Regenerative endodontic procedure combined with non-surgical root canal treatment in an immature permanent maxillary molar: A 7-year follow-up case report

The aim of this report is to present the results of a personalised endodontic treatment for an immature molar, using regenerative endodontic procedure (REP) combined with non-surgical root canal treatment (NSRCT), with 7 years of follow-up. The tooth#3 presented combined endodontic pathologies in each root, with different pulpal and periapical status. A REP in the palatal (P) canal and a NSCRT in the mesio-buccal (MB) and disto-buccal (DB) canals were performed. Absence of clinical signs/symptoms and continuous palatal root development with apical closure were observed over 4-years. After 5-years an apical lesion in the MB root was observed. Both MB canals were selectively retreated by completely filling them with TotalFill BC RRM Fast Set putty. After 7-years, the tooth remained functional and the apical lesion was resolving. The palatal root was completely mature. This case report reveals the potential for use of combined treatment approaches for immature multirooted teeth.

Design, implementation, and preliminary in-vivo assessment of a high-CMRR low-NEF wireless EEG miniaturized platform

This work presents the design, manufacture, test, and preliminary in-vivo assessment of the proof-of-concept of a miniaturized wireless platform for acquiring electroencephalography signals, where the input stage is a high-CMRR current-efficiency custom-made integrated neural preamplifier.Clinical relevance- Small, low-power consumption, wireless, wearable devices for chronically monitoring EEG recordings may contribute to the diagnosis of transient neurological events, the characterization and potential forecasting of epileptic seizures, and provide signals for controlling prosthetic and aid devices.

Relationship between iron deficiency and expression of genes involved in iron metabolism in human myocardium and skeletal muscle

BACKGROUND

Iron deficiency (ID) is associated with adverse prognosis in patients with heart failure. This study aims to investigate the relationship between ID and expression of genes involved in iron metabolism in human myocardium and skeletal muscle, focusing on Transferrin 1 receptor (TfR1), the main pathway of cellular iron uptake.

METHODS

Patients undergoing elective CABG were assessed prior to surgery with echocardiography and serum iron parameters. Core needle biopsies were collected from the left and right ventricle (LV, RV), the right atrium and intercostal skeletal muscle (SM). Gene expression analyses were done by mRNA sequencing.

RESULTS

Of 69 patients (median age 69 years, 91% men), 28% had ID. 26% had HFrEF, 25% had HFpEF physiology according to echocardiographic findings and NT-proBNP levels, and 49% had normal LV function. The expression of TfR1 was increased in patients with ID compared to patients without ID in ventricular tissue (p = 0.04) and in intercostal SM (p = 0.01). The increase in TfR1 expression in LV and RV was more pronounced when analysing patients with absolute ID (S-Ferritin<100 μg/L). Analysing the correlation between various iron parameters, S-Ferritin levels showed the strongest correlation with TfR1 expression. There was no correlation with NT-proBNP levels and no difference in TfR1 expression between different HF phenotypes.

CONCLUSIONS

In patients undergoing elective CABG we found an association between ID and increased TfR1 expression in myocardium regardless of LV function, indicating physiologically upregulated TfR1 expression in the presence of ID to restore intracellular iron needs.

CLINICAL TRIAL REGISTRATION

Clinicaltrials.govNCT03671122.

Robotic Magnetic Surgery: Results From the First Prospective Clinical Trial

To evaluate a novel Magnetic Robotic Platform during reduced-port laparoscopic surgery in a prospective, multicenter clinical trial.

Background

Magnetic surgery has been developed to increase the benefits of minimally invasive surgery, with prior studies demonstrating its clinical benefits. Robotic-assisted surgery increases the surgeon's control over the instruments, offering less dependency on an assistant. The synergism of both techniques may escalate these individual benefits.

Methods

A prospective, multicenter, single-arm, open-label study was performed to assess the safety and performance of a robotic magnetic surgical system (Levita Robotic Platform). The investigational device was used during reduced-port laparoscopic cholecystectomy and laparoscopic bariatric surgery. The primary endpoints evaluated were safety and feasibility. Patients were followed for 30 days post-procedure.

