Orofacial pain of cardiac origin: review literature and clinical cases

The most common types of orofacial pain originate at the dental or periodontal level or in the musculoskeletal structures. However, the patient may present pain in this region even though the source is located elsewhere in the body. One possible source of heterotopic pain is of cardiac origin. Objectives: Report two cases of orofacial pain of cardiac origin and review the clinical cases described in the literature. Study Design: Description of clinical cases and review of clinical cases. Results and conclusions: Nine cases of atypical pain of cardiac origin are recorded, which include 5 females and 4 males. In craniofacial structures, pain of cardiac origin is usually bilateral. At the craniofacial level, the most frequent location described is in the throat and jaw. Pain of cardiac origin is considered atypical due to its location, although roughly 10% of the cases of cardiac ischemia manifest primarily in craniofacial structures. Finally, the differential diagnosis of pain of odontogenic origin must be taken into account with pain of non-odontogenic origin (muscle, psychogenic, neuronal, cardiac, sinus and neurovascular pain) in order to avoid diagnostic errors in the dental practice as well as unnecessary treatments.

Identification and prospective validation of clinically relevant chronic obstructive pulmonary disease (COPD) subtypes.

Background Chronic obstructive pulmonary disease (COPD) is increasingly considered a heterogeneous condition. It was hypothesised that COPD, as currently defined, includes different clinically relevant subtypes. Methods To identify and validate COPD subtypes, 342 subjects hospitalised for the first time because of a COPD exacerbation were recruited. Three months after discharge, when clinically stable, symptoms and quality of life, lung function, exercise capacity, nutritional status, biomarkers of systemic and bronchial inflammation, sputum microbiology, CT of the thorax and echocardiography were assessed. COPD groups were identified by partitioning cluster analysis and validated prospectively against cause-specific hospitalisations and all-cause mortality during a 4 year follow-up. Results Three COPD groups were identified: group 1 (n ¼ 126, 67 years) was characterised by severe airflow limitation (postbronchodilator forced expiratory volume in 1 s (FEV 1 ) 38% predicted) and worse performance in most of the respiratory domains of the disease; group 2 (n ¼ 125, 69 years) showed milder airflow limitation (FEV 1 63% predicted); and group 3 (n ¼ 91, 67 years) combined a similarly milder airflow limitation (FEV 1 58% predicted) with a high proportion of obesity, cardiovascular disorders, iabetes and systemic inflammation. During follow-up, group 1 had more frequent hospitalisations due to COPD (HR 3.28, p < 0.001) and higher all-cause mortality (HR 2.36, p ¼ 0.018) than the other two groups, whereas group 3 had more admissions due to cardiovascular disease (HR 2.87, p ¼ 0.014). Conclusions In patients with COPD recruited at their first hospitalisation, three different COPD subtypes were identified and prospectively validated:"severe respiratory COPD","moderate respiratory COPD", and"systemic COPD'

Valoració dels estudiants universitaris sobre la incorporación de la Universitat Autònoma de Barcelona a l'Espai Europeu d'Educació Superior

Els canvis de metodologia docent que ha comportat el Procés de Bolonya impliquen variacions en l'avaluació continuada, augment dels treballs en grup, reducció de les classes magistrals i un nombre més elevat de pràctiques. Les valoracions dels estudiants en relació amb la introducció dels canvis metodològics del Procés de Bolonya són positives i negatives alhora. Els estudiants veuen amb bons ulls aquests canvis metodològics, perquè poden significar millores en els aprenentatges que adquireixin, però consideren que, tal com s¿estan duent a terme en aquesta universitat, ràpidament, sense recursos i amb poca reflexió prèvia, comporten finalment efectes negatius per a ells. Davant l'alta càrrega de treball que han comportat aquests canvis, els estudiants es converteixen en actors estratègics, atès que duen a terme accions superficials o profundes segons les tasques que els demanen els professors. Els canvis en la metodologia docent poden produir efectes positius en el procés d'aprenentatge dels estudiants (pertinença, seguretat i necessitats fisiològiques), però fins que els factors de manteniment no arribin a un cert llindar de qualitat, els efectes positius no es visualitzaran.

Estrategias de gestión y comunicación de los líderes intermedios en la aplicación de los ECTS

Los datos que se utilizan en este artículo proceden de una investigación sobre el Proceso de Bolonia llevada a cabo en diez titulaciones de una sola universidad; seis de ellas forman parte del proyecto piloto para incorporar los European Credit Transfer System (ECTS). En este trabajo, nos centramos en cómo los líderes intermedios de las titulaciones piloto estudiadas ponen en marcha la implementación de los ECTS siguiendo estrategias diferenciadas de gestión, generación de consenso y comunicación. Asimismo, se examinan las respuestas que el profesorado de las mismas titulaciones da, en términos de valoración de la gestión, las actitudes ante la reforma y el grado de información percibido. El análisis nos permite identificar algunas oportunidades y constricciones ¿derivadas de las formas de gestión consideradas legítimas por los miembros de esta institución universitaria¿ ante las que se sitúa la acción de los líderes intermedios.

Epigenetic Activation of SOX11 in Lymphoid Neoplasms by Histone Modifications

Recent studies have shown aberrant expression of SOX11 in various types of aggressive B-cell neoplasms. To elucidate the molecular mechanisms leading to such deregulation, we performed a comprehensive SOX11 gene expression and epigenetic study in stem cells, normal hematopoietic cells and different lymphoid neoplasms. We observed that SOX11 expression is associated with unmethylated DNA and presence of activating histone marks (H3K9/14Ac and H3K4me3) in embryonic stem cells and some aggressive B-cell neoplasms. In contrast, adult stem cells, normal hematopoietic cells and other lymphoid neoplasms do not express SOX11. Such repression was associated with silencing histone marks H3K9me2 and H3K27me3. The SOX11 promoter of non-malignant cells was consistently unmethylated whereas lymphoid neoplasms with silenced SOX11 tended to acquire DNA hypermethylation. SOX11 silencing in cell lines was reversed by the histone deacetylase inhibitor SAHA but not by the DNA methyltransferase inhibitor AZA. These data indicate that, although DNA hypermethylation of SOX11 is frequent in lymphoid neoplasms, it seems to be functionally inert, as SOX11 is already silenced in the hematopoietic system. In contrast, the pathogenic role of SOX11 is associated with its de novo expression in some aggressive lymphoid malignancies, which is mediated by a shift from inactivating to activating histone modifications.

Sistema de becas y equidad participativa en la universidad

El objetivo del artículo es analizar el impacto del aumento de tasas universitarias del 66% que se implementó en Cataluña en el cuso 2012-13 y el papel de las becas provenientes del gobierno central. Se analizan los datos de los estudiantes de nuevo acceso de dos universidades catalanas, considerando clase social, titulación elegida y solicitud de beca, y se compara el año anterior y posterior al aumento de las tasas. Se constata cómo hay una diferente composición social en las diferentes titulaciones según coste de la matrícula y dificultad de superar los créditos. Así se muestra una estratificación en las universidades analizadas y un aumento de ésta en los cursos analizados, alejando así el sistema universitario de la equidad participativa de los estudiantes.