Evaluación de la extrusión de residuos apicales y permeabilidad apical en sistemas endodónticos rotativos continuos y recíprocos.

The aim of the study was to quantify and compare apical debris extrusion in two systems of continuous and reciprocating rotary instrumentation with, and without, the use of a patency file. An experimental study was carried out in 120 mesial roots of lower first molars, which were randomized in the following 4 groups: Group A. Reciproc (VDW) R25 without a patency file, Group B Mtwo (VDW) without a patency file, Group C Reciproc (VDW) R25 with a patency file and Group D Mtwo with a patency file. Groups A, B and C presented statistically significant differences in comparison to group D, Mtwo with the use of a patency file (p<0.008 to 95% reliability). In conclusion, the greater amount of debris extruded through the apex occurred in roots instrumented with the reciprocating rotary system; this difference was statistically significant in relation to teeth treated with the Mtwo continuous rotary system with the use of a patency file.El objetivo del estudio fue cuantificar y comparar la extrusión de residuos apicales en dos sistemas de instrumentación endodónticos rotativos, continuo y recíproco, con y sin el uso de una lima de pasaje apical. Se realizó un estudio experimental en 120 raíces mesiales de primeros molares inferiores, que se aleatorizaron en los siguientes 4 grupos: Grupo A. Reciproc (VDW) R25 sin lima de pasaje apical, Grupo B Mtwo (VDW) sin lima de pasaje apical, Grupo C Reciproc (VDW) R25 con lima de pasaje apical y Grupo D Mtwo con lima de pasaje apical. Los grupos A, B y C presentaron diferencias estadísticamente significativas en comparación con el grupo D, Mtwo con el uso de una lima de pasaje apical (p<0.008 a 95% de confiabilidad). En conclusión, la mayor cantidad de residuos extruidos a través del ápice ocurrió en raíces preparadas con el sistema rotativo recíproco; Esta diferencia fue estadísticamente significativa en relación a los dientes tratados con el sistema rotativo continuo Mtwo con el uso de una lima de pasaje apical

Kounis Syndrome in a Clinical Case

Kounis syndrome is the grouping of an acute coronary artery disease associated with an anaphylactic allergy, in which there is an antigen-antibody reaction caused by the release of inflammatory mediators and mast cells act by causing degranulation, and in this situation there is the presence of cells of inflammation, causing an anaphylactic reaction. There are several triggers that can trigger an allergic reaction and therefore Kounis syndrome, patients with atopy are more susceptible, it has been associated with insect bites, medications and some foods, environmental contamination and some medical conditions. Any age because it has been described even in children. There are not many clinical studies, nor a larger sample of patients to reach a consensus on this pathology. We present a 46-year-old patient who is admitted to the Emergency service of the national institute of cardiology and cardiovascular surgery in Havana. Cuba; with a history of Systemic Arterial Hypertension (HT), which is an increase in blood  pressure above the upper limits of normality. Grade II obesity, which is a body mass index ≥35. In addition to referred dyslipidemia. In the results according to the diagnostic criteria of Kounis syndrome, the following were found: Signs and symptoms of myocardial ischemia, urticaria, pruritus, dyspnea, sinus tachycardia after bee sting. Electrocardiogram (ECG): With ST segment elevation in 2 or more continuous leads. Echocardiography: Transient segmental motility disorders. Cardiac chambers of preserved size and function. Serum myocardial biomarkers within normal parameters, increased Histamine, Tryptase, leukotriene values. The objective is to describe the clinical characteristics, complementary examinations, their diagnosis, evolution and treatment. It was concluded that the diagnosis of Kounis syndrome is eminently clinical. in itself everything that leads to the activation of mast cells can produce the syndrome. The prognosis depends on the type of Kounis, cardiovascular risk factors and pre‐existing coronary artery disease. Keywords: ischemia, inflammatory response, angina, vasospasm, atherosclerosis, histamine. RESUMEN El síndrome de Kounis es la agrupación de una arteriopatía coronaria aguda asociado a una alergia anafiláctica, en la que hay una reacción antígeno-anticuerpo causado por la liberación de mediadores inflamatorios los mastocitos y estos actúan provocando degranulación, y ante esta situación hay presencia de células de la inflamación, provocando una reacción anafiláctica. Existen varios gatillantes que pueden desencadenar una reacción alérgica y por ende el síndrome de Kounis, son más susceptibles los pacientes con atopia, se le ha relacionado mucho con picaduras de insectos, medicamentos y algunos alimentos, contaminación ambiental y algunas condiciones médicas Se puede presentar a cualquier edad porque se ha descrito incluso en niños. No hay muchos estudios clínicos, ni una muestra más grande de pacientes para realizar un consenso de esta patología. Presentamos una paciente de 46 años de edad que es ingresada al servicio de Emergencia del instituto nacional de cardiología y cirugía cardiovascular de la habana. Cuba; con antecedente de Hipertensión Arterial Sistémica (HTA) que es aumento de la presión arterial por encima de los limites superiores de normalidad. Obesidad grado II que es el índice de masa corporal ≥ 35. además de dislipidemia referida. En los resultados según los criterios diagnóstico del síndrome de Kounis se encontró: Signos y síntomas de isquémica miocárdica, urticaria, prurito, disnea, taquicardia sinusal tras picadura de una abeja. Electrocardiograma (ECG): Con elevación del segmento ST en 2 o más derivaciones continuas. Ecocardiografía: Trastornos de motilidad segmentaria transitorio. cavidades cardiacas de tamaño y función conservada. Los biomarcadores miocárdicos sérico dentro de los parámetros normales, incremento de los valores de Histamina, Triptasa, leucotrienos. El objetivo es describir las características clínicas, exámenes complementarios, su diagnóstico, evolución y tratamiento. Se concluyó que el diagnóstico del síndrome de Kounis es eminentemente clínico. en sí todo lo que conlleve a la activación de mastocitos puede producir el síndrome. El pronóstico depende del tipo de Kounis, de los factores de riesgos cardiovasculares y coronariopatía preexistente. Palabras claves: isquemia, respuesta inflamatoria, angina, vasoespasmo, ateroesclerosis, histamina

