Diabetes or hypertension as risk indicators for missing teeth experience: An exploratory study in a sample of Mexican adults.

BACKGROUND: To determine an exploratory estimation of the strength of type 2 diabetes mellitus (T2DM) and hypertension diagnoses as risk indicators for missing teeth in a sample of Mexican adults. MATERIALS AND METHODS: A comparative cross-sectional study of sixty adult patients in a health center in Mexico included as dependent variable, the number of missing teeth (and having a functional dentition) and as independent variables, diagnoses for diabetes or hypertension, age, sex, maximum level of schooling, and tobacco use. Of the 60 participants, 20 were diagnosed with T2DM, 13 with hypertension, and 27 were otherwise diagnosed as healthy in their most recent medical checkup. A negative binomial regression (NBR) model was generated. RESULTS: Mean age was 50.7 ± 16.2 and 50.0% were women. Mean number of missing teeth was 4.98 ± 4.17. In the multivariate NBR model, we observed that individuals with T2DM had higher risk of more missing teeth (incidence rate ratios [IRRs] = 3.13; 95% confidence interval [CI] = 2.09-4.69), followed by those with hypertension (IRRs = 2.63; 95% CI = 1.77-3.90). In addition, participants with current tobacco use were significantly more likely to have suffered tooth loss (P < 0.05) than those who were never smokers or former smokers, just like older participants (P < 0.05). CONCLUSIONS: T2DM and hypertension are independently associated with higher experience of missing teeth in an open adult population in Mexico. Future studies with a more sophisticated epidemiological design and encompassing a more detailed landscape of chronic diseases, type and length of use of long-term medications, and patterns of dental care use are needed to better delineate these associations.

Fractura-avulsión pélvica durante la actividad deportiva / Pelvic avulsion fracture during sports activity

Las fracturas pélvicas por avulsión se producen tras contracciones musculares violentas o explosivas en pacientes con esqueleto inmaduro. Tienen lugar por un desequilibrio entre la fuerza de tracción del músculo o tendón y la resistencia del cartílago apofisario donde se insertan, siendo verdaderos autotraumatismos. Estas lesiones habitualmente tienen un buen pronóstico, mediante un tratamiento conservador. Presentamos el caso clínico de un niño de 13 años que durante una actividad deportiva sufrió dolor e impotencia funcional en el muslo derecho, diagnosticándose de fractura-avulsión de la espina ilíaca anteroinferior derecha. Realizamos un seguimiento clínico y ecográfico; el paciente presentó una correcta evolución con reposo articular y analgesia y pudo reincorporarse a la actividad deportiva a los dos meses de la lesión(AU)

Avulsion fractures occur after violent or explosive muscular contractions in skeletally immature patients. They take place because of an imbalance between the pulling muscle force and the bone resistance where they are inserted. These lesions have a good prognosis with conservative treatment. We report a case of a thirteen year old male patient, who during sports activity referred acute pain and functional disability in the right thigh. An avulsion fracture of the anterior inferior iliac spine was diagnosed. A clinical and ultrasound imaging follow up was made, showing a satisfactory progress with joint rest and conventional analgesia, restoring sports activity two months after the initial injury(AU)

Ab initio study of the elastic properties of single and polycrystal TiO(2), ZrO(2) and HfO(2) in the cotunnite structure.

In this work, we study theoretically the elastic properties of the orthorhombic (Pnma) high-pressure phase of IV-B group oxides: titania, zirconia and hafnia. By means of the self-consistent SIESTA code, pseudopotentials, density functional theory in the LDA and GGA approximations, the total energies, hydrostatic pressures and stress tensor components are calculated. From the stress-strain relationships, in the linear regime, the elastic constants C(ij) are determined. Derived elastic constants, such as bulk, Young's and shear modulus, Poisson coefficient and brittle/ductile behavior are estimated with the polycrystalline approach, using Voigt-Reuss-Hill theories. We have found that C(11), C(22) and C(33) elastic constants of hafnia and zirconia show increased strength with respect to the experimental values of the normal phase, P 2(1)/c. A similar situation applies to titania if these constants are compared with its normal phase, rutile. However, shear elastic constants C(44), C(55) and C(66) are similar to the values found in the normal phase. This fact increases the compound anisotropy as well as its ductile behavior. The dependence of unit-cell volumes under hydrostatic pressures is also analyzed. P-V data, fitted to third-order Birch-Murnaghan equations of state, provide the bulk modulus B(0) and its pressure derivatives B'(0). In this case, LDA estimations show good agreement with respect to recent measured bulk moduli of ZrO(2) and HfO(2). Thermo-acoustic properties, e.g. the propagation speed of transverse, longitudinal elastic waves together with associated Debye temperatures, are also estimated.

