Bacteria associated with apical periodontitis promotes in vitro the differentiation of macrophages to osteoclasts.

OBJECTIVE: To analyze the possible in vitro effect of the cytokine RANKL and bacteria involved in apical periodontitis on the differentiation of macrophages into osteoclasts. MATERIAL AND METHODS: Bacteria were isolated (mainly E. faecium and E. faecalis) from the root canal of fifty patients with apical periodontitis, the possible effect of these bacteria on the phagocytic activity of the monocyte cell line THP-1 was analyzed by flow cytometry. Furthermore, the effect of these bacteria (alone or in combination with the cytokine RANKL) on the differentiation of THP-1 macrophages into osteoclasts was analyzed through the expression of the receptor RANK and the tartrate-resistant acid phosphatase TRAP. Finally, the release of different cytokines (IL-1ß, TNF-α, IL-6, IL-8, IL-10, and IL-12p70) by THP-1 cells induced to differentiate into osteoclasts was also analyzed. RESULTS: We observed a significant proportion of THP-1 cells were able to internalize E. faecium and E. faecalis. Furthermore, these bacteria were able to induce (alone or in combination with RANKL) a significant expression of RANK by THP-1 macrophages; accordingly, E. faecium and E. faecalis induced very significant levels of TRAP in these cells. Finally, during the differentiation of THP-1 macrophages induced by RANKL or bacteria, a significant release of the pro-inflammatory cytokines IL-6 and TNF-α was observed. CONCLUSIONS AND CLINICAL RELEVANCE: Our data suggest that the causative agents of apical periodontitis can induce the differentiation of osteoclasts as well as the release of pro-inflammatory cytokines, phenomena that may have an important role in the bone damage observed in this condition.

B regulatory cells associated with changes in biochemical and inflammatory parameters in normal-glycemic individuals, pre-diabetes and T2DM patients.

AIM: To determine the percentages of (CD19 + CD24 + CD38+, CD19 + CD24 + CD27+, CD19 + IL-10+)-Breg cells, IL-17 single and IL-17+/IFN-γ double producers T cells and IFN-γ+ T cells, in normal-glycemic individuals, prediabetes and T2DM patients, and to analyze the association of Breg cells with metabolic parameters of T2DM. METHODS: percentages of Breg cells, IL-17+ and IL-17 + IFN-γ+ T cells, IFN-γ+ T cells and IL-10 were determined by flow cytometry. IL-6 levels were evaluated by ELISA assay. RESULTS: increased IL-6 levels, IL-17+ and IL-17 + IFN-γ+ T cells and a diminution of IL-10 levels and CD19 + IL-10+ cells in T2DM patients were observed. We found that CD19 + CD24 + CD27+ cells and CD19 + CD24 + CD38+ cells were increased in T2DM patients. The percentages of CD19 + CD24 + CD38+ cells were associated with HOMA-B, TyG index, HDL and cholesterol values. In normal-glycemic individuals, CD19 + CD24 + CD27+ cells were inversely associated to triglycerides and TyG index. In prediabetes patients, CD19 + CD24 + CD38+ cells were inversely related with cholesterol and LDL. Finally, CD19 + CD24 + CD38+ cells were inversely related with HDL values in T2DM patients. CONCLUSION: Our results suggest that increased percentages of IL-17 single and IL-17/IFN-γ double producers T cells in T2DM patients may be a consequence of the initial CD19 + IL-10+ cells reduction. Furthermore, dyslipidemia could play an important role in percentages and activity of B regulatory cells.

Hydrogeochemical baseline in a human-altered landscape of the central Pacific coast of Costa Rica.

Groundwater pollution in tropical and human-altered coastal landscapes is receiving novel attention due to decreasing in annual recharge as a consequence of recurrent droughts and overexploitation, whereby saline intrusion, point and diffuse source contamination, and water conflicts are common denominators. This study presents a detailed groundwater evaluation in a coastal aquifer within the central Pacific coast of Costa Rica. Three sampling campaigns including major ions, heavy metals, and fecal coliform analyses were conducted between July 2013 and March 2014 across 17 wells within the alluvial and fissured units of the Jacó aquifer. The groundwater system is classified as mixed HCO3--Ca2+-Mg2+ type. Coliforms presence was found in two wells, nearby Mona Creek headwaters and near the coastal line. Heavy metal concentrations were below quantification limits in most of the wells; however, chromium concentrations up to 6.56 µg/L were quantified within the coastal line and central portion of the alluvial aquifer in 20 out of the 48 samples. The spatial distribution of major ions (K+, Na+, Ca2+, Mg2+, Cl-, SO42-, and HCO3-) exhibited an increasing trend towards the central portion of the alluvial aquifer, which may be potentially associated with the large unregulated urban expansion, invoking a need of a continuous water quality monitoring program in this touristic hot spot. This study provides useful information for other similar coastal aquifers in Central America, whereby increasing population growth and unregulated touristic, industrial, and agricultural activities are posing a truly challenge to ensure water security and sustainability parallel to the economic development in a changing climate.

