Factors affecting outcome in frameless non-isocentric stereotactic radiosurgery for trigeminal neuralgia: A multicentric cohort study

Background: Stereotactic radiosurgery (SRS) is an effective treatment for trigeminal neuralgia (TN). Nevertheless, a proportion of patients will experience recurrence and treatment-related sensory disturbances. In order to evaluate the predictors of efficacy and safety of image-guided non-isocentric radiosurgery, we analyzed the impact of trigeminal nerve volume and the nerve dose/volume relationship, together with relevant clinical characteristics. Methods: Two-hundred and ninety-six procedures were performed on 262 patients at three centers. In 17 patients the TN was secondary to multiple sclerosis (MS). Trigeminal pain and sensory disturbances were classified according to the Barrow Neurological Institute (BNI) scale. Pain-free-intervals were investigated using Kaplan Meier analyses. Univariate and multivariate Cox regression analyses were performed to identify predictors. Results: The median follow-up period was 38 months, median maximal dose 72.4 Gy, median target nerve volume 25 mm3, and median prescription dose 60 Gy. Pain control rate (BNI I-III) at 6, 12, 24, 36, 48, and 60 months were 96.8, 90.9, 84.2, 81.4, 74.2, and 71.2%, respectively. Overall, 18% of patients developed sensory disturbances. Patients with volume 65 30 mm3 were more likely to maintain pain relief (p = 0.031), and low integral dose (< 1.4 mJ) tended to be associated with more pain recurrence than intermediate (1.4-2.7 mJ) or high integral dose (> 2.7 mJ; low vs. intermediate: log-rank test, \u3c72 = 5.02, p = 0.019; low vs. high: log-rank test, \u3c72 = 6.026, p = 0.014). MS, integral dose, and mean dose were the factors associated with pain recurrence, while re-irradiation and MS were predictors for sensory disturbance in the multivariate analysis. Conclusions: The dose to nerve volume ratio is predictive of pain recurrence in TN, and re-irradiation has a major impact on the development of sensory disturbances after non-isocentric SRS. Interestingly, the integral dose may differ significantly in treatments using apparently similar dose and volume constraints

Molecular characterization of severe and mild cases of Influenza A (H1N1) 2009 strain from Argentina

While worldwide pandemic influenza A(H1N1) pdm case fatality rate (CFR) was 0.4%, Argentina's was 4.5%. A total of 34 strains from mild and severe cases were analyzed. A full genome sequencing was carried out on 26 of these, and a partial sequencing on the remaining eight. We observed no evidence that the high CFR can be attributed to direct virus changes. No evidence of re-assortment, mutations associated with resistance to antiviral drugs, or genetic drift that might contribute to virulence was observed. Although the mutation D225G associated with severity in the latest reports from the Ukraine and Norway is not observed among the Argentine strains, an amino acid change in the area (S206T) surrounding the HA receptor binding domain was observed, the same previously established worldwide

Socioeconomic inequalities in low birth weight risk before and during the COVID-19 pandemic in Argentina: A cross-sectional study