[Epistaxis as initial manifestation of disseminated renal adenocarcinoma]. / Epístaxis como primera manifestación de un adenocarcinoma renal diseminado.

Peculiar renal carcinoma tendency to unusual distant metastases suggest this primary neoplasm to be accounted in differential diagnosis of metastases as first clinical symptom of cancer. Renal cell carcinoma present metastases in 26-30% of cases at the time of diagnosis. Head and neck metastases from renal carcinoma are said to be present in 8% (6-15.2%) of patients, and half of them are asented on paranasal sinuses. We report a 70-years-old patient with recurrent epistaxis as first clinical sign of a nasosinusal metastases from renal disseminated carcinoma, who precised selective embolization. Epidemyologic, diagnostic and therapeutical aspects are briefly reviewed in literature. Nasosinusal metastases are uncommon in clinical practice. We emphasized the need of primary tumor investigation in the organs most often responsible for these metastasic deposits as: kidney (50%), lungs, breast, gastrointestinal tract, urogenital ridge and thyroid gland. Individualized treatment depends on leasions number and localization. On routine follow up of hipernephroma nephrectomized patients a high suspect index has to be considered as paranasal metastases can eventually occur.

[Brucellar orchiepididymitis]. / Orquiepididimitis brucelosa.

The brucellosis is an unusual entity whose incidence has diminished due to the improvement in preventive measures. We have carried out a retrospective study of all the patients admitted in our service between 1996 and 1998, with diagnosis of orchitis. Two of the 31 patients admitted for this reason presented a final diagnosis of brucellar orchiepididymitis. Both patients presented clinic of affectation from the general state accompanied by resistance to habitual antibiotic treatment. The patient's epidemic antecedents, accompanied by the suitable clinical evolution took to the suspicion of orchiepididymitis of brucellar etiology, with change in the antibiotic rule. The diagnosis of the process was obtained by means of serologic tests and blood cultures.

[Malignant melanoma of the penis]. / Melanoma maligno de pene.

OBJECTIVE: To report a case of malignant melanoma of the penis, a rare malignant neoplasm whose aggressive behaviour carries a poor prognosis. METHODS: A 58-year-old male consulted for a pigmented elevated lesion in the balanopreputial sulcus. The biopsy was positive for melanoma. Complementary studies did not demonstrate disseminated disease. RESULTS: Partial resection of the penis and bilateral inguinal lymphadenectomy were performed. Histological analysis showed two positive nodes in the same lymphatic chain. Interferon was administered for 6 months. The patient remains disease-free at 35 months' follow-up. CONCLUSIONS: Although surgery is the treatment of choice, adjuvant therapy (chemotherapy and immunotherapy) should be considered in those patients without localized disease.

[Urologic complications in renal transplantation. Study of 250 cases]. / Complicaciones urológicas en el trasplante renal. Estudio en 250 casos.

OBJECTIVE: The aim of this study is value the incidence of urological complications (fistulae and estenosis) in our serie of renal transplant, to analyze the variables that can influence in their appearance and the treatments used. Likewise, to value the follow-up of theses patients and the survival of the renal graft and of the patient. MATERIAL AND METHODS: 250 renal transplants are carried out between july of 1985 and october of 1998. The relationship among the variables you makes by means of the test chi 2 of Pearson and the test of Fisher; the contrasts of stockings with the t of Student; the survival of the organ and of the patient, by means of the analysis of curved of survival according to the method of Kaplan and Meier; and the comparison among curved of survival was carried out with the test of Cloth and Cox. RESULTS: Of the 250 transplants, 46 patients suffered for complications, 29 urinary fistulae (11.6%) and 21 estenosis (8.4%). The most frequent localization in both complications was the union uretero-vesical. The presence of urinary fistulae didn't influence negatively in a significant way nor over the survival of the implant (p < 0.211), neither over the patient's survival. The estenosis appearance was related in a significant way with the donor's age (p < 0.02). The estenosis presence was not related in a significant way neither with the survival of the implant neither with that of the receiver. CONCLUSIONS: The incidence of urological complications was of 18.4% (11.6% estenosis and 8.4% fistulae). The most frequent localization was the union uretero-vesical. The presence of estenosis correlated with the increase of the age of the donors. The technique of reimplante ureteral didn't influence in the results in a significant way. We don't find any relationship between the appearance of urological complications and the patient's survival.

[Malignant neoplasms of the penis]. / Neoplasias malignas del pene.

