Modified Early Warning Score vs Cardiac Arrest Risk Triage Score for Prediction of Cardiopulmonary Arrest: A Case-Control Study.

Background: Delayed transfer to the intensive care unit (ICU) contributes to increased mortality. Clinical tools, developed to shorten this delay, are especially useful in hospitals where the ideal healthcare provider-to-patient ratio is not met. This study aimed to validate and compare the accuracy of the well-accepted modified early warning score (MEWS) and the newer cardiac arrest risk triage (CART) score in the Philippine setting. Patients and methods: This case-control study involved 82 adult patients admitted to the Philippine Heart Center. Patients who had cardiopulmonary (CP) arrest at the wards and those transferred to the ICU were included. Vital signs and alert-verbal-pain-unresponsive (AVPU) scales were recorded from recruitment until 48 hours prior to CP arrest or ICU transfer. The MEWS and CART scores were computed at specific time points and compared using measures of validity. Results: The highest accuracy was obtained by the CART score with a cut-off of ≥12 at 8 hours prior to CP arrest or ICU transfer, with a specificity of 80.43% and sensitivity of 66.67%. At this time point, the MEWS with a cut-off of ≥3 had a specificity of 78.26% but a lower sensitivity of 58.33%. The area under the curve (AUC) analysis revealed that these differences were not statistically significant. Conclusion: We recommend an MEWS threshold of 3 and a CART score threshold of 12 to help identify patients at risk for clinical deterioration. The CART score had comparable accuracy to the MEWS, but the latter's computation may be easier. How to cite this article: Tan ADA, Permejo CC, Torres MCD. Modified Early Warning Score vs Cardiac Arrest Risk Triage Score for Prediction of Cardiopulmonary Arrest: A Case-Control Study. Indian J Crit Care Med 2022;26(7):780-785.

Intervención educativa sobre riesgo preconcepcional en mujeres de un Área de salud en Guantánamo

Fundamento: La salud reproductiva está presente durante el ciclo vital de las mujeres y los hombres; en la que juega unpapel decisivo la planificación familiar, el conocimiento y manejo del riesgo reproductivo.Objetivo: Evaluar la efectividad de una intervención educativa, en mujeres de edad fértil con riesgo preconcepcional,pertenecientes al consultorio “La Colonia”, del Policlínico “Rafael Teope Fonseca”, “El Salvador”, Guantánamo, desdeseptiembre 2017 a abril 2019.Metodología: Se realizó un estudio cuasiexperimental, tipo intervención educativa sobre riesgo preconcepcional, con diseñoantes y después. El universo fue de 65 mujeres en edad fértil. Se utilizó muestreo no probabilístico intencional. La muestrafue de 45 mujeres con riesgo preconcepcional. La investigación se realizó en 3 etapas: diagnóstica, intervención y evaluación.La información se recogió en una encuesta semiestructurada que se aplicó antes y después de la intervención. Las variablesfueron: métodos para planificar el embarazo, edad óptima para el embarazo, antecedentes obstétricos desfavorables,importancia del consumo de ácido fólico antes del embarazo y conocimiento general sobre el tema. Se determinó el test deMcNemar para el análisis estadístico e índice de kappa para determinar efectividad de la intervención.Resultados: Antes de la intervención se diagnosticó nivel de conocimiento inadecuado sobre los métodos para planificar elembarazo (42 porcientro), edad óptima para el embarazo (40 porcientro) y en los antecedentes obstétricos (36 porcientro). Posterior a la intervenciónel nivel de conocimiento adecuado fue significativo (p<0.05) en todas las variables. El índice kappa arrojó acuerdoconsiderable.Conclusiones: La intervención educativa fue efectiva [AU]

Crosstalk Between Dermal Fibroblasts and Dendritic Cells During Dengue Virus Infection.

