Sensitivity and specificity of the ICDAS II system and bitewing radiographs for detecting occlusal caries using the Spectra™ caries detection system as the reference test in children.

BACKGROUND: Most studies assessing the sensitivity and specificity of caries detection methods have been performed in vitro using the histological method as the gold standard showing inconsistent values. The aim of this study was to compare the sensitivity and specificity in detecting occlusal caries using the International Caries Detection and Assessment System (ICDAS II) with the radiographic method (RM), while using the Spectra™ Caries Detection System (SCDS) as the reference test. METHODS: One hundred sixty children, ages 7-12 years, participated in the study. Five zones in the occlusal surfaces of 859 primary and 632 first permanent molars were examined visually using ICDAS-II, the RM using bitewing radiographs and SCDS. The descriptive statistics of sensitivity and specificity were calculated and compared. RESULTS: For all molars combined and for primary molars only, the sensitivity of ICDAS II was higher for detecting total caries (p < 0.001), caries in enamel (p < 0.001), and caries in dentin (p = 0.016), but it was not different for detecting caries in the dentin of permanent first molars (p = 0.214), and primary second molars (p = 0.761). The specificity of RM was higher for detecting total caries, caries in enamel for all molars combined and for permanent first molars (p < 0.001). For caries in dentin, the specificity of ICDAS II was higher for all molars combined and for primary molars only (p < 0.001). For total caries in primary molars only, and caries in dentin of permanent first molars only, the specificity was not different (p = 0.156 and p = 0.181 respectively). CONCLUSIONS: The sensitivity and specificity of ICDAS II and RM changes depending on whether the carious lesion compromises the enamel or dentin, and if the caries detection is performed in the primary molars or permanent first molars.

Effects of endozoochory and diploendozoochory by captive wild mammals on Juniperus deppeana seeds.

Carnivorous mammals disperse seeds through endozoochory and diploendozoochory. The former consists of ingestion of the fruit, passage through the digestive tract, and expulsion of the seeds, a process that allows scarification and dispersal of the seeds over long or short distances. The latter is typical of predators that expel seeds that were contained in the prey and the effects of which may differ from those of endozoochory with respect to the retention time of the seeds in the tracts, as well as their scarification and viability. The objective of this study was to conduct an experimental evaluation comparing the capacity of each mammal species in terms of the dispersal of Juniperus deppeana seeds and, at the same time, to compare this capacity through the two dispersal systems: endozoochory and diploendozoochory. We measured dispersal capacity using indices of recovery, viability, changes in testas, and retention time of seeds in the digestive tract. Juniperus deppeana fruits were collected in the Sierra Fría Protected Natural Area in Aguascalientes, Mexico, and were administered in the diet of captive mammals: gray fox (Urocyon cinereoargenteus), coati (Nasua narica) and domestic rabbits (Oryctolagus cuniculus). These three mammals represented the endozoochoric dispersers. For the diploendozoochoric treatment, seeds excreted by rabbits were incorporated into the diets of captive mammals: bobcat (Lynx rufus) and cougar (Puma concolor), in a local zoo. Seeds present in the scats were then collected, and recovery rates and retention times were estimated. Viability was estimated by X-ray optical densitometry and testa thicknesses were measured and surfaces checked using scanning electron microscopy. The results showed a recovery of seeds greater than 70% in all the animals. The retention time was <24 h in the endozoochory but longer at 24-96 h in the diploendozoochory (p < .05). Seed viability (x¯ ± SD) was decreased in rabbits (74.0 ± 11.5%), compared to fruits obtained directly from the canopy (89.7 ± 2.0%), while gray fox, coati, bobcat, and cougar did not affect seed viability (p < .05). An increase in the thickness of the testas was also observed in seeds excreted from all mammals (p < .05). Through evaluation, our results suggest that mammalian endozoochory and diploendozoochory contribute to the dispersal of J. deppeana by maintaining viable seeds with adaptive characteristics in the testa to promote forest regeneration and restoration. In particular, feline predators can provide an ecosystem service through scarification and seed dispersal.

