Synthesis, chemical and biochemical characterization of Lu2O3-iPSMA nanoparticles activated by neutron irradiation.

Among the nanomaterials, rare sesquioxides (lanthanide oxides such as Lu2O3) are of interest due to their adequate thermal conductivity, excellent chemical stability, and high light output. The prostate-specific membrane antigen (PSMA) is an integral multifunctional protein overexpressed in various types of cancer cells. The radiolabeled PSMA inhibitor peptides (iPSMA) have demonstrated their usefulness as specific probes in the treatment and detection of a wide variety of neoplasms, mainly due to their high in vivo recognition by the PSMA protein. The objective of this research was to synthesize Lu2O3-iPSMA nanoparticles (NPs) and characterize their physicochemical properties before and after neutron activation, as well as to assess their biodistribution profile and in vitro potential to target cells overexpressing PSMA. The Lu2O3 NPs were synthesized by the precipitation-calcination method and conjugated to the iPSMA peptide using DOTA (1,4,7,10-tetraazocyclodecane-N,N',N″,N‴-tetraacetic acid) as a linking agent. Results of the physicochemical characterization by FT-IR and UV-Vis spectroscopies, SEM, TEM, DLS, HRTEM, SAED, DSC-TGA, and X-ray diffraction indicated the formation of Lu2O3-iPSMA NPs (diameter of 29.98 ± 9.07 nm), which were not affected in their physicochemical properties after neutron activation. 177Lu2O3-iPSMA NPs showed high affinity (Kd = 5.7 ± 1.9 nM) for the PSMA protein, evaluated by the saturation assay on HepG2 hepatocellular carcinoma cells (PSMA-positive). The biodistribution profile of the nanosystem in healthy mice showed the main uptake in the liver. After irradiation, radioactive Lu2O3-iPSMA NPs exhibited radioluminescent properties, making the in vivo acquisition of their biodistribution, via optical imaging, possible. The results obtained from this research validate the execution of additional preclinical studies with the objective of evaluating the potential of the 177Lu2O3-iPSMA NPs for the targeted radiotherapy and in vivo imaging of tumors overexpressing the PSMA protein.

Cerebral Hemodynamics Patterns by Transcranial Doppler in Patients With Acute Liver Failure.

INTRODUCTION: About half of patients with acute liver failure (ALF) show clinical signs of cerebral edema and intracranial hypertension. Neuroimaging diagnostics and electroencephalography have poor correlation with intracranial pressure measurement. OBJECTIVE: The objective of this study was to characterize the cerebral hemodynamics patterns with transcranial Doppler (TCD) sonography in patients with ALF. METHOD: We studied 21 patients diagnosed with ALF, admitted to the intensive care unit (ICU) at the Centro de Investigaciones Médico Quirúrgicas of Cuba. All of these patients had a TCD performed on arrival at ICU, evaluating the following: systolic (SV), diastolic (DV), and medium (MV) flows velocities and pulsatility index (PI) in right middle cerebral artery (RMCA) via temporal windows. RESULTS: The sonographic patterns of cerebral hemodynamics were as follows: low-flow, 12 patients (57.1%); high resistance, 5 patients (23.8%); and hyperemic, 4 patients (19%). Patients who died while waiting had lower MV RMCA (56.1 vs 58.1 cm/s) and higher PI (1.71 vs 1.41) than patients who could undergo transplantation (P = .800 and P = .787, respectively). CONCLUSIONS: In patients diagnosed with ALF admitted to the ICU the predominating cerebral hemodynamic pattern was low-flow with resistance increase. The TCD was shown to be a useful tool in the initial evaluation for prognosis and treatment.

Biochemical comparison of venoms from young Colombian Crotalus durissus cumanensis and their parents

Crotalus durissus cumanensis, a rattlesnake endemic to Colombia and Venezuela, is considered one of the most lethal snake species in Latin America. The aim of the present study was to compare the protein content and biological activity of the venom obtained from eight specimens of C. durissus cumanensis, namely two adults from different localities of Colombia and six offspring born in captivity. Protein profiles of crude venoms were analyzed by SDS-PAGE and RP-HPLC, and biological activities were evaluated for lethality, edema, defibrination, hemolytic and coagulant activities to assess individual venoms of adults and a pool of young snake venoms. Transient edema appeared rapidly after venom inoculation, whereas hemorrhagic effect was not observed. Differences in protein profiles, lethality, hemolytic, coagulant and defibrinating activities between both adult snake venoms were observed; those from the mother snake exhibited higher activities. Venoms from young snakes were similar to the one obtained from the mother, but the coagulant effect was stronger in offspring venoms. Notably, biological effects of the father snake venom were not comparable to those previously described for C. durissus cumanensis from Venezuela and C. durissus terrificus from Brazil, confirming the high variability of the venom from Crotalus species.

