Antibiotic prophylaxis habits in dental implant surgery among dentists in Spain. A cross-sectional survey.

BACKGROUND: The use of antibiotics to prevent dental implant failures and postoperative infections remains a controversial issue. The objectives of this study were to assess the current antibiotic prescribing patterns and antibiotic prescribing frequency of dentists in Biscay (Spain) in conjunction with routine dental implant surgery among healthy patients and to determine whether any consensus has been reached by such practitioners and last published evidence was being followed. MATERIAL AND METHODS: Observational cross-sectional study: electronic survey. This study was reported according to the STROBE guidelines. This anonymous questionnaire contained open-ended and close-ended questions. An email was sent 26 October 2017 to all the registered members of the Biscay dentists' College (n=989). The collected data were analyzed using STATA® 14 software, and 95% confidence intervals (CI) were used to assess the frequency of prescription for each antibiotic regimen. RESULTS: The survey was responded to by a total of 233 participants (response rate=23.56%). Overall, 210 participants finished the survey completely, and 23 surveys were answered partially. The questionnaire was responded to by 122 females (58.1%) and 88 males (41.9%). Of the participants, 88% (n=207) always routinely prescribed prophylactic antibiotics in conjunction with dental implant surgery (95% CI: 84.79-92.88%). Approximately 9% (n=22) prescribed antibiotics sometimes (95% CI: 5.68-13.19%), and only 4 dentists (1.72%) never prescribed antibiotics (95% CI: 0.04-3.38%). Overall, 179 of 233 respondents prescribed both pre- and postoperative antibiotics (78.85%, 95% CI: 72.96-83.97%), 13 prescribed antibiotics only preoperatively (5.73%, 95% CI: 3.08-9.59%), and 35 prescribed antibiotics exclusively after routine dental implant surgery (15.42%, 95% CI: 10.98-20.78%). CONCLUSIONS: Most of the dentists working in Biscay routinely prescribe prophylactic antibiotics in conjunction with dental implant surgery among healthy patients. A large range of prophylactic regimens are prescribed and the most recently published evidence is not being followed.

Pliocene-Pleistocene ecological niche evolution shapes the phylogeography of a Mediterranean plant group.

Estimating species ability to adapt to environmental changes is crucial to understand their past and future response to climate change. The Mediterranean Basin has experienced remarkable climatic changes since the Miocene, which have greatly influenced the evolution of the Mediterranean flora. Here, we examine the evolutionary history and biogeographic patterns of two sedge sister species (Carex, Cyperaceae) restricted to the western Mediterranean Basin, but with Pliocene fossil record in central Europe. In particular, we estimated the evolution of climatic niches through time and its influence in lineage differentiation. We carried out a dated phylogenetic-phylogeographic study based on seven DNA regions (nDNA and ptDNA) and fingerprinting data (AFLPs), and modelled ecological niches and species distributions for the Pliocene, Pleistocene and present. Phylogenetic and divergence time analyses revealed that both species form a monophyletic lineage originated in the late Pliocene-early Pleistocene. We detected clear genetic differentiation between both species with distinct genetic clusters in disjunct areas, indicating the predominant role of geographic barriers limiting gene flow. We found a remarkable shift in the climatic requirements between Pliocene and extant populations, although the niche seems to have been relatively conserved since the Pleistocene split of both species. This study highlights how an integrative approach combining different data sources and analyses, including fossils, allows solid and robust inferences about the evolutionary history of a plant group since the Pliocene.

Malformación cerebral en dos niños inmigrantes / Cerebral malformation in two immigrant children

La esquisencefalia es un infrecuente trastorno de la migración neuronal, caracterizado por presentar una hendidura profunda cerebral, unilateral o bilateral, desde la piamadre hasta la superficie del ventrículo, recubierta de sustancia gris. Hay dos tipos: el tipo I, de labios cerrados, y el tipo II, más infrecuente, de labios abiertos. Suele cursar de forma asintomática en el neonato, y la clínica aparece en el segundo trimestre de la vida, con alteraciones en el perímetro craneal, espasmos infantiles, epilepsia parcial rebelde, monoparesia espástica, retraso mental con espasticidad, etc. Describimos los casos de dos pacientes inmigrantes diagnosticados de parálisis cerebral en sus países de origen, en los que se diagnosticaron los dos tipos de esquisencefalia al ser remitidos a nuestro centro. También pretendemos subrayar la rareza del tipo II (AU)

