Clinical evaluation of posterior zirconia-based and porcelain-fused-to-metal crowns with a vertical preparation technique: an up to 5-year retrospective cohort study.

OBJECTIVE: To evaluate the clinical conditions of single-unit posterior restorations on teeth prepared without finishing line, after 5.6 years of clinical service. MATERIALS AND METHODS: 50 crowns (25 zirconia-based (Zr) and 25 porcelain-fused-to-metal (PFM)) were selected from 34 patients. The restorations were evaluated according to the California Dental Association (CDA) Quality Criteria, and periodontal variables were studied in the abutment teeth compared with the unrestored contralateral teeth. Variables were examined using Mann-Whitney and Pearson´s Chi-Square tests (α = 0.05). The success of the prosthesis was calculated using Kaplan-Meier test. RESULTS: CDA Quality Criteria was considered satisfactory-excellent in all restorations except for one of them, due to chipping on a PFM crown. At, 66 months, the success rates for PFM and Zr crowns were 85.7% and 100%, respectively. The plaque index (PI) showed that the restored abutment teeth accumulated significantly less plaque than the control teeth, but the gingival index (GI) was statistically higher in the abutment teeth. In 80% of cases the probing depth (PB) was ≤ 3mm. In addition, in 21% of the cases, gingival recession was less than 2mm. The restoration material had a statistically significant effect on GI and PB, with Zr crowns showing less inflammation and less deep pockets than PFM restorations. On the contrary, greater gingival recession was found at the margins of the Zr crowns when compared to the PFM. No statistical differences were found between the two materials in the GI. CONCLUSIONS: Cemented crowns on vertical preparations show good clinical behavior after 5 years. The periodontal parameters (PI, GI, PD) of the Zr restorations are significantly better than those of PFM, with the exception of gingival recession. CLINICAL RELEVANCE: The use of restorations on vertically prepared teeth is a suitable alternative to classical horizontal preparations.

Intravitreal faricimab as an adjuvant in the management of tubercular uveitis.

PURPOSE: To report the use of intravitreal faricimab used as an adjunct in the management of intraocular tuberculosis (IOTB) in a patient with occlusive retinal vasculitis (ORV) and choroiditis. METHODS: A case report. RESULTS: A 27-year-old Asian male presented with bilateral choroiditis and ORV complicated by retinal neovascularization and vitreous hemorrhage in one eye. The patient had a positive tuberculin skin test, indeterminate interferon-gamma release assay, and Ghon's focus on chest radiography. With a diagnosis of IOTB, the patient was treated with anti-tubercular therapy. Due to the significant vitreous hemorrhage, he underwent pars plana vitrectomy in one eye. The patient received bilateral faricimab. Within a week of the injection, he had a near-complete resolution of the extensive choroidal and retinal vascular inflammation. CONCLUSIONS: Intravitreal faricimab, given its angiopoietin-2 (ang2) inhibition and anti-vascular endothelial growth factor action, maybe a helpful adjunct in IOTB. Whether ang2 inhibition provides any additional benefit needs further evaluation in extensive studies.

CH bond activation in aromatic ketones mediated by iridium-tris(pyrazolyl)borate complexes.

Reaction of complex [TpMe2Ir(η4-CH2C(Me)C(Me)C2)] (1) with a series of aromatic ketones at 130 °C renders, by means of a selective ortho-CH activation, Ir(III)-metallacycles 2-5, which display an Ir-H bond. When [TpMe2Ir(C6H5)2N2] (6) is treated with 2-(trifluoromethyl)acetophenone and 2-fluoroacetophenone at 80 °C, the formation of dimeric (7) and trimeric architectures (8) is achieved through the meta- and para-CH activation of the aromatic ketone, respectively. The generation of complexes 2-5 is proposed to occur by the initial formation of Ir(III) η1-ketone adducts as key intermediates, followed by aromatic CH activations and the release of a butadiene ligand. The formation of complexes 7 and 8 involves an assisted process in which a metal center activation of the less sterically hindered C-H bond of the aromatic ketone takes place (releasing a benzene molecule), followed by the coordination of the carbonyl group, which generates the respective dimeric and trimeric structures. Complexes 7 and 8 are efficient catalysts for the transfer hydrogenation of ketones and aldehydes using isopropanol as the hydrogen source. All complexes have been fully characterized by NMR spectroscopy, FT-IR, elemental analysis and, in the cases of 7 and 8, X-ray crystallography. Details of the reaction conditions, isolation of the products, and proposals for the pathways of formation of complexes 2-5 and 7-8 are discussed.

