Terapia descompresiva en el manejo no quirúrgico de lesiones perirradiculares de gran tamaño / Decompressive therapy in the non-surgical management of large periradicular lesions

Introducción: La periodontitis apical asintomática es de los diagnósticos endodónticos más comunes que se presentan en la población mundial. Consiste en la afectación del tejido periapical como resultado de la activación de mecanismos de inflamación, los que incluyen lisis y reabsorción de tejidos de soporte como cemento, ligamento y hueso alveolar. El signo patognomónico de la periodontitis apical es la presencia de radiolucidez periapical, resultado de la destrucción de los tejidos periapicales. Su principal tratamiento abarca el manejo endodóntico convencional cuyo objetivo es la eliminación de los irritantes locales dentro del conducto radicular. Sin embargo, cuando se desarrollan lesiones de gran tamaño es necesario complementar con terapias que aceleren la reparación, una de ellas la descompresión, la cual a partir de la reducción de la presión intralesión e intraósea con lo que favorece la formación de tejido fibroso, conectivo y óseo. Objetivo: Describir la técnica de descompresión intraconducto en el manejo de lesiones periapicales de gran tamaño. Presentación del caso: Paciente de 33 años de edad, con diagnóstico de periodontitis apical asintomática y evaluación tomográfica de lesión periapical de gran tamaño (67,5 UH) manejado con terapia endodóntica convencional y descomprensión intraconducto como terapia coadyuvante. Posterior a la restauración se realizaron controles clínicos y radiográficos. A los 24 meses se evidenció reparación de los tejidos involucrados con restauración del espacio del ligamento periodontal. Conclusiones: En este caso, la terapia descomprensiva fue una alternativa en el manejo de una lesión periapical de gran tamaño, que permitió regular la presión intraósea y facilitar la regeneración del tejido óseo, evitando la intervención quirúrgica siendo así más confortante para el paciente(AU)

Introduction: Asymptomatic apical periodontitis is one of the most common endodontic disorders diagnosed in the world population. It consists in damage to the periapical tissue due to activation of inflammation mechanisms, including lysis and resorption of support tissues like cementum, ligament and alveolar bone. The pathognomonic sign of apical periodontitis is the presence of periapical radiolucency due to the destruction of periapical tissue. Its main treatment includes conventional endodontic management aimed at removing local irritants from the root canal. However, when large lesions develop, it is necessary to complement the conventional treatment with therapies speeding up the repair process, such as decompression, which reduces intralesion and intraosseous pressure, fostering the formation of fibrous, connective and bone tissue. Objective: Describe the use of intracanal decompression technique in the management of large periapical lesions. Case presentation: A case is presented of a 33-year-old patient diagnosed with asymptomatic apical periodontitis and a tomographic evaluation of a large periapical lesion (67.5 UH) treated with conventional endodontic therapy and intracanal decompression as adjuvant therapy. Restoration was followed by clinical and radiographic controls. At 24 months it was observed that the tissues involved had been repaired and the periodontal ligament space restored. Conclusions: The use of decompressive therapy as an alternative in the management of a large periapical lesion, made it possible to regulate intraosseous pressure and facilitate bone tissue regeneration, relieving the patient from the discomforts of a surgical intervention(AU)

Anti-inflammatory and antinociceptive activities of Loasa speciosa in rats and mice.

In the range of doses of 250-500 mg/kg (given i.p.) the aqueous extract of Loasa speciosa leaves showed an inhibitory effect on leukocyte migration, and a reduction on the pleural exudate, as well as dose-dependent anti-inflammatory and peripheral antinociceptive activities.

Biological activity of Ruta chalepensis (Rutaceae) and Sechium pittieri (Cucurbitaceae) extracts on Hypsipyla grandella (Lepidoptera: Pyralidae) larvae.

Biological activity of a plant extract (common rue, Ruta chalepensis) and a semi purified fraction (from "tacaco cimarrón", Sechium pittieri) on mahogany shootborer larvae (Hypsipyla grandella) was studied. A randomized complete block design, with four replications, was used. H. grandella third instar larvae were exposed for 24 h to Cedrela odorata leaf discs dipped in several treatment dissolutions of each extract (0.1, 0.32, 1.0, 3.20, and 10%); afterwards, each larva was transferred to a flask containing an artificial diet and was allowed to complete its development. Variables measured included food consumption (foliar area eaten in 24 h), mortality, and developmental effects (developmental time for each larval instar and the pupa, and pupal weight). The common rue extract showed a clear antifeedant activity at a concentration as low as 0.32%, whereas the "tacaco cimarrón" fraction caused toxicity, especially at the two highest concentrations (3.20 and 10%).

Structures and antiproliferative activity of saponins from Sechium pittieri and S. talamancense.

