The Effect of Implantoplasty on the Fatigue Behavior and Corrosion Resistance in Titanium Dental Implants.

Implantoplasty is a technique increasingly used to remove the biofilm that causes peri-implantitis on dental implants. This technique of mechanization of the titanium surface makes it possible to eliminate bacterial colonies, but it can generate variations in the properties of the implant. These variations, especially those in fatigue resistance and electrochemical corrosion behavior, have not been studied much. In this work, fatigue tests were performed on 60 dental implants without implantoplasty, namely 30 in air and 30 in Hank's solution at 37 °C, and 60 with implatoplasty, namely 30 in air and 30 in Hank's solution at 37 °C, using triaxial tension-compression and torsion stresses simulating human chewing. Mechanical tests were performed with a Bionix servo-hydraulic testing machine and fracture surfaces were studied by scanning electron microcopyElectrochemical corrosion tests were performed on 20 dental implants to determine the corrosion potentials and corrosion intensity for control implants and implantoplasty implants. Studies of titanium ion release to the physiological medium were carried out for each type of dental implants by Inductively Coupled-Plasma Mass Spectrometry at different immersion times at 37 °C. The results show a loss of fatigue caused by the implantoplasty of 30%, observing that the nucleation points of the cracks are in the areas of high deformation in the areas of the implant neck where the mechanization produced in the treatment of the implantoplasty causes an exaltation of fatigue cracks. It has been observed that tests performed in Hank's solution reduce the fatigue life due to the incorporation of hydrogen in the titanium causing the formation of hydrides that embrittle the dental implant. Likewise, the implantoplasty causes a reduction of the corrosion resistance with some pitting on the machined surface. Ion release analyses are slightly higher in the implantoplasted samples but do not show statistically significant differences. It has been observed that the physiological environment reduces the fatigue life of the implants due to the penetration of hydrogen into the titanium forming titanium hydrides which embrittle the implant. These results should be taken into account by clinicians to determine the convenience of performing a treatment such as implantoplasty that reduces the mechanical behavior and increases the chemical degradation of the titanium dental implant.

Peri-implantitis and maxillary sinus membrane thickening: A retrospective cohort study.

OBJECTIVE: The objective of this study is to investigate the association of peri-implantitis (PI) and sinus membrane thickening and to assess the resolution of membrane thickening following intervention (implant removal or peri-implantitis treatment) aimed at arresting PI. MATERIALS AND METHODS: Forty-five patients with 61 implants in the posterior maxillary region were retrospectively included in the study. Twenty-four patients were diagnosed with peri-implantitis (PI) and 21 had peri-implant health (PH). Cone-beam computed tomography (CBCT) scans were evaluated to assess maxillary sinus characteristics, including membrane thickening, sinus occupancy and ostium patency. The CBCT scans taken 6 months after intervention aimed at arresting disease (implant removal or treatment of PI) in the PI group were also appraised and compared to baseline scans. RESULTS: At baseline, all parameters evaluating membrane thickness disorders yielded significant differences between groups (p < .001). Patients with posterior maxillary implants diagnosed with PI were 7× more likely to present membrane thickening compatible with pathology when compared to patients with healthy implants (OR = 7.14; p = .005). Furthermore, the likelihood was 6x greater in implants diagnosed with PI to exhibit moderate membrane thickening (OR = 6.75, p = .001). The patients receiving interventions aimed at arresting PI experienced significant enhancement in all radiographic parameters related to the sinus cavity at the 6-month follow-up (p < .001), though these variations were similarly independent of whether treatment consisted of PI treatment or implant removal. CONCLUSIONS: Maxillary sinus membrane thickening and the permeability/obstruction of the ostium are frequently associated with the presence of PI in posterior implants. Interventions targeting disease resolution effectively reduce membrane thickness to levels compatible with maxillary sinus health.

Effect of Insulin Resistance on Abdominal Obesity, Liver Fat Infiltration, and Body Mass Index in Youngsters.

