OPCIONES DE TRATAMIENTOS FIJOS SOBRE IMPLANTES

Se describe las diferentes opciones de tratamiento protésico fijo sobre implantes, sea unitarios o múltiples. Se pone un especial énfasis en comparar los beneficiosy desventajas de las prótesis cementadas y atornilladas en puntos específicos de los tratamientos protésicos como son la; recuperabilidad, estética, retención,pasividad y oclusión. Introduciendo a su vez una tercera opción con el sistema de “Cross pin” que es una combinación de ambos sistemas.Comparando los resultados de diferentes artículos científicos se llega a la conclusión de que, la elección de tratamiento debe ser elegida primariamente por elclínico, este debe conocer las limitaciones y desventajas de cada método para poder elegir una prótesis que sea la más apropiada para cada situación clínica. Kiru2012;9(1): 77-82

Miopatías autoinmunes: revisión de diagnóstico y manejo

Idiopathic inflammatory myopathies (MII) are a group of autoimmune diseases that mainly affect the proximal muscles. The most common types are Dermatomyositis (DM), Polymyositis (PM), Necrotizing autoimmune myopathy and Inclusion body myositis. Unique forms are identified in their clinical presentation consisting of muscular and extramuscular manifestations, their myopathic alterations in the electromyogram and the elevation of muscle enzymes. However, muscle biopsy remains the gold standard for diagnosis. These disorders are tratable with a proper. The goals of treatment are to eliminate inflammation, restore muscle performance, reduce morbidity and improve quality of life.This review aims at a basic diagnostic approach in patients with suspicion of MMI through its main clinical, laboratory and histopathological findings.Las miopatías inflamatorias idiopáticas (MII) son un grupo de enfermedades autoinmunes crónicas que afectan principalmente a los músculos proximales. Los tipos más comunes son dermatomiositis (DM), polimiositis (PM), miopatía autoinmune necrotizante y miositis por cuerpos de inclusión. Se identifican de forma única por su presentación clínica que consiste en manifestaciones musculares y extramusculares, sus alteraciones miopáticas en el electromiograma y la elevación de las enzimas musculares. Sin embargo, la biopsia muscular sigue siendo el gold estándar para el diagnóstico. Estos trastornos son potencialmente tratables con un diagnóstico adecuado. Los objetivos del tratamiento son eliminar la inflamación, restaurar el rendimiento muscular, reducir la morbilidad y mejorar la calidad de vida. Esta revisión tiene como objetivo proporcionar un enfoque de diagnóstico básico a los pacientes con sospecha de MMI a través de sus principales hallazgos clínicos, de laboratorio e histopatológicos

Estrategias de afrontamiento y ansiedad según variables sociodemográficas en el personal de la salud durante la pandemia COVID-19: revisión aplicada

La presente investigación tuvo como objetivos principales identificar la relación entre las estrategias de afrontamiento y los niveles de ansiedad en el personal de salud durante el COVID-19 y determinar la asociación de las variables sociodemográficas con las estrategias de afrontamiento y los niveles de ansiedad en el personal de la salud durante el COVID-19. Por lo tanto, se realizó una búsqueda en diversas bases de datos en las cuales se identificaron 10 investigaciones primarias que analizan la relación entre las variables de estudio. Se concluyó que existe una relación negativa entre las variables niveles de ansiedad y las estrategias de afrontamiento adaptativas y una relación positiva entre las variables niveles de ansiedad y estrategias de afrontamiento desadaptativas. Por último, no se encontraron relaciones significativas en la mayoría de investigaciones entre la relación antes mencionada y los factores de las fichas sociodemográficas excepto por edad, sexo, posición laborar y ocupación.The present investigation had as main objectives to identify the relationship between coping strategies and anxiety levels in health personnel during COVID-19 and to determine the association of sociodemographic variables with coping strategies and anxiety levels in the health personnel during COVID-19. Therefore, a search was carried out in various databases, in which 10 primary investigations that analyze the relationship between the study variables were identified. It was concluded that there is a negative relationship between the variables anxiety levels and adaptive coping strategies and a positive relationship between the variables anxiety levels and maladaptive coping strategies. Finally, no significant relationships were found in most of the investigations between the aforementioned relationship and the factors of the sociodemographic records except for age, sex, job position, and occupation