Insights on the structure and stability of Licanantase: a trimeric acid-stable coiled-coil lipoprotein from Acidithiobacillus thiooxidans

Licanantase (Lic) is the major component of the secretome of Acidithiobacillus thiooxidans when grown in elemental sulphur. When used as an additive, Lic improves copper recovery from bioleaching processes. However, this recovery enhancement is not fully understood. In this context, our aim is to predict the 3D structure of Lic, to shed light on its structure-function relationships. Bioinformatics analyses on the amino acid sequence of Lic showed a great similarity with Lpp, an Escherichia coli Lipoprotein that can form stable trimers in solution. Lic and Lpp share the secretion motif, intracellular processing and alpha helix structure, as well as the distribution of hydrophobic residues in heptads forming a hydrophobic core, typical of coiled-coil structures. Cross-linking experiments showed the presence of Lic trimers, supporting our predictions. Taking the in vitro and in silico evidence as a whole, we propose that the most probable structure for Lic is a trimeric coiled-coil. According to this prediction, a suitable model for Lic was produced using the de novo algorithm “Rosetta Fold-and-Dock”. To assess the structural stability of our model, Molecular Dynamics (MD) and Replica Exchange MD simulations were performed using the structure of Lpp and a 14-alanine Lpp mutant as controls, at both acidic and neutral pH. Our results suggest that Lic was the most stable structure among the studied proteins in both pH conditions. This increased stability can be explained by a higher number of both intermonomer hydrophobic contacts and hydrogen bonds, key elements for the stability of Lic’s secondary and tertiary structure

Improving Physical Activity Levels and Psychological Variables on University Students in the Contemplation Stage

This study aimed to investigate the effects of a physical activity intervention, based on self-determination theory and the transtheoretical model, on university students in the contemplation stage. Participants: 42 students, in the contemplation stage at baseline, were randomly assigned to an experimental group (16 women, 2 men; M age = 19.1 ± 1.15) and a control group (18 women, 2 men; M age = 20.1 ± 5.7). Methods: Physical activity was measured at different moments by accelerometry. Other cognitive variables were measured by self-reported scales. Results: We did not find any significant increases in students’ physical activity in favor of the intervention group. Intragroup analyses indicate that the intervention has an effect on physical activity (moderate-to-vigorous physical activity), basic psychological needs, and intrinsic and extrinsic motivation. Conclusions: Results partially demonstrate that applying social cognitive theories seems to be effective in improving physical activity and cognitive variables in university students in the contemplation stag

