Evaluación de la maloclusión, alteraciones funcionales y hábitos orales en una población escolar: Tarragona y Barcelona

Fundamento: La etiología de la maloclusión puede ser multifactorial y difícil de clasificar durante el desarrollo del individuo. Los objetivos del estudio son conocer las características de la maloclusión y su posible relación con las alteraciones funcionales y los hábitos orales. Métodos: Se estudió a 1.270 individuos representativos de la población escolar de Cataluña; 596 niños y 674 niñas de entre 6 y 14 años. Se obtuvo información mediante registros clínicos y cuestionarios. Se trata de un estudio observacional descriptivo mixto transversal, llevado a cabo entre 2006 y 2007 a través de un muestreo no probabilística de conveniencia. Se ha realizado el calibrado de los examinadores. Resultados: Fueron incluidos 1051 escolares con una edad media de 9,32 años. El 72,8% presenta según Angle Clase I, 19,0% y 5,2% Clase II/1 y II/2 respectivamente y 2,9% Clase III. El hábito onicofagia fue el más frecuente con un 46,4%. El mayor nivel de limitación funcional fue la hipertrofia amigdalar con un 21,2%. Existe relación estadísticamente significativa entre maloclusión sagital y tipo de respiración y movilidad lingual y entre maloclusión horizontal y tiempo de succión digital y movilidad lingual (p<0,05). Conclusiones: El diagnóstico de alteraciones funcionales y de hábitos orales puede advertir de la presencia de maloclusión

Biomechanical effects of Teuscher activator in hyperdivergent Class II malocclusion treatment : a finite element analysis

In orthodontic treatment, the combination of an activator with a headgear is commonly used in treatment of the hyperdivergent Class II malocclusion. However, the distribution of stresses transmitted to the maxilla by these appliances has been little stud

Rethinking Proteasome Evolution: Two Novel Bacterial Proteasomes

The proteasome is a multisubunit structure that degrades proteins. Protein degradation is an essential component of regulation because proteins can become misfolded, damaged, or unnecessary. Proteasomes and their homologues vary greatly in complexity: from HslV (heat shock locus v), which is encoded by 1 gene in bacteria, to the eukaryotic 20S proteasome, which is encoded by more than 14 genes. Despite this variation in complexity, all the proteasomes are composed of homologous subunits. We searched 238 complete bacterial genomes for structures related to the proteasome and found evidence of two novel groups of bacterial proteasomes. The first, which we name Anbu, is sparsely distributed among cyanobacteria and proteobacteria. We hypothesize that Anbu must be very ancient because of its distribution within the cyanobacteria, and that it has been lost in many more recent species. We also present evidence for a fourth type of bacterial proteasome found in a few β-proteobacteria, which we call β-proteobacteria proteasome homologue (BPH). Sequence and structural analyses show that Anbu and BPH are both distinct from known bacterial proteasomes but have homologous structures. Anbu is encoded by one gene, so we postulate a duplication of Anbu created the 20S proteasome. Anbu’s function appears to be related to transglutaminase activity, not the general stress response associated with HslV. We have found different combinations of Anbu, BPH, and HslV within these bacterial genomes, which raises questions about specialized protein degradation systems

The role of the proteasome in the generation of MHC class I ligands and immune responses

The ubiquitin–proteasome system (UPS) degrades intracellular proteins into peptide fragments that can be presented by major histocompatibility complex (MHC) class I molecules. While the UPS is functional in all mammalian cells, its subunit composition differs depending on cell type and stimuli received. Thus, cells of the hematopoietic lineage and cells exposed to (pro)inflammatory cytokines express three proteasome immunosubunits, which form the catalytic centers of immunoproteasomes, and the proteasome activator PA28. Cortical thymic epithelial cells express a thymus-specific proteasome subunit that induces the assembly of thymoproteasomes. We here review new developments regarding the role of these different proteasome components in MHC class I antigen processing, T cell repertoire selection and CD8 T cell responses. We further discuss recently discovered functions of proteasomes in peptide splicing, lymphocyte survival and the regulation of cytokine production and inflammatory responses

Effectiveness of thrombectomy in stroke according to baseline prognostic factors: inverse probability of treatment weighting analysis of a population-based registry

Background and Purpose In real-world practice, the benefit of mechanical thrombectomy (MT) is uncertain in stroke patients with very favorable or poor prognostic profiles at baseline. We studied the effectiveness of MT versus medical treatment stratifying by different baseline prognostic factors. Methods Retrospective analysis of 2,588 patients with an ischemic stroke due to large vessel occlusion nested in the population-based registry of stroke code activations in Catalonia from January 2017 to June 2019. The effect of MT on good functional outcome (modified Rankin Score ≤2) and survival at 3 months was studied using inverse probability of treatment weighting (IPTW) analysis in three pre-defined baseline prognostic groups: poor (if pre-stroke disability, age >85 years, National Institutes of Health Stroke Scale [NIHSS] >25, time from onset >6 hours, Alberta Stroke Program Early CT Score 3), good (if NIHSS <6 or distal occlusion, in the absence of poor prognostic factors), or reference (not meeting other groups’ criteria). Results Patients receiving MT (n=1,996, 77%) were younger, had less pre-stroke disability, and received systemic thrombolysis less frequently. These differences were balanced after the IPTW stratified by prognosis. MT was associated with good functional outcome in the reference (odds ratio [OR], 2.9; 95% confidence interval [CI], 2.0 to 4.4), and especially in the poor baseline prognostic stratum (OR, 3.9; 95% CI, 2.6 to 5.9), but not in the good prognostic stratum. MT was associated with survival only in the poor prognostic stratum (OR, 2.6; 95% CI, 2.0 to 3.3). Conclusions Despite their worse overall outcomes, the impact of thrombectomy over medical management was more substantial in patients with poorer baseline prognostic factors than patients with good prognostic factors