Background: The coronavirus disease 2019 (COVID-19) pandemic may have exacerbated existing socioe- conomic inequalities in health. In Argentina, public hospitals serve the poorest uninsured segment of the population, while private hospitals serve patients with health insurance. This study aimed to assess whether socioeconomic inequalities in low birth weight (LBW) risk changed during the first wave of the COVID-19 pandemic. Methods: This multicenter cross-sectional study included 15929 infants. A difference-in-difference (DID) analysis of socioeconomic inequalities between public and private hospitals in LBW risk in a pandemic cohort (March 20 to July 19, 2020) was compared with a prepandemic cohort (March 20 to July 19, 2019) by using medical records obtained from ten hospitals. Infants were categorized by weight as LBW < 2500 g, very low birth weight (VLBW) < 1500 g and extremely low birth weight (ELBW) < 1000 g. Log binomial regression was performed to estimate risk differences with an interaction term representing the DID estimator. Covariate-adjusted models included potential perinatal confounders. Findings: Of the 8437 infants in the prepandemic cohort, 4887 (57 ? 9%) were born in public hospitals. The pandemic cohort comprised 7492 infants, 4402 (58 ? 7%) of whom were born in public hospitals. The DID estimators indicated no differences between public versus private hospitals for LBW risk ( −1 ? 8% [95% CI −3 ? 6, 0 ? 0]) and for ELBW risk ( −0 ? 1% [95% CI −0 ? 6, 0 ? 3]). Significant differences were found between public versus private hospitals in the DID estimators ( −1 ? 2% [95% CI, −2 ? 1, −0 ? 3]) for VLBW risk. The results were comparable in covariate-adjusted models. Interpretation: In this study, we found evidence of decreased disparities between public and private hos- pitals in VLBW risk. Our findings suggest that measures that prioritize social spending to protect the most vulnerable pregnant women during the pandemic contributed to better birth outcomes. Funding: No funding was secured for this study.Fil: Cuestas, Eduardo. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Córdoba. Instituto de Investigaciones en Ciencias de la Salud. Universidad Nacional de Córdoba. Instituto de Investigaciones en Ciencias de la Salud; ArgentinaFil: Gómez Flores, Martha E.. Gobierno de la Provincia de Buenos Aires. Hospital Doctor Ramón Carrillo; ArgentinaFil: Charras, María D.. Gobierno de la Provincia de Buenos Aires. Hospital Doctor Ramón Carrillo; ArgentinaFil: Peyrano, Alberto J.. Hospital Materno Provincial Dr. Raúl Felipe Lucini; ArgentinaFil: Montenegro, Clara. Hospital Materno Provincial Dr. Raúl Felipe Lucini; ArgentinaFil: Sosa Boye, Ignacio. No especifíca;Fil: Burgos, Verónica. Universidad Católica de Córdoba. Facultad de Medicina. Clínica Universitaria Reina Fabiola; ArgentinaFil: Giusti, Graciela. Clínica y Maternidad del Sol; ArgentinaFil: Espósito, Mario. Clínica y Maternidad del Sol; ArgentinaFil: Blanco Pool, Silvyana S.. Hospital Misericordia Nuevo Siglo ; Gobierno de la Provincia de Cordoba; ArgentinaFil: Gurevich, Debora P.. Hospital Misericordia Nuevo Siglo ; Gobierno de la Provincia de Cordoba; ArgentinaFil: Ahumada, Luis A.. Hospital Misericordia Nuevo Siglo ; Gobierno de la Provincia de Cordoba; ArgentinaFil: Pontoriero, Ricardo D.. Hospital Misericordia Nuevo Siglo ; Gobierno de la Provincia de Cordoba; ArgentinaFil: Rizzotti, Alina. Hospital Privado Universitario de Córdoba; ArgentinaFil: Bas, José I.. Hospital Privado Universitario de Córdoba; ArgentinaFil: Vaca, María B.. Hospital Universitario de Maternidad y Neonatología; ArgentinaFil: Miranda, María J.. Hospital Universitario de Maternidad y Neonatología; ArgentinaFil: Ferreyra, Mirta E.. Hospital Misericordia Nuevo Siglo ; Gobierno de la Provincia de Cordoba; ArgentinaFil: Moreno, Gabriela C.. Gobierno de la Provincia de Buenos Aires. Hospital Doctor Ramón Carrillo; ArgentinaFil: Pedicino, Héctor. Hospital Italiano; ArgentinaFil: Rojas Rios, Melvy. Hospital Italiano; Argentin

Association between COVID-19 mandatory lockdown and decreased incidence of preterm births and neonatal mortality

