Reduction of NrF2 as coadjuvant during the development of persistent periapical lesions.

BACKGROUND: Persistent periapical lesions (PPL) are the result of pulpar necrosis induced by bacterial infection resulting in bone degradation and culminating with the loss of dental piece. Pathological changes in the peripapice are associated with the presence of free radicals. The transcription factor Nrf2 is the main regulator of the endogenous antioxidant response against oxidative stress and has been implicated in the regulation of osteoclastogenesis.The aim is to determine the oxidative condition in samples from patients with Persistent Periapical Injuries as a detonating factor of tissue damage. MATERIAL AND METHODS: An observational, descriptive, cross-sectional study was carried out in samples with PPL (cases) and samples by removal of third molars (controls) obtained in the clinic of the specialty in endodontics, University of Guadalajara. Samples were submitted to histological staining with Hematoxylin-Eosin, lipoperoxide analysis, Superoxide Dismutase (SOD), Glutathione-Peroxidase (GPx) and Catalase (CAT) activities were determined by immunoenzymatic assays and NrF2 by Western Blot analysis. RESULTS: Samples from PPL patients histologically showed an increased presence of lymphocytes, plasma cells, and eosinophils, as well as a decrease in extracellular matrix proteins and fibroblast cells. There was a rise in lipid peroxidation, GPx and SOD activities, but an important decline (36%) in Catalase activity was observed (p<0.005); finally, NrF2-protein was diminished at 10.41%. All comparisons were between cases vs controls. CONCLUSIONS: The alterations in antioxidants endogenous NrF2-controlled are related to osseous destruction in patients with PPL.

Oral processing and dynamics of texture perception in commercial gluten-free breads.

There is an increasing demand for gluten-free products, with the texture being a critical aspect. The aim of this work was to study the food bolus properties of gluten-free breads in relation to the dynamics of sensations perceived during its consumption. In this study, five-commercial gluten-free breads and two regular breads were analysed for their texture, crumb structure, and moisture content. Bread bolus particle size after three chews, bolus characteristics at the swallowing point, and oral activity were determined. The dynamics of textural sensations during bread consumption was evaluated using the temporal dominance of sensations (TDS) technique. Texture and structure properties vary among gluten-free breads being some of them close to regular breads (crumb with more and smaller cells that shows low hardness and high springiness) that lead to different in-mouth breakdown and TDS patterns. At the beginning, harder breads with low springiness values resulted in hard dominant sensations, in contrast, breads with low hardness and high springiness values were perceived soft and spongy. Breads that fragmented into a greater number of small size particles created crumbly and sandy sensations, characteristic of gluten-free breads with large air cell sizes. Compact sensation appeared in breads with low saliva uptake during bolus formation, while pasty and sticky sensations were related to a cohesive and adhesive bolus, respectively. Not only structure and mechanical properties, but also its oral behaviour in terms of fragmentation and bolus formation can fully explain the dynamics of texture perception of gluten-free breads.

Relating texture perception of cooked ham to the bolus evolution in the mouth.

The aim of the present study was to characterize the dynamics of the bolus formation that take place during mastication of commercial cooked ham samples. In addition, the relationships between these properties and texture perception were studied. Five commercial samples which presented different mechanical properties and moisture contents were studied. Ten participants were asked to chew the cooked ham samples normally and to expectorate the bolus after different chewing periods. Oral activity measurements (chewing time and number of chewing strokes), moisture content, saliva uptake and particle size distribution in the boluses were obtained. Seventeen participants evaluated the sensory perceptions generated over the sample consumption time, using the Temporal Check-All-That-Apply (TCATA) method. The results revealed that the duration of mastication and number of chewing cycles through to swallowing varied significantly among the cooked ham samples and were mainly related to instrumental texture parameters. The pattern of fragmentation under mastication also varied greatly between samples. Sensations of softness and hardness during ham consumption were again linked to instrumental texture parameters (TPA hardness, TPA chewiness and shear force). The perception of fibrousness was related to the degree of fragmentation of the ham in the mouth, and juiciness seemed to be related to the amount of saliva taken up by the product.

