Comparación de la posición condilar entre dos técnicas de registro de relación céntrica mediante tomografía espiral / Condylar position comparison between two centric relation recording methods, by means of a spiral tomography technique

Objetivo: El objetivo de este estudio fue comparar la variación de la posición del cóndilo mandibular entre la técnica de registro de relación céntrica auto-inducida de tipo activa y otra de manipulación mandibular de tipo chin-point. Método: En una muestra por conveniencia de 9 sujetos (4 hombres y 5 mujeres), se estudiaron un total de 18 articulaciones témporomandibulares determinando la variación de la posición condilar con el uso de imágenes obtenidas mediante tomografía espiral, utilizando para ambas técnicas un deprogramador anterior de Neff para estandarizar el grosor del material de registro. Resultados: Se observó que con la técnica chin-point, el cóndilo adopta una posición más posterior (55.6 por ciento) y superior (72.2 por ciento) respecto a la auto-inducida de tipo activa, con diferencias estadísticamente significativas (p<0.001, t-test). En promedio se observó que la técnica chin-point produjo una magnitud de desplazamiento de 1.5mm en dirección cefálica y 1.1mm hacia posterior, tomando como referencia la posición registrada con la técnica auto-inducida de tipo activa. Conclusiones: La técnica chin-point produce una posición condilar más posterior y superior que la técnica auto-inducida de tipo activa.

Objective: The aim of this study was to compare the mandibular condylar position between two centric relation recording methods: Active self-induced type and chin-point manipulation. Method: In a convenient sample of 9 subjects (5 females and 4 males), the condylar position variation was determined in the 18 temporomandibular joints by means of a spiral tomography radiographic technique. To standardize the thickness of the registration material, a Neff anterior deprogramming appliance was used. Results: It was observed that with the chin-point technique, the condyle adopted a significantly more superior (72.2 percent) and posterior (55.6 percent) position compared to the active self-induced technique (p<0.001, t-test). Regarding magnitudes, chin-point produced an average of 1.5mm cephalic and 1.1mm posterior displacements, using the position obtained with the active self-induced technique as a reference. Conclusions: Chin-point technique generates a more superior and posterior condylar position that the one determined by the active self-induced.

Estudio de prevalencia de la deficiencia de yodo en una población escolarizada de 6 años / Prevalence study of iodine deficiency in a 6-year-old school population

Introducción: El yodo es un oligoelemento cuyo déficit provoca diferentes complicaciones agrupadas bajo el nombre de trastornos por déficit de yodo. La ingesta de alimentos ricos en yodo es la única vía de administración del mismo. Se considera déficit leve de yodo una yoduria inferior a 100μg/l; aumentando la posibilidad de trastornos por déficit de yodo. Objetivo: Determinar la prevalencia de déficit de yodo en los niños de 6 años de la provincia de Lleida. Métodos: Estudio trasversal de selección aleatoria, en niños escolarizados en la provincia de Lleida. Tras la aceptación, se cumplimentó un cuestionario y se realizó un análisis de orina para determinar el nivel de yodo. Resultados: Inclusión de 328 niños (5 sin muestra de orina), 46,8% varones, 54,27% en escuelas públicas, 17,2% inmigrantes y 40,95% utilizaba el comedor escolar. El 62,42% comía pescado 2 o más veces a la semana, sal yodada el 60,98% y el 90,65% leche diariamente. La yoduria media se situó en 234,4μg/l (DT=133,7). El déficit de yodo fue establecido al 9,29% (6,12–12,45%) de la muestra, relacionándose significativamente con el tipo de centro (concertado o público), origen del niño, sal yodada, consumo de pescado y leche. Conclusiones: La prevalencia de déficit leve de yodo en Lleida es inferior a la de estudios parecidos anteriores, mostrando unos buenos parámetros nutricionales. El déficit de yodo es superior en niños inmigrantes, aunque se presentan modificaciones nutricionales que pueden establecer mejoras superiores a la de la población autóctona (AU)