Enuresis nocturna. Estudio epidemiológico en población escolar / Nocturnal enuresis. Epidemiological study in school population

Introducción: la enuresis nocturna (EN) es un problema de salud infantil frecuente, con repercusión personal y social, que requiere un manejo adecuado y personalizado por parte de los profesionales sanitarios. Se ha realizado un estudio cuyo objetivo es establecer la prevalencia de EN en la ciudad de Burgos (España) en población pediátrica entre siete y diez años de edad. Pacientes y métodos: estudio observacional transversal en el que se han obtenido datos de una muestra aleatoria de niños escolarizados entre segundo y quinto curso de Educación Primaria Obligatoria en la ciudad de Burgos mediante la cumplimentación de una encuesta. Resultados: se ha obtenido una prevalencia de EN del 7,3%. La EN es más frecuente en varones, con antecedentes familiares de enuresis nocturna, con algún tipo de enfermedad crónica, que asocian trastornos del sueño y del comportamiento y con bajo rendimiento escolar. Conclusiones: la prevalencia es menor a la de otras poblaciones de características similares. Los niños con EN de Burgos presentan características epidemiológicas semejantes a las de otras poblaciones. La EN es un problema de salud infradiagnosticado en nuestro medio (AU)

Introduction: nocturnal enuresis (NE) is a common childhood health condition. This problem causes personal and social repercussion. The health professionals have to make an individualized and adequate management of this problem. The aim of this study is to know the prevalence of NE in children between seven and ten years old of the city of Burgos. Patients and methods: to this end, we have designed an observational and transversal study. We have selected a random sample of school children in Burgos between 2nd and 5th year of Obligatory Primary Education. They have completed a questionnaire. Results: the prevalence of NE was 7.3%. NE is more frequent in males and children with familiar precedents of NE, with some type of chronic illness, with associated disorders of the sleep and behavior and with low academic performance. Conclusions: the prevalence of NE in children in Burgos city is lower than in another child groups of similar characteristics. There is a low diagnosis rate of NE in Burgos city (AU)

Tumoración en tobillo en niño de 2 años / Knee tumour in a 2-year old child

No disponible

Protective effect of fallopian tubal fluid against activated leucocyte-induced sperm DNA fragmentation: preliminary results.

The integrity of the paternal genome is of paramount importance in the initiation and maintenance of a viable pregnancy. Oxygen radicals (ROS) have been identified as one of the main factors responsible for the induction of sperm DNA damage. Spermatozoa are mainly protected against ROS-induced damage by seminal plasma. However, this protective effect disappears once spermatozoa enter the female genital tract. The fallopian tube mucosa may play a protective role against ROS-induced sperm damage. The main objective of this study was to determine whether human tubal explants and tubal fluid exert a protective effect on ROS-induced sperm DNA damage. Spermatozoa were exposed to tubal explants and/or tubal fluid in the presence of phorbol myristate acetate (PMA)-activated polymorphonuclear leucocytes or control medium and sperm DNA fragmentation was measured using the TdT-mediated dUTP-biotin nick end labelling (TUNEL) test. Exposure of human spermatozoa to PMA-activated leucocytes resulted in a 2-fold increase in sperm DNA fragmentation. Co-incubation of spermatozoa with tubal explants did not reduce this damage. However, pre-incubation of spermatozoa with tubal fluid resulted in a statistically significant reduction in sperm DNA fragmentation levels, comparable to those observed in control. In conclusion, tubal fluid appears to protect against activated leucocyte-induced sperm DNA fragmentation, thus preserving the integrity of the paternal genome.