Results

Between May 2021 and December 2021, 30 patients undergoing laparoscopic surgery were recruited. There were 22 females and 8 males with a mean age of 39 years (22-69 years) and median body mass index of 33 kg/m2 (21.6-50.4 kg/m2). Procedures included 15 gastric sleeves, 14 cholecystectomies, and 1 Roux en-Y gastric bypass. The procedures were successfully performed by utilizing the robotic magnetic surgical system and a reduced-port technique in all 30 patients. No device-related serious adverse events were reported. The device provided adequate visualization and retraction in all cases.

Conclusions

This clinical trial shows for the first time that this novel Magnetic Robotic Platform is safe and feasible in reduced-port laparoscopic cholecystectomy and laparoscopic bariatric surgery. This robotic platform brings the benefits of magnetic surgery in terms of reduction of incisions plus increasing the control for the surgeon.

Gestational nutrient restriction under extensive grazing conditions: Effects on muscle characteristics and meat quality in heavy lambs

We evaluated maternal undernutrition effects induced by a lower natural pasture allowance (gestation days 30-143) on histological-biochemical and meat traits in muscles Semitendinosus, cranial Gluteobiceps and Supraspinatus from 200-day old male and female lambs. Maternal undernutrition increased oxidative and reduced glycolytic fibers in all muscles (P ≤ 0.01). Maternal undernutrition reduced the diameter of glycolytic fibers in the cranial Gluteobiceps of exclusively female lambs (P = 0.05) and reduced the diameter of oxidative fibers in the Supraspinatus of exclusively male lambs (P = 0.02). Maternal undernutrition increased lipid content in the Supraspinatus of females (P = 0.001), reduced lactate content (P = 0.03) and WB shear force (P = 0.02) in the Semitendinosus of females, and increased cooking losses in the Semitendinosus of males (P = 0.0069). In conclusion, gestational nutrient restriction induced fetal programming effects on muscle characteristics of lambs. Moreover, our study demonstrates that maternal undernutrition influences muscle and meat characteristics in a sex and muscle-dependent way.

A-56 Predicting Performance on the Raven’s Matrices from the Findings of the Boston Longitudinal MIDUS Study

Objective

To examine the relationship between different cognitive measures and Raven’s Progressive Matrices (RPM) during midlife.

Methods

Data was derived from a de-identified MIDUS-II database (n = 328, 57.8% male, Mage = 48.14, Meducation = 15.8, 93% Caucasian). All participants were administered cognitive tests consisting of several measures of cognitive ability (Trails-B, Vocabulary, Forward & Backward-Digit-Span, and Digit-Symbol-Substitution-Test (DSST)) and RPM.

Results

Pearson correlations were conducted between cognitive performance on various measures and performance on RPM. Using a Bonferroni correction across all correlations, p-value was set at .001. Better performance on RPM was negatively associated with Trails-B (r(139) = -.446,p = .001) and positively associated with Vocabulary (r(168) = .424,p = .001), Forward-Digit-Span (r(168) = .318,p = .001), Backward-Digit-Span (r(166) = .257,p = .001), DSST (r(166) = .516,p = .001).

Conclusions

Results suggest that DSST is the strongest predictor of RPM performance, followed by Trails-B. Reasons for the strong DSST correlation suggest the shared component of sustained attention, processing speed, working memory and set shifting. A moderate association with Trails-B implies the shared components of visual-conceptualization, visual motor tracking, and working memory. Both DSST and Trails-B not only require working memory, but also visuospatial skills, suggesting the use of high-level processes may be required for successful performance on the RPM. Moreover, visuospatial skills may be more strongly related to fluid intelligence than other abilities. This suggests that visualization skills to perceive and mentally reproduce patterns, mental rotation, and flexibility of closure to detect a stimulus hidden within a complex figure are all essential in RPM performance. Future studies should focus on gender and age differences in relation to visuospatial skills, specifically the age at which these differences occur.

Preventing the recurrence of depression with a Mediterranean diet supplemented with extra-virgin olive oil. The PREDI-DEP trial: study protocol

BACKGROUND

The role of dietary patterns in the prevention of unipolar depression has been analyzed in several epidemiological studies. The primary aims of this study are to determine the effectiveness of an extra-olive oil-enriched Mediterranean diet in reducing the recurrence of depression and improving the symptoms of this condition.

