Apical periodontitis and cardiovascular diseases: previous findings and ongoing research

Aim: (i) To discuss the possibility that dental infections in general, and endodontic infections (apical periodontitis) more specifically, may affect cardiovascular health, (ii) which preventive measures should be adopted during the treatment of endodontic infections for infective endocarditis (IE), and (iii) What should be the priorities for future research, in the light of the literature available. Methodology: A literature review was performed. Results and Conclusions: (i) Poor oral health and endodontic infections are associated with cardiovascular diseases, and endodontic infection appears to be associated with initial endothelial damage, (ii) preventive measures for IE should be adopted during endodontic treatment of patients at risk for cardiovascular events according to the American and European available official guidelines, and (iii) more research focused on apical periodontitis and systemic diseases is neede

Ultrasound examination for the detection of simulated periapical bone lesions in bovine mandibles: an ex vivo study

Aim: To evaluate the accuracy of ultrasound examination (USE) for the detection of artificial bone defects in bovine mandibles in the absence of complete erosion of the cortical bone plate and to determine the minimum cortical thickness that constitutes a barrier for ultrasound waves. Methodology : Sixty bovine mandibular anatomical blocks were harvested and uniformly distributed amongst six experimental groups. The negative control consisted of blocks with no intra-bony defects, whereas the positive control consisted of blocks with an artificial lesion of 2 mm diameter that perforated the buccal cortical bone plate. Two experimental groups comprised blocks with small (2 mm) and large (5 mm) artificial defects created under a cortical plate thinned to varying thicknesses. Two additional groups had small (2 mm) and large (5 mm) artificial defects that did not involve the cortical plate. After USE, the scans were saved and submitted to three blinded examiners. Sensitivity, specificity, predictive values and receiver-operating characteristics (ROC) were analysed. The significance of the findings (P < 0.05) was appraised using the chi-square statistics with the Yates correction, whilst the intra- and inter-examiner agreements were evaluated through Kappa statistics. Results: USE was associated with high sensitivity (97.3%) and negative predictive value (89%), and a perfect score for specificity and positive predictive value. The ROC curve analysis revealed an accuracy of 97.8%. The k-values were 0.86 and 0.89 for the first and second examinations, respectively, demonstrating very high inter-observer agreement. The intra-observer agreement was also high (k-value = 0.92). A significant correlation between the echographic diagnosis and the presence or absence of artificial intraosseous lesions in the anatomical blocks of bovine mandibles was observed (P < 0.0001). Conclusions: USE was highly accurate and reliable for the detection of artificial lesions within bovine mandibles, regardless of the thickness or presence of the cortical plate

Ultrasound examination for the detection of simulated periapical bone lesions in bovine mandibles: an ex vivo study

Aim: To evaluate the accuracy of ultrasound examination (USE) for the detection of artificial bone defects in bovine mandibles in the absence of complete erosion of the cortical bone plate and to determine the minimum cortical thickness that constitutes a barrier for ultrasound waves. Methodology : Sixty bovine mandibular anatomical blocks were harvested and uniformly distributed amongst six experimental groups. The negative control consisted of blocks with no intra-bony defects, whereas the positive control consisted of blocks with an artificial lesion of 2&nbsp;mm diameter that perforated the buccal cortical bone plate. Two experimental groups comprised blocks with small (2&nbsp;mm) and large (5&nbsp;mm) artificial defects created under a cortical plate thinned to varying thicknesses. Two additional groups had small (2&nbsp;mm) and large (5&nbsp;mm) artificial defects that did not involve the cortical plate. After USE, the scans were saved and submitted to three blinded examiners. Sensitivity, specificity, predictive values and receiver-operating characteristics (ROC) were analysed. The significance of the findings (P&nbsp;&lt;&nbsp;0.05) was appraised using the chi-square statistics with the Yates correction, whilst the intra- and inter-examiner agreements were evaluated through Kappa statistics. Results: USE was associated with high sensitivity (97.3%) and negative predictive value (89%), and a perfect score for specificity and positive predictive value. The ROC curve analysis revealed an accuracy of 97.8%. The k-values were 0.86 and 0.89 for the first and second examinations, respectively, demonstrating very high inter-observer agreement. The intra-observer agreement was also high (k-value&nbsp;=&nbsp;0.92). A significant correlation between the echographic diagnosis and the presence or absence of artificial intraosseous lesions in the anatomical blocks of bovine mandibles was observed (P&nbsp;&lt;&nbsp;0.0001). Conclusions: USE was highly accurate and reliable for the detection of artificial lesions within bovine mandibles, regardless of the thickness or presence of the cortical plate

The perioperative dental screening and management of patients undergoing cardiothoracic, vascular surgery and other cardiovascular invasive procedures: A systematic review