AIM: Evaluate insulin resistance (IR) as a mediator of the effect of body fat distribution on liver fat infiltration and stiffness (LSt) in young adults using structural equation modeling (SEM). METHODS: We invited 500 first year students from two universities and evaluated their family history to determine the risk for cardiometabolic disease. Of these, 174 students (age 19 ± 1 years) were assessed for total body fat percentage (BF%), LSt, fat infiltration (Coefficient attenuated parameter CAP), and serum biochemical analysis. We performed a mediation analysis using two different structural equation models to determine the relationship between BMI, BF%, abdominal obesity (AO), IR, LSt, and fat infiltration using standardized ß coefficients. The symbol "->" means "explains/causes". RESULTS: Model#1 supported that mediation analysis and had a better fit than the direct effect. AO->IR (b = 0.62, p = 0.005), AO->CAP (b = 0.63, p <0.001), and CAP->IR (b = 0.23, p = 0.007), with negligible effect of BMI on CAP and IR. Model#2 showed direct effect of BMI on LSt was a better fit than mediation. BMI->LSt (b = 0.17, p = 0.05) but no effect AO->LSt. Interestingly, LSt->IR (b = 0.18, p = 0.001), but bi-directional IR->LSt (b = 0.23, p = 0.001). CONCLUSIONS: AO and BMI in young adults have differential phenotypic effects on liver CAP and LSt. Visceral fat had a direct effect on IR and CAP. Meanwhile, BMI was associated with LSt. Our findings shed light on the complex interplay of factors influencing liver stiffness, particularly in young individuals. Further research is needed to elucidate the precise mechanisms underlying these associations and their implications for liver health.

Clinical outcomes and associated factors in the treatment of peri-implant mucositis, combining mechanical debridement and prosthesis modification: A 30-month follow-up prospective case series.

AIM: To evaluate the clinical outcome and the associated factors of a treatment protocol for peri-implant mucositis. MATERIALS AND METHODS: Patients were evaluated 30 months after a treatment protocol including professional mechanical debridement and modification of the prosthesis contours to improve access for biofilm control. Clinical performance was assessed by means of probing with an electronic pressure-calibrated periodontal probe. The possible impact of implant- and patient-level factors on the changes in peri-implant mucosal inflammation measured with the modified bleeding index (mBI) was evaluated. RESULTS: Twenty patients and 61 implants were included in the analysis. At the final visit, 50% of the patients presented bleeding on probing, with a mean mBI of 0.22 (SD 0.27). The adjusted linear regression model showed a significant association between patient's compliance with supportive care visits (p = .006) and mucosal inflammation. Similarly, at the implant level, modified plaque index (p < .001) and an irregular use of interdental brushes (p = .017) had a significant impact on final mBI. CONCLUSIONS: Prosthesis modification when needed in association with non-surgical treatment may be an important intervention in the treatment of peri-implant mucositis. Compliance with supportive care visits and the regular use of inter-dental brushes were identified as important factors to achieve mucosal inflammation control.

Clinical Efficacy of SARS-CoV-2 Vaccination in Hemodialysis Patients.

Introduction: The COVID-19 pandemic is a global public health problem. Patients with end-stage renal disease on hemodialysis are at a higher risk of infection and mortality than the general population. Worldwide, a vaccination campaign has been developed that has been shown to reduce severe infections and deaths in the general population. However, there are currently limited data on the clinical efficacy of vaccinations in the hemodialysis population. Methods: A national multicenter observational cohort was performed in Chile to evaluate the clinical efficacy of anti-SARS-CoV-2 vaccination in end-stage renal disease patients on chronic hemodialysis from February 2021 to August 2021. In addition, the BNT162b2 (Pfizer-BioNTech) and CoronaVac (Sinovac) vaccines were evaluated. The efficacy of vaccination in preventing SARS-CoV-2 infection, hospitalizations, and deaths associated with COVID-19 was determined. Results: A total of 12,301 patients were evaluated; 10,615 (86.3%) received a complete vaccination (2 doses), 490 (4.0%) received incomplete vaccination, and 1196 (9.7%) were not vaccinated. During follow-up, 1362 (11.0%) patients developed COVID-19, and 150 died (case fatality rate: 11.0%). The efficacy of the complete vaccination in preventing infection was 18.1% (95% confidence interval [CI]:11.8-23.8%), and prevention of death was 66.0% (95% CI:60.6-70.7%). When comparing both vaccines, BNT162b2 and CoronaVac were effective in reducing infection and deaths associated with COVID-19. Nevertheless, the BNT162b2 vaccine had higher efficacy in preventing infection (42.6% vs. 15.0%) and deaths (90.4% vs. 64.8%) compared to CoronaVac. Conclusion: The results of our study suggest that vaccination against SARS-CoV-2 in patients on chronic hemodialysis was effective in preventing infection and death associated with COVID-19.