METHODS

Multicenter, two-arm, parallel-group clinical trial. Arm 1, extra-virgin olive oil Mediterranean diet; Arm 2, control group without nutritional intervention. Dieticians are in charge of the nutritional intervention and regular contact with the participants. Contacts are made through our web platform ( https://predidep.es/participantes/ ) or by phone. Recurrence of depression is assessed by psychiatrists and clinical psychologists through clinical evaluations (semi-structured clinical interviews: Spanish SCID-I). Depressive symptoms are assessed with the Beck Depression Inventory. Information on quality of life, level of physical activity, dietary habits, and blood, urine and stool samples are collected after the subject has agreed to participate in the study and once a year.

DISCUSSION

To the best of our knowledge, the PREDI-DEP trial is the first ongoing randomized clinical trial designed to assess the role of the Mediterranean diet in the prevention of recurrent depression. It could be a cost-effective approach to avoid recurrence and improve the quality of life of these patients.

TRIAL REGISTRATION

The study has been prospectively registered in the U.S. National Library of Medicine ( https://clinicaltrials.gov ) with NCT number: NCT03081065.

Immunotherapy for oncogenic-driven advanced non-small cell lung cancers: Is the time ripe for a change?

Immune checkpoint inhibitors (ICIs) have been incorporated in the treatment strategy of advanced non-small cell lung cancer (NSCLC) in first- and second-line setting improving the prognosis of these patients. However, the treatment landscape has been also drastically overturned with the advent of targeted therapies in oncogenic-addicted advanced NSCLC patients. Despite ICIs represent an active and new treatment option for a wide range of advanced NSCLC patients, the efficacy and the optimal place of ICI in the treatment strategy algorithm of oncogenic-addicted tumors remains still controversial, as only a minority of trials with ICI enrol oncogenic-addicted NSCLC patients previously treated with standard therapy. Therefore, there are still several open questions about ICI in oncogenic-driven NSCLC, such as the efficacy and toxicities, which need to be addressed before considering treatment with ICI as a standard approach in this population. It is in this framework, we provide a thorough overview on this currently controversial topic.

A multilevel trait-based approach to the ecological performance of Microcystis aeruginosa complex from headwaters to the ocean

The Microcystis aeruginosa complex (MAC) clusters cosmopolitan and conspicuous harmful bloom-forming cyanobacteria able to produce cyanotoxins. It is hypothesized that low temperatures and brackish salinities are the main barriers to MAC proliferation. Here, patterns at multiple levels of organization irrespective of taxonomic identity (i.e. a trait-based approach) were analyzed. MAC responses from the intracellular (e.g. respiratory activity) to the ecosystem level (e.g. blooms) were evaluated in wide environmental gradients. Experimental results on buoyancy and respiratory activity in response to increased salinity (0-35) and a literature review of maximum growth rates under different temperatures and salinities were combined with field sampling from headwaters (800km upstream) to the marine end of the Rio de la Plata estuary (Uruguay-South America). Salinity and temperature were the major variables affecting MAC responses. Experimentally, freshwater MAC cells remained active for 24h in brackish waters (salinity=15) while colonies increased their flotation velocity. At the population level, maximum growth rate decreased with salinity and presented a unimodal exponential response with temperature, showing an optimum at 27.5°C and a rapid decrease thereafter. At the community and ecosystem levels, MAC occurred from fresh to marine waters (salinity 30) with a sustained relative increase of large mucilaginous colonies biovolume with respect to individual cells. Similarly, total biomass and, specific and morphological richness decreased with salinity while blooms were only detected in freshwater both at high (33°C) and low (11°C) temperatures. In brackish waters, large mucilaginous colonies presented advantages under osmotic restrictive conditions. These traits values have also been associated with higher toxicity potential. This suggest salinity or low temperatures would not represent effective barriers for the survival and transport of potentially toxic MAC under likely near future scenarios of increasing human impacts (i.e. eutrophication, dam construction and climate change).

Healthy properties of green and white teas: an update

Green tea has been consumed for centuries in Japan, China and Morocco.

