Altered Surface Expression of Insulin-Degrading Enzyme on Monocytes and Lymphocytes from COVID-19 Patients Both at Diagnosis and after Hospital Discharge.

Although the COVID-19 disease has developed into a worldwide pandemic, its pathophysiology remains to be fully understood. Insulin-degrading enzyme (IDE), a zinc-metalloprotease with a high affinity for insulin, has been found in the interactomes of multiple SARS-CoV-2 proteins. However, the relevance of IDE in the innate and adaptative immune responses elicited by circulating peripheral blood mononuclear cells is unknown. Here, we show that IDE is highly expressed on the surface of circulating monocytes, T-cells (both CD4+ and CD4-), and, to a lower extent, in B-cells from healthy controls. Notably, IDE's surface expression was upregulated on monocytes from COVID-19 patients at diagnosis, and it was increased in more severe patients. However, IDE's surface expression was downregulated (relative to healthy controls) 3 months after hospital discharge in all the studied immune subsets, with this effect being more pronounced in males than in females, and thus it was sex-dependent. Additionally, IDE levels in monocytes, CD4+ T-cells, and CD4- T-cells were inversely correlated with circulating insulin levels in COVID-19 patients (both at diagnosis and after hospital discharge). Of note, high glucose and insulin levels downregulated IDE surface expression by ~30% in the monocytes isolated from healthy donors, without affecting its expression in CD4+ T-cells and CD4- T-cells. In conclusion, our studies reveal the sex- and metabolism-dependent regulation of IDE in monocytes, suggesting that its regulation might be important for the recruitment of immune cells to the site of infection, as well as for glucometabolic control, in COVID-19 patients.

Use of platelet concentrates in Oral Implantology, a narrative review. / Uso de concentrados plaquetarios en Implantología Oral, una revisión narrativa. / Uso de concentrados de plaquetas em Implantodontia Oral, uma revisão narrativa.

The use of regenerative modalities in dentistry has become widespread in recent years, specifically in implantology, this area currently being the best treatment option to replace missing teeth. For the success of the implantation, a healthy alveolus is needed, with osseointegration being essential in this process. This stage is favored by alternatives such as platelet concentrates, specifically Plasma rich in Fibrin. Collect and analyze information about platelet concentrates, specifically PRF, its benefits when applying it in the installation of immediate dental implants. Know its advantages compared to other concentrates and explore some improvements that have been worked on around this topic. A medline search was performed through Pubmed using the formula with MeSh terms ("Dental Implants"[Mesh]) AND "Platelet-Rich Fibrin"[Mesh]. 47 results were found, of which 38 were excluded by reading the title and abstract. The rest were read in full text, including all of them. In addition, a search with free terms was carried out to find literature about epidemiological data of the Chilean population, including 1 more study.

El uso de modalidades regenerativas en odontología se ha masificado en los últimos años, específicamente en implantología, siendo actualmente esta área la mejor opción de tratamiento para reemplazar dientes faltantes. Para el éxito de la implantación se necesita un alvéolo sano, siendo la osteointegración fundamental en este proceso. Esta etapa es favorecida por alternativas como los concentrados plaquetarios, específicamente Plasma rico en Fibrina. Recopilar y analizar información acerca de concentrados plaquetarios, específicamente PRF, sus beneficios al aplicarlo en instalación de implantes dentales inmediatos. Conocer sus ventajas frente a otros concentrados y explorar algunas mejoras que se han trabajado en torno a este tema.Se realizó una búsqueda en medline a través de Pubmed mediante la fórmula con términos MeSh ("Dental Implants"[Mesh]) AND "Platelet-Rich Fibrin"[Mesh]. Se encontraron 47 resultados de los cuales se excluyeron 38 mediante lectura de título y resumen. Los restantes se leyeron a texto completo incluyéndose todos. Además, se realizó una búsqueda con términos libres para encontrar literatura acerca de datos epidemiológicos de la población chilena, incluyendo 1 estudio más.

