¿Los Quistes Periradiculares Dependen de la Infección Endodóntica?

RESUMEN: Los quistes periradiculares, tanto los de bolsillo como los verdaderos, son de origen inflamatorio; sin embargo, en la literatura ha existido una gran controversia asociada, en primer lugar, a la dependencia de la infección contenida dentro del sistema de conductos radiculares y, en segundo lugar, al tipo de tratamiento endodóntico llevado a cabo en este tipo de lesiones. Con el fin de dilucidar esta controversia se realizará una revisión a la literatura sobre quistes perira diculares donde se explicará cuál es la técnica más adecuada en el diagnóstico de quistes verdaderos y de bolsillo. Igualmente, se explicará la teoría de autosustentabilidad, así como el tratamiento endodóntico de grandes lesiones periradiculares asociadas a dichos quistes. Ahora bien, en la actualidad se ha demostrado que ambos quistes están asociados a infecciones contenidas en el sistema de conductos radiculares y son diferentes solamente en su morfología. Así mismo, se ha recomendado el tratamiento de conducto convencional en dientes con grandes lesiones asociadas a quistes.

ABSTRACT: Radicular cysts, either the pocket or the true cysts, are originated by an inflammation. However, in the literature, there has been great controversy surrounding, firstly, the dependence of the infection contained within the radicular conducts and, secondly, the kind of endodontic treatment performed in this sort of injury. In order to clarify this controversy, the literature concerning radicular cysts will be reviewed and it will be explained what technique is the most appropriate for diagnosing true cysts and pocket cysts. Likewise, the theory of self-sustaining, as well as the endodontic treatment for large radicular injuries associated to such cysts, will be further explained. Nonetheless, nowadays it has been demonstrated that both cysts are associated to infections contained within the system of radicular conducts and that they are only morphologically different. In addition, the root canal treatment has been recommended for teeth with great injuries associated to cysts.

BNCT research activities at the Granada group and the project NeMeSis: Neutrons for medicine and sciences, towards an accelerator-based facility for new BNCT therapies, medical isotope production and other scientific neutron applications.

The Granada group in BNCT research is currently performing studies on: nuclear and radiobiological data for BNCT, new boron compounds and a new design for a neutron source for BNCT and other applications, including the production of medical radioisotopes. All these activities are described in this report.

Exploring neutron capture therapy with 33S and 10B.

The 33S(n,α)30Si reaction was proposed as cooperative neutron capturer to 10B(n,α)7Li in Neutron Capture Therapy (NCT). At that moment, the available 33S(n,α)30Si cross-section data were scarce and discrepant in key energy ranges for its use in NCT. Since then, three experiments have been carried out at n_TOF facility at CERN and at Institut Laue-Langevin. These new data are used for the calculation of the dose rate on ICRU-4 tissue by using kerma factors, a simplified model of tissue and a 13.45 keV neutron beam, energy of the most important 33S(n,α)30Si resonance. A significant enhancement of the dose rate due to the presence of 33S is shown. In spite of the limitations, the cooperative action of 33S and 10B is an interesting possibility to be studied for accelerator-based neutron sources with non-moderated neutrons.

Synthetic Oligomers Mimicking Capsular Polysaccharide Diheteroglycan are Potential Vaccine Candidates against Encapsulated Enterococcal Infections.

Infections caused by Enterococcus spp. are a major concern in the clinical setting. In Enterococcus faecalis, the capsular polysaccharide diheteroglycan (DHG), composed of ß-d-galactofuranose-(1 → 3)-ß-d-glucopyranose repeats, has been described as an important virulence factor and as a potential vaccine candidate against encapsulated strains. Synthetic structures emulating immunogenic polysaccharides present many advantages over native polysaccharides for vaccine development. In this work, we described the synthesis of a library of DHG oligomers, differing in length and order of the monosaccharide constituents. Using suitably protected thioglycoside building blocks, oligosaccharides up to 8-mer in length built up from either Galf-Glcp or Glcp-Galf dimers were generated, and we evaluated their immunoreactivity with antibodies raised against DHG. After the screening, we selected two octasaccharides, having either a galactofuranose or glucopyranose terminus, which were conjugated to a carrier protein for the production of polyclonal antibodies. The resulting antibodies were specific toward the synthetic structures and mediated in vitro opsonophagocytic killing of different encapsulated E. feacalis strains. The evaluated oligosaccharides are the first synthetic structures described to elicit antibodies that target encapsulated E. faecalis strains and are, therefore, promising candidates for the development of a well-defined enterococcal glycoconjugate vaccine.

Conjugation of Different Immunogenic Enterococcal Vaccine Target Antigens Leads to Extended Strain Coverage.

