White Matter Tract Integrity in Alzheimer's Disease vs. Late Onset Bipolar Disorder and Its Correlation with Systemic Inflammation and Oxidative Stress Biomarkers

Background: Late Onset Bipolar Disorder (LOBD) is the development of Bipolar Disorder (BD) at an age above 50 years old. It is often difficult to differentiate from other aging dementias, such as Alzheimer's Disease (AD), because they share cognitive and behavioral impairment symptoms.Objectives: We look for WM tract voxel clusters showing significant differences when comparing of AD vs. LOBD, and its correlations with systemic blood plasma biomarkers (inflammatory, neurotrophic factors, and oxidative stress).Materials: A sample of healthy controls (HC) (n = 19), AD patients (n = 35), and LOBD patients (n = 24) was recruited at the Alava University Hospital. Blood plasma samples were obtained at recruitment time and analyzed to extract the inflammatory, oxidative stress, and neurotrophic factors. Several modalities of MRI were acquired for each subject,Methods: Fractional anisotropy (FA) coefficients are obtained from diffusion weighted imaging (DWI). Tract based spatial statistics (TBSS) finds FA skeleton clusters of WM tract voxels showing significant differences for all possible contrasts between HC, AD, and LOBD. An ANOVA F-test over all contrasts is carried out. Results of F-test are used to mask TBSS detected clusters for the AD > LOBD and LOBD > AD contrast to select the image clusters used for correlation analysis. Finally, Pearson's correlation coefficients between FA values at cluster sites and systemic blood plasma biomarker values are computed.Results: The TBSS contrasts with by ANOVA F-test has identified strongly significant clusters in the forceps minor, inferior longitudinal fasciculus, inferior fronto-occipital fasciculus, and cingulum gyrus. The correlation analysis of these tract clusters found strong negative correlation of AD with the nerve growth factor (NGF) and brain derived neurotrophic factor (BDNF) blood biomarkers. Negative correlation of AD and positive correlation of LOBD with inflammation biomarker IL6 was also found.Conclusion: TBSS voxel clusters tract atlas localizations are consistent with greater behavioral impairment and mood disorders in LOBD than in AD. Correlation analysis confirms that neurotrophic factors (i.e., NGF, BDNF) play a great role in AD while are absent in LOBD pathophysiology. Also, correlation results of IL1 and IL6 suggest stronger inflammatory effects in LOBD than in AD

Increased nuclear β-catenin expression in oral potentially malignant lesions: a marker of epithelial dysplasia

Background: Deregulation of β-catenin is associated with malignant transformation; however, its relationship with potentially malignant and malignant oral processes is not fully understood. The aim of this study was to determine and compare the nuclear β-catenin expression in oral dysplasia and oral squamous cell carcinoma (OSCC). Material and Methods: Cross sectional study. Immunodetection of β-catenin was performed on 72 samples, with the following distribution: 21 mild dysplasia, 12 moderate dysplasia, severe dysplasia 3, 36 OSCC including 19 well differentiated, 15 moderately differentiated and 2 poorly differentiated. Through microscopic observation the number of positive cells per 1000 epithelial cells was counted. For the statistical analysis, the Kruskal Wallis test was used. Results: Nuclear expression of β-catenin was observed in all samples with severe and moderate dysplasia, with a median of 267.5, in comparison to mild dysplasia whose median was 103.75. Only 10 samples (27.7%) with OSCC showed nuclear expression, with statistically significant differences between groups ( p < 0.05). Conclusions: Our results are consistent with most of the reports which show increased presence of β-catenin in severe and moderate dysplasia compared to mild dysplasia; however the expression of nuclear β-catenin decreased after starting the invasive neoplastic process. This suggests a role for this protein in the progression of dysplasia and early malignant transformation to OSCC. Immunodetection of β-catenin could be a possible immune marker in the detection of oral dysplasi

Evaluación del grado de queratinización y el recuento de AgNORs en citología exfoliativa de mucosa oral normal de individuos fumadores y no fumadores