Effects of Zinc, Mercury, or Lead on [3H]MK-801 and [3H]Fluorowillardiine Binding to Rat Synaptic Membranes.

Glutamate (Glu) is considered the most important excitatory amino acid neurotransmitter in the mammalian Central Nervous System. Zinc (Zn) is co-released with Glu during synaptic transmission and interacts with Glutamate receptors and transporters. We performed binding experiments using [3H]MK-801 (NMDA), and [3H]Fluorowillardine (AMPA) as ligands to study Zn-Glutamate interactions in rat cortical synaptic membranes. We also examined the effects of mercury and lead on NMDA or AMPA receptors. Zinc at 1 nM, significantly potentiates [3H]MK-801 binding. Lead inhibits [3H]MK-801 binding at micromolar concentrations. At millimolar concentrations, Hg also has a significant inhibitory effect. These effects are not reversed by Zn (1 nM). Zinc displaces the [3H]FW binding curve to the right. Lead (nM) and Hg (µM) inhibit [3H]FW binding. At certain concentrations, Zn reverses the effects of these metals on [3H]FW binding. These specific interactions serve to clarify the role of Zn, Hg, and Pb in physiological and pathological conditions.

Theoretical Study of the Function of the IP3 Receptor/BK Channel Complex in a Single Neuron / Estudio Teórico de la Función del Complejo Receptor-IP3/Canales BK en Neurona Única

ABSTRACT Large conductance calcium-activated potassium (BK) channels carry out many functions in the central nervous system. These channels open in response to increased cytosolic calcium ([Ca2+]cyt) concentration. The influx of calcium ions to the cytosol can occur through voltage-gated calcium channels (VGCCs) on the plasma membrane and/ or through IP3 receptors (IP3-Rs) and ryanodine receptors (RyRs) on the endoplasmic reticulum membrane. The BK channel/IP3-R/RyR interaction has been widely reported in smooth muscle but scarcely investigated in relation to neurons. The aim of this study was to theoretically explore the function of the BK/IP3-R complex by means of a computational model of a neuron that replicates the interaction between the release of Ca2+ from the endoplasmic reticulum (through IP3-Rs) and the opening of the BK channels. The mathematical models are based on the Hodgkin-Huxley formalism and the Goldbeter model. These models were implemented on Visual Basic® and differential equations were solved numerically. Distinct conditions were contemplated for BK conductance and the efflux of endoplasmic Ca2+ to the cytosol. An abrupt rise in [Ca2+]cyt (≥ 5 μM) and short duration (spark) was found to activate BK channels and either pause or stop the action potential train.

RESUMEN Los canales de potasio activados por calcio de gran conductancia (canales BK) cumplen múltiples funciones en el sistema nervioso central. Estos canales se abren en respuesta al incremento de la concentración de calcio citosólico ([Ca2+]cyt). La entrada de Ca2+ puede ocurrir a través de canales de calcio dependientes de voltaje (VGCCs) localizados en la membrana plasmática y por eflujo de Ca2+ del retículo endoplásmico (ER) causado por 1,4,5-Trifosfato (IP3) o rianodina (RyR). La interacción BK/IP3/RyR ha sido ampliamente estudiada en músculo liso, pero escasamente en neuronas. El objetivo de este estudio fue explorar teóricamente la función del complejo BK/IP3-R mediante un modelo computacional de una neurona que replica la interacción entre la liberación de Ca2+ del retículo endoplásmico (a través de IP3-Rs) y la apertura de los canales BK. Los modelos matemáticos se basan en el formalismo de Hodgkin-Huxley y el modelo de Goldbeter. Estos modelos fueron implementados en Visual Basic® y las ecuaciones diferenciales fueron resueltas por métodos numéricos. Se contemplaron distintas condiciones para la conductancia del canal BK y la salida de Ca2+ endoplásmico al citosol. Los resultados muestran que un incremento abrupto de [Ca2+] cyt (≥ 5 μM) y de corta duración (spark) activa los canales BK y producen una pausa o detiene el tren de potenciales de acción.

