Artículos Ciencias de la Salud

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A Novel Nonsurgical Smooth Thread Technique to Correct Gummy Smiles: Preliminary Report
(2025) Carrasco Avilés, Fabiola Inés; Cavallini, Maurizio; Claysset, Barbara; Llorca Pérez, Vicenta María; Raichi, Mauro
Background: “Gummy smile” describes the aesthetically unappealing display of gums that extends more than 2 to 3 mm when individuals smile. The multifactorial etiology of the gummy smile leads to various surgical and nonsurgical treatment strategies, including orthodontic therapies, lip fillers, and primarily botulinum toxin as a nonsurgical treatment. Objectives: In this paper, the authors present the preliminary report of a novel, minimally invasive, and non-neurotoxic treatment option for gummy smiles based on the insertion of smooth-surfaced resorbable polydioxanone threads along the vectors of the lip elevator muscles, offering long-lasting satisfactory aesthetic outcomes. Methods: The proposed subcutaneous thread insertion technique utilizes 23 G, 38 mm cannulas with 14 smooth threads per cannula. Twentytwo female patients with subjectively distressing gummy smiles have been treated so far. The correction of gummy smiles is rapid and has been documented for up to 18 months, with the most protracted case lasting 20 months. The first cannula is positioned 1.5 cm from the labial commissure and 0.5 cm above it, following the vector of the orbicularis oris muscle from the modiolus to the upper white lip. The second cannula targets the levator labii superioris muscle vector, entering from the modiolus, and the third cannula follows the zygomaticus major and zygomaticus minor muscle vectors. The insertion points are the same for the first, second, and third cannula. The fourth cannula is inserted 2 cm from the insertion point of the first, second, and third cannulas toward the premasseteric area and the internal corner of the eye, crossing the third thread in a crossed pattern. Only the 2 threads along the levator labii superioris and orbicularis oris vectors were inserted in 1 of the 22 treated patients, who displayed no molar teeth exposure while smiling. Results: No novel excessive gingival display has occurred in the 22 mbulatory patients treated so far for 9 to 12 months. In the patients treated so far, the mean distances between the diagnostic reference points decreased by 0.85 and 1.25 mm after 2 and 6 weeks, respectively, with negligible pain during the procedure and high satisfaction among all patients. Conclusions: The proposed smooth thread technique could be a technically convenient and minimally invasive option for addressing disturbing gummy smile problems.
Accurate ratios for the calculation of Speech and Language Therapy staffing for health institutions: a systematic review
(2025) Rosales Lillo, Felipe; Monichi Valdenegro, Giovanna
While the role of Speech and Language Therapy is well-documented, there is no consensus on the optimal method for estimating staffing needs in health institutions. This study aims to determine the accurate ratios for the calculation of Speech and Language Therapy staffing for health institutions. A systematic review with a qualitative approach was performed, including published evidence between 2024 and 2006 in PubMed, Web of Science and SciELO databases. The keywords ‘Speech and Language Therapy’, ‘Speech and Language Therapist’, ‘Staff’ and ‘Staffing’ were included. Of 4,837 reviewed documents, seven were selected for analysis. PRISMA guideline was used for the report. Ratios varied from .025 to 2.000 whole-time equivalent professionals per 10 clinical beds, with higher ratios for stroke, neurological conditions, and critical care patients. Extra staffing may be required for special needs patients or complex cases. Weekend therapy improves health outcomes. Seven-day rehabilitation services are recommended, adjusting staffing ratios accordingly. Stroke patients should receive 45 minutes of rehabilitation daily, while critical care patients require consistent and safe therapy, with service requirements subject to local review. Patient attributable time includes case conferences, ward rounds, report writing, and participation in multidisciplinary team activities. In conclusion, the ratios for Speech and Language Therapy staffing vary between according to pathologies. It is suggested to calculate the staffing according to patients’ pathologies. Also, to develop a unique formula for outpatients, and to update the ratios, as the allied rehabilitation professionals have been increasingly included in multidisciplinary teams.