Proyecto Neuro Help

En el presente documento se presentará la idea de negocio Neuro Help, ofreciendo un servicio online personalizado de consultas psicológicas en la especialidad de Neuropsicología. Mediante métodos de investigación, tales como entrevistas, focus groups y encuestas; se plantearon hipótesis para corroborar la viabilidad del proyecto. Igualmente, se buscará analizar el entorno interno como fortalezas y debilidades; y el entorno externo, que son factores los cuales no tenemos control alguno. Asimismo, la identificación del mercado objetivo es importante y por ello también se hizo un estudio de este para comprender a donde se dirigirán los esfuerzos de ventas, teniendo en cuenta sus necesidades y los problemas que le aquejan. Por ello, teniendo conocimiento de la situación actual del país y la viabilidad que tendría el proyecto, mediante un análisis financiero, se confirmará la escalabilidad en el mercado y el cumplimiento de los objetivos tanto a corto, mediano y largo plazo; asegurando un crecimiento e impacto sostenible con el transcurrir de los años.This document will present the business idea of Neuro Help, an online service of psychology consultations in the specialist of neurology. Through different Market research methods such as interviews, focus groups and surveys; it was proposed different hypotheses in order to corroborate the viability of the business. Also, we will seek to analyze the internal environment such as strengths and weaknesses; and the external environment, uncontrollable factors that can affect the business development. In addition, seeking to understand the market that will surround us, we will investigate in which segment will be the target to which the sales efforts will be directed, knowing the different problems that they have throughout social networks. Therefore, knowing what it is really going on with the country and the entire world, and the viability of the business; we will confirm the scalability in the market and accomplishing with different strategies in short, medium and long term, ensuring a sustainable growing over the years.Trabajo de investigació

Findings from the Longitudinal CINRG Becker Natural History Study

BACKGROUND: Becker muscular dystrophy is an X-linked, genetic disorder causing progressive degeneration of skeletal and cardiac muscle, with a widely variable phenotype. OBJECTIVE: A 3-year, longitudinal, prospective dataset contributed by patients with confirmed Becker muscular dystrophy was analyzed to characterize the natural history of this disorder. A better understanding of the natural history is crucial to rigorous therapeutic trials. METHODS: A cohort of 83 patients with Becker muscular dystrophy (5-75 years at baseline) were followed for up to 3 years with annual assessments. Muscle and pulmonary function outcomes were analyzed herein. Age-stratified statistical analysis and modeling were conducted to analyze cross-sectional data, time-to-event data, and longitudinal data to characterize these clinical outcomes. RESULTS: Deletion mutations of dystrophin exons 45-47 or 45-48 were most common. Subgroup analysis showed greater pairwise association between motor outcomes at baseline than association between these outcomes and age. Stronger correlations between outcomes for adults than for those under 18 years were also observed. Using cross-sectional binning analysis, a ceiling effect was seen for North Star Ambulatory Assessment but not for other functional outcomes. Longitudinal analysis showed a decline in percentage predicted forced vital capacity over the life span. There was relative stability or improved median function for motor functional outcomes through childhood and adolescence and decreasing function with age thereafter. CONCLUSIONS: There is variable progression of outcomes resulting in significant heterogeneity of the clinical phenotype of Becker muscular dystrophy. Disease progression is largely manifest in adulthood. There are implications for clinical trial design revealed by this longitudinal analysis of a Becker natural history dataset

Validation, reproducibility, and reliability of food photographic record for food intake assessment

