Influence of risedronate on orthodontic tooth movement in rodents: a systematic review and case report.

INTRODUCTION: Bisphosphonates have an inhibitory impact on osteoclastic activity, reducing bone resorption. However, the influence of risedronate on tooth movement is not well-defined. OBJECTIVE: This systematic review assessed the effect of risedronate intake on orthodontic tooth movement. A case report was also provided. METHODS: Two independent reviewers searched six databases (PubMed, Web of Science, Ovid, Lilacs, Scopus, and Open Grey). The searches were carried out in April/2020, and an update was set in place in June/2023. Therefore, the searches considered a timeline from the databases' inception date until June/2023, with no publication date and/or language restrictions. The clinical question focused on evaluating the orthodontic tooth movement and relapse movement (Outcome) in animals (Population) exposed to risedronate (Exposure), compared to control groups (Comparison). The Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) guidelines were applied, and the protocol was registered in PROSPERO (CRD42020168581). The risk of bias was determined using the Systematic Review Centre for Laboratory Animal Experimentation protocol (SYRCLE). RESULTS: Two studies in rats and one in guinea pigs were included in the systematic review. The studies reported a decrease in orthodontic tooth movement, a reduction in the relapse movement, and a reduced number of positive tartrate-resistant acid phosphatase (TRAP) cells, with a significantly reduced number of bone gaps after the administration of risedronate in rats. A case report illustrated the effects of risedronate administration in one patient. CONCLUSION: Based on the systematic review, risedronate seems to impair orthodontic tooth movement and relapse due to a decrease in bone resorption cells.

Results of the in situ fenestration technique for preservation of the Left subclavian artery in the endovascular repair of acute aortic syndromes in a reference center.

INTRODUCTION: The in situ fenestration (ISF) technique consists of maintaining the patency of the aortic branch after the endoprosthesis is already in place as a viable, effective, and fast-performing alternative to revascularize the aortic arch arteries. OBJECTIVE: To report the experience with a series of cases of endovascular treatment of Acute Aortic Syndromes involving the aortic arch, using the ISF technique in a specialized center. METHODS: We analyzed data collected from patients treated with ISF during TEVAR for Acute Aortic Syndromes involving the aortic arch from June 2020 to January 2022, assessing perioperative outcomes, including immediate and late success rates, complications, morbidity and mortality, and short and medium term aortic branch patency. RESULTS: Of the 11 patients eligible for the ISF procedure, 9 were successful, with a technical success rate of 81%. No patient had a type 1A endoleak related to fenestration. There was complete thrombosis of the false lumen in the thoracic aorta in 77% cases. No death was related to the fenestration technique. CONCLUSION: ISF as feasible and with a high rate of technical success and good results in the short and medium term. Prospective studies with long-term clinical follow-up are still needed to fully assess the durability of these unreinforced fenestrations.

Influence of risedronate on orthodontic tooth movement in rodents: a systematic review and case report

ABSTRACT Introduction: Bisphosphonates have an inhibitory impact on osteoclastic activity, reducing bone resorption. However, the influence of risedronate on tooth movement is not well-defined. Objective: This systematic review assessed the effect of risedronate intake on orthodontic tooth movement. A case report was also provided. Methods: Two independent reviewers searched six databases (PubMed, Web of Science, Ovid, Lilacs, Scopus, and Open Grey). The searches were carried out in April/2020, and an update was set in place in June/2023. Therefore, the searches considered a timeline from the databases' inception date until June/2023, with no publication date and/or language restrictions. The clinical question focused on evaluating the orthodontic tooth movement and relapse movement (Outcome) in animals (Population) exposed to risedronate (Exposure), compared to control groups (Comparison). The Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) guidelines were applied, and the protocol was registered in PROSPERO (CRD42020168581). The risk of bias was determined using the Systematic Review Centre for Laboratory Animal Experimentation protocol (SYRCLE). Results: Two studies in rats and one in guinea pigs were included in the systematic review. The studies reported a decrease in orthodontic tooth movement, a reduction in the relapse movement, and a reduced number of positive tartrate-resistant acid phosphatase (TRAP) cells, with a significantly reduced number of bone gaps after the administration of risedronate in rats. A case report illustrated the effects of risedronate administration in one patient. Conclusion: Based on the systematic review, risedronate seems to impair orthodontic tooth movement and relapse due to a decrease in bone resorption cells.

