success. By considering these factors, clinicians can optimize treatment outcomes and improve the long-term prognosis of the treated teeth. This systematic review serves as a valuable resource for clinicians and researchers in the field of endodontics. How to cite this article: Gomez-Sosa JF, Granone-Ricella M, Rosciano-Alvarez M, et al. Determining Factors in the Success of Direct Pulp Capping: A Systematic Review. J Contemp Dent Pract 2024;25(4):392-401.

Global 30-Day Morbidity and Mortality of Primary Bariatric Surgery Combined with Another Procedure: The BLEND Study.

BACKGROUND: No robust data are available on the safety of primary bariatric and metabolic surgery (BMS) alone compared to primary BMS combined with other procedures. OBJECTIVES: The objective of this study is to collect a 30-day mortality and morbidity of primary BMS combined with cholecystectomy, ventral hernia repair, or hiatal hernia repair. SETTING: This is as an international, multicenter, prospective, and observational audit of patients undergoing primary BMS combined with one or more additional procedures. METHODS: The audit took place from January 1 to June 30, 2022. A descriptive analysis was conducted. A propensity score matching analysis compared the BLEND study patients with those from the GENEVA cohort to obtain objective evaluation between combined procedures and primary BMS alone. RESULTS: A total of 75 centers submitted data on 1036 patients. Sleeve gastrectomy was the most commonly primary BMS (N = 653, 63%), and hiatal hernia repair was the most commonly concomitant procedure (N = 447, 43.1%). RYGB accounted for the highest percentage (20.6%) of a 30-day morbidity, followed by SG (10.5%). More than one combined procedures had the highest morbidities among all combinations (17.1%). Out of overall 134 complications, 129 (96.2%) were Clavien-Dindo I-III, and 4 were CD V. Patients who underwent a primary bariatric surgery combined with another procedure had a pronounced increase in a 30-day complication rate compared with patients who underwent only BMS (12.7% vs. 7.1%). CONCLUSION: Combining BMS with another procedure increases the risk of complications, but most are minor and require no further treatment. Combined procedures with primary BMS is a viable option to consider in selected patients following multi-disciplinary discussion.

Estimating pulmonary arterial remodeling via an animal-specific computational model of pulmonary artery stenosis.

Pulmonary artery stenosis (PAS) often presents in children with congenital heart disease, altering blood flow and pressure during critical periods of growth and development. Variability in stenosis onset, duration, and severity result in variable growth and remodeling of the pulmonary vasculature. Computational fluid dynamics (CFD) models enable investigation into the hemodynamic impact and altered mechanics associated with PAS. In this study, a one-dimensional (1D) fluid dynamics model was used to simulate hemodynamics throughout the pulmonary arteries of individual animals. The geometry of the large pulmonary arteries was prescribed by animal-specific imaging, whereas the distal vasculature was simulated by a three-element Windkessel model at each terminal vessel outlet. Remodeling of the pulmonary vasculature, which cannot be measured in vivo, was estimated via model-fitted parameters. The large artery stiffness was significantly higher on the left side of the vasculature in the left pulmonary artery (LPA) stenosis group, but neither side differed from the sham group. The sham group exhibited a balanced distribution of total distal vascular resistance, whereas the left side was generally larger in the LPA stenosis group, with no significant differences between groups. In contrast, the peripheral compliance on the right side of the LPA stenosis group was significantly greater than the corresponding side of the sham group. Further analysis indicated the underperfused distal vasculature likely moderately decreased in radius with little change in stiffness given the increase in thickness observed with histology. Ultimately, our model enables greater understanding of pulmonary arterial adaptation due to LPA stenosis and has potential for use as a tool to noninvasively estimate remodeling of the pulmonary vasculature.

A Qualitative Study Assessing the Management of Predatory Journals and Their Publishing Activities: Results From the ASGLOS Study.

