Liver Abscess in a Pediatric Patient with Ulcerative Colitis: A Case Presentation.

Hepatic abscesses are an uncommon extra-intestinal manifestation of inflammatory bowel disease, the incidence of which has been estimated to be approximately 7 per 10,000 patients with inflammatory bowel disease. It is unclear whether patients with Crohn's disease or patients with ulcerative colitis (UC) are at higher risk of developing this complication. Based on case reports, most cases are found in Crohn's disease; however, a recent cohort study showed an increased risk in UC instead. Hepatic abscesses in the pediatric population are rare, and there have been no reported cases of hepatic abscesses in a pediatric patient with UC. We describe herein a pediatric patient with UC who developed hepatic abscesses and portal vein thrombosis. This patient also had an extended time in remission from his UC despite being off of immunosuppressive therapies, and we speculate on how his clinical course and treatment strategies may have contributed to this.

Frecuencia de algunos signos de provocación para el nervio cubital en el codo en una población sana / Fréquence de quelques signes de provocation du nerf ulnaire au coude dans une population saine / Frequency of some signs of challenge to the ulnar nerve at the elbow in a healthy population

Introducción: el síndrome del túnel cubital en el codo es a menudo subdiagnosticado y confundido con la epicondilitis medial. Presenta, con frecuencia, variabilidad en las pruebas del codo contra gravedad; se determinó la proporción de signos positivos sobre el total de codos examinados. Objetivo: determinar en una población sana asintomática la frecuencia de los signos del síndrome del túnel cubital en el codo. Métodos: en 380 codos de una población voluntaria, se realizaron las pruebas de Tinel, de flexión del codo, de rotación interna y flexión del codo, el scratch-collapse y test de flexión del codo contra gravedad; se determinó la proporción de signos positivos sobre el total de codos examinados. Resultados: en total, 66 personas (34,7 por ciento) tuvieron al menos un test positivo en uno o ambos codos. El 45,4 por ciento de las mujeres y el 20,7 por ciento de los hombres tuvieron al menos un test positivo (p=0,001). La prueba de flexión del codo con estimulo de presión tuvo la mayor frecuencia (13,4 por ciento), luego la prueba de Tinel (8,9 por ciento). El test de flexión del codo contra gravedad (4,2 por ciento) y la prueba scratch-collapse (3,4 por ciento) obtuvieron bajas frecuencias. Conclusiones: el 34,7 por ciento de individuos tuvieron al menos un test positivo en uno o ambos codos, cifra alta que sugeriría una alta tasa de falsos positivos en pacientes con síndrome del túnel cubital. En las mujeres, que tenían el doble que los hombres de positividad, sugiere que algunos factores anatómicos, hormonales y otros desconocidos podrían influenciar en esto. El test de flexión del codo contra gravedad tiene en cuenta el flujo contra gravedad de la circulación arterial del nervio cubital, que sumado a la flexión del codo, reproduciría más rápido los síntomas en un paciente con síndrome del túnel cubital. En población sana se encontró una frecuencia baja (4,2 por ciento), lo cual se sugiere como un nuevo signo para apoyar el diagnóstico clínico. No obstante se requiere de otros estudios en pacientes con esta afección para determinar la sensibilidad y especificidad(AU)

Introduction: cubital tunnel syndrome in the elbow is often sub-diagnosed and confused with medial epicondylitis. Variability has often provocative tests. Objective: determine frequency of signs of cubital tunnel syndrome in the elbow in a healthy asymptomatic population. Methods: 380 elbows in a voluntary population were tested by Tinel tests, elbow flexion, internal rotation and elbow flexion, the scratch test-collapse and elbow flexion against gravity; the proportion of positive signs on total elbows examined was determined. Results: in total, 66 persons (34.7 percent) had at least one positive test on one or both elbows. 45.4 percent women and 20.7 men had at least one positivest (p = 0.001). The elbow flexion test with pressure stimulus had the highest rate (13.4 percent e test (p = 0.001). The elbow flexion test with pressure stimulus had the highest rate (13.4 percent), then Tinel test (8.9 percent). The test of elbow flexion against gravity (4.2 percent) and the scratch-collapse (3.4 percent) had low test frequencies. Conclusions: 34.7 percent of subjects had at least one positive test on one or both elbows. This high number would suggest high rate of false positives in patients with cubital tunnel syndrome. In women, they were positive twice as men, suggesting that some anatomical, hormonal and other unknown factors could influence. The test of elbow flexion against gravity takes into account the gravity flow against the arterial circulation of the ulnar nerve, which added to the elbow flexion reproduce faster symptoms in a patient with cubital tunnel syndrome. In the healthy population low frequency (4.2 percent) was found, which is suggested as a new sign to support the clinical diagnosis. However it requires further studies in patients with this condition to determine sensitivity and specificity(AU)

