Importancia de la apropiada selección de aditamentos protésicos sobre implantes para conservar el estado de salud gingival: reporte de caso / Importance of the appropriate selection of prosthetic attachments on implants to preserve the state of gingival health: case report

Introducción: La rehabilitación oral en pacientes edéntulos parciales que requieren implantes dentales ha incrementado su demanda en los últimos años, convirtiéndose en un tratamiento de rutina, donde procedimientos quirúrgicos y protésicos tienen un éxito considerable. En algunos casos estas complicaciones se resuelven de forma simple, en otros, se necesita de una mejor planificación. Objetivo: Modificar y complementar el plan de tratamiento del paciente como solución definitiva al posicionamiento equivocado de los implantes dentales oseo integrados. Presentación del Caso: Paciente de 64 años, hombre, asistió a Centro de Atención Odontológica de la Universidad de Las Américas (CAO/UDLA), para terminar tratamiento odontológico de especialidad, rehabilitación de cuatro implantes colocados en zona 1.6 (Mis: C1 4.20 x 13mm); 1.4 (Mis: C1 3.75x11.50 mm); 1.2 (Mis: C1 3.75 x 11.50 mm); 2.1 (Mis: C1 4.20 x 11.50 mm), a examen clínico se pudo observar prótesis acrílica transicional inmediata desadaptada e inestable oclusalmente como resultado de proceso de cicatrización de tejidos, pérdida de piezas dentales postero-inferiores (3.6; 3.7; 4.6 y 4.7).La angulación equivocada de los implantes anteriores obligó la necesidad de corregirla mediante el uso de aditamentos rotacionales Multi-unit rectos de 2 mm altura en implantes 1.6; 1.4, aditamentos anti rotacionales tipo Multi-unit angulados de 1 mm de altura a 30º para los implantes 1.2 y 2.1 con healingcaps para proteger el aditamento de la acumulación de placa bacteriana y facilitar la higienización e inserción de la prótesis múltiple. Conclusiones: Los aditamentos colocados modificaron y complementaron la rehabilitación de los implantes incluso en la zona anterior donde se encontró tejido mucoso insuficiente que cubra de forma completa el aditamento elegido. (AU)

Introduction: Oral rehabilitation in partial edentulous patients who require dental implants has increased its demand in recent years, becoming a routine treatment, where surgical and prosthetic procedures have considerable success In some cases these complications are resolved simply, in others. Aims: Better planning is needed modify and complement the patient’s treatment plan as a definitive solution to the wrong positioning of osseointegrated dental implants. Presentation of the Case: Patient of 64 years, man, attended the Dental Care Center of the University of the Americas (CAO / UDLA), to finish specialty dental treatment, rehabilitation of four implants placed in zone 1.6 (Mis: C1 4.20 x 13mm); 1.4 (Mis: C1 3.75x11.50 mm); 1.2 (Mis: C1 3.75 x 11.50 mm); 2.1 (Mis: C1 4.20 x 11.50 mm), On clinical examination, immediate transitional acrylic prosthesis could be observed maladapted and occlusally unstable as a result of tissue healing process, loss of postero-inferior teeth (3.6; 3.7; 4.6 and 4.7). The wrong angulation of the previous implants forced the need to correct it through the use of 2 mm high straight Multi-unit rotational attachments in implants 1.6; 1.4, angled Multi-unit anti-rotational attachments from 1 mm high to 30 mm for implants 1.2 and 2.1 with healing caps to protect the attachment from the accumulation of bacterial plaque and facilitate the sanitization and insertion of the multiple prosthesis. Conclusions: The attachments placed modified and complemented the rehabilitation of the implants even in the anterior area where insufficient mucous tissue was found to completely cover the chosen attachment. (AU)

Low frequency of AIP mutations in patients with young-onset sporadic pituitary macroadenomas.

