Postoperative pain after one-visit root-canal treatment on teeth with vital pulps : comparison of three different obturation techniques

Objectives. To investigate and compare postoperative pain after one-visit root canal treatment (RCT) on teeth with vital pulps using three different obturation techniques. Study Design. Two hundred and four patients (105 men and 99 women) aged 12 to 77 years were randomly assigned into three treatments groups: cold lateral compaction of gutta-percha (LC), Thermafil technique (TT), and Backfill - Thermafil obturation technique (BT). Postoperative pain was recorded on a visual analogue scale (VAS) of 0 - 10 after 2 and 6 hours, and 1, 2, 3, 4, 5, 6 and 7 days. Data were statistically analyzed using multivariate logistic regression analysis. Results. In the total sample, 87% of patients experienced discomfort or pain in some moment between RCT and the seventh day. The discomfort experienced was weak, light, moderate and intense in 6%, 44%, 20% and 6% of the cases, respectively. Mean pain levels were 0.4 ± 0.4, 0.4 ± 0.3, and 1.4 ± 0.7 in LC, BT, and TT groups, respectively. Patients of TT group experienced a significantly higher mean pain level compared to other two groups (p < 0.0001). In TT group, all patients felt some level of pain at six hours after RCT. Conclusions. Postoperative pain was significantly associated with the obturation technique used during root canal treatment. Patients whose teeth were filled with Thermafil obturators (TT technique) showed significantly higher levels of discomfort than patients whose teeth were filled using any of the other two techniques

Induction of prophages by fluoroquinolones in streptococcus pneumoniae: implications for emergence of resistance in genetically-related clones

Antibiotic resistance in Streptococcus pneumoniae has increased worldwide by the spread of a few clones. Fluoroquinolone resistance occurs mainly by alteration of their intracellular targets, the type II DNA topoisomerases, which is acquired either by point mutation or by recombination. Increase in fluoroquinolone-resistance may depend on the balance between antibiotic consumption and the cost that resistance imposes to bacterial fitness. In addition, pneumococcal prophages could play an important role. Prophage induction by fluoroquinolones was confirmed in 4 clinical isolates by using Southern blot hybridization. Clinical isolates (105 fluoroquinolone-resistant and 160 fluoroquinolone-susceptible) were tested for lysogeny by using a PCR assay and functional prophage carriage was studied by mitomycin C induction. Fluoroquinolone-resistant strains harbored fewer inducible prophages (17/43) than fluoroquinolone-susceptible strains (49/70) (P = 0.0018). In addition, isolates of clones associated with fluoroquinolone resistance [CC156 (3/25); CC63 (2/20), and CC81 (1/19)], had lower frequency of functional prophages than isolates of clones with low incidence of fluoroquinolone resistance [CC30 (4/21), CC230 (5/20), CC62 (9/21), and CC180 (21/30)]. Likewise, persistent strains from patients with chronic respiratory diseases subjected to fluoroquinolone treatment had a low frequency of inducible prophages (1/11). Development of ciprofloxacin resistance was tested with two isogenic strains, one lysogenic and the other non-lysogenic: emergence of resistance was only observed in the non-lysogenic strain. These results are compatible with the lysis of lysogenic isolates receiving fluoroquinolones before the development of resistance and explain the inverse relation between presence of inducible prophages and fluoroquinolone-resistance

Bone mass disorders in patients treated with a replacement dose of levothyroxine.

Some thyroid diseases have been associated with osteoporosis due to the effect of thyroid hormones on bone resorption. On this basis, chronic treatment with thyroid hormones, especially suppressive doses, could lead to osteoporosis. Objective: To estimate the prevalence of osteoporosis in patients treated with thyroid hormone in a health center in the city of Albacete. Methods: Cross-sectional study, conducted in patients diagnosed with subclinical hypothyroidism in treatment with levothyroxine in the city of Albacete. Patients were selected by reviewing medical records and laboratory parameters. Physical examination and medical history data were collected. Subsequently they underwent a bone density test and completed a questionnaire. Results: 112 patients were included in the study, with female predominance (88.5%), mean age of 42.5 years and a tendency to be overweight (mean BMI of 25.67 kg/m2, 95% CI: 18,02-35,49) . The average TSH was 6.67 mU / ml (95% CI: 4.31 - 11.15) with normal free T4. Osteoporosis was only found in 14%, with osteopenia prevailing among those where some kind of bone loss was found. Paradoxically, there is a greater bone mass loss in patients with a higher BMI. Although the bone mass deficit has been significantly associated with sex and years of treatment with levothyroxine, it is not related to dose nor to hormone levels detected in blood. Conclusions: The characteristics of our population do not make it particularly susceptible to developing osteoporosis (premenopausal women, overweight, non-smokers) and cases that were found are not doses dependent, but rather time dependent, therefore there must be other factors contributing to this pathology

