Diagnóstico de la higiene bucal en pacientes con aparatos de ortodoncia

Fundamento:una adecuada higiene bucal es necesaria en los pacientes que portan aparatos de ortodoncia.Objetivo:identificar conocimientos, actitudes, prácticas e higiene bucal en pacientes con aparatos de ortodoncia.Métodos:se realizó un estudio con diseño no experimental, descriptivo y transversal en la Clínica Estomatológica Docente Provincial de Sancti Spíritus en el período entre septiembre de 2018 y julio de 2019. Se utilizaron métodos del nivel teórico, empírico (encuesta, entrevista, observación y estadístico). La población estuvo constituida por 30 pacientes de esta institución con tratamiento de ortodoncia. Se midieron las variables: edad y sexo del paciente, tipo de aparato de ortodoncia, nivel de conocimiento sobre salud bucodental, actitud y prácticas del paciente de higiene bucal, frecuencia, forma y eficiencia del cepillado dental, así como el cepillado o no después de la ingestión de alimentos azucarados.Resultados:el 100 % de los pacientes presentó conocimientos deficientes sobre salud bucal y prácticas desfavorables, aunque se constató actitudes favorables en el 63,3 % de los pacientes. Predominó una higiene bucal regular en la población estudiada antes de iniciar el tratamiento y después de instalar los aparatos, de manera similar en los grupos con aparatos removibles, funcionales y fijos.Conclusiones:los pacientes de la población estudiada necesitan educación para apropiarse de conocimientos suficientes para mantener actitudes, prácticas e higiene bucal saludables.[AU]

Variation of the CD4, CD8, and MHC II cell population in granulomas of immunocompetent and immunosuppressed rabbits in Encephalitozoon cuniculi infection.

Encephalitozoon cuniculi (E. cuniculi) is a fungi-related, obligate, zoonotic, spore-forming intracellular eukaryotic microorganism. This emerging pathogen causes granulomas in brain and kidneys of infected individuals. The objective of this study was to detect the distribution of CD4, CD8 and MHCII-positive cells within granulomas in these organs in infected immunocompetent (group A) and infected immunosuppressed (group B) New Zealand white rabbits using immunohistochemistry. In brain, labeled CD4 immune cells were mainly located in the periphery of granulomas in group B. Kidneys of groups A and B, displayed CD4-positive in granulomas and were significant different when compared to brain. CD8 immune cells in brain and kidneys were disseminated in the granulomas in groups A and B; however, no significant difference was observed. MHCII-positive cells were more numerous in brain sections of group B and were significantly different when compared to kidney sections. Granulomas were not observed in control animals of group C and D. In conclusion, we identified CD4-positive cells in both the brain and kidneys of immunocompetent and immunosuppressed animals; CD8-positive cells were more numerous in brain of immunosuppressed rabbits and MHCII cells were more predominant in brain of immunocompetent rabbits. Apparently, the immunosuppression stimulated a change in the cellular phenotype of Th1- to Th2-like granulomas in brain and kidneys by an unknown mechanism. These results increase our understanding of CD4, CD8 and MHCII positive cells within the E. cuniculi granuloma microenvironment and will help in future microsporidian granulomas studies of both immunocompetent and immunosuppressed individuals.

Nuevas consideraciones sobre el control glicémico en pacientes con diabetes tipo 2 y sus implicancias sobre el riesgo cardiovascular / New considerations on glycemic control in patients with type 2 diabetes and its implications on cardiovascular risk

Los resultados de los últimos estudios utilizando una terapia hipoglicemiante intensiva en pacientes con diabetes mellitus tipo 2 han demostrado ser exitosos en el control glicémico de estos pacientes, sin embargo, no han logrado obtener una reducción significativa de la mortalidad por patología cardiovascular.

Ovarian response and embryo production in llamas treated with equine chorionic gonadotropin alone or with a progestin-releasing vaginal sponge at the time of follicular wave emergence.

The objective of the study was to compare the ovulatory response and embryo production in llamas (Lama glama) treated with a single dose of equine chorionic gonadotropin (eCG) alone or combined with intravaginal medroxyprogesterone acetate (MPA) at the time of follicular wave emergence. Llamas with a growing follicle >or=7 mm in diameter were assigned to one of the following groups: (1) Control (n=28): Nonstimulated llamas were mated and embryos were collected 7 d after mating. (2) eCG (n=32): Llamas were given 5mg luteinizing hormone (LH) (Day 0) to induce ovulation, 1000 IU eCG on Day 2, a luteolytic dose of prostaglandin F(2alpha) on Day 6, mating on Day 7, and embryo collection on Day 14. (3) eCG+MPA (n=34): Llamas were treated as those in the eCG group, but a sponge containing 60 mg MPA was placed intravaginally from Days 2 to 6. Llamas that did not respond to synchronization or superstimulation were excluded, leaving data from n=26, 26, and 27 in the control, eCG, and eCG+MPA groups, respectively, for statistical analysis. The mean (+/-SD) number of follicles>7 mm at the time of mating was greatest in the eCG group, intermediate in the eCG+MPA group, and lowest in the control group (16.6+/-5.3, 12.9+/-3.7, and 1.0+/-0.0, respectively, P<0.001). The number of corpora lutea was similar between eCG and eCG+MPA groups (10.1+/-2.9 and 8.6+/-3.7, respectively); both were higher (P<0.001) than in controls (0.9+/-0.3). The number of embryos did not differ significantly between the eCG and eCG+MPA groups (4.8+/-2.8 and 3.5+/-3.0, respectively), but both were higher (P<0.001) than in the controls (0.7+/-0.4). In conclusion, eCG, with or without MPA effectively induced a superovulatory response and multiple embryo production in llamas.