PURPOSE: Mutations in the aryl hydrocarbon receptor interacting protein (AIP) gene cause familial isolated pituitary adenomas (FIPA). AIP mutations have also been found in patients with apparently sporadic pituitary adenomas, particularly in young patients with large adenomas. The aim of this study was to determine the frequency of AIP germline mutations in patients with young-onset sporadic pituitary macroadenomas. METHODS: The AIP gene was sequenced in 218 Portuguese patients with sporadic pituitary macroadenomas diagnosed before the age of 40 years. RESULTS: Heterozygous rare sequence variants in AIP were identified in 18 (8.3%) patients. However, only four (1.8%) patients had pathogenic or likely pathogenic variants. These consisted of two already known mutations (p.Arg81* and p.Leu115Trpfs*41) and two novel mutations (p.Glu246*, p.Ser53Thrfs*36). All four patients had GH-secreting adenomas diagnosed between the ages of 14 and 25 years. The frequency of AIP pathogenic or likely pathogenic variants in patients under the age of 30 and 18 years was 3.4% and 5.0%, respectively. CONCLUSION: The frequency of AIP mutations in this cohort was lower than in other studies. Previous reports may have overestimated the contribution of AIP mutations due to the inclusion of genetic variants of uncertain significance. The identification of novel AIP mutations expands the known spectrum of genetic causes of pituitary adenomas and may help understand the role of AIP mutations in the molecular mechanisms underlying pituitary tumorigenesis.

Conocimiento sobre la no adherencia de métodos anticonceptivos ¿Podría disminuir la mortalidad materna?

Introducción : En el Perú, el 78,1% de mujeres, entre 15 a 49 años, utilizan un método anticonceptivo, lo cual se ve mermado por diversos factores asociados a su no adherencia; ello ha generado embarazos no deseados y contagio de enfermedades de transmisión sexual. Objetivo : Determinar los factores asociados a la no adherencia de métodos anticonceptivos en mujeres en edad fértil en el Perú, según la ENDES 2021. Métodos : Estudio de tipo observacional, analítico y transversal. La información utilizada se encuentra en la base de datos pública de la ENDES 2021. La población está constituida por peruanas de 15 a 49 años. El análisis estadístico se realizó con el programa estadístico SPSS versión 26.0. Las variables cualitativas fueron representadas en una tabla univariada con frecuencias y coeficientes de variación. El valor de significancia estadística aprobado fue de confianza al 95%. Resultados : El 43,7% de mujeres no tuvieron adherencia al método anticonceptivo. Hubo asociación significativa para las variables: área de residencia rural (RPa 1,05, IC 1 - 1,1) , estado civil separada (RPa 1,1, IC 1 - 1,1) , estado civil viuda (RPa 1,3, IC 1,1 - 1,5), estado civil conviviente (RPa 1,1, IC 1,1 - 1,2), índice de riqueza pobre(RPa 1,03, IC 0,9 - 1,0). Conclusiones : Los factores asociados a la no adherencia de métodos anticonceptivos en mujeres de edad fértil en el Perú, los cuales se asocian de manera significativa son: el área de residencia rural, el estado civil separada, viuda y conviviente y poseer un índice de riqueza pobre.

Introduction: In Peru, 78.1% of women between the ages of 15 and 49 use a contraceptive method, which is diminished by various factors associated with non-adherence to the contraceptive method, thus producing unwanted pregnancies and the spread of sexually transmitted diseases. Objective: To determine the factors associated with non-adherence to contraceptive methods in women of childbearing age in Peru according to ENDES 2021. Methods: Observational, analytical and cross-sectional study. The information used is found in the ENDES 2021 public database. The population of this research is made up of peruvian women between the ages of 15 and 49. Statistical analysis was performed with the statistical program SPSS version 26.0. The qualitative variables were represented in a univariate table with frequencies and coefficients of variation. The approved statistical significance value was p <0.05 with 95% confidence intervals. Results: 43.7% of women did not adhere to the contraceptive method. There was a significant association for the variables: area of rural residence (RPa 1.05 IC 1 - 1.1), separated marital status (RPa 1.1, IC 1 - 1.1), widow marital status (RPa 1.3, IC 1.1 - 1.5), cohabiting marital status (RPa 1.1, IC 1.1 - 1.2) , poor wealth index (RPa 1.03, IC 0.9 - 1.0) Conclusions: The factors associated with non-adherence to contraceptive methods in women of childbearing age in Peru, which are significantly associated are: rural area of residence, separate marital status, widow and cohabitant and have a poor wealth index.

Patient-Reported Outcome Measures After Surgical Management of Unstable Lisfranc Injuries in Athletes.

