Bisfosfonatos y Patología Oral I: aspectos generales y preventivos

Los bisfosfonatos constituyen un grupo de fármacos capaces de modular el recambio óseo y disminuir su remodelado cuando existe una reabsorción excesiva. Por ello están indicados en numerosas patologías óseas como la osteoporosis postmenopáusica o la osteolisis asociada al cáncer de mama o al mieloma múltiple. En los últimos años y a raíz de su utilización masiva se han ido publicando numerosos casos de complicaciones asociadas a su uso. Entre los posibles efectos adversos más importantes se encuentran los orales, con la aparición de ulceraciones y sobre todo los casos de osteonecrosis de los maxilares asociados a esta terapéutica. En esta revisión analizamos las características generales de estos medicamentos y su mecanismo de actuación, así como los efectos adversos descritos, especialmente los orales y maxilofaciales, haciendo una referencia especial sobre la prevención de la osteonecrosis de los maxilares, a la luz de los casos descritos en la literatura médica y odontológica. El protocolo preventivo refuerza el papel fundamental del odontólogo en la prevención efectiva de este proceso antes, durante y después del tratamiento.Bisphosphonates constitute a group of drugs capable of modulating bone turnover, and reduce its remodelling when an excessive resorption occurs. This is why they are indicated in a large group of bone diseases like postmenopausal osteoporosis or osteolisis associated with breast cancer or multiple myeloma. Over the last years and due to their extensive use, many cases of complications associated with their use have been published. Among the most important possible adeverse effects are the oral ones, with the appearance of ulcerations and, especially, osteonecrosis of the jaws associated with this therapy. In this paper, we have analyzed the general characteristics of these drugs and their mechanisms of action as well as the described adverse effects, especially oral and maxillofacial has been made special reference regarding the prevention of osteonecrosis of the jaws, hightened by cases described in medical and odontological literature. The preventive protocol backs up the fundamental role of the odontologist in the effective prevention of this process before, during and after the treatment

Bisphosphonates and Oral Pathology II. Osteonecrosis of the jaws : Review of the literature before 2005

Bisphosphonates are bone-turnover modulating drugs which are used in the management of a number of bone diseases ranging from osteoporosis to neoplasic pathology-associated osteolysis. In the last years a number of cases of osteonecrosis of the jaws associated with these drugs have been reported. In this review we analyze the cases published in the literature indexed from 2003 to December 2005. During this period 246 cases were reported, being more frequently associated with women in the sixth decade of life. More frequently associated bisphosphonates were the nitrogenated bisphosphonates (pamidronate, zolendronic acid) and the most common oral antecedent was a dental extraction. Nevertheless more than 25% of the cases were spontaneous. The most frequent site was the mandible and most of the cases presented clinical evidence of bone exposure and pain. Different treatments have been proposed with different antibiotic therapies with or without surgery, showing in general terms an uncertain prognosis with low healing rates

Bisphosphonates and Oral Pathology I : general and preventive aspects

Los bisfosfonatos constituyen un grupo de fármacos capaces de modular el recambio óseo y disminuir su remodelado cuando existe una reabsorción excesiva. Por ello están indicados en numerosas patologías óseas como la osteoporosis postmenopáusica o la osteolisis asociada al cáncer de mama o al mieloma múltiple. En los últimos años y a raíz de su utilización masiva se han ido publicando numerosos casos de complicaciones asociadas a su uso. Entre los posibles efectos adversos más importantes se encuentran los orales, con la aparición de ulceraciones y sobre todo los casos de osteonecrosis de los maxilares asociados a esta terapéutica. En esta revisión analizamos las características generales de estos medicamentos y su mecanismo de actuación, así como los efectos adversos descritos, especialmente los orales y maxilofaciales, haciendo una referencia especial sobre la prevención de la osteonecrosis de los maxilares, a la luz de los casos descritos en la literatura médica y odontológica. El protocolo preventivo refuerza el papel fundamental del odontólogo en la prevención efectiva de este proceso antes, durante y después del tratamiento

StarHorse: A Bayesian tool for determining stellar masses, ages, distances, and extinctions for field stars

