Simple and Sustainable Preparation of Cathodes for Li-S Batteries: Regeneration of Granular Activated Carbon from the Odor Control System of a Wastewater Treatment Plant.

To obtain a wide variety of green materials, numerous investigations have been undertaken on industrial waste that can act as sustainable resources. The use of hazardous wastes derived from wastewater treatment plants (WWTPs), especially the activated carbon used in odor control systems, is a highly abundant, scalable, and cost-effective strategy. The reuse of waste materials is a key aspect, especially for the sustainable development of emerging energy storage systems, such as lithium-sulfur (Li-S) batteries. Herein, granular active carbons from two WWTP treatment lines were regenerated in air at low temperature and utilized as the sulfur host with micro-/mesoporous framework. The resulting regenerated carbon and sulfur composites were employed as cathodes for Li-S cells. The SL-ACt3@S composite electrode with 60 wt% loaded sulfur exhibited a remarkable initial capacity of 1100 mAh g-1 at C/10 rate and higher than 800 mAh g-1 at C/2. Even at a rate of 1C, it maintained a high capacity of almost 700 mAh g-1 with a capacity retention of 85.4 % after 350 cycles, demonstrating a very low capacity fading of only 0.042 % per cycle. It is essential to note that the coulombic efficiency was always higher than 96 % during all the cycles. In this proposal, the only used source material was expired carbon from WWTP that was obtained with a simple and effective regeneration process. This "trash into treasure" strategy leads to a new way for using hazardous waste material as high-performance and environmentally safe electrodes for advanced Li-S batteries.

Validation of an Automated Screening System for Diabetic Retinopathy Operating under Real Clinical Conditions.

BACKGROUND: Retinopathy is the most common microvascular complication of diabetes mellitus. It is the leading cause of blindness among working-aged people in developed countries. The use of telemedicine in the screening system has enabled the application of large-scale population-based programs for early retinopathy detection in diabetic patients. However, the need to support ophthalmologists with other trained personnel remains a barrier to broadening its implementation. METHODS: Automatic diagnosis of diabetic retinopathy was carried out through the analysis of retinal photographs using the 2iRetinex software. We compared the categorical diagnoses of absence/presence of retinopathy issued by family physicians (PCP) with the same categories provided by the algorithm (ALG). The agreed diagnosis of three specialist ophthalmologists is used as the reference standard (OPH). RESULTS: There were 653 of 3520 patients diagnosed with diabetic retinopathy (DR). Diabetic retinopathy threatening to vision (STDR) was found in 82 patients (2.3%). Diagnostic sensitivity for STDR was 94% (ALG) and 95% (PCP). No patient with proliferating or severe DR was misdiagnosed in both strategies. The k-value of the agreement between the ALG and OPH was 0.5462, while between PCP and OPH was 0.5251 (p = 0.4291). CONCLUSIONS: The diagnostic capacity of 2iRetinex operating under normal clinical conditions is comparable to screening physicians.

The use of a surgical planning tool for evaluating the optimal surgical accessibility to the stapedius muscle via a retrofacial approach during cochlear implant surgery: a feasibility study.

PURPOSE: During cochlear implant (CI) surgery, visual detection of the stapedius reflex as movements of the stapes tendon, electrically elicited via the CI, is a standard measure to confirm the system's functionality. Direction visualization of the stapedius muscle (SM) movements might be more reliable, but a safe access to the small SM is not defined. A new surgical planning tool for pre-operative evaluation of the accessibility to the stapedius muscle (SM) during a cochlear implantation (CI) via a retrofacial approach was now evaluated. METHODS: A surgical planning tool was developed in MATLAB using an image processing algorithm to evaluate drilling feasibility. A flat-panel computed tomography (CT) combining a rotational angiographic C-arm units with flat-panel detectors (Dyna-CT) was used. In total, 30 3D Dyna-CT-based temporal bone reconstructions were evaluated by automatized algorithms, generating a series of trajectories and comparing their feasibility and safety to reach the SM via a retrofacial approach. The predictability of the surgical planning tool results was tested in 5 patients. RESULTS: The surgical planning tool showed that a retrofacial access to the SM would be feasible in 25/30 cases. Moreover, the evaluation of the predictability of the results obtained with the surgical planning tool conducted during 5 CI surgeries confirmed the results. Both the surgical planning tool and the results on SM accessibility via retrofacial approach during CI showed that this is safe and feasible only when the SM-exposed area was > 25% of its total, the distance between the SM and the facial nerve was > 0.8 mm, and the surgical corridor diameter was > 3 mm. CONCLUSION: The surgical planning tool seems to be useful for the pre-operative evaluation of the accessibility to the SM during a CI surgery via a retrofacial approach. Further prospective studies are needed to validate the results in larger cohorts.