Dengue virus infection (DENV-2) is transmitted by infected mosquitoes via the skin, where many dermal and epidermal cells are potentially susceptible to infection. Most of the cells in an area of infection will establish an antiviral microenvironment to control viral replication. Although cumulative studies report permissive DENV-2 infection in dendritic cells, keratinocytes, and fibroblasts, among other cells also infected, little information is available regarding cell-to-cell crosstalk and the effect of this on the outcome of the infection. Therefore, our study focused on understanding the contribution of fibroblast and dendritic cell crosstalk to the control or promotion of dengue. Our results suggest that dendritic cells promote an antiviral state over fibroblasts by enhancing the production of type I interferon, but not proinflammatory cytokines. Infected and non-infected fibroblasts promoted partial dendritic cell maturation, and the fibroblast-matured cells were less permissive to infection and showed enhanced type I interferon production. We also observed that the soluble mediators produced by non-infected or Poly (I:C) transfected fibroblasts induced allogenic T cell proliferation, but mediators produced by DENV-2 infected fibroblasts inhibited this phenomenon. Additionally, the effects of fibroblast soluble mediators on CD14+ monocytes were analyzed to assess whether they affected the differentiation of monocyte derived dendritic cells (moDC). Our data showed that mediators produced by infected fibroblasts induced variable levels of monocyte differentiation into dendritic cells, even in the presence of recombinant GM-CSF and IL-4. Cells with dendritic cell-like morphology appeared in the culture; however, flow cytometry analysis showed that the mediators did not fully downregulate CD14 nor did they upregulate CD1a. Our data revealed that fibroblast-dendritic cell crosstalk promoted an antiviral response mediated manly by type I interferons over fibroblasts. Furthermore, the maturation of dendritic cells and T cell proliferation were promoted, which was inhibited by DENV-2-induced mediators. Together, our results suggest that activation of the adaptive immune response is influenced by the crosstalk of skin resident cells and the intensity of innate immune responses established in the microenvironment of the infected skin.

Reliance on Facebook for news and its influence on political engagement.

This paper examines the link between reliance on Facebook for news, political knowledge, and political engagement in the Philippines. We tested five hypotheses using data gathered from an online survey of 978 Filipinos conducted from February 1 to March 31, 2016. Findings support the hypothesis that those who rely less on social media as a news source exhibit higher levels of perceived knowledge about politics than those who rely more on it for news. Controlling for traditional news use, following political officials or institutions on social media is associated with higher levels of political interest and engagement, those with more politically active friends on Facebook have higher levels of exposure to political content online, and there is a positive correlation between Facebook being a source of information about politics and discussing politics more often with others. However, the hypothesis that those with more friends on their network who are politically active, will have greater political knowledge and more political engagement than those who have few politically active friends on their Facebook network is not supported.

Prevalencia y resultados perinatales adversos en adolescentes con diabetes mellitus gestacional según tres criterios diagnósticos internacionales / Prevalence and adverse perinatal outcomes in adolescent women with gestational diabetes mellitus according to three criteria international diagnostics

Resumen: OBJETIVO: comparar la prevalencia y resultados perinatales adversos de la diabetes mellitus gestacional en mujeres embarazadas adolescentes utilizando tres criterios diagnósticos internacionales diferentes. MATERIAL Y MÉTODOS: estudio comparativo y observacional de cohorte retrospectiva efectuado en adolescentes a quienes se tomó una curva de tolerancia oral a la glucosa de 75g-2 h, entre las 24 y 28 semanas de gestación. Se analizaron la prevalencia y los resultados perinatales adversos, con criterios del Fifth International Workshop-Conference on Gestational Diabetes Mellitus, International Association of Diabetes and Pregnancy Study Groups y National Institute for Health and Care Excellence. RESULTADOS: se estudiaron 493 adolescentes en quienes se obtuvo una prevalencia de diabetes mellitus gestacional de: 0.2, 6.3 y 1.8%, con los criterios del Fifth International Workshop-Conference on Gestational Diabetes Mellitus, International Association of Diabetes and Pregnancy Study Groups y National Institute for Health and Care Excellence, respectivamente. La prevalencia de diabetes mellitus gestacional fue significativamente mayor con los criterios de la International Association of Diabetes and Pregnancy Study Groups, sin diferencias significativas en los resultados perinatales adversos al utilizar cualquiera de los tres criterios. CONCLUSIÓN: la prevalencia de diabetes mellitus gestacional según los criterios de la International Association of Diabetes and Pregnancy Study Groups es 3 veces mayor que con los criterios del National Institute for Health and Care Excellence y 30 veces mayor con los criterios de la Fifth International Workshop-Conference on Gestational Diabetes Mellitus. No hubo riesgo incrementado de resultados perinatales adversos en adolescentes con diabetes mellitus gestacional; sin embargo, podrían tener mayor riesgo de padecer diabetes mellitus tipo 2 a largo plazo.

