Impacted lower third molars and distal caries in the mandibular second molar. Is prophylactic removal of lower third molars justified?

Background: The objective of this study was to evaluate the association between the presence of mandibular third molars and the occurrence of carious lesions in the distal aspect of the mandibular second molar. Material and Methods: A retrospective cohort study comprising 327 lower third molars extracted in the Oral Surgery and Implantology Master's Degree program of the School of Dentistry of the University of Barcelona (Barcelona, Spain) was carried out. A descriptive and bivariate analysis was made. The diagnosis of caries in the second molar and the position of the mandibular third molar were evaluated through panoramic radiographies. Results: The sample included 203 patients, 94 males (46.3%) and 109 females (53.7%), with a mean age of 26,8 years and 327 lower third molars. The prevalence of second molar distal caries was 25.4% (95% CI= 20.6% to 30.2%). This pathology was significantly more frequent when the third molar was in a horizontal position (27.7%), when the contact point was at (45,8%) or below (47.0%) the cementoenamel junction (CEJ), and when the distal CEJ of the mandibular second molar and the mesial CEJ of the third molar was 7 to 12 mm apart. Conclusions: Horizontal lower third molars with contact points at or below the CEJ are more likely to produce distal caries in the mandibular second molars. Due to the high prevalence of this pathology (20.6% to 30.2%), a prophylactic removal of lower third molars with the above-mentioned features might be advisable

Aplicación de la imagen tridimensional a la cirugía laparoscópica del colon: análisis morfométrico a partir de reconstrucciones de TAC, estudio en cadáver y en vivo

El objetivo de este trabajo ha sido analizar las modificaciones que sufre el colon en su anatomía y su disposición, en relación con la posición, el sexo, la edad y el índice de masa corporal, y describirlas a través de reconstrucciones tridimensionales obtenidas a partir de imágenes de TAC. Se dividió el trabajo en un Estudio radiológico en cadáveres, y un Estudio radiológico en pacientes. En el primero, se emplearon tres cadáveres humanos conservados con la técnica de Thiel, en los que fueron reproducidas las condiciones reales de una colectomía laparoscópica en cuanto a neumoperitoneo, con 15 mmHg, y decúbitos posturales, con 15 º de decúbito lateral derecho, izquierdo, o Trendelenburg, en diez series según el protocolo establecido, realizándoles un TAC abdominal una vez obtenidas las mencionadas condiciones. En el segundo estudio, se seleccionaron 130 pacientes del Hospital Royo Villanova de Zaragoza con un TAC abdominal con contraste intravenoso y sin patología a nivel del colon. Se realizó una reconstrucción tridimensional de las imágenes de TAC obtenidas con el software OsiriX ®, y se localizaron en ésta los puntos anatómicos definidos (PUBIS, ESPINA, AH, AE, UIC, UDS, AMS y AMI), para posteriormente realizar con el software ImageJ ® la medida de las variables morfométricas establecidas entre los puntos (longitudes ESPINA - ESPINA, PUBIS - AMS, PUBIS - AMI, AMS - AMI, PUBIS - AH, PUBIS - AE, PUBIS - UIC, PUBIS - UDS, AMS - AH, AMS - AE, AMI - AH y AMI - AE, y ángulos AH - PUBIS - AE, AH - AMS - AE y AH - AMI - AE). De las 450 medidas realizadas en el Estudio radiológico en cadáveres, 202 sufrieron modificaciones entre el 5 % y el 9,99 %, y 112 por encima del 10 %, en las diferentes series que modificaron la presión de neumoperitoneo y el grado de decúbito lateral y de Trendelenburg. Las mayores diferencias se observaron en las medidas que relacionaban el pubis con ambas arterias mesentéricas y las arterias mesentéricas con los ángulos del colon, siendo éstas todavía mayores en las tres últimas series del estudio, en las que se realizó una manipulación en la posición del colon transverso al elevar el epiplon mayor. En el Estudio radiológico en pacientes, se observó una importante variabilidad anatómica en la morfología del colon con las reconstrucciones tridimensionales obtenidas, y se evidenciaron diferencias significativas en las medidas planteadas al estudiar los sujetos del estudio por grupos de sexo (hombres y mujeres), edad (65 años y menores, y mayores de 65 años) e índice de masa corporal (normopeso, sobrepeso y obesidad). Como conclusión, se considera que el colon se puede estudiar en cuanto a su variabilidad anatómica y su diferente disposición, con reconstrucciones tridimensionales obtenidas a partir de imágenes de TAC, y que éste sufre modificaciones que se pueden relacionar con la posición, el sexo, la edad y el índice de masa corporal

