[Use of platelet concentrate in bone regeneration through exodontics. Narrative review]. / Uso de concentrados plaquetarios en la regeneración ósea por exodoncia. Revisión narrativa.

Introduction: The post-exodontic alveolar atrophy requires quality bone regeneration techniques, and therefore, it is necessary to apply platelet concentrates, which are bioactive agents in the process of preserving the alveolar bone. The use of platelet concentrates proved to be an excellent osteoinducer since it leads to three important effects for maintaining bone structure. Objective: To analyze the use of platelet concentrates in post-exodontic bone regeneration. Materials and methods: A descriptive, explanatory study. A narrative review in which data was collected from 26 scientific articles published in scientific databases such as PubMed, Redalyc, ScienceDirect, and Ovid between 2012 and 2022. Conclusions: Platelet concentrates are physiological materials that speed up the healing time of post-extraction wounds. They are autologous since they are taken from the patient him/herself, reducing the risk of postoperative reactions, and the transmission of diseases by parenteral route. They relieve both inflammation and edema as well as post-surgery symptoms that appear after a dental extraction. They also help to preserve the alveolar ridge, avoiding long-term atrophy.

Polyostotic fibrous dysplasia (McCune-Albright) with rare multiple epiphyseal lesions in association with aneurysmal bone cyst and pathologic fracture.

Fibrous dysplasia, including McCune-Albright syndrome, is a genetic, non-inheritable benign bone disorder that may involve a single or multiple bone, typically occurring in the diaphysis or the metaphysis of long bones. In very rare instances polyostotic fibrous dysplasia present involvement of the epiphysis in long bones. Aneurysmal bone cysts are benign, expansile, lytic bone lesions formed by cystic cavities containing blood, that may occur de novo or secondary to other lesions of bone, including fibrous dysplasia. We report a case of an 18-year-old female with polyostotic fibrous dysplasia (McCune-Albright syndrome) with diaphyseal and unusual multiple foci of epiphyseal involvement of long bones as well as in the patella, and a simultaneous aneurysmal bone cyst of the left femoral neck with pathologic fracture. This is the first report of a simultaneous aneurysmal bone cyst in a patient with polyostotic fibrous dysplasia (McCune-Albright syndrome) with involvement of diaphysis and epiphysis of long bones, highlighting that fibrous dysplasia should be included in the differential diagnosis of polyostotic tumors involving the diaphysis as well as the epiphysis. In patients with polyostotic fibrous dysplasia there should be an active search for lesions in the epiphysis.

Micobacterium avium complex en paciente inmunodeprimido: reporte de un caso / Mycobacterium avium complex in immunosuppressed patient: a case report

INTRODUCCIÓN: Dentro de las micobacterias atípicas destaca el Complejo Micobacterium Avium, cuyo nicho principal en humanos son los pacientes con inmunodeficencia. PRESENTACIÓN DEL CASO: Paciente masculino, 30 años, con antecedentes de infección por Virus de Inmonudeficiencia Humana en terapia antirretroviral y por virus Hepatitis B. Hospitalizado por cuadro de dolor abdominal asociado a síndrome consuntivo. Durante hospitalización se realizó Tomografía Computarizada que mostró múltiples adenopatías. Luego se realizó biopsia ganglionar que concluyó Tuberculosis ganglionar, comenzando con tratamiento antituberculoso. En el transcurso del tratamiento el paciente inició con sintomatología respiratoria y sus baciloscopías de esputo persistieron positivas, manteniéndose con dicho cuadro hasta confirmar la presencia de Micobacterium Avium en el cultivo, comenzando su tratamiento específico, con positivos resultados. DISCUSIÓN: El Complejo Micobacterium Avium corresponde a la causa más común de enfermedad por micobacteria no tuberculosa en inmunosuprimidos. Por lo tanto, es un patógeno que merece ser considerado al menos como diagnóstico diferencial en dicho tipo de pacientes. En el presente caso se evidencia tanto una sospecha como un diagnóstico tardío, lo que llevó a una demora en el inicio del tratamiento y a complicaciones sintomáticas del paciente. Es necesario para la pesquisa precoz, realizar cultivos tanto para M. tuberculosis como para micobacterias atípicas para mejorar pronóstico y a su vez disminuir el riesgo de complicaciones.