OBJECTIVE: To assess the behaviour and management of these uncommon neoplasias. MATERIAL AND METHODS: Between March 1975 and July 1999, a total of 95 malignant neoplasias of the penis were diagnosed and treated by our unit. Patients mean age was 62 years (28 to 87 years). A retrospective analysis of any associated lesions, biological behaviour of the various neoplasias, as well as therapies used is carried out. RESULTS: The squamous carcinoma of the penis (SCP) is the most frequent pathohistological entity entailing 78 cases (82%), followed by verrucous carcinoma (VC) 13 cases (13.5%), basal cells carcinoma 1 case, and melanoma, lymphoma and penile metastasis 1 case each. There is a significant presence of associated lesions with marked predominance of phimosis. The most frequent reason for the call is an injury of the penis (74 cases; 78%). Treatment was mainly partial penectomy (51 patients; 53.7%), followed by conservative treatment in 28 cases (30%). Inguinal lymphadenectomy was performed in 13 patients (14%), due to either a positive nodular biopsy or a persistent adenopathy following antibiotic therapy. CONCLUSIONS: Neoplasias showing superior biological behaviour are basal cell carcinoma of the penis, and verrucous carcinoma. Prognosis in SCP is based on pathological status and node involvement. Patients with pT1 tumours showed no metastatic adenopathies after follow-up regardless of cytological grading, and are therefore candidates to watchful waiting with regular monitoring. Melanoma of the penis is a highly aggressive tumour due to its high metastatic capacity with a poor prognosis.

[Squamous carcinoma of the penis]. / Carcinoma escamoso de pene.

OBJECTIVE: To present our experience with squamous cell carcinoma of the penis. METHODS: We reviewed our series of 73 squamous cell carcinoma of the penis over the last 23 years. Patient mean age was 65.7 years. All lesions had been previously biopsied. Patient records were reviewed for a history of phimosis and related lesions. The histological, clinical and therapeutic aspects, and survival are analyzed. RESULTS: Most of the squamous cell carcinoma of the penis were superficial lesions (pT1). Treatment was by partial penile resection in 42 cases, total penile resection in 9, and emasculation in 2 cases. Conservative surgery was performed in 20 cases (tumor excision in 14 and posthectomy in 6 cases). Lymphadenectomy was performed in 11 patients. Eight patients received radiotherapy to the inguinal region. The rate of recurrence after surgery was 11% (8 cases). Five of the 8 patients with tumor recurrence had been treated by conservative surgery. The 5-year survival rate was 78%. CONCLUSIONS: Penile cancer is uncommon and accounts for less than 1% of tumors in the male in our setting. A higher incidence has been found in men with phimosis, poor hygiene and low sociocultural level. Partial penile resection is the treatment of choice for the primary lesion. The outcome is worse in patients with invasive tumor, poor cell differentiation, ulceroendophytic morphology, and above all in patients with metastatic adenopathy. Radiotherapy provided no benefits, made inguinal evaluation difficult and increased the morbidity in some cases. Patients with pT1 tumor and good cell differentiation showed no metastatic adenopathy during follow-up. Patient follow-up is fundamental to detect recurrence or metastatic adenopathy and to institute treatment immediately.

[Intraperitoneal bladder perforation in emphysematous cystitis]. / Perforación vesical intraperitoneal en el transcurso de una cistitis enfisematosa.

Contribution of one case report of a 69-year old diabetic male patient with neurogenic bladder. The patient developed emphysematous cystitis and peritonitis secondary to intraperitoneal perforation of the bladder. Emphysematous cystitis is an uncommon clinico-radiologic entity more frequent in diabetic and female patients and the elderly. Early diagnosis and treatment may avoid a fatal outcome. The paper includes a review of this condition.

Pólipo fibroepitelial de uretra posterior en niños / Fibroepithelial polyp in the posterior urethra in children

El pólipo fibroepitelial de uretra posterior es una lesión infrecuente. Afecta con mayor frecuencia a niños que adultos. Se debe tener presente en todos aquellos lactantes o niños que presenten trastornos miccionales, en especial retención urinaria. Presentamos dos casos, ambos ocurridos en niños de 2 y 5 años (AU)

[Basal cell carcinoma of the penis]. / Carcinoma basocelular de pene.

OBJECTIVE: To report an uncommon case of basal cell carcinoma of the penis. METHODS: A case of basal cell carcinoma of the penis is presented. This has been the only case of this tumor type detected in our setting. The literature is briefly reviewed. RESULTS/CONCLUSIONS: Basal cell carcinoma of the penis is rare. To date only 20 cases have been reported in the literature. To our knowledge, no case of distant metastasis has been documented. Diagnosis by gross examination may be difficult due to the broad polymorphism of this lesion and must be confirmed by histological analysis.

[Posterior urethral fibroepithelial polyp in children]. / Pólipo fibroepitelial de uretra posterior en niños.

A fibroepithelial polyp in the posterior urethra is a uncommon lesion. It is seen more frequently in children than in adults. It should be considered whenever an infant or a child presents with micturition disorders, particularly in the case of urinary retention. Contribution of two cases, both in children 2- and 5-year old.