Background Predatory journals are an emerging problem in scientific literature, as they have financial motives without guaranteeing scientific quality. Therefore, the scientific community needs to establish how this issue can be solved in the long term. Objective The study aims to provide information that can be used to take action against predatory journals and to guide future change. Methods A Google Forms (Google LLC, Mountain View, California, United States) survey was designed and disseminated between September 2021 and April 2022. Reflexive thematic analysis was used as a qualitative analysis technique in this study, with the assistance of the NVivo software (Lumivero LLC, Denver, Colorado, United States) to manage and support the analysis process. Results A total of 978 responses from 58 countries worldwide, achieving a response rate of 19.9%, were analyzed. Five key themes emerged regarding participants' suggestions on techniques to cope with the detrimental impact of predatory journals: "Checking," "Increasing education and awareness," "Responsibility," "Use of technology," and "Obstacles to the solution." Conclusion The outcomes of this study will help us focus and channel efforts in the future to combat predatory journals and aid us in understanding what needs to be done. We hope that this study will influence management strategies and encourage more education and awareness on a global scale.

Efficacy and Safety of Mycophenolate Mofetil In De Novo Renal Transplantation in a Retrospective Cohort of Transplant Recipients in Colombia-Esmitren Study.

BACKGROUND: To describe and establish the efficacy and safety of Mycophenolate Mofetil (Micoflavin) in patients with de novo renal transplantation during one-year post-transplant follow-up. As secondary objectives, the behavior of mycophenolic acid (MPA) C0 levels in this population, the relationship between MPA levels and renal function of the grafts, the incidence of acute rejection, and the incidence of adverse effects were evaluated. METHODS: A prospective cohort study was conducted on patients who received a first kidney transplant from a deceased donor between March 1, 2021, and February 28, 2022, at the Alma Mater of Antioquia Hospital of the Antioquia's University, in Medellín, Colombia. MPA C0 levels were taken from the patients on days 15, 30, 90, 180, and 360 after the kidney transplantation. RESULTS: Patients presented MPA therapeutic levels in the study. The average of the MPA levels in the population was 2.5 µg/mL, with an IQR of 2.13 to 3.32. There were 5 acute rejections (27%), but none of the patients with acute rejection presented subtherapeutic levels of mycophenolate. No significant relationship was observed between mycophenolic acid levels and rejection (P = .255). The patients who completed the study had no gastrointestinal intolerance to mycophenolate, cytomegalovirus infections, or significant hematological complications. CONCLUSIONS: MMF (Micoflavin) maintained mycophenolic acid levels C0 within the therapeutic range, was well tolerated and without the presence of significant adverse events, and maintained stable renal function throughout the follow-up period in the population studied.

Technical feasibility of uro-dynamic MRI study of voiding biomechanics: a pilot study.

INTRODUCTION: Dynamic volumetric MRI was used to non-invasively assess voiding biomechanics in a healthy male volunteer. METHODS: Using 3D Differential Subsampling with Cartesian Ordering (DISCO) Flex acquisition sequence, volumetric bladder images were obtained throughout the voiding effort. These were subsequently segmented using MIMICS. Segmented anatomical volumes were used to quantify total voided volume, post-void residual, volumetric displacement of urine over time, bladder neck angle, sphericity index, and prostatic urethral angle through the voiding effort. RESULTS: Bladder sphericity index correlated positively with flow rate. The greatest degree of bladder neck funneling correlated with the maximum urine flow rate. There was straightening of the prostatic urethral angle during voiding that also correlated positively with urine flow. CONCLUSION: This pilot study confirms the potential of dynamic MRI to provide non-invasive assessment of lower urinary tract anatomy and biomechanics during voiding.

Vital Pulp Therapy in Permanent Teeth Diagnosed with Symptomatic Irreversible Pulpitis: Reports with Long-Term Controls.

