Neuroprotective effect of a new variant of Epo nonhematopoietic against oxidative stress.

Human erythropoietin is mainly recognized for its hematopoietic function; however, by binding to its receptor (EpoR), it can activate different signaling pathways as STAT, PI3K, MAPK and RAS to increase cellular differentiation or provide neuroprotective effects, among others. A recombinant human erythropoietin variant with low glycosylation and without hematopoietic effect (EpoL) was purified from skimmed goat milk. Recombinant human erythropoietin (Epo) was obtained from CHO cell line and used as control to compare EpoL effects. Neuroprotection studies were performed in PC12 cells and rat hippocampal slices. Cells were pretreated during 1h with EpoL or Epo and exposed to oxidative agents (H2O2 or FCCP); cell viability was assayed at the end of the experiment by the MTT method. Hippocampal slices were exposed to 15min of oxygen and glucose deprivation (OGD) and the neuroprotective drugs EpoL or Epo were incubated for 2h post-OGD in re-oxygenated medium. Cell cultures stressed with oxidative agents, and pretreated with EpoL, showed neuroprotective effects of 30% at a concentration 10 times lower than that of Epo. Moreover, similar differences were observed in OGD ex vivo assays. Neuroprotection elicited by EpoL was lost when an antibody against EpoR was present, indicating that its effect is EpoR-dependent. In conclusion, our results suggest that EpoL has a more potent neuroprotective profile than Epo against oxidative stress, mediated by activation of EpoR, thus EpoL represents an important target to develop a potential biopharmaceutical to treat different central nervous system pathologies related to oxidative stress such as stroke or neurodegenerative diseases.

Abordaje Clínico de un Incisivo Maxilar Permanente con Fractura Corono Radicular Compleja Mediante Reimplante Intencional / Clinical Approach of Permanent Maxillary Incisor with Complicated Crown-root Fracture Through Intentional Replantation

El manejo de las fracturas corono radiculares es un desafío clínico interdisciplinario, tanto en su atención de urgencia como en la planificación y ejecución del tratamiento definitivo. Se describen tres alternativas principales como terapia: tracción quirúrgica u ortodóncica del remanente corono radicular, gingivectomía y reimplante intencional dependiendo algunos factores como: edad del paciente, condición ligamento periodontal, longitud radicular, extensión del rasgo e fractura, entre otros. Paciente de sexo masculino de 10 años, con trauma dentoalveolar complejo, donde destaca la fractura corono radicular, diente 11, que presenta extensión subgingival mayor a 5 mm. Dada la complejidad de la situación clínica, se optó por el reimplante intencional, para permitir la reposición del fragmento con técnica adhesiva extra-oral. Luego de los primeros dieciséis meses de seguimiento se observa una adecuada cicatrización periodontal y un resultado estético aceptable. El reimplante intencional puede ser considerado un adecuado tratamiento en casos de fracturas corono radiculares complejas, cuando el rasgo de fractura se encuentra ubicado en zonas que impiden la utilización de otras técnicas, para su rehabilitación. De igual manera se permite la mantención de la altura y volumen del hueso alveolar de pacientes en crecimiento.

Crown root fracture management is a clinical and interdisciplinary challenge, either in its initial emergency care as in the definitive treatment planning and execution. Three main treatment alternatives are described: surgical and orthodontic extrusion of crown-root remnant, gingivectomy and intentional reimplantation, depending on factors such as: age of patient, clinical conditions of periodontal ligament and root length. This paper reports a clinical case of an adhesive fragment reattachment in a complicated crown root fracture in upper maxillary central incisor through intentional replantation. A 10 year-old male patient with complex dentoalveolar trauma, which highlights a complicated crown root fracture on tooth 11 with subgingival extension greater than 5 mm. Given the complexity of the clinical situation, we opted for intentional replantation, to allow reattachment of the crown fragment by adhesive technique. After the first sixteen months of follow-up, an adequate periodontal healing, acceptable aesthetic and functional outcome were observed. The intentional replantation can be considered adequate treatment in cases of complex crown root fractures when the fracture feature is located in areas that prevent the use of other techniques for rehabilitation. In the same way it allows the maintenance of the height and volume of the alveolar bone of growing patients.

Asociación entre malnutrición por exceso con caries temprana de la infancia / Association between overweight and early childhood caries

Objective: To determine whether overweight is a risk factor for the development of early childhood caries (ECC) in preschoolers. Patients and Method: An observational retrospective cohort study was performed in 196 children under 2 years of age at Calbuco Hospital, Los Lagos Region, Chile, who were admitted between 2007 and 2009. Patients were grouped based on their nutritional status at admission in the two following categories: eutrophic and overweighed children as a result of excessive intake. Information regarding caries incidence and nutritional status were annually retrieved from records until the age of 5 years, according to medical and dental records. Results: At the beginning of the study, 33.67% were overweight and 16.33% were obese, reaching 40% overweight and 20.56% obese at four years of age. The incidence of early childhood caries in overweighed children was 57.14% compared to 40.82% in normal weight children (p = 0.022), with 1.4 RR (95% CI, 1044-1.88). Conclusions: The increased risk of early childhood decay in overweighed patients makes necessary to create instances of timely mutual referral between the professional that diagnoses overweighed children and the pediatric dentist in order to develop preventive treatments for both diseases.