[Management of obstructive uropathy in pregnancy]. / Manejo de la uropatía obstructiva en el embarazo.

INTRODUCTION: Obstructive uropathy in pregnant women is a relatively common condition. It can be difficult to assess due to the frequency with which physiologic dilation of the upper urinary tract is seen in pregnant women. PATIENTS AND METHOD: Over the past 3 years 40 pregnant women with symptomatic obstructive uropathy were seen in our service. RESULTS: Most pregnant women responded to conservative treatment (pain killers and antibiotics). In the remaining group, instrumentation was necessary through the urinary route: double J ureteral catheterism (10 patients: 6 due to uterine compression and 4 to lithiasis), percutaneous nephrostomy (4 patients: 2 due to ureteral catheter obstruction impossible to replace, and two due to urinary sepsis), or ureterorenoscopy (1 patient with lithiasis). CONCLUSIONS: The single most common cause for obstructive uropathy in our experience is ureteral compression due to a gravid uterus. Choice therapy in most cases is conservative treatment. When in spite of conservative treatment signs and symptoms persist, urinary by-pass with antibiotic prophylaxis must be performed. Ureterorenoscpy as a diagnostic and therapeutical approach should be taken into consideration in pregnant women with ureteral lithiasis. Incidence of pre-term labour was not higher than usual.

Weight, corticosterone and glucose: changes with time of day after food deprivation.

The effects of constant food deprivation, terminated at different times of day were examined with respect to percent body weight loss (%BWL), plasma corticosterone (PC) and plasma glucose (PG). A 19-hour food deprivation paradigm schedule staggered around varying times of the day-night cycle was used. Patterns of %BWL related to nocturnal lipogenesis and diurnal lipolysis showed the greatest loss (10%) occurring at 0700 hr, while in evening hours, there was an increasing pattern of weight loss, with the greatest amount (7%) occurring at 2200 hr. A pattern suggestive of neuroregulatory cycles of glucocorticoid release was evident for PC levels; maximum levels for PC (23.2 micrograms%) were reported at 0700 hr and at 1900 hr (16.6 micrograms%). Similar patterns were also noted in PG levels, with respective maximum levels of 138.0 mg% and 125.8 mg% occurring at 0700 hr and 1900 hr. These results indicate that the time of day that a deprivation schedule is initiated and terminated is an important consideration due to the impact of circadian photoperiodism. Time of day should be an essential consideration when utilizing deprivation paradigms.

Neuromelanogenic and cytotoxic properties of canine brainstem peroxidase.

We have isolated a heme protein from canine midbrains that possesses potent peroxidase activity. This enzyme catalyzes the oxidation of dopamine to neuromelanin in the presence of H2O2. We have further shown that the isolated peroxidase possesses potent cytotoxic activity in the presence of superoxide or H2O2 and Cl-. The enzyme possesses an endogenous NAD(P)H oxidase activity that can promote the cytotoxic activity by virtue of its production of superoxide. Other enzymes such as dihydroorotate dehydrogenase and galactose oxidase, which produce O2- and H2O2, respectively, are also effective in promoting the cytotoxic activity of the brainstem peroxidase. Although rat erythrocytes were routinely used as the target cell, other cell types, including rat hepatoma and mouse neuroblastoma cells, are also susceptible to the toxic action of the peroxidase. The cytotoxic action of the brainstem peroxidase is dramatically enhanced by kainic acid and is significantly enhanced by Mn2+, whereas dopamine was found to be a potent inhibitor of the cytotoxic activity. Based on these findings, we postulate a central role for the brainstem peroxidase in dopamine metabolism as well as in the biochemical and anatomical changes associated with Parkinson's disease.

Exposure to ethanol during pregnancy in mice: potential importance of dose for the development of tolerance in offspring.

CD-1 albino mice were given Portagen-10 percent ethanol (ETOH) or isocaloric Portagen-sucrose during pregnancy to determine if tolerance developed in utero and to describe the temporal pattern of its decline postnatally. ETOH mothers did not significantly increase their consumption of ETOH but gained in body weight during pregnancy, showed no signs in the open field of withdrawal from ETOH shortly after delivery and showed less pup-caring behavior than pair-fed controls (PFC). Among offspring 1, 3, 10, 25 and 60 days old, only 25-day old ETOH pups metabolized and cleared an anesthetic dose of ETOH more efficiently than PFC animals, suggesting the absence of Dispositional Tolerance in the other animals. PFC offspring 10 days old took significantly longer to lose the righting reflex than their ETOH counterparts following the anesthetic dose of ETOH, the difference being opposite that which would suggest the occurrence of Adaptive Tolerance. Data are discussed primarily in terms of decreases in dose of ETOH to which mothers and fetuses were exposed during pregnancy.