Consideraciones sobre la Ley 41/2002. Peculiaridades en pediatría / Considerations concerning Law 41/2002: particularities in pediatrics

Varias son las normas y leyes que tratan de establecer un reglamento básico que regule la relación entre el médico y el paciente y los derechos y deberes que ambos tienen durante dicho proceso. Por ello, muchos son los organismos que han realizado declaraciones o normas jurídicas relativas a este tema (UNESCO, OMS, Unión Europea, etc.). Todos estos preceptos se hallan resumidos en la Ley 41/2002, promulgada por las Cortes españolas. De la misma forma, dentro de nuestro país, varias comunidades autónomas han regulado mediante una ley estos aspectos, haciendo especial hincapié en la información clínica y el consentimiento informado (Cataluña, Galicia, Navarra, Castilla y León, etc.).Mención especial requiere la relación médico-paciente en los casos pediátricos, ya que ésta es diferente y, además, generalmente suelen intervenir en ella más individuos (padres o tutores en la mayoría de los casos). La Ley 41/2002 establece ciertas características especiales en la relación médico-paciente pediátrico y marca los límites legales en la relación entre el sanitario, el niño y sus familiares o tutores. Pero el debate actualmente va más allá, ya que entra en juego el concepto de «menor maduro», según el cual el límite para establecer la mayoría de edad en cuanto a decisiones sobre su propia persona queda más difuminado. De esta forma, se regula la posibilidad de que las decisiones sobre la salud del niño pueda tomarlas él mismo, o al menos sugerir lo que él considera mejor para sí mismo, en el momento en que el profesional sanitario lo considere «maduro» (AU)

There are several standards and laws that attempt to establish basic regulations to control the relationship between the doctor and the patient and the rights and obligations of each during the process. Therefore, many organizations (such as the United Nations Educational, Scientific and Cultural Organization [UNESCO], the World Health Organization [WHO], the European Union. etc) have issued statements or legal standards regarding this issue. All these precepts have been summarized in law 41/2002, promulgated by the Spanish Parliament. Likewise, a number of autonomous regions in our country (Catalonia, Galicia, Navarre, Castile-León, etc.) now regulate these aspects by law, with special emphasis on clinical information and informed consent. The doctor-patient relationship in pediatric cases is different, and other individuals are involved in it (mainly parents or legal tutors).Law 41/2002 establishes special characteristics for this doctor pediatric patient relationship and specifies the legal limits relative to the relationship among the health worker, the child and his or her family or tutors. However the debate nowadays goes beyond this. The new concept of the “mature minor” comes into play. In this concept, the limit for establishing the age of majority regarding decisions concerning his or her own self becomes blurrier. Thus, the decisions to be made over the health of the child are standardized: when the physician considers the patient “mature” enough, the child himself will be allowed to make decisions, or atleast suggest what he considers better for himself/herself (AU)

[Supracricoid partial laryngectomy: quality of life assessment]. / Laringectomía parcial supracricoidea. Análisis de calidad de vida.

OBJECTIVES: To assess quality of life in patients diagnosed with epidermoid carcinoma of the larynx, after supracricoid partial laryngectomy (SCPL). To examine how quality-of-life may be associated to the treatment received. PATIENTS AND METHOD: A descriptive, observational, cross-sectional study was conducted involving 32 patients out of a group of 57. They were all males with an average age of 63.3 years at the time of the interview. We used the disease-specific quality of life questionnaire devised by the University of Michigan: the Head and Neck Cancer-specific Quality of life instrument (HNQOL). RESULTS: During an average follow-up period of 86 months, 3 patients (5.26%) suffered a recurrence. Estimated survival after 3, 5 and 10 years was 94.73%. Communication and overall bother caused by treatment were found to be the two quality-of-life domains mainly affected. Patients who had received CHP, radiotherapy, those who had not had their tracheal cannula removed or had undergone neck dissection were the most affected. CONCLUSIONS: SCPL as a surgical technique allows good control of the condition and has a low impact on the patient's quality of life.

[Middle ear adenoma: our casuistry and revision of the literature]. / Adenoma de oído medio: nuestra casuística y revisión de la literatura.

Tumours of the middle ear are rare. Among them glomus tympanicum is the most frequent, followed by adenoma of the middle ear (AME). This insidious pathology entity displays unspecific clinical and audiological features. Advances in histology and immunohistochemistry have greatly contributed to an accurate diagnosis. We report our experience with two patients, a middle-aged man and a woman, diagnosed in our hospital. Both patients underwent surgical treatment and have shown no signs of recurrence after a 27- and 28-month follow-up. In both cases an accurate diagnosis was confirmed by histological and immunohistochemical analysis.