Hipoglucemia tumoral dependiente y no dependiente de células ß-pancreáticas, un reto diagnóstico / Tumor and non-tumor mediated hypoglycemia by pancreatic beta cells, a diagnostic challenge

La hipoglucemia es una urgencia médica frecuente que en la mayoría de los casos es secundaria al uso de fármacos hipoglucemiantes, orales o inyectados, indicados en pacientes con diabetes mellitus. No obstante, puede presentarse en forma espontánea y severa relacionándose con múltiples condiciones clínicas, incluyendo las neoplasias. Ante una hipoglucemia de origen paraneoplásico se deben reconocer los mecanismos fisiopatológicos que la generan y establecer el diagnóstico oportuno y preciso para disminuir las complicaciones propias de este síndrome clínico. Presentamos dos pacientes con cuadro de hipoglucemia refractaria al manejo médico inicial, de aparición similar con patologías diferentes. El primer caso corresponde a un paciente con insulinoma y el segundo con un hemangiopericitoma.

Hypoglycemia is a common medical emergency which is mostly secondary to the use of oral or injected hypoglycemic drugs indicated in patients with diabetes mellitus. However, it can present spontaneously and severely in relation to multiple clinical conditions, including neoplasms. When faced with hypoglycemia associated with paraneoplastic disorders, the pathophysiological mechanisms of hypoglycemia must be recognized and a timely and accurate diagnosis must be established in order to diminish complications inherent to this clinical syndrome. We herein present two patients with hypoglycemia refractory to initial medical management, sharing similar appearance with other pathologies. The first case corresponds to a patient with an insulinoma and the second to a patient with a hemangiopericytoma.

Can two different pneumococcal conjugate vaccines be used to complete the infant vaccination series? A randomized trial exploring interchangeability of the 13-valent pneumococcal conjugate vaccine and the pneumococcal non-typeable Haemophilus influenzae protein D-conjugate vaccine.

Background: We assessed the safety and immunogenicity of 2 + 1 infant regimens initiated with the 13-valent pneumococcal conjugate vaccine (PCV13) and completed with the pneumococcal non-typeable Haemophilus influenzae protein D-conjugate vaccine (PHiD-CV). Methods: This partially blinded study randomized 6-12-week-old infants to receive two-dose priming and a booster (at ages 2, 4, 12-15 months) with: PCV13 at priming and PHiD-CV at boosting (PPS); PCV13 then PHiD-CV at priming and PHiD-CV at boosting (PSS); or PHiD-CV at priming and boosting (SSS control). All analyses were descriptive, i.e., no statistical significance tests were done. Results: The total vaccinated cohort at priming comprised 294 infants. Grade 3 adverse events were reported after 8.7% (PPS), 11.4% (PSS), and 16.9% (SSS) of primary doses (primary objective). No serious adverse events were considered vaccination-related. For most PHiD-CV serotypes, observed percentages of children reaching antibody concentrations ≥0.2 µg/mL and opsonophagocytic activity (OPA) titers above cutoffs were similar across groups 1 month post-priming and post-booster. Observed geometric mean antibody concentrations and OPA titers were lower for some PHiD-CV serotypes with the mixed regimens than with PHiD-CV only, especially for PSS. However, no tests of statistical significance were performed. Conclusions: Immunogenicity of the two mixed PCV13/PHiD-CV regimens seemed mostly similar to that of a PHiD-CV-only series, although observed antibody GMCs and OPA GMTs for some PHiD-CV serotypes were lower. No safety concerns were raised. The clinical relevance of the observed differences is unknown. Clinical trial registration: ClinicalTrials.gov: NCT01641133.

