Presentación del tumor de Pindborg de forma mandibular doble. A propósito de un caso

El tumor odontogénico epitelial calcificante (TOEC) es una rara lesión de los maxilares. Este artículo describe un caso singular en un varón de 22 años. Presenta dos TOEC, uno en el lado derecho de la mandíbula y otro en el izquierdo, con los tres elementos típicos del TOEC: células epiteliales con citoplasma eosinófilo, sustancia eosinófila homogénea y depósito de calcio

Osteoma de la escotadura sigmoidea mandibular. Descripción de un caso

Se describe un caso de osteoma periférico del maxilar inferior de localización excepcional en la escotadura sigmoidea. Se trataba de un paciente de 73 años, con dolor a nivel de la articulación temporomaxilar izquierda, limitación de la apertura bucal y que referia la percepción de un roce al masticar. La radiografia lateral, tomografia y ortopantomografia confirmaron la presencia de un tumor bilobulado en la escotadura sigmoidea mandibular. Tras la exéresis quirúrgica por vía preauricular, el estudio histológico confirmó el diagnóstico de osteoma al observarse tejido óseo muy denso formado por trabéculas amplias e irregulares con escaso tejido intertrabecular. La evolución ha sido favorable con apertura y cierre bucal correctos y recuperación progresiva del funcionalismo articular

Correlation between endothelial function and carotid atherosclerosis in rheumatoid arthritis patients with long-standing disease

Introduction In this study, we aimed to determine the relationship between flow-mediated endothelium-dependent vasodilatation (FMD) and carotid artery intima-media wall thickness (IMT), two surrogate markers of atherosclerosis, in a series of Spanish patients with rheumatoid arthritis (RA) without clinically evident cardiovascular (CV) disease. Methods One hundred eighteen patients who fulfilled the 1987 American College of Rheumatology classification criteria for RA, had no history of CV disease and had at least one year of follow-up after disease diagnosis were randomly selected. Brachial and carotid ultrasonography were performed to determine FMD and carotid IMT, respectively. Results Carotid IMT values were higher and FMD percentages derived by performing ultrasonography were lower in individuals with a long duration from the time of disease diagnosis. Patients with a disease duration ≤ 7 years had significantly lower carotid IMT (mean ± SD) 0.69 ± 0.17 mm than those with long disease duration (0.81 ± 0.12 mm in patients with ≥ 20 years of follow-up). Also, patients with a long disease duration had severe endothelial dysfunction (FMD 4.0 ± 4.0% in patients with disease duration from 14.5 to 19.7 years) compared with those with shorter disease duration (FMD 7.4 ± 3.8% in patients with disease duration ≤ 7 years). Linear regression analysis revealed that carotid IMT was unrelated to FMD in the whole sample of 118 patients. However, carotid IMT was negatively associated with FMD when the time from disease diagnosis ranged from 7.5 to 19.7 years (P = 0.02). Conclusions In patients with RA without CV disease, endothelial dysfunction and carotid IMT increased with the duration of RA. The association between FMD and carotid IMT values was observed only in patients with long disease duration

Giant cell arteritis: is the clinical spectrum of the disease changing?

Background: Giant cell arteritis is a vasculitis of large and middle-sized arteries that affects patients aged over 50 years. It can show a typical clinical picture consisting of cranial manifestations but sometimes nonspecific symptoms and large-vessel involvement prevail. Prompt diagnosis and treatment is essential to avoid irreversible damage. Discussion: There has been an increasing knowledge on the occurrence of the disease without the typical cranial symptoms and its close relationship and overlap with polymyalgia rheumatica, and this may contribute to reduce the number of underdiagnosed patients. Although temporal artery biopsy is still the gold-standard and temporal artery ultrasonography is being widely used, newer imaging techniques (FDG-PET/TAC, MRI, CT) can be of valuable help to identify giant cell arteritis, in particular in those cases with a predominance of extracranial large-vessel manifestations. Conclusions: Giant cell arteritis is a more heterogeneous condition than previously thought. Awareness of all the potential clinical manifestations and judicious use of diagnostic tests may be an aid to avoid delayed detection and consequently ominous complications.This review was funded by Roche Farma S.A. Spain