Effect of thyme and oregano essential oils on the shelf life of salmon and seaweed burgers.

The effect of different essential oils on the quality and shelf life of fish and seaweed burgers during storage was evaluated. For this purpose, thyme and oregano essential oils were selected at a concentration of 0.05% (v/w). Three types of salmon and seaweed burgers were prepared: without essential oil, burgers with red thyme essential oil (0.05% (v/w)) and burgers with oregano essential oil (0.05% (v/w)), which were vacuum packaged and stored at 4 ℃ for 17 days. Physicochemical and microbiological analyses were carried out periodically throughout storage. The addition of both essential oils did not have any effect on the evolution of the pH, the moisture content or texture parameters. Only the thyme essential oil managed to slightly slow down the increase of total volatile basic nitrogen and trimethylamine nitrogen. The samples with oregano essential oil and especially those with thyme essential oil showed minor oxidation. The salmon and seaweed burgers without essential oils and those which contained oregano essential oil showed a faster increase of mesophilic counts than those which had thyme essential oil, but no noticeable improvement was observed in the shelf life of the burgers with thyme essential oil. To improve the shelf life of the fish and seaweed burgers, it would be necessary to increase the concentration of both essential oils.

Masticatory mechanosensitivity, mouth opening and impact of headache in subjects with a history of orthodontics use: a cross-sectional study.

BACKGROUND: The correlation between orthodontics and the development of signs and symptoms of temporomandibular disorders (TMD) is a major concern in the physical rehabilitation field. AIM: The aim of the study was to observe whether subjects with a history of orthodontics use show differences from subjects who have never used orthodontics in: 1) masseter and temporalis muscle mechanosensitivity; 2) maximal vertical mouth opening (VMO); and 3) the impact of headache on their quality of life. DESIGN: Cross-sectional study. SETTING: The study was carried out in the Faculty of Nursing, Physiotherapy and Podiatry of the University of Sevilla, Spain. POPULATION: All participants were pre graduate students from the University of Sevilla, Spain. The final sample comprised 65 subjects (N.=65) with a mean age of 21 ± 2.46 years (18-29) divided into two groups; orthodontics group (N.=31) and non-orthodontics group (N.=34). METHODS: All students followed the same testing protocol. Measurements were taken of the pressure pain threshold (PPT) in two locations of the masseter (M1, M2) and temporalis (T1, T2) muscles, the maximal VMO, and the incidence of headache (Headache Impact Test-6; HIT-6, Spanish version). RESULTS: The measured values of the masticatory muscle PPTs were lower in the non-orthodontics group. Besides, the maximal VMO and HIT-6 scores were better in the orthodontics group. Nevertheless, none of these intergroup differences were statistically significant (ANOVA test): (M1 P=0.790); (M2 P=0.329); (T1 P=0.249); (T2 P=0.440); (HIT-6 P=0.443); (VMO P=0.626). CONCLUSION: A previous history of orthodontics use does not seem to lead to any greater sensitivity of the masticatory muscles, limitations of vertical mouth opening, or greater impact of headache on the subject's quality of life. CLINICAL REHABILITATION IMPACT: There is no evidence enough to support either a positive or negative correlation between orthodontics and signs and symptoms of TMD. Pain is a subjective perception and it is influenced by several factors. It remains uncertain if the use of orthodontics might be one of them.

Short-term changes in median nerve neural tension after a suboccipital muscle inhibition technique in subjects with cervical whiplash: a randomised controlled trial.