Biochemical comparison of venoms from young Colombian Crotalus durissus cumanensis and their parents

Crotalus durissus cumanensis, a rattlesnake endemic to Colombia and Venezuela, is considered one of the most lethal snake species in Latin America. The aim of the present study was to compare the protein content and biological activity of the venom obtained from eight specimens of C. durissus cumanensis, namely two adults from different localities of Colombia and six offspring born in captivity. Protein profiles of crude venoms were analyzed by SDS-PAGE and RP-HPLC, and biological activities were evaluated for lethality, edema, defibrination, hemolytic and coagulant activities to assess individual venoms of adults and a pool of young snake venoms. Transient edema appeared rapidly after venom inoculation, whereas hemorrhagic effect was not observed. Differences in protein profiles, lethality, hemolytic, coagulant and defibrinating activities between both adult snake venoms were observed; those from the mother snake exhibited higher activities. Venoms from young snakes were similar to the one obtained from the mother, but the coagulant effect was stronger in offspring venoms. Notably, biological effects of the father snake venom were not comparable to those previously described for C. durissus cumanensis from Venezuela and C. durissus terrificus from Brazil, confirming the high variability of the venom from Crotalus species.(AU)

Two perspectives on equipartition in diffuse elastic fields in three dimensions.

The elastodynamic Green function can be retrieved from the cross correlations of the motions of a diffuse field. To extract the exact Green function, perfect diffuseness of the illuminating field is required. However, the diffuseness of a field relies on the equipartition of energy, which is usually described in terms of the distribution of wave intensity in direction and polarization. In a full three dimensional (3D) elastic space, the transverse and longitudinal waves have energy densities in fixed proportions. On the other hand, there is an alternative point of view that associates equal energies with the independent modes of vibration. These two approaches are equivalent and describe at least two ways in which equipartition occurs. The authors gather theoretical results for diffuse elastic fields in a 3D full-space and extend them to the half-space problem. In that case, the energies undergo conspicuous fluctuations as a function of depth within about one Rayleigh wavelength. The authors derive diffuse energy densities from both approaches and find they are equal. The results derived here are benchmarks, where perfect diffuseness of the illuminating field was assumed. Some practical implications for the normalization of correlations for Green function retrieval arise and they have some bearing for medium imaging.

[Diagnostic value of cardiac 123I-metaiodobenzylguanidine (123I-MIBG) scintigraphy in Lewy body disorders]. / Valor diagnóstico de la gammagrafía cardíaca con 123I-metaiodobenzilguanidina en las enfermedades con cuerpos de Lewy.

INTRODUCTION: Lewy body disorders such as Parkinson's disease (PD) and Lewy body dementia (LBD) are associated with cardiac sympathetic denervation, which can be visualized on 123I-MIBG scintigraphy. Our objectives were to study the diagnostic value of this technique in Lewy body disorders and its relationship with PD clinical variables. PATIENTS AND METHODS: We studied 90 patients: 51 with PD, 19 with LBD, 9 with multiple system atrophy (MSA) and 11 controls. Scintigraphy images were qualitatively evaluated and early and delayed heart-to-mediastinum ratios (HMR) were calculated. The main confounding factors (ischemic heart disease, diabetes, hypertension and drugs) were controlled by multivariate linear regression analysis. We investigated correlations between scintigraphy variables and PD variables. RESULTS: The delayed HMR, which showed better discriminative ability was 2.03 +/- 0.32 in controls, 1.37 +/- 0.30 in PD (p<0.001 vs controls), 1.47+/-0.45 in LBD (p=0.001 vs controls) and 1.69+/-0.28 in MSA (p=0.02 vs controls; p=0.004 vs PD). This ratio was influenced by PD/LBD diagnosis (beta= -0.638; p<0.001) and to a lesser degree, by ischemic heart disease (beta= -0.244; p=0.028). Optimal cut-off value between PD/LBD and controls was 1.71 (83% sensitivity and 82% specificity). Within the PD group, those with a family history of PD/LB showed higher delayed HMR values (1.65+/-0.34 vs 1.30+/-0.24 without history; p<0.001) and proportion with normal scintigraphy (56% vs 5%; p=0.001). CONCLUSIONS: Cardiac 123I-MIBG scintigraphy is useful in the diagnosis of Lewy body disorders, although its value in PD is conditioned by having a family history of PD.