RESUMO Introdução: Os bifosfonatos têm um impacto inibitório na atividade osteoclástica, reduzindo a reabsorção óssea. No entanto, a influência do risedronato no movimento dentário não está bem definida. Objetivo: Esta revisão sistemática avaliou o efeito do uso de risedronato no movimento ortodôntico dos dentes. Um relato de caso também é apresentado. Métodos: Dois revisores independentes pesquisaram seis bases de dados (PubMed, Web of Science, Ovid, Lilacs, Scopus e Open Grey), considerando o período de abril de 2020 até junho de 2023, sem restrições de data e/ou idioma de publicação. A questão clínica focou em avaliar o movimento ortodôntico dos dentes e movimento de recidiva (resultado) em animais (população) expostos ao risedronato (exposição) em comparação com grupos de controle (comparação). Foram aplicadas as Diretrizes Preferenciais para Revisão Sistemática e Metanálise (PRISMA) e um protocolo foi registrado no PROSPERO (CRD42020168581). O risco de viés foi determinado utilizando o protocolo do Centro de Revisão Sistemática para Experimentação em Animais de Laboratório (SYRCLE). Resultados: Dois estudos em ratos e um em porquinhos-da-índia foram incluídos na revisão sistemática. Os estudos relataram uma diminuição no movimento ortodôntico dos dentes, uma redução no movimento de recidiva e um número reduzido de células positivas à fosfatase ácida tartarato-resistente (TRAP) com um número significativamente reduzido de falhas ósseas após a administração de risedronato em ratos. Um relato de caso ilustrou os efeitos da administração de risedronato em uma paciente. Conclusão: Com base na revisão sistemática, o risedronato parece interferir no movimento ortodôntico dos dentes e na recidiva devido a uma diminuição nas células de reabsorção óssea.

Interplay between epithelial and mesenchymal cells unveils essential proinflammatory and pro-resolutive mediators modulated by photobiomodulation therapy at 660 nm.

Photobiomodulation therapy (PBMT) has been widely used to promote tissue repair. However, PBMT's critical roles in the epithelial and mesenchymal tissues interactions are still barely known. Herein, we investigated light parameters on challenged keratinocytes (KC)-i.e., cultivated under oxidative stress-solely or associated with fibroblasts (FB) in a co-culture system. Cells were treated with PBMT at the wavelength of 660 nm, at 20 mW and 0.71 W/cm2 . Three different energy densities were primarily evaluated on KC: 1 (1.4 s), 5 (7 s), and 50 J/cm2 (70 s). Next, KC and FB were co-cultured and assessed at 5 J/cm2 . This energy density was also tested in ex vivo murine skin samples. Our main data suggest that PBMT can increase cellular proliferation at low doses and cell migration in a biphasic mode (1 and 50 J/cm2 ), both further confirmed by the epidermal growth factor receptor ligand-amphiregulin-upregulation. IL-1RA mRNA-the IL-1ß (interleukin-1ß) receptor antagonist recognized to fasten wound repair-was upregulated in the co-culture system. Upon PBMT, the ex vivo findings showed a progressive increase in the epidermal thickness, although presenting qualitatively less differentiated epithelium than the control group. In conclusion, PBMT effects are dependent on the cellular interactions with the surrounding microenvironment. Ultimately, PBMT is anti-inflammatory and contributes to the expression of critical mediators of wound repair.

Simultaneous occurrence of Epstein-Barr virus (EBV) in periodontal pockets and in oral squamous cell carcinoma: a cross-sectional study.