The aim of this study was to describe the treatment of permanent teeth diagnosed with irreversible pulpitis, which can be effectively managed with partial or total pulpotomy. This alternative approach has shown great clinical and radiographic success in the long term compared to traditional pulpectomies. In this series of clinical cases, all the teeth exhibited symptoms of intense pain upon exposure to cold and at night. The clinical examination revealed extensive caries, while radiographic imaging showed radiolucent lesions in contact with the pulp chamber, indicating symptomatic irreversible pulpitis. The chosen treatment approach was either partial or total pulpotomy. The tooth was anesthetized, and the operative field was isolated and disinfected. After removing caries with a sterile round drill, the area was rinsed with sodium hypochlorite. In some cases, a portion of the pulp tissue was removed, while in others, the entire tissue of the pulp chamber was extracted using diamond burs. Hemostasis was achieved by applying sterile cotton pellets for 2 to 6 minutes. Following that, the tissue exhibited no signs of bleeding. Bioceramic cements were used, and the tooth was definitively restored. Periodic follow-up examinations were conducted, consistently showing positive pulp responses and no evidence of periradicular radiolucent lesions on radiographs.

Epicardial Adipose Tissue Changes After Bariatric and Metabolic Surgery: a Systematic Review and Meta-analysis.

Epicardial adipose tissue (EAT) is a visceral fat depot located between the myocardium and visceral epicardium. Emerging evidence suggests that excessive EAT is linked to increased risk of cardiovascular conditions and other metabolic diseases. A literature search was conducted from the earliest studies to the 26th of November 2022 on PubMed, Embase, and the Cochrane. All the studies evaluating changes in EAT, pericardial adipose tissue (PAT), or total cardiac fat loss before and after BS were included. From 623 articles, 35 were eventually included in the systematic review. Twenty-one studies showed a significant reduction of EAT after BS, and only one study showed a non-significant reduction (p = 0.2).

The ASGLOS Study: A global survey on how predatory journals affect scientific practice.

Predatory journals and conferences are an emerging problem in scientific literature as they have financial motives, without guaranteeing scientific quality and exposure. The main objective of the ASGLOS project is to investigate the predatory e-email characteristics, management, and possible consequences and to analyse the extent of the current problem at each academic level. To collect the personal experiences of physicians' mailboxes on predatory publishing, a Google Form® survey was designed and disseminated from September 2021 to April 2022. A total of 978 responses were analysed from 58 countries around the world. A total of 64.8% of participants indicated the need for 3 or fewer emails to acquire a criticality view in distinguishing a real invitation from a spam, while 11.5% still have doubt regardless of how many emails they get. The AGLOS Study clearly highlights the problem of academic e-mail spam by predatory journals and conferences. Our findings signify the importance of providing academic career-oriented advice and organising training sessions to increase awareness of predatory publishing for those conducting scientific research.

Shoulder problems after percutaneous antegrade intramedullary nailing in humeral diaphyseal fractures using contemporary straight third-generation nail.

BACKGROUND: Antegrade intramedullary nailing in humeral shaft fracture has been abandoned by certain orthopedic surgeons because of rotator cuff injury caused by first- and second-generation intramedullary nails (IMNs). However, only a few studies have specifically addressed the results of antegrade nailing for the treatment of humeral shaft fractures with a straight third-generation IMN; thus, complications need to be re-evaluated. We hypothesized that fixation of displaced humeral shaft fractures with a straight third-generation antegrade IMN with the percutaneous technique avoid shoulder problems (stiffness and pain) incurred by first- and second-generation IMNs. METHODS: This was a retrospective, single-center, nonrandomized study of 110 patients with a displaced humeral shaft fracture between 2012 and 2019 treated surgically with a long third-generation straight IMN. Mean follow-up was 35.6 months (range, 15-44 months). RESULTS: There were 73 women and 37 men with a mean age of 64.7 ± 19 years. All fractures were closed (37.3% 12A1, 13.6% 12B2, and 13.6% 12B3 AO/OTA classification). Mean Constant score was 82 ± 19, Mayo Elbow Performance Score 96 ± 11 and the mean EQ-5D visual analog scale score was 69.7 ± 21.5. Mean forward elevation 150° ± 40°, abduction 148° ± 45°, and external rotation 38° ± 15°. Symptoms associated with rotator cuff disease were present in 6.4%. Evidence of radiographic fracture healing was detected in all but 1 case. One postoperative nerve injury and 1 adhesive capsulitis were present. Overall, 6.3% underwent second surgeries (4.5% were minor surgeries like hardware removal). CONCLUSION: Percutaneous antegrade intramedullary nailing of humeral shaft fractures with a straight third-generation nail considerably reduced complications related to shoulder problems and achieved good functional results.