Introduction: le syndrome du tunnel cubital au coude est souvent mal diagnostiqué et confondu avec l'épicondylite médiale. D'habitude, les tests de provocation ont des résultats variables. Objectif: le but de ce travail est de déterminer la fréquence des signes du syndrome du tunnel cubital au coude dans une population saine asymptomatique. Méthodes: dans une population volontaire (380 coudes), on a effectué des tests cliniques tels que le test de Tinel, le test de flexion du coude, le test de rotation interne et flexion du coude, le test de scratch-collapse, et le test de flexion active du coude contre la gravité. On a déterminé la proportion de signes positifs sur le total de coudes examinés. Résultats: au total, soixante-six personnes (34.7 pourcent) ont eu au moins un test positif d'un ou de tous les deux bras. Il y a eu au moins un test positif (p=0.001) dans 45.4 pourcent des femmes et dans 20.7 pourcent des hommes. Le test de flexion du coude à stimulus de pression a été le plus fréquent (13.4 pourcent), suivi par le test de Tinel (8.9 pourcent). Le test de flexion du coude contre la gravité (4.2 pourcent) et le test de scratch-collapse (3.4 pourcent) n'ont pas été assez fréquents. Conclusions: dans 34.7 pourcent des cas, il y a eu au moins un test positif d'un ou de tous les deux coudes. Cette chiffre considérée haute suggère un haut taux de faux positifs chez les patients atteints de syndrome du tunnel cubital. Chez les femmes ayant une positivité deux fois plus haute que chez les hommes, elle suggère que des facteurs anatomiques, hormonaux et d'autres encore inconnus peuvent influer. Le test de flexion du coude contre la gravité tient en compte le flux contra la gravité de la circulation artérielle du nerf cubital qui, conjointement avec la flexion du coude, reproduit plus rapidement les symptômes du syndrome du tunnel cubital chez un patient. Dans une population saine, on a trouvé une basse fréquence (4.2 pourcent), ce qui indique un nouveau signe soutenant le diagnostic clinique. Toutefois, il faut faire de nouvelles études pour déterminer la sensibilité et la spécificité(AU)

Esophageal infections: an update.

PURPOSE OF REVIEW: Infectious esophagitis generally occurs in patients with impaired immunity. Although methods to suppress the immune system evolve, the potential infectious consequences are poorly understood. The purpose of this article is to review the risk factors, diagnosis, and treatment of infectious esophagitis. RECENT FINDINGS: Minimal pediatric data, including a few case reports and series, involve infectious esophagitis. Esophageal infections are usually caused by the following microbes, in order starting with the most common: Candida albicans, herpes simplex virus, and cytomegalovirus. Uncommon risk factors in these and other reports include epidural triamcinolone and oral budesonide in addition to more common risk factors such as HIV infection, chemotherapeutic agents, and transplant immunosuppressive medications. Rare reports involve immunocompetent patients and treatment of these patients is controversial. SUMMARY: Understanding of infectious esophagitis is growing, and risk factors, diagnosis, and treatments are evolving.