Vías de ventilación y retracción epitimpánica en otitis media crónica no colesteatomatosa

Objetivo: Describir los hallazgos endoscópicos de las vías de ventilación encontrados durante la timpanoplastías tipo I en pacientes con OMC (Otitis media crónica) no colesteatomatosa. Materiales y métodos: Investigación transversal descriptiva, evaluamos 32 pacientes con OMC no colesteatomatosa con y sin retracción epitimpánica (RE) (Grado I-III, según clasificación de Mirko Tos), con antecedente de timpanoplastía tipo I (junio, 2018 - enero, 2020) en el servicio de otorrinolaringología del Hospital Nacional Arzobispo Loayza. Se excluyeron pacientes con cirugías previas de oído medio, con OMC colesteatomatosa, con RE grado IV y actos quirúrgicos no almacenados digitalmente. Resultados: El 71,8% de pacientes presentaron RE (Grado I 3,0%, grado II 30,0% y grado III 56,5%), todos presentaron istmo timpánico (IT) bloqueado. El 68,8% de participantes con RE, presentaron tensor fold (TF) completo. Se observó una relación significativa entre TF completo e IT bloqueado con RE (p=0,026 y 0,003 respectivamente). Conclusiones: Los hallazgos más frecuentes fueron el TF completo e IT bloqueado, estos tuvieron asociación significativa con la presencia de RE en pacientes con OMC no colesteatomatosa.

Objective: To describe the endoscopic findings of the ventilation pathways found during type I tympanoplasty in patients with non-cholesteatomatous COM (chronic otitis media). Materials and methods : Cross-sectional descriptive study, we evaluated 32 patients with non-cholesteatomatous COM with and without epitympanic retraction (ER) (Grade I-III, according to Mirko Tos classification), with a history of type I tympanoplasty (June, 2018 - January, 2020) in the otorhinolaryngology service of the Arzobispo Loayza National Hospital. Patients with previous middle ear surgeries, with cholesteatomatous COM, with ER grade IV and surgical acts not digitally stored were excluded. Results: 71.8% of patients presented ER (Grade I 3.0%, grade II 30.0% and grade III 56.5%), all presented blocked tympanic isthmus (TI). 68.8% of participants with ER presented complete tensor fold (TF). A significant relationship was observed between complete TF and blocked IT with ER (p=0.026 and 0.003, respectively). Conclusions: The most frequent findings were complete TF and blocked IT, these had a significant association with the presence of ER in patients with non-cholesteatomatous COM.

Attitudes toward Learning English and Procrastination in Students from a Private Institution Specialized in Foreign Languages in the City of Lima-Peru / Actitudes hacia el Aprendizaje de Inglés y Procrastinación en Estudiantes de una Institución Privada Especializada en Idiomas Extranjeros en la Ciudad de Lima-Perú

Abstract The current study has as its objective to analyze the relationship between students' attitude towards learning English and the procrastinating behavior at the academic level. Attitudes strengthen people's motivation to learn a foreign language (Delfín, 2007), and procrastination, which involves unjustified delaying of activities, causes negative consequences in completing academic tasks postponement of responsibilities (Rodríguez & Clariana, 2017). The design was correlational, and the sample consisted of 55 students learning English. The instruments were the Attitudes towards English language learning questionnaire and the academic procrastination questionnaire. According to the results, evidence shows that there is a positive median relationship between the variables, leading us to conclude that despite having positive attitudes towards learning English, procrastinating behavior does not diminish. The results of this study could be utilized in bilingual programs, or those could also be utilized to implement curricula in language programs at schools or universities. The idea is that higher education institutions include, as mandatory, the instruction of English as a global language.

Resumen El objetivo del trabajo fue analizar la relación que existe entre la actitud de los estudiantes hacia el aprendizaje del inglés y la conducta de procrastinar. Las actitudes refuerzan la motivación de las personas para aprender un idioma extranjero (Delfín, 2007) y la procrastinación, la cual tiene que ver con el aplazo injustificado de actividades, y provoca repercusiones negativas en las tareas académicas (Rodríguez & Clariana, 2017). El diseño fue correlacional y la muestra fue de 55 estudiantes de inglés. Los instrumentos fueron el cuestionario de Actitudes hacia el aprendizaje del idioma inglés y el cuestionario de procrastinación académica. De acuerdo a los resultados se evidencia que existe relación positiva media entre las variables, con lo cual se concluye que, a pesar de tener actitudes positivas hacia el aprendizaje del inglés, la conducta de procrastinar no disminuye. Los resultados de este estudio podrían ser utilizados en programas bilingües o podrían también ser utilizados para implementar currículos de programas de idiomas en escuelas y universidades. La idea es que las instituciones de educación superior tengan como obligación la implementación del curso de inglés como idioma global.