Previous studies suggest a decrease in preterm births (PTB) during de coronavirus disease 2019 (COVID-19), possibly due to the effect of the mandatory lockdown. Nevertheless, other reports have been unable to confirm this finding. Most of these studies originated in high-income countries and evaluated a limited number of potential confounders, and all of them assessed a short lockdown period. In addition, an important question remains unanswered: How can we be sure that the observed changes are due to lockdown, when most of the pregnancies delivered in the lockdown period were conceived prior to it?To date there is insufficient evidence to support the notion that public health interventions during the lockdown prevent PTB . The aim of this study was to compare the incidence of PTB, neonatal mortality (NM) and stillbirths adjusted by potential confounders during the lockdown period assessing a time window of nine and a half months during which all the pregnancies analyzed in the exposed group were conceived after the lockdown, with the corresponding incidence in the previous year where all the unexposed pregnancies analyzed were conceived before the lockdown.publishedVersionFil: Cuestas, Eduardo. Universidad Nacional de Córdoba. Facultad de Ciencias Médicas; Argentina.Fil: Cuestas, Eduardo. Consejo Nacional de Investigaciones Científicas y Técnicas. Instituto de Investigaciones en Ciencias de la Salud; Argentina.Fil: Gómez Flores, Martha E. Gobierno de la Provincia de Buenos Aires. Hospital Doctor Ramon Carrillo; Argentina.Fil: Charras, María D. Gobierno de la Provincia de Buenos Aires. Hospital Doctor Ramon Carrillo; Argentina.Fil: Peyrano, Alberto J. Hospital Materno Provincial Dr. Raúl Felipe Lucini; Argentina.Fil: Montenegro, Clara. Hospital Materno Provincial Dr. Raúl Felipe Lucini; Argentina.Fil: Sosa-Boye, Ignacio. Clínica Universitaria Reina Fabiola; Argentina.Fil: Burgos, Verónica. Clínica Universitaria Reina Fabiola; Argentina.Fil: Giusti, Graciela. Clínica y Maternidad del Sol; Argentina.Fil: Espósito, Mario. Clínica y Maternidad del Sol; Argentina.Fil: Blanco Pool, Silvyana S. Hospital Misericordia Nuevo Siglo; Argentina.Fil: Blanco Pool, Silvyana S. Sanatorio Allende; Argentina.Fil: Gurevich, Debora P. Sanatorio Allende; Argentina.Fil: Gurevich, Debora P. Hospital Misericordia Nuevo Siglo; Argentina.Fil: Ahumada, Luis A. Sanatorio Allende; Argentina.Fil: Ahumada, Luis A. Hospital Misericordia Nuevo Siglo; Argentina.Fil: Pontoriero, Ricardo D. Hospital Misericordia Nuevo Siglo; Argentina.Fil: Rizzotti, Alina. Hospital Privado Universitario de Córdoba; Argentina.Fil: Bas, José I. Hospital Privado Universitario de Córdoba; Argentina.Fil: Vaca, María B. Hospital Universitario de Maternidad y Neonatología; Argentina.Fil: Miranda, María J. Hospital Universitario de Maternidad y Neonatología; Argentina.Fil: Ferreyra, Mirta E. Sanatorio del Salvador; Argentina.Fil: Ferreyra, Mirta E. Hospital Misericordia Nuevo Siglo; Argentina.Fil: Moreno, Gabriela C. Sanatorio del Salvador; Argentina.Fil: Pedicino, Héctor. Instituto Universidad Escuela de Medicina del Hospital Italiano; Argentina.Fil: Rojas-Rios, Melvy. Instituto Universidad Escuela de Medicina del Hospital Italiano; Argentina