Descripción epidemiológica y evaluación de los desenlaces de interés de las fracturas de la extremidad superior del húmero en un grupo de niños / Epidemiological description and evaluation of the interesting outcomes of fractures of upper extremity of the humerus in a children's group

Antecedentes. Para el tratamiento de las fracturas de húmero proximal del niño, es indispensable el conocimiento anatómico y biomecánico del hombro, sus opciones terapéuticas y los factores independientes que condicionan su pronóstico funcional. Materiales y métodos. Serie de casos con pacientes con fracturas de húmero proximal en la Fundación HOMI de Bogotá, durante un lapso de 5 años; se estudiaron variables como sexo, edad, mecanismo de trauma, tipo y clasificación de la fractura, manejo, secuelas, deformidades, complicaciones, valoración radiológica y funcional con la escala quick-DASH. Resultados. De un total de 73 pacientes, 71% fueron manejados ortopédicamente. Al 66% de los intervenidos quirúrgicamente se les realizó reducción cerrada con fijación percutánea. La osteosíntesis con 2 clavos cruzados tuvo mayor frecuencia (55%) y con otro tipo de disposición de los clavos no se encontraron diferencias en consolidación o complicaciones. La valoración quick-DASH fue menor del 5% de incapacidad. Conclusión. Las fracturas de la extremidad superior del húmero en niños tienen una evolución benigna, por el alto potencial de remodelación en edades tempranas y se indica cirugía, en trazos con desplazamiento severo, fracturas abiertas y lesión neurológica. La reducción cerrada y fijación percutánea disminuye los riesgos quirúrgicos, sin diferencias en resultados clínicos, funcionales y radiológicos en cuanto al número y situación de los clavos utilizados, ni diferencias funcionales.

Background. For the treatment of fractures of the proximal humerus in children is essential anatomical and biomechanical knowledge of the shoulder. Their treatment options and independent factors influence functional prognosis. Materials and methods. A case of patients with proximal humerus fractures in Bogota HOMI Foundation, for a period of five years, studying variables such as sex, age, mechanism of trauma, type and fracture classification, management, sequelae, deformities complications, radiological and functional assessment scale with quick-DASH. Results. From 73 patients, 71% were managed orthopedically. 66% of the surgically treated patients underwent closed reduction with percutaneous fixation. Osteosynthesis with two crossed nails was most often (55%) and other disposition of the nails, no differences were found in consolidation or complications. The quick-DASH valuation was less than 5% disability. Conclusion. Fractures of the proximal humerus in children have a benign course, the high remodeling potential at an early age and surgery is indicated in severe displacement strokes, open fractures and neurological damage. Closed reduction and percutaneous fixation decreases surgical risks, no differences in clinical, functional and radiological results in the number and location of nails used, and functional differences.

Treatment of a maxillary central incisor with class III invasive cervical resorption and compromised ferrule: a clinical report.

This clinical report presents the treatment of a maxillary central incisor with class III invasive cervical resorption and a compromised ferrule. Nonsurgical endodontic therapy combined with periodontal surgery was provided for debridement. Direct light-polymerizing resin-modified glass ionomer cement and a zirconia crown were used to repair the defect. Symptomatic endodontic complication was diagnosed with localized cone beam computed tomography at 6-month follow-up, and periapical microsurgery was rendered. The patient was followed-up for 30 months after treatment and had no further complications.

Descripción epidemiológica y evaluación de los desenlaces de interés de las fracturas de platillos tibiales / Epidemiological description and evaluation of the interesting outcomes of tibial plateau fractures