Genome Sequences of Community SARS-CoV-2 B.1.526 and P.1 Variants Circulating in the Dominican Republic.

Nearly complete genome sequences were obtained for a severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) variant of concern and two variants of interest from nasopharyngeal swab samples obtained during surveillance activities in urban communities, among individuals with no previous travel history, in Santo Domingo, Dominican Republic.

Performance Comparison of Deep Learning Autoencoders for Cancer Subtype Detection Using Multi-Omics Data.

A heterogeneous disease such as cancer is activated through multiple pathways and different perturbations. Depending upon the activated pathway(s), the survival of the patients varies significantly and shows different efficacy to various drugs. Therefore, cancer subtype detection using genomics level data is a significant research problem. Subtype detection is often a complex problem, and in most cases, needs multi-omics data fusion to achieve accurate subtyping. Different data fusion and subtyping approaches have been proposed over the years, such as kernel-based fusion, matrix factorization, and deep learning autoencoders. In this paper, we compared the performance of different deep learning autoencoders for cancer subtype detection. We performed cancer subtype detection on four different cancer types from The Cancer Genome Atlas (TCGA) datasets using four autoencoder implementations. We also predicted the optimal number of subtypes in a cancer type using the silhouette score and found that the detected subtypes exhibit significant differences in survival profiles. Furthermore, we compared the effect of feature selection and similarity measures for subtype detection. For further evaluation, we used the Glioblastoma multiforme (GBM) dataset and identified the differentially expressed genes in each of the subtypes. The results obtained are consistent with other genomic studies and can be corroborated with the involved pathways and biological functions. Thus, it shows that the results from the autoencoders, obtained through the interaction of different datatypes of cancer, can be used for the prediction and characterization of patient subgroups and survival profiles.

Distribution of Beta-Lactamase Producing Gram-Negative Bacterial Isolates in Isabela River of Santo Domingo, Dominican Republic.

Bacteria carrying antibiotic resistance genes (ARGs) are naturally prevalent in lotic ecosystems such as rivers. Their ability to spread in anthropogenic waters could lead to the emergence of multidrug-resistant bacteria of clinical importance. For this study, three regions of the Isabela river, an important urban river in the city of Santo Domingo, were evaluated for the presence of ARGs. The Isabela river is surrounded by communities that do not have access to proper sewage systems; furthermore, water from this river is consumed daily for many activities, including recreation and sanitation. To assess the state of antibiotic resistance dissemination in the Isabela river, nine samples were collected from these three bluedistinct sites in June 2019 and isolates obtained from these sites were selected based on resistance to beta-lactams. Physico-chemical and microbiological parameters were in accordance with the Dominican legislation. Matrix-assisted laser desorption ionization-time of flight mass spectrometry analyses of ribosomal protein composition revealed a total of 8 different genera. Most common genera were as follows: Acinetobacter (44.6%) and Escherichia (18%). Twenty clinically important bacterial isolates were identified from urban regions of the river; these belonged to genera Escherichia (n = 9), Acinetobacter (n = 8), Enterobacter (n = 2), and Klebsiella (n = 1). Clinically important multi-resistant isolates were not obtained from rural areas. Fifteen isolates were selected for genome sequencing and analysis. Most isolates were resistant to at least three different families of antibiotics. Among beta-lactamase genes encountered, we found the presence of blaTEM, blaOXA, blaSHV, and blaKPC through both deep sequencing and PCR amplification. Bacteria found from genus Klebsiella and Enterobacter demonstrated ample repertoire of antibiotic resistance genes, including resistance from a family of last resort antibiotics reserved for dire infections: carbapenems. Some of the alleles found were KPC-3, OXA-1, OXA-72, OXA-132, CTX-M-55, CTX-M-15, and TEM-1.

Comparison of Peri-operative and Early Oncological Outcomes of Robot-Assisted vs. Open Salvage Lymph Node Dissection in Recurrent Prostate Cancer.