Background: Athletes sustaining Lisfranc joint instability after a low-energy injury often undergo surgical fixation. Limited studies report validated patient-reported outcome measures (PROMs) for this specific patient population. Our purpose was to report PROMs of athletes experiencing instability after a low-energy Lisfranc injury and undergoing surgical fixation. Methods: Twenty-nine athletes (23 competitive, 6 recreational) sustained an unstable Lisfranc injury (14 acute, 15 chronic) and met our inclusion criteria. Injuries were classified as acute if surgically managed within 6 weeks. All athletes completed validated PROMs pre- and postoperatively. The cohort underwent various open reduction internal fixation methods. We evaluated outcomes with the Foot and Ankle Ability Measure (FAAM) activities of daily living (ADL) and sports subscales. Results: Fourteen of 29 (48%) athletes reported PROMs at ≥2 years with a median follow-up time of 44.5 months. Substantial improvement for both FAAM ADL (50% vs 93%; P < .001) and sports (14.1% vs 80%; P = .002) subscales were found, when comparing preoperative to postoperative scores at ≥2 years. Conclusion: This study provides outcomes information for the young athletic population that were treated operatively for low-energy Lisfranc injury with apparent joint instability. Based on the FAAM sports subscale, these patients on average improved between their 6-month evaluation and their final ≥2 years but still scored 80% of the possible 100%, which indicates continued but "slight" difficulty with lower extremity function. Level of Evidence: Level IV, case series.

Síndrome de sobrecarga en cuidadores de Alzheimer. Revisión sistemática / Overload syndrome in Alzheimer’s caregivers. Systematic review

El progresivo envejecimiento de la sociedad hace que se disparen los índices de enfermedades asociadas a la senectud como es el caso de la enfermedad de Alzheimer (EA), la cual produce un deterioro cognitivo progresivo ge-nerando gran dependencia a los afectados y cuyo cuidado suele recaer en un único cuidador, con frecuencia conllevado una gran carga de trabajo y un deterioro de su salud. La presente revisión sistemática tiene como objetivo profundizar en el conocimiento sobre los factores relacionados con la sobrecarga en cuidadores informales de EA. Los hallazgos derivados de los estudios confirman el predominio de las mujeres en las tareas relacionadas con el cuidado. También queda de manifiesto la presencia de altos niveles de carga en cuidadores de EA y la existencia de factores moderadores, como la resiliencia, las estrategias de afrontamiento, los aspectos positivos del cuidado, la religiosidad, la autoeficacia o el apoyo social percibido (AU)

The progressive aging of society causes the rates of diseases associated with senescence to skyrocket, such as Alzheimer’s disease (AD), which produces a progressive cognitive deterioration generating great dependence on those affected and whose care usually falls on a single caregiver, often with a heavy workload and deteriorating health. The objective of this systematic review is to deepen our understanding of the factors related to overload in informal caregivers of AD. The findings derived from the studies confirm the predominance of women in care-related tasks. The presence of high levels of burden on AD caregivers and the existence of moderating factors, such as resilience, coping strategies, positive aspects of care, religiosity, self-efficacy or perceived social support are also evident (AU)

Challenges of Organ Donation: Potential Donors for Transplantation in an Area of Brazil's Northeast.

BACKGROUND: New strategies to manage the pool of potential donors are needed to increase organ donation rates. The purpose of the study was to identify the main causes of lack of organ donation and to identify the sociodemographic and clinical profiles of potential organ donors in an area of northeastern Brazil. METHODS: We conducted a cross-sectional, retrospective, observational study between November 2015 and January 2017. RESULTS: A total of 150 potential donors were included in the sample. The main cause of death among potential donors was hemorrhagic stroke (35.3%). Hypertension was the most prevalent comorbidity (25.6%). Family member's refusal was cited as the most common reason for not performing organ donation (49.4%). Among the causes of family member's refusal, the most prevalent was declaration of non-consent in life (23%), followed by family disagreement (20.3%). CONCLUSION: There is clearly a need for public educational efforts with regard to organ donation. Educational advertising campaigns can help improve the authorization rate of organ donation.

Associação à positividade da Lawsonia intracellularis com a expressão clínico-patológica da infecção em suínos da região metropolitana de Bucaramanga (Santander, Colômbia) / Association to positivity of Lawsonia intracellularis with the clinical and pathologic expression of infection in swine from the metropolitan area of Bucaramanga (Santander, Colombia)

Porções de íleo terminal foram coletados de 100 suínos com sinais de doença gastrointestinal na área metropolitana de Bucaramanga, a fim de se estudar a eficiência do diagnóstico de enteropatia proliferativa suína (PPE) pela técnica de PCR aninha (PCRa) empregando sequências específicas (primers) para L. intracellularis: 16S ARN região (270pb) e sua correlação com achados clínicos e patológicos. Todas as amostras foram processadas para se determinar a associação entre positividade por PCR, os sinais clínicos, os achados de necropsia e as lesões histológicas. Cinquenta e seis por cento das amostras foram positivas para L. intracellularis pela PCRa. Só 2% exibiram resultados positivos pela técnica Warthin-Starry. Trinta e um de 100 animais com sinais de anorexia resultaram positivos para PCRa (P>0,05). Não houve associação (P<0,05) entre diarreia e queda no crescimento, bem como associação (P<0,05) entre achados anatomopatológicos e histológicos com PCRa positivas.(AU)