Adenoma de oído medio: nuestra casuística y revisión de la literatura / Middle ear adenoma: our casuistry and revision of the literature

Los tumores del oído medio son poco habituales, siendo el de mayor frecuencia el glomus timpánico seguido en mucha menor frecuencia por el adenoma de oído medio (AOM). Es una entidad que se presenta de forma insidiosa, con unos hallazgos clínicos y audiológicos muy inespecíficos, a cuyo diagnóstico de certeza han contribuido de forma importante los avances en histología e inmunohistoquímica. Presentamos dos casos diagnosticados recientemente en nuestro centro, en un hombre y una mujer ambos de mediana edad. Los dos pacientes fueron tratados mediante cirugía y permanecen sin signos de recidiva después de 27 y 28 meses de seguimiento. En ambos casos se llegó al diagnóstico definitivo mediante el análisis histológico e inmunohistoquímico

Tumours of the middle ear are rare. Among them glomus tympanicum is the most frequent, followed by adenoma of the middle ear (AME). This insidious pathology entity displays unspecific clinical and audiological features. Advances in histology and immunohistochemistry have greatly contributed to an accurate diagnosis. We report our experience with two patients, a middle-aged man and a woman, diagnosed in our hospital. Both patients underwent surgical treatment and have shown no signs of recurrence after a 27- and 28-month follow-up. In both cases an accurate diagnosis was confirmed by histological and immunohistochemical analysis

[Toxic shock syndrome associated with nasal packing]. / Shock tóxico estafilocócico asociado a cirugía nasal.

Staphiloccocal Toxic Shock Syndrome is a potentially fatal multisystem disease associated to nasal packing, catheter insertion, retention of foreign materials and uneffective sterile techniques. It is usually developed in the immediate postoperative period (first 48 hours) with hypotension, skin rash, fever, multisystemic failure and shock. We report a case in a 24-year-old man secondary to nasal surgery.

Shock tóxico estafilocócico asociado a cirugía nasal / Toxic shock syndrome associated with nasal packing

El síndrome del shock tóxico estafilocócico es unaenfermedad multisistémica potencialmente letal que ha sidoasociada con diversos procedimientos quirúrgicos en relacióncon taponamientos nasales, inserción de catéteres, retenciónde cuerpos extraños y rupturas de la asepsia quirúrgica.Se suele desarrollar en las primeras 48 horas tras laintervención y cursa con hipotensión, rash cutáneo, síndromefebril y en algunos casos shock y fallo multiorgánico.Presentamos el caso de un paciente varón de 24 años deedad que desarrolla el cuadro en el postoperatorio de unaseptoplastia

Staphiloccocal Toxic Shock Syndrome is a potentiallyfatal multisystem disease associated to nasal packing,catheter insertion, retention of foreign materials and uneffectivesterile techniques. It is usually developed in the immediatepostoperative period (first 48 hours) with hypotension,skin rash, fever, multisystemic failure and shock. Wereport a case in a 24-year-old man secondary to nasal surgery

[Fibrous displasia of the temporal bone. Presentation of one case]. / Displasia fibrosa del hueso temporal. Presentación de un caso.

We present one case of a 14 years old girl, diagnosed of fibrous displasia of the temporal bone, who developed a conductive hearing loss of progressive character. We analyse the clinic manifestations, radiologic and histopathologic study, and therapeutic indications of this disease.

Displasia fibrosa del hueso temporal. Presentación de un caso / Fibrous diaplasia of the temporal bone. Presentation of one case

Se presenta el caso de una niña de 14 años diagnosticada de displasia fibrosa del hueso temporal que cursa con hipoacusia conductiva de carácter progresivo.Se realiza un análisis de las manifestaciones clínicas, estudio radiológico e histopatológico, así como de las indicaciones terapéuticas de dicha enfermedad

We present one case of a 14 years old girl, diagnosed of fibrous displasia of the temporal bone, who developed a conductive hearing loss of progressive character. We analyse the clinic manifestations, radiologic and histopathologic study, and therapeutic indications ofthis disease

[Assessment of quality of life in patients treated by supracricoid partial laryngectomy with cricohyoidoepiglottopexy (CHEP)]. / Calidad de vida en pacientes tratados mediante laringectomía parcial supracricoidea con cricohioidoepiglotopexia (CHEP).

OBJECTIVES: To assess quality of life in patients diagnosed with epidermoid carcinoma of the larynx, after supracricoid partial laryngectomy (SCPL) with cricohyoidoepiglottopexy (CHEP). To examine how quality-of-life may be associated to the treatment received: neck dissection, decannulation and radiotherapy. PATIENTS AND METHOD: A descriptive, observational, cross-sectional study was conducted involving 26 patients out of a group of 51. They were all males with an average age of 61.7 years at the time of the interview. We used the disease-specific quality of life questionnaire devised by the University of Michigan: the Head and Neck Cancer-specific Quality of life instrument (HNQOL). RESULTS: During an average follow-up period of 83.65 months, 2 patients (3.92%) suffered a recurrence. Estimated survival after 3, 5 and 10 years was 95.83%. Communication and overall disturbances caused by treatment were found to be the two quality-of-life domains mainly affected. Generally speaking, patients who had received radiotherapy, those who had not had their tracheal cannula removed or those that had undergone neck dissection were the most affected. CONCLUSIONS: SCPL with CHEP as a surgical technique allows good control of the condition and has a low impact on the patient's quality of life.

