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OBJECTIVES: To describe the number of second primary malignancies in a series of 33 patients with proliferative verrucous leukoplakia (PVL), detailing the mean time between primary malignancies and their clinical characteristics. MATERIALS AND METHODS: Two groups of patients were included in this study: group 1 comprised 33 PVL patients who had developed =2 oral squamous cell carcinoma (OSCC) and group 2 comprised 48 PVL patients without malignant degeneration. We compared the groups with regard to age, gender, oral location, and number of oral sites affected. For patients in group 1, we determined the locations, clinical forms, and TNM stages of oral cancers. We also recorded the intervals of time between instances of oral cancer for all patients. RESULTS: The groups did not differ significantly in age; however, group 1 included more women (p

Aims: To determine whether subjects with temporomandibular disorders (TMD) manifesting as chronic myofascial pain (MFP) involving the masseter muscle present with significantly greater masseter muscle width, as evidenced by ultrasound, compared to individuals without MFP. Methods: A case-control study was carried out. A total of 31 subjects presenting with MFP of the masticatory muscles involving the masseter muscle and 35 controls with TMD but no diagnosis of MFP, matched by age and sex, were included. Ultrasound was used to measure the maximum width of both masseter muscles at the intermediate point between the origin and insertion of the muscle in the light occlusal contact (LOC) position and under maximum contraction. Each side was analyzed separately. Means were compared by using single-factor analysis of variance and Mann-Whitney U test; P < .05 was considered to reflect statistical significance. Results: In the study group, the right masseter muscle had a mean +/- standard deviation width of 8.6 +/- 1.8 mm under LOC (controls: 8.6 +/- 1.6 mm; P = .85) and 11.5 +/- 2.1 mm under maximum contraction (controls: 11.7 +/- 1.9 mm; P = .86). The analagous measures in the left masseter muscle were 8.6 +/- 1.6 mm under LOC (controls: 8.2 +/- 1.5 mm; P = .42) and 11.3 +/- 1.8 mm under maximum contraction (controls: 11.5 +/- 1.8 mm) (P = .79), respectively. The increase in width of the right masseter muscle was 2.9 +/- 2.1 mm (controls: 3.1 +/- 1.2 mm; P = .67) in absolute terms and 1.4 +/- 0.3 mm (controls: 1.4 +/- 0.2 mm; P = .91) in relative values (width at maximum contraction/LOC width). In the case of the left masseter muscle, the respective values were 2.8 +/- 1.7 mm (controls: 3.2 +/- 0.9 mm; P = .25) and 1.3 +/- 0.2 mm (controls: 1.4 +/- 0.1 mm; P = .32). Conclusion: There were no statistically significant differences in masseter muscle width between MFP subjects and control subjects under LOC conditions or maximum contraction. The increase in width under maximum contraction was likewise not significantly different between the groups.

presentazione del libro contenente una rassegna internazionale di progetti per l'housing a basso costo ed alta efficienza energetica

To evaluate the occurrence of hepatotoxicity in patients during antiretroviral therapy (ART) that contains protease inhibitors and the role of hepatitis viruses in its development, we performed a retrospective study including 1325 HIV-infected patients treated with ART for at least 6 months. Presence or absence of hepatitis viruses, alanine aminotransferase (ALT), total bilirubin, CD4 cell count, and plasma HIV RNA levels were evaluated. Hepatotoxicity developed in a few study subjects without coinfection, whereas it was significantly higher in coinfected patients. Univariate logistic regression analysis showed that viral hepatitis coinfections are independent risk factors for hepatotoxicity. After 6 months of treatment, ritonavir was associated with higher rates of severe hepatotoxicity in the coinfected group; in fact, ritonavir seems to be the most strongly hepatotoxic agent among coinfected patients. After 12 months of therapy, hepatotoxicity occurred more frequently in patients with hepatitis C virus who did not respond to antiretroviral therapy (ART), whereas patients who did respond to ART showed decreased ALT levels. Hepatotoxicity is not exclusively an effect of drug toxicity, and the presence of hepatitis coinfection is an independent risk factor. Moreover, chronic hepatotoxicity mainly occurs in patients who did not respond to therapy. Conversely, patients who did respond to ART seemed to show improvement of chronic liver infection.