Schizencephaly is a rare neuronal migration disorder characterized by unilateral or bilateral clefts that extend from the pialsurface to the ependymal surface, with borders covered by gray matter. There are two types, type I (fused clefts) and type II (cleft walls separated). Asymptomatic during the neonatal period, the clinical features appear during the second trimester of life, with seizures, hemiparesis, and developmental deficits. We describe two cases of immigrant children who had been diagnosed as having cerebral palsy in their countries of origin, but were diagnosed with the two types of schizencephaly when referred to our hospital (AU)

Condiloma acuminado perianal gigante complicado / Perianal complicated giant condyloma acuminatum

No disponible

[Rational use of antibiotics in pediatrics: impact of a rapid test for detection of beta-haemolytic group A streptococci in acute pharyngotonsillitis]. / Empleo racional de los antibióticos en pediatría: impacto de la aplicación de un test rápido de detección de estreptococo beta-hemolítico del grupo A en la faringoamigdalitis aguda.

OBJECTIVES: To assess the reliability and validity of a rapid test for the identification of Streptococcus pyogenes in the pharyngeal exudate of children presenting with pharyngotonsillitis. To evaluate the impact of its use in outpatient clinics on antibiotic use, on the incidence of second medical visits and complications, and on the degree of parental satisfaction. PATIENTS AND METHODS: After a clinical diagnosis of acute pharyngitis was established and written informed consent obtained from the parents, dual throat swabs were collected from 430 children who attended the emergency department of our hospital or the pediatric offices of three health centers in our area. The first specimen was examined by the rapid test, QuickVue Flex Strep A, and the second one was sent to the laboratory for conventional culture. As a rule, antibiotics were indicated only when the rapid test was positive. Special emphasis was placed on explaining to parents that treatment was not necessary when the test was negative. Telephone follow-up was provided to the family during the next four weeks, after which a satisfaction survey was carried out. RESULTS: The sensitivity of the investigated rapid test was 91.2% (negative predictive value: 96.5%) and specificity was 96.2% (positive predictive value: 90.4%). Antibiotics were given to 41.9% of the patients, approximately half the expected rate in the absence of the rapid test. There was no significant difference in the number of second visits or hospitalizations between the groups of treated and non-treated subjects. Clinical evolution was good in all cases. The degree of parental satisfaction was very high, independent of the treatment given to the patients. CONCLUSIONS: The rapid test for the detection of group A streptococci is a reliable tool for the selection of patients able to benefit from antibiotic treatment. It is easy to handle and apply and its use allows a significant reduction in the administration of antibiotics in pharyngotonsillitis. Most users accept and are satisfied with this novel diagnostic and therapeutic procedure.

Empleo racional de los antibióticos en pediatría: impacto de la aplicación de un test rápido de detección de estreptococo beta-hemolítico del grupo a en la faringoamigdalitis aguda / Rational use of antibiotics in paediatrics: impact of a rapid test for detection of ß-haemolytic group A streptococci in acute pharyngotonsillitis

