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

Efecto prebiótico de dos fuentes de inulina en el crecimiento in vitro de Lactobacillus salivarius y Enterococcus faecium

Diarrhea in livestock species is controlled with antibiotics, but its inadequate use causes bacterial resistance. Lactic acid bacteria (LAB) in the intestinal microbiota have competitive exclusion against pathogens causing diarrhea, and inulin is a substrate for LAB. Therefore, the objective of this study was to determine the prebiotic effect of two inulin sources on in vitro growth of Lactobacillus salivarius (Ls) and Enterococcus faecium (Ef), with the use of Lactobacillus casei (Lc) as a positive control. In vitro incubations were performed at 37 °C, with glucose substitution by inulin of chicory (IAc) or agave (IAg) in MRS medium. The treatments (T) evaluated were T1: MRS-glucose+Lc; T2: MRS-IAc+Ls, T4: MRS-IAc+Ef, T5: MRS-IAg+Lc, T6: MRS-IAg+Ls and T7: MRS-IAg+Ef. The curve and the growth rate were determined by optical density (630 nm) at 0, 3, 6, 12, 24, 30, 36, 48, 54 and 60 h. A completely randomized design was used and the Tukey test for means comparison. MRS-IAg treatments showed higher (P<0.05) growth rates (0.51a, 0.50a and 0.50a h-1, T5, T6 and T7, respectively) and were similar to the positive control (T2) when grown in MRS- IAc (0.48a h-1). The positive control (T1) had a low growth rate (0.34b h-1) when the medium included glucose (MRS-glucose). pH during growth was different between treatments (P<0.05). Agave inulin favors the growth of probiotic bacteria such as Lactobacillus salivarius and Enterococcus faecium, and its prebiotic effect is better than chicory inulin.Las diarreas en especies pecuarias son controladas con antibióticos, pero su uso inadecuado causa problemas de resistencia bacteriana. Las bacterias ácido lácticas (BAL) en la microbiota intestinal ejercen exclusión competitiva contra patógenos causantes de diarreas, y la inulina es un sustrato para las BAL. Por lo tanto, el objetivo de este estudio fue determinar el efecto prebiótico de dos fuentes de inulina en el crecimiento in vitro de Lactobacillus salivarius (Ls) y Enterococcus faecium (Ef), con el uso de Lactobacillus casei (Lc) como control positivo. Las incubaciones in vitro se realizaron a 37 °C, con sustitución de glucosa por inulina de achicoria (IAc) o de agave (IAg) en el medio MRS. Los tratamientos (T) evaluados fueron T1: MRS-glucosa+Lc; T2: MRS-IAc+Lc, T3: MRS-IAc+Ls, T4: MRS-IAc+Ef, T5: MRS-IAg+Lc, T6: MRS-IAg+Ls y T7: MRS-IAg+Ef. La curva y la tasa de crecimiento se determinaron mediante densidad óptica (630 nm) a las 0, 3, 6, 12, 24, 30, 36, 48, 54 y 60 h. El diseño experimental fue completamente al azar, los datos se analizaron con PROC GLM (SAS) y la comparación de medias se realizó mediante la prueba de Tukey. Los tratamientos con MRS-IAg mostraron mayores (P<0.05) tasas de crecimiento (0.51a, 0.50a y 0.50a h-1, T5, T6 y T7, respectivamente) y resultaron similares al control positivo (T2) cuando creció en MRS-IAc (0.48a h-1). El pH durante el crecimiento fue diferente entre tratamientos (P<0.05). La inulina de agave favorece el crecimiento de bacterias probióticas como Lactobacillus salivarius y Enterococcus faecium, y su efecto prebiótico supera a la inulina de achicoria

Screening of a PDE-focused library identifies imidazoles with in vitro and in vivo antischistosomal activity

We report the evaluation of 265 compounds from a PDE-focused library for their antischistosomal activity, assessed in vitro using Schistosoma mansoni. Of the tested compounds, 171 (64%) displayed selective in vitro activity, with 16 causing worm hypermotility/spastic contractions and 41 inducing various degrees of worm killing at 100 μM, with the surviving worms displaying sluggish movement, worm unpairing and complete absence of eggs. The compounds that did not affect worm viability (n = 72) induced a complete cessation of ovipositing. 82% of the compounds had an impact on male worms whereas female worms were barely affected. In vivo evaluation in S. mansoni-infected mice with the in vitro ‘hit’ NPD-0274 at 20 mg/kg/day orally for 5 days resulted in worm burden reductions of 29% and intestinal tissue egg load reduction of 35% at 10 days post-treatment. Combination of praziquantel (PZQ) at 10 mg/kg/day for 5 days with NPD-0274 or NPD-0298 resulted in significantly higher worm killing than PZQ alone, as well as a reduction in intestinal tissue egg load, disappearance of immature eggs and an increase in the number of dead eggs

Planeamiento territorial sostenible: un reto para el futuro de nuestras sociedades; criterios aplicados

In a large part of the 17 sustainable development objectives set as goals for humanity by the UN, sustainability can be glimpsed. As a result of the dominant socio-productive model, the only way to head towards more sustainable territories that allow achieving and maintaining the well-being of the world's population is to bear in mind the need to properly plan territorial development. This work reflects on this need and takes a step forward in the definition of the main criteria to achieve territorial sustainability at regional and local scales