Introduction: Iodine is a dietary element, a deficiency of which leads to complications grouped with the name Iodine Deficiency Disorders (IDD). The intake of foods rich in iodine is the only route of iodine administration. Iodine is considered to deficient when its concentration is less than 100μg/L in urine, thus increasing the possibility of IDD. Aim: To determine the prevalence of iodine deficiency in 6-year-old school children in the region of Lleida. Methods: A randomised cross-sectional study of 6-year-old school children in the area of Lleida was selected. After the acceptance, a questionnaire had to be filled in and a urine sample was collected to determine the urinary iodine. Results: A total of 328 subjects were included (5 without urine sample), 46.8% boys, 54.27% in public schools, 17.2% immigrants and 40.95% had lunch at school. The majority (62.42%) ate fish twice or more a week, 60.98% used iodised salt and 90.65% drank milk daily. The iodine mean was 234.4μg/l (SD=133.7). Only 9.29% (6.12–12.45%) had iodine deficiency which was associated to the type of school the children attended (private or public), immigrant origin, iodised salt, fish and milk nutrition. Conclusions: The prevalence of iodine deficiency in Lleida is lower than in previous publications, shown by the good nutrition parameters. The shortage of iodine is higher in immigrant boys, although better nutrition measures could be taken to improve their situation (AU)

[Prevalence study of iodine deficiency in a 6-year-old school population]. / Estudio de prevalencia de la deficiencia de yodo en una población escolarizada de 6 años.

INTRODUCTION: Iodine is a dietary element, a deficiency of which leads to complications grouped with the name Iodine Deficiency Disorders (IDD). The intake of foods rich in iodine is the only route of iodine administration. Iodine is considered to deficient when its concentration is less than 100 microg/L in urine, thus increasing the possibility of IDD. AIM: To determine the prevalence of iodine deficiency in 6-year-old school children in the region of Lleida. METHODS: A randomised cross-sectional study of 6-year-old school children in the area of Lleida was selected. After the acceptance, a questionnaire had to be filled in and a urine sample was collected to determine the urinary iodine. RESULTS: A total of 328 subjects were included (5 without urine sample), 46.8% boys, 54.27% in public schools, 17.2% immigrants and 40.95% had lunch at school. The majority (62.42%) ate fish twice or more a week, 60.98% used iodised salt and 90.65% drank milk daily. The iodine mean was 234.4 microg/l (SD=133.7). Only 9.29% (6.12-12.45%) had iodine deficiency which was associated to the type of school the children attended (private or public), immigrant origin, iodised salt, fish and milk nutrition. CONCLUSIONS: The prevalence of iodine deficiency in Lleida is lower than in previous publications, shown by the good nutrition parameters. The shortage of iodine is higher in immigrant boys, although better nutrition measures could be taken to improve their situation.

Pediatric patients receiving palliative care in Canada: results of a multicenter review.

OBJECTIVES: To describe the patients who received care from the 8 dedicated pediatric palliative care programs in Canada in 2002 and to estimate the number of children who may have benefited but did not receive services from these programs. DESIGN: Retrospective review of medical records combined with a survey of each program. SETTING: Seven pediatric palliative care programs based in tertiary care settings and 1 freestanding children's hospice. PARTICIPANTS: The programs cared for 317 children during 2002, of whom 123 died during that year. An additional 32 children died by the end of 2003. MAIN EXPOSURE: Pediatric palliative care program. RESULTS: Nearly half (48.6%) of the patients were younger than 5 years, and almost half of these were younger than 1 year. Primary diagnoses were disorders of the nervous system (39.1%), malignancies (22.1%), and conditions arising in the perinatal period or congenital anomalies (22.1%). Most of the children (43.9%) died at home, with those centers reporting more comprehensive home care services having the highest percentage of home deaths. From a national perspective, between 5% and 12% of the children who could benefit from palliative care received services from 1 of these programs. CONCLUSIONS: Pediatric palliative care programs in Canada care for a diverse population of patients with a wide range of age and disease conditions. Only a small percentage of children who die, however, receive services from these dedicated programs.

Laser-assisted subepithelial keratectomy in children.

PURPOSE: To evaluate whether laser-assisted subepithelial keratectomy (LASEK) achieves effective targeted myopic correction with less post-treatment corneal haze than observed with photorefractive keratectomy (PRK) in children who fail traditional forms of treatment for myopic anisometropic amblyopia and high myopia. SETTING: Nonhospital surgical facility with follow-up in a hospital clinic setting. METHODS: This prospective study comprised 36 eyes of 25 patients. The mean patient age at treatment was 8.27 years (range 1.0 to 17.4 years). Patients were divided into 3 groups: those with myopic anisometropic amblyopia (13 patients/13 eyes), those with bilateral high myopia (11 patients/22 eyes), and those with high myopia post-penetrating keratoplasty (1 patient/1 eye). All patients were treated with LASEK under general anesthesia using the Visx 20/20 B excimer laser and a multizone, multipass ablation technique. Although the myopia was as high as -22.00 diopters (D) spherical equivalent (SE) in some eyes, no eye was treated for more than -19.00 D SE. RESULTS: At 1 year, the mean SE decreased from -8.03 D to -1.19 D. Forty-four percent of eyes were within +/-1.0 D of the targeted correction; 78% of eyes had clear corneas with no haze. In the entire group, the mean best corrected visual acuity improved from 20/80 to 20/50. A functional-vision survey demonstrated a positive effect on the patients' ability to function in their environments after LASEK. CONCLUSIONS: Laser-assisted subepithelial keratectomy in children represents another method of providing long-term resolution of bilateral high myopia and myopic anisometropic amblyopia with minimal post-laser haze. The reduction in post-laser haze with LASEK compared to that with the standard PRK technique may represent an advantage in treating these complex patients.