Introduction: Salvage lymph node dissection (sLND) has been proposed as a treatment option for prostate cancer patients with lymph node (LN) recurrence following radical prostatectomy to delay or avoid palliative androgen deprivation therapy (ADT). Historically sLND has been performed using an open approach, with its associated morbidity. A limited number of studies have reported peri-operative outcomes following robot-assisted sLND. However, a direct comparison with the open approach has hitherto not yet been reported. This study investigates whether robot-assisted sLND is associated with better peri-operative outcomes compared to the open approach. Early oncological outcomes are also compared. Patients and methods: In this retrospective study, clinical data were collected from 60 patients undergoing open sLND between 2010-2016 and 30 patients undergoing robot-assisted sLND between 2016 and 2018 at our tertiary referral center. The primary objective of the study was to compare peri-operative outcomes (length of stay, estimated blood loss, operative time, intra-operative, and postoperative complications) and LN yield between both procedures. As secondary objective early oncological outcome [biochemical recurrence-free survival (BRFS) and clinical recurrence-free survival (CRFS)] was compared. Variables of interest were compared using the chi-squared test (categorical variables), two sample t-test, and Mann-Whitney U-test (continuous variables). To compare BRFS and CRFS, Kaplan-Meier analysis, and log-rank tests were performed. Results: Robotic sLND was associated with reduced blood loss (median 100 vs. 275cc; p < 0.0001) and shorter length of stay (median 2 vs. 7 days; p < 0.0001) compared to open sLND. Moreover, postoperative complications within 30 days after surgery were more prevalent in the open sLND group compared to the robotic group (41.6% vs. 20%, p = 0.04). No significant differences in LN yield (for each sLND template), BRFS, and CRFS were detected between both groups. Conclusion: Robot-assisted sLND is associated with significantly reduced peri-operative morbidity compared to open sLND. No difference in LN yield, BRFS and CRFS was seen between both groups. Modern imaging techniques underestimate the tumor burden and therefore, the surgical sLND template should not be limited to the positive spots on pre-operative imaging.

Aportes al método de investigación en el síndrome de burnout / Contributions to the research method in burnout syndrome

No disponible

Paniculitis lúpica: características clínico-patológicas de una serie de 12 pacientes / Lupus panniculitis: Clinicopathological features of a series of 12 patients

Antecedentes y objetivo: La paniculitis lúpica (PL) es una forma infrecuente de lupus eritematoso cutáneo crónico, cuyo diagnóstico requiere una adecuada correlación clínico-patológica, especialmente si constituye la primera manifestación de lupus eritematoso (LE). Dependiendo del estado evolutivo de las lesiones, la biopsia puede mostrar cambios poco específicos que dificultan el diagnóstico. Existen pocas series publicadas sobre esta entidad. Aportamos la experiencia de nuestro centro en su diagnóstico y manejo. Materiales y métodos: Estudio clínico-patológico retrospectivo descriptivo de 12 casos diagnosticados de PL en nuestro servicio. Resultados: Todos los pacientes tenían placas y/o nódulos dolorosos recurrentes, característicamente localizados en la zona proximal de las extremidades, la cara y el cuero cabelludo. En la biopsia había paniculitis de predominio lobulillar con infiltrados linfoplasmocitarios. Esto, junto con la coexistencia de otras manifestaciones clínicas de LE y el estudio de expresión de CD123, permitió establecer el diagnóstico de PL. En 3 pacientes la PL fue la primera manifestación de LE. Conclusiones: La PL es una entidad de difícil diagnóstico. La presencia de otras manifestaciones clínicas y/o histológicas de lupus y la utilización de técnicas inmunohistoquímicas pueden ser útiles para el diagnóstico diferencial con otras paniculitis

Background and objective: Lupus panniculitis (LP) is a rare variant of chronic cutaneous lupus erythematosus, which diagnosis requires clinicopathological correlation, especially in those patients without any other manifestation of lupus erythematosus (LE). According to the phase when the biopsy is performed, histological findings can be non-specific. Few series have been published to date. Hence, we report our own experience in the diagnosis and management of this disease. Materials and methods: We conducted a retrospective descriptive clinicopathological study of 12 patients diagnosed in our centre. Results: All the patients had painful and recurrent plaques and/or nodules, with a predilection for proximal extremities, face and scalp. Histopathologic examination showed mostly lobular panniculitis and lymphoplasmacytic infiltrate. For the diagnosis, we also considered the coexistence of other clinical manifestations of LE as well as the expression of CD123 by immunohistochemistry. In 3 patients, LP was the first manifestation of LE. Conclusions: The diagnosis of LP can be difficult. The presence of other clinical and/or histological manifestations of LE along with immunohistochemistry techniques could help in the differential diagnosis with other panniculitis

Lupus panniculitis: Clinicopathological features of a series of 12 patients. / Paniculitis lúpica: características clínico-patológicas de una serie de 12 pacientes.