Young nursing and medical students' knowledge and attitudes towards sexuality and contraception in two spanish universities: an inferential study.

BACKGROUND: Living safely sexuality and without risk to one's health is an international priority. The youth age group has specific characteristics that make it a particularly vulnerable group for adverse consequences such as unwanted pregnancies or sexually transmitted infections. Health professionals are an important group to address this issue; however, to achieve a good result, sufficient knowledge is required to solve all the issues. This study aimed to assess the level of knowledge of young university students studying a nursing or a medical degree. METHODS: A descriptive cross-sectional study of young medical and nursing students was conducted. The selection of participants was made by convenience. The Sexuality and Contraceptive Knowledge Instrument scale was used to measure knowledge level. A bivariate analysis was conducted using the Mann-Whitney U test or the Kruskal-Wallis H test, depending on the number of categories of the independent variable. Finally, a multivariate analysis was conducted using a multiple linear regression model, establishing the level of knowledge as the dependent variable and all variables that obtained statistical significance in the bivariate analysis as predictors. Data collection was carried out from October 2020 to March 2021. RESULTS: The sample comprised 657 health university students. Participants had a good level of knowledge, with 77.9% answering 50% of the questions correctly. Before training, 34.15% of the participants did not pass 50% of the questions asked. This percentage decreased to 12.87% after receiving sexuality training during their university degrees. The main training gaps were found for the items on hormonal contraceptive methods. The bivariate analysis showed that female participants had significantly higher knowledge scores, as did those who had used a hormonal contraceptive method during the most recent intercourse or were aware of family planning centers. These variables maintained their significant effect at the multivariate level, obtaining two models with good explanatory power for participants of both university degrees. CONCLUSION: The general level of knowledge of the healthcare students was high and sufficient after receiving training during the university degree (87.13% of the participants obtain more than 50% of items correct). The main training gap was found for items on hormonal contraceptive methods, which should be emphasized in future training programs.

The Spanish version of the Constant-Murley Shoulder Score: translation, cultural adaptation, and validity.