Pharmacokinetics of E-6087, a new anti-inflammatory agent, in rats and dogs.

The pharmacokinetics of E-6087, a newly developed cyclooxygenase-2 inhibitor, was studied in rats and dogs after single oral and intravenous doses. In both animal species, E-6087 was characterized by a long elimination half-life (20-35 h), a low plasma clearance (0.10-0.22 l h(-1) kg(-1)) and a relatively large volume of distribution (2-6 l kg(-1)). Oral bioavailability was lower in dogs than in rats whereas a faster elimination was found in rats. Multiple peaks were present regardless of administration route and animal species, suggesting the existence of enterohepatic circulation. Gender effect on the pharmacokinetics of E-6087 was only found in rats, with greater exposure and longer elimination in females than in males. Food intake reduced the bioavailability (approximately 22%) with no apparent changes in the absorption rate. After oral dosing of 1, 5 and 25 mg kg(-1) to rats, linearity was lost at the highest dose due to the low aqueous solubility of E-6087. Drug absorption was improved by micronization. E-6087 and E-6132, (a pharmacologically active metabolite), showed different pharmacokinetics. The higher percentage of E-6087 at early times suggests that E-6087 is the main compound responsible for in vivo activity, although E-6132 would contribute to the activity at later times.

Simulation of acute spinal cord injury: effects on respiration.

The respiratory effects of acute spinal injury and paralysis are difficult to study. Urgent medical needs of human spinal cord injury victims usually preclude study, while induction of spinal cord lesions in awake animals is not feasible ethically. We utilized controlled, segmental infusion of epidural anesthetic in awake, highly trained, implanted canines to reversibly simulate the effects of thoracic and cervical (paraplegic and quadriplegic) spinal cord injury. We studied six animals, an average of 29 days after implantation with electromyogram and sonomicrometry transducers in transversus abdominis, external intercostal, parasternal intercostal and costal diaphragm muscles. Anesthetic was infused through an epidural catheter inserted percutaneously, under fluoroscopic guidance. Asymmetrical motor blockade was prevented using repositioning during epidural infusions. By sequential infusion we were able to induce three distinct, functional levels of spinal paralysis showing cumulative paralysis of abdominal, external intercostal, and parasternal intercostal muscles. Paralysis of the abdomen and chest wall, sparing only the diaphragm, showed unexpected bradypnea and failure to maintain minute ventilation.

Development and validation of two chromatographic methods for the quantification of E-6087 and one of its metabolites, E-6132, in rat plasma.

E-6087 is a nonsteroidal anti-inflammatory compound under development that selectively inhibits cyclooxygenase-2. In vitro studies have shown that one of its metabolites, E-6132, also inhibits this enzyme. Due to chromatographic reasons, two reverse phase HPLC methods were developed and validated in order to elucidate which compound is responsible for the pharmacological activity in vivo. Chromatographic separation of E-6087 was achieved using acetonitrile-phosphate buffer (pH 2.5; 25 mM) (60:40, v/v) as mobile phase and two 4.6 x 150 mm x 5 microm Inertsil ODS-2 columns. For E-6132, two Inertsil ODS-3 columns and 52% of acetonitrile were used instead. Internal standards and fluorescence detection differed between both methods. The same on-line solid-phase extraction method was used. Mean retention times for E-6087 and E-6132 were 15.2 (+/-1.3) and 36.1 (+/-0.6) min, respectively. The methods were selective and linear over the concentration range of 10--500 ng ml(-1) (r(2)>0.996) for E-6087 and 5--200 ng ml(-1) (r(2)>0.997) for E-6132. The limits of quantitation were 10 ng ml(-1) (E-6087) and 5 ng ml(-1) (E-6132) with a precision and accuracy <16% (E-6087) and <11% (E-6132). Mean recoveries from plasma were 43.2-61.9% (E-6087) and 60.4--65.2% (E-6132). For both compounds, both inter-assay and intra-assay precision and accuracy were within acceptable limits (<15%). As an example of the suitability of these methods, the results from a pharmacokinetic study are reported. After single oral administration of 5 mg kg(-1) of E-6087 to rats, plasma concentrations of E-6087 at peak time were higher than those of E-6132, suggesting that activity is mainly due to E-6087.