Time to culture conversion in smokers with pulmonary tuberculosis

Background and objective. It has been reported that tobacco smoking slows the sterilisation of sputum culture in pulmonary tuberculosis, but the factors that could delay culture conversion in patients who smoke are not known. Our aim is to identify the factors influencing sputum culture conversion in smokers with pulmonary tuberculosis. Methods. Ninety-nine patients with a smoking history and diagnosed with pulmonary tuberculosis were analysed retrospectively. The relationship between sputum culture status at the second month and the following variables: age, gender, pack-years index, comorbid diseases, number acid-fast bacilli (AFB) in sputum smear examination, radiological findings (cavitary, extensive or limited disease), drug susceptibility pattern and initial treatment, was analysed. The Student t-test, chi-square test and logistic regression model with forward stepwise conditional methods were used for statistical analysis. A p value of &lt;0.05 was considered to be statistically significant. Results. Twenty six patients (26.2%): 18 males (22.2%) and 8 females (44%) were sputum culture positive at the end of the second month of treatment. In univariate analysis, culture conversion time was significantly associated with female gender and extensive disease, but in a logistic regression analysis was only correlated with female gender (OR=5.63 95% CI 1.21-20.64-p=0.02). Conclusion. In current smokers with pulmonary tuberculosis, the ‘time to culture’ conversion relates only to the female gender.

Caracterización epidemiológica de las infecciones asociadas a la atención en salud en una IPS privada. Neiva 2013

Introducción: Las infecciones Asociadas a la Atención en Salud (IAAS) se han convertido en un problema de salud pública; en países desarrollados, entre el 5 y el 10% de los pacientes contraen una o más infecciones, y se considera que entre el 15 y el 40% de los pacientes internados en atención crítica resultan afectados. Métodos: Se realizó un estudio de corte transversal con enfoque analítico, con el objetivo de realizar una caracterización epidemiológica de las IAAS en una IPS privada de la Ciudad de Neiva en el año 2013. Se incluyeron 251 casos confirmados. Resultados: se logró determinar que las infecciones de mayor prevalencia fueron secundarias a procedimientos quirúrgicos (ISO), especialmente las de tipo superficial (31.9%); seguido se encuentran las Infecciones asociadas a dispositivos médicos, con mayor proporción las del tracto urinario asociado a catéter vesical. Las neumonías asociadas a la atención en salud representaron el 14,3%.Se tuvo una tasa de letalidad de las IAAS del 9,5% siendo la neumonía y las infecciones del torrente sanguíneo las de mayor proporción. Se tuvo una tasa de 1,9%. Conclusión: las características sociodemográficas de los casos de IAAS son similares al comportamiento de las instituciones de salud a nivel nacional y de países en vía de desarrollo.

Characterization of mandibular molar root and canal morphology using cone beam computed tomography and its variability in Belgian and Chilean population samples

Purpose

This study used cone-beam computed tomography (CBCT) to characterize mandibular molar root and canal morphology and its variability in Belgian and Chilean population samples.

Materials and Methods

We analyzed the CBCT images of 515 mandibular molars (257 from Belgium and 258 from Chile). Molars meeting the inclusion criteria were analyzed to determine (1) the number of roots; (2) the root canal configuration; (3) the presence of a curved canal in the cross-sectional image of the distal root in the mandibular first molar and (4) the presence of a C-shaped canal in the second mandibular molar. A descriptive analysis was performed. The association between national origin and the presence of a curved or C-shaped canal was evaluated using the chi-squared test.

Results

The most common configurations in the mesial root of both molars were type V and type III. In the distal root, type I canal configuration was the most common. Curvature in the cross-sectional image was found in 25% of the distal canals of the mandibular first molars in the Belgian population, compared to 11% in the Chilean population. The prevalence of C-shaped canals was 10% or less in both populations.

Conclusion

In cases of unclear or complex root and canal morphology in the mandibular molars, CBCT imaging might assist endodontic specialists in making an accurate diagnosis and in treatment planning.