OBJECTIVES: To assess the immediate effect of a suboccipital muscle inhibition (SMI) technique on: (a) neck pain, (b) elbow extension range of motion during the upper limb neurodynamic test of the median nerve (ULNT-1), and (c) grip strength in subjects with cervical whiplash; and determine the relationships between key variables. DESIGN: Randomised, single-blind, controlled clinical trial. SETTING: Faculty of Nursing, Physiotherapy and Podiatry, University of Seville, Spain. PARTICIPANTS: Forty subjects {mean age 34 years [standard deviation (SD) 3.6]} with Grade I or II cervical whiplash and a positive response to the ULNT-1 were recruited and distributed into two study groups: intervention group (IG) (n=20) and control group (CG) (n=20). INTERVENTIONS: The IG underwent the SMI technique for 4minutes and the CG received a sham (placebo) intervention. Measures were collected immediately after the intervention. MAIN OUTCOME MEASURES: The primary outcome was elbow range of motion during the ULNT-1, measured with a goniometer. The secondary outcomes were self-perceived neck pain (visual analogue scale) and free-pain grip strength, measured with a digital dynamometer. RESULTS: The mean baseline elbow range of motion was 116.0° (SD 10.2) for the CG and 130.1° (SD 7.8) for the IG. The within-group comparison found a significant difference in elbow range of motion for the IG [mean difference -15.4°, 95% confidence interval (CI) -20.1 to -10.6; P=0.01], but not for the CG (mean difference -4.9°, 95% CI -11.8 to 2.0; P=0.15). In the between-group comparison, the difference in elbow range of motion was significant (mean difference -10.5°, 95% CI -18.6 to -2.3; P=0.013), but the differences in grip strength (P=0.06) and neck pain (P=0.38) were not significant. CONCLUSION: The SMI technique has an immediate positive effect on elbow extension in the ULNT-1. No immediate effects on self-perceived cervical pain or grip strength were observed.

[Towards a line of action]. / Hacia una linea de accion.

PIP: The principal lines of act0ion contained in the Declaration of the 1995 International Conference on Population and Development in regard to the demographic situation, women, health, reproductive and sexual health, and family planning are synthesized in this work. The 114 pages and 16 chapters in the Declaration were approved by the 300 representatives of 170 countries. This work lists the major points of Chapter 4 on gender, equity, and the capacity of women for self-determination; chapter 5 on roles, rights, structure and composition of the family; and chapter 6 on population growth and structure, with particular attention to children and youth, the elderly, indigenous peoples, and the handicapped. For chapter 7, on reproductive rights and reproductive health, the two terms were defined and their components listed, after which the main proposals concerning family planning, sexually transmitted diseases, prevention of HIV infection, human sexuality and gender, and adolescents were outlined. The topics considered in chapter 8 on health, morbidity, and mortality included primary health care and the health sector, child survival, women's health and maternity without risks, and HIV infection and AIDS.^ieng

The clandestine epidemic: the practice of unsafe abortion in Latin America.

In Latin America, induced abortion is the fourth most commonly used method of fertility regulation. Estimates of the number of induced abortions performed each year in Latin America range from 2.7 to 7.4 million, or from 10 to 27 percent of all abortions performed in the developing world. Because of restrictive laws, nearly all of these abortions, except for those performed in Barbados, Belize, and Cuba, are clandestine and unsafe, and their sequelae are the principal cause of death among women of reproductive age. One of every three to five unsafe abortions leads to hospitalization, resulting in inordinate consumption of scarce and costly health-system resources. Increased contraceptive prevalence and restrictive abortion laws have not decreased clandestine practices. This article addresses how the epidemic of unsafe abortion might be challenged. Recommendations include providing safer outpatient treatment and strengthening family planning programs to improve women's contraceptive use and their access to information and to safe pregnancy termination procedures. In addition, existing laws and policies governing legal abortion can be applied to their fullest extent, indications for legal abortion can be more broadly interpreted, and legal constraints on abortion practices can be officially relaxed.