Objetivos. En individuos fumadores con mucosa oral clínicamente sana, se han observado cambios citológicos como una mayor queratinización, existiendo también reportes de un mayor grado de actividad nucleolar. En estos estudios, las células para frotis se han obtenido por medio de espátula de madera. Nuestro objetivo es evaluar la profundidad de muestras citológicas de mucosa oral obtenidas con cepillo para frotis (endobrush) y comparar el grado de queratinización y la actividad nucleolar en pacientes fumadores y no fumadores. Diseño del estudio. Se obtuvieron frotis de mucosa oral de borde de lengua clínicamente normal de 30 individuos fumadores y 30 no fumadores, utilizando espátula de madera y endobrush. Las muestras fueron teñidas con Papanicolaou y con la tinción AgNORs. Resultados. Con la espátula de madera se obtuvo un mayor porcentaje de células epiteliales superficiales anucleadas (P= 0.016) y con el endobrush se obtuvieron células más profundas (tipo intermedias) (P= 0.035). Los individuos fumadores presentaron un mayor porcentaje de células superficiales anucleadas con ambas técnicas, diferencia que fue estadísticamente significativa con la técnica endobrush (P=0.005). El promedio de AgNORs en las células nucleadas fue mayor en los individuos fumadores (3.83) que en los no fumadores (2.79) (P= 0.003). Conclusiones. El endobrush permite obtener células de estratos más profundos. Los individuos fumadores con mucosa clínicamente normal presentan un mayor porcentaje de células queratinizadas y una mayor actividad nucleolar, sugiriendo que el consumo de cigarrillo influye en la actividad celular de la mucosa del borde de lengua.Objetive.In smokers with clinically normal buccal mucosa, cytological changes such as increased keratinization, and higher nucleolar activity have been observed. In these studies the cells for cytological smears were obtained with a wooden spatula. Our objectives were to evaluate the depth of cytological smears of oral mucosa obtained with both a brush (endobrush) and a wooden spatula, and to compare the degree of keratinization and the nucleolar activity in smokers and non-smokers. Design. We obtained cytological smears of clinically normal lateral tongues of 30 smokers and 30 non-smokers using both a wooden spatula and endobrush. The samples were dyed with Papanicolaou and the AgNORs. Results. With the wooden spatula we found a greater percentage of enucleated superficial epithelial cells (P = 0.016) and deeper cells were obtained with an endobrush (intermediate cells) (P =0.035). The smokers showed a greater percentage of enucleated superficial cells with both techniques, however this difference was significantly greater with Endobrush (P=0.005). The average of AgNORs in the nucleated cells was greater in smokers (3.83) than in non-smokers (2.79) (P=0.003). Conclusion. The Endobrush allows the clinician to obtain deeper cells of buccal mucosa. Smokers with clinically normal mucosa show a greater percentage of keratinized cells and a greater nucleolar activity, suggesting that cigarette smoking influences the cellular activity of the mucosa of the lateral tongue

Determination of susceptibility to sensitization to dental materials in atopic and non-atopic patients

Introduction: Some studies report that atopic patients have a greater frequency of delayed-type sensitization than non-atopic patients. Objective: To determine the influence of the atopic condition on delayed sensitization to dental materials. Design: cross-sectional study. Methods: Forty (40) atopic subjects and forty (40) non-atopic subjects, of both sexes, between 20 and 65 years of age were included. The determination of delayed sensitization to dental materials was performed using patch test. An oral exam was also carried out to check for lesions of the oral mucosa. Results: 61.25% of the patients were positive for delayed-type sensitization to one or more allergens, being palladium chloride (21.25%), ammoniated mercury (20%), benzoyl peroxide (12.5%) and amalgam (10%) the most frequent. The frequency of sensitization was 67.5% in the group of atopic patients, compared to 55% in the non atopic group (p>0.05). The materials with the greatest difference of sensitization in atopic compared to non-atopic patients were ammoniated mercury, benzoyl peroxide, amalgam and Bisphenol A Dimethacrylate (BIS-GMA). Conclusion: The atopic condition is not related to a higher frequency of delayed sensitization to a battery of dental materials. © Medicina Oral