Multivariable clinical-genetic risk model for predicting venous thromboembolic events in patients with cancer

Venous thromboembolism (VTE) is a leading cause of death among patients with cancer. Outpatients with cancer should be periodically assessed for VTE risk, for which the Khorana score is commonly recommended. However, it has been questioned whether this tool is sufficiently accurate at identifying patients who should receive thromboprophylaxis. The present work proposes a new index, TiC-Onco risk score to be calculated at the time of diagnosis of cancer, that examines patients' clinical and genetic risk factors for thrombosis. We included 391 outpatients with a recent diagnosis of cancer and candidates for systemic outpatient chemotherapy. All were treated according to standard guidelines. The study population was monitored for 6 months, and VTEs were recorded. The Khorana and the TiC-Onco scores were calculated for each patient and their VTE predictive accuracy VTEs was compared. We recorded 71 VTEs. The TiC-Onco risk score was significantly better at predicting VTE than the Khorana score (AUC 0.73 vs. 0.58, sensitivity 49 vs. 22%, specificity 81 vs. 82%, PPV 37 vs. 22%, and NPV 88 vs. 82%). TiC-Onco risk score performed significantly better than Khorana score at identifying cancer patients at high risk of VTE who would benefit from personalised thromboprophylaxis

Spect cerebral con 99 tc- mibi para diferenciar una lesión vascular isquémica de un tumor cerebral. Presentación de dos casos.

ResumenDos pacientes con similares condiciones clínicas fueron ingresados en el servicio de Neurología del Hospital Clínico Quirúrgico “Hermanos Ameijeiras” presentando disfunción cerebelosa aguda. Los estudios de Resonancia Magnética de cráneo mostraron  lesiones hiperintensas en el cerebelo de características muy similares. En ambos casos este estudio no fue suficiente para esclarecer las dudas diagnósticas en cuanto a la etiología de dichas lesiones. Resultó útil la Tomografía por Emisión de Fotón Único Cerebral con 99mTecnecio - MIBI para discriminar entre una lesión vascular y tumoral en estas pacientes.Palabras clave: Ictus isquémico, Tumor cerebral, 99mTc – MIBI. AbstractTwo patients with similar clinic conditions were admittedin the Neurology Service at “Hermanos Ameijeiras” Hospital suffering acute cerebellar dysfunction; both with similar hyperintenses lesions in cerebellum on Cranial Magnetic Resonance.In both cases this study was not enough to establish an etiological diagnosis.  99mTc MIBI Brain-SPECT evidenced utility to discriminate ischemic ictus from brain tumor in these patients.Key words: Ischemic ictus, Brain Tumor, 99mTc – MIBI

Protumorigenic effects of Snail-expression fibroblasts on colon cancer cells

et al.Snail1 is a transcriptional factor that plays an important role in epithelial–mesenchymal transition and in the acquisition of invasive properties by epithelial cells. In colon tumors, Snail1 expression in the stroma correlates with lower specific survival of cancer patients. However, the role(s) of Snail1 expression in stroma and its association with patients' survival have not been determined. We used human primary carcinoma-associated fibroblasts (CAFs) or normal fibroblasts (NFs) and fibroblast cell lines to analyze the effects of Snail1 expression on the protumorigenic capabilities in colon cancer cells. Snail1 expression was higher in CAFs than in NFs and, as well as α-SMA, a classic marker of activated CAFs. Moreover, in tumor samples from 50 colon cancer patients, SNAI1 expression was associated with expression of other CAF markers, such as α-SMA and fibroblast activation protein. Interestingly, coculture of CAFs with colon cells induced a significant increase in epithelial cell migration and proliferation, which was associated with endogenous SNAI1 expression levels. Ectopic manipulation of Snail1 in fibroblasts demonstrated that Snail1 expression controlled migration as well as proliferation of cocultured colon cancer cells in a paracrine manner. Furthermore, expression of Snail1 in fibroblasts was required for the coadjuvant effect of these cells on colon cancer cell growth and invasion when coxenografted in nude mice. Finally, cytokine profile changes, particularly MCP-3 expression, in fibroblasts are put forward as mediators of Snail1-derived effects on colon tumor cell migration. In summary, these studies demonstrate that Snail1 is necessary for the protumorigenic effects of fibroblasts on colon cancer cells.This research was supported by the PI12/02037, Fundación Científica AECC, SAF2010-20750, S2010/BMD-2344, RTICC-RD12/0036/0041 and by the Fundación Banco Santander. Antonio García de Herreros’ laboratory was supported by RTICC-RD12/0036/0005 and SAF 2010-16089. Ma Jesús Larriba’s laboratory was supported by RD12/0036/0021. Cristina Peña and José Miguel García are recipients of Miguel Servet Contracts from the Instituto de Salud Carlos III.Peer reviewe

