Cyclophilins modify their profile depending on the organ or tissue in a murine inflammatory model.

Inflammation is the leading subjacent cause of many chronic diseases. Despite several studies in the last decades, the molecular mechanism involving its pathophysiology is not fully known. Recently, the implication of cyclophilins in inflammatory-based diseases has been demonstrated. However, the main role of cyclophilins in these processes remains elusive. Hence, a mouse model of systemic inflammation was used to better understand the relationship between cyclophilins and their tissue distribution. To induce inflammation, mice were fed with high-fat diet for 10 weeks. In these conditions, serum levels of interleukins 2 and 6, tumour necrosis factor-α, interferon-ϒ, and the monocyte chemoattractant protein 1 were elevated, evidencing a systemic inflammatory state. Then, in this inflammatory model, cyclophilins and CD147 profiles in the aorta, liver, and kidney were studied. The results demonstrate that, upon inflammatory conditions, cyclophilins A and C expression levels were increased in the aorta. Cyclophilins A and D were augmented in the liver, meanwhile, cyclophilins B and C were diminished. In the kidney, cyclophilins B and C levels were elevated. Furthermore, CD147 receptor was also increased in the aorta, liver, and kidney. In addition, when cyclophilin A was modulated, serum levels of inflammatory mediators were decreased, indicating a reduction in systemic inflammation. Besides, the expression levels of cyclophilin A and CD147 were also reduced in the aorta and liver, when cyclophilin A was modulated. Therefore, these results suggest that each cyclophilin has a different profile depending on the tissue, under inflammatory conditions.

Diverticulitis apendicular, reporte de un caso

Objetivo: Presentar un caso de diverticulitis apendicular y compararlo con la literatura actual. Material y M étodo: Registro clínico de un paciente que ingresa a urgencias del Hospital Padre Hurtado, incluyendo cuadro clínico, imagenología, manejo quirúrgico y anatomía patológica. Resultados: Paciente se presenta con cuadro de dolor abdominal atípico, con imagen sugerente de apendicitis diverticular. En pabellón se logra completar apendicectomía laparoscópica con buena evolución posterior. Al estudio patológico se confirman características histológicas de diverticulitis perforada apendicular. Discusión: Se presenta un cuadro clínico que se condice con lo descrito en la literatura actual, aportando imágenes características, tanto de radiología como histopatología. Conclusión: Debido a su mayor riesgo de perforación y mortalidad, la diverticulitis apendicular es una patología que debe considerarse en los diagnósticos diferenciales de dolores abdominales atípicos, en hombres mayores de 30 años, especialmente con los hallazgos imagenológicos característicos.

Objective: To present a clinical case of appendiceal diverticulitis and compare it to contemporary literature. Material and Method: Clinical record of a patient who attends the emergency service of Hospital Padre Hurtado, including clinical presentation, image studies, surgical management and histopathology studies. Results: A patient presents with atypical abdominal pain, image studies suggest appendiceal diverticulitis. Laparoscopic appendectomy was performed with optimal postoperative results. Pathological biopsy studies confirm histological characteristics of a perforated appendiceal diverticulitis. Discussion: A clinical case is presented, which correlates well with contemporary literature of the subject. We provide characteristic image and histopathological studies. Conclusion: Due to its higher perforation rate and mortality, appendiceal diverticulitis is a pathology which must be considered in the differential diagnosis of atypical abdominal pain, in males over 30 years old, especially with characteristic image studies.

[Positron emission tomography-CT scan (PET-CT) in the diagnosis of large vessel vasculitis]. / PET-CT FDG en el diagnóstico y seguimiento de vasculitis de grandes vasos.

Vasculitides are a broad group of diseases that can involve any kind of vessel in any organ. These can be classified according to the size of the affected vessels. The most used classification categorizes them in small, medium, and large vessel vasculitis. Large vessel vasculitis can be further divided in Takayasu arteritis and giant cell arteritis which can sometimes be indistinguishable, even with biopsy. Radiology plays an important role identifying distribution patterns and disease extension18. Fluorine-Fluorodeoxyglucose (FDG) PET-CT shows increased vessel wall FDG uptake in patients with active large vessel vasculitis. Multiple studies show that FDG PET-CT helps to identify the anatomic structures with the disease, as well as evaluate its progression with a high sensibility and specificity in non-treated patients with large vessel vasculitis.