Focus on the patientWhat is the context? Infant immunization programs worldwide include the pneumococcal conjugate vaccines Synflorix and Prevnar 13 to help combat pneumococcal diseases. Countries or regions choose whether to use Synflorix or Prevnar 13 and may decide to switch from one vaccine to the other. This can result in infants receiving a mixed vaccination regimen. Limited information is available about such mixed regimens. What is new? We assessed the immunogenicity of three infant vaccination regimens: 1) priming with two doses of Prevnar 13 and boosting with Synflorix; 2) priming with one dose of Prevnar 13 followed by one dose of Synflorix and boosting with Synflorix; 3) priming and boosting with Synflorix. The study showed that: Switching from Prevnar 13 to Synflorix at any time during the vaccination regimen did not seem to affect safety. When switching from Prevnar 13 to Synflorix at the time of boosting, immunogenicity was mostly similar to that of the Synflorix- only regimen. Switching vaccines during priming resulted in a trend toward lower immune responses for some vaccine components. What is the impact? This piece of evidence can be considered by doctors and health authorities when evaluating the possibility of switching pneumococcal vaccines in an immunization program or individual immunization regimen. Further effectiveness studies from countries or regions switching from Prevnar 13 to Synflorix (or vice versa) may shed more light on the feasibility of switching between these vaccines.

Socioeconomic deprivation and development of diabetic retinopathy in patients with type 1 diabetes mellitus.

INTRODUCTION: Very little is known about the influence of socioeconomic status on type 1 diabetes mellitus (T1DM) complications. Our aim was to determine whether socioeconomic level is a risk factor for the development of diabetic retinopathy (DR) in patients with T1DM. RESEARCH DESIGN AND METHODS: A cohort of 150 patients with T1DM were studied prospectively over 9 years. Socioeconomic status was assessed using a neighborhood-level measure based on an index of deprivation. The contribution of other variables such as hypertension, dyslipidemia, diabetic nephropathy and smoking habit was evaluated. Cox proportional hazards models were used to quantify the associations. RESULTS: The incidence of DR was 21.6 cases per 1000 patient-years. Multivariable analyses showed that for each percentage point increase in glycated hemoglobin (HbA1c), the risk of developing DR increased by 58% (HR 1.58, 95% CI 1.19 to 2.10).Patients with T1DM onset >18 years of age and resident in areas of lower socioeconomic levels presented with almost triple the risk of developing DR (HR 2.95, 95% CI 1.08 to 8.00) compared with those with onset <18 years of age and resident in less deprived areas. We did not find significant relationships with other variables studied such as hypertension, dyslipidemia, diabetic nephropathy and smoking habit. CONCLUSIONS: Low socioeconomic level is a risk factor, independent of glycemic control, in the development of DR in patients with T1DM when the onset of diabetes is in adulthood. This finding indicates that socioeconomic status and age of onset need to be considered in population screening for DR in patients with T1DM.

Workflows in a Virtual Morphology Lab: 3D scanning, measuring, and printing.

The aim of this paper is to give a practical overview, showing how recent available digital technology can be combined to build a laboratory capable to produce 3D (and reproduce in 3D) anatomical models for research, teaching and museum exhibitions on topics related to anatomy, morphology in natural sciences, biology and medicine. We present workflows in our Virtual Morphology Lab that can be used for research, training (museum, academic), and external service. We first review different surface scanning equipment and post-processing techniques that are useful for scanning in museum collections and provide technical recommendations for hard- and software as well as storing media on the web. This section is followed by an overview of available software packages for rigorous and effective 3D measurements of landmarks and sliding semi-landmarks, providing extensive supplementary information with guiding manuals for self-teaching in these cutting-edge but complicated research methods. We review briefly most recent work on virtual GM and describe ways for representing results in form of 3D images and 3D prints (outputs). The last part is dedicated to a summary of our experience in 3D-printing using FDM technology of differently sized printers and thermoplastic materials. Finally, we discuss the above-described workflows and its potential applications in research (paleo, biomedical), teaching and museums pedagogics.

Trigger Points, Pressure Pain Hyperalgesia, and Mechanosensitivity of Neural Tissue in Women with Chronic Pelvic Pain.