Speech-Language Therapist Staffing for the Rehabilitation of Adult and Paediatric In/Outpatients in Chilean Public Hospitals
(2025) Rosales Lillo, Felipe Gonzalo; Castro Abarca, Patricia; Villalón Barrionuevo, Antonia; Aguilera Soto, Haranni Antonella; Bravo Andrade, Teresita
Introduction. Speech and language therapists are key in health teams; health insti-tutions must have enough staff for quality care.Objective. To determine the professional provision of speech and language therapy staffing required for in-and-outpatient care of adult and paediatric patients in public hospitals of the Chilean healthcare network.Method. An observational, descriptive, cross-sectional study was carried out, which included clinical beds of Chilean public hospitals. The calculation was performed ac-cording to the Chilean Ministry of Health guidance for estimating the rehabilitation human resources required for in-and-outpatient care, according to the number and type of clinical beds (basic, medium and critical care) available in each public health institutions. Results. 189 hospitals were included, with 23,677 clinical beds analysed. 81% and 19% of them were for adult and paediatric patient care respectively. 28,950 hours per week of speech and language therapy staffing in public hospitals for in-and-out-patient care is required: 85% for adult patients and 15% for paediatric ones. The Magallanes and Ñuble Regions require the highest percentage of hours —92 and 91%, respectively— for adult patients. The Tarapacá, Metropolitana, and Aysén re-gions need 18% of hours for paediatric patients. The Metropolitana Region needs almost 35% of the total national hours, followed by Biobío (10.29%) and Valparaíso (9.87%) regions. Revista de Investigación e Innovación en Ciencias de la Salud · Volume 7, Number 2, 2025 · https://doi.org/10.46634/riics.4262Speech therapists for Chilean hospitalsRosales Lillo et al.Conclusion. Hospitals should review these results to ensure a correct planning of professionals, and consider the proposal for non-working days for the care of hospi-talised patients, to optimise their clinical results and quality of life, and the manage-ment results of each centre. It is necessary to continue generating evidence in favour of patient care, resource optimisation, and the well-being of clinical professionals
Omega-3 Fatty Acids and Exercise in Obesity Management: Independent and Synergistic Benefits in Metabolism and Knowledge Gaps
(2025) Sandoval, Viviana; Vergara-Nieto, Alvaro; Bentes, Amanda; Silva, Saulo; Núñez, Carolina; Martínez-Huenchullán, Sergio
Obesity is a significant global health issue, profoundly affecting metabolic and cardiovascular health and other related chronic conditions. In Chile, the prevalence of obesity is among the highest within the Organisation for Economic Cooperation and Development (OECD) countries, highlighting a critical public health challenge. This narrative review examines current evidence on the independent and potential synergistic roles of omega-3 fatty acids and exercise in managing obesity-related metabolic dysfunction. Omega-3 fatty acids, particularly eicosapentaenoic acid (EPA), have been shown to lower triglyceride levels, enhance lipid metabolism, and modulate inflammation via pathways involving peroxisome proliferator-activated receptors (PPARs) and sterol regulatory element-binding protein-1c (SREBP-1c). Exercise interventions, such as moderate-intensity continuous training (MICT) and high-intensity interval training (HIIT), provide distinct yet complementary metabolic benefits. Specifically, MICT improves body fat distribution and mitochondrial efficiency, whereas HIIT has notable effects on metabolic adaptability and insulin signaling. Additionally, emerging evidence points toward a potential role of the kinin-kallikrein system, particularly kallikrein 7 (KLK7), in obesity-associated insulin resistance. Despite these promising findings, several knowledge gaps persist regarding optimal dosing, intervention timing, population-specific effects, and the exact mechanisms behind the potential synergistic interactions between omega-3 supplementation and structured exercise. This review emphasizes the importance of conducting further research, particularly controlled clinical trials, to clarify these combined interventions’ effectiveness and establish targeted therapeutic strategies tailored to individual metabolic profiles.
Nivel de estrés percibido y su relación con los hábitos alimentarios en adultos chilenos durante la pandemia de COVID-19
(2024) Sánchez, María Francisca; Rojas, Katalina; Arévalo, Carola; Butikofer, Lily; Carías Picón, Diamela
Fundamentos: La pandemia causada por el virus SARS-CoV-2 ha provocado un aumento en los niveles de estrés en la población, el cual se relaciona con cambios en los hábitos alimentarios. El objetivo fue determinar la relación entre el nivel de estrés y los hábitos alimentarios en adultos chilenos durante la pandemia por la COVID-19, en el año 2021. Métodos: estudio observacional descriptivo y transversal. Se aplicó una encuesta autoadministrada que abordó características sociodemográficas, hábitos alimentarios, y la Escala de Estrés Percibido (EPP-10-C) adaptada para el contexto de esta emergencia sanitaria. Resultados: participaron 382 adultos con una edad promedio de 35,02 ± 13,08 años, que en su mayoría mostraron un bajo nivel de estrés, no cumplían con el consumo semanal de pescados, legumbres y lácteos de acuerdo con las Guías Alimentarias Chilenas, con una elevada frecuencia de consumo de alimentos azucarados, fritos, ricos en grasas y de comida rápida y que no realizaban ejercicio físico o la hacían de manera ocasional. Se encontró una mayor frecuencia de consumo de snacks dulces y/o salados entre comidas y de comidas rápidas, y de sedentarismo entre los adultos con alto nivel de estrés, respecto a los que mostraron bajo nivel de estrés. Conclusiones: la mayoría de los chilenos evaluados mostraron un elevado consumo de alimentos no saludables, acompañado de una baja realización de ejercicio físico. Surge la necesidad de implementar políticas que promuevan cambios en el estilo de vida, durante situaciones de confinamiento como la pandemia de COVID-19.