Design and Rationale for a Real-World Prospective, Multicenter Registry of Myocardial Revascularization Failure and Secondary Revascularization: The REVASEC Study.

AIM: To investigate key aspects of the problem of myocardial revascularization failure (MRF) and repeat or secondary myocardial revascularization (SR) in contemporary practice. METHODS: The registry of secondary revascularization (REVASEC) is an investigator-initiated, multicenter, prospective registry enhanced with data monitoring and independent event adjudication (ClinicalTrials.govNCT03349385). It includes patients with prior revascularization referred to coronary angiography for suspected MRF with broad inclusion criteria. The main objectives are to describe the characteristics of patients with prior revascularization referred for repeat angiography, to describe and the rate and mechanisms of MRF (stent or graft failure, coronary artery disease progression or residual coronary artery disease); to evaluate the management including medical treatment and SR of these patients; and to assess the prognosis according to the outlined causative mechanisms. The registry has one year follow up for the primary endpoint (Patient-oriented composite endpoint including all-cause death, any myocardial infarction or any new unplanned revascularization according to subsets of MRF), but extended follow-up will be carried out up to 5 years. CONCLUSION: The REVASEC Registry will provide updated data on the characteristics, patterns of treatment, and 1-year outcomes of patients with MRF and SR in contemporary clinical practice.

Looking for Crumbs in the Obesity Forest: Anti-obesity Interventions and Obesity-Associated Cardiometabolic Traits in the Mexican Population. History and Systematic Review With Meta-Analyses.

Mexicans and Mexican Americans share culture, genetic background, and predisposition for chronic complications associated with obesity and diabetes making imperative efficacious treatments and prevention. Obesity has been treated for centuries focused-on weight loss while other treatments on associated conditions like gout, diabetes (T2D), and hypertriglyceridemia. To date, there is no systematic review that synthesizes the origin of obesity clinics in Mexico and the efforts to investigate treatments for obesity tested by randomized clinical trials (RCT). We conducted systematic searches in Pubmed, Scopus, and Web of Science to retrieve anti-obesity RCT through 2019 and without an inferior temporal limit. The systematic review included RCT of anti-obesity treatments in the Mexican adult population, covering alternative medicine, pharmacological, nutritional, behavioral, and surgical interventions reporting metabolism-associated traits such as BMI, weight, waist circumference, triglycerides, glucose, among others. Only the studies with at least 3 months of treatment were included in the meta-analyses in order to reduce placebo effects. We found 634 entries, after removal of duplicates and screening the studies based on eligibility criteria, we analyzed 43 national, and 2 multinational-collaborative studies. Most of the national studies had small sample sizes, and the implemented strategies do not have replications in the population. The nutrition/behavioral interventions were difficult to blind, and most studies have medium-to-high risk of bias. Nutritional/behavioral interventions and medications showed effects on BMI, waist circumference, and blood pressure. Simple measures like pure water instead of sweet beverages decrease triglycerides and systolic blood pressure. Dark chocolate showed the highest effect for BMI and high blood pressure, and treatment with insulin increased weight in those with T2D. The study of obesity in Mexico has been on-going for more than four decades, the interest on RCT just increased until this millennium, but with small sample sizes and lack of replication. The interventions affect different cardiometabolic associated traits, which should be analyzed in detail in the population living near the Mexico-U.S. border; therefore, bi-national collaboration is desirable to disentangle the cultural effects on this population's treatment response. Systematic Review Registration: https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42020221436, identifier: CRD42020221436.

Examining the Gap Between Medical School Matriculation and Graduation Rates Amongst Self-Identified Minorities.