Canvis de residència en temps de COVID-19: una mica d'oxigen per al despoblament rural

Altres ajuts: "la Caixa" Social Research (SR21-00312) i Alan Turing Institute (1162533)Després de la irrupció de la pandèmia de COVID-19, diverses veus, sobretot des d'àmbits no acadèmics, van especular sobre un potencial èxode urbà cap a les àrees rurals. Malgrat això, aquesta hipòtesi no ha pogut ser corroborada fins ara a causa de la manca de dades amb el detall territorial adequat. En aquest Perspectives Demogràfiques es mostren els principals resultats d'una recerca del Centre d'Estudis Demogràfics i la Universitat Autònoma de Barcelona, que analitza les migracions internes entre les ciutats, els espais periurbans i les àrees rurals durant l'any 2020, i les compara amb els quatre anys que precedeixen la pandèmia. Per a l'anàlisi, s'utilitzen les microdades de l'Estadística de Variacions Residencials (EVR) de l'Institut Nacional d'Estadística (INE), que contenen tots els canvis de residència entre els 8.131 municipis espanyols. Els resultats de 2020 mostren alteracions remarcables, que es van plasmar principalment en un descens dels moviments cap a les ciutats i en un augment en les sortides des d'elles, especialment cap a municipis rurals. Aquests fluxos de persones van tenir un notable impacte demogràfic en les àrees rurals. Tanmateix, i malgrat els canvis observats, la major part de les migracions internes van ser majoritàriament entre ciutats, tal i com passava abans de la pandèmia, i tot apunta que es va tractar d'un fet conjuntural.After the outbreak of the COVID-19 pandemic, several commentators, especially from non-academic fields, speculated about a potential exodus from urban to rural areas. However, this hypothesis has not been confirmed due to a lack of data with information capturing changes of residence at local level. This issue of Perspectives Demogràfiques offers the main results of a study led by the Centre for Demographic Studies and the Autonomous University of Barcelona which analyses internal migration between cities, suburbs, and rural areas in 2020, compared to migration patterns during the four years preceding the pandemic. The analysis used microdata from the Residential Variation Statistics (EVR) of the Spanish Statistical Office (INE) which cover all changes of residence in the country's 8,131 municipalities. The results show significant changes in internal migration patterns during 2020. Inmigration to cities decreased, while out-migration increased, especially to rural areas. The latter flow had an important demographic impact on country villages. Despite these changes, internal migratory movements between and within urban areas dominated, as they did prior to the pandemic. At the same time, monthly data suggest that the changes are likely a temporary outcome.Tras la irrupción de la pandemia de COVID-19, diversas voces, sobre todo desde ámbitos no académicos, especularon acerca de un potencial éxodo urbano hacia las áreas rurales. Sin embargo, esta hipótesis no ha podido ser corroborada hasta ahora debido a la falta de datos con el detalle territorial adecuado. En este Perspectives Demogràfiques se muestran los principales resultados de una investigación liderada por el Centre d'Estudis Demogràfics y la Universidad Autónoma de Barcelona, analizando las migraciones internas entre las ciudades, los espacios periurbanos y las áreas rurales durante el año 2020, comparando con los cuatro años que preceden a la pandemia. Para el análisis, se utilizan los microdatos de la Estadística de Variaciones Residenciales (EVR) del Instituto Nacional de Estadística (INE), que contienen todos los cambios de residencia entre los 8.131 municipios españoles. Los resultados muestran alteraciones reseñables en 2020, que se plasmaron principalmente en un descenso de los movimientos hacia las ciudades y en un aumento en las salidas desde ellas, especialmente hacia municipios rurales. Estos flujos de personas tuvieron un notable impacto demográfico en las áreas rurales. No obstante, a pesar de los cambios observados, la mayor parte de las migraciones internas fueron mayoritariamente entre ciudades, al igual que antes de la pandemia, y todo apunta a que se trató de un hecho coyuntural

Del éxodo rural al éxodo interurbano de titulados universitarios : la segunda oleada de despoblación