The HIV-1 reservoir landscape in persistent elite controllers and transient elite controllers

FUNDING. Instituto de Salud Carlos III (FI17/00186, FI19/00083, MV20/00057, PI18/01532, PI19/01127 and PI22/01796), Gilead Fellowships (GLD22/00147). NIH grants AI155171, AI116228, AI078799, HL134539, DA047034, MH134823, amfAR ARCHE and the Bill and Melinda Gates Foundation.BACKGROUND. Persistent controllers (PCs) maintain antiretroviral-free HIV-1 control indefinitely over time, while transient controllers (TCs) eventually lose virological control. It is essential to characterize the quality of the HIV reservoir in terms of these phenotypes in order to identify the factors that lead to HIV progression and to open new avenues toward an HIV cure. METHODS. The characterization of HIV-1 reservoir from peripheral blood mononuclear cells was performed using next-generation sequencing techniques, such as full-length individual and matched integration site proviral sequencing (FLIP-Seq; MIP-Seq). RESULTS. PCs and TCs, before losing virological control, presented significantly lower total, intact, and defective proviruses compared with those of participants on antiretroviral therapy (ART). No differences were found in total and defective proviruses between PCs and TCs. However, intact provirus levels were lower in PCs compared with TCs; indeed the intact/defective HIV-DNA ratio was significantly higher in TCs. Clonally expanded intact proviruses were found only in PCs and located in centromeric satellite DNA or zinc-finger genes, both associated with heterochromatin features. In contrast, sampled intact proviruses were located in permissive genic euchromatic positions in TCs. CONCLUSIONS. These results suggest the need for, and can give guidance to, the design of future research to identify a distinct proviral landscape that may be associated with the persistent control of HIV-1 without ART.Instituto de Salud Carlos III (FI17/00186, FI19/00083, MV20/00057, PI18/01532, PI19/01127, PI22/01796)Gilead Fellowships (GLD22/00147)NIH grants AI155171, AI116228, AI078799, HL134539, DA047034, MH134823, amfAR ARCHEBill and Melinda Gates Foundatio

Desarrollo de herramientas metodológicas para incorporar contenidos de ciencia al aula y su valoración económica

La ciencia y la tecnología juegan un papel fundamental en nuestra sociedad. En este sentido, la ciudadanía parece necesitar unos conocimientos básicos que le permitan responder de manera autónoma a multitud de situaciones, tanto a nivel personal como social (Kolstø et al., 2006). Este requisito, conocido en la literatura como alfabetización científica, lleva siendo uno de los objetivos de la educación en las últimas décadas (Hodson, 2003; Feinstein, 2011). Sin embargo, parece que su consecución presenta algunos problemas. Una de las causas de estas dificultades parece ser la falta de conexión entre los contenidos que se trabajan en las clases y el día a día del ciudadano. Respecto a esto, una solución ampliamente citada en la literatura es contextualizar el aprendizaje, relacionando los contenidos trabajados en clase con escenarios cotidianos y familiares para el alumnado (Clegg & Kolodner, 2014). El proyecto pretendía que nuestros estudiantes llevasen a cabo un análisis de los contextos con contenidos científico-económicos y promovieran su utilización en el aula y en su futuro profesional. Es decir, formar a nuestros profesionales para que pudieran detectar e incorporar entre sus competencias la capacidad de conectar lo aprendido en las asignaturas con las necesidades sociales. En concreto, el proyecto tenía, en base a los problemas detectados en la percepción de la ciencia y en la formación de los ciudadanos, dos grandes tipos de objetivos: Objetivos relacionados con la percepción de los conocimientos científico-tecnológicos y su valoración económica (Ezquerra, Fernández-Sánchez, Cabezas, 2013; Ezquerra, Fernandez-Sanchez, 2014; Ezquerra, Fernandez-Sanchez, Magaña, 2015; 2016; Ezquerra, Fernandez-Sanchez, Magaña & Mingo, 2017): • Identificar en qué situaciones los ciudadanos, en su vida cotidiana, están en presencia de contenidos científicos o tecnológicos. • Determinar de qué modo llegan al ciudadano estos contenidos, con qué intensidad, cómo son propuestos, cómo son percibidos... • Analizar el modo en que podemos otorgar a estos contenidos una valoración económica. Objetivos educativos que se integran dentro de las asignaturas: • Analizar las correspondencias entre los currículos oficiales y los contenidos presentes en el entorno del ciudadano (Ezquerra, Fernandez-Sanchez, Magaña Ramos, 2015; Ezquerra y Magaña, 2016). • Introducir a los estudiantes en una propuesta de aprendizaje basada en la indagación (Rivero et al., 2013; Ezquerra, De Juanas, Martín del Pozo, 2015). • Valorar las estrategias y competencias de los futuros docentes para vincular sus conocimientos con la realidad circundante (De Juanas et al., 2012). • Analizar las actividades que los estudiantes propongan para identificar los contenidos de ciencia y estudiar su valoración económica