PURPOSE: Despite increasing diversity, data indicates that there is a gap between the matriculation or admission of and graduation rates amongst medical students who identify with racial or ethnic minority groups. The purpose of this study was to identify barriers experienced by minority medical students that may account for this gap. METHODS: An IRB approved online survey was created, and distributed electronically to minority medical students, residents, and practicing physicians. Information on demographics, family dynamics, academic struggles, health issues, financial difficulties and faculty diversity was collected via self-report. RESULTS: Participants (n = 167) who completed the survey identified as Black/African/African American (60%), Hispanic/Latinx (26%), Asian (8%), and as Other racial or ethnic minority (6%). The majority of survey participants graduated within the traditional 4 years of medical school (83%) and 17% did not. The most frequently reported reason was to pursue academic advancement (42%) which included completing a research year, dual degree, or PhD. The second reason was due to academic deficiencies (38%), either course failure or failure of a board exam. The majority of respondents (59%) also reported not having enough faculty members who were members of racial or ethnic minority groups at their medical school. CONCLUSIONS: Our data suggests the majority of racial and ethnic minority medical students graduate within the traditional 4 years of medical school. However, if they do not, it is either due to academic advancement to become a more successful residency applicant, or due to academic issues. The majority of respondents reported that they perceive a lack of racial and ethnic minority faculty members in academics.

Un caso de muerte súbita por estenosis aórtica subvalvular / Subvalvular aortic stenosis and sudden death. Presentation of a case

La estenosis subaórtica, aunque patología infrecuente, es susceptible de cursar con muerte súbita por un mecanismo arritmogénico. Si bien su etiología no está aún aclarada, dado el presumible componente genético subyacente, el examen autópsico se convierte en instrumento esencial para el diagnóstico posmortem y trasmitir el pertinente consejo médico a los familiares. Se presenta el estudio médico forense de una mujer de 39 años, que fallece de forma súbita a causa de esta etiología, se discuten los principales hallazgos y los antecedentes familiares conocidos

Subaortic stenosis, although an infrequent pathology, is prone to cause a sudden death through an arrhythmogenic mechanism. Although its aetiology is still unclear, and given an assumed underlying genetic component, the autopsy becomes an essential tool for post-mortem diagnosis of the disease and to give relevant medical advice to family members. A case of sudden death of a 39 year-old woman involving this aetiology is presented, and the medico-legal findings, as well as a discussion on the known family's medical background

Adjunctive effect of modifying the implant-supported prosthesis in the treatment of peri-implant mucositis.

AIM: To evaluate the adjunctive effect of modifying the implant-supported prosthesis to facilitate access to oral hygiene when treating peri-implant mucositis. MATERIAL AND METHODS: A 6-month randomized clinical trial was designed. Patients with peri-implant mucositis were treated by implant surface debridement with plastic curettes and a plastic tipped ultrasonic device. Then, they were randomly assigned to either modifying their prosthesis to allow for better oral hygiene (test group) or not (control group). Subsequently in both groups, individualized oral hygiene instructions were provided. Clinical and radiographical outcomes were evaluated at baseline and 1, 3 and 6 months after treatment. RESULTS: 48 patients were included, and 45 completed the clinical trial (24 test and 21 control patients). After 6 months, changes in the modified bleeding index between the control and test groups were 0.50 (standard deviation -SD = 0.70) and 1.14 (SD = 0.96), respectively (p = 0.01). The changes in implant probing pocket depth at 6 months were -0.02 (SD = 0.61) and 0.31 (SD = 1.20) mm, respectively (p = 0.04). CONCLUSIONS: Modifying the contour of the prostheses to improve access for oral hygiene significantly improved the clinical outcomes after standard mechanical treatment of peri-implant mucositis.

The adjunctive effect of a titanium brush in implant surface decontamination at peri-implantitis surgical regenerative interventions: A randomized controlled clinical trial.

AIM: To evaluate an additional mechanical approach, a titanium brush, in the implant surface decontamination performed during the regenerative surgical therapy of peri-implantitis. MATERIAL AND METHODS: A randomized double-blinded clinical trial, with a 1-year follow-up, was carried out. After a hygienic phase, peri-implantitis-affected implants were randomly assigned to a control or to a test group. In the control group, implant surface was decontaminated both mechanically and chemically with 3% H2 O2 and plastic ultrasonic scalers, respectively, while in the test group, a titanium brush was also applied. Intrabony defects in both groups were filled with an alloplastic material (ß-tricalcium phosphate and hydroxyapatite) and covered with a collagen membrane. The primary outcome was the reduction in probing pocket depth (PPD) at the deepest site. RESULTS: Thirty patients were included, 15 in each group. At 12 months, reduction in PPD was 4.87 (standard deviation [SD] 1.55) mm and 2.85 (SD: 1.91) mm, respectively (p = 0.009). The correspondent figures for residual PPD were 3.6 (SD: 0.91) and 4.92 (SD: 1.26) mm, respectively (p = 0.007). CONCLUSIONS: The additional use of a titanium brush during regenerative treatment of peri-implantitis resulted in statistically significant benefits in terms of PPD reduction after 12 months.