A utilização de modalidades regenerativas na odontologia tem se difundido nos últimos anos, especificamente na implantodontia, sendo esta área atualmente a melhor opção de tratamento para substituição de dentes perdidos. Para o sucesso da implantação é necessário um alvéolo saudável, sendo a osseointegração fundamental neste processo. Esta etapa é favorecida por alternativas como os concentrados de plaquetas, especificamente o Plasma rico em Fibrina. Coletar e analisar informações sobre os concentrados de plaquetas, especificamente o PRF, seus benefícios ao aplicá-lo na instalação de implantes dentários imediatos. Conheça suas vantagens em relação a outros concentrados e explore algumas melhorias que foram trabalhadas em torno desse tema. Uma busca no medline foi realizada através do Pubmed usando a fórmula com termos MeSh ("Dental Implants"[Mesh]) E "Platelet-Rich Fibrin"[Mesh]. Foram encontrados 47 resultados, dos quais 38 foram excluídos pela leitura do título e resumo. Os demais foram lidos na íntegra, incluindo todos eles. Além disso, foi realizada uma busca com termos livres para encontrar literatura sobre dados epidemiológicos da população chilena, incluindo mais 1 estudo.

Systems of care among children and youth with special health care needs with and without adverse childhood events: National Survey of Children's Health 2016-2017.

BACKGROUND: Knowledge of adverse childhood events (ACEs), the associated access to healthcare and unmet needs among children and youth with special health care needs (CYSHCN) is limited. OBJECTIVES: Our objectives were to compare the likelihood of CYSHCN versus non-CYSHCN experiencing one or more ACEs and document differences in receipt of recommended and needed health care among CYSHCN with and without ACEs. METHODS: We combined two years of data from the 2016 and 2017 National Survey of Children's Health (N = 71,181), providing a sample of 16,304 CYSHCN. Our primary outcome measures included eight adverse childhood events, compared to singular and aggregated ACEs among non-CYSHCN. We calculated associations between ACEs and secondary outcome measures for six components of well-functioning systems of care and unmet need for different types of health care using bivariate and multivariate analyses. RESULTS: CYSHCN were more likely to have each of the ACEs measured and were likelier to experience aggregated levels of ACEs compared to non-CYSHCN. The likelihood of CYSHCN having a medical home with family-centered and coordinated care decreased with increased ACEs, while one or more ACES increased the likelihood of having unmet needs for mental health care. CONCLUSION: The findings of the current study extend our understanding of the additional adverse event burden associated with special health care needs status, the accompanying limitations in access to family-centered and coordinated care in a medical home and unmet need for mental health care, indicating that much work remains in establishing appropriate care systems for this very vulnerable population.

Healthcare provider-child-parent communication in the preoperative surgical setting.

OBJECTIVES: Although preoperative preparation programs were once common, most children currently undergoing outpatient surgery are first exposed to the hospital on the day of the procedure. It is advocated that these outpatient children undergo the preparation just prior to surgery. AIM: To assess the amount of time that healthcare providers spend with children and families on the day of surgery in the preoperative area. MATERIALS AND METHODS: The study used video infrastructure in the preoperative holding area of Yale New Haven Children's Hospital to record all interactions between children, families, and healthcare providers. Videotapes were coded to characterize and quantify behaviors of healthcare professionals. RESULTS: On the day of surgery, healthcare providers spent medians of 2.75-4.81 min interacting with children and parents in the preoperative area. Families spent a median of 46.5 min in the preoperative area. Healthcare professionals spent the most time in medical talk (averages of 42.5-48.2% of time spent with family) and little time was spent in nonmedical talk (range of 6.2-6.9% of time spent with family). Anesthesiologists and surgeons spent 28% and 18% of the interview in talk to children; admitting nurses spent more of the interview talking to children (43%). CONCLUSIONS: Families interact with healthcare providers for only a small proportion of the time they spent in the preoperative area. This is likely to be a result of increased production pressure in the perioperative settings and has implications for providing preparation for surgery on the morning of the procedure.