Fragments of terminal ileum were collected from 100 pigs at slaughter from Bucaramanga Metropolitan Area (Santander, Colombia), to study the efficacy of the diagnosis of porcine proliferative enterophaty (PPE) through the technique of nested polymerase chain reaction (PCRa), employing specific sequences (primers) for L. intracellularis: 16S ARN region (270pb) and his correlation with clinic and pathological findings. All samples were processed by standard histological methods and stained with a Warthin-Starry technique. All samples were processed to determinate the association between positive PCRa results, clinical signs and necropsy findings. 56% of the 100 samples were positive for L. intracellularis through PCRa technic. Only 2% exhibited positive results through Warthin-Starry technique. A total of 31 (100) animals with anorexic symptoms were associated with positive results from PCRa (P>,05). No associations (P<0.05) were observed between diarrhea and delayed growth. No associations (P<0.05) were observed between anatomopathological and histological findings with positive PCRa.(AU)

Contribuição ao estudo farmacognóstico da Piper ovatum Vahl / Contribution to the pharmacognostic study of Piper ovatum Vahl

RESUMO: O presente estudo descreve as características morfo-anatômicas dos órgãos vegetativos e do pó da Piper ovatum Vahl de modo que os dados obtidos possam ser utilizados como referência em análises de controle de qualidade de amostras de fármacos, a fim de verificar sua autenticidade. As raízes, caules, pecíolos e folhas foram fixadas, seccionadas à mão livre e coradas, as secções transversais e paradérmicas foram analisadas por microscopia óptica e a superfície do limbo foi observada, também, por microscopia eletrônica de varredura (MEV). Os órgãos vegetativos da P. ovatum apresentam morfologia e anatomia similar às outras espécies de Piper. No entanto, não foram observadas inclusões celulares nas folhas de P. ovatum. Análises por MEV mostraram a presença de tricomas glandulares constituídos de pedúnculo unicelular e porção secretora globóide igualmente unicelular recoberto por cutícula, na epiderme abaxial das folhas. Também foi observada a presença de uma cutícula espessa e que origina crostas no limite entre uma célula e outra, em ambas as superfícies foliares. No mesófilo foi observada a presença de idioblastos oleíferos característica marcante de outras espécies de Piperaceae. Além disso, na microscopia do pó foram observados hipoderme e idioblastos oleíferos em fragmentos do limbo, fragmentos de fibras esclerenquimáticas do caule, além de células esclerosas isoladas ou em grupos no pecíolo. O perfil cromatográfico do extrato hidroetanólico das folhas de P. ovatum foi obtido por cromatografia líquida de alta eficiência (CLAE). Nas análises por CLAE foram identificados como substâncias majoritárias do extrato as amidas piperovatina e piperlonguminina nos tempos de retenção de 10,25 e 10,81 min., respectivamente.

ABSTRACT: The present study describes the morphological and anatomical characteristics of vegetative organs and powder of the Piper ovatum Vahl, in order to use the obtained data as reference in the quality control tests of pharmaceutical samples, investigating their authenticity. The roots, stems, petioles and leaves were fixed, freehand sectioned and stained according to usual microtechniques. The transverse and paradermal sections were analyzed by optical microscopy and the leaf surface was also observed by scanning electron microscopy (SEM). The vegetative organs of the P. ovatum show morphology and anatomy similar to other species of Piper. However, cellular inclusions were not observed in the P. ovatum leaves. The SEM analysis showed the presence of glandular trichomes consisting of a unicellular stalk and globular secretory portion covered by cuticle on the abaxial surface of the leaves. The SEM also had shown one thick cuticle forming crusts in the limit of the epidermal cells, on both leaf surfaces. In the mesophyll, we observed oil idioblasts, which are typical features of other species of Piperaceae. Moreover, in the powder of the P. ovatum we observed hypodermis and oil idioblasts in leaf fragments, fragments of sclerenchyma fibers from the stem and isolated sclereids or in petiole groups. The chromatographic profile of the hydroethanolic extract of the P. ovatum leaves was obtained by high performance liquid chromatography (HPLC). In this analysis, we identified the amides piperovatine and piperlonguminine in the retention times of 10.25 and 10.81 min., respectively, as majority compounds present in the extract.