Diagnóstico post mortem de las cardiopatías estructurales / Post-mortem diagnoses of structural cardiopathies

La patología cardiaca no solo es responsable del 80% de las muertes súbitas, sino que puede ser coadyuvante en las muertes ocurridas durante intervenciones quirúrgicas o en el transcurso de ingresos hospitalarios, y puede estar relacionada con muertes accidentales. Un estudio especializado y protocolizado del corazón garantiza una correcta valoración médico-legal del fallecimiento, pero además es esencial para la detección de cardiopatías familiares. Se presentan las características anatomopatológicas de las cardiopatías estructurales más frecuentes en el ámbito forense según criterios de los grupos de referencia en patología cardiovascular (AU)

Cardiac diseases are responsible for 80% of sudden deaths, but they may also be involved in deaths that have occurred during surgical procedures or in hospitalised patients, as well as being related to accidental deaths. A specialised heart examination guarantees the medico-legal assessment of the cause of death, and is essential in the diagnoses of familial cardiopathies. The pathological characteristics, according to cardiovascular pathology criteria of the most frequent structural cardiopathies in forensic practice are presented (AU)

Vancomycin and tobramycin impregnated mineralized allograft for the surgical regenerative treatment of peri-implantitis: a 1-year follow-up case series.

OBJECTIVES: To assess the clinical and radiographic outcomes of the regenerative treatment of peri-implantitis using a vancomycin and tobramycin impregnated allograft (VTA) after a 12-month period. MATERIAL AND METHODS: Thirteen consecutive patients who required a regenerative treatment of peri-implantitis were recruited. For the 17 implant sites, a flap was raised, and after mechanical and chemical implant decontamination, a vancomycin and tobramycin impregnated allograft was placed in the defect and then covered with a collagen membrane. Soft tissues were sutured allowing a non-submerged healing. Clinical and radiographic variables were evaluated at baseline and at 12 months after treatment. RESULTS: No signs of continuous bone loss were observed and no implant was lost, yielding a 100% survival rate. All patient's clinical examination at 12 months revealed peri-implant health showing absence of suppuration and a statistically significant reduction in terms of bleeding on probing scores (70.6%, P = 0.001). Initial probing pocket depth (7.88 ± 1.22 mm) was significantly reduced at 12 months healing, a mean reduction of 4.23 ± 1.47 mm (P = 0.001) was achieved. The mean radiological infrabony defect at baseline reached 4.33 ± 1.62 mm, and was significantly reduced up to 0.56 ± 0.88 mm, which represents an 86.99 ± 18.2% bone fill from the original infrabony defect. CONCLUSIONS: Within the limits of the study, the application of VTA with a collagen membrane yielded positive outcomes in terms of radiographic bone fill, pocket depth reduction, and attachment gain after a 12-month period. Thus, VTA plus a collagen membrane seem to be suitable for the regenerative treatment of peri-implantitis. CLINICAL RELEVANCE: The use of locally delivered antibiotic together with the bone graft may reduce the undesirable effects related to the systemic administration and the risk of resistances. In the light of the results obtained, these grafting materials might offer new treatment strategies in the surgical regenerative treatment of peri-implantitis.

Species abundance and temporal variation of arbovirus vectors in Brownsville, Texas.