INTRODUCTION: Among the atypical mycobacteria, the Micobacterium Avium Complex stands out. Its main niche in humans is immunodeficient patients. CASE REPORT: 30 years old male patient, with a history of infection by Human Immunodeficiency Virus on antiretroviral therapy, and Hepatitis B virus. Hospitalized for abdominal pain associated with consumptive syndrome. During his hospitalization, a computerized tomography was performed, showing multiple adenopathies. Then, a lymph node biopsy was performed that concluded nodal tuberculosis, beginning with antituberculous treatment. During the course of this treatment, patient presented respiratory symptoms and sputum bacilloscopy persisted positive, maintaining this condition until the presence of Mycobacterium Avium was confirmed in the culture, beginning with specific treatment, with positive results. DISCUSSION: The Mycobacterium Avium Complex is the most common cause of nontuberculous mycobacterial disease in immunosuppressed patients. Therefore, its a pathogen that has to be considered at least as a differential diagnosis in such patients. In the present case, suspicion and a late diagnosis are evidenced, which lead to a delay in the initiation of treatment and complications for the patient. It is necessary for early screening, culture for both M. tuberculosis and atypical mycobacteria to improve prognosis and to reduce the risk of complications.

Los sacrificados/comprometidos: un sistema cultural al interior de los centros de salud antes de la reforma / Sacrifice and commitment: a cultural system inside health centers (previous to the current health system reform)

El presente ensayo propone una interpretación antropológica sobre la cultura existente en los Centros de Salud y consultorios de la atención primaria en zonas urbanas de Chile antes de los procesos de Reforma de la Salud implementados en el gobierno de Ricardo Lagos. Se plantea la existencia de un sistema cultural que posibilita una buena o una mala atención. Para que exista una buena atención, los usuarios deben seguir una serie de normas, donde la principal es subordinar su tiempo al de los funcionarios, junto con no reclamar, tener paciencia y obedecer las órdenes. Estas normas se explican por la existencia de una ideología muy profunda que se basa en el sacrificio y el compromiso que implica atender y resolver problemas en condiciones precarias de trabajo. “Los funcionarios, porque son comprometidos, se sacrifican para que el usuario tenga atención”. Esta ideología justifica acciones positivas y negativas. Bajo este sistema se da muy mal trato a quienes no sigan las normas y permite redes informales que castigan a los funcionarios que se alejan de la misma, lo que funciona como mecanismo de control. Este sistema permite a los funcionarios controlar y manejar su propio tiempo, la situación con los usuarios y la justificación de acciones negativas como el mal desempeño o mala atención.

The present document proposes an anthropological interpretation of the prevailing culture in the primary health care Centers (Centros de Salud) of the urban zones of Chile before the Health Service reforms applied by the President Lagos administration came into effect. The existence of a cultural system that influences the quality of care is set forth for consideration. In order to receive good care, the users must follow certain norms, of which the main one is the subordination of its time availability to that of the staff, along with patience and submissiveness. These norms arise from a very deep ideology that is based on the recognition of the sacrifice and commitment implied in health care work that is performed under precarious conditions. “The staff sacrifice themselves in order to provide service, because they are committed to their functions”. This ideology justifies positive and negative consequences. Those users who the do not follow the norms are mistreated and informal networks are generated among the staff, whereby the employees who deviate from those norms are punished; this amounts to a control mechanism. This system allows the health personnel to control and to handle its own time, as well as their relationship with the users; and to justify any inadequate performance.

[Critical points for success in supracricoid partial laryngectomy with cricohyoidepiglottoepexy]. / Puntos críticos en el éxito de la laringectomía parcial supracricoidea (LPS) con cricohioidoepiglotopexia (CHEP).

Cancer of the larynx is a relatively rare neoplasia in Mexico as well as in the rest of the world; however, evolution of treatment in recent years showed important results in terms of survival and local control. Supracricoid partial laryngectomy with cricohyoidoepiglottopexy is a surgical technique that permits similar oncologic results to other conservatives techniques for glottic carcinoma, with excellent functional results. The objective of the present work was to show the critical points of the technique based on the description of Laccourreye, emphasizing the anatomical aspect of resection and reconstruction to avoid complications and achieve best results.