BACKGROUND: The Constant-Murley Score (CMS) is one of the most employed tools for assessing shoulder function. It was first devised in 1987 for the English population and is now widely used internationally. However, it had yet to be cross-culturally adapted and validated to Spanish, which is the world's second-most native language. Formal adaptation and validation of clinical scores is paramount for them to be used with rigorous scientific methodology. METHODS: Following international recommendations for the cross-cultural adaptation of self-report measures, the CMS was first adapted into Spanish in six stages: translation, synthesis, back-translation, a review by expert committee, pretesting, and final appraisal by expert committee. After conducting a pretest with 30 individuals, the Spanish version of the CMS was tested on 104 patients with various shoulder pathologies to assess content, construct, criterion validity, and reliability. RESULTS: No major conflicts were encountered in the process of cross-cultural adaptation, with 96.7% of pretested patients having a full understanding of every item in the test. The validation showed excellent content validity (content validity index = .90), construct validity (strong correlation between items within the same subsection of the test), and criterion validity (CMS - Simple Shoulder Test, Pearson r = .587, P = .01; CMS - American Shoulder and Elbow Surgeons, Pearson r = .690, P = .01). Reliability of the test was also excellent, with high internal consistency (Cronbach's α = .819), interrater reliability (intraclass correlation coefficient = .982), and intrarater reliability (intraclass correlation coefficient = .937), without showing ceiling or floor effects. CONCLUSION: Spanish version of the CMS has been proved to accurately reproduce the original score and to be easily comprehensible by native Spanish speakers with acceptable intrarater-interrater reliability and construct validity. INTRODUCCIóN: La escala de Constant-Murley (CMS) es una de las más empleadas para evaluar la función del hombro. Se ideó por primera vez para la población inglesa en 1987 y actualmente es ampliamente empleada a nivel internacional. Sin embargo, su validación y adaptación transcultural no se han realizado al español, la segunda lengua nativa más hablada en el mundo. Actualmente no puede resultar admisible el empleo de escalas en las que no tengamos la seguridad de que existe una equivalencia conceptual, cultural y lingüística entre la versión original y la empleada. MATERIAL Y MéTODO: La versión traducida al español de la CMS se realizó siguiendo las recomendaciones internacionales: traducción, síntesis de la traducción, retrotraducción, revisión por comité de expertos, pretest y validación. Tras la realización del pretest en 30 individuos, la versión española de la escala de CMS se probó en 104 pacientes con diferentes patologías de hombro para evaluar las propiedades psicométricas de la escala: contenido, constructo, validez de criterio y fiabilidad. RESULTADOS: No se encontraron problemas importantes durante el proceso de adaptación transultural con un entendimiento completo de todos los ítems del pretest por el 96.7% de los pacientes. La escala adaptada demostró una excelente validez de contenido (índice de validez de contenido = .90), de constructo (fuerte correlación entre ítems de la misma subsección del test), y de criterio (CMS-SST Pearson's r = .587, p = .01; CMS-ASES Pearson's r = .690, p = .01). La Fiabilidad del test resultó excelente, con una elevada consistencia interna (Cronbach's α = .819), fiabilidad interobservador (ICC = .982) e intraobservador (ICC = .937), sin efectos techo y suelo. CONCLUSIóN: La versión Española de la CMS garantiza la equivalencia con respecto al cuestionario original. Los presentes resultados, sugieren que esta versión es válida, fiable y reproducible para la evaluación de la patología de hombro en nuestro entorno.

The Role of Growth Hormone and Insulin Growth Factor 1 in the Development of Non-Alcoholic Steato-Hepatitis: A Systematic Review.

Diabetic and obese patients have a high prevalence of non-alcoholic fatty liver disease (NAFLD). This condition groups a spectrum of conditions varying from simple steatosis to non-alcoholic steatohepatitis (NASH), with or without fibrosis. Multiple factors are involved in the development of NAFLD. However, details about its pathogenesis and factors that promote the progression to NASH are still missing. Growth hormone (GH) and insulin-like growth factor 1 (IGF-1) regulate metabolic, immune, and hepatic stellate cell functions. Increasing evidence suggests they may have roles in the progression from NAFLD to NASH. Following the PRISMA reporting guidelines, we conducted a systematic review to evaluate all clinical and experimental studies published in the literature correlating GH and IGF-1 to inflammation and fibrosis in NAFLD and NASH. Our results showed that GH and IGF-1 have a fundamental role in the pathogenesis of NASH, acting in slightly different ways to produce a synergic effect. Indeed, GH may mediate its protective effect in the pathogenesis of NASH by regulating lipogenesis pathways, while IGF-1 has the same effect by regulating cholesterol transport. Therefore, they could be used as therapeutic strategies in preventing NAFLD progression to NASH.

Risk Factors Involved in the High Incidence of Bladder Cancer in an Industrialized Area in North-Eastern Spain: A Case-Control Study.