210 FACTORS AFFECTING SUPEROVULATION RESPONSE IN CATTLE: A RETROSPECTIVE STUDY

Superovulation, embryo collection, and transfer allow for genetic improvement resulting in more rapid enhancement of production traits. Despite these advantages, variability in the response to superovulation has been observed between and within individual animals, becoming a costly inconvenience of these techniques. The purpose of this study was to evaluate the factors that influenced the superovulatory response and the resulting quantity and quality of the ova/embryos collected during embryo flushing in the study group, with cow as the experimental unit. A retrospective study was conducted, evaluating superovulation records from 794 embryo donors collected for the first time. Individual information was classified as breed (Angus or Holstein), parity (heifers or dry cow), body condition score (BCS; 5, 6, or 7 was considered optimal and BCS <5 or >7 was considered not optimal; in a 1 to 9 scale), hormonal dose used (375 or 500 IU of FSH), ovarian response (presence of more than one corpus luteum), collection (abnormal: blood or <80% fluid recovered or normal: bicornual >80% fluid recovered) and season at collection (summer, fall, winter, spring) to determine their predictive value for the total number of ova/embryos collected: number of transferable embryos, degenerated embryos, and unfertilized oocytes (UFOs) according to the IETS standards for classification. Variables were evaluated and transformed when needed to establish normality. Binary logistic regression was used to identify predictors of ovarian response or nonresponse. A model was built for each of these dependent variables using a general linear model (GLM). Tukey's post hoc test was used to compare adjusted means between groups when there were significant factors identified by the GLM. The study found a significant difference (P = 0.024) in the percentage of cows responding to superovulation treatment in summer compared with spring (91.5% v. 98.4%). From the 755 donors that responded, the mean number (±s.e.m.) of ova/embryos collected from donors with optimal BCS was higher (P = 0.052) than those from donors with nonoptimal BCS (9.8 ± 0.37 v. 8.4 ± 0.42). The mean numbers of total ova/embryos obtained from normal collections was higher (P < 0.001) than the mean from those collections classified as abnormal (10.25 ± 0.30 v. 6.60 ± 0.62). The mean number of viable embryos from responding donors was 5.66 ± 0.18 per collection. Donors with BCS classified as optimal had significantly higher (P = 0.034) mean number (±s.e.m.) of viable embryos compared with donors with nonoptimal BCS (5.95 ± 0.23 v. 5.18 ± 0.29). For the present study, the percentage of cows treated that responded and were collected decreased in summer. The effect of ambient temperature may be reduced by evaporative cooling of donors or by avoiding collections during the hottest days of the summer. Complications during the collection are rare and can be partially avoided by using experienced technicians only. Results may improve when donors are in an appropriate nutrition status, either by supplementing those animals with low body scores or by restricting diets for those that are overweight, to improve the efficiency of the technique.

Tidal volume is a major determinant of cyclic recruitment-derecruitment in acute respiratory distress syndrome

BACKGROUND

Overdistension and cyclic recruitment-derecruitment contribute to ventilator-induced lung injury. High tidal volumes are thought to increase mortality mainly by inducing overdistension. However, experimental evidence suggests that tidal volume (VT) may also influence cyclic recruitment-derecruitment. Our main goal was to determine whether high tidal volumes increase cyclic recruitment-derecruitment in acute respiratory distress syndrome (ARDS) patients, as measured by dynamic computed tomography (CT).

METHODS

We studied 9 ARDS patients with diffuse attenuations on CT who underwent a protocol including 2 ventilatory modes: (a) VT 6 mL/kg, respiratory rate 30/min, PEEP 9 cmH2O, (b) VT 12 mL/kg, respiratory rate 15/min, PEEP 9 cmH2O. A dynamic computed tomography of 8 seconds on a fixed transverse region was performed during each ventilator mode. Cyclic recruitment-derecruitment was determined as non-aerated tissue variation between inspiration and expiration and was expressed as % of lung tissue weight.

RESULTS

VT 12 mL/kg exhibited less non-aerated tissue at expiration compared to VT 6 ml/kg (40.15 [35.94-56.00] and 45.31 [37.95-59.32], respectively, P<0.05). However, VT 12 ml/kg increased cyclic recruitment-derecruitment compared to VT 6 mL/kg (7.32 [6.58-9.29] mL/kg vs. 4.51 [3.42-5.75] mL/kg, P<0.01). Tidal hyperinflation was also larger at VT 12 mL/kg (0.55 [0.27-2.24] vs. 0.24 [0.18-0.83], P<0.01).

CONCLUSION

High tidal volume is a major determinant of cyclic recruitment-derecruitment in ARDS patients with diffuse attenuations.