Objectives: This study aims to evaluate the presence of myofascial trigger points (TrPs), widespread pressure pain sensitivity, and mechanosensitivity of neural tissue in women with chronic pelvic pain. Design: Case-control study. Setting: Faculty of Health Sciences. Subjects: Forty women with chronic pelvic pain between age 18 and 60 years and 40 matched healthy controls were included in the study. Methods: TrPs were bilaterally explored in gluteus maximus, gluteus medius, gluteus minimus, quadratus lumborum, and adductor magnus muscles. The referred pain reproduced lumbopelvic symptoms. Pressure pain thresholds (PPTs) were also bilaterally assessed over the Pfannenstiel incision point on the abdominal, C5-C6 zygapophyseal joint, second metacarpal, and tibialis anterior muscle. Mechanosensitivity of neural tissue was assessed with the neurodynamics tests of slump and the straight-leg raising. Results: Significant between-group differences were found in TrP presence in patients with chronic pelvic pain (P < 0.001) compared with those included in the control group. Widespread pressure pain hyperalgesia was also found, with PPTs significantly reduced in the points assessed. Neurodynamics show a significantly decreased value in women with CPP. Conclusions: Patients with chronic pelvic pain presented a high percentage of TrPs that reproduce their symptoms. Patients also showed a widespread pressure pain hyperalgesia and more mechanosensitive neural tissue due to a decrease on the range of motion related to neurodynamics.

Physiotherapy interventions for patients with chronic pelvic pain: A systematic review of the literature.

Objective: To summarize the available scientific evidence on physiotherapy interventions in the management of chronic pelvic pain (CPP). Data Sources: A systematic review of randomized controlled trials was performed. An electronic search of MEDLINE, CINAHL, and Web of Science databases was performed to identify relevant randomized trials from 2010-2016. Study Selection: Manuscripts were included if at least one of the comparison groups received a physiotherapy intervention. Studies were assessed in duplicate for data extraction and risk of bias using the Physiotherapy Evidence Database scale PEDro. Data Extraction and Synthesis: Eight of the studies screened met the inclusion criteria. Four manuscripts studied the effects of electrotherapy including intravaginal electrical stimulation, short wave diathermy, respiratory-gated auricular vagal afferent nerve stimulation, percutaneous tibial nerve stimulation, and sono-electro-magnetic therapy with positive results. Three studies focused on manual assessing the efficacy of myofascial versus massage therapy in two of them and ischemic compression for trigger points. Conclusions: Although physiotherapy interventions show some beneficial effects, evidence cannot support the results. Heterogeneity in terms of population phenotype, methodological quality, interpretation of results, and operational definition result in little overall evidence to guide treatment.

Balance ability and posture in postmenopausal women with chronic pelvic pain.

OBJECTIVE: The aim of the present study was to analyze balance ability and posture in postmenopausal women with chronic pelvic pain (CPP). METHODS: This study includes a sample of 48 women with CPP recruited from the Gynecology Service of Virgen de las Nieves and San Cecilio Hospitals in Granada (Spain) and 48 healthy control women matched with respect to age and anthropometric characteristics. Outcome variables collected included: balance ability (Mini-Balance Evaluation Systems Test and Timed Up an Go Test) and posture (photogrammetry and Spinal Mouse). RESULTS: Significant differences were found in all Mini Best Test subscales: total (P < 0.001), anticipatory (P = 0.002), reactive postural control (P < 0.001), sensory orientation (P < 0.001), and dynamic gait (P < 0.001), and all Timed Up and Go test subscales: alone (P < 0.001), with manual (P = 0.002) and cognitive task (P = 0.030). Significant differences were also found on spinal cervical angles with a forward head posture in women with CPP; global spine alignment exhibited more deviation in the women with CPP (P < 0.001); and a higher percentage of women with CPP (58%) presented with increased thoracic kyphosis and lumbar lordosis. Cohen's d was used to calculate the effect size. Some subscales of balance and posture tests showed a large effect size (d ≥0.8), indicating a more consistent result. CONCLUSIONS: Women with CPP presented poor balance including anticipatory, reactive postural control, sensory orientation, dynamic gait, and dual task-related conditions. Posture showed higher values on the dorsal angle and lower sacral inclination, less spine alignment, and a more prevalent posture with increased kyphosis and lumbar lordosis.