Diverse Roles of Eph/ephrin Signaling in the Mouse Lens

Recent genetic studies show that the Eph/ephrin bidirectional signaling pathway is associated with both congenital and age-related cataracts in mice and humans. We have investigated the molecular mechanisms of cataractogenesis and the roles of ephrin-A5 and EphA2 in the lens. Ephrin-A5 knockout (-/-) mice often display anterior polar cataracts while EphA2(-/-) lenses show very mild cortical or nuclear cataracts at weaning age. The anterior polar cataract of ephrin-A5(-/-) lenses is correlated with multilayers of aberrant cells that express alpha smooth muscle actin, a marker for mesenchymal cells. Only select fiber cells are altered in ephrin-A5(-/-) lenses. Moreover, the disruption of membrane-associated β-catenin and E-cadherin junctions is observed in ephrin-A5(-/-) lens central epithelial cells. In contrast, EphA2(-/-) lenses display normal monolayer epithelium while disorganization is apparent in all lens fiber cells. Immunostaining of ephrin-A5 proteins, highly expressed in lens epithelial cells, were not colocalized with EphA2 proteins, mainly expressed in lens fiber cells. Besides the previously reported function of ephrin-A5 in lens fiber cells, this work suggests that ephrin-A5 regulates β-catenin signaling and E-cadherin to prevent lens anterior epithelial cells from undergoing the epithelial-to-mesenchymal transition while EphA2 is essential for controlling the organization of lens fiber cells through an unknown mechanism. Ephrin-A5 and EphA2 likely interacting with other members of Eph/ephrin family to play diverse functions in lens epithelial cells and/or fiber cells

Effects of enamel matrix derivative and transforming growth factor-β1 on human osteoblastic cells

<p>Abstract</p> <p>Background</p> <p>Extracellular matrix proteins are key factors that influence the regenerative capacity of tissues. The objective of the present study was to evaluate the effects of enamel matrix derivative (EMD), TGF-β1, and the combination of both factors (EMD+TGF-β1) on human osteoblastic cell cultures.</p> <p>Methods</p> <p>Cells were obtained from alveolar bone of three adult patients using enzymatic digestion. Effects of EMD, TGF-β1, or a combination of both were analyzed on cell proliferation, bone sialoprotein (BSP), osteopontin (OPN) and alkaline phosphatase (ALP) immunodetection, total protein synthesis, ALP activity and bone-like nodule formation.</p> <p>Results</p> <p>All treatments significantly increased cell proliferation compared to the control group at 24 h and 4 days. At day 7, EMD group showed higher cell proliferation compared to TGF-β1, EMD + TGF-β1 and the control group. OPN was detected in the majority of the cells for all groups, whereas fluorescence intensities for ALP labeling were greater in the control than in treated groups; BSP was not detected in all groups. All treatments decreased ALP levels at 7 and 14 days and bone-like nodule formation at 21 days compared to the control group.</p> <p>Conclusions</p> <p>The exposure of human osteoblastic cells to EMD, TGF-β1 and the combination of factors <it>in vitro </it>supports the development of a less differentiated phenotype, with enhanced proliferative activity and total cell number, and reduced ALP activity levels and matrix mineralization.</p

Analysis of microbiota associated with peri-implantitis using 16S rRNA gene clone library

Background: Peri-implantitis (PI) is an inflammatory disease which leads to the destruction of soft and hard tissues around osseointegrated implants. The subgingival microbiota appears to be responsible for peri-implant lesions and although the complexity of the microbiota has been reported in PI, the microbiota responsible for PI has not been identified. Objective: The purpose of this study was to identify the microbiota in subjects who have PI, clinically healthy implants, and periodontitis-affected teeth using 16S rRNA gene clone library analysis to clarify the microbial differences. Design: Three subjects participated in this study. The conditions around the teeth and implants were evaluated based on clinical and radiographic examinations and diseased implants, clinically healthy implants, and periodontally diseased teeth were selected. Subgingival plaque samples were taken from the deepest pockets using sterile paper points. Prevalence and identity of bacteria was analyzed using a 16S rRNA gene clone library technique. Results: A total of 112 different species were identified from 335 clones sequenced. Among the 112 species, 51 (46%) were uncultivated phylotypes, of which 22 were novel phylotypes. The numbers of bacterial species identified at the sites of PI, periodontitis, and periodontally healthy implants were 77, 57, and 12, respectively. Microbiota in PI mainly included Gram-negative species and the composition was more diverse when compared to that of the healthy implant and periodontitis. The phyla Chloroflexi, Tenericutes, and Synergistetes were only detected at PI sites, as were Parvimonas micra, Peptostreptococcus stomatis, Pseudoramibacter alactolyticus, and Solobacterium moorei. Low levels of periodontopathic bacteria, such as Porphyromonas gingivalis and Aggregatibacter actinomycetemcomitans, were seen in peri-implant lesions. Conclusions: The biofilm in PI showed a more complex microbiota when compared to periodontitis and periodontally healthy teeth, and it was mainly composed of Gram-negative anaerobic bacteria. Common periodontopathic bacteria showed low prevalence, and several bacteria were identified as candidate pathogens in PI