Registrar la ingesta alimentaria permite su valoración y acompañar el proceso de autoevaluación, autocontrol y motivación al cambio del comportamiento alimentario. Las nuevas tecnologías y el uso de teléfonos móviles proponen otra forma de registrar la ingesta.Objetivo: Validar y valorar el Registro Dietético Fotográfico (RDF) como un instrumento de utilidad en la práctica profesional.Metodología: Participaron 40 Licenciados en Nutrición. En una primera etapa, se analizaron y correlacionaron variables alimentarias obtenidas a través de los instrumentos RDF versus cuestionario de frecuencia de consumo alimentario (CFCA) y recordatorio de 24 horas (R24hs). En una segunda etapa, se aplicó nuevamente el RDF y se valoró su estabilidad temporal en los registros obtenidos (RDF 1 versus RDF 2). Se aplicaron el test de Wilcoxon y el test de correlación de Spearman. Resultados: Se encontró una asociación positiva moderada y estadísticamente significativa para el VET y grasas totales, entre RDF y R24hs (r=0,68, p=0,0008 y r=0,52, p=0,01, respectivamente). Además, se observó una asociación positiva de intensidad moderada y estadísticamente significativa para el VET, proteínas y grasas entre RDF 1 y RDF 2 (r=0,61, p=0,0004; r=0,60, p=0,0005; r=0,64, p=0,0002, respectivamente). Conclusión: el RDF es un método válido en la práctica profesional para la estimación de la ingesta alimentaria, con mayor consonancia con los datos obtenidos con el R24hs, y presenta estabilidad temporal para los registros de VET, proteínas y grasas. Además, colabora en la adquisición de hábitos de alimentarios positivos como ingestas más conscientes, entre otros beneficios.Introduction: food intake records are a useful resource for diet assessment, as well as for self-evaluation, self-control, and self-motivation to change an eating behavior. New technologies based on mobile phones permit a different way of recording food intake. Objective: to validate and assess food photographic record (FPR) as a useful instrument in professional practice for assessing food intake. Methodology: forty nutrition professionals participated. In a first stage, food variables obtained through FPR were analyzed and correlated with data from the frequency of food consumption questionnaire (FFQ) and a 24-hour recall (24HR). In a second stage, FPR was applied again to evaluate temporal stability (FPR 1 versus FPR 2). Wilcoxon’s test and Spearman’s correlation test were applied. Results: a moderate and significant positive association was found for total caloric intake (TCI) and total fat between FPR and 24HR (r = 0.68, p = 0.0008, and r = 0.52, p = 0.01, respectively). In addition, a positive and moderate association was found for TCI, proteins and fats between FPR 1 and FPR 2 (r = 0.61, p = 0.0004; r = 0.60, p = 0.0005; r = 0.64, p = 0.0002, respectively). Conclusion: FPR is a valid method for professional practice to estimate dietary intake, with greater consistency with 24HR data than FFQ, and presents temporal stability for TCI, protein and fat recordings. In addition, FPR may facilitate the adoption of positive eating habits such as more conscious intakes, among other benefits.Fil: Defagó, María Daniela. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Córdoba. Instituto de Investigaciones en Ciencias de la Salud. Universidad Nacional de Córdoba. Instituto de Investigaciones en Ciencias de la Salud; Argentina. Universidad Nacional de Córdoba. Facultad de Medicina. Escuela de Nutrición; ArgentinaFil: Gaitieri, Ludmila. Universidad Nacional de Córdoba. Facultad de Medicina. Escuela de Nutrición; ArgentinaFil: Longo, Noelia Jesica. Universidad Nacional de Córdoba. Facultad de Medicina. Escuela de Nutrición; ArgentinaFil: Muiño, María Cielo. Universidad Nacional de Córdoba. Facultad de Medicina. Escuela de Nutrición; ArgentinaFil: Bazzoni, Gabriela Fabiana. Universidad Nacional de Córdoba. Facultad de Medicina. Escuela de Nutrición; ArgentinaFil: Bertorini, Candela. Universidad Nacional de Córdoba. Facultad de Medicina. Escuela de Nutrición; ArgentinaFil: Sartor, Sandra. Universidad Nacional de Córdoba. Facultad de Medicina. Escuela de Nutrición; Argentina. Fundación ConCiencia; Argentin

Long-Term Blocking of Calcium Channels in mdx Mice Results in Differential Effects on Heart and Skeletal Muscle

The disease mechanisms underlying dystrophin-deficient muscular dystrophy are complex, involving not only muscle membrane fragility, but also dysregulated calcium homeostasis. Specifically, it has been proposed that calcium channels directly initiate a cascade of pathological events by allowing calcium ions to enter the cell. The objective of this study was to investigate the effect of chronically blocking calcium channels with the aminoglycoside antibiotic streptomycin from onset of disease in the mdx mouse model of Duchenne muscular dystrophy (DMD)