OBJECTIVES: This study aimed to investigate the detection of Epstein-Barr virus (EBV) in oral squamous cell carcinoma (OSCC) and to verify the concordance of EBV-DNA frequency in subgingival sites and in the OSCC. METHODS: A cross-sectional study with 30 OSCC patients, aged from 44 to 88 years old, was conducted. Samples were collected in subgingival sites and at the OSCC, then submitted to DNA isolation, qPCR, and genotyping. Descriptive statistic was performed to report the frequency of EBV-DNA in all samples, and McNemar test was applied to verify the concordance among the EBV-DNA frequency in both sites. RESULTS: The individuals presented 62 years old in average, and the majority were male (66.6%). EBV-DNA was detected in 56.7% OSCC lesions. Among the subgroup of 19 dentate individuals, high concordance (73.7%) in both EBV-DNA detection and the absence in subgingival sites and OSCC was observed, and it was statistically significant (p < 0.05). CONCLUSIONS: We report the notable occurrence of EBV-DNA in OSCC; also, the presence of EBV in periodontal sites may contribute to find it in OSCC, although the possible contribution of EBV in the OSCC remains to be investigated. CLINICAL RELEVANCE: The identification of this easily accessible site of EBV latent infection may help to improve the patient's quality of life by maintenance of oral/periodontal health condition and preventing further possible disorders related to the virus, and also encourages new approaches for investigating EBV, periodontitis, and OSCC.

Management of Mucocele of the Glands of Blandin-Nuhn With a High-Intensity Laser: A Case Report.

Introduction: The glands of Blandin-Nuhn are mucous and serous salivary glands situated on both sides of the midline of the ventral surface of the tongue. In this area, a mucocele generally results from trauma. The diagnosis of mucoceles is based on clinical and histopathological examinations and the recommended treatment is surgical excision. Case Report: This report describes a case of mucocele of the glands of Blandin-Nuhn (MGBN) affecting a 20-year-old male. Oval-shaped swelling with a smooth and bright surface of soft consistency was observed on the ventral surface of the individual's tongue. The diagnostic hypothesis was mucocele. Surgical excision was performed in a single session with a diode laser. A histopathological examination revealed mucus extravasating into connective tissue, with foamy macrophages and granulation tissue. Conclusion: The high-intensity laser was a safe and effective tool for treating MGBN. No need for a suture, minimal or no intraoperative bleeding, and a minimal report of pain and edema by the patient were observed. A diode laser may be a helpful tool because it is less invasive and it is safe and effective.

A retrospective analysis of oral and maxillofacial lesions in children and adolescents reported in two different services.

BACKGROUND: Most epidemiological studies involving oral and maxillofacial lesions assess only data from histopathological analysis. This may lead to a poor notification of diseases whose diagnosis is predominantly clinical. Aim: To evaluate and to compare the frequency of oral and maxillofacial lesions in children and adolescents in two different types of services: Oral Medicine clinic service and laboratory service. MATERIAL AND METHODS: The records of patients ≤ 19 years attending the Oral Medicine clinic service and records from the laboratory service in Oral and Maxillofacial Pathology of the Dental School of a university were analyzed. RESULTS: 828 records from the Oral Medicine clinic service and 2,409 records from the laboratory service were analyzed. The most common lesion group in both services was inflammatory/reactive lesions; however, infectious lesions and variations of normality were more frequently in the clinical service. Mucocele was the most common lesion in both services. The lips (28.9%) were the most affected region in the clinical service, while in the laboratory service, the bones (34.7%) were the most affected region. CONCLUSIONS: Some differences may occur with respect to the frequency of oral and maxillofacial lesions among pediatric individuals when data from different sources are compared. Key words:Epidemiology, oral and maxillofacial pathology, oral medicine, oral and maxillofacial lesions, children, adolescents.

Basal Cell Nevus Syndrome with Unusual Associated Findings: A Case Report with 17 Years of Follow-Up.