Percepción de cambios en el peso corporal y el estilo de vida de adolescentes chilenos durante la pandemia de la COVID-19
(2024) Anabalón Araneda, Bárbara Daniela; Vera Concha, Michelle Andrea; Araya Fuentes, Ana; Carías Picón, Diamela
Fundamentos: La pandemia de COVID-19, impactó especialmente los hábitos alimentarios y los estilos de vida. El objetivo fue evaluar la percepción de los cambios en el peso corporal y el estilo de vida de adolescentes de la región del Bío Bío durante la pandemia de la COVID-19. Métodos: Estudio descriptivo y transversal en una muestra de adolescentes chilenos. Se utilizó una encuesta que abordó características sociodemográficas, percepción de cambios en el peso corporal, hábitos alimentarios, actividad física, horas de sueño y horas frente a la pantalla durante la pandemia de la COVID-19. Resultados: Participaron 122 adolescentes entre 14 y 18 años, con un 64,8% de mujeres. El 45,0% percibió un aumento en el peso corporal. El 59,0% indicó que la calidad de su alimentación no fue saludable. Un porcentaje importante manifestó un aumento en el consumo de pasteles y dulces, así como de comida basura y bebidas azucaradas, mientras que mantuvo el consumo de frutas, verduras y grasas, y disminuyó el consumo de pescado. La mayoría de los adolescentes informó una disminución en el tiempo dedicado a la actividad física y en las horas de sueño, y, por el contrario, un aumento en la cantidad de horas que pasa frente a las pantallas. Conclusiones: Los resultados muestran cambios negativos en el estilo de vida de los adolescentes durante la pandemia, afectando su alimentación, actividad física y patrones de sueño.
The Lancet Oncology Commission:
(2024) Momodu, Jaleelat I.; Carvajal, Claudia; Pryma, Daniel A.; Ayettey Anie, Hannah; Michalski, Jeff M.; Yom, Sue S.; Pawlicki, Todd; Corn, Benjamin W.
Neural basis of speech and grammar symptoms in non-fluent variant primary progressive aphasia spectrum
(2024) Lorca-Puls, Diego L.; Gajardo-Vidal, Andrea; Mandelli, Maria Luisa; Illán-Gala, Ignacio; Ezzes, Zoe; Wauters, Lisa D.; Battistella, Giovanni; Bogley, Rian; Ratnasiri, Buddhika; Licata, Abigail E.; Battista, Petronilla; García, Adolfo M.; Lead Tee, Boon; Lukic, Sladjana; Boxer, Adam L.; Rosen, Howard J.; Seeley, William W.; Grinberg, Lea T.; Spina, Salvatore; Miller, Bruce L.; Henry, Maya L.; Dronkers, Nina F.; Gorno-Tempini, Maria Luisa
The nonfluent/agrammatic variant of primary progressive aphasia (nfvPPA) is a neurodegenerative syndrome primarily defined by the presence of apraxia of speech (AoS) and/or expressive agrammatism. In addition, many patients exhibit dysarthria and/or receptive agrammatism. This leads to substantial phenotypic variation within the speech-language domain across individuals and time, in terms of both the specific combination of symptoms as well as their severity. How to resolve such phenotypic heterogeneity in nfvPPA is a matter of debate. “Splitting” views propose separate clinical entities: “primary progressive apraxia of speech” (PPAOS) when AoS occurs in the absence of expressive agrammatism, “progressive agrammatic aphasia” (PAA) in the opposite case, and “AOS + PAA” when mixed motor speech and language symptoms are clearly present. While therapeutic interventions typically vary depending on the predominant symptom (e.g., AoS vs expressive agrammatism), the existence of behavioral, anatomical, and pathological overlap across these phenotypes argues against drawing such clear-cut boundaries. In the current study, we contribute to this debate by mapping behavior to brain in a large, prospective cohort of well characterized patients with nfvPPA (n = 104). We sought to advance scientific understanding of nfvPPA and the neural basis of speech-language by uncovering where in the brain the degree of MRI-based atrophy is associated with inter-patient variability in the presence and severity of AoS, dysarthria, expressive agrammatism, or receptive agrammatism. Our cross-sectional examination of brain-behavior relationships revealed three main observations. First, we found that the neural correlates of AoS and expressive agrammatism in nfvPPA lie side by side in the left posterior inferior frontal lobe, explaining their behavioral dissociation/association in previous reports. Second, we identified a “left-right” and “ventral-dorsal” neuroanatomical distinction between AoS