Subperiostial orbital abscess and apex syndrome as a complication after a mandibular molar extraction

Indexación: Web of Science; ScieloIntroducción: La diseminación de las infecciones que se extienden de dientes mandibulares y estructuras adyacentes hacia la órbita y tejido periorbitario son infrecuentes, pero graves ya que tienen el potencial de causar la pérdida de la visión. Objetivos: El propósito de este artículo es publicar un caso clínico muy interesante por lo infrecuente, y explicar a juicio de los autores las vías de diseminación de la infección, a su vez alertar a los diferentes especialistas involucrados sobre las severas consecuencias que pueden resultar tras la extracción de piezas dentales, como es la pérdida definitiva de la visión. Reporte del caso: Se trata de un paciente masculino de 43 años, sin antecedentes mórbidos relevantes, que fue enviado al Servicio Médico Legal para examen clínico forense con pérdida total de la visión del ojo derecho por atrofia óptica como complicación de un síndrome del vértice orbitario, luego de la exodoncia del tercer molar mandibular derecho. Conclusiones: Es fundamental el tratamiento oportuno y agresivo para detener la diseminación de una infección desde las estructuras adyacentes hacia la órbita. La comunicación efectiva interdisciplinaria entre los profesionales involucrados evita complicaciones de tipo médico-legales y secuelas definitivas al paciente.Introduction: Infection dissemination from mandibular teeth to the orbit and adjacent structures is infrequent, but nevertheless serious, as they may cause severe problems, including vision loss. Aim: The purpose of this study is to present a rare and interesting case of such a dissemination, to discuss the possible routes of infection propagation, and to alert the different specialists involved on the possible complications after dental extractions, such as visual loss. Report of the case: The case of a 43-year-old previously healthy male is presented. The patient was sent to the Medical Legal Service for clinical forensic examination after total vision loss of the right eye, caused by optic atrophy as a complication of orbital apex syndrome, after the extraction of the third right mandibular molar. Conclusions: Opportune and aggressive treatment is crucial to stop infection spread from adjacent structures to the orbit. Effective communication among the professionals involved avoids medical - legal complications and precludes permanent sequels to the patient.http://ref.scielo.org/yz5gt

Molecular forms of butyrylcholinesterase and obesity

This study compared obese (N = 134) and unobese (N = 92) male blood donors, regarding the relative intensity (RI) and activity of different molecular forms (G1, G2, G4 and G1-ALB) of butyrylcholinesterase (BChE, EC 3.1.1.8) found in plasma, thereby searching for an association between these variables with obesity and SNPs of exons 1 and 4 of the BCHE gene. It was shown that obese and unobese individuals do not differ in the RI of each BChE band, even when classifying the sample into three genotypes of exons 1 and 4 of the BCHE gene (-116GG/539AA, -116GG/539AT, -116GA/539AT). Although the mean BChE activity of each band was significantly higher in obese than in unobese blood donors, the proportions of BChE bands were maintained, even under the metabolic stress associated to obesity, thereby leading to infer that this proportion is somehow regulated, and may therefore be important for BChE functions

Characteristics of the lunch box of pre-school children and nutritional knowledge of the carer: A pilot study in Lima, Peru, 2016

Cartas al EditorRevisión por pare

Enfoque del tratamiento de la Salud Mental en los últimos 70 años en Bs As, Argentina

Objetivos: evaluar el impacto terapéutico y costos asociados a tratamientos de patología mental en los últimos 70 años. Metodología: estudio retrospectivo-descriptivo con etapa analítica en el cual se evaluaron historias clínicas de pacientes internados en Institución de Salud Mental de Buenos Aires. Las variables analizadas fueron: edad, sexo, motivo de internación, promedio de estadía, re-internaciones, número y tipo de medicamentos por década, resultados en términos de mejoría clínica, costo de medicamentos e internaciones en cada década

Impacto de una investigación epidemiológica seguida de una intervención comunitaria para garantizar el acceso a la atención de las enfermedades crónicas de poblaciones socialmente vulnerables