PET-CT FDG en el diagnóstico y seguimiento de vasculitis de grandes vasos / Positron emission tomography-CT scan (PET-CT) in the diagnosis of large vessel vasculitis

Vasculitides are a broad group of diseases that can involve any kind of vessel in any organ. These can be classified according to the size of the affected vessels. The most used classification categorizes them in small, medium, and large vessel vasculitis. Large vessel vasculitis can be further divided in Takayasu arteritis and giant cell arteritis which can sometimes be indistinguishable, even with biopsy. Radiology plays an important role identifying distribution patterns and disease extension18. Fluorine-Fluorodeoxyglucose (FDG) PET-CT shows increased vessel wall FDG uptake in patients with active large vessel vasculitis. Multiple studies show that FDG PET-CT helps to identify the anatomic structures with the disease, as well as evaluate its progression with a high sensibility and specificity in non-treated patients with large vessel vasculitis.

Reevaluation of the acute toxicity of palytoxin in mice: Determination of lethal dose 50 (LD50) and No-observed-adverse-effect level (NOAEL).

Palytoxin is an emergent toxin in Europe and one of the most toxic substances know to date. The toxin disrupts the physiological functioning of the Na+/K+-ATPase converting the enzyme in a permeant cation channel. Human intoxications by PLTX after consumption of contaminated fishery products are a serious health issue and can be fatal. Several reports have previously investigated the oral and intraperitoneal toxicity of PLTX in mice. However, in all cases short observation periods (24 and 48 h) after toxin administration were evaluated. In this work, single oral or intraperitoneal doses of PLTX were administered to healthy mice and surviving animals were followed up for 96 h. The data obtained here allowed us to calculate the oral and intraperitoneal lethal doses 50 (LD50) which were in the range of the values previously described. Surprisingly, the oral NOAEL for PLTX was more than 10 times lower than that previously described, a fact that indicates the need for the reevaluation of the levels of the toxin in edible fishery products.

Lower prevalence of gastroesophageal reflux disease in patients with noncardiac chest pain on opiates: a cross-sectional study.

Opiates can cause heartburn and spastic esophageal dysmotility but their role in noncardiac chest pain (NCCP) is not known. Our aim was to characterize opiate effects on esophageal function using esophageal pH monitoring and high-resolution manometry (HREM) in these patients.We performed a cross sectional study of opiate users with NCCP who underwent HREM and esophageal pH study from 2010 to 2017 using opiate nonusers as a comparison group. Demographic data, symptoms, opiate use, endoscopic findings, esophageal pH study parameters, and HREM data were abstracted.Thirty three patients with NCCP on opiates were compared to 144 opiate non-users. Compared to opiate nonusers, opiate users had lower total acid exposure (2.3% vs. 3%, P = 0.012), lower upright acid exposure (1.2% vs. 3.1%, P = 0.032) and lower DeMeester score (6.5 vs. 12.7, P = 0.016). Opiate users also had higher lower esophageal sphincter integrated relaxation pressure (LES-IRP) (7.0 mm Hg [2.2, 11.7] vs. 3.7 mm Hg [1.1, 6.2] P = 0.011) and greater mean distal contractile integral (DCI) (2575 mm.Hg.s.cm [1134, 4466] vs. 1409 mm.Hg.s.cm [796, 3003] P = 0.03) than opiate non-users. The prevalence of hypertensive motility disorders (15.2% vs. 11.1%) and achalasia (12.1% vs. 2.1%) was higher in opiate users (P = 0.039) but did not reach significance on multivariate analysis.In patients presenting with NCCP, opiate users had lower esophageal acid exposure compared to opiate nonusers. This might be due to higher LES pressures preventing reflux and higher DCI leading to more rapid acid esophageal clearance.