Cognitive Behavioral Therapy Program for Cannabis Use Cessation in First-Episode Psychosis Patients: A 1-Year Randomized Controlled Trial

Despite the negative influence of cannabis use on the development and prognosis of first-episode psychosis (FEP), there is little evidence on effective specific interventions for cannabis use cessation in FEP. The aim of this study was to compare the efficacy of a specific cognitive behavioral therapy (CBT) for cannabis cessation (CBT-CC) with treatment as usual (TAU) in FEP cannabis users. In this single-blind, 1-year randomized controlled trial, 65 participants were randomly assigned to CBT-CC or TAU. The primary outcome was the reduction in cannabis use severity. The CBT-CC group had a greater decrease in cannabis use severity and positive psychotic symptoms over time, and a greater improvement in functioning at post-treatment than TAU. The treatment response was also faster in the CBT-CC group, reducing cannabis use, anxiety, positive and general psychotic symptoms, and improving functioning earlier than TAU in the follow-up. Moreover, patients who stopped and/or reduced cannabis use during the follow-up, decreased psychotic symptoms and increased awareness of disease compared to those who continued using cannabis. Early intervention based on a specific CBT for cannabis cessation, may be effective in reducing cannabis use severity, in addition to improving clinical and functional outcomes of FEP cannabis users

Cuantificación de papilas fungiformes en pacientes sanos

Objective: The study aims to quantify the density and the diameter of fungiform papillae (FP) in healthy patients of different age ranges.  Material and Methods: A dental chart of all participants was created, and subsequently informed consent was obtained from those who met the inclusion criteria (n = 16, 7 women and 9 men, from 8 to 57 years of age). Blue food-dye was applied to the back of their tongues, followed by a 12mm diameter metal ring that was placed in the anterior tongue dorsal surface, and photographs were taken3. The density of FP in the ring and the diameter of the largest FP within the circle were determined. Quantification and measurement were carried out in Photoshop digital program4. Data were analyzed descriptively using the STATA v12.0 program. The association between variables was determined by Student's t-test and Pearson's correlation, with a significance level of 5%.Results: The average FP density was 15 ± 7 PF / cm2, and the average of the largest FP diameter was 0.74 ± 0.1mm. The age of the patients was negatively correlated with the FP density (R = -0.56, p = 0.02) and positively with the mean of the largest FP diameter (R = 0.56, p = 0.02). There was no significant association found between density and the mean number of the largest diameter of PF with the sex of the participants.Conclusion: The density and the largest diameter of FP are negatively and positively correlated with the age of the patients, respectively. Objetivo: El objetivo del estudio es cuantificar la densidad y el diámetro mayor de papilas fungiformes en pacientes sanos de distintos rangos etarios. Materiales y métodos: Se realizó una ficha clínica a los participantes, posteriormente, se hizo toma de consentimiento informado a las personas que cumplieran con requisitos de inclusión y exclusión. Se aplicó colorante azul de comida en el dorso lingual, luego, se ubicó un aro metálico de 12mm de diámetro en el sector anterior de la cara dorsal de la lengua y se tomaron fotografías3. Posteriormente, se determinó densidad de papilas fungiformes (PF) en el aro y el diámetro mayor de cada PF dentro del círculo. Cuantificación y medición se realizó en programa digital Photoshop, siguiendo criterios previamente descritos4. Con el programa STATA v12.0 se analizaron los datos descriptivamente. La asociación entre variables se determinó mediante test t de Student y correlación de Pearson, con un nivel de significación del 5%. Resultados: El promedio de densidad de PF fue de 15 ± 7 PF/cm² y el promedio del diámetro mayor de PF fue de 0,74 ± 0,1mm. La edad de los pacientes se correlacionó negativamente con la densidad de PF (R=-0,56 p=0,02) y positivamente con el promedio del diámetro mayor de PF (R=0,56,p=0.02). No se encontró asociación significativa entre densidad y promedio del diámetro mayor de PF con el sexo de los participantes. Conclusión: La densidad y el diámetro mayor de PF se correlacionan de forma negativa y positiva con la edad de los pacientes, respectivamente