BACKGROUND AND OBJECTIVE: Lupus panniculitis (LP) is a rare variant of chronic cutaneous lupus erythematosus, which diagnosis requires clinicopathological correlation, especially in those patients without any other manifestation of lupus erythematosus (LE). According to the phase when the biopsy is performed, histological findings can be non-specific. Few series have been published to date. Hence, we report our own experience in the diagnosis and management of this disease. MATERIALS AND METHODS: We conducted a retrospective descriptive clinicopathological study of 12 patients diagnosed in our centre. RESULTS: All the patients had painful and recurrent plaques and/or nodules, with a predilection for proximal extremities, face and scalp. Histopathologic examination showed mostly lobular panniculitis and lymphoplasmacytic infiltrate. For the diagnosis, we also considered the coexistence of other clinical manifestations of LE as well as the expression of CD123 by immunohistochemistry. In 3 patients, LP was the first manifestation of LE. CONCLUSIONS: The diagnosis of LP can be difficult. The presence of other clinical and/or histological manifestations of LE along with immunohistochemistry techniques could help in the differential diagnosis with other panniculitis.

El uso del contraste para el diagnóstico de ameloblastoma: a propósito de un caso / Contrast's use for the diagnosis of ameloblastoma: about a case

Los ameloblastomas son los tumores odontogénicos benignos más comunes, sin tomar en cuenta a los odontomas; su comportamiento es localmente invasivo, destructivo con alta tasa de recurrencia, no exhiben predilección en cuanto al sexo y presentan picos de incidencia dentro de la cuarta y quinta década de vida; sin embargo los ameloblastomas uniquísticos, en su mayoría son diagnosticados durante la segunda década de vida. El presente reporte muestra las características imagenológicas del ameloblastoma, haciendo uso de diferentes técnicas de adquisición de imágenes; entre ellas se resalta el uso de la tomografía helicoidal multicorte (THM) con administración de contraste endovenoso, la cual nos permite obtener datos adicionales para la caracterización de la estructura interna de la lesión, diferenciándola así de otras patologías.

Ameloblastomas are the most common benign odontogenic tumors, without regard to odontomas; Its behavior is locally invasive, destructive with high rate of recurrence. They do not have sex predilection and theirs peak of incidence is in the fourth and fifth decades of life; however, uniquistic ameloblastomas are mostly diagnosed during the second decade of life. The present report shows the imaging characteristics of ameloblastoma, using different techniques of image acquisition; among them the use of Helicoidal Multidetector Computed Tomography (HMCT) with intravenous contrast administration, which allows us to obtain additional data for the characterization of the internal structure of the lesion, thus differentiating it from other pathologies.

Bacteria of the genus Rickettsia in ticks (Acari: Ixodidae) collected from birds in Costa Rica.

The aim of this study was to document the presence of Rickettsia spp. in ticks parasitizing wild birds in Costa Rica. Birds were trapped at seven locations in Costa Rica during 2004, 2009, and 2010; then visually examined for the presence of ticks. Ticks were identified, and part of them was tested individually for the presence of Rickettsia spp. by polymerase chain reaction (PCR) using primers targeting fragments of the rickettsial genes gltA and ompA. PCR products were DNA-sequenced and analyzed in BLAST to determine similarities with previously reported rickettsial agents. A total of 1878 birds were examined, from which 163 birds (9%) were infested with 388 ticks of the genera Amblyomma and Ixodes. The following Amblyomma (in decreasing order of abundance) were found in immature stages (larvae and nymphs): Amblyomma longirostre, Amblyomma calcaratum, Amblyomma coelebs, Amblyomma sabanerae, Amblyomma varium, Amblyomma maculatum, and Amblyomma ovale. Ixodes ticks were represented by Ixodes minor and two unclassified species, designated here as Ixodes sp. genotype I, and Ixodes sp. genotype II. Twelve of 24 tested A. longirostre ticks were found to be infected with 'Candidatus Rickettsia amblyommii', and 2 of 4 A. sabanerae were found to be infected with Rickettsia bellii. Eight of 10 larval Ixodes minor were infected with an endosymbiont (a novel Rickettsia sp. agent) genetically related to the Ixodes scapularis endosymbiont. No rickettsial DNA was found in A. calcaratum, A. coelebs, A. maculatum, A. ovale, A. varium, Ixodes sp. I, and Ixodes sp. II. We report the occurrence of I. minor in Costa Rica for the first time and a number of new bird host-tick associations. Moreover, 'Candidatus R. amblyommii' and R. bellii were found in A. longirostre and A. sabanerae, respectively, in Costa Rica for the first time.