Clonal chromosomal mosaicism and loss of chromosome Y in elderly men increase vulnerability for SARS-CoV-2

The pandemic caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2, COVID-19) had an estimated overall case fatality ratio of 1.38% (pre-vaccination), being 53% higher in males and increasing exponentially with age. Among 9578 individuals diagnosed with COVID-19 in the SCOURGE study, we found 133 cases (1.42%) with detectable clonal mosaicism for chromosome alterations (mCA) and 226 males (5.08%) with acquired loss of chromosome Y (LOY). Individuals with clonal mosaic events (mCA and/or LOY) showed a 54% increase in the risk of COVID-19 lethality. LOY is associated with transcriptomic biomarkers of immune dysfunction, pro-coagulation activity and cardiovascular risk. Interferon-induced genes involved in the initial immune response to SARS-CoV-2 are also down-regulated in LOY. Thus, mCA and LOY underlie at least part of the sex-biased severity and mortality of COVID-19 in aging patients. Given its potential therapeutic and prognostic relevance, evaluation of clonal mosaicism should be implemented as biomarker of COVID-19 severity in elderly people. Among 9578 individuals diagnosed with COVID-19 in the SCOURGE study, individuals with clonal mosaic events (clonal mosaicism for chromosome alterations and/or loss of chromosome Y) showed an increased risk of COVID-19 lethality

Osteoporosis in patients with subclinical hypothyroidism treated with thyroid hormone

Objective: to estimate the prevalence of osteoporosis in patients being treated with thyroid hormone. Method: cross-sectional retrospective study of primary care patients. Experimental Group: patients diagnosed with subclinical hypothyroidism receiving thyroid hormone replacement therapy. Control Group: patients not receiving replacement therapy. Once the sample was selected its members were summoned to complete a clinical questionnaire and undergo a bone density scan with a validated measuring device. The description of qualitative data was done in absolute frequencies and percentages and that of the quantitative data as mean standard deviation, median. In the comparison of qualitative data between groups we used the Chi-square test and contingency tables by rearranging the percentages of several variables. Results: 182 patients were studied (112 experimental and 70 control), diagnosed with subclinical hypothyroidism. The average age at diagnosis was 42.5 and 41.2 years, respectively. 32.7% and 33.2% were smokers. In the experimental group the coexistence of two or more cardiovascular risk factors was detected in 5.7% of the patients. Mean TSH was 6.67 mU/L, mean freeT4 1,04 ng/dl. 67% of the patients studied had some level of bone loss: 87% osteopenia and 14% osteoporosis. 56% of those suffering from bone less were women. With regard to the size of the thyroid hormone treatment, only 12% received 150 μg/day or more. 61% had received treatment for between 5 and 10 years and 19.5% for more than 10 years. Conclusions: there is a high prevalence of bone loss in patients with subclinical hypothyroidism treated with exogenous thyroxi

La revendication de l’indépendance éditoriale face aux politiques publiques du livre

La reivindicaci&oacute;n de los editores independientes, a menudo organizados en colectivos, se ha ido fortaleciendo en los &uacute;ltimos quince a&ntilde;os, sobre todo en las regiones latinoamericana y franc&oacute;fona. &Eacute;sta se inscribe en un contexto de globalizaci&oacute;n liberal y financiera, sustentada en la defensa de la "bibliodiversidad" - neologismo que ha experimentado una propagaci&oacute;n muy r&aacute;pida en el espacio p&uacute;blico- y que actualmente ha sido recogido por los responsables pol&iacute;ticos y los medios de comunicaci&oacute;n. De esta manera, los editores independientes han contribuido a sensibilizar a los gobiernos y las autoridades locales respecto a la cuesti&oacute;n de la diversidad cultural, alert&aacute;ndoles sobre la necesidad de desarrollar pol&iacute;ticas espec&iacute;ficas para el libro. Los resultados concretos son innegables, aunque diferenciados seg&uacute;n cada pa&iacute;s.&nbsp;La revendication des &eacute;diteurs ind&eacute;pendants, souvent rassembl&eacute;s en collectifs, s&rsquo;est affirm&eacute;e au cours des quinze derni&egrave;res ann&eacute;es, tout particuli&egrave;rement dans les espaces latino-am&eacute;ricain et francophone. Elle s&rsquo;inscrit, dans le contexte de la mondialisation lib&eacute;rale et financi&egrave;re, au nom de la d&eacute;fense de la &laquo; bibliodiversit&eacute; &raquo;, n&eacute;ologisme qui a connu une diffusion extr&ecirc;mement rapide dans l&rsquo;espace public et est aujourd&rsquo;hui repris par le monde politique et m&eacute;diatique. Les &eacute;diteurs ind&eacute;pendants ont ainsi contribu&eacute; &agrave; sensibiliser les gouvernements et pouvoirs locaux &agrave; la question de la diversit&eacute; culturelle et les ont alert&eacute;s sur la n&eacute;cessit&eacute; de mettre en &oelig;uvre et/ou de d&eacute;velopper des politiques sp&eacute;cifiques du livre. Les r&eacute;sultats concrets sont ind&eacute;niables, bien que contrast&eacute;s selon les pays.&nbsp