Reactividad vascular in vitro y estudio morfométrico de venas safenas utilizadas como bypass coronario: técnica "no-touch" versus convencional / In vitro vascular reactivity and morphometric study of saphenous veins graft used as coronary bypass: "no-touch" versus conventional technique

Resumen Introducción: Prolongar la permeabilidad de los injertos utilizados en bypass coronario es un desafío constante. Objetivo: Comparar anatomofuncionalmente venas safenas humanas (VSH) extraídas con técnica convencional (TC) vs técnica "no-touch" (NT). Material y Método: Estudio experimental. Se diseccionó VSH con TC y NT en el pabellón de cirugía cardiaca del Hospital Regional de Antofagasta. Las muestras de VSH fueron seccionadas en anillos de 3 mm y conservados en cámaras de órganos aislados con solución Ringer-Krebs. Para evaluar la vasomotilidad se administró norepinefrina (10-6M), papaverina (10-4M), acetilcolina (10-6M) y nitroprusiato de sodio (10-5M). Un segmento de las muestras fue fijado en formalina al 10%, procesado con técnica histológica y analizado bajo microscopía óptica. Las muestras fueron teñidas con hematoxilina-eosina, Verhoeff y orceína. El análisis estadístico fue realizado mediante el software Prism Graphad. Resultados: Reactividad vascular: La vasoconstricción inducida por noradrenalina fue significativamente superior en anillos del grupo NT vs TC (p < 0,0001). La vasodilatación producida por papaverina y acetilcolina fue superior en el grupo NT (p < 0,004) y (p < 0,0003), respectivamente. Estudio morfométrico: El grupo NT presentó túnica muscular (0,755 vs 0,680 mm), adventicia (0,5600 vs 0,4663 mm) y pared total (1,344 vs 0,962 mm) más gruesa que el grupo TC. No hubo diferencias significativas respecto el número de vasa vasorum. Conclusión: El grupo NT responde significativamente mejor a estímulos vasoconstrictores y vasodilatadores. Los resultados se asocian con las diferencias morfométricas.

Introduction: Prolonging of the grafts permeability used in coronary bypass is a constant challenge. Objective: To compare anatomical and functional human saphenous veins (VSH) extracted "No touch" (NT) technique vs conventional technique (TC). Materials and Methods: Experimental study. VSH dissected with CT and NT in the Regional Hospital of Antofagasta cardiac surgery ward. VSH samples were sectioned into 3 mm rings and preserved in isolated organs chambers with Krebs-Ringer solution. To evaluate the vasomotor activity, norepinephrine (10-6M), papaverine (10-4M), acetylcholine (10-6M) and sodium nitroprusside (10-5M) was administered. A segment of samples was fixed in 10% formalin, processed and histological analyzed under light microscopy technique with hematoxylin-eosin, Verhoeff and orceína. Statistical analysis was performed using the Prism software Graphad. Results: Vascular Reactivity: norepinephrine-induced vasoconstriction was significantly higher in the group rings NT vs TC (p < 0.0001). Vasodilation was higher with papaverine and acetylcholine in the NT group (p < 0.004) and (p < 0.0003), respectively. Morphometric study: The NT group presented muscularis (0.755 vs 0.680 mm), adventitious (0.5600 vs 0.4663 mm), and total wall (1.344 vs 0.962 mm) thicker than the TC group. No significant differences in vasa vasorum number identified. Conclusion: The NT group vasoconstrictor and vasodilator responds significantly better. Results correlate with morphometric differences.

Subacute immunotoxicity of the marine phycotoxin yessotoxin in rats.

Yessotoxin (YTX) is a marine phycotoxin produced by dinoflagellates and accumulated in filter feeding shellfish. YTX content in shellfish is regulated by many food safety authorities to protect human health, although currently no human intoxication episodes have been unequivocally related to YTX presence in food. The immune system has been proposed as one of the target organs of YTX due to alterations of lymphoid tissues and cellular and humoral components. The aim of the present study was to explore subacute immunotoxicity of YTX in rats by evaluating the haematological response, inflammatory cytokine biomarkers and the presence of YTX-induced structural alterations in the spleen and thymus. The results showed that repeated administrations of YTX caused a decrease of lymphocyte percentage and an increase of neutrophil counts, a reduction in interleukine-6 (IL-6) plasmatic levels and histopathological splenic alterations in rats after four intraperitoneal injections of YTX at doses of 50 or 70 µg/kg that were administered every 4 days along a period of 15 days. Therefore, for the first time, subacute YTX-immunotoxicity is reported in rats, suggesting that repeated exposures to low amounts of YTX might also suppose a threat to human health, especially in immuno-compromised populations.

In vivo cardiomyocyte response to YTX- and AZA-1-induced damage: autophagy versus apoptosis.