Enterococci have emerged as important nosocomial pathogens due to their resistance to the most commonly used antibiotics. Alternative treatments or prevention options are aimed at polysaccharides and surface-related proteins that play important roles in pathogenesis. Previously, we have shown that 2 Enterococcus faecium proteins, the secreted antigen A and the peptidyl-prolyl cis-trans isomerase, as well as the Enterococcus faecalis polysaccharide diheteroglycan, are able to induce opsonic and cross-protective antibodies. Here, we evaluate the use of glycoconjugates consisting of these proteins and an enterococcal polysaccharide to develop a vaccine with broader strain coverage. Diheteroglycan was conjugated to these 2 enterococcal proteins. Rabbit sera raised against these glycoconjugates showed Immunoglobulin G titers against the corresponding conjugate, as well as against the respective protein and carbohydrate antigens. Effective opsonophagocytic killing for the 2 sera was observed against different E. faecalis and E. faecium strains. Enzyme-linked immunosorbent assays against whole bacterial cells showed immune recognition of 22 enterococcal strains by the sera. Moreover, the sera conferred protection against E. faecalis and E. faecium strains in a mouse infection model. Our results suggest that these glycoconjugates are promising candidates for vaccine formulations with a broader coverage against these nosocomial pathogens and that the evaluated proteins are potential carrier proteins.

Effects of an individualized home-based unsupervised aerobic training on body composition and physiological parameters in obese adults are independent of gender.

PURPOSE: Evaluation of the effects of an individualized home-based unsupervised aerobic training on body composition, physical and physiological parameters in female and male obese adults. METHODS: Two hundred and twenty obese adults (age 47.9 ± 12.4 years; BMI 38.0 ± 7.2 kg/m2) entered the 4-month training program. Body composition, physiological and functional capacities were assessed pre- and post-intervention. All subjects were requested to perform unsupervised aerobic training with the intensity based on heart rate, walking speed and OMNI-RPE score corresponding to the individual ventilatory threshold for at least 5 days/week. RESULTS: After 4-month study period, 40% of patients completed the protocol, 24% had high compliance (HC) (exercise ≥ 3 days/week), while 16% had low compliance (LC) to exercise prescription (exercise < than 3 days/week). In HC group, a significant improvement of body composition variables after training was performed. Moreover, oxygen uptake and metabolic equivalent at peak significantly increased after training. Six-minute walking test (6MWT) distance significantly increased while heart rate during 6MWT was significantly lower after training. No significant differences were found in LC group between pre- and post-intervention in all variables. Interestingly, gender does not influence the effects of training. CONCLUSIONS: Our results indicate that subjects, independent of gender, with high compliance to the aerobic training based on a new individualized method can achieve a significant reduction in weight loss and also an improvement in physical and physiological parameters. This innovative personalized prescription could be a valuable tool for exercise physiologist, endocrinologists, and nutritionists to approach and correct life style of obese subjects.

Effect of immunocastration with Bopriva on carcass characteristics and meat quality of feedlot Holstein bulls.

To evaluate the effect of immunocastration on carcass and meat characteristics, Holstein bulls aged between 7 and 8months with a live weight of 232±1.19kg were given two separate treatments, placebo (intact bulls) versus Bopriva, and then slaughtered after approximately 239days of fattening. While the testosterone levels in intact bulls remained at 0.42ng/ml throughout the study, by day 181, differences (P<0.05) were observed in immunized bulls, with values of 0.21ng/ml. The carcasses of animals treated with Bopriva recorded both a higher hot carcass weight (HCW) and a cold carcass weight (CCW), as well as higher dorsal fat density, marbling and KPH (P<0.05); however, no differences (P>0.05) were observed in the Longissimus lumborum area. No significant differences (P>0.05) were recorded between the treatments for pH, L*, a*, b* C* and H*. The carcasses of the animals treated with Bopriva were heavier, with higher dorsal fat density and marbling score.

Prevalence of Mental Health problems in sentenced men in prisons from Andalucía (Spain).