Intravenous alteplase for stroke with unknown time of onset guided by advanced imaging: systematic review and meta-analysis of individual patient data

Background: Patients who have had a stroke with unknown time of onset have been previously excluded from thrombolysis. We aimed to establish whether intravenous alteplase is safe and effective in such patients when salvageable tissue has been identified with imaging biomarkers. Methods: We did a systematic review and meta-analysis of individual patient data for trials published before Sept 21, 2020. Randomised trials of intravenous alteplase versus standard of care or placebo in adults with stroke with unknown time of onset with perfusion-diffusion MRI, perfusion CT, or MRI with diffusion weighted imaging-fluid attenuated inversion recovery (DWI-FLAIR) mismatch were eligible. The primary outcome was favourable functional outcome (score of 0–1 on the modified Rankin Scale [mRS]) at 90 days indicating no disability using an unconditional mixed-effect logistic-regression model fitted to estimate the treatment effect. Secondary outcomes were mRS shift towards a better functional outcome and independent outcome (mRS 0–2) at 90 days. Safety outcomes included death, severe disability or death (mRS score 4–6), and symptomatic intracranial haemorrhage. This study is registered with PROSPERO, CRD42020166903. Findings: Of 249 identified abstracts, four trials met our eligibility criteria for inclusion: WAKE-UP, EXTEND, THAWS, and ECASS-4. The four trials provided individual patient data for 843 individuals, of whom 429 (51%) were assigned to alteplase and 414 (49%) to placebo or standard care. A favourable outcome occurred in 199 (47%) of 420 patients with alteplase and in 160 (39%) of 409 patients among controls (adjusted odds ratio [OR] 1·49 [95% CI 1·10–2·03]; p=0·011), with low heterogeneity across studies (I2=27%). Alteplase was associated with a significant shift towards better functional outcome (adjusted common OR 1·38 [95% CI 1·05–1·80]; p=0·019), and a higher odds of independent outcome (adjusted OR 1·50 [1·06–2·12]; p=0·022). In the alteplase group, 90 (21%) patients were severely disabled or died (mRS score 4–6), compared with 102 (25%) patients in the control group (adjusted OR 0·76 [0·52–1·11]; p=0·15). 27 (6%) patients died in the alteplase group and 14 (3%) patients died among controls (adjusted OR 2·06 [1·03–4·09]; p=0·040). The prevalence of symptomatic intracranial haemorrhage was higher in the alteplase group than among controls (11 [3%] vs two [&lt;1%], adjusted OR 5·58 [1·22–25·50]; p=0·024). Interpretation: In patients who have had a stroke with unknown time of onset with a DWI-FLAIR or perfusion mismatch, intravenous alteplase resulted in better functional outcome at 90 days than placebo or standard care. A net benefit was observed for all functional outcomes despite an increased risk of symptomatic intracranial haemorrhage. Although there were more deaths with alteplase than placebo, there were fewer cases of severe disability or death. Funding: None

Evaluación de la maloclusión, alteraciones funcionales y hábitos orales en una población escolar: Tarragona y Barcelona

Fundamento: La etiología de la maloclusión puede ser multifactorial y difícil de clasificar durante el desarrollo del individuo. Los objetivos del estudio son conocer las características de la maloclusión y su posible relación con las alteraciones funcionales y los hábitos orales. Métodos: Se estudió a 1.270 individuos representativos de la población escolar de Cataluña; 596 niños y 674 niñas de entre 6 y 14 años. Se obtuvo información mediante registros clínicos y cuestionarios. Se trata de un estudio observacional descriptivo mixto transversal, llevado a cabo entre 2006 y 2007 a través de un muestreo no probabilística de conveniencia. Se ha realizado el calibrado de los examinadores. Resultados: Fueron incluidos 1051 escolares con una edad media de 9,32 años. El 72,8% presenta según Angle Clase I, 19,0% y 5,2% Clase II/1 y II/2 respectivamente y 2,9% Clase III. El hábito onicofagia fue el más frecuente con un 46,4%. El mayor nivel de limitación funcional fue la hipertrofia amigdalar con un 21,2%. Existe relación estadísticamente significativa entre maloclusión sagital y tipo de respiración y movilidad lingual y entre maloclusión horizontal y tiempo de succión digital y movilidad lingual (p<0,05). Conclusiones: El diagnóstico de alteraciones funcionales y de hábitos orales puede advertir de la presencia de maloclusión