Las enfermedades crónicas como la diabetes o la hipertensión se han vuelto endémicas en la mayoría de los países del mundo incluyendo a la Argentina. Debido a que ambas patologías mencionadas son oligosintomáticas, los pacientes suelen pasar muchos años sin percatarse de las mismas y frecuentemente el sistema de salud las identifica por una complicación asociada o por una descompensación que sufren los pacientes afectados. La consulta profesional vinculada a dichas enfermedades crónicas es realizada en forma muy tardía, configurándose cómo práctica extendida en gran parte de la población bonaerense. Los alcances del fenómeno han sido captados por estudios epidemiológicos oficiales realizados por la Sub-Secretaria de Planificación del Ministerio de Salud de la Provincia de Bs As, que muestran que solo el 13,5% de la población consulta oportunamente a los servicios de Salud. Asimismo, gran parte de los individuos que son diagnosticados, y a los que se les prescribe un tratamiento farmacológico, no tienen la adherencia al tratamiento esperada, con las consecuencias ominosas que ello tiene para su salud. Con el fin de establecer cuál es el impacto de un estudio epidemiológico de detección precoz de estas patologías y de una intervención que incluya un monitoreo continuo y garantice el cumplimiento adecuado del tratamiento en los pacientes con patologías crónicas, se inició el presente estudio que forma parte del proyecto de investigación M194 del programa incentivos docentes de la SPU

Effects of physical exercise on butyrylcholinesterase in obese adolescents

Abstract The aim of the present study was to evaluate the effect of a 12 week program of physical exercise (PE) on butyrylcholinesterase (BChE) in obese adolescents. This study compared obese adolescents (N = 54) before and after PE, regarding the relative intensity (RI) and activity of different molecular forms (G1, G2, G4 and G1-ALB) of BChE found in plasma. Waist circumference (WC) and lipid profile were also assessed before and after PE. It was shown that before PE, mean plasma BChE activity was significantly higher in obese than in non-obese adolescents and that it was significantly reduced after PE, becoming similar to that found in non-obese adolescents. Lipid profile and WC also changed in response to PE. These results are consistent with studies that found a correlation between BChE and lipid metabolism and suggest that PE may have led to a physiological regularization of plasma BChE activity. Although mean BChE activity of each isoform was significantly reduced by PE, their RI did not change. This is in accordance with a previous suggestion that this proportion is maintained under factors such as obesity, and may therefore be important for BChE functions. Key words: BChE activity; physical exercise, obesity. Butyrylcholinesterase (BChE; EC 3.1.1.8) is coded by BCHE gene (3q26.1-q26.2), synthesized in the liver and distributed to several parts of the organism. Plasmatic BChE is found in four possible homomeric forms (G1 monomers, G2 dimmers, G3 trimers and G4 tetramers) or heteromeric forms formed in association with other proteins, such as albumin, G1-Alb (Masson, 1989). Several studies verified that BChE has a role in lipid metabolism The aim of this study was to compare the relative intensity (RI) of BChE isoforms revealed as bands (G1, G1-Alb, G2 and G4) in obese adolescents before and after 12 weeks of physical exercise (PE), and to search for a correlation between RI of BChE isoform bands, plasma BChE activity and PE. The sample comprised 54 obese adolescents (BMI above percentile 95 and mean age 12.6 ± 2.01), these being participants of a 12 week program of physical exercise. Aerobic exercise consisted of 50 to 100 min activity during the first four weeks. Intensity was set at 35%-55% of VO 2 peak, and was increased to 55%-75% during the next eight weeks. Plasma was sampled at baseline and after terminating the program. A sample of non-obese adolescents (N = 45; mean age 13.3 ± 2.15) was used to measure plasma BChE activity. The detection and analysis of BChE bands in plasma was made according to Mean plasma BChE activity was significantly reduced after the 12 weeks program (before: 7.66 ± 2.64 KU/L, after: 5.89 ± 2.34 KU/L; t = 2.96, p = 0.008). Accompanying BChE activity, waist circumference (WC; before: 97.41 ± 11.20 cm, after: 94.62 ± 10.51 cm, t = 3.6 and p = 0.03), LDL-cholesterol (LDL-C; before: 94.45 ± 20.83 mg/dL, after: 86.00 ± 16.37 mg/dL, t = 2.77 and p = 0.012) and triglycerides (TG; before: 114.30 ± 57.14 mg/dL, after: 82.75 ± 42.66 mg/dL, t = 3.1 and p = 0.006) also showed significant reduction with PE

Survival of hereditary non-polyposis colorectal cancer patients compared with sporadic colorectal cancer patients

<p>Abstract</p> <p>Background</p> <p>Patients with hereditary non-poliposys colorectal cancer (HNPCC) have better prognosis than sporadic colorectal cancer (CRC). Aim of our retrospective study was to compare the overall survival between sporadic CRC and HNPCC patients.</p> <p>Methods</p> <p>We analyzed a cohort of 40 (25 males and 15 females) HNPCC cases with a hospital consecutive series of 573 (312 males and 261 females) sporadic CRC observed during the period 1970–1993. In 15 HNPCC patients we performed mutational analysis for microsatellite instability. Survival rates were calculated by Kaplan-Meier method and compared with log rank test.</p> <p>Results</p> <p>The median age at diagnosis of the primary CRC was 46.8 years in the HNPCC series versus 61 years in sporadic CRC group. In HNPCC group 85% had a right cancer location, vs. 57% in the sporadic cancer group. In the sporadic cancer group 61.6% were early-stages cancer (Dukes' A and B) vs. 70% in the HNPCC group (p = ns). The crude 5-years cumulative survival after the primary CRC was 94.2% in HNPCC patients vs. 75.3% in sporadic cancer patients (p < 0.0001).</p> <p>Conclusion</p> <p>Our results show that overall survival of colorectal cancer in patients with HNPCC is better than sporadic CRC patients. The different outcome probably relates to the specific tumorigenesis involving DNA mismatch repair dysfunction.</p