Calidad de vida en pacientes tratados mediante laringectomía parcial supracricoidea con cricohioidoepiglotopexia (CHEP) / Assessment of quality of life in patients treated by supracricoid partial laryngectomy with cricohyoidoepiglottopexy (CHEP)

Objetivos: Cuantificar el grado de calidad de vida en los pacientes con carcinoma epidermoide laríngeo tratados mediante laringectomía parcial supracricoidea (LPSC) con cricohioidoepiglotopexia (CHEP) y detectar las posibles relaciones con algunos aspectos referentes al tratamiento como la realización de vaciamientos cervicales, la decanulación y la radioterapia. Pacientes y método: Estudio descriptivo observacional de tipo transversal llevado a cabo sobre 26 pacientes seleccionados de un grupo de 51; todos ellos varones y con una edad media en el momento de la entrevista de 61,7 años. Para cuantificar la calidad de vida se empleó un cuestionario específico de la Universidad de Michigan para tumores de cabeza y cuello, el Head and Neck Cancer-Specific Quality of Life (HNQOL). Resultados: En un período medio de seguimiento de 83,65 meses se produjeron 2 recidivas (3,92 por ciento). La supervivencia estimada a 3, 5 y 10 años fue de 95,83 por ciento. Los dominios de calidad de vida más afectados fueron la comunicación y las molestias globales ocasionadas por el tratamiento. En líneas generales los pacientes más afectados fueron los que recibieron radioterapia, los no decanulados y aquellos a los que se le hizo vaciamiento cervical. Conclusiones: La LPSC con CHEP es una técnica que aporta un excelente control de la enfermedad con escaso impacto en la calidad de vida del paciente (AU)

OBJECTIVES: To assess quality of life in patients diagnosed with epidermoid carcinoma of the larynx, after supracricoid partial laryngectomy (SCPL) with cricohyoidoepiglottopexy (CHEP). To examine how quality-of-life may be associated to the treatment received: neck dissection, decannulation and radiotherapy. PATIENTS AND METHOD: A descriptive, observational, cross-sectional study was conducted involving 26 patients out of a group of 51. They were all males with an average age of 61.7 years at the time of the interview. We used the disease-specific quality of life questionnaire devised by the University of Michigan: the Head and Neck Cancer-specific Quality of life instrument (HNQOL). RESULTS: During an average follow-up period of 83.65 months, 2 patients (3.92%) suffered a recurrence. Estimated survival after 3, 5 and 10 years was 95.83%. Communication and overall disturbances caused by treatment were found to be the two quality-of-life domains mainly affected. Generally speaking, patients who had received radiotherapy, those who had not had their tracheal cannula removed or those that had undergone neck dissection were the most affected. CONCLUSIONS: SCPL with CHEP as a surgical technique allows good control of the condition and has a low impact on the patient's quality of life (AU)

[Burkitt's nasopharyngeal lymphoma in pediatric age]. / Linfoma de Burkitt nasofaríngeo en edad pediátrica.

The Burkitt's lymphoma is a haematological neoplasia typical of early ages. In our country, the lymphatic nodes affectation is the most usual. We present a case report with a 12 year-old boy who consults for a asymptomatic cervical mass. The ultimate diagnosic was a nasopharyngeal Burkitt's lymphoma with neck extension.

[Cordectomy by laryngofissure. Review of the period 1978-1998]. / Cordectomía por laringofisura. Revisión del periodo 1978-1998.

OBJECTIVE: The early glottic carcinoma can be approached by different therapeutic options. We analyze the results obtained by means of cordectomy opened up by laryngofissure. MATERIAL AND METHOD: We design a descriptive retrospective study including 75 patients with glottic carcinoma T1N0M0 handled by means of cordectomy by laryngofissure (72 males and 3 females). The anaesthetic technique was locoregional and sedation. Tumor T1a, 62 patients (82.66%); T1b, 13 patients (17.33%). RESULTS: The specific survival rate at three, five and ten years was 100, 96.8 and 85.2% respectively; the global survival was 98.66, 90.47 and 52.17% respectively to three, five and ten years. There were ten recurrences (13.3%). Following treatment, 50% of the relapsed patients died. The probability of survival free of illness to three, five and ten years was considered in 0.9322, 0.9172 and 0.7093 respectively. CONCLUSIONS: This technique means good control of the illness and technical easiness. When doing it without a tracheostomy it is tolerated better and it generates lower costs per patient.