Metabolic and proteomic study of NS0 myeloma cell line following the adaptation to protein-free medium.

Proteomics and metabolomics technologies are potentially useful tool for the study of the very complex process of cell adaptation to protein-free medium. In this work, we used the iTRAQ technology to analyze different protein levels in adapted and non-adapted NS0 myeloma cell line. Several proteins with differential expression profile were characterized and quantified. Carbohydrate metabolism, protein synthesis and membrane transport were the principal pathways that change after the adaptation. Changes in lactate production rate with respect to glucose consumption rate were observed according to the changes observed by proteomic.

[Clinical utility of deep brain stimulation in an advanced Parkinson's disease]. / Utilidad clínica de la estimulación cerebral profunda en la enfermedad de Parkinson avanzada.

INTRODUCTION: Bilateral deep brain stimulation (DBS) of the subthalamic nucleus (STN) or globus pallidus internus (GPi) have demonstrated efficacy in advanced Parkinson's disease (PD). We aimed to assess the clinical utility of these procedures in terms of the quality of life, and to determine the pre and postsurgical characteristics related to the outcome. METHOD: A prospective study was conducted on a cohort of 20 patients with advanced PD who underwent bilateral DBS: 14 in STN and 6 in GPi. They were assessed according to the CAPSIT-PD protocol before and after surgery, with a mean follow-up of 9 and 11 months, respectively. The main outcome variables were change in the UPDRS III score in off efficacy and the PDQ-39 quality of life questionnaire score (clinical utility). RESULTS: The STN group improved their UPDRS III in off by a mean of 35% (p = 0.001) and their PDQ-39 by 21% (p = 0.026). The GPi group improved their UPDRS III in off by 21% (p = 0.028) and their PDQ-39 by 37% (p = 0.116). The presurgical levodopa-equivalent dose was a positive predictor of the efficacy and clinical utility of STN DBS and a negative predictor of the efficacy of GPi DBS. In both groups, the clinical utility was determined by improvement in functional disability in off scales. CONCLUSIONS: Bilateral DBS demonstrated middle-term efficacy and clinical utility in the treatment of advanced PD. The presurgical levodopa-equivalent dose was a predictor of the efficacy and clinical utility of DBS.

Socio-demographic characteristics and sex practices related to herpes simplex virus type 2 infection in Mexican and Central American female sex workers.

This study aimed to evaluate the relationship between HSV-2 infection and several socio-demographic and sexual practices of Mexican and Central American female sex workers (FSWs) in the Soconusco region in the State of Chiapas, Mexico. A cross-sectional study was carried out based on a sample frame of bars where FSWs were active in the Soconusco region. FSWs consented to investigations and answered a questionnaire and provided a blood sample for specific HSV-2 antibody analysis. One hundred and sixteen bars were studied and 484 women were interviewed. The overall frequency of HSV-2 infected women was 85.7%. Variables that reflected exposure to HSV-2 were significantly associated with the frequency of the infection. Additionally, variables such as education and country of origin were significantly associated with HSV-2 infection. These results suggest that this infection is highly endemic in the Soconusco, posing a health risk for the study population.

Age-related changes in blood capillary endothelium of human dental pulp: an ultrastructural study.