Understanding the formation and evolution of our Galaxy requires accurate distances, ages and chemistry for large populations of field stars. Here we present several updates to our spectro-photometric distance code, that can now also be used to estimate ages, masses, and extinctions for individual stars. Given a set of measured spectro-photometric parameters, we calculate the posterior probability distribution over a given grid of stellar evolutionary models, using flexible Galactic stellar-population priors. The code (called {\tt StarHorse}) can acommodate different observational datasets, prior options, partially missing data, and the inclusion of parallax information into the estimated probabilities. We validate the code using a variety of simulated stars as well as real stars with parameters determined from asteroseismology, eclipsing binaries, and isochrone fits to star clusters. Our main goal in this validation process is to test the applicability of the code to field stars with known {\it Gaia}-like parallaxes. The typical internal precision (obtained from realistic simulations of an APOGEE+Gaia-like sample) are $\simeq 8\%$ in distance, $\simeq 20\%$ in age,$\simeq 6\$ in mass, and $\simeq 0.04$ mag in $A_V$. The median external precision (derived from comparisons with earlier work for real stars) varies with the sample used, but lies in the range of $\simeq [0,2]\%$ for distances, $\simeq [12,31]\%$ for ages, $\simeq [4,12]\%$ for masses, and $\simeq 0.07$ mag for $A_V$. We provide StarHorse distances and extinctions for the APOGEE DR14, RAVE DR5, GES DR3 and GALAH DR1 catalogues.Comment: 21 pages, 12 figures, accepte

Small Bowel Enteroscopy - A Joint Clinical Guideline by the Spanish and Portuguese Small-Bowel Study Groups

The present evidence-based guidelines are focused on the use of device-assisted enteroscopy in the management of small-bowel diseases. A panel of experts selected by the Spanish and Portuguese small-bowel study groups reviewed the available evidence focusing on the main indications of this technique, its role in the management algorithm of each indication, and its diagnostic and therapeutic yield. A set of recommendations was issued accordingly.info:eu-repo/semantics/publishedVersio

Molecular analysis of the APC and MUTYH genes in Galician and Catalonian FAP families: a different spectrum of mutations?

<p>Abstract</p> <p>Background</p> <p>Familial adenomatous polyposis (FAP) is an autosomal dominant-inherited colorectal cancer syndrome, caused by germline mutations in the <it>APC </it>gene. Recently, biallelic mutations in <it>MUTYH </it>have also been identified in patients with multiple colorectal adenomas and in <it>APC</it>-negative patients with FAP. The aim of this work is therefore to determine the frequency of <it>APC </it>and <it>MUTYH </it>mutations among FAP families from two Spanish populations.</p> <p>Methods</p> <p>Eighty-two unrelated patients with classical or attenuated FAP were screened for <it>APC </it>germline mutations. <it>MUTYH </it>analysis was then conducted in those <it>APC</it>-negative families and in 9 additional patients from a previous study. Direct sequencing, SSCP analysis and TaqMan genotyping were used to identify point and frameshift mutations, meanwhile large rearrangements in the <it>APC </it>gene were screened by multiplex ligation-dependent probe amplification (MLPA).</p> <p>Results</p> <p><it>APC </it>germline mutations were found in 39% of the patients and, despite the great number of genetic variants described so far in this gene, seven new mutations were identified. The two hotspots at codons 1061 and 1309 of the <it>APC </it>gene accounted for 9,4% of the <it>APC</it>-positive families, although they were underrepresented in Galician samples. The deletion at codon 1061 was not found in 19 <it>APC</it>-positive Galician patients but represented 23% of the Catalonian positive families (p = 0,058). The same trend was observed at codon 1309, even though statistical analysis showed no significance between populations. Twenty-four percent of the <it>APC</it>-negative patients carried biallelic <it>MUTYH </it>germline mutations, and showed an attenuated polyposis phenotype generally without extracolonic manifestations. New genetic variants were found, as well as the two hotspots already reported (p.Tyr165Cys and p.Gly382Asp).</p> <p>Conclusion</p> <p>The results we present indicate that in Galician patients the frequency of the hotspot at codon 1061 in <it>APC </it>differs significantly from the Catalonian and also other Caucasian populations. Similar results had already been obtained in a previous study and could be due to the genetic isolation of the Galician population. <it>MUTYH </it>analysis is also recommended for all <it>APC</it>-negative families, even if a recessive inheritance is not confirmed.</p