Induction of prophages by fluoroquinolones in streptococcus pneumoniae: implications for emergence of resistance in genetically-related clones

Antibiotic resistance in Streptococcus pneumoniae has increased worldwide by the spread of a few clones. Fluoroquinolone resistance occurs mainly by alteration of their intracellular targets, the type II DNA topoisomerases, which is acquired either by point mutation or by recombination. Increase in fluoroquinolone-resistance may depend on the balance between antibiotic consumption and the cost that resistance imposes to bacterial fitness. In addition, pneumococcal prophages could play an important role. Prophage induction by fluoroquinolones was confirmed in 4 clinical isolates by using Southern blot hybridization. Clinical isolates (105 fluoroquinolone-resistant and 160 fluoroquinolone-susceptible) were tested for lysogeny by using a PCR assay and functional prophage carriage was studied by mitomycin C induction. Fluoroquinolone-resistant strains harbored fewer inducible prophages (17/43) than fluoroquinolone-susceptible strains (49/70) (P = 0.0018). In addition, isolates of clones associated with fluoroquinolone resistance [CC156 (3/25); CC63 (2/20), and CC81 (1/19)], had lower frequency of functional prophages than isolates of clones with low incidence of fluoroquinolone resistance [CC30 (4/21), CC230 (5/20), CC62 (9/21), and CC180 (21/30)]. Likewise, persistent strains from patients with chronic respiratory diseases subjected to fluoroquinolone treatment had a low frequency of inducible prophages (1/11). Development of ciprofloxacin resistance was tested with two isogenic strains, one lysogenic and the other non-lysogenic: emergence of resistance was only observed in the non-lysogenic strain. These results are compatible with the lysis of lysogenic isolates receiving fluoroquinolones before the development of resistance and explain the inverse relation between presence of inducible prophages and fluoroquinolone-resistance

Induction of prophages by fluoroquinolones in streptococcus pneumoniae: implications for emergence of resistance in genetically-related clones

Antibiotic resistance in Streptococcus pneumoniae has increased worldwide by the spread of a few clones. Fluoroquinolone resistance occurs mainly by alteration of their intracellular targets, the type II DNA topoisomerases, which is acquired either by point mutation or by recombination. Increase in fluoroquinolone-resistance may depend on the balance between antibiotic consumption and the cost that resistance imposes to bacterial fitness. In addition, pneumococcal prophages could play an important role. Prophage induction by fluoroquinolones was confirmed in 4 clinical isolates by using Southern blot hybridization. Clinical isolates (105 fluoroquinolone-resistant and 160 fluoroquinolone-susceptible) were tested for lysogeny by using a PCR assay and functional prophage carriage was studied by mitomycin C induction. Fluoroquinolone-resistant strains harbored fewer inducible prophages (17/43) than fluoroquinolone-susceptible strains (49/70) (P = 0.0018). In addition, isolates of clones associated with fluoroquinolone resistance [CC156 (3/25); CC63 (2/20), and CC81 (1/19)], had lower frequency of functional prophages than isolates of clones with low incidence of fluoroquinolone resistance [CC30 (4/21), CC230 (5/20), CC62 (9/21), and CC180 (21/30)]. Likewise, persistent strains from patients with chronic respiratory diseases subjected to fluoroquinolone treatment had a low frequency of inducible prophages (1/11). Development of ciprofloxacin resistance was tested with two isogenic strains, one lysogenic and the other non-lysogenic: emergence of resistance was only observed in the non-lysogenic strain. These results are compatible with the lysis of lysogenic isolates receiving fluoroquinolones before the development of resistance and explain the inverse relation between presence of inducible prophages and fluoroquinolone-resistance