AIM: To describe the ultrastructural changes that occur in pulpal blood capillaries as a result of ageing. METHODOLOGY: Thirty samples of healthy dental pulps were obtained from functional human permanent teeth. Two age groups were examined: young (10-17 years) and old (>60 years). The teeth were extracted under local anaesthesia using mepivacaine without adrenaline (Scandonest 3%, Septodont, Saint-Maur des Fossés, France) and split longitudinally in a bench press. The pulps were gently removed, immersed in fixative solution, sectioned and processed by conventional transmission electron microscopic techniques. Micrographs were taken from the endothelium, and the whole capillary area of each vessel was examined. RESULTS: In young pulps, the endothelial cell layer was characterized by the presence of numerous pinocytotic vesicles and microvesicles, RER cisterns, free ribosomes, a small Golgi complex, centrioles, microtubules, microfilaments and mitochondria. In the endothelial cell cytoplasm of older pulpal vessels, pinocytotic vesicles and microvesicles, as well as microfilaments, were more numerous. In addition, lipid-like vacuoles, monogranular glycogen granules and extensive Golgi complexes with dilated cisterns were also present. Weibel-Palade bodies were observed in both age groups without showing variations related with age. CONCLUSIONS: The results obtained in capillaries of aged pulpal tissue suggest that the endothelium experiences morphological changes that could be associated with advancing age.

Long-term follow-up of contralateral lobe in patients hemithyroidectomized for solitary follicular adenoma.

OBJECTIVES: Since there are no available conclusive studies on the long-term evolution of remnant thyroid tissue after hemithyroidectomy in patients who undergo surgery for solitary follicular adenomas, we searched for such cases in our records to elucidate this issue. DESIGN: Search criteria were as follows: (i) presence of a single palpable thyroid nodule with the remainder of the gland normal on palpation; (ii) clinically euthyroid status at the time of surgery; (iii) histological diagnosis of nodule as follicular adenoma; (iv) a hemithyroidectomy operation, sparing the contralateral lobe; (v) normal macroscopic aspect of the contralateral lobe at the time of surgery; and (vi) at least 4 years of postoperative follow-up. PATIENTS: Only 47 female cases were found to meet above criteria, with a mean age of 45.9 years (range: 23-79) at the time of surgery and a mean follow-up of 7.2 years (range: 4-32). Besides evaluating the presence or absence of antithyroid antibodies and the extranodular histology of tissue removed during surgery, a preoperative TRH test also allowed patients to be classified into two groups: normal extranodular thyroid (NET) (n = 32) and abnormal extranodular thyroid (AET) (n = 15). RESULTS: Eleven of the 15 patients with AET had thyroid autoimmunity, with or without overt histological thyroiditis, and the remaining four had subclinical hypothyroidism with negative antithyroid antibody titres. In the entire study population, only 28 patients received treatment with L-T4 immediately after surgery, none of whom had any alterations in the contralateral lobe. However, six of the nineteen patients not treated with T4 (31.6%) developed overt abnormalities in the contralateral lobe, including the only three with AET who had not received L-T4 treatment. The remaining three were two patients with NET, who showed postoperative TSH hyper-responsiveness to TRH (peak TSH > 25 mU/l), and one who developed a new follicular adenoma 32 years later. To date, none of the patients with NET, who had a normal TRH test after surgery, have developed any kind of alterations in the contralateral lobe, even those who received no L-T4 prophylactic treatment. CONCLUSIONS: The findings of this study suggest that: (i) there is a higher risk of follicular adenomas developing in a gland affected by thyroid autoimmunity than in a previously normal gland; (ii) L-T4 therapy may prevent the formation of new nodules or the development of goitre in the contralateral lobe; and (iii) in the absence of prophylactic treatment after surgery, the contralateral lobe of subjects with thyroid autoimmunity and/or previous subclinical hypothyroidism develops morphological abnormalities.

Paradoxical behavior of PR interval dynamics during exercise and recovery and its relationship to cardiac memory at the atrioventricular node.

This preliminary study deals with the dynamics of the PR interval during exercise testing by using a Bruce protocol in 31 nonmedicated, normal patients with ages of 33 +/- 14 years. The behavior of the PR interval permitted its categorization into 2 groups. In Group I (27 of 31, 87.1% of patients) the PR interval showed the expected biphasic behavior with a gradual shortening with increasing exercise and a gradual lengthening during recovery. In contrast, the PR interval in Group II (4 of 31, 12.9% of patients) showed a triphasic behavior since, toward the end of recovery, there was a second decrease in duration. Because of this temporal relation to the phases of exercise, this paradoxical response, in analogy to what happened to the QT interval during exercise, could have been caused by a form of short-term memory or to varying, but normal, intergroup differences in autonomic function. However, further studies involving a greater number of patients are required to reach definite conclusions.