Misoprostol and declining abortion-related morbidity in Santo Domingo, Dominican Republic: a temporal association.

OBJECTIVE: To validate anecdotal reports that abortion-related complications decreased in the Dominican Republic after the introduction of misoprostol into the country. DESIGN: Retrospective records reviews and cross-sectional surveys, interviews and focus groups. SETTING: Family planning clinics, pharmacies, door-to-door canvassing and a tertiary care maternity hospital in Santo Domingo, Dominican Republic. POPULATION: Women of reproductive age in Santo Domingo, Dominican Republic. METHODS: Qualitative and quantitative methods were used. Individual interviews and focus groups of reproductive health professionals, non-governmental organisation leaders and women's group leaders (n= 50) were conducted to discover the role of misoprostol in the Dominican Republic. Local women (n= 157) were surveyed to determine their knowledge of misoprostol as an abortifacient and mystery client visits were made to 80 pharmacies in order to purchase misoprostol without a prescription. Sales data were obtained that documented when misoprostol was introduced to the Dominican Republic pharmacies. Hospital admissions for abortions from the prior eight years were reviewed and hospital emergency room consultation ledgers of 31,190 visits for the period 1994-2001 were reviewed for abortion complications. MAIN OUTCOME MEASURES: Frequencies of maternal morbidities and knowledge of misoprostol. RESULTS: Mystery clients purchased misoprostol without a prescription in nearly 64% of pharmacies; staff provided little additional information or counselling. Reliable sales data documented the introduction of misoprostol in 1986. Abortion complications decreased from 11.7% of abortions in 1986 to 1.7% in 2001. The majority of professionals interviewed felt that knowledge of these findings should be made public. CONCLUSIONS: The data were of too poor quality to validate the verbal reports reliably, but misoprostol appears to have been widely used over a period when abortion-related morbidity fell. It remains plausible that the use of misoprostol contributed to the reduction.

Rinosinusitis crónica: Variantes anatómicas determinadas mediante tomografía helicoidal / Chronic Rhinosinusitis: anatomical variants determined by helical tomography

El objetivo fue determinar las principales alteraciones anatómicas de la nariz y los senos paranasales en pacientes con diagnóstico de rinosinusitis crónica (RSC), de esta manera conseguir puntos de reparo para la cirugía endoscópica funcional. La investigación se llevo a cabo en el Servicio de Otorrinolaringología del Hospital Nacional Arzobispo Loayza (agosto 2003-mayo 2004), se evaluaron 85 pacientes que cumplieron los criterios de selección, con edades comprendidas entre 18 y 79 años, de ambos sexos, quienes fueron evaluados con un tomógrafo helicoidal marca Picker 2000S de cuarta generación. Se hallaron celdillas de Agger Nasi en el 65%, desviación septal en el 60%, alteraciones de la apófisis unciforme (horizontalización y colapso) 55%, bulla etmoidal 53%, concha bullosa 40%, cornetes paradójicos 35%, celdillas de Haller y Onodi en 21% cada uno, hipoplasias sinusal en el 10%. En alrededor 60% la alteraciones fueron bilaterales. Por otro lado, se observó las deformidades del cornete medio asociadas a una desviación contralateral en un 60%. Se puede concluir que la tomografía computarizada es el examen de elección para definir la patología de la nariz y los senos paranasales en RSC y permite el planeamiento quirúrgico endoscópico con previsión de las áreas de riesgo.