Colestasis intrahepática benigna recurrente, un reto diagnóstico / Recurrent Benign Intrahepatic Cholestasis is a Diagnostic Challenge

La colestasis hepática incluye una gran variedad de desórdenes que pueden comprometer la vía intra o extrahepática, requiriendo para su diagnóstico una asociación de hallazgos clínicos, bioquímicos, imagenológicos y en algunos casos, patológicos. Se describe el caso de un paciente que presenta episodios intermitentes y autoresolutivos de ictericia recurrente asociados con dolor abdominal y prurito intenso, en quien se encuentra durante los episodios de agudización un patrón colestásico intrahepático que se resuelve completamente durante los episodios de remisión.

Hepatic cholestasis includes a large variety of disorders which can compromise the intrahepatic and extrahepatic pathways. Diagnosis requires a combination of clinical, biochemical, imaging, and sometimes pathological, findings. We describe the case of a patient with intermittent episodes of jaundice which resolved by themselves but which were and decisive associated with abdominal pain and severe itching. These episodes occurred during exacerbation of the intrahepatic cholestatic pattern but completely resolved during episodes of remission.

[Guía latinoamericana para el diagnóstico y tratamiento de alergia a las proteínas de la leche de vaca (GL-APLV)].

Cow's milk allergy (CMA) is an immune-based disease that has become an increasing problem. The diagnosis and management of CMA varies from one clinical setting to another and represents a challenge in pediatric practice. In addition, because nonallergic food reactions can be confused with CMA symptoms, there is an overdiagnosis of the disease. In response to these situations, pediatric specialties from recognized institutions throughout Latin America decided to develop a clinical guideline for diagnosis and management of cow's milk allergy. These guidelines include definitions, epidemiology, pathophysiology overview, clinical and evidencebased recommendations for the diagnosis and treatment of CMA. They also include prevention and prognosis sections and identify gaps in the current knowledge to be addressed through future research.

Carcinoma papilar intraquístico asociado a adenocarcinoma ductual infiltrante en un hombre: reporte de un caso / Papillary intra cyst carcinoma associated with ductal adenocarcinoma in a man: case report

El carcinoma papilar intraquístico es un subtipo de carcinoma ductal no invasivo, puede estar asociado o no acarcinoma in situ y a carcinoma infiltrante, es una patología poco frecuente por lo tanto su aparición en hombres es extremadamente rara. El tratamiento en estos casos es equivalente al carcinoma de mama en mujeres, se debate entre mastectomía simple o mastectomía parcial más radioterapia. Presentamos el caso de un hombre a quien se diagnostica preoperatoriamente con un carcinoma papilar y se realiza mastectomía simple más ganglio centinela.

The papillary intra cyst carcinoma is a sub type of ductal no invasive carcinoma, it can be or not associated to in situ carcinoma and to infiltrant carcinoma, is a pathology less frequent, for these reason his apparition in men is extremely rare. The treatment is equivalent to the breast carcinoma in women, debated between simple mastectomy and partial mastectomy with radiation therapy. We present a clinical case of a man with pre operative diagnostic with a papillary carcinoma and realized simple mastectomy with sentinel node.

Detección ganglio centinela con azul patente cáncer de mama localmente avanzado después de quimioterapia neoadyuvante / Detection of sentinel node with blue patent in local advance breast cancer after neo-adjuvant chemeotherapy

Estudiar la exactitud diagnóstica, factibilidad y validez de la disección del ganglio centinela en pacientes con cáncer de mama localmente avanzado posterior a quimioterapia neoadyuvante. Estudio de tipo prospectivo, analítico realizado entre diciembre de 2009 y mayo de 2011 en el Servicio de Cirugía General del Hospital Militar “Dr. Carlos Arvelo”. Se incluyeron 13 pacientes con diagnóstico de cáncer de mama localmente avanzado que recibieron quimioterapia neoadyuvante. Se realizó la inyección sub-areolar de 2 cm3 de azul patente 15 min previos al acto quirúrgico, se procedió a la ubicación del ganglio centinela con posterior disección de los niveles I y II de Berg. La tasa de identificación del ganglio centinela fue de 92,3%. El estado axilar fue predicho con una sensibilidad de 71,4%, especificidad 80%. La tasa de falsos negativos resultó del 20%, siendo el ganglio centinela positivo en 58,3% de las pacientes de la serie. Una alta tasa de identificación y 20% de falsos negativos está dentro de esa gran gama de resultados; sin embargo, por ser un estudio prospectivo y este un informe preliminar, el escaso número de la muestra limita la aplicabilidad general en este tipo de pacientes. Todavía falta mucho que precisar sobre el ganglio centinela en pacientes que recibieron quimioterapia, por lo que la disección axilar debe seguir siendo parte del tratamiento. Estudios adicionales son necesarios

