Pacientes con trastorno del espectro autista en odontopediatría / Patients with autism spectrum disorder in pediatric dentistry

El trastorno del espectro autista engloba una serie de trastornos del desarrollo cerebral que pueden causar problemas importantes a nivel de socialización, comunicación y conducta. La Asociación Psiquiátrica Norteamericana los clasifica en: trastorno autista, trastorno de Asperger, trastorno desintegrativo infantil, trastorno generalizado del desarrollo no especificado y trastorno de Rett. La etiología es multifactorial; con interacción de factores genéticos y ambientales. Actualmente se desconocen cuáles son y cómo interactúan los posibles elementos ambientales sobre la susceptibilidad genética. Los trastornos del espectro autista no son fáciles de diagnosticar; y para ello se precisa la evaluación de la conducta y el desarrollo del niño. Por lo general, se detectan en torno a los 18 meses, siendo el sexo masculino el afectado en mayor proporción. La detección temprana es importante ya que los resultados de la terapia precoz proporcionan una mayor y más rápida mejoría que una intervención tardía. Estos trastornos, por sí mismos, no comprenden características orales diferentes a las encontradas en pacientes sin esta patología, no obstante, el riesgo aumenta debido a la capacidad limitada de comprensión así como de asumir responsabilidades en la salud oral, lo que puede aumentar severamente el índice de caries y enfermedad periodontal. Además, se ha encontrado una mayor incidencia de hábitos parafuncionales y autolesiones. El manejo odontológico de estos pacientes es complejo y demanda de una adecuada interacción entre el paciente y el odontólogo. Debido a que son pacientes que requieren de una atención y seguimiento especializado, es imprescindible la formación adecuada de los profesionales (AU)

The Autism Spectrum Disorders cover a range of developmental brain disorders that can cause significant problems at the level of socialization, communication and behavior. The American Psychiatric Association classifies them as: autistic disorder, Asperger's syndrome, childhood disintegrative disorder, pervasive developmental disorder not specified and Rett’s syndrome. The etiology is multifactorial with interaction of genetic and environmental factors. Currently, it is unknown which they are and how they interact with potential environmental elements on genetic susceptibility. The autism spectrum disorders are difficult to diagnose; and for this, the behavioral assessment and development of the child is required. They are usually detected around 18 months and males are being affected to a greater extent. Early detection is important because the results of early therapy provide greater and more rapid improvement than later intervention. These disorders, by themselves, do not have different oral characteristics to those found in patients without this pathology, however, the risk increases due to the limited capacity of understanding and assuming responsibilities in oral health, which can severely heighten index of caries and periodontal disease. Moreover, a higher incidence of parafunctional habits and self-harm have been found. The dental management of these patients is complex and demand proper interaction between the patient and the dentist. Because they are patients who require specialized care and monitoring is essential that professionals have a proper training (AU)

Quantification of polyphenols and flavonoid content and evaluation of anti-inflammatory and antimicrobial activities of Stenocereus stellatus extracts.

The hexanic, ethyl acetate and methanolic extracts from branches of Stenocereus stellatus were tested in both the 12-O-tetradecanoylphorbol-13-acetate (TPA) - induced ear oedema model and antimicrobial activity assay. The % of oedema inhibition, the Minimum Inhibitory Concentration (MIC), as well as the polyphenolic and flavonoid content were determined. Also, extracts were analysed by gas chromatography-mass spectrometry (GC-MS). In TPA model, the three extracts showed moderate oedema inhibition. In the antimicrobial activity assay, methanolic extract shows better MIC against all strains. The lowest MICs were for Candida albicans (31 µg/mL) and Rhizopus sp. (15 µg/mL). Also, 50.78 mg eq. of gallic acid/g extract of polyphenol and 115.12 mg eq. of catequine/g extract of flavonoids content were founded in ethyl acetate extract. In the chromatographic analysis, ß-sitosterol, ß-amyrine, betulin and some other molecules were identified. The results show that S. stellatus possess antimicrobial activities against some fungus species.

