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Introduction: Medications are a fundamental part of the treatment of multiple pathologies. However, despite their benefits, some are considered potentially inappropriate medications for older people given their safety profile. Epidemiological data differences related to potentially inappropriate medications make it difficult to determine their effects on elderly people. Objective: To estimate the prevalence and types of potentially inappropriate medications using the 2019 Beers Criteria® in a cohort of adults older than 65 years. Materials and methods: We performed an observational, multicenter, retrospective, longitudinal study of a four-year follow-up of potentially inappropriate medications in community-dwelling older adults. Results: We followed 820 participants from five cities for four years (2012-2016) and evaluated them in three different moments (m1 = 2012, m2 = 2014, and m3 = 2016). The average age was 69.07 years, and 50.9% were women. The potentially inappropriate medication prevalence in the participants was 40.24%. The potentially inappropriate medications' mean among the studied subjects in the first moment was 1.65 (SD = 0.963), in the second was 1.73 (SD = 1.032), and in the third was 1.62 (SD = 0.915). There were no statistical differences between measurements (Friedman test, value = 0.204). The most frequent potentially inappropriate medications categories were gastrointestinal (39.4%), analgesics (18.8%), delirium-related drugs (15.4%), benzodiazepines (15.2%), and cardiovascular (14.2%). Conclusions: About half of the population of the community-dwelling older adults had prescriptions of potentially inappropriate medications in a sustained manner and without significant variability over time. Mainly potentially inappropriate medications were gastrointestinal and cardiovascular drugs, analgesics, delirium-related drugs, and benzodiazepines.

Introducción. Los fármacos son parte fundamental del tratamiento de múltiples enfermedades. Sin embargo, a pesar de sus beneficios, algunos se consideran medicamentos potencialmente inapropiados en adultos mayores, dado su perfil de seguridad. Las diferencias en los datos epidemiológicos relacionados con los medicamentos potencialmente inapropiados dificultan el establecimiento de sus efectos en adultos mayores. Objetivo. Estimar la prevalencia longitudinal y los tipos de medicamentos potencialmente inapropiados, utilizando los criterios Beers® del 2019 en una cohorte de adultos mayores de 65 años. Materiales y métodos. Se realizó un estudio observacional, multicéntrico, retrospectivo y longitudinal, de cuatro años de seguimiento de los medicamentos potencialmente inapropiados en adultos mayores de la comunidad. Resultados. Se evaluaron 820 participantes de cinco ciudades durante cuatro años (2012 a 2016) en tres momentos (m1: 2012, m2: 2014 y m3; 2016). La edad promedio fue de 69,07 años y el 50,9 % eran mujeres. La prevalencia de medicamentos potencialmente inapropiados en los participantes fue del 40,24 %. El promedio de estos medicamentos entre los sujetos estudiados en el primer momento fue de 1,65 (DE = 0,963), en el segundo fue de 1,73 (DE = 1,032) y en el tercero fue de 1,62 (DE = 0,915). No hubo diferencias estadísticas entre las mediciones (prueba de Friedman, p = 0,204). Las categorías de los medicamentos potencialmente inapropiados más frecuentes fueron: gastrointestinales (39,4 %), analgésicos (18,8 %), relacionados con delirium (15,4 %), benzodiacepinas (15,2 %) y cardiovasculares (14,2 %). Conclusiones. En cerca de la mitad de la población de adultos mayores de la comunidad, se prescribieron medicamentos potencialmente inapropiados de manera sostenida y sin variabilidad importante en el tiempo. Los más recetados fueron aquellos para tratar malestares gastrointestinales y cardiovasculares, analgésicos, para el delirium y benzodiacepinas.