Aspergiloma de seno maxilar con erosión ósea. Reporte de caso / Aspergiloma of maxillary bosom with bony erosion. Report of case

La Rinosinusitis fúngica es una entidad nosológica que viene recibiendo especial atención entre las diferentes modalidades de afecciones del tracto respiratorio superior, debido al notable incremento de su incidencia en los últimos años. La suficiencia de la respuesta inmunitaria del huésped moldearía el tipo de manifestación micótica. Siendo las formas no invasoras generalmente desarrolladas por el huésped inmunosuficiente, que estarían representadas con alguna frecuencia por la Bola fúngica, cuyo cuadro clínico es inespecífico y requiere para su diagnóstico definitivo de la comprobación microbiológica, histopatológica y radiológica sociada a una minuciosa observación clínica. La finalidad del presente artículo es realizar un análisis de la metodología diagnóstica y del tratamiento de un caso de Aspergiloma de seno maxilar derecho con erosión ósea, manejado por el equipo de Médicos Residentes del Servicio de Otorrinolaringología del Hospital Nacional Arzobispo Loayza.

High levels of palmitic acid lead to insulin resistance due to changes in the level of phosphorylation of the insulin receptor and insulin receptor substrate-1.

Insulin resistance is defined as the decrease in the glucose disposal in response to insulin by the target tissues. High concentrations of nonesterified fatty acids (NEFA) in plasma have been implicated with many insulin resistance states. We evaluated several aspects of the insulin resistance induced by palmitic acid in rats and found that after treatment with 0.09 g/kg of palmitic acid there is a delay in the curve of tolerance to glucose. We measured the changes in protein phosphorylation in samples from abdominus rectus muscle and there was a decrease of 64 and 75% in the levels of phosphorylation in tyrosine of the insulin receptor and insulin receptor substrate-1, respectively. This diminution in the tyrosine phosphorylation is consistent with a decrease in the main pathway known to be activated after insulin treatment, the mitogen activated protein kinases (MAPKs). If the animals were treated with inhibitors of PKC, like sphingosine, there was a prevention of the effect of palmitic acid determined at the level of tyrosine phosphorylation. According with this result, we found an increase in the phosphorylations in serine of the insulin receptor after the treatment with palmitate. These results suggest that PKC has a role as negative regulator (by phosphorylation in serine) of the insulin receptors activation in the insulin resistance induced by palmitic acid.

Rechazo y eficacia de el dispositivo intrauterino transcesarea en la Maternidad Nuestra Señora de la Altagracia / Rejection and efficacy of the intrauterine transcesarean dispositive in our lady of La Altagracia Maternity Hospital

Antecedentes: La inserción de el dispositivo intrauterino (DIU) durante una operación cesárea ofrece las ventajas de la fácil inserción; sin embargo se señala que con frecuencia el DIU es rechazado en un periodo corto de tiempo y por tanto no cumple su cometido. Materiales y métodos: Se realizó un estudio prospectivo en 44 pacientes cesareadas a las cuales se les insertó un Dispositivo Intrauterino (DIU), durante el tranquirúrgico en la Maternidad Nuestra Señora de la Altagracia en Santo Domingo, República Dominicana. Resultados: De los 44 DIU insertados 6 fueron rechazados en un periodo de tres meses para un 13.6//; de los DIU rechazados tres lo fueron el primer mes posterior a su inserción. Los restantes DIU permanecieron en su lugar hasta que fueron retirados voluntariamente. Conclusión: En nuestro trabajo la tasa de rechazo fue inferior a otros trabajos y por tanto consideramos este método uno de los mas efectivos para la prevención del embarazo

Cesárea: histerorrafia en un plano / Cesarean section: one plane histerorraphy

Se comparó la morbimortalidad entre la histerorrafia en un plano y en dos planos. Se estudiaron cien pacientes a las que se realizó histerorrafia en un plano, tomando un grupo testigo de otras cien con histerorrafia en dos planos comparando evolución. En la cesárea con histerorrafia en un plano con respecto a la de dos planos se obtuvo: Tiempo quirúrgico aproximadamente el 50 por ciento menor (P menor a 0.0001); sangrado 100cc menos (P menor a 0.001); Complicaciones sin diferencia estadísticamente significativa. No hubo diferencia en la morbimortalidad. Cicatrización a los 60 días semejante