The recent outbreaks of the dengue fever and West Nile viruses and the looming threats of the Zika and chikungunya viruses highlight the importance of establishing effective, proactive arboviral surveillance in communities at high risk of transmission, such as those on the Texas-Mexico border. Currently, there are no approved human vaccines available for these mosquito-borne diseases, so entomological control and case management are the only known methods for decreasing disease incidence. The principal vectors, which include Culex quinquefasciatus, Aedes aegypti, and Ae. Albopictus, all have an established presence in South Texas. The public health response to most arbovirus outbreaks in the region has been reactionary rather than proactive. However, after the 2005 dengue outbreak and subsequent fatality, the City of Brownsville Public Health Department began collecting data on mosquito vector abundance and incidence. The objective of this study was to describe the various species of mosquitoes found in vector surveillance in Brownsville, Texas, during 2009-2013; quantify their prevalence; and identify any associations with temporal or weather-related variations. The results confirm a significant mosquito population in Brownsville in late winter months, indicating a high risk of arbovirus transmission in South Texas year-round, and not just until November, previously considered the end date of arbovirus season by state health services. The data from Brownsville's surveillance program can help characterize local vector ecology and facilitate more proactive mitigation of future arboviral threats in South Texas.

Species abundance and temporal variation of arbovirus vectors in Brownsville, Texas / Abundancia de especies y variación temporal de los vectores de arbovirus en Brownsville, Texas

The recent outbreaks of the dengue fever and West Nile viruses and the looming threats of the Zika and chikungunya viruses highlight the importance of establishing effective, proactive arboviral surveillance in communities at high risk of transmission, such as those on the Texas– Mexico border. Currently, there are no approved human vaccines available for these mosquito-borne diseases, so entomological control and case management are the only known methods for decreasing disease incidence. The principal vectors, which include Culex quinquefasciatus, Aedes aegypti, and Ae. Albopictus, all have an established presence in South Texas. The public health response to most arbovirus outbreaks in the region has been reactionary rather than proactive. However, after the 2005 dengue outbreak and subsequent fatality, the City of Brownsville Public Health Department began collecting data on mosquito vector abundance and incidence. The objective of this study was to describe the various species of mosquitoes found in vector surveillance in Brownsville, Texas, during 2009–2013; quantify their prevalence; and identify any associations with temporal or weather-related variations. The results confirm a significant mosquito population in Brownsville in late winter months, indicating a high risk of arbovirus transmission in South Texas year-round, and not just until November, previously considered the end date of arbovirus season by state health services. The data from Brownsville’s surveillance program can help characterize local vector ecology and facilitate more proactive mitigation of future arboviral threats in South Texas.

Los últimos brotes de los virus del dengue y del Nilo Occidental y la inminente amenaza del virus del Zika y el chikunguña ponen de relieve la importancia de instaurar un sistema eficaz y proactivo de vigilancia de los arbovirus en las comunidades expuestas a un riesgo alto de transmisión, como las ubicadas en la frontera entre Texas y México. Actualmente no se dispone de ninguna vacuna humana aprobada contra estas enfermedades transmitidas por mosquitos, de manera que el control entomológico y el manejo de los casos son los únicos métodos conocidos para reducir la incidencia de estas enfermedades. Está comprobada la presencia de los princi-pales vectores, entre los que se cuentan las especies Culex quinquefasciatus, Aedes aegypti y Ae. albopictus, en la zona sur de Texas. La respuesta de salud pública a la mayoría de los brotes de arbovirus en la región ha sido reactiva en lugar de proactiva. Sin embargo, después del brote de dengue registrado en el 2005 y dada su letalidad, el Departamento de Salud Pública de la Ciudad de Brownsville empezó a recopilar datos sobre la abundancia de los mosquitos vectores y la incidencia de las enfermedades que transmi-ten. El objetivo de este estudio fue describir las diversas especies de mos-quitos encontrados mediante la vigilancia de vectores realizada en Brownsville (Texas) entre los años 2009 y 2013, cuantificar su prevalencia y determinar si hay alguna relación con las variaciones temporales o climáti-cas. Los resultados confirman que Brownsville tiene una población signifi-cativa de mosquitos en los últimos meses del invierno, lo que indica un alto riesgo de transmisión de arbovirus en la zona sur de Texas durante todo el año y no solo hasta noviembre, mes en el que los servicios de salud del estado solían considerar que culminaba la temporada de arbovirus. Los datos del programa de vigilancia de Brownsville pueden ayudar a caracte-rizar la ecología local de los vectores y propiciar una mitigación más proac-tiva de las futuras amenazas arbovirales en la zona sur de Texas.

Organic Compounds Detected in Deciduous Teeth: A Replication Study from Children with Autism in Two Samples.