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The aim of this work was to assess the effect of in vitro human digestion on the chemical composition (carbohydrates and phenolic compounds) and bioactivity of hydro-alcoholic-acid pomace extracts from two mandarin varieties (Clemenule and Ortanique) by measuring their antioxidant, antidiabetic, anti-glycative, hypolipidemic, and anti-inflammatory properties. The phenolic compound profile showed that nobiletin was the main flavonoid found in the extracts and digests of Clemenule pomace and extract, while isosinensetin/sinensetin/tangeretin were the ones in the Ortanique samples. The digests of Clemenule and Ortanique extracts showed Folin reaction values of 9.74 and 9.20 mg gallic acid equivalents (GAE)/g of sample, ABTS values of 83.2 and 91.7 µmol Trolox equivalents (TE)/g of sample, and ORAC-FL values of 142.8 and 891.6 µmol TE/g of sample, respectively. Extracts (50-500 µg/mL) inhibited intracellular reactive oxygen species (ROS) formation in CCD-18Co cells under physiological and oxidative-induced conditions. Clemenule and Ortanique extract digests showed IC50 values of 13.50 and 11.07 mg/mL for α-glucosidase, 28.79 and 69.64 mg/mL for α-amylase, and 16.50 and 12.77 mg/mL for AGEs, and 2.259 ± 0.267 and 0.713 ± 0.065 mg/mL for pancreatic lipase inhibition, respectively. Ortanique extract (250-1000 µg/mL) inhibited the production of nitric oxide in RAW264.7 macrophages under inflammation-induced conditions, and intracellular ROS formation. In conclusion, altogether, the results supported the potential of mandarin extracts to be used as health promoters by reducing the risk of non-communicable chronic diseases.

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AIM: Apical periodontitis (AP) is the chronic inflammation of the periradicular tissues in response to root canal infection. Whilst AP has been linked with systemic inflammation and noncommunicable diseases, its potential association with nonalcoholic fatty liver disease (NAFLD) is unknown. We aimed to evaluate the serum alanine aminotransferase (ALT) and aspartate aminotransferase (AST) levels as surrogate markers of hepatic injury, and the systemic inflammatory burden in otherwise healthy individuals with and without AP diagnosis. METHODOLOGY: Cross-sectional study. Individuals with AP (n = 30) and healthy controls (n = 29) were recruited. The number, mean diameter (mm) and periapical index of the apical lesions of endodontic origin (ALEO) were assessed. ALT and AST levels (pg/mL) were measured through enzyme-linked immunosorbent assays. The serum levels of TNF-α, IL-4, IL-9, IL-10, IL-17A and IL-22 were evaluated by Multiplex assay. Inferential analysis was performed using t-test or Mann-Whitney tests according to data distribution and linear regression models. Data were analysed with StataV16 (p < .05). RESULTS: ALT and AST levels were significantly higher in individuals with AP compared to controls (p < .05). Serum inflammatory biomarkers showed no significant differences between the study groups. Bivariate and multivariate analyses confirmed that AP diagnosis was independently associated with ALT and AST elevations (p < .05). Additionally, the number of ALEO positively influenced AST levels (p = .002). IL-22 on the other hand, was associated with reduced ALT levels (p = .043). CONCLUSION: AP is associated with higher serum hepatic transaminases ALT and AST, potentially contributing to NAFLD physiopathology in young adults.

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AIM: To determine the systemic inflammatory burden, including hsCRP and its monomeric forms, in patients with apical lesions of endodontic origin treated with root canal treatment (RCT). METHODOLOGY: Prospective pre-/post-study. Apical periodontitis (AP) individuals aged 16-40 were included (N = 29). Individuals received RCT and were followed at 1 and 6 months. Fasting blood samples were obtained. Apical lesions of endodontic origin (ALEO) diameter (mm), and periapical index (PAI), were recorded. The serum concentrations of total hsCRP were determined by turbidimetry. Tumour necrosis factor (TNF)-α, interleukin (IL)-6, IL-10, IL-1ß, and soluble (s) E-selectin were assessed by Multiplex assay. Additionally, mCRP forms were determined in the serum of AP patients with a baseline moderate to high cardiovascular risk based on hsCRP stratification (hsCRP ≥1 mg/L) by immunowestern blot (n = 15). Also, CRP isoforms were explored in ALEOs from AP individuals (n = 4). Data were analysed with StataV16. RESULTS: Periapical index and ALEO sizes were reduced at both follow-up visits after RCT (p < .05). Serum levels of TNF-α, IL-6, IL-10, IL-1ß, and sE-selectin did not show significant differences. CRP was borderline reduced at 1 month (p = .04); however, in AP individuals at cardiovascular risk (hsCRP ≥ 1 mg/L), hsCRP and its monomeric isoform significantly decreased at 1 and 6 months (p < .05). CONCLUSIONS: High-sensitivity CRP and mCRP are reduced after RCT in AP individuals at cardiovascular risk.