versus dysarthria, highlighting (i) that dysarthria, but not AoS, is significantly influenced by tissue loss in right-hemisphere motor-speech regions and (ii) that, within the left hemisphere, dysarthria and AoS map onto dorsally versus ventrally located motor-speech regions, respectively. Third, we confirmed that, within the large-scale grammar network, left frontal tissue loss is preferentially involved in expressive agrammatism and left temporal tissue loss in receptive agrammatism. Our findings thus contribute to define the function and location of the epicenters within the large-scale neural networks vulnerable to neurodegenerative changes in nfvPPA. We propose that nfvPPA be redefined as an umbrella term subsuming a spectrum of speech and/or language phenotypes that are closely linked by the underlying neuroanatomy and neuropathology.
Assessing processing speed and its neural correlates in the three variants of primary progressive aphasia with a non-verbal tablet-based task
(2024) Gajardo-Vidal, Andrea; Maxime Montembeault, Maxime; Lorca-Puls, Diego L.; Licata, Abigail E.; Bogley, Rian; Erlhoff, Sabrina; Ratnasiri, Buddhika; Ezzes, Zoe; Battistella, Giovanni; Tsoy, Elena; Watson Pereira, Christa; DeLeon, Jessica; Lead Tee , Boon; Henry, Maya L.; Miller, Zachary A.; Rankin, Katherine P.; Mandelli, Maria Luisa; Katherine L. Possin, Katherine; Gorno-Tempini, Maria Luisa
Prior research has revealed distinctive patterns of impaired language abilities across the three variants of Primary Progressive Aphasia (PPA): nonfluent/agrammatic (nfvPPA), logopenic (lvPPA) and semantic (svPPA). However, little is known about whether, and to what extent, non-verbal cognitive abilities, such as processing speed, are impacted in PPA patients. This is because neuropsychological tests typically contain linguistic stimuli and require spoken output, being therefore sensitive to verbal deficits in aphasic patients. The aim of this study is to investigate potential differences in processing speed between PPA patients and healthy controls, and among the three PPA variants, using a brief non-verbal tablet-based task (Match) modeled after the WAIS-III digit symbol coding test, and to determine its neural correlates. Here, we compared performance on the Match task between PPA patients (n = 61) and healthy controls (n = 59) and across the three PPA variants. We correlated performance on Match with voxelwise gray and white matter volumes. We found that lvPPA and nfvPPA patients performed significantly worse on Match than healthy controls and svPPA patients. Worse performance on Match across PPA patients was associated with reduced gray matter volume in specific parts of the left middle frontal gyrus, superior parietal lobule, and precuneus, and reduced white matter volume in the left parietal lobe. To conclude, our behavioral findings reveal that processing speed is differentially impacted across the three PPA variants and provide support for the potential clinical utility of a tabled-based task (Match) to assess non-verbal cognition. In addition, our neuroimaging findings confirm the importance of a set of fronto-parietal regions that previous research has associated with processing speed and executive control. Finally, our behavioral and neuroimaging findings combined indicate that differences in processing speed are largely explained by the unequal distribution of atrophy in these fronto-parietal regions across the three PPA variants.
Nuevos horizontes del manejo nutricional clínico en hipotiroidismo
(2024-06) Yañez-Barros, Edson; Santillana-Tobar, Natalia; Hernández-Madrid, Judith; Briones-Suarez, Lautauro; Bórquez-Pérez, Juan; Ramírez-Araya, Luisa Amanda
El hipotiroidismo es una enfermedad endocrina frecuente en la población, que deriva de una disminución de la función de la glándula tiroides y afecta la producción de hormonas tiroideas. Esta patología tiene diversas implicancias para la salud, y su gestión clínica va más allá del tratamiento farmacológico convencional. La nutrición está fuertemente relacionada con la función de la glándula tiroides, sin embargo, no se han propuesto recomendaciones nutricionales sustentadas en la evidencia científica actual. La presente revisión aborda en primera instancia la patogenia del hipotiroidismo, seguido de un abordaje actualizado de nutrientes y alimentos asociados a la función tiroidea.