Objetivos: Analizar la fiabilidad y validez de un test rápido para la identificación de Streptococcus pyogenes en exudado faríngeo de niños con faringoamigdalitis aguda. Evaluar el impacto de su aplicación ambulatoria sobre la utilización de antibióticos, la incidencia de segundas visitas y complicaciones y el grado de satisfacción de los usuarios. Pacientes y métodos Tras proceder al diagnóstico clínico de faringitis aguda, informar a los padres y obtener su consentimiento escrito, se realizó frotis faringoamigdalar con 2 torundas a 430 niños atendidos en el servicio de urgencias de nuestro hospital o en las consultas de pediatría de 3 centros de salud de la zona. Con una muestra se efectuó el test rápido QuickVue(r) Flex Strep A, enviándose la otra al laboratorio para cultivo convencional. Salvo excepciones, se indicó tratamiento antibiótico sólo si el test rápido era positivo, haciéndose especial hincapié en explicar la ausencia de indicación de antibioterapia en el caso contrario. Se proporcionó seguimiento telefónico a los familiares durante 4 semanas, pasando al final una encuesta de satisfacción. Resultados La sensibilidad del test rápido fue del 91,2 por ciento (valor predictivo negativo 96,5 por ciento) y la especificidad 96,2 por ciento (valor predictivo positivo 90,4 por ciento). Recibió tratamiento antibiótico el 41,9 por ciento de los pacientes, aproximadamente la mitad de lo esperado en ausencia del test rápido. No se encontraron diferencias significativas en el número de segundas visitas ni de hospitalizaciones entre los grupos de tratados y no tratados. La evolución clínica fue favorable en todos los casos. El grado de satisfacción de los familiares resultó muy elevado entre los encuestados, independientemente de que el paciente hubiese recibido antibiótico o no. Conclusiones El test rápido citado tiene una sensibilidad y especificidad adecuadas para orientar sin riesgos el tratamiento. Es de fácil manejo y aplicación, y su uso permite una disminución significativa del empleo de antibióticos en esta patología. La gran mayoría de usuarios acepta y está satisfecha con esta nueva aproximación diagnóstico-terapéutica (AU)

Immunocytochemical distribution of serotonin and neuropeptide Y (NPY) in mouse adrenal gland.

By the use of immunocytochemical staining methods, we studied the morphology and distribution of 5HT and NPY immunoreactive cells and fibres in the mouse adrenal gland. The 5HT-immunoreactive cells were numerous and widely localized in the medullar tissue. These cells were arranged in three cellular types with regard to their morphological and immunocytochemical features. One of them showed cells with polygonal shape, being intensified like the typical medullary chromaffin cells. These immunoreactive cells were observed arranged in medullar islets. The second 5HT-immunoreactive cellular type was constituted by cells with polygonal shape and strong immunoreactivity. The third one was formed by cells with immunoreactive prolongations. We found some islets of chromaffin non-immunoreactive cells surrounded by immunostained cells. We also observed some 5HT-immunoreactive nerve fibres in the medullar tissue. NPY-like immunoreactivity was detected in both chromaffin and ganglion cells in adrenal medulla. NPY-like immunoreactivity was also detected in nerve fibres at cortical level. In a few cases, we observed medullar 5HT- and NPY-immunoreactive tissue in the adrenal cortex (monotremas).

[Walker-Warburg syndrome: experience at the Virgen de la Arrixaca Hospital]. / Síndrome de Walker-Warburg: experiencia del Hospital Virgen de la Arrixaca.

We report five patients with Walker-Warburg syndrome. These patients showed congenital hydrocephalus, encephalocele, agyria, ocular abnormalities (cataracts in 100%), and in four signs of muscular dystrophy. No cause is known for theses abnormalities. Death occurred before two years of age; however, one patient is currently alive with 6 months of age. This disease is recognized as a genetically determined condition with an autosomal recessive mode of inheritance. We comment on the similarities of this syndrome with other syndromes and the latest investigations concerning the pathogenesis. We believe that it is very important to suspect this illness in order that genetic counseling can be offered.

Distribution of serotonin-immunoreactive cells in the mouse pancreas during development.

The distribution and time of appearance of 5HT-storing cells were studied in samples from the pancreas of mice embryos from 7 to 19 days of gestation. Additionally, 1- and 15-day-old newborns and adult specimens were also examined. Serotonin-immunoreactive cells appeared for the first time in the dorsal pancreatic primordium at 10 days of gestation and increased rapidly in number through E15. From this age, the cellular number diminished in the exocrine pancreatic parenchyma, although an increase of endocrine cells in Wirsung's duct can be detected. At day 15 of extrauterine life, we could only observe some cells in the surface epithelium of pancreatic duct of Wirsung. Islet immunoreactive cells could only be detected in adult animals.