The objective of this work is to study accuracy, feasibility and validity of sentinel lymph node detection in patients with locally advanced breast cancer after neoadjuvant chemotherapy. Prospective and analytical study performed between December 2009 and May 2011 at the General Surgery Service of the Hospital Militar “Dr. Carlos Arvelo”. We included 13 patients with a diagnosis of locally advanced breast cancer that received neoadjuvant chemotherapy. Sub-areolar injection of 2 cm3 of patent blue dye was done 15 min before initiating the surgical procedure. The sentinel lymph node was detected and then axillary dissection of levels I and II of Berg was performed. The sentinel lymph node identification rate was 92.3%. The axillaries status was predicted with a sensibility of 71.4 % and specificity of 80%. The false positive rate was 20%. The sentinel lymph node was positive in 58.3% of the patients in this study. A high identification rate and 20% of false negative cases is possible among a large spectrum of results. As this is a prospective study and a preliminary report, the scarce number of patients limits the application of these results to this type of patients. There are still many unanswered questions concerning sentinel lymph node detection in patients that have received chemotherapy, so axillary lymph node detection must remain the standard of care. Future studies are necessary

Carcinoma papilar intraquístico asociado a adenocarcinoma ductal infiltrante en un hombre: reporte de un caso / Papillary intra cystic carcinoma associated to ductal infiltrant adenocarcinoma in male: a case report

El carcinoma papilar intraquístico es un subtipo de carcinoma ductal no invasivo, puede estar asociado o no a carcinoma in situ y a carcinoma infiltrante, es unapatología poco frecuente por tanto su aparición en hombres es extremadamente rara. El tratamiento en estos casos es equivalente al carcinoma de mama en mujeres, debatiéndose entre mastectomía simple o mastectomía parcial más radioterapia. Presentamos el caso de un hombre a quien se diagnostica preoperatoriamente con un carcinoma papilar y se realiza mastectomía simple más ganglio centinela

The papillary intra cyst carcinoma is a sub type of ductal no invasive carcinoma, it can be associated or no to carcinoma in situ and infiltrate carcinoma, is less frequent, for this reason his apparition in male is rare. The treatment in is equivalent to breast carcinoma in women, with two modalities of treatment: simple mastectomy or simple mastectomy with radiation therapy. We present clinical case of male whom is diagnostic pre surgery with a papillary carcinoma and realized simple mastectomy with sentinel node

Urgencias en un servicio de prótesis estomatológica / Emergencies in a service of dental prosthesis

Se llevó a efecto un estudio descriptivo y transversal de los pacientes que acudieron al Servicio de Prótesis de la Clínica Estomatológica de Palma Soriano, provincia de Santiago de Cuba, en busca de atención inmediata o de urgencia, con historia clínica o sin ella, para sobre la base de las causas que les obligaron a acudir a la instalación, adoptar las medidas pertinentes sin interferir en el cumplimiento de las consultas programadas. Entre los principales resultados sobresalió la primacía del sexo femenino, del área urbana, de la estomatitis subprotésica, de la úlcera traumática, de las afecciones bucales en las personas ancianas, de las reparaciones (dientes fracturados o caídos) y de las cementaciones de restauraciones individuales o puentes dentarios.

A descriptive and cross-sectional study was carried out in patients who attended the Dental Department at the Dental Clinic in Palma Soriano in Santiago de Cuba province, searching immediate or emergent care, with or without medical record, to adopt the corresponding measures on the base of the causes which forced them to attend the service, without interfering in the programmed visits. Among the main results the female sex, the urban area, subprosthesis stomatitis, traumatic ulcer, buccal disorders in old people, repairs (fractured or fallen teeth) and cementations of individual restorations or dental bridges prevailed.