Espondilodiscitis tuberculosa: uso de los exámenes complementarios con una nueva perspectiva: A propósito de dos casos clínicos y revisión de la literatura / Tuberculous spondylodiscitis: use of complementary tests with a new perspective: A report of two cases and review of literature

Introducción. La tuberculosis constituye actualmente un grave problema sanitario. Es una enfermedad reemergente, su principal factor de riesgo es la infección por el virus de la inmunodeficiencia humana (VIH), siendo las formas extrapulmonares mucho más frecuentes en este grupo respecto a la población general. La espondilodiscitis tuberculosa (ET) representa 3% del total de las infecciones tuberculosas y 35% de las formas extrapulmonares. Su clínica es insidiosa, de diagnóstico complejo, la imagenología y microbiología son imprescindibles para un correcto diagnóstico. Todo esto suele determinar un retraso importante en el manejo, con consecuencias directas en el pronóstico del paciente. Material y método. Se presentan dos casos de ET asistidos en un Hospital público uruguayo (2012-2013), en pacientes con inmunocompromiso severo y noción de contacto epidemiológico en uno de ellos, diagnosticados tras la sospecha clínico-imagenológica y confirmación microbiológica por punción-aspiración bajo tomografía computarizada (TC). Resultados. Se inició el tratamiento con una latencia superior a tres meses. Discusión y Conclusiones. Las técnicas de biología molecular e inmunología constituyen hoy día una herramienta de gran valor para el diagnóstico precoz de esta enfermedad, permitiendo abreviar los tiempos en el inicio del tratamiento y reduciendo la tasa de complicaciones asociadas a ella.

Introduction. Tuberculosis (TB) constitutes a serious health problem nowadays. It is a reemerging disease whose main risk factor is the human immunodeficiency virus (HIV) infection, in which extrapulmonary forms are much more frequent than in general population. Tuberculous spondylodiscitis (TS) represents 3% of all TB infections and 35% of extrapulmonary forms. It has an insidious clinical presentation; the diagnosis is difficult requiring imagenologic and microbiologic technics. These characteristics result in a significant diagnosis delay which impacts on patient prognosis. Materials and methods. We present two cases of TS admitted to a public hospital in Uruguay (2012-2013) in immunocompromised patients and with epidemiological notion of contact in one of them. Results. The diagnosis was done after clinical and radiological suspicion; needle aspiration guided by computed tomography was performed. The treatment was instituted with a latency exceeding three months. Discussion and conclusions. The techniques of molecular biology and immunology are now a valuable tool for early diagnosis of this disease, shortening the initiation of treatment and reducing the rate of complications associated with it.

Consequences of cavity size and chemical environment on the adsorption properties of isoreticular metal-organic frameworks: an inverse gas chromatography study.

The role of the structure of three isoreticular metal-organic frameworks (IRMOFs) on their adsorption behavior has been studied in this work, selecting different kinds of volatile organic compounds (VOCs) as adsorbates (alkanes, alkenes, cycloalkanes, aromatics and chlorinated). For this purpose, three samples (IRMOF-1, IRMOF-8 and IRMOF-10) with cubic structure and without functionalities on the organic linkers were synthesized. Adsorption capacities at infinite dilution were derived from the adsorption isotherms, whereas thermodynamic properties have been determined from chromatographic retention volume. The capacity and the strength of adsorption were strongly influenced by the adsorbate size. This effect is especially relevant for n-alkanes adsorption, indicating the key role of the cavity size on this phenomenon, and hence the importance of the IRMOF structural properties. A different behavior has been observed for the polar compounds, where an enhancement on the specificity of the adsorption with the π-electron rich regions was observed. This fact suggests the specific interaction of these molecules with the organic linkers of the IRMOFs.

Mapping geosites for geoheritage management: a methodological proposal for the regional park of Picos de Europa (León, Spain).

Mapping is a basic requirement for land use management, as effective protection of nature requires a clear delimitation of the sites involved. Additionally, mapping has other benefits for the transfer of information, as long as it is a comprehensible way of information exchange. The knowledge of geoheritage (geological heritage) and how it can be incorporated into the management of natural areas is an emerging topic. In this paper, a methodology that can be used to map geoheritage is proposed through the example of the Regional Park of Picos de Europa (Spain). Cartography is designed to be used as a tool for both prescriptive geoheritage management and land use planning processes in the protected area. The current examples of mapping consist of two groups of maps: (1) basic descriptive maps, where geosites are represented and which offer an overview of the geoheritage in the territory and (2) applied derived maps, which use the previous base cartography but also implement specific queries for management. Information codified in the derived maps may be diverse, ranging from the geosite degradation risk to the most adequate geosite use. The designed maps also achieve an important aim: They are easily interpreted and, therefore, might be used by many different professionals involved in environmental management.