OBJECTIVES: To estimate the prevalence of different mental health problems in men serving prison sentences in Andalusia. METHODS: Descriptive, cross-sectional study of a random sample of 472 men interned in two prisons located in Andalusia. We collected socio-demographic and general criminal and penitentiary data, and we identified mental health problems with two validated instruments for epidemiological research in mental health: the SCID-I interview to diagnose Axis 1 disorders of the DSM-IV and the self-applied questionnaire IPDE to estimate personality disorders. We analyzed the data (proportions and confidence intervals) with the SPSS-18 statistical package. RESULTS: 82.6% of the sample had a history of having suffered some type of mental health problem throughout their life (prevalence-life) and 25.8 have suffered from them in the past month (month prevalence). The most common disorders of the Axis I (DSM-IV) are related to abuse of and dependence on psychoactive substances (prevalence life of 65.9% and month prevalence of 6.6%), with an important but less frequent presence of affective (31.4%-9.3%), anxiety (30.9%-10, 4%) and psychotic disorders (9.5%-3, 4%). As regards personality disorders, the estimated probable prevalence lies between the 56.6% ("5" cutoff point) and the 79.9 ("4" cut-off point). CONCLUSIONS: The male inmate population in prisons in Andalucía shows a high prevalence of mental health problems, similar to that found in other Spanish and international prisons, but their care needs should take into account the different pathologies that they present.

Evaluation of the efficacy of Grofactor, a beta-adrenergic agonist based on zilpaterol hydrochloride, using feedlot finishing bulls.

Beta-adrenergic agonists (ß-AA) have been shown to positively impact finishing performance and some carcass traits of feedlot cattle. Our objective was to evaluate the efficacy of a ß-AA on the basis of zilpaterol hydrochloride (Grofactor, Laboratorios Virbac México, Guadalajara, Mexico) on growth and DMI, carcass characteristics, and meat quality of finishing bulls. Forty-five bulls (75% 25% ) initially weighing 448.7 ± 2.58 kg were blocked by BW and randomly assigned to 1 of 3 diets, using pens of 3 animals, in a randomized complete block design: 1) daily feeding without ß-AA in the basal diet (Control), 2) daily feeding with 0.15 mg/kg BW of Grofactor added to the basal diet (ZHG), or 3) daily feeding with 0.15 mg/kg BW of Zilmax (MSD Salud Animal México, Mexico City, Mexico) added to the basal diet (ZHZ). The duration of the feeding period was 30 d with a subsequent 4-d withdrawal period. Compared with Control bulls, the group fed ZHG had a 12% better ( < 0.025) G:F ratio, and their final BW ( 0.094) and ADG ( 0.084) tended to be enhanced. Feedlot performance of ZHG and ZHZ bulls was similar, although the DMI was ∼4% lower ( 0.05) in ZHG bulls vs. the ZHZ and Control groups. The HCW ( 0.001) and dressing percentage ( 0.015) were higher by 20 kg and 3%, respectively, in ZHG bulls vs. Control bulls. The KPH fat was lower ( 0.007) in bulls fed ZHG than in nonsupplemented bulls, but other carcass characteristics were not different in the ZHG and ZHZ bulls, and noncarcass components were not affected by ZHG or ZHZ supplementation. At 48 h postmortem, ZHG bulls had lower ( 0.007) water holding capacity and trended toward ( 0.06) increased chroma and reduced pH ( 0.09) compared to Control bulls. However, compared to ZHZ bulls, ZHG bulls had higher ( 0.02) chroma and a trend ( 0.08) toward increased hue angle. At 14 d postmortem, meat quality variables did not differ between the 3 groups of bulls. Supplementation of ZH Grofactor improved feedlot performance and some carcass characteristics of finishing bulls without affecting meat quality. The effects of Grofactor on feedlot performance, carcass traits, and meat quality were similar to those of Zilmax.

Using a Tandem Pelletron accelerator to produce a thermal neutron beam for detector testing purposes.

Active thermal neutron detectors are used in a wide range of measuring devices in medicine, industry and research. For many applications, the long-term stability of these devices is crucial, so that very well controlled neutron fields are needed to perform calibrations and repeatability tests. A way to achieve such reference neutron fields, relying on a 3 MV Tandem Pelletron accelerator available at the CNA (Seville, Spain), is reported here. This paper shows thermal neutron field production and reproducibility characteristics over few days.

Apical extrusion of bacteria when using reciprocating single-file and rotary multifile instrumentation systems.

AIM: To evaluate ex vivo, apical bacterial extrusion associated with two reciprocating single-file systems (WaveOne and Reciproc) compared with a conventional multifile rotary system (BioRace). METHODOLOGY: Forty-five human single-rooted mandibular incisors were used. Endodontic access cavities were prepared, and root canals were contaminated with an Enterococcus faecalis suspension. Following incubation at 37 °C for thirty days, the contaminated teeth were divided into three groups of 15 specimens each (G1 - Reciproc, G2 - WaveOne and G3 - BioRace). Positive and negative controls consisted of 5 infected teeth and 3 uninfected incisors that were instrumented with one of the tested NiTi systems, respectively. Bacteria extruded from the apical foramen during instrumentation were collected into vials containing 0.9% NaCl. The microbiological samples were taken from the vials and incubated in brain heart agar medium for 24 h. The resulting bacterial titre, in colony-forming units (CFU) per mL, was determined, and these data were analysed by Wilcoxon matched-pairs signed rank test and Kruskal-Wallis H-test. The level of significance was set at α = 0.05. RESULTS: No significant difference was found in the number of CFU between the two reciprocating systems (P = 0.41). The conventional multifile rotary system group was associated with significantly higher CFU than both of the two reciprocating groups (P = 0.01). CONCLUSIONS: All instrumentation systems extruded bacteria beyond the foramen. However, both reciprocating single-file systems extruded fewer bacteria apically than the conventional multifile rotary system.