Pathology of the temporomandibular joint (TMJ) affects an important part of the population, though it is not viewed as a public health problem. Between 3-7% of the population seeks treatment for pain and dysfunction of the ATM or related structures. The literature reports great variability in the prevalence of the clinical symptoms (6-93%) and signs (0-93%), probably as a result of the different clinical criteria used. In imaging studies it is common to observe alterations that have no clinical expression of any kind. Radiographic changes corresponding to osteoarthrosis are observed in 14-44% of the population. Age is a risk factor, though with some particularities. In elderly patients there is an increased prevalence of clinical and radiological signs, though also a lesser prevalence of symptoms and of treatment demands than in younger adults. Approximately 7% of the population between 12 and 18 years of age is diagnosed with mandibular pain-dysfunction. Temporomandibular dysfunction (TMD) is more frequent in females. No clear relationship has been established between occlusal alterations and TMJ disease. Only disharmony between centric relation and maximum intercuspidation, and unilateral crossbite, have demonstrated a certain TMJ disease-predictive potential. Both local and systemic hyperlaxity has been postulated as a possible cause of TMD. Parafunctional habits and bruxism are considered risk factors of TMD with odds ratios (ORs) of up to 4.8. Psychophysiological theory holds stress as a determinant factor in myofascial pain. Genetic factors and orthodontic treatment have not been shown to cause TMD. La patología de la articulación temporomandibular (ATM) afecta a un colectivo importante de población aunque no se considere un problema de salud pública. Entre el 3 y el 7% de la población busca tratamiento a causa del dolor y la disfunción de sus ATMs o estructuras anexas. Los estudios encuentran una extraordinaria variabilidad en cuanto a prevalencia de síntomas (6-93%) y en cuanto a signos clínicos (0-93%), variación que está probablemente relacionada con los diferentes criterios clínicos utilizados. En los estudios de imagen es frecuente el hallazgo de signos sin que estos se traduzcan en sintomatología clínica alguna. Se observan cambios radiográficos de osteoartrosis entre el 14 y el 44% de la población. La edad constituye un factor de riesgo aunque con matices. En pacientes ancianos hay mayor prevalencia de signos clínicos y radiográficos, pero menor prevalencia de síntomas y de demanda de tratamiento que en pacientes de edad adulta. Alrededor del 7% de la población entre 12 y 18 años es diagnosticada de dolor-disfunción mandibular. La DTM (disfunción temporomandibular), es mas frecuente en el sexo femenino. No se ha podido establecer relación inequívoca entre alteraciones de oclusión y patología de la ATM. Únicamente disarmonías entre relación céntrica y màxima intercuspidación, y mordida cruzada unilateral han mostrado un cierto poder predictivo de patología de la ATM. La hiperlaxitud, tanto local como sistémica se ha postulado como posible causa de DTM. Los hábitos parafuncionales y el bruxismo se consideran factores de riesgo de DTM con odds ratio de hasta 4,8. El estrés es considerado por la teoría psicofisiológica como el factor determinante del dolor miofascial. Factores genéticos y tratamiento ortodóncico no se han mostrado como causantes de DTM.

Currently three different methods have been taken to develop new mutagenicity tester strains containing human cytochrome P450s (CYPs). Each of these use a single expression vector. In this paper we describe a fourth approach, i.e., the coexpression of a CYP and its electron-transfer flavoprotein, NADPH CYP reductase (RED), encoded by two different expression vectors. The Escherichia coli mutagenicity tester strain BMX100 has been expanded to a strain, MTC which stably expresses human RED. This new tester strain permits the biplasmid coexpression of human CYP1A2 and RED (MTC1A2). This novel strain can be used for the determination of the mutagenicity of chemicals known to be procarcinogens and metabolized by CYP1A2. The mutagenicity tester strain MTC1A2 was compared with: (i) BMX100 using the post-mitochondrial rat liver fraction (S9); (ii) BMX100 with expressing CYP1A2 alone (iii) or with expressing CYP1A2 fused to rat RED or (iv) with expressing CYP1A2, bicistronically coexpressed with rat RED. The biplasmid RED/CYP coexpression system generated a strain with the highest methoxy- and ethoxy-resorufin dealkylase activities and highest mutagenic activities for the procarcinogens 2-aminoanthracene (2AA), aflatoxin B1 (AFB1) and 2-amino-3-methylimidazo(4,5-f)quinoline (IQ). Furthermore, the metabolism of 2AA and IQ was detected more efficiently using the MTC1A2 strain than with the BMX100 strain plus the standard rodent liver S9 metabolic system.

Exposición de las principales líneas de actuación pedagógicas en el marco de la sociedad nacionalsindicalista. Se confunde la educación con cultura, con las convicciones sociales o incluso con las religiosas, sin embargo, el verdadero concepto de educación está en la formación intelectual, teológica y exagórica, estando al servicio del conjunto de la sociedad. Los ideales de la educación, entendidos como objetivos de perfección, serían en esta época, la voluntad apasionada del deberes religioso, personal y social. El primero y más alto ideal de la educación es inculcar a los educando profundas convicciones cristianas. El segundo, inculcar la idea de que el trabajo es una función natural de la persona. Y el tercero, inculcar la conciencia del bien colectivo. Ésta es la finalidad natural de la formación del hombre según la concepción cristiana de la obra educadora, la cual debe ser secundada por todos los poderes educadores, para conseguir disponer las voluntades al cumplimiento de estos deberes sociales, éticos y civiles. Ministerio Educación CIDE Biblioteca de Educación del Ministerio de Educación, Cultura y Deporte; Calle San Agustín, 5 - 3 Planta; 28014 Madrid; Tel. +34917748000; biblioteca@mecd.es ESP