Objetivo: Determinar si la malnutrición por exceso es un factor de riesgo para el desarrollo de caries temprana de la infancia (CTI) en preescolares. Pacientes y Método: Se realizó un estudio observacional de cohorte retrospectivo en 196 niños de 2 años del Hospital de Calbuco, Región de Los Lagos, Chile, ingresados durante los años 2007 a 2009. Los pacientes fueron agrupados de acuerdo a su estado nutricional al ingreso en niños eutróficos y niños con malnutrición por exceso. La información respecto a incidencia de caries y el estado nutricional fueron recuperados de la ficha anualmente hasta la edad de 5 años, según registro de las fichas médicas y odontológicas. Resultados: El 33,67% estaba en sobrepeso al inicio de la cohorte y el 16,33% obeso, alcanzando 40% sobrepeso y 20,56% obesidad a los cuatro años de edad. La incidencia de caries temprana de la infancia en niños con malnutrición por exceso fue de 57,14% en relación al 40,82% de los niños eutróficos (p = 0,022) con RR de 1,4 (95% IC, 1.044-1,88). Conclusiones: El mayor riesgo asociado a CTI en pacientes con malnutrición por exceso invita a generar las instancias de derivación oportuna desde el profesional que pesquisa a niños con malnutrición por exceso hacia el odontólogo infantil, con el fin de desarrollar intervenciones preventivas para ambas patologías.

[Association between overweight and early childhood caries]. / Asociación entre malnutrición por exceso con caries temprana de la infancia.

OBJECTIVE: To determine whether overweight is a risk factor for the development of early childhood caries (ECC) in preschoolers. PATIENTS AND METHOD: An observational retrospective cohort study was performed in 196 children under 2 years of age at Calbuco Hospital, Los Lagos Region, Chile, who were admitted between 2007 and 2009. Patients were grouped based on their nutritional status at admission in the two following categories: eutrophic and overweighed children as a result of excessive intake. Information regarding caries incidence and nutritional status were annually retrieved from records until the age of 5 years, according to medical and dental records. RESULTS: At the beginning of the study, 33.67% were overweight and 16.33% were obese, reaching 40% overweight and 20.56% obese at four years of age. The incidence of early childhood caries in overweighed children was 57.14% compared to 40.82% in normal weight children (p = 0.022), with 1.4 RR (95% CI, 1044-1.88). CONCLUSIONS: The increased risk of early childhood decay in overweighed patients makes necessary to create instances of timely mutual referral between the professional that diagnoses overweighed children and the pediatric dentist in order to develop preventive treatments for both diseases.

Estudio clínico del primer molar permanente en niños de 6 años de edad de la comuna de calbuco, chile / Clinical study of the first permanent molar in children 6 years of age Calbuco commune, chile

Determinar la prevalencia de caries que presentan los Primeros Molares Permanentes (PMP) en niños chilenos de 6 años. Se realizó un estudio descriptivo, de corte transversal del estado de los PMP, en niños de seis años que asistieron al Hospital de Calbuco, X Región, Chile, durante el año 2008. Un operador calibrado examinó 166 niños de nivel socio-económico similar. La presencia de caries se estableció en base a los criterios propuestos por la OMS en el Oral Health Survey Basic Methods, para estudios epidemiológicos. El 65% (434/664) de los PMP se encontraban erupcionados, 47 (7%) semi- erupcionados y el 28% (183/664) aún no erupcionaban. De los PMP erupcionados y semierupcionados, el 69,02% (332/481) presenta caries. Al comparar la prevalencia de caries entre los PMP superiores y los inferiores se encontró una diferencia estadísticamente significativa (p<0,001). En los PMP superiores la mayor prevalencia de caries fue en la superficie oclusal, con un 56% (131/235), y en los PMP inferiores la superficie más afectadas fue la vestibular con un 68% (168/246).Conclusión: Los resultados demuestran la necesidad de incorporar estrategias de educativas y preventivas antes de la erupción del PMP

To determinate the prevalence of caries in first permanent molar (FPM) in six year-old Chilean children.Method: A Cross-sectional study was performed to state of FPM in six year-old children who attended in Calbuco Hospital, during 2008. A investigator previously calibrated to examined 166 Children belonging to the same socio-economic level. Caries diagnoses were carried out using standardized methods World Health Organization. 65% (434/664) of FPM were erupted and 47 (7%) partially erupted and 28% (183/664) were not erupted yet. From FPM erupted and partially erupted 69,02% (332/481) have caries. When comparing the prevalence of caries between upper and lower PFM, a significant statistical association was found (p<0,001). In the upper FPM the mayor prevalence of caries was found in the occlusal with 56% (131/235), in the lower FPM the most affected surface was the vestibular with a 68% (168/246). The results show the necessity of incorporating educative and preventive strategies before the eruption of FPM