Detection of specific antibodies to Neospora caninum and Toxoplasma gondii in naturally infected alpacas (Lama pacos), llamas (Lama glama) and vicunas (Lama vicugna) from Peru and Germany.

Sera of an experimentally Neospora caninum infected llama and a non-infected control llama were used to establish an immunoblot, an ELISA and an IFAT to detect antibodies against N. caninum tachyzoites. Subsequently, serum samples collected from a total of 871 South American Camelids (SAC: Lama glama, Lama pacos, Lama vicugna) of two farms in Peru and from 32 SAC of a farm in central Germany were examined for antibodies against N. caninum and Toxoplasma gondii. Based on the recognition of specific bands in the immunoblot, sera of SAC from Peru were differentiated into N. caninum-positive (n = 18) and T. gondii-positive (n = 30) samples and into samples negative or inconclusive for both parasites. Using the immunoblot results as the reference, a modified version of the p38-ELISA and the IFAT were evaluated for detecting N. caninum antibodies in SAC sera. Applying a cut-off as determined by two graph-receiver operating characteristic analysis both, the ELISA and the IFAT, exhibited a sensitivity and specificity of about 95% in the SAC sera from Peru. Serological testing confirmed that SAC may become infected with N. caninum under field conditions in Peru. In addition to alpacas and llamas also 114 wild living vicunas had been examined for antibodies against N. caninum. However, only the alpacas and llamas but no vicunas were found N. caninum-positive. In contrast, T. gondii-seropositive animals were detected in all three SAC species. The lack of N. caninum-seropositive vicunas indicates that in the study area in Peru wild canids might not serve as definitive hosts of N. caninum while for T. gondii a life cycle including wild felids is likely. On the German farm no N. caninum- but only T. gondii-seropositive SAC (n = 14) were detected. The seroprevalence of T. gondii infection was significantly higher in adult SAC (alpacas in Peru, llamas in Germany) than in crias (i.e. < 12 months old foals) indicating that the predominant route of infection is post natal. Since the present study was restricted to a few farms, the seroprevalences determined are not representative. However, our results confirm natural infections with N. caninum and T. gondii in SAC. Whether these infections are linked to any disease, e.g. reproductive losses, has to be clarified in further studies.

Tratamiento quirúrgico del quiste pilonidal / Surgical treatment of the pilonidal cyst

Se presenta la experiencia en el manejo quirúrgico de 182 pacientes con quiste pilonidal, tratados durante el período 1980-1988 en nuestro Hospital. Se contó con buena información de seguimiento postoperatorio en 88 de ellos (48%) y este grupo constituyó la presente serie. Se analizó la forma de presentación clínica y el tratamiento quirúrgico efectuado y su resultado. Los síntomas principales fueron tumoración e infección y en más del 50% de los casos la sintomatología estaba presente por un período mayor de un año. En el 74% se efectuó una técnica quirúrgica que inclyó cierre primario y en el 26% se efectuó una técnica abierta. Cuando se empleó cierre primario hubo recidiva de 10%, en cambio esta fue de 4% con técnica abierta. Se concluye que cualquiera sea la técnica, el grado de curación es alto, siempre mayor de 85%.

Atrofia espinal infantil progresiva.Enfermedad de Werdnig-Hoffmann. / Progressive spinal atrophy in infancy.Werdnig-Hoffmann's disease

La atrofia espinal infantil progresiva o enfermedad de Werdnig-Hoffmann (EWH) es un desorden hereditario que afecta nucleos motores del asta anterior de la medula; se distinguen tres tipos clinicos con comportamiento especifico. Sin embargo los ninos con este padecimiento son frecuentemente diagnosticados como portadores de miopatias congenitas o paralisis cerebral infantil. Hasta ahora no existen metodos especificos de diagnostico, pues las alteraciones que se detectan son compartidas por diversas enfermedades.En la observacion de nuestros casos y por lo referido en la literatura medica, es fundamental el juicio clinico para considerar esta entidad. A la fecha, no existen perspectivas de tratamiento y los pacientes llegan inexorablemente a la muerte. El tiempo de sobrevida depende tanto del tipo clinico como de las medidas de sosten para prolongar la existencia