Effectiveness of the first component of Gam-COVID-Vac (Sputnik V) on reduction of SARS-CoV-2 confirmed infections, hospitalisations and mortality in patients aged 60-79: a retrospective cohort study in Argentina

Background A first-dose of various vaccines provides acceptable protection against infections by SARS-CoV-2 and evolution to the most severe forms of COVID-19. The recombinant adenovirus (rAd)-based vaccine, Gam-COVID-Vac (Sputnik V), was proven efficacious but information about effectiveness in the real-world setting is lacking. The aim of our study was to investigate the association between the rollout of the first component (rAd26) of Gam-COVID-Vac and PCR-positive tests, hospitalisations and deaths. Methods We conducted a retrospective cohort study which analyzed individuals aged 60-79 who self-registered in the online vaccination system of the Province of Buenos Aires, Argentina, from December 29, 2020 to March 21, 2021. Exclusion criteria were having a previous positive RT-PCR or antigen tests for SARS-CoV-2, having received other vaccines, or two doses of any vaccine. Proportions of new laboratory-confirmed SARS-CoV-2 infections, hospitalisations and deaths until 83 days of vaccination were compared between vaccinated and unvaccinated subjects. Vaccine effectiveness for the three outcomes was calculated as (1–OR) × 100. Kaplan-Meier cumulative incidence curves were constructed. Findings During the study period 415995 registered subjects received the first component of Gam-COVID-Vac; 40387 belonged to the 60-79 age group, and were compared to 38978 unvaccinated. Vaccine effectiveness for preventing laboratory-confirmed infections was 78•6% [CI95% 74·8 - 81·7]; and for reducing hospitalizations and deaths was, respectively, 87·6% [CI95% 80·3 - 92·2] and 84·8% [CI95% 75·0 - 90·7]. Effectiveness was high across all subgroups. Interpretation Similarly to other vaccines, the administration of one dose of Gam-COVID-Vac was effective for a wide range of COVID-19–related outcomes.Facultad de Ciencias Médica

Revised Lithostratigraphy of the Sonsela Member (Chinle Formation, Upper Triassic) in the Southern Part of Petrified Forest National Park, Arizona

BACKGROUND: Recent revisions to the Sonsela Member of the Chinle Formation in Petrified Forest National Park have presented a three-part lithostratigraphic model based on unconventional correlations of sandstone beds. As a vertebrate faunal transition is recorded within this stratigraphic interval, these correlations, and the purported existence of a depositional hiatus (the Tr-4 unconformity) at about the same level, must be carefully re-examined. METHODOLOGY/PRINCIPAL FINDINGS: Our investigations demonstrate the neglected necessity of walking out contacts and mapping when constructing lithostratigraphic models, and providing UTM coordinates and labeled photographs for all measured sections. We correct correlation errors within the Sonsela Member, demonstrate that there are multiple Flattops One sandstones, all of which are higher than the traditional Sonsela sandstone bed, that the Sonsela sandstone bed and Rainbow Forest Bed are equivalent, that the Rainbow Forest Bed is higher than the sandstones at the base of Blue Mesa and Agate Mesa, that strata formerly assigned to the Jim Camp Wash beds occur at two stratigraphic levels, and that there are multiple persistent silcrete horizons within the Sonsela Member. CONCLUSIONS/SIGNIFICANCE: We present a revised five-part model for the Sonsela Member. The units from lowest to highest are: the Camp Butte beds, Lot's Wife beds, Jasper Forest bed (the Sonsela sandstone)/Rainbow Forest Bed, Jim Camp Wash beds, and Martha's Butte beds (including the Flattops One sandstones). Although there are numerous degradational/aggradational cycles within the Chinle Formation, a single unconformable horizon within or at the base of the Sonsela Member that can be traced across the entire western United States (the "Tr-4 unconformity") probably does not exist. The shift from relatively humid and poorly-drained to arid and well-drained climatic conditions began during deposition of the Sonsela Member (low in the Jim Camp Wash beds), well after the Carnian-Norian transition