Métodos radiográficos para avaliação do desenvolvimento no paciente ortodôntico: aplicabilidade e limitações

Chronological age provides a reference framework for assessing a child's development. However, it is the biological age that expresses the level of maturity reached by the individual, based on parameters such as dental and skeletal age. Therefore, knowing the biological age is essential in orthodontic treatment as it provides information for making decisions regarding the timing, options, and limitations of therapy for the patient. Similarly, dental and skeletal development have been used to predict the timing of pubertal growth, estimate its rate, and determine the proportion of remaining growth in order to achieve successful treatments. This narrative review aims to explore the scope and limitations of different radiographic methods used in the assessment of growth and development in orthodontic patients. It provides fundamental concepts, inherent limitations of each developed method, and their contributions in the current context.La edad cronológica provee un marco referencial para la valorar el desarrollo del niño, sin embargo, es la edad biológica quien expresa el grado de madurez alcanzado por el individuo mediante parámetros como la edad dental y ósea. Por tal motivo, conocer la edad biológica es fundamental en el tratamiento ortodóntico ya que aporta información para tomar decisiones acerca del tiempo, opciones y limitaciones de la terapéutica en el paciente. De igual manera, el desarrollo dental u óseo han sido utilizados para predecir el momento del crecimiento puberal, estimar la velocidad del mismo y la proporción de crecimiento remanente a fin de lograr tratamientos exitosos. La presente revisión narrativa tiene como objetivo conocer los alcances y limitaciones de los diferentes métodos radiográficos empleados en la valoración del crecimiento y desarrollo del paciente ortodóntico, aportando conceptos fundamentales, limitaciones propias de cada método desarrollado y sus aportes en el contexto actual.A idade cronológica fornece um referencial para avaliação do desenvolvimento infantil, porém é a idade biológica que expressa o grau de maturidade alcançado pelo indivíduo por meio de parâmetros como idade dentária e idade óssea. Por esta razão, conhecer a idade biológica é essencial no tratamento ortodôntico, pois fornece informação para tomar decisões sobre o tempo, opções e limitações da terapia do paciente. Da mesma forma, o desenvolvimento dentário ou ósseo tem sido utilizado para predizer o momento do crescimento puberal, estimar sua velocidade e a proporção de crescimento remanescente para alcançar tratamentos bem-sucedidos. O objetivo desta revisão narrativa é conhecer o alcance e as limitações dos diferentes métodos radiográficos utilizados na avaliação do crescimento e desenvolvimento do paciente ortodôntico, fornecendo conceitos fundamentais, limitações de cada método desenvolvido e suas contribuições no contexto atual

Diversity of clinical, radiographic and genealogical findings in 41 families with amelogenesis imperfecta