Adiposidad y perfil lipídico en mujeres posmenopáusicas venezolanas
(2023) Barrios Ospino, Yubire Beatriz; Carías, Diamela; Acosta García, Edgar José; Albornoz González, María Gracia
Durante la menopausia se producen cambios metabólicos que favorecen la ganancia de peso y la obesidad abdominal, lo cual facilita el desarrollo de dislipidemias y aumenta el riesgo cardiovascular. El propósito del estudio fue comparar el perfil lipídico y los índices de riesgo cardiometabólico (IRCM) entre mujeres posmenopáusicas del Municipio Naguanagua, Estado Carabobo, Venezuela, clasificadas de acuerdo con su grado de adiposidad. El estudio fue de corte transversal, descriptivo, en el cual participaron 205 mujeres con una mediana de edad de 56 años. Se evaluaron indicadores de adiposidad: índice de masa corporal (IMC), porcentaje de grasa corporal (PGC), circunferencia de cintura (CC), e índice cintura/talla (ICT); así como el perfil lipídico y los IRCM. Se encontraron altos porcentajes de exceso de peso (80%), exceso de grasa corporal (92%), obesidad abdominal (61%) y riesgo metabólico de acuerdo con el ICT (69%). Las mujeres con obesidad mostraron los valores más bajos de cHDL, y aquellas con grasa muy alta, obesidad abdominal y riesgo metabólico de acuerdo con el ICT, los valores más elevados del índice TG/HDL. Se recomiendan otros estudios en este grupo poblacional para comprender mejor la asociación encontrada entre el grado de adiposidad y las alteraciones en el metabolismo de los lípidos con el fin de tomar acciones preventivas en estos trastornos relacionados con el síndrome metabólico.
A comprehensive health efects assessment of the use of sanitizers and disinfectants during COVID‑19 pandemic: a global survey
(2023) Hashemi, Fallah; Hoepner, Lori; Soleimani Hamidinejad, Farahnaz; Haluza, Daniela; Afrashteh, Sima; Abbasi, Alireza; Omeragić, Elma; Imamović, Belma; Rasheed, Narin A.; Taher, Taqi M. J.; Kurniasari, Fitri; Wazqar, Dhuha Youssef; Apalı, Özge Ceren; Yildirim, Ayca Demir; Zhao, Bo; Kalikyan, Zaruhi; Guo, Cui; Chong Valbuena, Andrea; Mititelu, Magdalena; Martínez Pando, Carolina; Saridi, Maria; Toska, Aikaterini; Lopez Cuba, Magalys; Kwablah Kwadzokpui, Precious; Tadele, Niguse; Nasibova, Tohfa; Harsch, Stefanie; Munkh‑Erdene, Luvsan; Menawi, Wafaa; Evangelou, Efi; Dimova, Antoniya; Marinov, Dimitar; Dimitrova, Teodora; Shalimova, Anna; Fouly, Howieda; Suraya, Anna; Pereira da Silva Faquim, Juliana; Oumayma, Bouadil; Annunziato, Maria Antonieta; Narvaez, Carmen Gloria; Narváez, Carmen Gloria
COVID-19 has affected all aspects of human life so far. From the outset of the pandemic, preventing the spread of COVID-19 through the observance of health protocols, especially the use of sanitizers and disinfectants was given more attention. Despite the effectiveness of disinfection chemicals in controlling and preventing COVID-19, there are critical concerns about their adverse effects on human health. This study aims to assess the health effects of sanitizers and disinfectants on a global scale. A total of 91,056 participants from 154 countries participated in this cross-sectional study. Information on the use of sanitizers and disinfectants and health was collected using an electronic questionnaire, which was translated into 26 languages via web-based platforms. The findings of this study suggest that detergents, alcohol-based substances, and chlorinated compounds emerged as the most prevalent chemical agents compared to other sanitizers and disinfectants examined. Most frequently reported health issues include skin effects and respiratory effects. The Chi-square test showed a significant association between chlorinated compounds (sodium hypochlorite and per-chlorine) with all possible health effects under investigation (p-value <0.001). Examination of risk factors based on multivariate logistic regression analysis showed that alcohols and alcohols-based materials were associated with skin effects (OR, 1.98; 95%CI, 1.87–2.09), per-chlorine was associated with eye effects (OR, 1.83; 95%CI, 1.74–1.93), and highly likely with itching and throat irritation (OR, 2.00; 95%CI, 1.90–2.11). Furthermore, formaldehyde was associated with a higher prevalence of neurological effects (OR, 2.17; 95%CI, 1.92–2.44). Furthermore, formaldehyde was associated with a higher prevalence of neurological effects (OR, 2.17; 95%CI, 1.92–2.44). The use of sodium hypochlorite and per-chlorine also had a high chance of having respiratory effects. The findings of the current study suggest that health authorities need to implement more awareness programs about the side effects of using sanitizers and disinfectants during viral epidemics especially when they are used or overused.