Yessotoxins (YTX) and azaspiracids (AZAs) are marine toxins produced by phytoplanktonic dinoflagellates that get accumulated in filter feeding shellfish and finally reach human consumers through the food web. Both toxin classes are worldwide distributed, and food safety authorities have regulated their content in shellfish in many countries. Recently, YTXs and AZAs have been described as compounds with subacute cardiotoxic potential in rats owed to alterations of the cardiovascular function and ultrastructural heart damage. These molecules are also well known in vitro inducers of cell death. The aim of this study was to explore the presence of cardiomyocyte death after repeated subacute exposure of rats to AZA-1 and YTX for 15 days. Because autophagy and apoptosis are often found in dying cardiomyocytes, several autophagic and apoptotic markers were determined by western blot in heart tissues of these rats. The results showed that hearts from YTX-treated rats presented increased levels of the autophagic markers microtubule-associated protein light chain 3-II (LC3-II) and beclin-1, nevertheless AZA-1-treated hearts evidenced increased levels of the apoptosis markers cleaved caspase-3 and -8, cleaved PARP and Fas ligand. Therefore, while YTX-induced damage to the heart triggers autophagic processes, apoptosis activation occurs in the case of AZA-1. For the first time, activation of cell death signals in cardiomyocytes is demonstrated for these toxins with in vivo experiments, which may be related to alterations of the cardiovascular function.

Subacute Cardiotoxicity of Yessotoxin: In Vitro and in Vivo Studies.

Yessotoxin (YTX) is a marine phycotoxin produced by dinoflagellates and accumulated in filter feeding shellfish. Although no human intoxication episodes have been reported, YTX content in shellfish is regulated by many food safety authorities due to their worldwide distribution. YTXs have been related to ultrastructural heart damage in vivo, but the functional consequences in the long term have not been evaluated. In this study, we explored the accumulative cardiotoxic potential of YTX in vitro and in vivo. Preliminary in vitro evaluation of cardiotoxicity was based on the effect on hERG (human ether-a-go-go related gene) channel trafficking. In vivo experiments were performed in rats that received repeated administrations of YTX followed by recordings of electrocardiograms, arterial blood pressure, plasmatic cardiac biomarkers, and analysis of myocardium structure and ultrastructure. Our results showed that an exposure to 100 nM YTX for 12 or 24 h caused an increase of extracellular surface hERG channels. Furthermore, remarkable bradycardia and hypotension, structural heart alterations, and increased plasma levels of tissue inhibitor of metalloproteinases-1 were observed in rats after four intraperitoneal injections of YTX at doses of 50 or 70 µg/kg that were administered every 4 days along a period of 15 days. Therefore, and for the first time, YTX-induced subacute cardiotoxicity is supported by evidence of cardiovascular function alterations related to its repeated administration. Considering international criteria for marine toxin risk estimation and that the regulatory limit for YTX has been recently raised in many countries, YTX cardiotoxicity might pose a health risk to humans and especially to people with previous cardiovascular risk.

Subacute Cardiovascular Toxicity of the Marine Phycotoxin Azaspiracid-1 in Rats.

Azaspiracids (AZAs) are marine toxins produced by Azadinium spinosum that get accumulated in filter feeding shellfish through the food-web. The first intoxication was described in The Netherlands in 1990, and since then several episodes have been reported worldwide. Azaspiracid-1, AZA-2, and AZA-3 presence in shellfish is regulated by food safety authorities of several countries to protect human health. Azaspiracids have been related to widespread organ damage, tumorogenic properties and acute heart rhythm alterations in vivo but the mechanism of action remains unknown. Azaspiracid toxicity kinetics in vivo and in vitro suggests accumulative effects. We studied subacute cardiotoxicity in vivo after repeated exposure to AZA-1 by evaluation of the ECG, arterial blood pressure, plasmatic heart damage biomarkers, and myocardium structure and ultrastructure. Our results showed that four administrations of AZA-1 along 15 days caused functional signs of heart failure and structural heart alterations in rats at doses ranging from 1 to 55 µg/kg. Azaspiracid-1 altered arterial blood pressure, tissue inhibitors of metalloproteinase-1 plasma levels, heart collagen deposition, and ultrastructure of the myocardium. Overall, these data indicate that repeated exposure to low amounts of AZA-1 causes cardiotoxicity, at doses that do not induce signs of other organic system toxicity. Remarkably, human exposure to AZAs considering current regulatory limits of these toxins may be dangerously close to clearly cardiotoxic doses in rats. These findings should be considered when human risk is estimated particularly in high cardiovascular risk subpopulations.