Antecedentes. Las fracturas de platillos tibiales suceden con alta frecuencia en grupos especiales como el personal de la policía, por su mayor exposición a mecanismos de trauma de alta energía y las características anatómicas y biomecánicas propias de la extremidad proximal de la tibia, que atribuyen a este tipo de fracturas una variabilidad importante en cuanto a abordaje terapéutico y su pronóstico. Materiales y métodos. Estudio tipo de serie de casos (nivel de evidencia IV), en pacientes adultos con fracturas de platillos tibiales, con atención inicial en el Hospital Central de la Policía desde enero de 2005 hasta diciembre de 2010, con diagnóstico confirmado por ortopedista y seguimiento mínimo de un año, a quienes se les aplicó una ficha de recolección de datos, con las variables estipuladas en el estudio. Resultados. De 93 pacientes seleccionados, el 82% fueron de sexo masculino y el 91% presentaron fracturas cerradas. A quienes se les realizó fijación interna más externa suplementaria tuvieron mayores tiempos de consolidación radiológica (180 días). Las secuelas más frecuentes fueron Artrosis (24%) y meniscopatía (21%), y las principales complicaciónes fueron las infecciones en un 6,4% de los pacientes, siendo las fracturas abiertas grado III (33%) las más afectadas. El promedio de consolidación radiológica fue de 125 días. Fueron manejadas quirúrgicamente el 69,9% de los casos. El grupo etáreo de 30 a 39 años fue el más comprometido. El principal mecanismo de trauma fueron los accidentes en moto (40%) y el tipo de fractura con mayor frecuencia fue la Shatzker tipo IV (28%) y las abiertas tipo Gustilo III (75%). Discusión. Las características propias del trabajo como agente de policía, en cuanto a su rango de edad, sexo predominante y actividades de riesgo como desplazamiento en moto, porte y utilización de armas de fuego, así como las actividades de riesgo propias de su trabajo, determinan mecanismos de trauma de moderada y alta energía predominantes en este tipo de fracturas, y en esto radica que la mayor parte de fracturas fueron tipo Shatzker IV. Conclusión. Se relacionaron mayores porcentajes de infección, complicaciones, secuelas y necesidad de manejo quirúrgico, con el grado de severidad de la fractura y compromiso de tejidos blandos, así como un mayor tiempo de consolidación.

Background. The fractures of tibial plateau happens with high frequency in special groups as well as the police, due to their greater exposition to mechanisms of trauma of high energy and its own anatomical and biomechanical characteristics of the proximal extremity of the tibia. These features acquire an important variability as far as therapeutic boarding and its prognosis. Materials and methods. A Study type is series of cases (level of evidence IV), in adult patients with fractures of tibial plateau, with initial attention in the Hospital Central de la Policía - Bogotá, from January of 2005 to December of 2010, with diagnosis confirmed by orthopaedist and minimum pursuit of a year, to those who had a card of data collection applied to them, with the variables stipulated in the study. Results. From 93 selected patients, 82% were of male gender and 91% presented closed fractures. Those who were practiced external and internal fixation had better times of radiological consolidation (180 days). The most frequent sequels were Arthrosis (24%) and meniscopathy (21%), and the main complication was the infections in a 6.4% of the patients. The open fractures degree III (33%) were the most affected. The average of radiological consolidation was of 125 days. Operative management happens in 69.9% of the cases. The age group of 30 to 39 years was the most affected. The main mechanism of trauma (40%) were the accidents in motorcycle, and the type of fracture most frequently were the Shatzker type IV (28%) and the Gustilo type III open fracture (75%). Discussion. The own characteristics of the police agent job, as far as their rank of age, predominant sex and activities of risk like motorcycle transportation, carry and use of firearms, as well as the own activities of risk of their job, determine mechanisms of moderate and high trauma of predominant magnitudes in this type of fractures, being the most frecuent fractures type the Shatzker IV. Conclusion. The percentage of infection, complications, sequels and necessity of surgical management, were related with the degree of severity of the fracture and soft weave commitment, as well as a greater time of consolidation.

Metabolic effects of different protein intakes after short term undernutrition in artificially reared infant rats.

BACKGROUND: Early postnatal nutrition is involved in metabolic programming. Small for gestational age and premature babies commonly receive insufficient dietary protein during the neonatal period due to nutrition intolerance, whereas high protein formulas are used to achieve catch up growth. Neither the short term, nor the long term effects of such manipulation of protein intake are known. AIM: We hypothesized that high or low protein intake during infancy would induce metabolic alterations both during early-life and in adulthood. METHODS: Gastrostomized neonatal rat pups received either 50% (P50%), 100% (P100%), or 130% (P130%) of the normal protein content in rat milk from the 7th to the 15th day of life (D7 to D15), when they were either sacrificed or placed with mothers for the long term study. Glucose tolerance tests (GTT) were performed at D230. Long term rats were sacrificed at D250. RESULTS: At D15, weight of P50% pups was lower than P100% and P130% pups. Neither liver and kidney mass, nor islet beta-cell areas were altered. Brain weight (adjusted to body weight) was higher in P50% vs. P130% (p<0.05). Insulin/glucose ratio was lower in P50% vs. P130%. Expression of GLUT4 on adipocyte cell membrane and GLUT2 in liver cytosol was significantly enhanced in P50% vs. P130%. Long term, neither GTT results nor body nor organ weights differed between groups. CONCLUSION: In neonatal rats, higher protein intakes via the enteral route led to enhanced short term weight gain, insulin resistance, and modified expression of glucose transporters. However, these differences were not sustained.

