What influence do anticoagulants have on oral implant therapy? A systematic review.

OBJECTIVES: This systematic review aims to assess the risks (both thromboembolic and bleeding) of an oral anticoagulation therapy (OAT) patient undergoing implant therapy and to provide a management protocol to patients under OAT undergoing implant therapy. MATERIAL AND METHODS: Medline, Cochrane Data Base of Systematic Reviews, the Cochrane Central Register of Controlled Trials and EMBASE (from 1980 to December 2008) were searched for English-language articles published between 1966 and 2008. This search was completed by a hand research accessing the references cited in all identified publications. RESULTS: Nineteen studies were identified reporting outcomes after oral surgery procedures (mostly dental extractions in patients on OAT following different management protocols and haemostatic therapies). Five studies were randomized-controlled trials (RCTs), 11 were controlled clinical trials (CCTs) and three were prospective case series. The OAT management strategies as well as the protocols during and after surgery were different. This heterogeneity prevented any possible data aggregation and synthesis. The results from these studies are very homogeneous, reporting minor bleeding in very few patients, without a significant difference between the OAT patients who continue with the vitamin K antagonists vs. the patients who stopped this medication before surgery. These post-operative bleeding events were controlled only with local haemostatic measures: tranexamic acid mouthwashes, gelatine sponges and cellulose gauzes's application were effective. Post-operative bleeding did not correlate with the international normalised ratio (INR) status. In none of the studies was a thromboembolic event reported. CONCLUSIONS: OAT patients (INR 2-4) who do not discontinue the AC medication do not have a significantly higher risk of post-operative bleeding than non-OAT patients and they also do not have a higher risk of post-operative bleeding than OAT patients who discontinue the medication. In patients with OAT (INR 2-4) without discontinuation, topical haemostatic agents were effective in preventing post-operative bleeding. OAT discontinuation is not recommended for minor oral surgery, such as single tooth extraction or implant placement, provided that this does not involve autogenous bone grafts, extensive flaps or osteotomy preparations extending outside the bony envelope. Evidence does not support that dental implant placement in patients on OAT is contraindicated.

Ciència catalana a Madrid: el discurs de Jesús M. Bellido Golferichs a la Biblioteca Nacional (1927)

We analyze Dr. Bellido"s discourse at the Spanish National Library in Madrid (1927) in the framework of what has been called Medical Catalanism. Further development of this case study will provide a better understanding of Catalan as a scientific language, the importance of the role played by Catalan publishing industry and the cultural and political relationship between Madrid and Barcelona.

Madrid 2020, ahora o nunca

Aquest treball té la voluntat de ser un reportatge d’investigació sobre la cursa olímpica de Madrid, des de la candidatura de 2012 fins la de 2020. Els defensors dels Jocs Olímpics a la capital espanyola justifiquen el seu tercer intent consecutiu en el fet de tenir el 80% de les infraestructures necessàries construïdes. En canvi, l’oposició ha trobat en la crisi econòmica el millor motiu per posicionar-se en contra de la celebració dels JJOO.Hem realitzat una sèrie de 15 entrevistes amb tota mena d’experts i personalitats de l’àmbit, intentant albergar sempre tots els possible punts de vista que hagin sorgit al respecte. El resultat ha sigut un article de llarga extensió que fa un repàs a tota la història olímpica de Madrid fins a dia d’avui i intenta interpretar tots els esdeveniments ocorreguts fins ara.

Lapatax: Safety profile of neoadjuvant lapatinib combined with docetaxel in Her 2/neu overexpressing breast cancer - EORTC protocol 10054

Objective: To assess the safety/tolerability of the combination lapatinib (L) and docetaxel (D) in patients with Her 2/neu overexpressing breast cancer (BC). This study is important as it will define how to deliver lapatinib with taxotere, a highly active drug in breast cancer. Patients and Methods: Female patients (pts) with locally advanced, inflammatory or large operable BC were treated with escalating doses of L from 1000 to 1250 mg/day, in combination with D given IV every 21 days at doses ranging from 75 to 100 mg/m2 for 4 cycles. At least 3 pts were treated at each dose level. The definition of dose limiting toxicity (DLT) is based on the toxicity assessed at cycle 1 as follows: any grade 3−4 non hematological toxicity, ANC < 0.5 G/L lasting for 7 days or more, febrile neutropenia or thrombocytopenia <25 G/L. GCSF was not permitted as primary prophylaxis. Core biopsies were mandatory at baseline and after cycle 4. Pharmcokinetic (PK) samples were collected on day 1 of cycles 1 and 2. Results: To date, 18 pts with a median age of 53 years (range 36−65) have been enrolled at 5 Dose Levels (DLs). The toxicity profile for 18 patients (68 documented cycles) is summarized below. At DL5 (1000/100), 2 pts had DLTs (neutropenia grade 4 _7 days and febrile neutropenia), and 3 additional pts were enrolled with primary prophylactic G-CSF. As expected, the safety profile improved and the dose escalation will continue with prophylactic G-CSF to investigate DL6 (1250/100). These findings are consistent with published Phase I data for this combination [1]. N= 18 patients n (%) Grade 1 Grade 2 Grade 3 Grade 4 neutropenia 1 (6) 3 (17) 13 (72) febrile neutropenia 2 (11) fatigue 8 (44) 7 (39) diarrhoea 9 (50) 3 (17) pain: joint/muscle/other 5 (28)/4 (22)/3 (17) 4 (22)/4 (22)/3 (17) 0/0/1 (6) constipation 2 (11) 3 (17) 1 (6) elevated transaminases SGPT/SGOT 7 (39)/5 (28) Conclusions: The main toxicity of the L + D combination is haematological and was reached at DL5 (1000/100), without primary GCSF. An additional DL6 with primary prophylactic GCSF is being investigated (1250/100). PK data will be presented at the meeting plus the recommended dose for phase II studies.