Amelogenesis imperfecta (AI) is a group of enamel development disorders that alter the structure and chemical composition of the tissue. There is great variability in the clinical presentation; according to Witkop, AI can be categorized into 14 subtypes, which makes its diagnosis extremely complex. Objective: This study aimed to describe and determine the frequency of clinical and radiographic features and inheritance patterns found in 41 Chilean families diagnosed with diverse types of AI. Material and Methods: We analyzed the clinical records, photographs, pedigrees and radiographs of 121 individuals recruited between 2003 and 2016. All of the information was included in a database that was analyzed using the application Stata 14. Results: The 72 affected individuals had average age of 16 years, and no sex association with the presence of AI was found. The most frequent clinical subtypes were as follows: 43% hypomature, 25% hypoplastic, 21% hypomature/hypoplastic, 7% hypocalcified and 4% hypocalcified/hypoplastic. The number of severely affected teeth was 22, which occurred in the patients with hypocalcified and hypocalcified/hypoplasic AI who presented the highest number of damaged teeth. Caries and periodontal disease were found in 47 and 32% of the patients, respectively. Malocclusions were observed in 43% of the individuals with AI, with open bite being the most frequent. Radiographically, the thickness of the enamel decreased in 51% of the patients, and 80% showed decreased radiopacity of the enamel compared to that of dentin. Autosomal dominant inheritance pattern was found in 37% of the families with hypoplastic AI, and autosomal recessive pattern was present in 56% of the other clinical subtypes, but more frequently in those affected with hypomature and hypocalcified AI. Conclusion: Of the five clinical subtypes, autosomal recessive hypomature, autosomal dominant hypoplastic and autosomal recessive hypomature/hypoplastic AI were the most prevalent subtypes in this group

Online psycho-education to the treatment of bipolar disorder: protocol of a randomized controlled trial

Background: Bipolar disorder patients frequently present recurrent episodes and often experience subsyndromal symptoms, cognitive impairment and difficulties in functioning, with a low quality of life, illness relapses and recurrent hospitalization. Early diagnosis and appropriate intervention may play a role in preventing neuroprogression in this disorder. New technologies represent an opportunity to develop standardized psychological treatments using internet-based tools that overcome some of the limitations of face-to-face treatments, in that they are readily accessible and the timing of therapy can be tailored to user needs and availability. However, although many psychological programs are offered through the web and mobile devices for bipolar disorder, there is a lack of high quality evidence concerning their efficacy and effectiveness due to the great variability in measures and methodology used. Methods: This clinical trial is a simple-blind randomized trial within a European project to compare an internet-based intervention with treatment as usual. Bipolar disorder patients are to be included and randomly assigned to one of two groups: 1) the experimental group (tele-care support) and 2) the control group. Participants in both groups will be evaluated at baseline (pre-treatment) and post-treatment. Discussion: This study describes the design of a clinical trial based on psychoeducation intervention that may have a significant impact on both prognosis and treatment in bipolar disorder. Specifically, bringing different services together (service aggregation), it is hoped that the approach proposed will significantly increase the impact of information and communication technologies on access and adherence to treatment, quality of the service, patient safety, patient and professional satisfaction, and quality of life of patients.This study has received funding from the European Union's Seventh Framework Programme for research, technological development and demonstration under grant agreement No 604691

Desarrollo de una presentación interactiva y multimedia orientada a la docencia del análisis cinemático del Movimiento Armónico Simple

Nowadays, computers suppose a great potential as complementary didactic tool to traditional means of education. For that reason, the advantage of this potential is considered by the work group, creating interactive and multimedia presentations oriented to facilitate teaching of different physics fields. In particular, the objective of this work is the design of a presentation oriented to teaching kinematical aspects of the simple harmonic movement. Given the dynamic nature of the subject, it is evident the adventages that suppose an animated presentation which it helps the student to understand the kinematical magnitudes. This tool will be very useful to the professor as complement of theoretical classes, and available to the students in the reinforcement of the knowledge.Es evidente el gran potencial que el ordenador supone como herramienta didáctica complementaria a los medios de enseñanza tradicionales. Es por ello que el grupo de trabajo se plantea el aprovechamiento de este potencial, creando presentaciones interactivas y multimedia orientadas a la docencia en los distintos campos de la física.En concreto, en este trabajo se plantea el diseño de una presentación orientada a la docencia de los aspectos cinemáticas del movimiento armónico simple. Dada la naturaleza dinámica del tema en cuestión, es evidente las ventajas que supone disponer de una presentación animada del mismo que ayude al alumno a entender la magnitudes cinemáticas implicadas, herramientas de gran utilidad para el profesor como complemento de sus clases teóricas, y disponible para alumnos de ayuda en el afianzamiento de los conocimientos