CHARACTERIZING THE V -BAND LIGHT-CURVES OF HYDROGEN-RICH TYPE II SUPERNOVAE

We present an analysis of the diversity of V-band light-curves of hydrogen-rich type II supernovae. Analyzing a sample of 116 supernovae, several magnitude measurements are defined, together with decline rates at different epochs, and time durations of different phases. It is found that magnitudes measured at maximum light correlate more strongly with decline rates than those measured at other epochs: brighter supernovae at maximum generally have faster declining light-curves at all epochs. We find a relation between the decline rate during the 'plateau' phase and peak magnitudes, which has a dispersion of 0.56 magnitudes, offering the prospect of using type II supernovae as purely photometric distance indicators. Our analysis suggests that the type II population spans a continuum from low-luminosity events which have flat light-curves during the 'plateau' stage, through to the brightest events which decline much faster. A large range in optically thick phase durations is observed, implying a range in progenitor envelope masses at the epoch of explosion. During the radioactive tails, we find many supernovae with faster declining light-curves than expected from full trapping of radioactive emission, implying low mass ejecta. It is suggested that the main driver of light-curve diversity is the extent of hydrogen envelopes retained before explosion. Finally, a new classification scheme is introduced where hydrogen-rich events are typed as simply 'SNII' with an s2 value giving the decline rate during the 'plateau' phase, indicating its morphological type.Comment: Accepted for publication in ApJ. Revised edition corrects errors in affiliation number

Tablas De Frecuencia Simple - Parte 1

Objeto de aprendizaje: Presentación MultimediaThe frequency table is a table where the statistical data are well organized, distributed according to its frequency, that is, according to the number of times it is repeated in the sample.La tabla de frecuencia es una tabla donde los datos estadísticos aparecen bien organizados, distribuidos según su frecuencia, es decir, según las veces que se repite en la muestra.1. Introducción2. Explicación1.0MatemáticoPregrad

Medidas Estadísticas De Variabilidad

Objeto de aprendizaje: Presentación MultimediaMeasures of variability are three that are: average deviation, variance and standard deviation, each will be explained in excel to understand what they refer to.Medidas de variabilidad se hablaran de tres que son: desviación promedio, varianza y desviación estándar se explicara en excel cada una para poder comprender a que se refieren.1. Introducción2. Mapa conceptual3. Explicación1.0MatemáticoPregrad

Estadística Descriptiva Con Statgraphics

Presentación práctica que explica el todo de desarrollo de la distribución de frecuencia por intervalos, enunciando los datos que se deben averiguar para tal fin y método matemático para encontrarlos.In summary we can detail that this presentation is purely exploratory in the statistical software Statgraphics, gives an introduction the most complete possible on how to use this important statistical tool, indicating all the functionalities that this tool has.Resumidamente podemos detallar que esta presentación es netamente exploratoria en el software de estadística Statgraphics, se da una introducción lo más completa posible sobre el modo de uso de esta importante herramienta estadística, indicando todas las funcionalidades con que cuenta dicha herramienta.1. Introducción2. Explicación3. Ejercicios1.0MatemáticoPregrad

Introducción A La Distribución Normal

Objeto de aprendizaje: Presentación MultimediaNormal distribution when random variables are continuous, the associated probability distributions are mathematical models that result in curves therefore are areas under those curves.Distribución normal cuando las variables aleatorias son continuas, las distribuciones de probabilidad asociadas son modelos matemáticos que dan lugar a curvas por lo tanto son áreas bajo esas curvas.1. Introducción2. Distribución normal3. Fenómenos naturales4. Características de la curva5. Representación de la distribución6. Bibliografía1.0MatemáticoPregrad