Background: One controversial issue in the relationship between oral care and cardiovascular diseases is how and whether to manage oral infections prior to cardiovascular surgery or other cardiovascular invasive procedures. Design: We designed a systematic review to assess the information available on three main questions. Is there an agreement on the need for dental evaluation and treatment before cardiovascular interventions? Are consistent clinical recommendations or protocols available? Is dental treatment prior to cardiovascular interventions effective? Methods: A systematic electronic search of MEDLINE, Scopus and Web of Science was performed from the database inceptions up to 31 April 2016. Searches were performed using Boolean operators to combine medical subject headings and free text words. Because this review included a large, heterogeneous group of study designs and sources, the results were synthesised in a narrative approach. Results: In total, 2447 studies were identified: 2099 ( +241 duplicates) were excluded after screening; 107 were included for full-text assessment; 55 were excluded for not meeting the inclusion criteria; and 11 were not available. Thus, 44 studies meeting the inclusion criteria were analysed. We found that, for patients undergoing cardiovascular surgery, there is a general agreement on the need for screening and treatment of dental infections, but not on the protocols. We also found that there are conflicting indications on when and to what extent to perform the treatment and that the risk-tobenefit ratios for these treatments are controversial. Conclusion: No satisfactory answers regarding dental care before cardiovascular invasive procedures are available

Ultrasound examination for the detection of simulated periapical bone lesions in bovine mandibles: an ex vivo

Aim: To evaluate the accuracy of ultrasound examination (USE) for the detection of artificial bone defects in bovine mandibles in the absence of complete erosion of the cortical bone plate and to determine the minimum cortical thickness that constitutes a barrier for ultrasound waves. Methodology : Sixty bovine mandibular anatomical blocks were harvested and uniformly distributed amongst six experimental groups. The negative control consisted of blocks with no intra-bony defects, whereas the positive control consisted of blocks with an artificial lesion of 2 mm diameter that perforated the buccal cortical bone plate. Two experimental groups comprised blocks with small (2 mm) and large (5 mm) artificial defects created under a cortical plate thinned to varying thicknesses. Two additional groups had small (2 mm) and large (5 mm) artificial defects that did not involve the cortical plate. After USE, the scans were saved and submitted to three blinded examiners. Sensitivity, specificity, predictive values and receiver-operating characteristics (ROC) were analysed. The significance of the findings (P < 0.05) was appraised using the chi-square statistics with the Yates correction, whilst the intra- and inter-examiner agreements were evaluated through Kappa statistics. Results: USE was associated with high sensitivity (97.3%) and negative predictive value (89%), and a perfect score for specificity and positive predictive value. The ROC curve analysis revealed an accuracy of 97.8%. The k-values were 0.86 and 0.89 for the first and second examinations, respectively, demonstrating very high inter-observer agreement. The intra-observer agreement was also high (k-value = 0.92). A significant correlation between the echographic diagnosis and the presence or absence of artificial intraosseous lesions in the anatomical blocks of bovine mandibles was observed (P < 0.0001). Conclusions: USE was highly accurate and reliable for the detection of artificial lesions within bovine mandibles, regardless of the thickness or presence of the cortical plate

THEORETICAL AND PRACTICAL CONSIDERATIONS CONCERNING THE PLEA OF BARGAIN AND THE PROSECUTIONAL DISCRETION IN COLOMBIAN CRIMINAL PROCEDURE LAW

Dentro del departamento de derecho procesal, de la Pontifica Universidad Javeriana, hay un centro de estudios de victimología y criminología en cuyo marco se conformó una línea de investigación llamada derecho procesal penal y victimología que tiene como objeto de análisis la estructuración de la reforma legal del proceso penal colombiano. En este contexto, el análisis se ha centrado en lapreparación de los textos legales que han sido objeto de dicha reformay la aplicación de dichos textos en la práctica jurídica penal. En este marco de estudio, se ha desarrollado el siguiente texto que tiene como finalidad profundizar sobre las instituciones del principiode oportunidad y de los preacuerdos que hacen parte del derecho penal en Colombia. En desarrollo de éste fin se acude a las bases jurídicas de influencia como el esquema penal de Norteamérica y aquel Continental/Europeo, para puntualizar las semejanzas y diferencias respecto del nuevo sistema penal acusatorio de Colombia. Finalmente, con el análisis normativo necesario, se continúa haciendo una descripción respecto de cada una de las instituciones mencionadas,planteando, a su vez las críticas necesarias en búsqueda de un mejoramiento del proceso penal acusatorio en su aplicación práctica.In the Department of Procedural law, at the Pontificia UniversidadJaveriana , there is a research group of Victiminology and Criminology with an investigation line called Procedural Criminal Law and Victiminology, that focuses its investigations in Colombian procedural criminal law amendment. In this context, the analysis has focused in the arrangements of legal texts related to such reform, and the corresponding application of such documents in the legal practice.This study has developed the following text, which aims to deepen into the institutions of the principle of opportunity and the preliminary agreements that are part of criminal law in Colombia. In the development of this work, the text compares the influence of North America and the criminal Continental/European law, to point out the similarities and differences with the new accusatory system in Colombia