Biological samples are an important part of investigating toxic exposures and disease outcomes. However, blood, urine, saliva, or hair can only reflect relatively recent exposures. Alternatively, deciduous teeth have served as a biomarker of early developmental exposure to heavy metals, but little has been done to assess organic toxic exposures such as pesticides, plastics, or medications. The purpose of our study was to determine if organic chemicals previously detected in a sample of typically developing children could be detected in teeth from a sample of children with autism. Eighty-three deciduous teeth from children with autism spectrum disorders (ASD) were chosen from our tooth repository. Organic compounds were assessed using liquid chromatography tandem mass spectrometry and gas chromatography methods. Consistent with a prior report from Camann et al., (2013), we have demonstrated that specific semivolatile organic chemicals relevant to autism etiology can be detected in deciduous teeth. This report provides evidence that teeth can be useful biomarkers of early life exposure for use in epidemiologic case-control studies seeking to identify differential unbiased exposures during development between those with and without specific disorders such as autism.

Socioeconomic context and the food landscape in Texas: results from hotspot analysis and border/non-border comparison of unhealthy food environments.

PURPOSE: The purpose of this paper is to describe the food landscape of Texas using the CDC's Modified Retail Food Environment (mRFEI) and to make comparisons by border/non-border. METHODS: The Modified Retail Food Environment index (mRFEI (2008)) is an index developed by the CDC that measures what percent of the total food vendors in a census track sell healthy food. The range of values is 0 (unhealthy areas with limited access to fruits and vegetables) to (100-Healthy). These data were linked to 2010 US Census socioeconomic and ethnic concentration data. Spatial analysis and GIS techniques were applied to assess the differences between border and non-border regions. Variables of interest were mRFEI score, median income, total population, percent total population less than five years, median age, % receiving food stamps, % Hispanic, and % with a bachelor degree. RESULTS: Findings from this study reveal that food environment in Texas tends to be characteristic of a "food desert". Analysis also demonstrates differences by border/non-border location and percent of the population that is foreign born and by percent of families who receive food stamps. CONCLUSIONS: Identifying the relationship between socioeconomic disparity, ethnic concentration and mRFEI score could be a fundamental step in improving health in disadvantage communities, particularly those on the Texas-Mexico border.

Autopsia cardiaca en patología forense / Cardiac autopsy in forensic pathologhy

El estudio del corazón es esencial en la investigación de un gran número de autopsias judiciales, especialmente en los casos de muerte súbita cardiaca. Un estudio óptimo requiere un examen macroscópico y microscópico protocolizado. El objetivo de este artículo es presentar unos conceptos básicos sobre el procedimiento de estudio del corazón, con el fin que los médicos forenses estén familiarizados con el mismo(AU)

The study of the heart is essential in the investigation of a large number of forensic autopsies, especially in cases of sudden cardiac death. An optimal study requires a protocolized macroscopic and microscopic examination. The aim of this article is to present some basic concepts about the procedure for examining the heart, thus ensuring the forensic physicians are familiar with it(AU)

The use of elastin immunostain improves the evaluation of melanomas associated with nevi.

BACKGROUND: Twenty to 30% of malignant melanomas are associated with melanocytic nevi; however, sometimes it is difficult to distinguish the melanoma from the nevus by routine histology. We have previously described distinctive patterns of elastic fibers in nevi and in melanomas. METHODS: We analyzed elastic fiber patterns using elastin immunostain and elastic van Gieson (EVG) stain in 30 cases of invasive melanomas associated with nevi, 12 control melanocytic nevi and 14 control invasive melanomas. RESULTS: Elastin immunostain was superior to EVG in showing the elastic fiber patterns. In nevi, the elastic fibers were preserved between nests and often around individual melanocytes. In contrast, melanomas had markedly decreased elastic fibers in the stroma and within the nests of melanocytes. The melanoma pushed down the pre-existing thin elastic fibers of the papillary dermis, forming a compressed layer at its base, which separated the melanoma from the nevus. On sun-damaged skin, the solar elastosis had similar elastin and EVG patterns. In three cases with dense inflammation, the layer of elastic fibers between melanoma and nevus was still present but less evident. CONCLUSIONS: The distinctive patterns of elastic fibers, best shown by the elastin immunostain, were helpful in evaluating melanomas associated with melanocytic nevi.