Abstract: OBJECTIVE: To compare the prevalence and perinatal outcomes of gestational diabetes mellitus in adolescent women using three international diagnostics criteria. METHODS: An observational retrospective cohort study, 493 adolescents were included, an oral glucose tolerance test 75g-2 h was performed, between 24 and 28 weeks of gestation, the prevalence and adverse perinatal outcomes was analyzed, with criteria of Fifth International Workshop-Conference on Gestational Diabetes Mellitus, International Association of Diabetes and Pregnancy Study Groups and National Institute for Health and Care Excellence. RESULTS: The prevalence of gestational diabetes mellitus was: 0.2%, 6.3% and 1.8%, with the criteria of Fifth International Workshop-Conference on Gestational Diabetes Mellitus, International Association of Diabetes and Pregnancy Study Groups and National Institute for Health and Care Excellence, respectively. The prevalence of gestational diabetes mellitus was significantly higher with criteria of the International Association of Diabetes and Pregnancy Study Groups; there were no significant differences among adverse perinatal outcomes when using any of the three criteria. CONCLUSION: Prevalence of gestational diabetes mellitus using the criteria of the International Association of Diabetes and Pregnancy Study Groups is 3 times higher than National Institute for Health and Care Excellence criteria and 30 times higher than the Fifth International Workshop-Conference on Gestational Diabetes Mellitus criteria. There was no increased risk of adverse perinatal outcomes in adolescents with gestational diabetes mellitus; however, adolescents may be at increased risk of developing type 2 diabetes mellitus long term.

Mycoplasma agassizii in Morafka's desert tortoise (Gopherus morafkai) in Mexico.

We conducted health evaluations of 69 wild and 22 captive Morafka's desert tortoises (Gopherus morafkai) in Mexico between 2005 and 2008. The wild tortoises were from 11 sites in the states of Sonora and Sinaloa, and the captive tortoises were from the state-managed Centro Ecológico de Sonora Zoo in Hermosillo and a private residence in the town of Alamos. We tested 88 tortoises for mycoplasmal upper respiratory tract disease (URTD) using enzyme-linked immunosorbent assays for specific antibody and by culture and PCR for detection of Mycoplasma agassizii and Mycoplasma testudineum. Fifteen of 22 captive tortoises had one or more positive diagnostic test results for M. agassizii whereas no wild tortoises had positive tests. Tortoises with positive tests also had significantly more moderate and severe clinical signs of mycoplasmosis on beaks and nares compared to tortoises with negative tests. Captive tortoises also exhibited significantly more clinical signs of illness than did wild tortoises, including lethargy and moderate to severe ocular signs. The severity of trauma and diseases of the shell and integument did not differ significantly among tortoises by site; however, clinical signs of moderate to severe trauma and disease were more prevalent in older tortoises. Similar to research findings for other species in the genus Gopherus in the US, we found that URTD is an important disease in captive tortoises. If they escape or are released by intention or accident to the wild, captive tortoises are likely to pose risks to healthy, naïve wild populations.

Psicopatología de los adolescentes residentes en hogares funcionales que precisan hospitalización psiquiátrica / Psychopathology of adolescents living in foster care who require a psychiatric hospitalization