Experiencia de la clínica de traqueostomía del Hospital del Niños Doutor Carlos Sáenz Herrera, enero 2003-julio 2007 / Experience of the tracheostomy clinic of the national children Hospital Nacional de Niños Doutor Carlos Sáenz Herrera, January 2003 to July 2007

La traqueostomía ha sido realizada en un grupo grande de pacientes pediátricos, pero no hay estudios nacionales publicados. El objetivo de esta investigación es describir las características epidemiológicas y clínicas de la población traqueostomizada, en el periodo de estudio, para mejorar, con base en los hallazgos, las pautas generales de manejo. Materiales y métodos: Se efectuó una revisión retrospectiva de la población traqueostomizada desde 2003 hasta el primer semestre de 2007, para cuantificar la realización de la traqueostomías, historial de hospitalizaciones, uso de tratamiento profiláctico, historial de decanulaciones, decanulaciones fallidas, causa de muerte y clasificación técnica de la población atendida en la Clínica de Traqueostomía del Hospital Nacional de Niños "Dr. Carlos Sáenz Herrera". Se incluyeron 50 casos que acudieron al menos a una consulta durante el periodo de estudio, y se recopilaron los datos de edad, sexo, causa de realización de traqueostomía, complicaciones post traqueostomía, gérmenes causales de infección local, tratamiento, patologías asociadas, costos del equipo y materiales para el egreso. Resultados: En promedio se realizaron 28 traqueostomías anuales. El grupo etario al que se colocaron más traqueostomías fue de 1 a 3 años, con predominio en el sexo masculino (M: F,11:6); un 36 por ciento se efectuó a causa de parálisis cerebral infantil; se decanuló al 33 por ciento de los pacientes; hubo un 15 por ciento de decanulaciones fallidas. La mortalidad ocurrió en un 20 por ciento de los pacientes, por causas no relacionadas con la traqueostomía. El germen más frecuente causante de infección fue Pseudomona Aureoginosa (54 por ciento). El 22 por ciento de los pacientes con cultivos positivos utilizaron antibióticos profilácticos. Un 16 por ciento de los pacientes fue hospitalizado por problemas asociados con la traqueostomía...

The tracheostomy was performed in a large group of pediatric patients, but nopublished studies. The objective of this research is to describe the epidemiological and clinicalcharacteristics of the population traqueostomized during the study period, to improve based on the findings, the general pattern of management. Materials and methods: A retrospective review of the population traqueostomized since 2003to the first half of 2007 to quantify the performance of the tracheostomy, history of hospitalizations, use of prophylactic treatment, history of decanulations, decanulations failures, cause of death and the technical classification of the population attending the clinic of tracheostomy. We included 50 patients who attended at least one consultation during the study period and data were collected: age, sex, cause of realization of a tracheostomy, tracheostomy complications, germs that cause local infection, treatment, associated diseases, equipment costs and materials for release. Results: On average 28 tracheotomy were performed per year. The group that is ethereal tracheostomy was placed over 1 to 3 years, with predominance in males (M: F, 11:6), 36% for cerebral palsy child; 33% of patients are decanulation, there were 15% decanulations failures. Mortality occurred in 20% of patients, for reasons unrelated to the tracheostomy. The most common germ causing infection was Pseudomona Aureoginosa (54%); 22% of patients with positive cultures using prophylactic antibiotics; 16% of patients hospitalized for problems associated with tracheostomy. In 88% of cases the principal caregiver is the mother of which 72% were married, 56% had incomplete primary. The cost of equipment and materials necessary for the discharge from the hospital and home care was very high. Conclusions: The tracheostomy is a procedure common in pediatric practice in a specialized hospital, more and more useful for the handling of the complicated child that requires...

El discurso médico sobre las matronas a mediados del siglo XX / Medical discuss about midwives on the half of century XX

Objetivo. Contribuir a la historia más reciente de la profesión de matrona a través de los textos escritos por médicos. Métodos. Análisis cualitativo, histórico, de contenido y de discurso, a través de fuentes secundarias escritas hace más de medio siglo. Las fuentes analizadas son ocho artículos escritos por médicos en la revista Matronas de la Escuela Oficial de Matronas de la Casa de Salud de Santa Cristina de Madrid (España). Resultados. El denominador común de los artículos analizados es inculcar a las matronas las competencias y habilidades físicas y morales que deben tener, justificado en lo importante de la práctica de su profesión, pero subyace un discurso de adoctrinamiento para la sumisión del colectivo de matronas. Conclusiones. En el periodo estudiado las matronas estaban sometidas al control y jerarquía de género en favor del prestigio de los médicos. Como vehículo de adoctrinamiento, entre otros, utilizaron las revistas profesionales de matronas. Estas perdieron espacios de poder y control sobre su profesión con relación a épocas anteriores en las que tuvieron gran autonomía. El régimen político, la moral católica y la visión androcéntrica de los años centrales del siglo XX, ejercieron como elementos negativos de los intereses de un colectivo profesionalizado pero femenino (AU)