Review of differential diagnosis and management of spasmodic dysphonia

Purpose of Review: The recent literature on spasmodic dysphonia is reviewed with regard to pathogenesis, differential diagnosis, treatment options, audits, and current methods of management. Recent Findings: Advances in technology have enabled clinicians to better understand the connection between brain and laryngeal function and dysfunction. Refinements in imaging and genetic investigation techniques have led to advances in the understanding of the underlying mechanism of this neuro-laryngeal disorder. Development of diagnostic assessment tools and measures of Quality of Life hold the potential to improve treatment and care. Summary: Fifty articles published between 2014 and 2015 were selected for this review. The sources were drawn from several clinical specialties: 54% come under the scope of laryngology, 32% from neurology, and 14% from other areas. It remains poorly understood, misdiagnosed and under diagnosed. Its identification, diagnosis, treatment selection, and coordination of care require an expert specialist multi-disciplinary team. More training is required to help people who have this chronic and psychosocially disabling voice disorder, which impinges on all aspects of their lives. Spasmodic dysphonia is now classified as a “rare” disease in the USA. This designation will assist in international standards of diagnosis, assessment, treatment, and management

Meta-analysis of muscle transcriptome data using the MADMuscle database reveals biologically relevant gene patterns

<p>Abstract</p> <p>Background</p> <p>DNA microarray technology has had a great impact on muscle research and microarray gene expression data has been widely used to identify gene signatures characteristic of the studied conditions. With the rapid accumulation of muscle microarray data, it is of great interest to understand how to compare and combine data across multiple studies. Meta-analysis of transcriptome data is a valuable method to achieve it. It enables to highlight conserved gene signatures between multiple independent studies. However, using it is made difficult by the diversity of the available data: different microarray platforms, different gene nomenclature, different species studied, etc.</p> <p>Description</p> <p>We have developed a system tool dedicated to muscle transcriptome data. This system comprises a collection of microarray data as well as a query tool. This latter allows the user to extract similar clusters of co-expressed genes from the database, using an input gene list. Common and relevant gene signatures can thus be searched more easily. The dedicated database consists in a large compendium of public data (more than 500 data sets) related to muscle (skeletal and heart). These studies included seven different animal species from invertebrates (<it>Drosophila melanogaster, Caenorhabditis elegans</it>) and vertebrates (<it>Homo sapiens, Mus musculus, Rattus norvegicus, Canis familiaris, Gallus gallus</it>). After a renormalization step, clusters of co-expressed genes were identified in each dataset. The lists of co-expressed genes were annotated using a unified re-annotation procedure. These gene lists were compared to find significant overlaps between studies.</p> <p>Conclusions</p> <p>Applied to this large compendium of data sets, meta-analyses demonstrated that conserved patterns between species could be identified. Focusing on a specific pathology (Duchenne Muscular Dystrophy) we validated results across independent studies and revealed robust biomarkers and new pathways of interest. The meta-analyses performed with MADMuscle show the usefulness of this approach. Our method can be applied to all public transcriptome data.</p

Suitability of external controls for drug evaluation in Duchenne muscular dystrophy

OBJECTIVE: To evaluate the suitability of real-world data (RWD) and natural history data (NHD) for use as external controls in drug evaluations for ambulatory Duchenne muscular dystrophy (DMD). METHODS: The consistency of changes in the 6-minute walk distance (Δ6MWD) was assessed across multiple clinical trial placebo arms and sources of NHD/RWD. Six placebo arms reporting 48-week Δ6MWD were identified via literature review and represented 4 sets of inclusion/exclusion criteria (n = 383 patients in total). Five sources of RWD/NHD were contributed by Universitaire Ziekenhuizen Leuven, DMD Italian Group, The Cooperative International Neuromuscular Research Group, ImagingDMD, and the PRO-DMD-01 study (n = 430 patients, in total). Mean Δ6MWD was compared between each placebo arm and RWD/NHD source after subjecting the latter to the inclusion/exclusion criteria of the trial for baseline age, ambulatory function, and steroid use. Baseline covariate adjustment was investigated in a subset of patients with available data. RESULTS: Analyses included ∼1,200 patient-years of follow-up. Differences in mean Δ6MWD between trial placebo arms and RWD/NHD cohorts ranged from -19.4 m (i.e., better outcomes in RWD/NHD) to 19.5 m (i.e., worse outcomes in RWD/NHD) and were not statistically significant before or after covariate adjustment. CONCLUSIONS: We found that Δ6MWD was consistent between placebo arms and RWD/NHD subjected to equivalent inclusion/exclusion criteria. No evidence for systematic bias was detected. These findings are encouraging for the use of RWD/NHD to augment, or possibly replace, placebo controls in DMD trials. Multi-institution collaboration through the Collaborative Trajectory Analysis Project rendered this study feasible