Caracterización molecular de cepas de influenza A (H1N1) 2009 de casos leves y graves de la Argentina

Fil: Cisterna, Daniel. ANLIS Dr.C.G.Malbrán. Instituto Nacional de Enfermedades Infecciosas; Argentina.Fil: Campos, Ana. ANLIS Dr.C.G.Malbrán. Instituto Nacional de Enfermedades Infecciosas; Argentina.Fil: Pontoriero, Andrea. ANLIS Dr.C.G.Malbrán. Instituto Nacional de Enfermedades Infecciosas; Argentina.Fil: Alonio, Virginia. ANLIS Dr.C.G.Malbrán. Instituto Nacional de Enfermedades Infecciosas; Argentina.Fil: Molina, Viviana. ANLIS Dr.C.G.Malbrán. Instituto Nacional de Enfermedades Infecciosas; Argentina.Fil: Palacios, Gustavo. Columbia University. Center for Infection and Immunity; Estados Unidos.Fil: Solovyov, Alexander. Columbia University. Center for Infection and Immunity; Estados Unidos.Fil: Hui, Jeffrey. Columbia University. Center for Infection and Immunity; Estados Unidos.Fil: Savji, Nazir. Columbia University. Center for Infection and Immunity; Estados Unidos.Fil: Bussetti, Ana Valeria. Columbia University. Center for Infection and Immunity; Estados Unidos.Fil: Jabado, Omar J. Columbia University. Center for Infection and Immunity; Estados Unidos.Fil: Street, Craig. Columbia University. Center for Infection and Immunity; Estados Unidos.Fil: Hirschberg, David L. Columbia University. Center for Infection and Immunity; Estados Unidos.Fil: Rabadan, Raul. Columbia University. Department of Biomedical Informatics; Estados UnidosFil: Hutchison, Stephen. 454 Life Sciences; Estados UnidosFil: Egholm, Michael. 454 Life Sciences; Estados Unidos.Fil: Lipkin, W. Ian. Columbia University. Center for Infection and Immunity; Estados Unidos.Fil: Baumeister, Elsa. ANLIS Dr.C.G.Malbrán. Instituto Nacional de Enfermedades Infecciosas; ArgentinaWhile worldwide pandemic influenza A(H1N1) pdm case fatality rate (CFR) was 0.4%, Argentina’s was 4.5%. A total of 34 strains from mild and severe cases were analyzed. A full genome sequencing was carried out on 26 of these, and a partial sequencing on the remaining eight. We observed no evidence that the high CFR can be attributed to direct virus changes. No evidence of re-assortment, mutations associated with resistance to antiviral drugs, or genetic drift that might contribute to virulence was observed. Although the mutation D225G associated with severity in the latest reports from the Ukraine and Norway is not observed among the Argentine strains, an amino acid change in the area (S206T) surrounding the HA receptor binding domain was observed, the same previously established worldwide. (ES) Mientras que la tasa de letalidad (CFR) para (H1N1)pdm en todo el mundo era del 0.4%, en la Argentina la mortalidad observada fue de 4.5%. La secuenciación del genoma completo de 26 cepas de virus argentinos de influenza A (H1N1)pdm de casos leves y graves y de 8 cepas secuenciadas parcialmente no mostró evidencia de que la elevada tasa de letalidad se pueda atribuir directamente a cambios en el virus. No se encontraron hallazgos de recombinación, de mutaciones asociadas con la resistencia a los medicamentos antivirales ni de variaciones genéticas que puedan contribuir a la virulencia observada. Si bien la mutación D225G asociada con la gravedad, comunicada en informes procedentes de Ucrania y Noruega, no se ha encontrado en las cepas argentinas estudiadas, se ha observado un cambio aminoacídico en la región (S206T) en torno al dominio del sitio de unión al receptor en la HA, el mismo hallado en cepas distribuidas alrededor del mundo