Molecular cloning of an alpha-glucosidase-like gene from Penicillium minioluteum and structure prediction of its gene product.

The dexC cDNA, which is expressed in dextran-containing medium by the filamentous fungus Penicillium minioluteum, was cloned and sequence characterized. The cDNA sequence comprises 1859 bp plus a poly (A) tail, coding for a predicted protein of 597 amino acids. The genomic counterpart was isolated by PCR, finding three introns in its sequence. The dexC gene was located by Southern blot in the same 9-kb fragment that the previously isolated dextranase-encoding gene (dexA). Sequence analysis revealed that the deduced DexC protein belongs to glycosyl hydrolase family 13, showing a high sequence identity (58%) with Aspergillus parasiticus alpha-1,6-glucosidase. In addition, the high sequence identity (51%) between DexC protein and oligo-1,6-glucosidase of Bacillus cereus, with three-dimensional (3D) structure determined, leads us to proposed a 3D model for the structural core of DexC protein.

Demencia en la enfermedad de Creutzfeldt-Jakob

Se presenta el caso clínico de un paciente admitido en el Servicio de Psiquiatría del Hospital Carlos Andrade Marín, con un cuadro demencial rápidamente progresivo y cuyas características clinicopatológicas y electroencefalográficas son compatibles con la enfermedad de Creutzfeldt-Jakob. Se complementa con una breve revisión de la literatura existente sobre esta patología.

Regression and its mechanisms after laser in situ keratomileusis in moderate and high myopia.

OBJECTIVE: The purpose of the study was to evaluate the degree and mechanism of regression after laser in situ keratomileusis (LASIK) on moderate to highly myopic eyes during the first postoperative year. DESIGN: A prospective, single-center, clinical trial. PARTICIPANTS: A total of 52 eyes of 38 patients were entered in the study; 47 eyes had complete data available at each postoperative visit. INTERVENTION: The intervention was LASIK using the microkeratome to create an 8.5- to 9.0-mm diameter, 130- to 160-micron-thick flap. A spherical midstromal multizone ablation (inner zone, 4.5 mm; outer zone, 5.5-6.0) was then performed using the Summit OmniMed excimer laser (Summit Technology, Inc, Waltham, MA). The mean preoperative refraction was -14.02 diopters (D). Retreatment for undercorrection and regression was performed between postoperative months 3 and 6 on 13 eyes. MAIN OUTCOME MEASURES: Manifest spherical equivalent, mean central corneal power, and central corneal thickness were the parameters measured. RESULTS: At 3 months, follow-up data were available on 47 eyes. The mean refractive regression was -1.07 D (7.6%) from the first week to the third month. During the first postoperative year, the mean regression of manifest spherical equivalent (MSE), increase in corneal power, and increase in corneal thickness were symmetric in magnitude and time course for the 34 eyes that did not require retreatment (-0.96 D, +1.03 D, and 15 microns, respectively). CONCLUSION: Early regression of refractive effect after LASIK appears to be a consequence of an increase in corneal thickness associated with central corneal steepening. No evidence of progressive corneal ectasia was observed during the first year of follow-up. Longer follow-up is required to confirm these trends.

Shigellosis: más allá de la enterocolitis / Shigellosis: more to the enterocolitis

Con el fin de estudiar la frecuencia de bacteremias en niños con diarrea producidas por Shigella y sus características clínicas, se revisaron 9.833 hemocultivos realizados en el Hospital de Niños "J. M. de los Ríos", entre 1995 y Agosto 1998, así como las historias clínicas de los pacientes cuyos hemocultivos resultaron positivos a Shigella. Se encontró que 4 de los niños (0,4 por ciento) presentaron bacteremia a Shiguella flexneri, de los cuales, 3 (75 por ciento) evolucionaron tórpidamente y 1 (25 por ciento) sufrió meningitis con secuelas neurológicas permanentes. Se identificó déficit nutricional en uno de ellos (25 por ciento). El 100 por ciento de las cepas fueron Shigella flexneri resistentes in vitro a ampicilina y sulfatrimetropin y sensibles a cefalosporinas de tercera generación. Una (25 por ciento) prsentó sensibilidad disminuida al cloranfenicol