Six bisdesmosidic bayogenin saponins, named tacacosides A1, A2, B1, B2, B3 and C, were isolated from the fruit and aerial parts of Sechium pittieri (COGN.) C. Jeffrey and S. talamancense (WUNDERLIN) C. Jeffrey, Costa Rican cucurbitaceae plants. Their structures were elucidated on spectral and chemical evidence as follows. Tacacoside A1: 3-O[beta-D-glucopyranosyl-(1-->3)-beta-D-glucopyranosyl]bayogenin 28-O-(alpha-L-rhamnopyranosyl- (1-->3)-beta-D-xylopyranosyl-(1-->4)-beta-D-apiofuranosyl-(1-->3)] - alpha-L-rhamnopyranosyl-(1-->2)-alpha-L-arabinopyranosyl) ester, tacacoside A2: 3-O-[beta-D-glucopyranosyl-(1-->3)-beta-D-glucopyranosyl]bayogenin 28-O-(alpha-L-rhamnopyranosyl- (1-->3)-beta-D-xylopyranosyl-(1-->4)-[beta-D-xylopyranosyl-(1-->3)]-a lph a-L- rhamnopyranosyl-(1-->2)-alpha-L-arabinopyranosyl) ester, tacacoside B1: 3-O-[beta-D-glucopyranosyl]bayogenin 28-O-(alpha-L-rhamnopyranosyl-(1-->3)-beta-D-xylopyranosyl- (1-->4)-[beta-D-apiofuranosyl-(1-->3)]-alpha-L-rhamnopyranosyl-(1- ->2)-alpha- arabinopyranosyl) ester, tacacoside B2: 3-O-[beta-D-glucopyranosyl]bayogenin 28-O-(alpha-L-rhamnopyranosyl-(1-->3)- beta-D-xylpyranosyl-(1-->4)-[beta-D-xylopyranosyl- (1-->3)]-alpha-L-rhamnopyranosyl-(1-->2)-alpha-L-arabinopyranosyl) ester, tacacoside B3: 3-O-[beta-D-glucopyranosyl-(1-->3)-beta-D-glucopyranosyl] bayogenin 28-O-[alpha-L-rhamnopyranosyl-(1-->3)-beta-D-xylopyranosyl- (1-->4)-alpha-L-rhamnopyranosyl- (1-->2)-alpha-L-arabinopyranosyl] ester, and tacacoside C: 3-O-[beta-D-glucopyranosyl]bayogenin 28-O-[alpha-L-rhamnopyranosyl- (1-->3)-beta-D-xylopyranosyl-(1-->4)-alpha-L-rhamnopyranosyl-(1-->2)- alpha-L-arabinopyranosyl] ester. These saponins showed moderate antiproliferative activity (ED50:10-74 micrograms/ml) against MK-1, HeLa and B16F10 cells.

Costaricine, a new antiplasmodial bisbenzylisoquinoline alkaloid from Nectandra salicifolia trunk bark.

A MeOH extract of Nectandra salicifolia trunk bark, obtained during a diversity-based plant collection in a lower montane rainforest in Costa Rica, showed activity in an in vitro antiplasmodial assay measuring incorporation of [3H]-labeled hypoxanthie by Plasmodium falciparum. In addition to 15 known alkaloids isolated from samples of trunk bark, roots, and leaves/twigs of this species, a new bisbenzylisoquinoline alkaloid (+)-costaricine [(+)-12-O-methyllindoldhamine] (1) was isolated from bark (0.038% yield) and from roots (0.001%). (+)-Costaricine was active in the antiplasmodial assay, with IC50 values of 50 ng/mL vs. the chloroquine-sensitive D6 clone and 294 ng/mL vs. the chloroquine-resistant W2 clone of P. falciparum.

Experimental model of single ventricle. Influence of carbon dioxide on pulmonary vascular dynamics.

BACKGROUND: Important in the postoperative management of neonates with single-ventricle complexes, such as hypoplastic left heart syndrome and pulmonary atresia with intact ventricular septum, is the fact that the pulmonary circulation is connected to the systemic circulation via a shunt. The distribution of flow to the pulmonary and systemic vascular beds depends directly on the pulmonary-to-systemic vascular resistance ratio. Changes in this ratio result in alterations in flow that have an impact on survival. METHODS AND RESULTS: PICO2 has a potent effect on pulmonary vascular resistance. In this study, the addition of CO2 to inspired gas (PICO2) is assessed as a means of modulating the ratio of pulmonary-to-systemic vascular resistance and thus flow, while avoiding the consequences of hypoventilation. Thirteen neonatal piglets (age, 17 to 30 days) were subjected to atrial septectomy, patch closure of the tricuspid valve, and creation of a 4-mm systemic-to-pulmonary arterial shunt to mimic the physiology of single-ventricle complexes. Pulmonary and systemic flows; aortic, pulmonary artery, and atrial pressures; and arterial blood gases were measured with the addition of different levels of CO2 to the inspired gases (PICO2 = 0 to 35 mmHg). In all animals, pulmonary vascular resistance (PVR) increased in direct correlation with PICO2. In group 1 (n = 8), PVR increased in direct correlation with PICO2 and PACO2, and inversely with respect to pH (r = .98, .74, and .83, respectively). Group 2 animals (n = 5) received infusions of Tham to buffer hydrogen ion and compensate for respiratory acidosis. PVR again increased in direct correlation with FICO2 (r = .97). In both groups, systemic vascular resistance (SVR) was less directly influenced by FICO2 (r = .53). CONCLUSIONS: CO2 exerts a vasoactive influence on pulmonary vasculature that is largely independent of SVR and pH. Regulating PICO2 is an effective means of achieving a favorable ratio of pulmonary-to-systemic vascular resistance and thus flow in the fragile physiology encountered in neonates with single-ventricle complexes.

Long-acting contraceptive agents: norethisterone esters of monoalkenyl and monoalkynyl acids.

The synthesis of nine new esters of norethisterone (17 alpha-ethynyl-17 beta-hydroxyestr-4-en-3-one) is described, with the esterifying acids bearing an acetylenic or olefinic function in a chain of eight or nine carbon atoms, for evaluation as long-acting contraceptive agents.