[Population growth and the need to implement family planning programs]. / Crecimiento poblacional y la necesidad de implementar programas de planificacion familiar

PIP: This article discusses the value of family planning programs (FPP) in improvements in maternal and child health and contribution in raising people's standard of living. Access to FFP increases the contraceptive prevalence rate (CPR) with fertility rates dropping. This happened in Matlab, Bangladesh where the CPR rose to 45% as opposed to only 16% in the rest of the country. FPP helps prevent high numbers of abortions and keeps maternal mortality rates. For example when Chile began its program in 1963, 3% of couples used contraception. By 1978 the CPR rose to 23% and the death rates due to abortion fell from 118 to 24/1,000,000. The World Bank states that 85 developing countries, representing 95% of the population in The Third World, now offer FPP, and this has been achieved by offering couples information and access to contraception. However, most of these FPP are still not reaching the rural populations, the retention rates are low, and the administration of services is poor. A major social problem still remains-the high incidence of adolescent pregnancies. Worldwide it has been estimated that between 25-50% of maternal deaths could be prevented by the use of contraception to avoid high-risk or unwanted pregnancies. Worldwide between 20-30% of all unwanted pregnancies end up in abortions, legal or illegal. 80% of these abortions are illegal, with an estimated 100,000- 200,000 women dying annually. FP has many additional benefits including: 1) helping to make paternity a responsibility; 2) increasing people options and alternatives; and 3) helping mothers to space their pregnancies assuring better health for themselves and their children. Their success also depends on medical, political and financial support nationally and internationally.^ieng

[Paper on sterilization in the family planning programs of Colombia: a national debate]. / El papel de la esterlizacion en los programas de planificacion familiar de Colombia: un debate nacional

PIP: During 1984, family planning became the object of heated public debate in Colombia. In particular, considerable controversy surrounded the practice of sterilization. In Colombia in 1980, 49% of married women were practicing family planning. The main protagonist has been Profamilia, an IPPF affliate, which runs clinics and advisory services throughout Colombia. Sterilization is performed quite extensively on men of at least 28 years and women of 25 with 3 living children. Further activities of Profamilia include community distribution and social marketing programs. Many of the health facilities used are those of the Ministry of Public Health. The Minister of Health responded to criticism levelled by the Catholic church and others by instituting an investigation into alleged practices of mass sterilization. Profamilia declared publicy that sterilization was performed only under certain conditions, after waiting periods, and under no circumstances with coersion. Various groups including medical associations publicy supported Profamilia. Although recognizing the need for families to be limited in size, religious and other commentators suggested that sterilization was often presented as a solution to family ills, and that it represented foreign involvement in Colombian social policy. The opposing opinions were that church-supported natural family planning was not an effective enough strategy. The ministry has resolved to invoke more stringent screening of women desiring sterilization to include natural family planning in its programs, and to deal with international organizations only on the ministry level. The number of sterilizations has diminished. The controversy helped to expose political weaknesses of Profamilia's programs (e.g. the use of monetary incentives; lack of supervision).^ieng

[The abortion problem in Latin America]. / Problematica del aborto en America Latina.

PIP: Abortion is one of the major female health problems in Latin America, and the cost of hospital treatment after illegal abortion often drains resources needed to treat other health problems. The number of abortions per year is not known, and it is not definitely known whether the contraceptive programs dating from the mid-1970's have decreased the incidence of abortion. Estimates for Colombia range up to 1/2 million annualy. Underreporting ofabortion is common even in countries where abortion is legal, and in those where it is illegal its incidence comes to light mainly in the case of complications. Information on abortion is difficult to obtain in interviews or surveys. The numerous specialized hospital studies of abortion do not give a true picture of the place of abortion in the community. Indirect indicators such as the number of abortion cases treated in clinics and hospitals, the percent of abortions with complications of hemorrhage or infection, the proportion of maternal deaths attributable to abortion, extrapolations from surveys, and others are compared to estimate its extent. In most Latin American countries such indicators have varied little over the years despite progress in health and family planning programs. The methodological problems in studying the incidence of abortion are aggravated by the high cost of most of the proposed studies.^ieng