Sinusitis maxilar por osteonecrosis asociada a bisfosfonatos en pacientes con cáncer de mama: serie de casos / Maxillary sinusitis associated to bisphosphonate-related osteonecrosis in patients with breast cancer: case series

Los bisfosfonatos (BF) son fármacos ampliamente utilizados como estabilizadores óseos en el tratamiento de metástasis óseas, osteoporosis, enfermedad de Paget, entre otras patologías, debido a sus efectos anti-tumorales y a la característica de inhibir la actividad osteoclástica. La osteonecrosis maxilar asociada a BF, hoy en día osteonecrosis maxilar asociada a fármacos (ONMF) es definida como la presencia de hueso expuesto, no-vascularizado y necrótico en la cavidad oral por un periodo mayor a ocho semanas, con una historia positiva de tratamiento con fármacos anti-reabsorción ósea (BP, inhibidores del ligando RANKL) y/o anti-angiogénicos y sin antecedentes de tratamiento con radiación o metástasis obvia en los maxilares. La frecuencia de ONMF es incierta. La mandíbula es más frecuentemente afectada por ONMF que el maxilar. Pocos casos de ONMF en el maxilar han sido descritos con un diagnostico de sinusitis maxilar simultáneo. Tres casos con sinusitis maxilar asociada a ONMF son presentados en este trabajo. Todos los pacientes fueron mujeres con una historia positiva de cáncer de mama y tratamiento con bisfosfonatos. Los primeros dos casos, desarrollaron ONMF después de una extracción del tercer molar maxilar. El tercer caso con ONMF en el maxilar, sólo tenía antecedentes de curetaje periodontal. Una tomografía computada fue realizada y mostró compromiso del seno maxilar en todos los pacientes. Modalidades diagnósticas para evaluar la extensión de la necrosis y el compromiso del seno, como también alternativas de tratamiento son descritas en este estudio. Finalmente, una revisión actualizada de la literatura es presentada.

Bisphosphonates are widely used as bone-stabilizers in the treatment of osseous metastases, osteoporosis, Paget's disease and others,due to their ability to inhibit osteoclast activity and anti-tumor effects. Bisphosphonate-related osteonecrosis of the jaw, nowadays medication-related osteonecrosis of the jaw (MRONJ), is defined as the presence of exposed, non-vascularized and necrotic bone tissue in the oral cavity over a period of 8 weeks with a current or previous history of treatment with antiresorptive (bisphosphonates, RANKL ligand inhibitor) and/or antiangiogenic agents, and no history of radiation therapy to the jaws or obvious metastatic disease to the jaws. The frequency of MRONJ is unclear. The mandible appears to be more frequently affected by MRONJ than the maxilla. Isolated cases of maxillary MRONJ have been described in wich a simultaneous sinusitis maxillaris was diagnosed. Three cases of MRONJ associated with maxillaris sinusitis are presented. All cases were females with a positive history of breast cancer and bisphosphonate therapy. The first two, developed MRONJ after a third molar upper extraction. The third case with MRONJ, had a history of periodontal curettage. A computed tomography was performed and showed a maxillary sinus compromise in all patients. Imaging modalities to evaluate the extent of the necrosis and the sinus compromise, as also treatment options were described in this study. Finally, an updated literature review is presented.

Brain Pathology in Adult Rats Treated With Domoic Acid.

Domoic acid (DA) is a neurotoxin reported to produce damage to the hippocampus, which plays an important role in memory. The authors inoculated rats intraperitoneally with an effective toxic dose of DA to study the distribution of the toxin in major internal organs by using immunohistochemistry, as well as to evaluate the induced pathology by means of histopathologic and immunohistochemical methods at different time points after toxin administration (6, 10, and 24 hours; 5 and 54 days). DA was detected by immunohistochemistry exclusively in pyramidal neurons of the hippocampus at 6 and 10 hours after dosing. Lesions induced by DA were prominent at 5 days following treatment in selected regions of the brain: hippocampus, amygdala, piriform and perirhinal cortices, olfactory tubercle, septal nuclei, and thalamus. The authors found 2 types of lesions: delayed death of selective neurons and large areas of necrosis, both accompanied by astrocytosis and microgliosis. At 54 days after DA exposure, the pathology was characterized by still-distinguishable dying neurons, calcified lesions in the thalamus, persistent astrocytosis, and pronounced microgliosis. The expression of nitric oxide synthases suggests a role for nitric oxide in the pathogenesis of neuronal degeneration and chronic inflammation induced by DA in the brain.