BACKGROUND Nevoid basal cell carcinoma syndrome (NBCCS), also known as Gorlin-Goltz syndrome (GGS), is an inherited autosomal dominant disorder caused by mutations in the patched (PTCH) tumor-suppressor gene, which has high penetrance and variable phenotypic expressivity. In 1960, Gorlin and Goltz defined the condition by 3 main characteristics: multiple basal cell carcinomas, odontogenic keratocyst (OKC), and skeletal anomalies. Nowadays, many neurologic, ophthalmic, endocrine, and genital manifestations are known to be associated with this syndrome. Considering the complexity of the clinical manifestations, a multidisciplinary approach is necessary for the diagnosis and follow-up of patients with NBCCS. CASE REPORT We report the case of a 27-year-old woman who presented with multiple maxillary and mandibular OKCs, as well as mandibular dentigerous cysts, all detected by X-ray. The medical records of the patient reported other findings such as falx cerebri calcification, osteolysis in femoral bones, and focal bone alteration suggestive of simple bone cysts. Based on the presented manifestations, it was concluded that the patient had characteristics of NBCCS. A multidisciplinary approach was necessary, and odontological intervention was used in managing treatment of the jaw cysts. CONCLUSIONS In view of this combination of findings, it is of primary importance for dental surgeons and physicians to be able to recognize the signs and symptoms of NBCCS in order to achieve an early diagnosis and avoid the progression of oral cysts, the metastasis of skin lesions, and progression of other less frequent manifestations.

Investigação de pericitos e fotobiomodulação no reparo tecidual em modelo murino diabético / Investigation of pericytes under effect of photobiomodulation in tissue repair in a diabetic murine mice

Em indivíduos com diabetes mellitus (DM) o reparo tecidual cutâneo atrasado representa um desafio para o sistema de saúde. Evidências recentes mostram o potencial da fotobiomodulação (PBM, do inglês, photobiomodulation) em induzir a diferenciação de células-tronco em múltiplos tecidos. Os pericitos são células-tronco perivasculares com ampla plasticidade, podendo ser considerados alvos potenciais para a PBM durante o reparo tecidual. Assim, o objetivo deste estudo foi investigar o efeito da PBM na modulação de células indiferenciadas em feridas de camundongos em condição sistêmica análoga ao DM tipo-II. Trata-se de um estudo in vivo (CEUA#62/2019) utilizando camundongos transgênicos diabéticos induzidos artificialmente e com marcação endógena para pericitos (NG2+/DsRed+; Nestina+/GFP+ & NG2+/DsRed+) e células mesenquimais indiferenciadas (Nestina+/GFP+). Foram realizadas bilateralmente feridas no dorso dos camundongos, e as mesmas foram submetidas ou não a PBM e avaliadas nos tempos experimentais 1, 3 e 7 dias. O reparo tecidual foi acompanhado por morfometria, avaliação de fluxo sanguíneo, análises histológicas nos tempos 1, 3 e 7 dias, além de identificação dos pericitos por microscopia confocal ao final de 3 e 7 dias. Os dados obtidos foram submetidos à análise estatística. As análises morfométricas e histológicas mostraram maior efeito de reparo nas feridas submetidas a PBM, onde a média de área remanescente após 1 de PBM foi 73% da medida de área total inicial no grupo PBM e 86,21% no controle (p=0,0257); aos 3 dias, foram 66,98% e 87,49% respectivamente (p=0,026) e aos 7 dias, 25,54% no grupo PBM e 39,43% no controle (p<0,05). A perfusão sanguínea foi maior nas áreas das feridas quando comparadas a pele íntegra, no entanto, não foram observadas diferenças entre as feridas submetidas ou não a PBM. Por outro lado, foram observadas nestas (PBM), maiores quantidades de células mesenquimais indiferenciadas (Nestina+/GFP+) e de pericitos tipo-I (NG2+/DsRed+) após 7 dias. A utilização de PBM em processos de reparo tecidual em modelo diabético de feridas demostraram resultados significativos tanto clínicos com a nível celular, envolvendo em grande parte as células mesenquimais (nestina+/GFP+) e pericitos (NG2+/DsRed+). Conhecer os mecanismos celulares de ação da PBM em feridas de modelo diabético permite controlar esse processo, além de explorar essa técnica e abrir caminhos para investigação de outras ferramentas e protocolos úteis para o tratamento de feridas nestes indivíduos afetados.