INTRODUCCIÓN: Los adolescentes residentes en Hogares Funcionales presentan más riesgo de presentar Trastorno disocial y consumo de tóxicos. MÉTODO: Se estudió una muestra compuesta por todos los 431 adolescentes (12 y 17 años, 50,1% varones) que requirieron hospitalización en la Unidad de Psiquiatría Infanto-Juvenil del Hospital Universitario Basurto a lo largo de 68 meses consecutivos. Analizamos las características diferenciadoras respecto al motivo de ingreso, diagnóstico psiquiátrico, consumo de tabaco, alcohol y drogas, antecedentes psiquiátricos personales y familiares entre aquellos adolescentes ingresados que residían en hogares funcionales y los que residían con sus familias. RESULTADOS: El motivo más frecuente de ingreso para el total de la muestra fue alteración de la conducta (60,7% para los menores residentes en hogares funcionales y 33% para los residentes con familia de origen), seguidos de descompensación psicótica (24,7%) para residentes en hogares funcionales, y trastorno de la conducta alimentaria (16,4%) para los residentes con sus familias (p < 0,001). El diagnóstico psiquiátrico al alta más frecuente en ambos grupos fue trastorno psicótico (39,3% y 28,9%), siendo el trastorno disocial (37,1%) más prevalente en los adolescentes de hogares funcionales (p < 0,001). Los residentes en hogares funcionales consumían más tabaco (59,6%) (p < 0,001), cannabis (50,6%) (p < 0,001), anfetaminas (15,7%) (p < 0,01) y cocaína (14,6 %) (p < 0,05), y tenían más antecedentes de tratamiento psiquiátrico previo (p < 0,05) y antecedentes familiares psiquiátricos (p < 0,001). CONCLUSIONES: Los adolescentes que residen en hogares funcionales y precisan una hospitalización psiquiátrica representan un grupo de población en mayor riesgo de presentar trastorno disocial, consumir tabaco, cannabis y otras sustancias y poseer más antecedentes familiares psiquiátricos

INTRODUCTION: adolescents living in Foster care show high risk of conduct disorder and drug use. METHOD: A sample comprised by all 431 adolescents (ages 12-17, 50,1% men) admitted at the Child and Adolescent Psychiatric Inpatient Unit of Hospital Universitario Basurto during a period of 68 months was collected. Reason for admission, psychiatric diagnosis, tobacco, alcohol and drug use, personal and family psychiatric history were studied comparing those adolescents who live in Foster care with those living with their families. RESULTS: The most common reason for admission was behavioral problems (60.7% in those living in foster care and 33% in those living with their families), followed by psychotic symptoms (24.7%) for adolescents in foster care, and eating disorders (16.4%) for those living with their families (p < 0.001). The most frequent psychiatric diagnosis at discharge was in both groups psychotic disorder (39.3%, 28.9%); and conduct disorder (37.1%) was more prevalent in adolescents in foster care (p < 0.001). Those adolescents in Foster care smoke more frequently (59.6%) (p < 0.001), and use cannabis (50.6%) (p < 0.001), amphetamines (15.7%) (p < 0.01), and cocaine (14.6 %) (p < 0.05) also more frequently. They had had more previous psychiatric treatments (p < 0.05) and more psychiatric disorders in their families (p < 0.001). CONCLUSIONS: Adolescents in Foster Care who are admitted to inpatient psychiatric units are a group at a high risk of conduct disorder, tobacco, cannabis and drug use, and have more frequent history of psychiatric disorders in their families

Identification and in vitro reactivity of celiac immunoactive peptides in an apparent gluten-free beer.

Gluten content from barley, rye, wheat and in certain oat varieties, must be avoid in individuals with celiac disease. In most of the Western countries, the level of gluten content in food to be considered as gluten-free products is below 20 parts per million measured by ELISA based on specific anti-gluten peptide antibody. However, in beverages or food suffering complex hydrolytic processes as beers, the relative proportion of reactive peptides for celiac patients and the analytical techniques may differ, because of the diversity of the resulting peptide populations after fermentations. A beer below 20 parts per million of gluten but yet detectable levels of gluten peptides by anti-gliadin 33-mer antibodies (G12 and A1) was analyzed. We identified and characterized the relevant peptides for either antibody recognition or immunoactivity in celiac patients. The beer was fractionated by HPLC. The relative reactivity of the different HPLC fractions to the G12/A1 antibodies correlated to the reactivity of peripheral blood mononuclear cells isolated from 14 celiac individuals. Peptides from representative fractions classified according to the relative reactivity to G12/A1 antibodies were identified by mass spectrometry. The beer peptides containing sequences with similarity to those of previously described G12 and A1 epitopes were synthesized and confirmed significant reactivity for the antibodies. The most reactive peptides for G12/A1 also confirmed the highest immunogenicity by peripheral blood mononuclear cell activation and interferon γ production from celiac patients. We concluded that preparative HPLC combined with anti-gliadin 33-mer G12/A1 antibodies were very sensitive and specific methods to analyze the relevant immunogenic peptides in hydrolyzed gluten.