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Introducción: Los dientes supernumerarios constituyen una anomalía de número en la cual se excede la cantidad normal de piezas dentales. La geminación es una anomalía de forma que se caracteriza por la presencia de una corona bífida y una raíz común. Los dientes supernumerarios geminados son de rara aparición; indicar exámenes imagenológicos son importantes para determinar sus características y su relación con las estructuras vecinas. Objetivo: Presentar el caso clínico de un paciente con un diente supernumerario geminado. Caso clínico: Paciente de sexo masculino de 23 años de edad, acude a la consulta odontológica por presentar una elevación del lado izquierdo en el paladar, sin molestias. En el examen clínico se observa un aumento de volumen de mucosa palatina de piezas dentales 24 y 25. Los exámenes de imagen fueron realizados y se diagnosticó un diente supernumerario geminado retenido, se realizó tratamiento quirúrgico y el paciente evolucionó favorablemente. Conclusión: Los dientes supernumerarios geminados son poco frecuentes, una oportuna y correcta evaluación imagenológica, le permitirá al clínico realizar un adecuado diagnóstico y tratamiento(AU)

Introduction: Supernumerary teeth constitute an anomaly of number where the normal number of teeth is exceeded and gemination is an anomaly of shape characterized by the presence of a bifid crown, a common root. Geminate supernumerary teeth are of rare occurrence; indicating imaging examinations are important to determine their characteristics and their relationship with neighboring structures. Objective: To present the clinical case of a patient with a geminate supernumerary tooth. Clinical case: A 23-year-old male patient came to the dental office due to an elevation on the left side of the palate, without discomfort. In the clinical examination, an increase in the volume of the palatal mucosa of teeth 24 and 25 was observed. The imaging examinations were performed and a retained geminated supernumerary tooth was diagnosed, surgical treatment was performed and the patient progressed favorably. Conclusion: Geminate supernumerary teeth are rare; a timely and correct imaging evaluation will allow the clinician to make an adequate diagnosis and treatment(AU)

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Emerging epidemiological evidence links atopic dermatitis (AD) and periodontitis, although the mechanisms remain unclear. Th2-derived cytokines are key in the development of both diseases, and different gingival crevicular fluid (GCF) profiles among healthy and diseased subjects have been previously reported. This case-control study examined the GCF levels of interleukins (IL)-13, IL-31, and thymic stromal lymphopoietin (TSLP) in 29 subjects with moderate-to-severe AD and 33 controls. All subjects underwent comprehensive clinical and oral evaluations, followed by GCF collection. GCF levels of IL-13, IL-31, and TSLP were assessed using a multiplex-bead immunoassay. Demographic and periodontal parameters were similar among groups (p > 0.05). The GCF levels of IL-31 and TSLP were higher in AD subjects compared to controls (p < 0.05), whereas no significant differences in the GCF levels of IL-13 were noticed (p = 0.377). Moderate-to-severe AD was positively associated with the GCF levels of IL-31 and TSLP, whereas severe periodontitis was negatively associated with IL-31 (p < 0.05). The GCF levels of IL-13 showed no significant associations with either condition (p = 0.689). There was no significant interaction between AD and periodontitis for IL-31 (p < 0.869). These results suggest that AD and periodontitis independently influence the GCF levels of IL-31 in opposing ways, whereas AD alone influences the levels of TSLP.

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AIM: Angiogenesis contributes to the development of apical periodontitis, periodontitis, and other oral pathologies; however, it remains unclear how this process is triggered. The aim was to evaluate whether lipopolysaccharide (LPS) from Porphyromonas endodontalis and Porphyromonas gingivalis induced angiogenesis-related effects in vitro via TLR2 and TLR4. METHODOLOGY: Porphyromonas endodontalis LPS (ATCC 35406 and clinical isolate) was purified with TRIzol, whereas P. gingivalis LPS was obtained commercially. The effects of the different LPS (24 h) in endothelial cell migration were analysed by Transwell assays, following quantification in an optical microscope (40×). The effects of LPS on FAK Y397 phosphorylation were assessed by Western blotting. Angiogenesis in vitro was determined in an endothelial tube formation assay (14 h) in Matrigel in the absence or presence of either LPS. IL-6 and VEGF-A levels were determined in cell supernatants, following 24 h treatment with LPS, and measured in multiplex bead immunoassay. The involvement of TLR2 and TLR4 was assessed with blocking antibodies. The statistical analysis was performed using STATA 12® (StataCorp LP). RESULTS: The results revealed that P. endodontalis LPS, but not P. gingivalis LPS, stimulated endothelial cell migration. Pre-treatment with anti-TLR2 and anti-TLR4 antibodies prevented P. endodontalis LPS-induced cell migration. P. endodontalis LPS promoted FAK phosphorylation on Y397, as observed by an increased p-FAK/FAK ratio. Both P. gingivalis and P. endodontalis LPS (ATCC 35406) induced endothelial tube formation in a TLR-2 and -4-dependent manner, as shown by using blocking antibodies, however, only TLR2 blocking decreased tube formation induced by P. endodontalis (clinical isolate). Moreover, all LPS induced IL-6 and VEGF-A synthesis in endothelial cells. TLR2 and TLR4 were required for IL-6 induction by P. endodontalis LPS (ATCC 35406), while only TLR4 was involved in IL-6 secretion by the other LPS. Finally, VEGF-A synthesis did not require TLR signalling. CONCLUSION: Porphyromonas endodontalis and P. gingivalis LPS induced angiogenesis via TLR2 and TLR4. Collectively, these data contribute to understanding the role of LPS from Porphyromonas spp. in angiogenesis and TLR involvement.