Caracterización sanitaria y nutricional de colonias de abejas melíferas en forestaciones de Eucalyptus grandis

En Uruguay muchos apicultores trasladan sus colonias a las forestaciones de Eucalyptus grandis al final del verano y en otoño obteniendo importantes cosechas de miel. Sin embargo, cuando finaliza la floración las colonias se encuentran muy debilitadas, sobreviniendo una elevada mortalidad. Problemas nutricionales y sanitarios podrían explicar el debilitamiento de las colonias. Para averiguar las causas del debilitamiento se llevaron colonias de igual tamaño a una forestación de E. grandis, separadas en tres grupos diferenciados por la disponibilidad de polen. A lo largo del periodo de floración se registró: el origen botánico y el contenido de proteína cruda del polen que ingresaba en las colmenas, la proteína corporal de las abejas, la infección por Nosema ceranae y la infestación por Varroa destructor, el área de cría y la producción de miel. Los resultados más importantes hallados fueron: i) la sostenida disminución de la diversidad botánica del polen a medida que transcurría el periodo de floración de E. grandis hasta quedar únicamente el polen de esta especie; ii) el polen de E. grandis presentó valores de proteína bruta cercanos al 30%, pero fue disminuyendo paulatinamente hasta alcanzar un valor inferior a 20% al final de la floración; iii) las colonias que contaban inicialmente con reservas de polen presentaron abejas con mayor proteína corporal pocos días después de llegar a la forestación y menor infestación de N. ceranae durante la mayor parte del periodo de floración; iv) la disponibilidad de polen no incidió en la infestación de V. destructor, el área de cría y la producción de miel. El déficit nutricional de las abejas durante la floración de E. grandis podría generar las condiciones adecuadas para la multiplicación de N. ceranae. Al final de la floración del eucalipto las colonias presentaron promedialmente más del 90% de las abejas pecoreadoras infectadas con N. ceranae y 12% de V. destructor en las abejas adultas. La incidencia de ambos patógenos sobre las abejas debilitadas podría explicar la pérdida de colonias.

Whole-blastocyst culture followed by laser drilling technology enhances the efficiency of inner cell mass isolation and embryonic stem cell derivation from good- and poor-quality mouse embryos: new insights for derivation of human embryonic stem cell lines

The optimization of human embryonic stem (hES) cell line derivation methods is challenging because many worldwide laboratories have neither access to spare human embryos nor ethical approval for using supernumerary human embryos for hES cell derivation purposes. Additionally, studies performed directly on human embryos imply a waste of precious human biological material. In this study, we developed a new strategy based on the combination of whole-blastocyst culture followed by laser drilling destruction of the trophoectoderm for improving the efficiency of inner cell mass (ICM) isolation and ES cell derivation using murine embryos. Embryos were divided into good- and poor-quality embryos. We demonstrate that the efficiency of both ICM isolation and ES cell derivation using this strategy is significantly superior to whole-blastocyst culture or laser drilling technology itself. Regardless of the ICM isolation method, the ES cell establishment depends on a feeder cell growth surface. Importantly, this combined methodology can be successfully applied to poor-quality blastocysts that otherwise would not be suitable for laser drilling itself nor immunosurgery in an attempt to derive ES cell lines due to the inability to distinguish the ICM. The ES cell lines derived by this combined method were characterized and shown to maintain a typical morphology, undifferentiated phenotype, and in vitro and in vivo three germ layer differentiation potential. Finally, all ES cell lines established using either technology acquired an aneuploid karyotype after extended culture periods, suggesting that the method used for ES cell derivation does not seem to influence the karyotype of the ES cells after extended culture. This methodology may open up new avenues for further improvements for the derivation of hES cells, the majority of which are derived from frozen, poor-quality human embryos.

Socio-economic gradient in food selection and diet quality among 70-year olds

OBJECTIVE

The aim of this study was to assess social disparities in food choices and diet quality in a population of 70-year old Swedes.

DESIGN

Cross-sectional study among participants in the 2000 Gerontological and Geriatric Population Studies in Goteborg.

PARTICIPANTS

A representative population of men (n=233) and women (n=321) from Goteborg, a city on the south western coast of Sweden.

METHODS

One hour diet history interviews were performed and 35 specific foods and food groups were identified; in addition a diet quality index (DQI) was calculated. Differences in food choices and diet quality scores were tested across educational and socio-economic index categories (SEI).

RESULTS

Men with higher education and SEI had higher diet quality scores than those with lower socio-economic status, while no differences in DQI were noted in women. Further analysis of women based on their husband's occupational group also yielded no differences in diet quality. When studying individual foods, socio-economic differences were observed in women and men.

CONCLUSIONS

Selection of food varies by education and occupational status in both sexes although socio-economic disparities in diet quality were observed in men only.