Urgencias en un servicio de prótesis estomatológica / Emergencies in a service of dental prosthesis

Se llevó a efecto un estudio descriptivo y transversal de los pacientes que acudieron al Servicio de Prótesis de la Clínica Estomatológica de Palma Soriano, provincia de Santiago de Cuba, en busca de atención inmediata o de urgencia, con historia clínica o sin ella, para sobre la base de las causas que les obligaron a acudir a la instalación, adoptar las medidas pertinentes sin interferir en el cumplimiento de las consultas programadas. Entre los principales resultados sobresalió la primacía del sexo femenino, del área urbana, de la estomatitis subprotésica, de la úlcera traumática, de las afecciones bucales en las personas ancianas, de las reparaciones (dientes fracturados o caídos) y de las cementaciones de restauraciones individuales o puentes dentarios(AU)

A descriptive and cross-sectional study was carried out in patients who attended the Dental Department at the Dental Clinic in Palma Soriano in Santiago de Cuba province, searching immediate or emergent care, with or without medical record, to adopt the corresponding measures on the base of the causes which forced them to attend the service, without interfering in the programmed visits. Among the main results the female sex, the urban area, subprosthesis stomatitis, traumatic ulcer, buccal disorders in old people, repairs (fractured or fallen teeth) and cementations of individual restorations or dental bridges prevailed(AU)

Fibrohistiocitoma maligno en pared abdominal: reporte de un caso / Malignant fibrohystiocytoma of the abdominal wall: a case report

El fibrohistiocitoma maligno es el sarcoma de partes blandas más común en la edad adulta, en un grupo etario mayor de 50 años y afecta principalmente a hombres. Estos tumores mesenquimales, con sus distintas variedades morfológicas, precisan de un análisis inmunohistoquímico para su diagnóstico diferencial, fundamentalmente con el carcinoma sarcomatoide, el tumor miofibroblástico inflamatorio y el leiomiosarcoma. Macroscópicamente son neoplasias voluminosas, con múltiples áreas de necrosis en la superficie de corte; desde el punto de vista microscópico el tumor muestra una proliferación desordenada de células fusocelulares, con un patrón esteliforme y/o presencia de células multinucleadas con atipia, mitosis atípicas y un estroma que muestra gran cantidad de colágeno así como un número variable de células inflamatorias mononucleadas e histiocitos espumosos. Su diagnóstico es realizado en base a su morfología e inmunohistoquímica. Presentamos el caso de un paciente masculino de 54 años y la forma como se manejó en nuestro departamento.

The malignant fibrohystiocytoma is the most frequent soft tissue sarcoma in the adult age, in an age group mayor of 50 years old, and affect principal to the man. These mesenquimal tumors with distinct morphological varieties need an immunohistochemistry analysis for his differential diagnostic, principal with the sarcomatoide carcinoma, the miofibroblastic inflammatory tumor and the leiomiosarcomas. Macroscopically there are bulky neoplasm with multiples necrosis areas in the superficial incision, of the microscopically point of view, the tumor show a no order proliferation of the fusocellular cells, with a esteliform patron and or the presence of multinucleate cells with atypical mitosis and a stroma, with show a big quantities of collagen and a variety numbers of inflammatory cells mononucleotic and spumoni hystiocyts. The diagnostic is realized in base to his morphologic and the immunohistochemistry. We present the case of a male patient 54 years old and the form of his management.

Promoción de salud bucodental en educandos de la enseñanza primaria: motivaciones, estrategias y prioridades odontopediátricas / Promotion of oral and dental health in students of the primary teaching; motivations, strategies and odonto-pediatric priorities

Se realizó una amplia revisión bibliográfica sobre promoción de salud bucodental en escolares de la enseñanza primaria, que abarcó elementos relacionados con el marco referencial de la odontopediatría, responsabilidad del personal de estomatología que atiende a niños y niñas, prevención de enfermedades bucodentales, educación para la salud y otros. Se concluyó que la intervención educativa es un método eficaz y adecuado para adquirir e incrementar conocimientos sobre salud bucal, por cuanto posibilita que los educandos de uno y otros sexos, además de transmitirlos a miembros de su familia y demás condiscípulos, se conviertan en verdaderos promotores de salud bucal en su entorno comunitario.

A wide literature review on the oral and dental health promotion in primary school students which comprised elements related to the referencial field of Odonto-Pediatrics, a responsibility of the stomatology staff that assists boys and girls, the prevention of oral and dental conditions, the education for health and others was carried out. It was concluded that the educational intervention is an effective and appropriate method to acquire and increase knowledge on oral health, as it makes possible that the students from one or another sex, besides transmitting it to members of their families and other schoolmates, become true oral health promoters in their community environment.