Degeneracy in the neurological model of auditory speech repetition
(2023) Sajid, Noor; Gajardo-Vidal, Andrea; Ekert, Justyna O.; Lorca-Puls, Diego L.; Hope , Thomas M. H.; Green, David W.; Friston, Karl J.; Price, Cathy J.
Both classic and contemporary models of auditory word repetition involve at least four left hemisphere regions: primary auditory cortex for processing sounds; pSTS (within Wernicke’s area) for processing auditory images of speech; pOp (within Broca’s area) for processing motor images of speech; and primary motor cortex for overt speech articulation. Previous functional-MRI (fMRI) studies confirm that auditory repetition activates these regions, in addition to many others. Crucially, however, contemporary models do not specify how regions interact and drive each other during auditory repetition. Here, we used dynamic causal modelling, to test the functional interplay among the four core brain regions during single auditory word and pseudoword repetition. Our analysis is grounded in the principle of degeneracy—i.e., many-to-one structure-function relationships—where multiple neural pathways can execute the same function. Contrary to expectation, we found that, for both word and pseudoword repetition, (i) the effective connectivity between pSTS and pOp was predominantly bidirectional and inhibitory; (ii) activity in the motor cortex could be driven by either pSTS or pOp; and (iii) the latter varied both within and between individuals. These results suggest that different neural pathways can support auditory speech repetition. This degeneracy may explain resilience to functional loss after brain damage.
Network anatomy in logopenic variant of primary progressive aphasia
(2022) Mandelli, Maria Luisa; Lorca-Puls, Diego L.; Lukic, Sladjana; Montembeault, Maxime; Gajardo-Vidal, Andrea; Licata, Abigail; Scheffler, Aaron; Battistella, Giovanni; Grasso, Stephanie M.; Bogley, Rian; Ratnasiri, Buddhika M.; Joie, Renaud La; Mundada, Nidhi S.; Europa, Eduardo; Rabinovici, Gil; Miller, Bruce L.; Leon , Jessica De; Henry, Maya L.; Miller, Zachary; Gorno-Tempini, Maria Luisa
The logopenic variant of primary progressive aphasia (lvPPA) is a neurodegenerative syndrome characterized linguistically by gradual loss of repetition and naming skills resulting from left posterior temporal and inferior parietal atrophy. Here, we sought to identify which specific cortical loci are initially targeted by the disease (epicenters) and investigate whether atrophy spreads through predetermined networks. First, we used cross-sectional structural MRI data from individuals with lvPPA to define putative disease epicenters using a surface-based approach paired with an anatomically fine-grained parcellation of the cortical surface (i.e., HCP-MMP1.0 atlas). Second, we combined cross-sectional functional MRI data from healthy controls and longitudinal structural MRI data from individuals with lvPPA to derive the epicenter-seeded resting-state networks most relevant to lvPPA symptomatology and ascertain whether functional connectivity in these networks predicts longitudinal atrophy spread in lvPPA. Our results show that two partially distinct brain networks anchored to the left anterior angular and posterior superior temporal gyri epicenters were preferentially associated with sentence repetition and naming skills in lvPPA. Critically, the strength of connectivity within these two networks in the neurologically-intact brain significantly predicted longitudinal atrophy progression in lvPPA. Taken together, our findings indicate that atrophy progression in lvPPA, starting from inferior parietal and temporoparietal junction regions, predominantly follows at least two partially nonoverlapping pathways, which may influence the heterogeneity in clinical presentation and prognosis.
Enhanced left superior parietal activation during successful speech production in patients with left dorsal striatal damage and error-prone neurotypical participants
(2023) Geva, Sharon; Schneider, Letitia M.; Khan, Shamima; Lorca-Puls, Diego L.; Gajardo-Vidal, Andrea; PLORAS team; Hope, Thomas M. H.; Green, David W.; Price, Cathy J.