Neonatal formula feeding leads to immunological alterations in an animal model of type 1 diabetes.

Neonatal diet may influence the development of type 1 diabetes (T1D) in susceptible individuals through an intestinal mucosal inflammatory response, resulting in loss of self-tolerance. We tested the hypothesis that formula feeding during the neonatal period accelerates the development of T1D in diabetes-prone BioBreeding (BBDP) rats through regulation of CD4+CD25+ regulatory T lymphocytes (T(reg)) and anti-inflammatory cytokines. BBDP rat pups fed rat milk substitute (RMS) via a "pup-in-the cup" system were compared with mother-fed (MF) rats. The spleen and thymus were analyzed for Foxp3-expressing CD4+/CD25+ T cells. Multiplex enzyme-linked immunosorbent assays (ELISAs) were performed to measure cytokine-induced neutrophil chemoattractant (CINC), tumor necrosis factor alpha (TNF-alpha), interferon-gamma (IFN-gamma), interleukin (IL)-4, IL-10, and IL-18. Diabetes-free survival, time of disease onset, and T(reg)/total T lymphocyte ratios were not different. MF pups had higher ileal CINC (p < 0.001) and IL-18 (p = 0.002), but no differences in the liver. There were no differences in ileal cytokine concentrations of 75-d-old rats, but the formula-fed rats had greater liver TNF-alpha (p < 0.001), IFN-gamma, and IL-4 (p < 0.01) and lower IL-10 (p = 0.002) compared with MF animals. Formula versus maternal milk altered the hepatic cytokine profile at 75 d toward an inflammatory pattern but did not result in altered T(reg) cell frequencies or the development of T1D.

Treatment-dependent calcium diffusion from two sealers through radicular dentine.

This study examined how root canal irrigation with sodium hypochlorite and citric acid affected calcium diffusion, using a calcium hydroxide-based sealer and a zinc oxide eugenol-based sealer with little calcium hydroxide. Sixty-eight single-rooted, freshly extracted teeth were decrowned to 14 mm, instrumented using a crown down technique, and divided into two groups: the experimental group (irrigated with 5.25% NaOCl followed by 10% citric acid) and the control (irrigated with 5.25% NaOCl only). Both groups were divided into two subgroups, depending on the type of sealers used in obturation with gutta-percha. Coronal and apical openings were sealed and teeth were placed in water (37 degrees C). Spectrophotometry was used to measure the amount of calcium released in water through radicular dentin. For each sealer, the calcium diffused from the experimental group was significantly higher than that of the control group (p < 0.05).

Lactobacillus rhamnosus GG decreases lipopolysaccharide-induced systemic inflammation in a gastrostomy-fed infant rat model.

OBJECTIVES: A gastrostomy-fed rat infant "pup-in-a-cup" model was used to test the hypothesis that enterally administered Lactobacillus rhamnosus GG (LGG) decreases the proinflammatory response induced by Escherichia coli lipopolysaccharide (LPS) in the developing infant rat small intestine, plasma, lung and liver. METHODS: Two groups of 6- to 7-day-old pups were fed a rat milk substitute with LPS added via the gastrostomy tube for 6 days. One of the rat milk substitute-fed groups received supplemental LGG; another group received LPS without LGG. Age-matched mother-fed rat pups were used as controls. RESULTS: LPS treatment blunted body growth, but LGG supplementation had no effect on weight increments. LGG decreased LPS-induced inflammation in intestinal tissue; CINC-1 (rodent IL-8 equivalent) production in plasma, liver, lung and distal small intestine; and tumor necrosis factor alpha (TNF-alpha) production in plasma and lung. Cytokine multiplex assay showed lung interleukin (IL)-1beta, IL-6, IL-10, IL-18, growth-related oncogene (GRO)/KC (rat CINC-1) and TNF-alpha were significantly higher in gastrostomy-fed, LPS-treated pups than in mother-reared pups, and LGG significantly blunted the LPS-induced elevation of IL-1beta, IL-10, IL-18, GRO/KC and TNF-alpha; liver GRO/KC was significantly higher in gastrostomy-fed, LPS-treated pups than in mother-reared pups, and LGG significantly blunted the LPS-induced elevation of GRO/KC. CONCLUSIONS: LGG provided by the enteral route is able to downregulate LPS-induced proinflammatory mediators. This effect is not only present in the splanchnic organs, that is, the intestine and the liver, but extends to the plasma and a distal organ, the lung.