In individuals with diabetes mellitus (DM) delayed cutaneous tissue repair represents a challenge for the health system. Recent evidence shows the potential of photobiomodulation (PBM) to induce stem cell differentiation in multiple tissues. Pericytes, in turn, are perivascular stem cells with wide plasticity and can be considered potential targets for PBM during tissue repair. The objective of this study was to investigate the role of PBM in stem cell modulation in wounds of mice under systemic condition analogous to type-II DM. This is an in vivo study (Ethical protocol: CEUA#62/2019) using artificially induced transgenic diabetic mice with endogenous labeling for pericytes (NG2+/DsRed+; Nestin+/GFP+ & NG2+/DsRed+) and undifferentiated mesenchymal cells (Nestin+/GFP+). Wounds on the mice's back were bilaterally performed, and then submitted or not to laser therapy and evaluated at experimental times 1, 3 and 7 days. Tissue repair was followed by periodic measurements of wound diameter, blood flow assessment, histological analysis and screening of pericytes by confocal microscopy at the end of each experimental time. The data obtained were submitted to statistical analysis. The histologic and morphometric analysis showed a greater repair effect in wounds submitted to PBM, where the average area remaining after 1 day of laser application was 73% of the initial total area measurement in the PBM group, and 86.21% in the control (p= 0.0257); at 3 days, they were 66.98% and 87.49% respectively (p= 0. 026), and at 7 days, 25.54% in the PBM group and 39.43% in the control (p<0.05). Blood perfusion was greater in wound areas when compared to intact skin, however, no statistical differences were observed between wounds submitted or not to PBM. On the other hand, larger amounts of undifferentiated mesenchymal cells (Nestin+/GFP+) and type-I pericytes (NG2+/DsRed+) were observed in these wounds after 7 days. The use of PBM in tissue repair processes in a diabetic wound healing model showed significant clinical and cellular results, involving mostly mesenchymal cells (nestin+/GFP+) and pericytes (NG2+/DsRed+). Knowing the cellular mechanisms of action of PBM in wounds of diabetic, allows better management of the therapy, also it opens paths for the investigation of other tools and protocols useful for the treatment of wounds in DM individuals.

Photobiomodulation drives pericyte mobilization towards skin regeneration.

Photobiomodulation is being widely applied for improving dermal or mucosal wound healing. However, the underlying cellular and molecular processes that directly contribute to its effects remain poorly understood. Pericytes are relevant cells involved in the wound microenvironment and could be one of the main targets of photobiomodulation due to their plasticity and perivascular localization. Herein, we investigate tissue repair under the photobiomodulation stimulus using a pericyte labeled (or reporter) transgenic mice. Using a model of two contralateral back wounds, one the control and the other photoactivated daily (660 nm, 20 mW, 0.71 W/cm2, 5 J/cm2, 7 s, 0.14 J), we showed an overall influx of immune and undifferentiated cells and higher mobilization of a potent pericyte subpopulation (Type-2 pericytes) in the photoactivated wounds in comparison to the controls. Doppler analysis showed a significant increase in the blood flow in the photoactivated wounds, while marked vascular supply was observed histologically. Histochemical analysis has indicated more advanced stages of tissue repair after photoactivation. These data suggest that photobiomodulation significantly accelerates tissue repair through its vascular effects with direct recruitment of pericytes to the injury site.

Orofacial outcomes in adolescents with perinatally infected HIV in antiretroviral therapy.

OBJECTIVE: To assess the frequency of orofacial outcomes in adolescents with perinatally infected HIV in treatment with antiretroviral therapy (ART). DESIGN: A Brazilian institution-based retrospective study analyzing medical charts and medication dispensing data. METHODS: Medical records of 137 adolescents were reviewed. HIV viral load, CD4 T-cell count (CD4), ART regimen, nonadherence events, and prolonged ART discontinuation were recorded. The frequency of each outcome was determined. Associations between the most frequent outcomes and both records of undetectable viral load and CD4 at least 500 cells/µl were carried out. Associations of lymphadenitis, Group 1 orofacial manifestations and Group 2 orofacial manifestations with records of Center for Disease Control and Prevention (CDC) category C illness were also performed. Odds ratio (OR), confidence intervals (CI) and P values were provided. RESULTS: Cervical and submandibular lymphadenitis (45.25%), dental caries (32.84%) and periodontal issues (11.67%) were the most frequent orofacial outcomes. A detectable viral load (OR = 2.61, 95% CI 1.16--5.88) and CD4 less than 500 cells/µl (OR = 2.34, 95% CI 1.13--4.82) were associated with a greater risk of lymphadenitis. Orofacial outcomes associated with HIV were found in adolescents with longer ART discontinuation and a greater number of ART discontinuation events (P < 0.05). No association was found between records of CDC category C illness and group 1 orofacial manifestations, group 2 manifestations or lymphadenitis (P > 0.05). CONCLUSION: Orofacial outcomes, in particular, cervical and submandibular lymphadenitis were common among the adolescents assessed. Long-term ART and long-term exposure to HIV virus may have altered the orofacial outcome profile in adolescents perinatally infected by HIV.