Functional imaging studies of neurotypical adults report activation in the left putamen during speech production. The current study asked how stroke survivors with left putamen damage are able to produce correct spoken responses during a range of speech production tasks. Using functional magnetic resonance imaging, activation during correct speech production responses was assessed in 5 stroke patients with circumscribed left dorsal striatal lesions, 66 stroke patient controls who did not have focal left dorsal striatal lesions, and 54 neurotypical adults. As a group, patients with left dorsal striatal damage (our patients of interest) showed higher activation than neurotypical controls in the left superior parietal cortex during successful speech production. This effect was not specific to patients with left dorsal striatal lesions as we observed enhanced activation in the same region in some patient controls and also in more error-prone neurotypical participants. Our results strongly suggest that enhanced left superior parietal activation supports speech production in diverse challenging circumstances, including those caused by stroke damage. They add to a growing body of literature indicating how upregulation within undamaged parts of the neural systems already recruited by neurotypical adults contributes to recovery after stroke.
The effect of right temporal lobe gliomas on left and right hemisphere neural processing during speech perception and production tasks
(2022) Yamamoto, Adam Kenji; Gajardo-Vidal, Andrea; Sanjuán, Ana; Pope, Rebecca; Parker Jones, Oiwi; Hope, Thomas M. H.; Prejawa, Susan; Oberhuber, Marion; Mancini, Laura; Ekert, Justyna O.; Creasey, Megan; Yousry , Tarek A.; Green, David W.; Price, Cathy J.
Using fMRI, we investigated how right temporal lobe gliomas affecting the posterior superior temporal sulcus alter neural processing observed during speech perception and production tasks. Behavioural language testing showed that three pre-operative neurosurgical patients with grade 2, grade 3 or grade 4 tumours had the same pattern of mild language impairment in the domains of object naming and written word comprehension. When matching heard words for semantic relatedness (a speech perception task), these patients showed under-activation in the tumour infiltrated right superior temporal lobe compared to 61 neurotypical participants and 16 patients with tumours that preserved the right postero-superior temporal lobe, with enhanced activation within the (tumour-free) contralateral left superior temporal lobe. In contrast, when correctly naming objects (a speech production task), the patients with right postero-superior temporal lobe tumours showed higher activation than both control groups in the same right postero-superior temporal lobe region that was under-activated during auditory semantic matching. The task dependent pattern of under-activation during the auditory speech task and over-activation during object naming was also observed in eight stroke patients with right hemisphere infarcts that affected the right postero-superior temporal lobe compared to eight stroke patients with right hemisphere infarcts that spared it. These task-specific and site-specific cross-pathology effects highlight the importance of the right temporal lobe for language processing and motivate further study of how right temporal lobe tumours affect language performance and neural reorganisation. These findings may have important implications for surgical management of these patients, as knowledge of the regions showing functional reorganisation may help to avoid their inadvertent damage during neurosurgery.
Factores pronósticos que influyen en los resultados de tratamiento de la periimplantitis: Una revisión sistemática
(2023) Sánchez, Camila; Asenjo, Claudia; Jofré, Jorge
Objetivo: Esta revisión sistemática tiene como objetivo identificar los factores pronósticos y/o determinantes del éxito del tratamiento de la periimplantitis. Materiales y métodos: Se realizó una búsqueda bibliográfica estructurada y exhaustiva para identificar referencias relevantes en las bases de datos MEDLINE (PubMed), Scielo y Springerlik. La estrategia de búsqueda se realizó combinando los términos periimplantitis con factores pronósticos y / o determinantes del éxito del tratamiento como MeSH y texto libre combinando con los operadores booleanos AND y OR. Se utilizó la clasificación de SIGN (Scottish Intercollegiate Guidelines Network) para analizar el nivel de evidencia. Resultados: De los 239 artículos revisados, 17 cumplieron con los criterios de selección para el análisis cualitativo de la evidencia. Conclusiones: El tipo de implante (macro y microgeometría) y la morfología del defecto, los cuales dificulta el acceso a las superficies contaminadas, son factores que influyen en el resultado del tratamiento de la periimplantitis. No hay evidencia sobre el método de descontaminación más eficaz. Las condiciones generales como la diabetes mellitus y la presencia de enfermedad periodontal activa afectan el resultado del tratamiento, así como la frecuencia de un programa de mantención de higiene profesional postquirúrgica, la cual mejora la sobrevida del implante. Objective: This systematic review aimed at identifying prognostic factors influencing periimplantitis treatment outcomes. Materials and