Protocol de viabilitat socioecològica del llop : àrea d'estudi de la Vall d'Alinyà

Aquest estudi analitza diferents variables ecològiques i socials amb l’objectiu de determinar la viabilitat de l’espècie Canis lupus en el territori que compren la Vall d’Alinyà, i definir unes pautes per extrapolar aquest tipus d’anàlisis a altres àrees d’estudi. El llop va desaparèixer de Catalunya a causa de la forta pressió antròpica exercida sobre l’espècie en el passat. En l’última dècada, s’han donat indicis d’una possible reaparició del súper depredador en el territori català. Com a mètode per a la cerca del llop s’ha experimentat amb l’ús de gossos de rastreig per a la cerca i diferenciació de rastres de llop, aquesta és una tècnica innovadora no utilitzada anteriorment per a aquest tipus d’objectiu. L’exploració de les inquietuds dels ramaders i caçadors de la zona, mostra una bona predisposició a la reaparició de l’animal. Malgrat no s’ha detectat llop amb els mètodes emprats, es demostra que li és viable d’establir-se a la zona.

Detecting the oxidative reactivity of nanoparticles: a new protocol for reducing artifacts

Understanding the oxidative reactivity of nanoparticles (NPs; <100 nm) could substantially contribute to explaining their toxicity. We attempted to refine the use of 2′7-dichlorodihydrofluorescein (DCFH) to characterize NP generation of reactive oxygen species (ROS). Several fluorescent probes have been applied to testing oxidative reactivity, but despite DCFH being one of the most popular for the detection of ROS, when it has been applied to NPs there have been an unexplainably wide variability in results. Without a uniform methodology, validating even robust results is impossible. This study, therefore, identified sources of conflicting results and investigated ways of reducing occurrence of artificial results. Existing techniques were tested and combined (using their most desirable features) to form a more reliable method for the measurement of NP reactivity in aqueous dispersions. We also investigated suitable sample ranges necessary to determine generation of ROS. Specifically, ultrafiltration and time-resolved scan absorbance spectra were used to study possible optical interference when using high sample concentrations. Robust results were achieved at a 5 µM DCFH working solution with 0.5 unit/mL horseradish peroxidase (HRP) dissolved in ethanol. Sonication in DCFH-HRP working solution provided more stable data with a relatively clean background. Optimal particle concentration depends on the type of NP and in general was in the µg/mL range. Major reasons for previously reported conflicting results due to interference were different experimental approaches and NP sample concentrations. The protocol presented here could form the basis of a standardized method for applying DCFH to detect generation of ROS by NPs.

Improvement of a fully distributed decision making protocol for CRN

Abstract¿La deteción del espectro libre para las comunicaciones inalámbricas en un momento puntual es una tarea compleja cuyo desarrollo se simplica al realizarse de forma distribuida por una red de radio cognitiva. Sin embargo existes dificultades y vulnerabilidades de seguridad que han de ser tenidas en cuenta y solventadas a la hora de autenticar y validar los nodos de la red. Este artículo presenta una propuesta de mejora del protocolo fully distributed decision making protocol for CRN con el fin de llevar a cabo esta tarea de detección del espectro de una manera eficiente y segura.

To differentiate complementary mri sequences to standard protocol in detecting degenerative inflammatory lumbar spine lesions

Purpose: To compare the additional informations obtainedwith axial and sagittal T2 weighted with fat saturation(T2FS) and T1 weighted with Gadolinium iv sequenceswith fat saturation (T1FSGd) to detect degenerativeinflammatory lumbar spine lesions.Materials and Methods: Our retrospective study included73 patients (365 lumbar levels) with lumbar spinedegenerative disease (25 males, 48 females, mean age56 years). MRI protocol was performed with T1 and T2weighted sagittal and T2 weighted axial sequences(standard protocol), axial and sagittal T2FS and T1FSGd.Images were independently analyzed by two musculoskeletalradiologists and a neurosurgeon. Two groups ofsequences were analyzed: standard + T2FS sequences(group 1), standard + T1FSGd sequences (group 2).Degenerative inflammatory lumbar spine lesions werenoted at each level in: anterior column (vertebralendplate), spinal canal (epidural and peri-radicular fat)and posterior column (facet joint with capsular recessand subchondral bone).Results: Degenerative inflammatory lesions were present in18% (66/365) of levels in group 1, and 48% (175/365) oflevels in group 2. In details, lesions were noted in group 1 and2 respectively:-in 44 and 66 levels for anterior column,-in22 and 131 levels for posterior column,-in 0 and 36 levelsfor spinal canal. All these differences were statisticallysignificant. Intra and Interobserver agreements were good.Conclusion: The T1FSGd sequence is more sensitive thanT2FS to show the degenerative inflammatory lumbar spinelesions, especially in spinal canal and posterior column.

Anàlisi econòmica i financera dels sectors de béns de consum i serveis de consum de la Borsa de Madrid

Aquest treball consisteix en una anàlisi econòmica i financera dels sectors de béns de consum i serveis de consum de la Borsa de Madrid en el període 2007-2011. Aquest consisteix en realitzar un estudi dels diferents comptes anuals consolidats de les diferents empreses que configuren cadascun dels sectors mitjançant diferents instruments financers, amb l’objectiu de saber si la crisi econòmica i financera actual ha afectat o no aquests.

Tratado firmado en Madrid, 13 de enero de 1750, para determinar los limites de los Estados pertenecientes a las coronas de España y Portugal, en Asia y América

[Traité. 1750-01-13. Madrid]