Bladder cancer (BC) is the most common of the malignancies affecting the urinary tract. Smoking and exposure to occupational and environmental carcinogens are responsible for most cases. Vallès Occidental is a highly industrialized area in north-eastern Spain with one of the highest incidences of BC in men. We carried out a case-control study in order to identify the specific risk factors involved in this area. Three hundred and six participants were included (153 cases BC and 153 controls matched for age and sex): in each group, 89.5% (n = 137) were male and the mean age was 71 years (range 30-91; SD = 10.6). There were no differences between groups in family history, body mass index, or dietary habits. Independent risk factors for CV were smoking (OR 2.08; 95% CI 1.30-3.32; p = 0.002), the use of analgesics in nonsmokers (OR 10.00; 95% CI 1.28-78.12; p = 0.028), and profession (OR: 8.63; 95% CI 1.04-71.94; p = 0.046). The consumption of black and blond tobacco, the use of analgesics in nonsmokers, and occupational exposures are risk factors for the development of BC in this area, despite the reduction in smoking in the population and the extensive measures taken in the last few decades in major industries to prevent exposure to occupational carcinogens.

Systematic review of population-based bladder cancer registries: How criteria heterogeneity affects the comparison of incidences.

BACKGROUND: The population-based registry of bladder cancer (BC) raises specific problems intrinsic to the tumor, as the inclusion of noninfiltrating, potentially malignant and multiple tumors. We performed a systematic review (PRISMA guidelines) of population-based BC registries to obtain information on their geographic areas involved, last dates of real incidence of BC, and rules coding used in BC for uncertain behavior, in situ and multiple tumors. METHODS: Using MEDLINE and Google Scholar, we identified scientific publications of in the last 10 years in English or Spanish, whether they were related to a national or international cancer registry, provided information on registry rules, and provided data on the incidence of BC. RESULTS: After the first screening, a total of 194 references were obtained. After a second analysis, three registries were selected: International Agency for Research on Cancer (IARC) is a world registry providing real incidence of BC in the period 2008-2012. Surveillance, Epidemiology, and End Results (SEER) Program registered incidence until 2017 in more than 90% of the US population. Spanish Network of Cancer Registries (REDECAN) unifies 14 Spanish registries (27.4% of the population) with real incidence data from 2010 to 2015. The coding and inclusion rules have been modified, but currently, most registries include BC in situ and uncertain behavior tumors. Whenever a new case occurs 36 months after a previous diagnosis, SEER registers those as multiple incident cancers in the same location, while IARC and REDECAN only allow one cancer per location during the lifespan of the patient. CONCLUSIONS: Comparison of the incidence of BC among different population-based cancer registries is prone to bias due to the methodological differences regarding the inclusion of carcinomas in situ, indeterminate, and multiple tumors. A good cancer registry could provide better surveillance strategies for BC patients.

Impacto de la rehabilitación neuropsicológica computarizada en un paciente con anemia de células falciformes y TDAH. Estudio experimental de caso único

Introducción: La anemia de células falciformes (ACF) es una enfermedad genética que provoca una malformación en el glóbulo rojo, volviéndolo más frágil y desencadenando su lisis. Por su forma anómala predispone a eventos oclusivos en vasos de menor tamaño, incluyendo aquellos en el sistema nervioso central. La literatura documenta presencia de infartos cerebrales silentes y no silentes asociados a ACF, con sus respectivas alteraciones cognitivas. En los últimos años se ha reportado que existe compromiso cognitivo y mayor presencia de trastornos del neurodesarrollo, como el trastorno por déficit de atención e hiperactividad (TDAH) en aquellos niños con ACF que aún no han tenido eventos cerebrales isquémicos. Método: Se llevó a cabo un estudio experimental y prospectivo de caso único, que consistió en un programa de rehabilitación por medio de la plataforma de entrenamiento cognitivo para la atención y concentración de CogniFit. Durante 45 sesiones, se realizaron mediciones de respuestas en atención y control inhibitorio, utilizando la Batería de Evaluación Cognitiva para la Atención (CAB-AT). Resultados: Se observó que la intervención tuvo un impacto significativo en el componente de atención, el cual se mantuvo por encima de la línea de base, incluso después de suspender la intervención. Sin embargo, no se encontró un impacto importante en el control inhibitorio. Conclusión: Aunque la intervención mejoró la atención, no lo hizo con el control inhibitorio. Se recomienda complementar la rehabilitación con manejo farmacológico y diseñar nuevos estudios con poblaciones heterogéneas.