methods: A structured and comprehensive literature search was performed to identify relevant references from MEDLINE (PubMed), Scielo and Springerlik databases. The search strategy was carried out combining the search terms periimplantitis with prognostic factors and/or determinants of treatment success as MeSH and free text combining with the boolean logical operators AND and OR. The SIGN (Scottish Intercollegiate Guidelines Network) was used to analyze the level of evidence. Results: From 239 articles reviewed, 18 fulfilled the selection criteria for the qualitative analysis of the evidence. Conclusions: The type of implant (macro and microgeometry) and the defect morphology, which make access to contaminated surfaces difficult, are factors that influence the outcome of peri-implantitis treatment. There is no evidence on the most effective decontamination method. General conditions such as diabetes mellitus and the presence of active periodontal disease affect the outcome of the treatment. as Also, the frequency of a post-surgical professional hygiene maintenance program improves the dental implant survival post-treatment
Mental training in dentistry: A scoping review
(2023) Jofré, Jorge; Michel, Manuel; Quintana, Paula; Fuentes, Jeannette; Conrady, Yuri; Valenzuela, Daniela; Asenjo, Claudia
Introduction: Clinical motor skills are essential to train dental students. There is evidence that imagery serves to acquire and improve motor skills, but there is scarce information on its application in dental education. In order to broadly map the available evidence and to detect knowledge gaps in the mental training used to develop motor skills in dentistry, a scoping review was conducted. Materials and methods: A structured search was conducted to identify relevant references from the Web of Science, Scopus and MEDLINE/PubMed databases for studies addressing mental training methods applied to develop motor skills in dentistry. Results: A total of 758 articles were screened and four were selected, all of which were randomized clinical trials. Three studies investigated the effectiveness of visual imagery, and one investigated kinesthetic imagery. The research theme identified was motor skill acquisition. Conclusion: The reviewed studies indicate the usefulness of mental training for skill acquisition in dentistry. To improve the generalizability of the results, further research with standardized mental training on motor skills in dentistry is needed.
Remodelación de papila gingival interdental con ácido hialurónico. Una solución estética.
(2019) Iribarra-Leigh, Javiera; Soto-Royo, María; Rubio-Muñoz, María; Torres-Castillo, Oscar; Baldeig, Loreta; Gómez-Morales, Andrés
El objetivo de este trabajo es evaluar el efecto de remodelación y relleno mediante aplicación de ácido hialurónico en papilas gingivales de sector estético con defectos de triángulo negro en un paciente tratado periodontalmente. Se inyectaron 0.15 ml de gel de ácido hialurónico dividido en 3 sesiones. Clínicamente se observó aumento de volumen y aumento de dimensiones verticales y horizontales en las papilas, mejorando así los parámetros estéticos. Como conclusión la aplicación de ácido hialurónico es efectiva en la remodelación y relleno en pérdidas de papila clase I de Nordland y Tarnow.
Generalizing post-stroke prognoses from research data to clinical data
(2019) Loughnan, Robert; Lorca, Diego; Gajardo-Vidal, Andrea; Espejo, Valeria; Gillebert, Céline; Mantini, Dante; Price, Cathy; Hope, Thomas
Around a third of stroke survivors suffer from acquired language disorders (aphasia), but current medicine cannot predict whether or when they might recover. Prognostic research in this area increasingly draws on datasets associating structural brain imaging data with outcome scores for ever-larger samples of stroke patients. The aim is to learn brain-behaviour trends from these data, and generalize those trends to predict outcomes for new patients. The practical significance of this work depends on the expected breadth of that generalization. Here, we show that these models can generalize across countries and native languages (from British patients tested in English to Chilean patients tested in Spanish), across neuroimaging technology (from MRI to CT), and from scans collected months or years after stroke for research purposes, to scans collected days or weeks after stroke for clinical purposes. Our results suggest one important confound, in attempting to generalize from research data to clinical data, is the delay between scan acquisition and language assessment. This delay is typically small for research data, where scans and assessments are often acquired contemporaneously. But the most natural, clinical application of these predictions will employ acute prognostic factors to predict much longer-term outcomes. We mitigated this confound by projecting the clinical patients' lesions from the time when their scans were acquired, to the time when their language abilities were assessed; with this projection in place, there was strong evidence that prognoses derived from research data generalized equally well to research and clinical data. These results encourage attention to the confounding role that lesion growth may play in other types of lesion-symptom analysis.

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