The developing intestinal ecosystem: implications for the neonate.

Interactions of resident intestinal microbes with the luminal contents and the mucosal surface play important roles in normal intestinal development, nutrition, and innate and adaptive immunity. The neonate, especially the premature, who possesses a highly immunoreactive intestinal submucosa underlying a single layer of epithelial cells that are continuously exposed to the luminal environment, is highly susceptible to perturbations of the luminal environment. Understanding the interactions of the intestinal ecosystem with the host and luminal nutritional environment, especially in regard to human milk and pre- and probiotics, has major implications for the pathogenesis of diseases that affect not only the intestine but distal organs such as the lung and brain.

Alive and dead Lactobacillus rhamnosus GG decrease tumor necrosis factor-alpha-induced interleukin-8 production in Caco-2 cells.

Certain probiotic bacteria show anti-inflammatory activity after being heat killed, whereas others do not, suggesting that the gastrointestinal environment may alter the activity of probiotic bacteria. Occasionally, probiotics are provided when a patient is also being treated with oral antibiotics; this may have an effect on the probiotic activity. We hypothesized that Lactobacillus rhamnosus GG (LGG) are capable of downregulating tumor necrosis factor-alpha (TNFalpha)-induced interleukin (IL)-8 production under all 3 of these conditions, and that LGG act through the nuclear factor kappaB (NFkappaB)/inhibitor of kappaB (IkappaB) pathway. Caco-2 cells were treated with live or heat-killed LGG in doses ranging from 10(4) to 10(10) cfu/L, in the presence or absence of antibiotics and TNFalpha in the media. TNFalpha-induced production of IL-8 by Caco-2 cells was modulated by LGG under all 3 conditions. However, higher doses of live LGG without TNFalpha in the presence or absence of antibiotics in vitro induced the production of IL-8 (P = 0.001). Heat-killed LGG also blunted the TNFalpha-induced IL-8 production (P < 0.01), but by itself did not increase IL-8 production at higher doses as markedly as live LGG (P < 0.05). LGG reduced the TNFalpha-induced NFkappaB translocation to the nucleus and lessened the decrease in IkappaB in the cytoplasm (P < 0.05). LGG reduced TNFalpha-induced IL-8 production by affecting the NFkappaB/IkappaB pathway in Caco-2 cells. High doses of live LGG markedly increased IL-8 production, but heat-killed LGG caused only a slight increase in IL-8. Thus, heat-killed LGG may effectively ameliorate inflammation with a lower potential than live LGG at high doses to cause inflammation.

Using ParaPost Tenax fiberglass and ParaCore build-up material to restore severely damaged teeth.

This article describes a technique using ParaPost Tenax Fiber White, ParaPost Cement, and ParaPost ParaCore build-up material to restore a tooth with a significant loss of tooth structure. After successful root canal therapy, the posts were bonded in the canals and the core was built using ParaPost ParaCore build-up material. At that point, the tooth was prepared to receive a conventional porcelain-fused-to-metal crown.

Changes in intestinal morphology and permeability in the biobreeding rat before the onset of type 1 diabetes.