Epstein-Barr virus (EBV) in periodontal sites of human immunodeficiency virus (HIV)-positive individuals in North Brazil: a cross-sectional study.

OBJECTIVE: This study aimed to investigate the Epstein-Barr virus (EBV) prevalence and viral load in subgingival sites of human immunodeficiency virus type 1 (HIV-1) positive (HIV+) individuals, correlating subgingival EBV load to the clinical periodontal condition, HIV systemic load, EBV systemic load, and use of antiretroviral therapy (ART). METHOD AND MATERIALS: Ninety individuals were recruited and divided into three categories: those without periodontal disease (G1), with gingivitis (G2), and with periodontitis (G3). Subgingival biofilm and blood samples were analyzed by quantitative polymerase chain reactions (qPCR). A questionnaire was administered to collect general information about patients, and data regarding HIV and use of ART were accessed from their medical records. RESULTS: EBV was detected in 85.6% of the samples. Comparing subgingival and systemic load of EBV in G1, G2, and G3, there was a statistical difference only in G3 (3.93 log10 copies/mL and 5.47 log10 copies/mL, respectively; P = .014), where EBV load was higher in periodontal pockets than in the blood. All groups had high EBV loads in subgingival sites (> 2,000 copies/mL). A positive linear correlation between systemic HIV load and EBV subgingival load was found in G1 and G2 (r = 0.647; P < .001), but not in G3. Only G1 individuals using ART had lower subgingival EBV loads than those not using it (5.03 log10 copies/mL, and 7.14 log10 copies/mL, respectively; P = .0348). CONCLUSIONS: Subgingival sites, especially the periodontal pockets, are suggested to act as a reservoir of EBV in HIV+ individuals. Therefore, the identification of latent EBV infections in this easily accessible site might help to improve quality of life in patients with HIV by maintaining oral/periodontal health. In addition it might encourage new approaches in investigating EBV-associated disorders in HIV+ patients.

Low-level laser as a complementary therapy in orofacial granulomatosis management: a case report.

Orofacial granulomatosis (OFG) is a chronic inflammatory disease that typically affects the soft tissues of the orofacial region. The most common clinical manifestation of OFG is lip swelling, which may be associated with intrabuccal ulcerations and increased growth of the gingiva and mucosa, as well as cutaneous erythema and facial edema. The treatment for OFG is challenging, and sometimes considered unsatisfactory. Thus, this study presents a case report of OFG and the therapeutic regimen applied. A 47-year-old man presented with increased lip volume which had started 10 months earlier. His lips were thick with a fibroelastic consistency, which were painless upon palpation. Incisional biopsy and histopathological analysis of the upper lip revealed non-specific granulomatous inflammation and the diagnosis of OFG was subsequently made. Low-level laser therapy was successfully used to treat OFG in this case, and appears to be an efficient treatment for OFG when corticosteroid therapy is not enough.

Short-run effects of accountability pressures on teacher policies and practices in the voucher system in Santiago, Chile.

This research analyzes the impact of the Adjusted Voucher Laws school rankings on low-performing schools in Santiago, Chile, and provides evidence on the effects of the pressures of accountability systems on teacher policies and practices. The empirical strategy is based on the fact that schools are ranked according to their position on a set of thresholds. We used a generalization of the traditional regression discontinuity design for the case where treatment assignment is determined by n variables. To gather information on teacher policies and practices, we conducted a survey of 4th-grade teachers in the Greater Santiago area. The results indicate that low-performing schools responded to the treatment by implementing policies that seek to improve their results in the short term. We also found no significant effects on teaching practices, suggesting that many of these changes are implemented top down from the school administrators, without involving teachers in the process.