Human Papillomavirus Associated with Papillary Squamous Cell Carcinoma of the Oropharynx in a Renal Transplant Recipient

The papillary squamous cell carcinoma (PSCC) is a rare variant of the head and neck squamous cell carcinoma. Established etiological factors can include tobacco smoking and heavy alcohol abuse. Moreover, human papillomavirus infection can be involved in the pathogenesis of PSCC. This tumor is more frequent in patients with immunosuppression including those who have received a transplant. Most of the cases are produced by genotype HPV-6 and HPV-16, although there is a possibility of infection by other HPV subtypes. We present a case report of a PSCC and papilloma with oropharyngeal location in which high-risk HPV type 16 and low-risk HPV type 6, respectively, were identified by PCR in a renal transplant patient.

General safety guidances in stem cell bank installations

The use of cell cultures in research and in regenerative medicine programs has increased in the past few years, and control of the risks inherent to these procedures should be increased. People who work in stem cell bank installations should be aware of the risks implied in their work and take necessary self-protection measures for the known and unidentified risks. Work in stem cell bank installations is subject to different types of risks, such as toxicologic, carcinogen and, mainly, infectious risks. Different types of safety measurements should be distinguished and secured, for example for protection of personnel, protection of the cell cultures and protection in general of humans and the environment.

Prescribed daily doses and 'risk factors' associated with the use of benzodiazepines in primary care

OBJECTIVE

To assess the extent, characteristics and determinants of benzodiazepine prescription in outpatient Primary Health Care.

METHODS

A clinical audit of a stratified random sample of Primary Health Care Centres in the seven islands and 1.6 million inhabitants region of 'Canarias' in Spain was carried out. From those centres, a random sample of 1045 clinical records was reviewed and information on diagnosis, prescription and prescribed dosages was collected in a structured questionnaire. A multivariate logistic regression analysis was performed in order to determine the 'risk factors' for the use of benzodiazepines.

RESULTS

Benzodiazepine prescription was recorded in 23.4% of all clinical records; 87.7% of these were for benzodiazepines classified as anxiolytics (N05B) and 12.3% for hypnotics (N05C2). Benzodiazepine prescription was more common for women, elderly, widowed, divorced, low educational background, housewives and retired people. Using multivariate logistic regression, the probability of benzodiazepine prescription was found to be closely related to age, gender and employment status, but not with educational level. Prescribed Daily Doses were lower than Defined Daily Doses (DDD) in 77.1% of all anxiolytic prescriptions, but were in agreement with DDD in 90% of hypnotic prescriptions. The duration of treatment recorded in the clinical records was 25+/-21 months, with a range of 1 and 144 months. General Practitioners were responsible for 67% of all benzodiazepine prescription. Anxiolytics were prescribed as a single daily dose in 57% of the cases, and only 'at supper' in 48.6%.

CONCLUSION

In the general population attending Primary Health Care Centres of the Canary Islands Health System the prescription of benzodiazepines is higher for women and the elderly, and the most common use is chronic, with a duration of over 2 years in most cases. Anxiolytics are prescribed in doses which are much lower than those used as DDD and were used only 'at night' in almost half of the cases. This could represent an overlapping of the indications with hypnotics, and explain part of the huge difference in the use of anxiolytics in Spain compared with other figures in Europe. This fact must also be taken into account when making inferences of benzodiazepine use from sales statistics, which are very imprecise measures of drug use.

Self-reported stress levels predict subsequent breast cancer in a cohort of Swedish women

The association between stress and breast cancer has been studied, mostly using case-control designs, but rarely examined prospectively. The purpose of this paper is to describe the role of stress as a predictor of subsequent breast cancer. A representative cohort of 1,462 Swedish women aged 38-60 years were followed for 24 years. Stress experience at a baseline examination in 1968-69 was analysed in relation to incidence of breast cancer with proportional hazards regression. Women reporting experience of stress during the five years preceding the first examination displayed a two-fold rate of breast cancer compared with women reporting no stress (age-adjusted relative risk 2.1; 95% CI [1.2-3.7]). This association was independent of potential confounders including reproductive and lifestyle factors. In conclusion, the significant, positive relationship between stress and breast cancer in this prospective study is based on information that is unbiased with respect to knowledge of disease, and can be regarded as more valid than results drawn from case-control studies.