Introduction: Sickle cell anemia (SCA) is a genetic disease that causes a malformation in red blood cells, making them more fragile and leading to their lysis. Due to their abnormal shape, they predispose to occlusive events in smaller blood vessels, including those in the central nervous system. Literature documents the presence of silent and non-silent cerebral infarctions associated with SCA, along with respective cognitive impairments. In recent years, cognitive impairment and a higher prevalence of neurodevelopmental disorders such as attention deficit hyperactivity disorder (ADHD) have been reported in children with SCA who have not experienced ischemic brain events. Method: An experimental and prospective single-case study was conducted, consisting of a rehabilitation program using the CogniFit platform for cognitive training in attention and concentration. Measurements of attention and inhibitory control responses were taken during 45 sessions, using the Cognitive Assessment Battery for Attention (CAB-AT). Results: It was observed that the intervention had a significant impact on the attention component, which remained above the baseline even after discontinuing the intervention. However, no significant impact was found on inhibitory control. Conclusion: Although the intervention improved attention, it did not have the same effect on inhibitory control. Complementing rehabilitation with pharmacological management and designing new studies involving heterogeneous populations are recommended.

Artificial Intelligence in the Diagnosis of Hepatocellular Carcinoma: A Systematic Review.

Hepatocellular carcinoma ranks fifth amongst the most common malignancies and is the third most common cause of cancer-related death globally. Artificial Intelligence is a rapidly growing field of interest. Following the PRISMA reporting guidelines, we conducted a systematic review to retrieve articles reporting the application of AI in HCC detection and characterization. A total of 27 articles were included and analyzed with our composite score for the evaluation of the quality of the publications. The contingency table reported a statistically significant constant improvement over the years of the total quality score (p = 0.004). Different AI methods have been adopted in the included articles correlated with 19 articles studying CT (41.30%), 20 studying US (43.47%), and 7 studying MRI (15.21%). No article has discussed the use of artificial intelligence in PET and X-ray technology. Our systematic approach has shown that previous works in HCC detection and characterization have assessed the comparability of conventional interpretation with machine learning using US, CT, and MRI. The distribution of the imaging techniques in our analysis reflects the usefulness and evolution of medical imaging for the diagnosis of HCC. Moreover, our results highlight an imminent need for data sharing in collaborative data repositories to minimize unnecessary repetition and wastage of resources.

Preparation and characterization of cellulose fibers from Meghatyrsus maximus: Applications in its chemical derivatives.

Non-wood lignocellulosic fibers have emerged and are becoming increasingly important as an alternative source of cellulose for derivatives, functional materials, and biofuels. This work aimed, to obtain cellulose from Meghatyrsus maximus grass with adequate properties through an alkaline delignification and alkaline hydrogen peroxide bleaching. Meghatyrsus maximus was chemically characterized as lignocellulosic biomass, which consisted of 45.0 %, cellulose, 35.0 % hemicellulose, and 20.0 % lignin. The obtained cellulose was characterized by Fourier transform infrared spectroscopy, X-ray diffraction analysis, thermogravimetric analysis, and scanning electron microscopy. The alpha-cellulose content was 98.50 % with a crystallinity of 61.0 %. The morphological study by scanning electron microscopy images indicates a clean surface and removal of non-cellulosic components present in the initial raw fibers. These results showed that high-quality cellulose was obtained and is comparable to a commercial alpha-cellulose, highlighting Meghatyrsus maximus as an alternative source of lignocellulosic fibers.