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OBJECTIVE: In Chile, the elderly represent 18% of the population. In women, the aging process impacts body composition, in addition to the coexistence of other pathologies such as chronic noncommunicable diseases (NCDs). The aim of the study was to relate body composition to the presence of chronic noncommunicable diseases in active older women in the city of Chillán. METHODS: The sample consisted of 284 women belonging to senior centers in Chillán. Body composition was determined by bioimpedanciometry. Sociodemographic information, prevalent pathologies, geriatric syndromes and physical activity were determined by means of a validated questionnaire. Data were analyzed with descriptive and inferential statistics in STATA 15.0 software with an α<0.05. RESULTS: Of the sample, 63% were under seventy-five years of age, 77.5% had less than twelve years of schooling, the predominant socioeconomic level was low, and the poor perception of health was mainly referred to as well as the use of regular medication. Arterial hypertension (AHT) and hypercholesterolemia were prevalent with 70.4% and 48.2% respectively. Body mass index (BMI) was 29.7±4.8 and 71.8% had excess malnutrition. The group older than seventy-five years presented more body fat (BMF) and extracellular water (ECW). AHT was related to higher BMI, TGM, MBC (Mean Arm Circumference), PC (Calf Circumference) and ECW (p<0.05), while Diabetes mellitus was related to BMI and MBC. CONCLUSIONS: Hypertension is the most frequent pathology and is related to higher BMI, MGT, CMB, CP and ECW, followed by DM2 which is related to BMI and CMB.

OBJETIVO: En Chile, las personas mayores representan el 18% de la población. En mujeres, el proceso de envejecimiento impacta sobre la composición corporal, además de coexistir con otras patologías como enfermedades crónicas no transmisibles (ECNT). El objetivo del estudio fue relacionar la composición corporal con la presencia de enfermedades crónicas no transmisibles en mujeres mayores activas de la ciudad de Chillán. METODOS: La muestra quedó compuesta por 284 mujeres pertenecientes a centros de adultos mayores de Chillán. La composición corporal se determinó por bioempidenciometría. La información sociodemográfica, las patologías prevalentes, los síndromes geriátricos y la actividad física se recabó mediante cuestionario validado. Los datos se analizaron con estadística descriptiva e inferencial en el software STATA 15.0 con un α<0,05. RESULTADOS: De la muestra, el 63% tenía menos de setenta y cinco años, 77,5% presentó una escolaridad por debajo de los doce años, el nivel socioeconómico predominante fue bajo, y la mala percepción de salud fue referida mayoritariamente al igual que el uso regular de medicamentos. La hipertensión arterial (HTA) y la hipercolesterolemia fueron prevalentes con un 70,4% y un 48,2%, respectivamente. El Índice de masa corporal (IMC) fue de 29,7±4,8 y el 71,8% tenía malnutrición por exceso. El grupo mayor a setenta y cinco años presentó más grasa corporal (MGT) y agua extracelular (AEC). La HTA se relacionó con mayor IMC, MGT, CMB (Circunferencia Media del Brazo), CP (Circunferencia de Pantorrilla) y AEC (p<0,05), mientras que la Diabetes mellitus con el IMC y la CMB. CONCLUSIONES: La hipertensión es la patología más frecuente y se relaciona con mayor IMC, MGT, CMB, CP y AEC, siguiéndole la DMII, que se relaciona con el IMC y la CMB.