Este trabajo se ha realizado en el marco del Programa de Doctorado en Demografía del Centre d'Estudis Demogràfics y el Departamento de Geografía de la Universitat Autònoma de Barcelona. Ha contado con la financiación de una beca FI de la Generalitat de Catalunya, dentro del proyecto "Integrating Research Infrastructure for European Expertise on Inclusive Growth from Data to Policy" (Union's Horizon 2020. Ref. 730998). También se integra en el proyecto "Comportamientos demográficos y estrategias residenciales: apuntes para el desarrollo de nuevas políticas sociales» (CSO2016-79142-R).Los desequilibrios interregionales se traducen en la emigración de capital humano de algunos territorios y en la concentración de éste en determinados enclaves geográficos. El objetivo de esta investigación es analizar los balances migratorios de jóvenes españoles por comunidades autónomas desde la perspectiva urbano-rural e incluyendo el nivel educativo. Para el estudio, se utilizan los microdatos de la Estadística de Variaciones Residenciales y de la Encuesta de Población Activa entre 1992 y 2018. Los resultados revelan que los intercambios interregionales son cada vez más desiguales, sobre todo desde de la crisis de 2008. En suma, uno de los principales componentes demográficos causantes de la despoblación, el éxodo de jóvenes, ahora afecta más a los ámbitos urbanos que al medio rural en las regiones emisoras del interior y del noroeste. Los flujos de salida son altamente selectivos en cuanto al nivel de estudios y se dirigen a las ciudades globales. La emigración de población cualificada no se ve compensada ni por la intensidad ni por el logro formativo de las personas que llegan desde otros lugares, generando procesos de descapitalización educativa que se agudizan con el paso del tiempo. La mayor parte de los jóvenes con estudios universitarios llegan a la ciudad de Madrid, donde se identifican dinámicas crecientes de acumulación del capital humano cualificado

Out-migration and brain drain in Castile and León

Castile and León hold among all the regions the highest proportion of young adults living in other areas of Spain. The negative balance is higher in the case of people with university studies. The high level of education of the native population and a labor market where the qualified jobs scarce, are the main reasons explaining the region’s brain drain. We use the microdata from the 2011 Census to analyze the status of Castile and León as a region exporting highly educated population to other areas in Spain, the migratory relation with other Autonomous Communities and the degree of overqualification in origin and in destination. In addition, we use a logistic regression model to capture the sociodemographic factors explaining internal migration

Autoimmune rheumatic diseases

"The term autoimmune rheumatic diseases (ARDs) encompasses a heterogeneous group of conditions characterized by joint involvement along with a wide spectrum of systemic manifestations. The most common ARDs are rheumatoid arthritis (RA) and systemic lupus erythematosus (SLE). Nevertheless, all these conditions share similar pathophysiological mechanisms [1, 2] and a common risk of developing a process of accelerated atherosclerosis [3]. In this regard, in this special issue J. Amaya-Amaya and colleagues discussed the mechanisms associated with the increased risk of cardiovascular disease (CVD) in patients with autoimmune diseases. These authors emphasize the relevance of the CVD in rheumatic conditions and its connection with inflammation and autoimmunity. They also highlight the need of a more aggressive management of these conditions, both of disease activity and classic cardiovascular risk factors. A good example of accelerated atherosclerosis in the setting of an ARD is SLE, in which endothelial dysfunction, an early step in the atherogenesis process, is observed before cardiovascular events can occur. With respect to this, A. Mak and N. Y. Kow performed a comprehensive review of the mechanisms that are involved in endothelial damage.These authors focused on the factors involved in endothelial damage and repair and, therefore, in the development of CVD in patients with SLE. They discussed the relevant role of factors such as type 1 interferon, proinflammatory cytokines, inflammatory cells, immune complexes, costimulatory molecules, neutrophils extracellular traps, lupus-related autoantibodies, oxidative stress, and dyslipidemia that along with the aberrant function of the endothelial progenitor cells lead to endothelial dysfunction and increased susceptibility to develop CVD in patients with SLE. Based on these lines of evidence, the authors’ claim is in favor of early intervention at the preclinical stage of atherogenesis in these patients