OBJECTIVE: Type 1 diabetes is an autoimmune disorder that occurs in genetically susceptible individuals. It has been hypothesized that the disease could be triggered by environmental agents that gain entry into the body through small intestinal absorption. Increased intestinal permeability has been reported both in spontaneous animal models of type 1 diabetes and human type 1 diabetes. In these studies, we examined both the physical and functional permeability characteristics of the small intestine in diabetes-prone and control rats. METHODS: In a series of studies, BioBreeding diabetes-prone(n = 31), BioBreeding diabetes-resistant (n = 20) and control Wistar (n = 25) rats were examined at intervals from 21 to 125 days of age. RESULTS: The percentage of goblet cells and the mucosal crypt depth were significantly greater in BioBreeding diabetes-prone than BioBreeding diabetes-resistant rats (P < 0.001 and P = 0.01, respectively). BioBreeding diabetes-prone and BioBreeding diabetes-resistant rats expressed less of the tight junction protein claudin (P < 0.05) and exhibited greater intestinal permeability (P < 0.001) than did Wistar rats. Intestinal permeability measured both in vivo and ex vivo decreased in all rat strains as age increased (P < 0.001). CONCLUSIONS: In a genetically susceptible rodent model of diabetes, early increased intestinal permeability might allow unregulated passage of environmental antigens that could potentially trigger the autoimmune response leading to type 1 diabetes.

Selectividad de la amoxicilina sobre anaerobios estrictos en abscesos dentoalveolares / Amoxicillin selectivity on anaerobic bacteria from dentoalveolar abscesses

En el control de los abcesos dentoalveolares, se ha sugerido la administración combinada de antimicrobianos, argumentando para ello la presencia de una flora mixta. Esto puede colocar al paciente en riesgo innecesario de reacciones de hipersensibilidad o de efectos tóxicos considerables. PROPOSITO: Observar el comportamiento selectivo de la amoxicilina frente a los anaerobios estrictos presentes en los abscesos dentoalveolares para considerar la viabilidad de utilizarla con monoterapia en el control inicial de tales abscesos. PACIENTES Y METODO: Se tomaron 30 pacientes con diagnóstico de absceso dentoalveolar de los cuales se obtuvieron muestras que fueron coleccionadas y transportadas con la ayuda del Anaerobic Culturette. Los microorganismos se cultivaron bajo condiciones de anaerobiosis y se identificaron con el sistema de BBL Crystal ID. RESULTADOS: De los anaerobios estrictos identificados el 60 por ciento correspondió a bacilos gram negativos, el 23 por ciento a positivos y el 17 por ciento a cocos gram positivos.

Selectividad de la amoxicilina sobre anaerobios estrictos en abscesos dentoalveolares / Amoxicillin selectivity on anaerobic bacteria from dentoalveolar abscesses

En el control de los abscesos dentoalveolares, se ha sugerido la administración combinada de antimicrobianos, argumentando la presencia de una flora mixta (aerobia y anaerobia). Esto puede colocar al paciente en riesgo innecesario de reacciones de hipersensibilidad o de efectos tóxicos considerables. Propósito: observar el comportamiento selectivo de la amoxicilina frente a los anaerobios estrictos presentes en los abscesos dentoalveolares, para considerar la viabilidad de utilizarla como monoterapia en el control de tales abscesos. Pacientes y método: se tomaron 30 pacientes con diagnóstico de absceso dentoalveolar, de los cuales se obtuvieron muestras que fueron coleccionadas y trasportadas con la ayuda del Anaerobic Culturette (Becton Dickinson Microbiology Systems). Los microorganismos se cultivaron bajo condiciones de anaerobiosis y se identificaron con el sistema de BBL Crystal ID. Luego, se procedió a realizar el antibiograma, utilizando sensidiscos de 10ug de amoxicilina diluidos en diferentes volúmenes de tioglicolato enriquecido, de tal forma que se obtuvieron concentraciones de 0,75, 1,5, 3 y 6ug de amoxicilina/ml de medio de cultivo. Resultados: de los anaerobios estrictos identificados, el 60 por ciento correspondió a bacilos gram negativos, el 23 por ciento a bacilos gram positivos y el 17 por ciento a cocos gram positivos. Las concentraciones inhibitorias mínimas de amoxicilina para estos microorganismos anaerobios estrictos se ubicaron en un rango de 0,75 a 3ug/ml. Conclusiones: la amoxicilina mostró un buen perfil selectivo contra los anaerobios estrictos identificados en la muestra. Se estima viable su utilización como monoterapia inicial en los abscesos dentoalveolares