Quality of life in hidradenitis suppurativa : Validation of the hsqol-24

Altres ajuts: reports grants, personal fees, non-financial support and other from Abbvie, Almirall, Amgen, Boehringer, Celgene, Janssen-Cilag, Leo Pharma, Lilly, MSD-Schering-Plough, Novartis, Pfizer and UCB, outside the submitted work. TGC reports personal fees from Lilly and Novartis, outside the submitted work. LP reports grants and personal fees from AbbVie, Almirall, Amgen, Boehringer Ingelheim, Celgene, Janssen, Leo-Pharma, Lilly, Novartis, Pfizer, Regeneron, Roche, Sanofi, and UCB, personal fees from Baxalta, Biogen, Fresenius-Kabi, JS Biocad, Mylan, Sandoz, Samsung-Bioepis, and Bristol Myers Squibb, outside the submitted work. The other authors have no conflicts of interest to declare.To date, there are no disease-specific instruments in Spanish to assess quality of life of patients with hidra-denitis suppurativa. A multicentre study was pre-viously carried out in Spain between 2016 and 2017 to develop the Hidradenitis Suppurativa Quality of Life-24 (HSQoL-24), a disease-specific questionnaire to assess quality of life in patients with hidradenitis suppurativa. The objectives of this study are to revali-date the HSQoL-24 in Spanish with a larger sample of patients, and to present the English version. In this multi centre study in Spain, patients with hidradenitis suppurativa completed the HSQoL-24, the Dermatology Life Quality Index and the Skindex-29. The Hurley staging system was used to assess the severity of the disease. Validation of the questionnaire was carried out in 130 patients, of whom 75 (57.7%) were women. This study demonstrates adequate values of reliability and validity of the HSQoL-24, confirming the previous test re-test validation and making this questionnaire one of wide clinical validity in terms of results perceiv-ed by patients

Multidrug-resistant tuberculosis treatment adherence in migrants: a systematic review and meta-analysis.

BACKGROUND: Multidrug-resistant tuberculosis (MDR-TB) is a growing concern in meeting global targets for TB control. In high-income low-TB-incidence countries, a disproportionate number of MDR-TB cases occur in migrant (foreign-born) populations, with concerns about low adherence rates in these patients compared to the host non-migrant population. Tackling MDR-TB in this context may, therefore, require unique approaches. We conducted a systematic review and meta-analysis to identify and synthesise data on MDR-TB treatment adherence in migrant patients to inform evidence-based strategies to improve care pathways and health outcomes in this group. METHODS: This systematic review and meta-analysis was conducted in line with PRISMA guidelines (PROSPERO 42017070756). The databases Embase, MEDLINE, Global Health and PubMed were searched to 24 May 2017 for primary research reporting MDR-TB treatment adherence and outcomes in migrant populations, with no restrictions on dates or language. A meta-analysis was conducted using random-effects models. RESULTS: From 413 papers identified in the database search, 15 studies reporting on MDR-TB treatment outcomes for 258 migrants and 174 non-migrants were included in the systematic review and meta-analysis. The estimated rate of adherence to MDR-TB treatment across migrant patients was 71% [95% confidence interval (CI) = 58-84%], with non-adherence reported among 20% (95% CI = 4-37%) of migrant patients. A key finding was that there were no differences in estimated rates of adherence [risk ratio (RR) = 1.05; 95% CI = 0.82-1.34] or non-adherence (RR = 0.97; 95% CI = 0.79-1.36) between migrants and non-migrants. CONCLUSIONS: MDR-TB treatment adherence rates among migrants in high-income low-TB-incidence countries are approaching global targets for treatment success (75%), and are comparable to rates in non-migrants. The findings highlight that only just over 70% of migrant and non-migrant patients adhere to MDR-TB treatment. The results point to the importance of increasing adherence in all patient groups, including migrants, with an emphasis on tailoring care based on social risk factors for poor adherence. We believe that MDR-TB treatment targets are not ambitious enough

Chemical analysis of Greek pollen - Antioxidant, antimicrobial and proteasome activation properties