Adopción y alteraciones de conducta en la adolescencia. Estudio en población hospitalaria / Adoption and behavioural disturbances in adolescence. A hospital patient sample

INTRODUCCIÓN: En las últimas décadas se han incrementado las adopciones en el mundo occidental. Se ha descrito que los adolescentes adoptados están sobrerrepresentados en los servicios de salud mental y que consultan con mayor frecuencia por trastornos de externalización. Planteamos un estudio para valorar la proporción de adolescentes adoptivos y la presencia de conductas externalizantes en una muestra hospitalaria. MÉTODOS: Se recogen prospectivamente los datos de todos los ingresos de adolescentes (12-17 años) hospitalizados en la Unidad de Hospitalización Infanto-Juvenil, que atiende a todo el territorio de Bizkaia, durante 56 meses (n = 431). Dividimos la muestra en adoptados (2,6%) y no adoptados (97,4%), y comparamos las siguientes variables: edad media al ingreso, sexo, motivo de ingreso, ingresos previos, diagnóstico al alta, consumo de tóxicos y resultados de la Overt Aggression Scale al ingreso. RESULTADOS: Los adolescentes adoptados están sobrerrepresentados en nuestra muestra (2,84% vs. 0,6% en la población general; p < 0,001). Comparándolos con el subgrupo de no adoptivos, ingresan significativamente más jóvenes (14,09 vs. 15,21 años; p = 0,017) y tienden a hacerlo más frecuentemente por alteraciones de conducta (63,6% vs. 38,1%; p = 0,086). CONCLUSIONES: Los adolescentes adoptados presentan más ingresos y lo hacen a una edad más temprana, datos que indican una mayor gravedad de la afección de estos adolescentes o una menor capacidad de contención de las familias adoptivas. Además, observamos que tienden a ingresar más por alteraciones conductuales, sin existir diferencias significativas en los diagnósticos al alta, lo que sugiere una tendencia a expresar la sintomatología de forma más externalizadora

INTRODUCTION: The number of adoptions has increased in the Western world in recent decades. An over-representation in mental health services and an increased risk of displaying behavioural disorders has been reported among adopted adolescents. In this study, we aim to assess the proportions of adopted and non-adopted adolescents and the presence of externalizing disorders in an inpatient setting. METHODS: Prospective data were collected over 56 months (n = 431) from all adolescent admissions (12-17 years of age) to the Child and Adolescent's Inpatient Psychiatric Unit, which serves the Biscay province (Basque Country, Spain). The sample was divided into adopted (2.6%) and non-adopted adolescents (97.4%), and the following variables were compared: age, gender, cause of admission, prior admissions, main diagnosis, drug use and Overt Aggression Scale score at admission. RESULTS: Adopted adolescents were over-represented in our sample (2.84% vs. 0.6% in the general population of Biscay, P<0.001). Compared to the non-adopted, age at admission was significantly lower (14.09 vs. 15.21 years old, P=.017) and they showed a statistical tendency to be admitted more frequently for behavioural disorders (63.6% vs. 38.1%, P=0.086). CONCLUSIONS: The over-representation and the earlier age at admission suggest that the conditions of adopted adolescents are more serious and-or adoptive families are less able to manage them. The data also show that they tend to be admitted more for behavioural disorders, whilst no significant differences in the diagnosis on discharge were found, which suggests that they tend to externalise their symptoms more

Tuning the electronic properties of nonplanar exTTF-based push-pull chromophores by aryl substitution.

A new family of π-extended tetrathiafulvalene (exTTF) donor-acceptor chromophores has been synthesized by [2 + 2] cycloaddition of TCNE with exTTF-substituted alkynes and subsequent cycloreversion. X-ray data and theoretical calculations, performed at the B3LYP/6-31G** level, show that the new chromophores exhibit highly distorted nonplanar molecular structures with largely twisted 1,1,4,4-tetracyanobuta-1,3-diene (TCBD) units. The electronic and optical properties, investigated by UV/vis spectroscopy and electrochemical measurements, are significantly modified when the TCBD acceptor unit is substituted with a donor phenyl group, which increases the twisting of the TCBD units and reduces the conjugation between the two dicyanovinyl subunits. The introduction of phenyl substituents hampers the oxidation and reduction processes and, at the same time, largely increases the optical band gap. An effective electronic communication between the donor and acceptor units, although limited by the distorted molecular geometry, is evidenced both in the ground and in the excited electronic states. The electronic absorption spectra are characterized by low- to medium-intense charge-transfer bands that extend to the near-infrared.