Effect of a topical formulation containing Calophyllum brasiliense Camb. extract on cutaneous wound healing in rats.

This study evaluated the wound healing effects of topical application of an emulsion containing the HPLC-standardised extract from Calophyllum brasiliense Cambess (Clusiaceae) leaves in rats. The macroscopic analysis demonstrated that the wounds treated with the C. brasiliense emulsion healed earlier than the wounds treated with emulsion base and Dersani®. The percentage of wound healing in the group treated with the C. brasiliense emulsion was significantly higher than in the other groups at 7 and 14 days. On day 14, the animals treated with the C. brasiliense emulsion exhibited a 90.67% reduction of the wound areas. The histological evaluation revealed that on day 21, the group treated with the C. brasiliense emulsion exhibited a significant increase in fibroblasts compared with the other groups. Thus, the C. brasiliense emulsion had healing properties in the topical treatment of wounds and accelerated the healing process.

Antileishmanial activity of an essential oil from the leaves and flowers of Achillea millefolium.

An essential oil was recently extracted from the leaves and flowers of yarrow (Achillea millefolium) and tested for in-vitro activity against Leishmania amazonensis and murine macrophages (i.e. the J774G8 cell line). The median inhibitory concentration (IC(50)) against L. amazonensis promastigotes was 7.8 µg/ml whereas the survival of amastigotes of this pathogen, within peritoneal murine macrophages, was halved by treatment with the oil at 6.5 µg/ml. The mean value for the median cytotoxic concentration of the oil, measured against adherent (uninfected) J774G8 macrophages, was 72.0 µg/ml (i.e. 9.2 and 11.0 times higher, respectively, than the IC(50) against the promastigotes and intracellular amastigotes). Scanning electron microscopy revealed that the oil caused morphological changes in the treated parasites, including alterations in their shape and size. In transmission electron microscopy, promastigotes treated with the oil (at the IC(50) of 7.8 µg/ml) showed various ultrastructural alterations, including changes in the flagellar membrane, abnormal membrane structures, rupture of the plasma membrane, atypical vacuoles, myelin-like figures, and vesicles that resembled autophagic vacuoles.

[Carcinoid tumor. An analysis of 131 cases]. / Tumor carcinoide. Análisis de 131 casos.

We would like to describe the characteristics of affection by carcinoid tumor in our surroundings. In so doing, we have reviewed the clinical histories of the 131 cases of carcinoid tumor diagnosed in our center between 1972 and 1990. The incidence has been 0.7 cases per 100,000 inhabitants per year. The age at diagnosis is from 8 to 88 years, and the proportion of men to women is practically 1. The most common locale affected the appendix (54 cases) followed by the bronchials (46 cases). The most common clinical presentation has been casual discovery and in the bronchials, in addition to hemoptysis and pneumonia. Carcinoid syndrome was found in only 4 cases, and of 17 determinations of indole acetic 5-hydoxi acid, only 2 resulted pathological. There were four cases of hepatic metastasis and two deaths related with the tumor.

Survey of butyltin contamination in Portuguese coastal environments.

Butyltin compounds (MBT, DBT and TBT) in intertidal sediments collected in four different Portuguese coastal environments have been measured in order to evaluate the extent of contamination. The sites chosen were the Rias of Aveiro and Faro, and the Sado and Tejo estuaries. These zones were traditional areas for shellfish production in the recent past, but the effects of industrial development have caused a deterioration of the environment. Specific contaminations were derived from the harbour (commercial and/or fisheries) and shipyard activities, resulting in a release of TBT and causing the oyster populations of the above mentioned estuaries to almost disappear. Results presented in this study give a survey of TBT contamination levels found in the four areas. The paper discusses the importance of the pollution in comparison with other European coastal areas.

[Myxedema coma]. / Coma mixedematoso.

Five patients, 4 female and 1 male, aged 45 to 73, were observed in myxedema coma between 1984 and 1992. In three patients hypothyroidism was not known. Depressed consciousness, hypothermia, bradycardia and no goiter were common to all and a precipitating factor could be identified in 3 of them. Therapy included L-thyroxine and/or triiodothyronine by nasogastric tube, hydrocortisone and supportive measures. Outcome was good in the 2 patients with known precipitating event, less impaired consciousness and normalization of body temperature by the third day of treatment.