Advanced BMP gene therapies for temporal and spatial control of bone regeneration.

Spatial and temporal patterns of bone morphogenetic protein (BMP) signaling are crucial to the assembly of appropriately positioned and shaped bones of the face and head. This review advances the hypothesis that reconstitution of such patterns with cutting-edge gene therapies will transform the clinical management of craniofacial bone defects attributed to trauma, disease, or surgical resection. Gradients in BMP signaling within developing limbs and orofacial primordia regulate proliferation and differentiation of mesenchymal progenitors. Similarly, vascular and mesenchymal cells express BMPs in various places and at various times during normal fracture healing. In non-healing fractures of long bones, BMP signaling is severely attenuated. Devices that release recombinant BMPs promote healing of bone in spinal fusions and, in some cases, of open fractures, but cannot control the timing and localization of BMP release. Gene therapies with regulated expression systems may provide substantial improvements in efficacy and safety compared with protein-based therapies. Synthetic gene switches, activated by pharmacologics or light or hyperthermic stimuli, provide several avenues for the non-invasive regulation of the expression of BMP transgenes in both time and space. Through new gene therapy platforms such as these, active control over BMP signaling can be achieved to accelerate bone regeneration.

Comparison of the reliability and validity of four contemporary risk stratification schemes to predict thromboembolism in non-anticoagulated patients with atrial fibrillation.

BACKGROUND: The risk of thromboembolic (TE) complications in atrial fibrillation (AF) patients is not homogeneous. Risk schemes can help target anticoagulant therapy for patients at highest risk of TE complications. OBJECTIVES: To test the predictive ability of 4 risk schemes: The Framingham, the 8th ACCP, the ACC/AHA/ESC 2006, and the CHA2DS2-VASc. METHODS: 186 patients with non-valvular AF and off anticoagulant therapy were included. All subjects who experienced a stroke, transient ischemic attack, or peripheral embolism were identified. Each schema was divided into low, intermediate, and high-risk categories. Discrimination was assessed via the c-statistic. RESULTS: We identified 10 TE events that occurred during 668 person-years off anticoagulation therapy. All risk schemes had fair discriminating ability (c-statistic ranged from 0.59 [for CHA2DS2-VASc] to 0.73 [for Framingham]). The proportion of patients assigned to individual risk categories varied widely across schemes. CHA2DS2-VASc categorized the fewest patients into low and intermediate-risk categories, whereas the Framingham schema assigned the highest patients into low-risk strata. There were no TE events in the low and intermediate-risk categories using CHA2DS2-VASc, whereas the most schemes assigned patients into intermediate-risk category had a event rate ranging from 2.5 (ACC/AHA/ESC and 8th ACCP schemes) to 6% (Framingham). The negative predictive value of TE events was of 100% for the no high-risk patients using CHA2DS2-VASc. CONCLUSIONS: Compared to ACC/AHA/ESC, 8th ACCP, and Framingham, CHA2DS2-VASc risk stratification schema may be better in discriminating between patients at a low and intermediate risk of TE complications.

Effects of two transport systems on lamb welfare and meat quality.

The aim of this study was to analyse the effect of a direct transport system (DTS) versus transport with a logistic stopover system (TLS) on lamb welfare and meat quality at two seasons. A total of 96 lambs were sampled in a 2×2×2 factorial design, testing two transport systems and two seasons (summer and winter), with two replicates in each season. Significant interactions (P≤0.05) between transport system and season in both welfare and meat quality were found. In general, lambs subjected to direct transport and logistic stopover during winter had a more intense stress response and poorer meat quality than lambs transported during summer. However, direct transport during the cold season seemed to be the most stressful, compared to the rest of the groups, which was reflected in significantly higher levels of cortisol, lactate, glucose, ratio of N/L, higher pH24 and darker and tougher meat.