In vivo arrhythmogenicity of the marine biotoxin azaspiracid-2 in rats.

Azaspiracids (AZAs) are marine biotoxins produced by the dinoflagellate Azadinium spinosum that accumulate in several shellfish species. Azaspiracid poisoning episodes have been described in humans due to ingestion of AZA-contaminated seafood. Therefore, the contents of AZA-1, AZA-2 and AZA-3, the best-known analogs of the group, in shellfish destined to human consumption have been regulated by food safety authorities of many countries to protect human health. In vivo and in vitro toxicological studies have described effects of AZAs at different cellular levels and on several organs, however, AZA target remains unknown. Very recently, AZAs have been demonstrated to block the hERG cardiac potassium channel. In this study, we explored the potential cardiotoxicity of AZA-2 in vivo. The effects of AZA-2 on rat electrocardiogram (ECG) and cardiac biomarkers were evaluated for cardiotoxicity signs besides corroborating the hERG-blocking activity of AZA-2. Our results demonstrated that AZA-2 does not induce QT interval prolongation on rat ECGs in vivo, in spite of being an in vitro blocker of the hERG cardiac potassium channel. However, AZA-2 alters the heart electrical activity causing prolongation of PR intervals and the appearance of arrhythmias. More studies will be needed to clarify the mechanism by which AZA-2 causes these ECG alterations; however, the potential cardiotoxicity of AZAs demonstrated in this in vivo study should be taken into consideration when evaluating the possible threat that these toxins pose to human health, mainly for individuals with pre-existing cardiovascular disease when regulated toxin limits are exceeded.

Hábitos de higiene oral en estudiantes de odontología de la Universidad de Chile / Oral health habits in dental students at the University of Chile

Los estudiantes de odontología son agentes involucrados en la educación de los cuidados bucodentales. No se han publicado estudios nacionales que describan sus hábitos de higiene oral. Objetivo: Describir la proporción de estudiantes de odontología de la Universidad de Chile con hábitos de higiene oral saludables según sexo, nivel socioeconómico y años de estudios. Material y método: Estudio transversal descriptivo. Se seleccionaron, por muestreo aleatario simple con afijación proporcional 150 estudiantes entre 1er- 4to año. Se aplicó un cuestionario sobre hábitos de higiene oral, que incluía uso y frecuencia de cepillado, seda dental y enjuagatorio bucal, tiempo transcurrido desde la última visita al dentista y variables sociodemográficas. Se construyó un índice Hábitos de Higiene Oral que incluía cepillado por lo menos dos veces al día, uso de seda dental diariamente y visita al dentista por lo menos una vez por año. Resultados: Un 98 por ciento se cepillaba los dientes por lo menos dos veces al día, 37 por ciento usaba seda dental diariamente y 74 por ciento había acudido al dentista por lo menos una vez en el último año. Sólo un 30 por ciento presentó un resultado positivo para el índice Hábitos de Higiene Oral. No se detectaron diferencias significativas según sexo, nivel socioeconómico y años de estudios. Conclusiones: Los estudiantes de odontología de la Universidad de Chile presentan alta frecuencia de cepillado dental y consultan frecuentemente al dentista, sin embargo, el uso de seda dental es bajo. Estudios futuros deberían analizar otras variables involucradas en un mejor cuidado de la salud bucal en este grupo.

Dental students are agents involved in the education of oral care. There are no published studies that describe their oral hygiene habits in Chile. Objective: To describe the proportion of dental students at the University of Chile with healthy oral hygiene habits by sex, socioeconomic status and years of study. Material and methods: A descriptive cross-sectional study on 150 students from 1st-4th year of dentistry studies were selected by simple sampling with proportional allocation. A questionnaire on oral hygiene habits that included questions about the use and frequency of brushing and flossing, mouthwashes use, time since the last dental visit and sociodemographic variables were used. An index about oral hygiene was constructed including brushing at least twice a day, flossing at least once a day and visiting your dentist at least once a year. Results: About 98 percent of students brushing teeth at least twice daily, 37 percent used dental floss daily and 74 percent had visited the dentist at least once in the past year. Only 30 percent of students had a positive outcome for the oral hygiene index. No significant differences by gender, socioeconomic status and years of study were observed. Conclusions: Dental students at the University of Chile show high frequency of tooth brushing and frequently visit to the dentist, however, flossing is low. Future studies should also analyze other variables involved in better oral health care in this group.