Identificaçäo da via lenta na reentrada nodal atrioventricular usando o intervalo atrioventricular mais curto / Slow pathway identification in AV nodal reentry using shortest atrioventricular interval

Em 10 pacientes consecutivos, realizou-se o mapeamento da parede septal do átrio direito durante taquicardia supraventricular por reentrada nodal AV, para comprovar a hipótese de que o intervalo AV mais curto identificava a área de conduçäo da via lenta. O septo atrial foi dividido em quatro zonas distintas. Em sete dos pacientes o intervalo AV anterógrado mais curto foi encontrado na zona 3; em dois, na zona 4; no último, na zona 2. A modificaçäo por radiofreqüência da via lenta foi obtida com sucesso, em todos os pacientes, na área de conduçäo AV mais curta. O intervalo AV durante ritmo sinusal permaneceu inalterado antes e após a ablaçäo. Após um seguimento de 21ñ4 meses, nenhum deles teve recorrência dos sintomas.

Aplicación de las medidas de bioseguridad por parte del personal destacado en las clínicas odontológicas de las unidades del Mispas en: Zacamil, San Miguelito, Ciudad Delgado y Díaz del Pinal de Santa Tecla en el periodo comprendido entre 18 al 29 de mayo 1998 / Application of biosecurity measures by the personnel stationed in the dental clinics of the Mispas units in: Zacamil, San Miguelito, Ciudad Delgado and Díaz del Pinal de Santa Tecla in the period between 18 to 29 May 1998

Conscientes de la importancia de la prevención y control de las infecciones en la práctica estomatológica, se ha considerado que la realización de la presente investigación es de mucha importancia debido a la necesidad de recalcar las precauciones necesarias para evitar la transmisión de enfermedades infecciosas. 1 La investigación fue realizada en las unidades de salud de San Miguelito, Ciudad Delgado, Zacamil y Díaz del Pina) en Santa Tecla, con el fin de verificar si se llevó a cabo la aplicación de las medidas de bio-seguridad, por parte del personal odontológico que labora en dichas unidades, ya que ellos se encuentran en contacto con materiales, instrumental y pacientes que pueden ser un posible riesgo de contaminación cruzada. El presente trabajo de investigación se divide en cuatro fases: Fase I: En la que se determinan los elementos del diagnóstico, se justifica la importancia de la aplicación adecuada de las medidas de prevención para conocer si la población en estudio las ponía en práctica, el objetivo general que se pretende lograr al final de la investigación y los objetivos específicos que se pretenden alcanzar de acuerdo a cada una de las medidas preventivas. Además, se explica cuáles fueron las limitaciones que se presentaron para el desarrollo del trabajo, al final de dicha fase se presentaron una serie de términos odontológicos básicos para ayudar a una mejor comprensión del contenido de la investigación. La fase II es el Marco de Referencia que consta de dos apartados: en el primero se plantean los antecedentes de la problemática en estudio, que empieza con una reseña histórica en la cual se da a conocer el inició de la aplicación de las medidas de prevención y corno han venido evolucionando gracias a los avances de la ciencia y descubrimientos relacionados con el tema. El segundo apartado comprende una discusión bibliográfica en la que se exponen los diferentes planteamientos de autores especialistas de libros y protocolos de aséps1a médica y odontológica, así como también las diversas opiniones de personas conocedoras del tema a las que se entrevistaron. Fase III corresponde a la Metodología, en la cual se define que la investigación es de tipo diagnóstica, cuya población en estudio está constituida por odontólogos, operadores y asistentes, destacados en las clínicas odontológicas de las unidades de salud antes mencionadas. También, se plantea el motivo por el que la guía de entrevista y la encuesta fueron consideradas las técnicas apropiadas para la recolección de la información, asimismo se explica la forma en que se aplicaron los instrumentos y los problemas que se encontraron al momento de hacerlo, igualmente la manera en que se llevó a cabo el 0roceso de vaciado de la información. Finalmente se especificó la metodología a ser utilizada para analizar los datos. ix Fase IV denominada resultados del diagnóstico, comprende la presentación de cuadros estadísticos con sus respectivos análisis en los que se interpretan los resultados obtenidos a través de los instrumentos, también se plantea un análisis general de la problemática en estudio en base a los resultados del diagnóstico, la experiencia propia de ' los investigadores y la opinión de los diversos autores consultados. Asimismo, en este apartado se establecen las conclusiones específicas y generales a las que se llegaron después del análisis de la problemática. Además, se plantean las recomendaciones pertinentes tanto al personal que labora en las clínicas odontológicas de las unidades de Salud en estudio como al Ministerio de Salud Pública y Asistencia Social.