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El acceso y disponibilidad a alimentos seguros y nutritivos, es prioritario para obtener una buena nutrición, con el fin de mejorar la salud y calidad de vida de las personas mayores (PM). El objetivo del estudio fue determinar la prevalencia de malnutrición por déficit e inseguridad alimentaria en PM institucionalizadas en ELEAM, de las comunas de Chillán y Chillán Viejo, Región de Ñuble. Estudio descriptivo que incluyó a 63 personas de 65-96 años, residentes en 7 ELEAM de las comunas de Chillán y Chillán Viejo que aceptaron participar del estudio. Se evaluó el estado nutricional mediante Índice de Masa Corporal (IMC), circunferencia braquial (CB), perímetro de pantorrilla (PP); y se aplicó Escala de Seguridad Alimentaria adaptada y validada. La información se analizó con estadística descriptiva uni y bivariada según tipo de variables. El grupo estuvo conformado mayoritariamente por mujeres (74,6%). La situación nutricional más prevalente fue la malnutrición por déficit (42,9%), seguida por el estado nutricional normal (31,7%). La CB mostró valores promedios de 26,9±3,5 cm en las mujeres y de 26,8±4,5 cm en los hombres; según PP el 39,6% presentó déficit de masa muscular. La seguridad alimentaria estuvo presente en el 20,6% de los encuestados y la inseguridad alimentaria en el 79,3%. Se concluye que las PM pertenecientes a los ELEAM estudiados, presentaron mayoritariamente malnutrición por déficit, e inseguridad alimentaria, lo que no contribuye a una mejor salud del grupo estudiado.

Access to and availability of sufficient, safe, and nutritious food is a priority for quality nutrition for the health and quality of life of the elderly. The objective of this study was to determine the prevalence of undernutrition due to food deficit and insecurity in institutionalized elderly individuals in long-term care facilities (ELEAM) in the communes of Chillán and Chillán Viejo, Ñuble Region, Chile. This descriptive study included 63 individuals aged 65-96 residing in seven ELEAM in the communes of Chillán and Chillán Viejo that accepted to participate. Nutritional status was evaluated by Body Mass Index (IMC), mid-arm circumference (MAC), and calf perimeter (CP); and an adapted and validated Food Security Scale was applied. The information was analyzed using univariate and bivariate descriptive statistics by type of variable. The group consisted mainly of women (74.6%). The most prevalent nutritional status was deficit malnutrition (42.9%), followed by normal nutritional status (31.7%). CB showed mean values of 26.9 ± 3.5 cm in women and 26.8± 4.5 cm in men; according to CP, 39.6% presented a deficit of muscular mass. Food security and insecurity were present in 20.6% and 79.3% of the respondents, respectively. It was concluded that the elderly belonging to the ELEAMs studied presented mostly deficit malnutrition, and food insecurity, which does not contribute to the better health of the group studied.

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Underestimating/overestimating resting metabolic rate (RMR) affects energy prescription. The objective was to compare RMR by indirect calorimetry (RMR IC) and RMR estimated by predictive equations in women with excess body fat. This was an analytical cross-sectional study with 41 women aged 18-28 with overnutrition according to body composition. The RMR IC was measured and RMR estimated using the FAO/WHO/UNU (1985), FAO/WHO/UNU (2004), Harris-Benedict, and Mifflin-St Jeor equations. The percentage of adequacy (90-110%), overestimation (>110%), and underestimation (<90%) were evaluated for RMR IC. Data were described by percentiles because of non-normal distribution according to the Shapiro-Wilk test. The Kruskal-Wallis test and Bland-Altman analysis were applied at a significance level of α < 0.05. The RMR IC was 1192 and 1183 calories/day (p = 0.429) in women with obesity and overweight, respectively. The FAO/WHO/UNU (1985), FAO/WHO/UNU (2004), Harris-Benedict, and Mifflin-St Jeor equations overestimated the RMR IC by 283.2, 311.2, 292.7, and 203.0 calories/day and by 296.7, 413.8, 280.0, and 176.6 calories/day for women with overweight and obesity (p < 0.001), respectively. The Harris-Benedict adjusted weight (0.5) equation underestimated RMR IC by 254.7 calories/day. The predictive equations overestimated RMR IC in women with excess body fat. The Mifflin-St Jeor equation showed less overestimation and better adequacy, but was not exempt from inaccuracy.