Enfermedad de Fabry: un año en tratamiento con migalastat

Introducción la enfermedad de Fabry (o enfermedad de Anderson-Fabry) es una enfermedad de depósito lisosomal causada por la deficiencia o ausencia de la enzima α-galactosidasa A, responsable del catabolismo del glucoesfingolípido globotriaosilceramida (Gb3). Objetivo exponer la evolución de caso de un paciente con diagnóstico de enfermedad de Fabry, en tratamiento con Migalastat, buscando contribuir al conocimiento médico científico a nivel local en el manejo de enfermedad de Fabry con nuevas opciones de tratamiento, considerando la necesidad de generación de evidencia del mundo real en una enfermedad rara como la mencionada. Presentación del caso paciente masculino de 64 años de edad, oriundo de Porto, Portugal, residente en Medellín, Colombia, con enfermedad de Fabry diagnosticada en el año 2010, que fue causada debido a la actividad de la Alfa Galactosidasa A más la mutación fenotípica C.239G>A. Discusión y conclusión este reporte de caso ha demostrado la adecuada respuesta del paciente en el manejo con la chaperona farmacológica migalastat. Por lo tanto, un paciente con enfermedad de Fabry, con manifestaciones típicas y una mutación GLA confirmada y que es susceptible de recibir migalastat, tiene esta excelente opción terapéutica con resultados favorables para sus signos y síntomas. Migalastat (chaperón farmacológico) es un tratamiento oral eficaz y seguro que se traduce en comodidad y beneficios para el paciente y su entorno, lo que permite una mejora significativa de la calidad de vida del paciente.

Introduction Fabry disease, or Anderson-Fabry disease, is a lysosomal deposition disease caused by deficiency or absence of the enzyme α-galactosidase A, which is responsible for the catabolism of the glycosphingolipid globotriaosylceramide (Gb3). Objective To present the evolution of the case of a patient diagnosed with Fabry disease, treated with Migalastat, seeking to contribute to local medical scientific knowledge in the management of Fabry disease with new treatment options, considering the need to generate real-world evidence in a rare disease such as the one mentioned. Case presentation A 64-year-old male patient, native of Porto-Portugal, resident in Medellin-Colombia, with Fabry disease diagnosed in 2010, due to Alpha Galactosidase A activity plus phenotyping mutation C.239G>A. Discussion and conclusions This case report has shown the adequate response of the patient in management with the pharmacological chaperone migalastat. Therefore, a patient with Fabry disease, with typical manifestations and a confirmed GLA mutation and who is susceptible to migalastat, has this excellent therapeutic option with favorable results for his signs and symptoms. Migalastat (pharmacological chaperone) is an effective and safe oral treatment which translates into comfort and benefits for the patient and his environment, and this allows a significant improvement in the patient's quality of life.

The use of the T-tube in biliary tract reconstruction during orthotopic liver transplantation: An umbrella review.

Biliary complications are one of the main concerns after liver transplantation, and to avoid these, the use of a T-tube has been advocated in biliary reconstruction. Most liver transplantation centres perform a biliary anastomosis without a T-tube to avoid the risk of complications and T-tube-related costs. Several meta-analyses have reached discordant conclusions regarding the benefits of using the T-tube. An umbrella review was performed to summarise quantitative measures about overall biliary complications, biliary leaks, biliary strictures and cholangitis associated with the T-tube use after liver transplantation. Published systematic reviews and meta-analyses related to the use of T-Tube in liver transplantation were searched and analysed. From the comprehensive literature search from PubMed, EMBASE and Cochrane Library databases on the 25th of October 2021, 104 records were retrieved. Seven meta-analyses and two systematic reviews were included in the final analysis. All the meta-analyses of RCT stated no differences in overall biliary complications and biliary leaks when using T-tube for a liver transplant (I2 ≥ 90% and I2 range 0-76%, respectively). The meta-analysis of the RCTs evaluating the risks of biliary strictures after liver transplantation showed that T-tube protects from the complication (I2 range 0-80%). Biliary anastomosis without a T-tube has equivalent overall biliary complications and bile leaks compared to the T-tube reconstruction. The incidence of biliary strictures is attenuated in patients with T-tubes, and most meta-analyses of RCTs have very low heterogeneity. Therefore, the present umbrella review suggests a selective T-tube use, particularly in small biliary ducts or transplants with marginal grafts at high risk of post-LT strictures.