Significant differences in coeliac immunotoxicity of barley varieties.

SCOPE: The only treatment available for coeliac disease (CD) is a strict diet in which the intake of wheat, barley, rye, or oats is avoided. Barley is a major cereal crop, grown mainly for its use in brewing, and it has high nutritional value. The identification of varieties with a reduced toxicity profile may contribute to improve the diet, the quality of life and health of CD patients. METHODS AND RESULTS: Searching for harmless barleys, we investigated accessions of malting and wild barley, used for developing new cultivated cereals. The CD toxicity profile of barleys was screened using G12 antibody and cell proliferation and IFN-γ release from peripheral blood mononuclear cells and intestinal biopsies from CD patients. We found a direct correlation between the reactivity with G12 and the immunogenicity of the different barleys. CONCLUSION: The malting barleys were less immunogenic, with reduced levels of toxic gluten, and were possibly less harmful to CD patients. Our findings could raise the prospect of breeding barley species with low levels of harmful gluten, and the attractive goal of developing nontoxic barley cultivars, always taking into account the Codex standard for foods for special dietary use for persons intolerant to gluten.

Inflammatory mediators and immune response in Mexican adolescents.

INTRODUCTION: Low-grade inflammation and increased immunity related to cardiovascular diseases have been described in children and adults, however, studies in Mexican adolescents are being done at present. OBJECTIVE: To evaluate inflammatory proteins and indicators of immunity in adolescents by gender and body mass index. MATERIAL AND METHODS: 115 Mexican adolescents, 15-18 years old (36 men), were divided into non-overweight, risk of overweight and overweight by CDC pediatric criteria by body mass index. Serum concentrations of ceruloplasmin, C3 and C4 were quantified by nephelometry; IL-6 and TNF-α from stimulated supernatant were analyzed with Human Th1-Th2 cytokine CBA II kit (BD Biosciences Pharmigen, San Diego, CA), and detected by flow cytometry. Data were analysed by Mann-Whitney U. RESULTS: Gender differences were found in C3 (men: median 118.8, mean rank: 41.0; women: median: 143.9, mean rank: 65.7, p=0.001) and ceruloplasmin (men: median: 31.01, mean rank: 47.06; women: median: 31.0, mean rank: 62.9, p=0.015). Differences by BMI were found in C3 (women non-overweight: median: 137.00 mena rank: 36.52; women with risk of overweight/overweight: median: 175.80, mean rank: 57.69, p=0.002) and C4 (men non-overweight: median: 23.40, mean rank: 16.60; men with risk of overweight/overweight: median: 26.40, mean rank: 26.36, p=0.028; women non-overweight: median: 24.25, mean rank: 37.16 and women with risk of overweight/overweight: median: 32.80, mean rank: 54.42, p=0.013). CONCLUSION: Inflammatory proteins are increased in adolescents with risk of overweight and overweight, particularly in women.

Diversity in oat potential immunogenicity: basis for the selection of oat varieties with no toxicity in coeliac disease.

BACKGROUND AND AIMS: Coeliac disease (CD) is triggered by an abnormal reaction to gluten. Peptides resulting from partially digested gluten of wheat, barley or rye cause inflammation of the small intestinal mucosa. Previous contradictory studies suggest that oats may trigger the abnormal immunological response in patients with CD. Monoclonal antibodies (moAbs) against the main immunotoxic 33-mer peptide (A1 and G12) react strongly against wheat, barley and rye but have less reactivity against oats. The stated aim of this study is to test whether this observed reactivity could be related to the potential toxicity of oats for patients with CD. METHODS: In the present study, different oat varieties, controlled for their purity and by their distinct protein pattern, were used to examine differences in moAb G12 recognition by ELISA and western blot. Immunogenicity of oat varieties was determined by 33-mer concentration, T cell proliferation and interferon γ production. RESULTS: Three groups of oat cultivars reacting differently against moAb G12 could be distinguished: a group with considerable affinity, a group showing slight reactivity and a third with no detectable reactivity. The immunogenicity of the three types of oats as well as that of a positive and negative control was determined with isolated peripheral blood mononuclear T cells from patients with CD by measurement of cell proliferation and interferon γ release. A direct correlation of the reactivity with G12 and the immunogenicity of the different prolamins was observed. CONCLUSIONS: The results showed that the reactivity of the moAb G12 is proportional to the potential immunotoxicity of the cereal cultivar. These differences may explain the different clinical responses observed in patients suffering from CD and open up a means to identify immunologically safe oat cultivars, which could be used to enrich a gluten-free diet.