Prevalencia de la hipertensión arterial en poblaciones rurales del norte argentino / Prevalence of arterial hypertension in rural areas of the north of Argentina

Como parte de un proyecto de atención médica primaria llevado a cabo en localidades rurales de la provincia del Chaco (Argentina), se realizó un estudio epidemiológico sobre la HTA (hipertensión arterial). La población analizada incluyó a 473 adultos. Según la clasificación del JNC-VII la prevalencia de HTA fue del 32,3%, prehipertensión arterial del 34,7%, y presión arterial normal del 33%. El sexo no era significativamente distinto en la población general, nientre los subgrupos de hipertensos y no hipertensos. La diabetes fue significativamente mayor entre los hipertensos, y los fumadores eran estadísticamente menos frecuentes en el grupo de HTA. En un subgrupo de paciente con diagnóstico de HTA, el 2,5% tenía criterios de hipertrofiaventricular izquierda en el electrocardiograma; el 14% retinopatía leve, y el 5% moderada en el examen del fondo de ojo (AU)

An epidemiological study on hypertension was carried out as part of a primary medical care program conducted in the rural areas of the Chaco state (Argentina). The population studied included 473 adults. According to the JNC-VII classification criteria, prevalence of hypertension was 32.3%, prehypertension 34.7%, and normal blood pressure 33%. Gender was not statistically different in the general population or between the subgroups of subjects with hypertension or normal blood pressure. Diabetes was significantly greater among the hypertensive group and smokers were statistically less frequent in the arterial hypertensive group. In the subgroup of patients with a diagnosis of hypertension, 2.5% had criteria for left ventricular hypertrophy (LVH) on the electrocardiogram whereas the eye fundus examination showed that14% had mild retinopathy and 5% had moderate retinopathy (AU)

Predicting mortality in hospitalized patients with 2009 H1N1 influenza pneumonia.

BACKGROUND: Community-acquired pneumonia (CAP) severity scores can identify patients at low risk for mortality who may be suitable for ambulatory care. Here, we follow the clinical course of hospitalized patients with CAP due to 2009 H1N1 influenza. OBJECTIVE: To evaluate the role of CAP severity scores as predictors of mortality. METHODS: This was a secondary data analysis of patients hospitalized with CAP due to 2009 H1N1 influenza confirmed by reverse transcriptase polymerase chain reaction enrolled in the CAPO (Community-Acquired Pneumonia Organization) international cohort study. CAP severity scores PSI (Pneumonia Severity Index), CURB-65 (confusion, urea, respiratory rate, blood pressure, age ≥ 65 years) and CRB-65 (confusion, respiratory rate, blood pressure, age ≥ 65 years) were calculated. Actual and predicted mortality rates were compared. A total of 37 predictor variables were evaluated to define those associated with mortality. RESULTS: Data from 250 patients with CAP due to 2009 H1N1 influenza were analyzed. Patients with low predicted mortality rates (0-1.5%) had actual mortality rates ranging from 2.6% to 17.5%. Obesity and wheezing were the only novel variables associated with mortality. CONCLUSIONS: The decision to hospitalize a patient with CAP due to 2009 H1N1 influenza should not be based on current CAP severity scores, as they underestimate mortality rates in a significant number of patients. Patients with obesity or wheezing should be considered at an increased risk for mortality.

Magnetic mesoporous silica spheres for hyperthermia therapy.

Magnetic nanoparticles coated with materials having unique properties, such as ordered pore structures and large surface areas, hold great potential for multimodal therapies. This study reports on the biocompatibility of composites of maghemite nanoparticles embedded in an ordered mesoporous silica-matrix to form magnetic microspheres (MMS), and on their ability to conduct magnetic hyperthermia upon exposure to a low-frequency alternating magnetic field (AMF). MMS particles were efficiently internalized by human A549, Saos-2 and HepG2 cells, and were excluded from the nuclear compartment. MMS treatment did not interfere with morphological features or metabolic activities of the cells, indicating good biocompatibility of the material. MMS did not affect the endogenous heat-shock response of a HeLa-derived cell line that precisely reports the intensity of thermal stresses through changes in the activities of a stably integrated hsp70B promoter and a constitutive viral promoter. Maximum temperature in MMS suspensions increased to a range above 42°C as a function of the amounts of particles exposed to AMF. Cell culture experiments showed that, by adjusting the amount of MMS and the time of exposure to AMF, heat treatments of mild to very high intensities could be achieved. Cell viability dropped as a function of the intensity of the heat treatment achieved by MMS and AMF exposures. The possibility of fine-tuning the heating power output, together with efficient uptake by tumor cells in vitro, makes MMS a promising agent by which to provide hyperthermia treatments aimed toward remission of solid tumors.