Identification of Pax6-Dependent Gene Regulatory Networks in the Mouse Lens

Lineage-specific DNA-binding transcription factors regulate development by activating and repressing particular set of genes required for the acquisition of a specific cell type. Pax6 is a paired domain and homeodomain-containing transcription factor essential for development of central nervous, olfactory and visual systems, as well as endocrine pancreas. Haploinsufficiency of Pax6 results in perturbed lens development and homeostasis. Loss-of-function of Pax6 is incompatible with lens lineage formation and results in abnormal telencephalic development. Using DNA microarrays, we have identified 559 genes expressed differentially between 1-day old mouse Pax6 heterozygous and wild type lenses. Of these, 178 (31.8%) were similarly increased and decreased in Pax6 homozygous embryonic telencephalon [Holm PC, Mader MT, Haubst N, Wizenmann A, Sigvardsson M, Götz M (2007) Loss- and gain-of-function analyses reveals targets of Pax6 in the developing mouse telencephalon. Mol Cell Neurosci 34: 99–119]. In contrast, 381 (68.2%) genes were differently regulated between the lens and embryonic telencephalon. Differential expression of nine genes implicated in lens development and homeostasis: Cspg2, Igfbp5, Mab21l2, Nrf2f, Olfm3, Spag5, Spock1, Spon1 and Tgfb2, was confirmed by quantitative RT-PCR, with five of these genes: Cspg2, Mab21l2, Olfm3, Spag5 and Tgfb2, identified as candidate direct Pax6 target genes by quantitative chromatin immunoprecipitation (qChIP). In Mab21l2 and Tgfb2 promoter regions, twelve putative individual Pax6-binding sites were tested by electrophoretic mobility shift assays (EMSAs) with recombinant Pax6 proteins. This led to the identification of two and three sites in the respective Mab21l2 and Tgfb2 promoter regions identified by qChIPs. Collectively, the present studies represent an integrative genome-wide approach to identify downstream networks controlled by Pax6 that control mouse lens and forebrain development

Morphometric study of the root anatomy in furcation area of mandibular first molars

Furcation involvement in periodontal disease has been a challenge for the dentist. OBJECTIVE: The aim of this study was to investigate root dimensions in the furcation area of 233 mandibular first molars. MATERIAL AND METHODS: Digital photomicrographs were used to obtain the following measurements on the buccal and lingual surfaces of each tooth: root trunk height (RT), horizontal interadicular distance obtained 1 mm (D1) and 2 mm (D2) below the fornix and interadicular angle (IA). RESULTS: Mean± standard deviation of buccal and lingual furcation measurements were, respectively, 1.37±0.78 mm and 2.04±0.89 mm for RT; 0.86±0.39 mm and 0.71±0.42 mm for D1; 1.50±0.48 mm and 1.38±0.48 mm for D2; 41.68±13.20º and 37.78±13.18º for IA. Statistically significant differences were found between all measured parameters for buccal and lingual sides (p<0.05, paired t test). CONCLUSIONS: In conclusion, the lingual furcation of mandibular first molars presented narrower entrance and longer root trunk than the buccal furcation, suggesting more limitation for instrumentation and worse prognosis to lingual furcation involvements in comparison to buccal lesions