Treatment of Langerhans cell histiocytosis with pamidronate.

A 14-year-old boy with longstanding multisystem Langerhans cell histiocytosis (LCH) had multifocal bone pain unresponsive to chemotherapy, corticosteroids, anti-inflammatories, and narcotic analgesics. He responded to two cycles of intravenous pamidronate, each 90 mg per day on three consecutive days. Two subsequent episodes of deterioration also responded to treatment. The pathophysiology of his bone pain and the likely mechanisms of biphosphonate action are discussed, with emphasis on the molecular and cellular basis of LCH.

Validation of an automated liquid chromatographic method for omeprazole in human plasma using on-line solid-phase extraction.

An automated system using on-line solid-phase extraction and HPLC with UV detection has been validated in order to determine omeprazole in human plasma. The extraction was carried out using C18 cartridges. After washing, omeprazole was eluted from the cartridge with mobile phase onto an Inertsil ODS-2 column. The developed method was selective and linear for drug concentrations ranging between 5 and 500 ng ml(-1). The recovery of omeprazole ranged from 88.1 to 101.5%, and the limit of quantitation (LOQ) was 5 ng ml(-1). The intraday accuracy ranged from 93.1 to 106.2% and the interday accuracy varied from 95.4 to 105.1%. For the LOQ, good values of precision (8.7 and 17.5% for intraday and interday, respectively) were also obtained. This automated system has been applied to determine omeprazole in human plasma samples from bioequivalence studies.

Absorption, distribution and excretion of [14C]-Lesopitron after single and repeated administration in rats and dogs.

Disposition of [14C]-lesopitron was investigated in male rats and dogs after single and repeated oral administration. Radioactivity was rapidly and efficiently absorbed from gastrointestinal tract following oral administration. After 7 days, the radioactivity was mainly excreted into feces via bile. The cumulative urinary and fecal excretion was 99% and 75% of the administered dose in rats and dogs, respectively. [14C]-Lesopitron was widely distributed in rats, with the highest concentrations in liver and kidney, while the concentration in brain was similar to that in plasma. Radioactivity in most tissues decreased essentially in parallel with that in plasma. In rats, plasma levels of [14C]-lesopitron radioactivity achieved steady state on day 2 of repeated administration. The distribution pattern obtained after 7 consecutive daily oral doses was similar to that in the single-dose study. At 72 h after the last administration, tissue radioactivity was fully eliminated and no accumulation occurred. After i.v. administration in rats and dogs, plasma concentrations of lesopitron decreased biphasically with an apparent elimination half-life of 100 min. The absolute bioavailability of lesopitron was about 10%, suggesting an important first-pass effect. In rats, the lesopitron plasma concentrations were similar to those obtained for its metabolites (5-hydroxylesopitron and PmP), whereas in dogs, the PmP plasma concentrations were higher than those for lesopitron and 5-hydroxylesopitron.

Automated high-performance liquid chromatographic assay for lesopitron, a novel anxiolytic, in human plasma using on-line solid-phase extraction.

A totally automated liquid chromatographic assay method based on a Prospekt solid-phase extraction unit was developed for the analysis of lesopitron and its metabolite 5-hydroxylesopitron in human plasma. On-line solid-phase extraction of lesopitron, 5-hydroxylesopitron and its internal standard in human plasma was carried out using C2 cartridges. After washing, the test substances were eluted with mobile phase onto an ODS-2 Inertsil column and measured by fluorescence detection. The total time for one analysis was 25 min. The method developed was selective and linear in the concentration range from 1 to 40 ng/ml for both parent drug and metabolite. Recovery of lesopitron and 5-hydroxylesopitron were higher than 80% and the quantification limits were 1 ng/ml for both compounds. Coefficients of variation obtained for precision parameters were all below 14.5% and 13.9% for parent drug and metabolite, respectively. Good values of accuracy were also obtained.

Pathogenesis of spike-wave status: a clinical-pathological study implicating cerebellar disturbance.

If cerebellar Purkinje cells function in a manner so as to terminate at least some types of seizures or to prevent their clinical development then loss of Purkinje cells should predispose to the prolonged or continuous occurance of these seizures. This study presents clinical data that may document such an instance and cites the supporting experimental data.