Unusual presentation of a metastatic uveal melanoma in a cat.

A 10 year-old, spayed female Domestic Short-Haired (DSH) cat was diagnosed with a large primary uveal melanoma and exenteration was recommended. Thoracic radiographs, abdominal ultrasonography, and complete blood count and serum biochemistry panel did not reveal any abnormality compatible with metastatic disease and surgery was performed. Histopathologic study of the eye confirmed a diffuse iris melanoma. Five months later, the cat presented with a lameness of the right anterior extremity. On physical exam the right elbow was swollen and painful. Radiographs showed a severe osteolysis of the radial head and proximal diaphysis. Fine needle aspiration of the radius head identified a round cell neoplasm with scattered cells containing intracytoplasmatic pigmented granules, compatible with metastatic melanoma. The owners decided not to treat the patient with chemotherapy and declined a biopsy. Two months later, the cat died and necropsy was performed confirming bone metastasis of the uveal melanoma. A diagnosis of generalized metastasis from primary diffuse iris melanoma was made. This report describes, for the first time, long bone metastasis from an uveal melanoma in a cat.

Estilos de vida, hábitos dietéticos y prevalencia del sobrepeso y la obesidad en una población infantil / Lifestyle, dietetic habits and overweight and obesity prevalence in a pediatric population

Objetivos: conocer la prevalencia del sobrepeso y la obesidad en la población infantil,las características de sus hábitos dietéticos, su estilo de vida y otros determinantes asociados. Material y métodos: diseño: estudio descriptivo transversal. Emplazamiento: Centro de Atención Primaria, ámbito urbano. Participantes: niños > 6 y < 10 años del ABS El Carmel (Barcelona) (n = 716). Criterios de selección: muestra aleatoria –n = 340; prevalencia: 15%; intervalo deconfianza (IC): 95%; precisión: 3%– de la base de datos SIAP (Sistema de Informaciónen Atención Primaria). No se establecieron criterios de exclusión. Sin respuesta: n = 63(95%: errores de filiación; 5%: falta de interés). Mediciones principales: peso y talla –para el índice de masa corporal (IMC)–, test rápido Krece Plus y test corto de actividad física Krece Plus (para hábitos dietéticos y estilode vida). Análisis descriptivo y bivariado: chi al cuadrado, test de la t de Student, test deAnova, test de correlación y regresión logística. Resultados: 276 encuestas (81,4%). Prevalencia del sobrepeso: 11,59% (IC 95%:7,81%-15,32%); prevalencia de la obesidad: 10,14% (IC 95%: 6,58%-13,7%). Hábitos alimentarios: 52,3% tiene una alimentación óptima y 4,4% presenta hábitos inadecuados. Estilo de vida: malo: 58,7%; bueno: 3,6%. La media del IMC es superior (p < 0,05) en los niños más inactivos, cuando el nivel de estudios de la madre es bajo o si nacieron fuera de España. El sobrepeso y la obesidad infantiles son 3,6 veces superiores (IC 95%: 1,37-8,05) si el padre es obeso y 3,1 veces superiores (IC 95%: 1,19-7,31) si lo es la madre. Conclusiones: el estudio proporciona una línea de base para establecer las directricesy actividades del programa de intervención comunitaria para la prevención de la obesidad infantil (AU)