Single Nucleotide Polymorphisms in the Wnt and BMP Pathways and Colorectal Cancer Risk in a Spanish Cohort

BACKGROUND: Colorectal cancer (CRC) is considered a complex disease, and thus the majority of the genetic susceptibility is thought to lie in the form of low-penetrance variants following a polygenic model of inheritance. Candidate-gene studies have so far been one of the basic approaches taken to identify these susceptibility variants. The consistent involvement of some signaling routes in carcinogenesis provided support for pathway-based studies as a natural strategy to select genes that could potentially harbour new susceptibility loci. METHODOLOGY/PRINCIPAL FINDINGS: We selected two main carcinogenesis-related pathways: Wnt and BMP, in order to screen the implicated genes for new risk variants. We then conducted a case-control association study in 933 CRC cases and 969 controls based on coding and regulatory SNPs. We also included rs4444235 and rs9929218, which did not fulfill our selection criteria but belonged to two genes in the BMP pathway and had consistently been linked to CRC in previous studies. Neither allelic, nor genotypic or haplotypic analyses showed any signs of association between the 37 screened variants and CRC risk. Adjustments for sex and age, and stratified analysis between sporadic and control groups did not yield any positive results either. CONCLUSIONS/SIGNIFICANCE: Despite the relevance of both pathways in the pathogenesis of the disease, and the fact that this is indeed the first study that considers these pathways as a candidate-gene selection approach, our study does not present any evidence of the presence of low-penetrance variants for the selected markers in any of the considered genes in our cohort

Small bowel enteroscopy - A joint clinical guideline from the spanish and portuguese small bowel study groups

The present evidence-based guidelines are focused on the use of device-assisted enteroscopy in the management of small-bowel diseases. A panel of experts selected by the Spanish and Portuguese small bowel study groups reviewed the available evidence focusing on the main indications of this technique, its role in the management algorithm of each indication and on its diagnostic and therapeutic yields. A set of recommendations were issued accordingly.Estas recomendações baseadas na evidência detalham o uso da enteroscopia assistida por dispositivo no manejo clínico das doenças do intestino delgado. Um conjunto de Gastrenterologistas diferenciados em patologia do intestino delgado foi selecionado pelos grupos de estudos Espanhol e Português de intestino delgado para rever a evidência disponível sobre as principais indicações desta técnica, o seu papel nos algoritmos de manejo de cada indicação e sobre o seu rendimento diagnóstico e terapêutico. Foi gerado um conjunto de recomendações pelos autores

Meanings given to algebraic symbolism in problem posing

Some errors in the learning of algebra suggest students have difficulties giving meaning to algebraic symbolism. In this paper, we use problem posing in order to analyze the students’ capacity to assign meaning to algebraic symbolism and the difficulties that students encounter in this process depending on the characteristics of the algebraic statements given. We designed a written questionnaire composed of eight closed algebraic statements expressed symbolically, which was administered to 55 students who had finished their compulsory education and that had some previous experience in problem posing. In our analysis of the data, we examine both syntactic and semantic structures of the problem posed. We note that in most cases students posed problems with syntactic structures different to those given. They did not include computations within variables, and changed the kinds of relationships connecting variables. Students easily posed problems for statements with additive structures. Other differences in the type of problems posed depend on the characteristics of the given statements

Ultracool dwarfs candidates based on 6 yr of the Dark Energy Survey data

We present a sample of 19 583 ultracool dwarf candidates brighter than z ≤23 selected from the Dark Energy Survey DR2 coadd data matched to VHS DR6, VIKING DR5, and AllWISE covering ∼ 480 deg2. The ultracool candidates were first pre-selected based on their (i–z), (z–Y), and (Y–J) colours. They were further classified using a method that compares their optical, near-infrared, and mid-infrared colours against templates of M, L, and T dwarfs. 14 099 objects are presented as new L and T candidates and the remaining objects are from the literature, including 5342 candidates from our previous work. Using this new and deeper sample of ultracool dwarf candidates we also present: 20 new candidate members to nearby young moving groups and associations, variable candidate sources and four new wide binary systems composed of two ultracool dwarfs. Finally, we also show the spectra of 12 new ultracool dwarfs discovered by our group and presented here for the first time. These spectroscopically confirmed objects are a sanity check of our selection of ultracool dwarfs and photometric classification method