<p>Abstract</p> <p>Background</p> <p>Pollen is a bee-product known for its medical properties from ancient times. In our days is increasingly used as health food supplement and especially as a tonic primarily with appeal to the elderly to ameliorate the effects of ageing. In order to evaluate the chemical composition and the biological activity of Greek pollen which has never been studied before, one sample with identified botanical origin from sixteen different common plant taxa of Greece has been evaluated.</p> <p>Results</p> <p>Three different extracts of the studied sample of Greek pollen, have been tested, in whether could induce proteasome activities in human fibroblasts. The water extract was found to induce a highly proteasome activity, showing interesting antioxidant properties. Due to this activity the aqueous extract was further subjected to chemical analysis and seven flavonoids have been isolated and identified by modern spectral means. From the methanolic extract, sugars, lipid acids, phenolic acids and their esters have been also identified, which mainly participate to the biosynthetic pathway of pollen phenolics. The total phenolics were estimated with the Folin-Ciocalteau reagent and the total antioxidant activity was determined by the DPPH method while the extracts and the isolated compounds were also tested for their antimicrobial activity by the dilution technique.</p> <p>Conclusions</p> <p>The Greek pollen is rich in flavonoids and phenolic acids which indicate the observed free radical scavenging activity, the effects of pollen on human fibroblasts and the interesting antimicrobial profile.</p

Multidrug-resistant tuberculosis and migration to Europe.

Multidrug-resistant tuberculosis (MDR-TB) in low-incidence countries in Europe is more prevalent among migrants than the native population. The impact of the recent increase in migration to EU and EEA countries with a low incidence of TB (<20 cases per 100 000) on MDR-TB epidemiology is unclear. This narrative review synthesizes evidence on MDR-TB and migration identified through an expert panel and database search. A significant proportion of MDR-TB cases in migrants result from reactivation of latent infection. Refugees and asylum seekers may have a heightened risk of MDR-TB infection and worse outcomes. Although concerns have been raised around 'health tourists' migrating for MDR-TB treatment, numbers are probably small and data are lacking. Migrants experience significant barriers to testing and treatment for MDR-TB, exacerbated by increasingly restrictive health systems. Screening for latent MDR-TB is highly problematic because current tests cannot distinguish drug-resistant latent infection, and evidence-based guidance for treatment of latent infection in contacts of MDR patients is lacking. Although there is evidence that transmission of TB from migrants to the general population is low-it predominantly occurs within migrant communities-there is a human rights obligation to improve the diagnosis, treatment and prevention of MDR-TB in migrants. Further research is needed into MDR-TB and migration, the impact of screening on detection or prevention, and the potential consequences of failing to treat and prevent MDR-TB among migrants in Europe. An evidence-base is urgently needed to inform guidelines for effective approaches for MDR-TB management in migrant populations in Europe

Contributions of mean and shape of blood pressure distribution to worldwide trends and variations in raised blood pressure: A pooled analysis of 1018 population-based measurement studies with 88.6 million participants

© The Author(s) 2018. Background: Change in the prevalence of raised blood pressure could be due to both shifts in the entire distribution of blood pressure (representing the combined effects of public health interventions and secular trends) and changes in its high-blood-pressure tail (representing successful clinical interventions to control blood pressure in the hypertensive population). Our aim was to quantify the contributions of these two phenomena to the worldwide trends in the prevalence of raised blood pressure. Methods: We pooled 1018 population-based studies with blood pressure measurements on 88.6 million participants from 1985 to 2016. We first calculated mean systolic blood pressure (SBP), mean diastolic blood pressure (DBP) and prevalence of raised blood pressure by sex and 10-year age group from 20-29 years to 70-79 years in each study, taking into account complex survey design and survey sample weights, where relevant. We used a linear mixed effect model to quantify the association between (probittransformed) prevalence of raised blood pressure and age-group- and sex-specific mean blood pressure. We calculated the contributions of change in mean SBP and DBP, and of change in the prevalence-mean association, to the change in prevalence of raised blood pressure. Results: In 2005-16, at the same level of population mean SBP and DBP, men and women in South Asia and in Central Asia, the Middle East and North Africa would have the highest prevalence of raised blood pressure, and men and women in the highincome Asia Pacific and high-income Western regions would have the lowest. In most region-sex-age groups where the prevalence of raised blood pressure declined, one half or more of the decline was due to the decline in mean blood pressure. Where prevalence of raised blood pressure has increased, the change was entirely driven by increasing mean blood pressure, offset partly by the change in the prevalence-mean association. Conclusions: Change in mean blood pressure is the main driver of the worldwide change in the prevalence of raised blood pressure, but change in the high-blood-pressure tail of the distribution has also contributed to the change in prevalence, especially in older age groups