Objectives: to determine the prevalence of overweight and obesity in children, characteristicsof their dietary habits, lifestyle and other associated determinants. Material and method: design: cross-sectional study. Location: Primary Health Center, urbanarea. Participants: children > 6 and < 10 years of ABS El Carmel (Barcelona) (n = 716).Selection criteria: random sample (n = 340; prevalence: 15%; CI: 95%; accuracy: 3%)from the database SIAP (System for Information in Primary Care), no exclusion criteria were established. No answer: n = 63 (95%: address error; 5%: lack of interest). Measurements: weight, height (for BMI), Quick Test and Short Test from Krece Plus (fordiet and lifestyle). Descriptive and bivariate analysis: Chi-square, t-test, ANOVA test, correlationtest and logistic regression. Results: two hundred and seventy-six surveys (81.4%). Overweight prevalence: 11.59%(95% CI: 7.81%-15.32%); obesity prevalence: 10.14% (95% CI: 6.58%-13.7%). Food habits:52.3% optimal feeding habits and 4.4% inadequate. Lifestyle: 58.7% bad lifestyle and 3.6% goodlifestyle. The BMI mean was higher (p < 0.05) in inactive children, in low education level of mothers, or in born outside Spain. Overweight and obesity in children is 3.6 times higher (95% CI:1.37-8.05) if the father is obese and 3.1 times higher (95% CI: 1.19-7.31) if the mother is obese. Conclusions: the study provides a baseline for establishing the guidelines and activities ofthe community intervention program for preventing childhood obesity (AU)

Periodontal health and lateral lower lip piercings: a split-mouth cross-sectional study.

AIM: To assess periodontal health of individuals with a lateral lower lip piercing and describe associated periodontal, dental and mucosal complications. MATERIAL AND METHODS: A split-mouth study was performed in a sample of 50 patients with a lateral lower lip piercing who attended the Periodontal Pathology and Surgery Unit of the Dental School of the University of Barcelona. The patients underwent periodontal, dental and mucosal examination on both the piercing and the control sides. RESULTS: Piercing users were predominantly women (78%), with a mean age of 21.3 years (SD=4.4). The amounts of keratinized and attached gingiva were significantly lower on the piercing side, and the prevalence of gingival recession was higher (p=0.012). The canine and first bicuspid teeth were the most affected. Tooth fractures and cracks were more frequent on the piercing side (20%) when compared with the control (4%). Mucosal alterations were found in seven patients. CONCLUSIONS: The use of lateral lower lip piercings enhances gingival recession and reduces the amounts of keratinized and attached gingiva. These ornaments are also associated with tooth fractures and cracks.

CAD / CAM dental systems in implant dentistry: Update

CAD/CAM systems (computer-aided design / computer aided manufacturing) used for decades in restorative dentistry have expanded its application to implant dentistry. This study aimed to look through CAD/CAM systems used in implant dentistry, especially emphasizing implant abutments and surgical templates manufacturing. A search of articles published in English at Medline and Scopus databases at present was conducted, introducing “dental CAD/CAM”, “implants abutments” and “surgical guide CAD/CAM” as key words. These systems consist of three components: 1) data capture using optical systems or laser scanning, 2) CAD for the design of the restoration, and 3) CAM to produce the restoration through the information generated by computer. CAD/CAM abutments present the advantages of being specific to each patient and providing a better fit than the rest of abutments, in addition to being much more tough as they employ materials such as titanium, alumina and zirconium. In order to improve accuracy during implant placement we use stereolithography to manufacture CAD/CAM surgical templates. Using this method, minimally invasive surgery is performed without a flap, and the prosthesis is delivered, achieving immediate functional loading to the implants (AU)

[Phytoplankton from Tehuantepec River, Oaxaca, Mexico and some biogeographical relationships]. / Fitoplancton del río Tehuantepec, Oaxaca, México y algunas relaciones biogeográficas.

Phytoplankton species collected from the limnetic to euryhaline sections of Tehuantepec River were identified, classified and compared with regional information from Mexico and South America. We collected 15 samples every three months from July 1997 through August 1998 with a 20 microm net and a Van Dorn bottle. Indicator values and a code checklist are included. A total of 58 families, 121 genera, 273 species, one subspecies, 75 varieties, 13 forms and one morphotype were identified in the taxa Bacillariophyta (42.0 %), Chlorophyta (29.0 %), Cyanoprocaryota (18.0 %), Euglenophyta (5.0 %), Dinophyta (3.0 %), Cryptophyta (2.0 %) and Chrysophyta (1.0 %). The predominant families were Scenedesmaceae (24 species), Oocystaceae (22), Bacillariophyceae (21), Chaetocerotaceae (15) and Euglenaceae (14). Five families, eight genera, 72 species, 45 varieties and eight forms are first records for Mexico. The species Chroococcus turgidus, Microcystis flosaquae and Pseudanabaena limnetica (which produce massive blooms or red tides) are important in this river of moderate water quality.