[Individual, social and environmental determinants of overweight and obesity among Chilean adolescents]. / Determinantes individuales, sociales y ambientales del sobrepeso y la obesidad adolescente en Chile.

BACKGROUND: In Chile, overweight and obesity are pressing issues in public health. AIM: To identify individual, social and environmental factors that affect the likelihood of adolescents to become overweight or obese. MATERIAL AND METHODS: We used physical condition data of a sample of 900 urban eighth grade students from Santiago, obtained in the 2011 National Study of Physical Education. This information was complemented with georeferenced data from the place of residence of students and the environment in which they live. We used three logistic regression models to estimate the relationship between individual, social and environmental factors and the likelihood of being overweight or obese. RESULTS: Men and students of high socioeconomic status (SES) have a lower probability of being overweight (-6 percentage points (pp.) and -12 pp. respectively). Furthermore, the determinants that affect overweight depend on SES. Namely, only men of middle and low SES have a lower probability of being overweight (-7 pp.). Participation in school sporting activities reduces the likelihood of being overweight only for students of middle and low SES (-5,5 pp.). For adolescents of high SES, the distance between their school and the nearest fast food restaurant decreases the likelihood of being overweight (-4.7 pp. per km.). CONCLUSIONS: The determinants of overweight differ by SES. Public policy design should consider socioeconomic inequalities that characterize the Chilean reality.

Determinantes individuales, sociales y ambientales del sobrepeso y la obesidad adolescente en Chile / Individual, social and environmental determinants of overweight and obesity among Chilean adolescents

Background: In Chile, overweight and obesity are pressing issues in public health. Aim: To identify individual, social and environmental factors that affect the likelihood of adolescents to become overweight or obese. Material and Methods: We used physical condition data of a sample of 900 urban eighth grade students from Santiago, obtained in the 2011 National Study of Physical Education. This information was complemented with georeferenced data from the place of residence of students and the environment in which they live. We used three logistic regression models to estimate the relationship between individual, social and environmental factors and the likelihood of being overweight or obese. Results: Men and students of high socioeconomic status (SES) have a lower probability of being overweight (-6 percentage points (pp.) and -12 pp. respectively). Furthermore, the determinants that affect overweight depend on SES. Namely, only men of middle and low SES have a lower probability of being overweight (-7 pp.). Participation in school sporting activities reduces the likelihood of being overweight only for students of middle and low SES (-5,5 pp.). For adolescents of high SES, the distance between their school and the nearest fast food restaurant decreases the likelihood of being overweight (-4.7 pp. per km.). Conclusions: The determinants of overweight differ by SES. Public policy design should consider socioeconomic inequalities that characterize the Chilean reality.

Stage IIIB carcinoma of the cervix in a 19-year-old: a case report.

BACKGROUND: As of December 2009, the American College of Obstetricians and Gynecologists recommends that cervical cancer screening not be initiated until age 21. However, cases, although rare, do exist of advanced cervical cancer diagnosed in women younger than age 21. Our case describes one such rare event and questions whether women should be evaluated based on their individual social behaviors and risk factors. CASE: A 19-year-old, nulliparous, African American female presented to the Methodist Dallas Hospital emergency department with complaints of chronic abdominal and pelvic pain of 3 months' duration which had become acutely more painful 1 week prior to presentation. The patient stated that she had been diagnosed and treated the previous week at a different hospital with pelvic inflammatory disease. On examination the patient was noted to have a large,fungating mass distorting the external surface of her cervix. At that time a Pap smear and a tissue sample biopsy were collected. The patient was admitted with a pelvic mass and was subsequently staged with Stage IIIB cervical cancer. CONCLUSION: Our patient demonstrates the importance of evaluating young women at high risk for cervical pathology despite new recommendations from ACOG that cervical cytologic screening begin uniformly at age 21.