Lysine-based surfactants in nanovesicle formulations: the role of cationic charge position and hydrophobicity in in vitro cytotoxicity and intracellular delivery

Understanding nanomaterial interactions within cells is of increasing importance for assessing their toxicity and cellular transport. Here, we developed nanovesicles containing bioactive cationic lysine-based amphiphiles, and assessed whether these cationic compounds increase the likelihood of intracellular delivery and modulate toxicity. We found different cytotoxic responses among the formulations, depending on surfactant, cell line and endpoint assayed. The induction of mitochondrial dysfunction, oxidative stress and apoptosis were the general mechanisms underlying cytotoxicity. Fluorescence microscopy analysis demonstrated that nanovesicles were internalized by HeLa cells, and evidenced that their ability to release endocytosed materials into cell cytoplasm depends on the structural parameters of amphiphiles. The cationic charge position and hydrophobicity of surfactants determine the nanovesicle interactions within the cell and, thus, the resulting toxicity and intracellular behavior after cell uptake of the nanomaterial. The insights into some toxicity mechanisms of these new nanomaterials contribute to reducing the uncertainty surrounding their potential health hazards

Integral strategy to supportive care in breast cancer survivors through occupational therapy and a m-health system: design of a randomized clinical trial

Background: Technological support using e-health mobile applications (m-health) is a promising strategy to improve the adherence to healthy lifestyles in breast cancer survivors (excess in energy intake or low physical activity are determinants of the risk of recurrence, second cancers and cancer mortality). Moreover, cancer rehabilitation programs supervised by health professionals are needed due to the inherent characteristics of these breast cancer patients. Our main objective is to compare the clinical efficacy of a m-health lifestyle intervention system alone versus an integral strategy to improve Quality of Life in breast cancer survivors. Methods: This therapeutic superiority study will use a two-arm, assessor blinded parallel RCT design. Women will be eligible if: they are diagnosed of stage I, II or III-A breast cancer; are between 25 and 75 years old; have a Body Mass Index > 25 kg/m2; they have basic ability to use mobile apps; they had completed adjuvant therapy except for hormone therapy; and they have some functional shoulder limitations. Participants will be randomized to one of the following groups: integral group will use a mobile application (BENECA APP) and will receive a face-to-face rehabilitation (8-weeks); m-health group will use the BENECA app for 2-months and will received usual care information. Study endpoints will be assessed after 8 weeks and 6 months. The primary outcome will be Quality of Life measured by The European Organization for Research and Treatment of Cancer Quality of Life Questionnaire Core and breast module. The secondary outcomes: body composition; upper-body functionality (handgrip, Disability of the Arm, Shoulder and Hand questionnaire, goniometry); cognitive function (Wechsler Adult Intelligence Scale, Trail Making Test); anxiety and depression (Hospital Anxiety and Depression Scale); physical fitness (Short version of the Minnesota Leisure Time Physical Activity Questionnaire, Self-Efficacy Scale for Physical Activity); accelerometry and lymphedema. Discussion: This study has been designed to seek to address the new needs for support and treatment of breast cancer survivors, reflecting the emerging need to merge new low cost treatment options with much-needed involvement of health professionals in this type of patients. Trial registration: ClinicalTrials.gov Identifier: NCT02817724 (date of registration: 22/06/2016).The study was funded by the Spanish Ministry of Economy and Competitiveness (Plan Estatal de I + D + I 2013-2016), Fondo de Investigación Sanitaria del Instituto de Salud Carlos III (PI14/01627), Fondos Estructurales de la Unión Europea (FEDER) and by the Spanish Ministry of Education (FPU14/01069). This is part of a Ph.D. Thesis conducted in the Clinical Medicine and Public Health Doctoral Studies of the University of Granada, Spain

Anti-tumour necrosis factor discontinuation in inflammatory bowel disease patients in remission: study protocol of a prospective, multicentre, randomized clinical trial

Background: Patients with inflammatory bowel disease who achieve remission with anti-tumour necrosis factor (anti-TNF) drugs may have treatment withdrawn due to safety concerns and cost considerations, but there is a lack of prospective, controlled data investigating this strategy. The primary study aim is to compare the rates of clinical remission at 1?year in patients who discontinue anti-TNF treatment versus those who continue treatment. Methods: This is an ongoing, prospective, double-blind, multicentre, randomized, placebo-controlled study in patients with Crohn?s disease or ulcerative colitis who have achieved clinical remission for ?6?months with an anti-TNF treatment and an immunosuppressant. Patients are being randomized 1:1 to discontinue anti-TNF therapy or continue therapy. Randomization stratifies patients by the type of inflammatory bowel disease and drug (infliximab versus adalimumab) at study inclusion. The primary endpoint of the study is sustained clinical remission at 1?year. Other endpoints include endoscopic and radiological activity, patient-reported outcomes (quality of life, work productivity), safety and predictive factors for relapse. The required sample size is 194 patients. In addition to the main analysis (discontinuation versus continuation), subanalyses will include stratification by type of inflammatory bowel disease, phenotype and previous treatment. Biological samples will be obtained to identify factors predictive of relapse after treatment withdrawal. Results: Enrolment began in 2016, and the study is expected to end in 2020. Conclusions: This study will contribute prospective, controlled data on outcomes and predictors of relapse in patients with inflammatory bowel disease after withdrawal of anti-TNF agents following achievement of clinical remission. Clinical trial reference number: EudraCT 2015-001410-1