[Renal transplantation with living donors. A critical analysis of surgical procedures based on 40 years of experience]. / Transplante renal de donante vivo: un análisis crítico de estrategias quirúrgicas basado en 40 años de experiencia.

INTRODUCTION: Absolute priority in an LDKT programme are donnor safety and kidney optimal anatomical and functional preservation. Reduced donnor morbidities, both at short and long term, are important objectives. Excellent technical grafting is a must as are the strategies employed for facilitatig it. We revised the incidences of our whole LDKT programme (40 years 243 donors) to confirm if these exigences have been acomplished or a change to new surgical procedures is recommended. MATERIAL AND METHODS: Between 1968-2008 243 nephrectomies and grafting has been performed, a reduced number per year (A cadaver programme has been running simultaneously since 1964). For the nephrectomies a Turner-Warrick apprach was inititialy used and since 1973 a miniincisional, anterior, extraperitoneal approach of approximately 10 cm in length. The right kidney was removed in 75% of the cases and the right iliac area for the implant in 85% In adjacent opperating rooms, one team performs the nephrectomy while the other prepares and dissects free the grafting vessels. Most of the time the same senior surgeon performed both operatios: the nephrectomy and the implant. Peroperative and postoperative complications were evaluated by urologists and nephrologists in charge. RESULTS: No donors dead, organs lost or major complications in the donors have been documented. Minor complications such as intestinal paresia, wound infection, persistent incisional pain were common. Miniincisional abdominal approach reduced postoperative pain and hospital stay (4 days). At long term no incisional hernia or abdominal paresia have been documented. Simultaneous work reduces ischemia time (30-45 s warm: 30-45 min cold) and opperatig room occupation(patient preparation plus anesthesia plus operation) estimated in 90-120 min for the nephrectomy and 120-160 for the grafting. The responsibility of the senior surgeon in both procedures facilitates vessel selection for the grafting. CONCLUSIONS: No reasons have been found to reconvert our current nephrectomy procedure to laparoscopic or modify current surgical strategy. Superior safety of open surgery for donors and organs is confirmed. Pain and recovery time are reduced in laparoscopic surgery but not as much when compared with miniincisional approach. Open surgery permits optimal anatomical and functional organ extration facilitatig the quality of the implant. As numbers matter in laparoscopic surgery open nephrectomy is recommended for reduced LDKT programmes.

[Unusual elements in renal calculi]. / Elementos no frecuentes en cálculos renales.

A group of 54 renal calculi were spontaneously passed renal stone after a nephritic colic. Two groups of calculi were found: papillary and non-papillary calculi. All calculi were analyzed by infrared spectroscopy and electronic microscopy scan (EMS) and EDAX. When the stones were analyzed with EDAX, elements such as C, N, O, Na, S, Mg, Al, Si, Cl, K, Ca, Mn, Fe, Ni, Zn were detected. The possible origin of these elements is discussed in this work.

Continuous gastric drip versus intravenous fluids in low birthweight infants.

UNLABELLED: This multicentre randomized study compared a continuous gastric drip (CGD) with intravenous (i.v.) fluid administration. Healthy newborns with birthweight from 1501 to 2000 g whose physician ordered i.v. fluids were randomized before the 2nd hour of life to CGD or i.v. fluids. The major outcome variable was the need for an i.v. line in the CGD group. Serum glucose was measured at 30 min, 1 h and every 6 h thereafter. Serum sodium and potassium were measured at least once during the first 72 h of life. Enteral feedings, feeding intolerance, number of venous lines and i.v. line-related complications were recorded until the interruption of CGD or the i.v. line. Twenty-nine infants were randomized to each group. The two groups were comparable in terms of birthweight and gestational age. Ten percent (3/29) of the infants randomized to the CGD group required i.v. fluids and 90% of them received electrolytes and glucose through an orogastric tube. The incidence of hypoglycaemia, hyponatraemia and episodes of feeding intolerance did not differ between the groups. CONCLUSION: Fluid administration by CGD reduces the need for i.v. lines without increasing the risk of complications.