O comportamentottático em diferentes categorias na execução do contra-ataque no futall / The tactial behaavior in different categories in the implementation ofcounter-attack in futsal

As ações de contra-ataque são determinantes para o sucesso no jogo de futsal e carecem de estudos na literatura científica. Desse modo, o objetivo do presente estudo foi caracterizar o perfil das ações de contra-ataque em diferentes categorias do futsal. A amostra constituiu-se de 3 jogos de futsal, totalizando 157 cenas-situações de contra-ataque. A avaliação desses momentos se deu pela observação e análise de jogo, segundo o local de início dos contra-ataques; o número de jogadores utilizados na efetivação do contra-ataque; e a ação defensiva geradora do contra-ataque. Em todas as categorias (sub-17, adulto amador e adulto profissional) os dados apresentaram uma predominância da origem dos contra-ataques na meia-quadra defensiva, com desenvolvimento por ações táticas de grupo. O erro de passe do adversário predominou como ação indutora do contra-ataque nas categorias adulto profissional e sub-17 e na categoria adulto o desarme foi prioritariamente utilizado.

The counterattack actions are crucial to success in futsal game and there is a lack of studies in scientific literature. The aim of this study was to characterize the profile of the actions in different categories. The sample consisted of 3 soccer games totaling 157 counterattack scenes situations. The evaluation of these moments occurred through observation and notational analysis place of the early counter-attacks, the number of players used in the counterattack and defensive action generating the counterattack. In all categories (sub-17, adult amateur and professional) data showed a predominant source of counter-attacks in half-court defensive and tactical actions with development by the group. The error of the pass of the opponent prevailed as induction action of the counterattack in the professional categories and sub-17 and in the adult category the disarm was primarily used.

Is heparin plasma suitable for the determination of B-type natriuretic peptide on the Beckman-Coulter Access 2?

BACKGROUND: The use of heparin as an alternative to EDTA in the production of plasma samples is of particular interest for B-type natriuretic peptide (BNP) measurements. Lithium heparin is now widely used for the determination of biochemical parameters, including cardiac markers. The goal of this study was to determine the feasibility of measuring BNP using heparin plasma instead of EDTA plasma with the Access 2 system (Beckman-Coulter). METHODS: BNP was determined in heparin plasma and EDTA plasma from 24 patients within 1 h of blood collection. Additional measurements were performed with heparin plasma, every hour for the first 4 h, and then 8 h after the collection of blood that was stored at room temperature. RESULTS: At H(0), the observed BNP concentrations in heparin plasma were much higher (mean values 65% higher) than those in EDTA plasma. Using predetermined thresholds, this difference would lead to 30% discordance between samples in heparin and EDTA. BNP stability decreased over time in heparin plasma: immunoreactivity decreased approximately by 30% during the first 2 h and by 60% after 8 h. CONCLUSIONS: Heparin plasma does not seem to be a suitable alternative to EDTA plasma for measurement of BNP using the Access 2 system, even if measurements are performed immediately after blood sampling.

A COMPARATIVE STUDY OF LUMBAR RANGE OF MOVEMENT IN HEALTHY ATHLETES AND NON-ATHLETES.

OBJECTIVE: To compare the amplitude of trunk flexion and extension through goniometry among athletes and non-athletes and to correlate these data with the popliteal angle and hamstring muscle tests. METHODS: The amplitude of trunk flexion and extension was evaluated in 50 individuals who practiced sports on a regular basis and 50 non-athletes who did not present any painful lumber symptoms or any symptoms that could affect test performance. The measurements were made consecutively by two independent examiners by means of goniometry. The trunk flexion and extension values from the goniometry evaluation were correlated with the popliteal angle and hamstring flexibility tests, and the statistical correlation between them was analyzed. RESULTS: The mean values obtained were 130.7 (101.9) for flexion and 40.2 (36.4) for extension. Statistically significant differences between the athletes and non-athletes were found in relation to the following parameters: goniometer in flexion with examiner 1, goniometer in flexion with examiner 2 and hamstring test. No statistically significant differences were found between the two groups in relation to the following parameters: goniometer in extension with examiner 1, goniometer in extension with examiner 2 and popliteal angle test. CONCLUSION: Individuals who practiced sports presented higher trunk flexion values. The use of goniometry to measure trunk amplitude showed variations in measurements between the examiners.