Objective. To contribute to the most recent history of midwife profession, analysing documents written by medics. Methods. Qualitative analysis of content and discuss, historic, using secondary bibliography fonts written most than medium century ago. The analysed bibliography is eight articles written by medics and published in Matronas review (this were the official review of the Midwives Official School of Health House of Santa Cristina in Madrid-Spain). Results. The common denominator of analysed articles is instruct to midwives about the physical and morals competences and abilities that they must have; that is based in the importance that has the practice in midwife profession, however it appears subjacent a doctrinal discuss in order to the submission of midwives collective. Conclusions. In the studied period the midwives were submitted to the hierarchy and control of gender, in favour of medical prestige. Midwives professionals reviews were utilised as a doctrinal vehicle, between others instruments. Midwifes lost the control and spaces of power in their profession, related with previous times when they had a great autonomy. The politic regimen, the catholic moral and the andocentric view during the half of XX century, implied negatives elements in concernments of a professionalized collective, however, a female collective (AU)

Inventario etnográfico de las parteras de Sierra Mágina. Aproximación a su relación con las Matronas / Ethnographic inventory of the traditional midwives of mountain mágina: approach to their relationship with the titled midwives

Introducción. Los cuidados a las mujeres durante el parto han sido tradicionalmente prestados por mujeres. La partera tradicional ha jugado un papel decisivo en la asistencia al nacimiento en las comunidades donde vivieron en tanto que se producía la institucionalización de las profesiones sanitarias. Pretendemos por tanto, visibilizar la identidad de unas mujeres de una comarca concreta, Sierra Mágina (Jaén) y la relación que mantuvieron con matronas tituladas contribuyendo a la historia de las gestoras del nacimiento desde la categoría de análisis de género. Participantes y método. Se trata de un microanálisis realizado entre los meses de Enero y Agosto de 2004 con técnicas de investigación etnográfica. El ámbito de estudio es la comarca de Sierra Mágina y el objeto de estudio las parteras tradicionales. Resultados. Hemos rescatado de la memoria colectiva y de las propias protagonistas los nombres o apodos de 41 parteras que ejercieron en Sierra Mágina desde principio hasta mediados del siglo XX. Conclusiones. En Mágina ha habido un gran número de parteras sin formación académica que han prestado sus servicios a la comunidad en la primera mitad del siglo XX. Hubo variedad de relaciones con las matronas, influenciada por diversos factores

Introduction. The cares to the women during the childbirth have been traditionally borrowed for women. The traditional midwives have played a decisive paper in the attendance to the birth in the communities where they lived as long as the installation of the sanitary professions. We seek therefore, to take out to the light the identity of a women of a concrete district, Mountain Mágina (Jaén) and the relationship that they maintained with titled midwives contributing to the history of the agents of the birth from the category of gender analysis. Method. It’s a microanalysis carried out between the months of January and August of 2004 with technical of ethnographic research. The study environment is the district of Mágina and the study object the traditional midwives. Results. We have rescued of the collective memory and of the own main characters the names and/or nicknames of 41 midwives that They exercised in Mountain Mágina from principle until half-filled of the XX century. Conclusions. In Mágina there has been a great number of traditional midwives without academic formation that they have lent their services to the community in the first half of the XX century. There was variety of relationships with the titled midwives, influenced by diverse factors

Cystic fibrosis mutations in Costa Rica.

Using polymerase chain reaction amplification of DNA in dried blood spots and a nonisotopic reverse dot blot hybridization method, we performed molecular genetic analysis for 6 and for 16 of the most common mutations of the cystic fibrosis transmembrane conductance regulator gene (CFTR) in 24 unrelated Costa Rican individuals with cystic fibrosis (CF). While many countries and ethnic groups have been surveyed for CF mutations since the cloning of CFTR, Costa Rica has not heretofore been studied. Moreover, Costa Rica represents an especially intriguing population because of its mixed European-African-Amerindian origins and the existence of a detailed historical record of the founding Spanish families. Thus, such a study may reveal not only the population frequencies of various mutant alleles in this country, but also something about their geographic migrations and ethnic founder effects. The most common CF mutation in Caucasians, deltaF508, was found in only 11 (23%) of the CF chromosomes studied, while the G542X mutation, relatively rare in the general population but more common in southern Europe, was observed in 12 (25%). None of the other mutations tested was found in any of the subjects. We failed to detect the second mutant allele in 17 subjects and could not detect either allele in 4 subjects. The high prevalence of the G542X mutation in our cohort, which exceeds that of both the general Caucasian population and the American Hispanic population, reflects the strong genetic influence of the original Spanish founding families of Costa Rica. These results highlight important differences in Costa Rican CF genotypes as compared both to other North American and European populations and to American Hispanics, raising important implications about isolated founder effects and strategies for population screening in that country.