Aware of the importance of the prevention and control of infections in dental practice, it has been considered that the realization of this research is of great importance due to the need to emphasize the necessary precautions to avoid the transmission of infectious diseases. 1 The investigation was carried out in the health units of San Miguelito, Ciudad Delgado, Zacamil and Díaz del Pina) in Santa Tecla, in order to verify whether the application of bio-security measures was carried out by the dental personnel who work in these units, since they are in contact with materials, instruments and patients that may be a possible risk of cross contamination. This research work is divided into four phases: Phase I: In the 9th that the elements of the diagnosis are determined, the importance of the adequate application of prevention measures is justified to know if the study population put them into practice, the general objective to be achieved at the end of the investigation and the specific objectives to be achieved according to each of the preventive measures. In addition, it is explained what were the limitations that were presented for the development of the work, at the end of this phase a series of basic dental terms were presented to help a better understanding of the content of the research. Phase II is the Reference Framework that consists of two sections: in the first, the antecedents of the problem under study are presented, which begins with a historical review in which the beginning of the application of prevention measures is announced. and how they have been evolving thanks to advances in science and discoveries related to the subject. The second section includes a bibliographic discussion in which the different approaches of specialist authors of books and protocols on medical and dental asepsis are exposed, as well as the diverse opinions of people familiar with the subject who were interviewed. Phase II is the Reference Framework that consists of two sections: in the first, the antecedents of the problem under study are presented, which begins with a historical review in which the beginning of the application of prevention measures is announced. and how they have been evolving thanks to advances in science and discoveries related to the subject. The second section includes a bibliographic discussion in which the different approaches of specialist authors of books and protocols on medical and dental asepsis are exposed, as well as the diverse opinions of people familiar with the subject who were interviewed. Phase III corresponds to the Methodology, in which it is defined that the research is of a diagnostic type, whose population under study is made up of dentists, operators and assistants, stationed in the dental clinics of the aforementioned health units. It also raises the reason why the interview guide and the survey were considered the appropriate techniques for collecting information, it also explains the way in which the instruments were applied and the problems encountered at the time of doing so. likewise the way in which the process of emptying the information was carried out. Finally, the methodology to be used to analyze the data was specified. ix Phase IV called diagnosis results, includes the presentation of statistical tables with their respective analyzes in which the results obtained through the instruments are interpreted, a general analysis of the problem under study is also proposed based on the results of the diagnosis , the own experience of the researchers and the opinion of the various authors consulted. Likewise, this section establishes the specific and general conclusions that were reached after the analysis of the problem. In addition, pertinent recommendations are made both to the personnel who work in the dental clinics of the Health units under study and to the Ministry of Public Health and Social Assistance.

Patología de cérvix uterino de mujeres del área suburbana de Quito / Pathology of the uterine cervix of women of the suburban area of Quito

Presenta un estudio retrospectivo de 33 pacientes sometidas a citología exfoliativa de cérvix uterino. Se averiguaron factores de riesgo, incluyéndose en el estudio las pacientes con dos o más de estos factores. Se observó que la mayoría estaban comprendidas entre los 21 y 40 años de edad, que el 66.66xciento de ellas nunca tuvieron una citología previa y que el 54.54xciento tenían más de tres embarazos. El 55.55xciento de pacientes tenían más de tres partos. En los resultados de las citologías, el 12.12xciento tenía clase I, el 78.78xciento tenía clase II, 9.09xciento clase III y 0xciento IV y V. Las pacientes con clase III tenían todas displasia leve. Se recalca la importancia de la detección precoz del carcinoma de cérvix por su importancia en mujeres de países en vías de desarrollo, por medio de citologías y servicios integrados, así como la detección de HPV y la mejora en la cobertura de pacientes con factores de riesgo...