Prevención de extubación no programada en pacientes con ventilación mecánica invasiva / Prevention of non-programed tube-extractions among patients with invasive mechanical ventilation / Prevenção de extubação não programada em pacientes com ventilação mecânica invasiva

Introducción Las extubaciones no programadas constituyen un evento adverso frecuente y de alto impacto, en la mayoría de los casos la presencia de este evento se relaciona con factores como la vía aérea, ventilación mecánica, nivel de sedación, estado y actividad mental del paciente, entre otros también prevenibles. Por ello, se establece un indicador de calidad para prevenir extubaciones no programadas en pacientes con ventilación mecánica invasiva y tubo endotraqueal. Objetivo Realizar la validación de contenido del indicador y describir el nivel de cumplimiento para la prevención de extubaciones no programadas en pacientes con ventilación mecánica invasiva en un hospital de tercer nivel de la Ciudad de México, con el propósito de dar a conocer nuevos aportes en materia de prevención. Metodología Estudio cuantitativo y descriptivo, con una muestra no probabilística a conveniencia conformada por 46 procesos observados durante el turno matutino en tres servicios de hospitalización. Resultados Se encontró que el 96% de los procesos observados arrojaron un nivel de prevención medio para las extubaciones no programadas. Al evaluar el índice de eficiencia global del indicador, se obtuvo un resultado del 59.8%, lo cual muestra que las acciones para prevenir una extubación no programada se cumplen en un porcentaje muy bajo. Conclusiones Se detectó una omisión de funciones por los profesionales de la salud en la prevención de este evento, por lo que se propuso un plan de mejora para la institución con el propósito de disminuir los eventos relacionados a las extubaciones.

Introduction Non-programed extubation, constitute a frequent high impact adverse event involving issues on the airway, mechanical ventilation, sedation level, patient´s mental activity, among others. Because of this, a quality indicator is established in order to help prevent non-programed extubation among patients with invasive mechanical ventilation and endotracheal tube. Objective To perform a validation of content on this indicator in a third level hospital of the City of Mexico, and describe the level of adherence to its components in order to prevent non-programed extubation among patients with invasive mechanical ventilation and endotracheal tube, and share the resulting contributions in the area of prevention. Methodology This is a quantitative and descriptive study with a non-probabilistic sample by convenience of 46 processes which were observed during the morning shifts in three hospitalization services. Results It was found that 96% of the processes observed showed an insufficient level of prevention of non-programed extubation. The assessment of the efficiency related to indicator´s components showed a 59.8% compliance, suggesting that the actions to prevent non-programed extubation are not sufficiently taken. Conclusions An important related omission by health professionals regarding the prevention of this kind of adverse events was detected, and thus, a corresponding improvement plan for the institution was proposed.

Introdução As extubaçãos não programadas constituem um evento adverso frequente e de alto impacto, na maioria dos casos, a presença deste evento relaciona-se com fatores como a via aérea, ventilação mecânica, nível de sedação, estado e atividade mental do paciente, entre outros, também preveníeis. Por isso, estabelece-se um indicador de qualidade para prevenir extubaçãos não programadas em pacientes com ventilação mecânica invasiva e tubo endotraqueal. Objetivo Realizar a validação de conteúdo do indicador e descrever o nível de cumprimento para a prevenção de extubaçãos não programadas em pacientes com ventilação mecânica invasiva em um hospital de terceiro nível da Cidade do México, com o propósito de dar a conhecer novas contribuições em matéria de prevenção. Metodologia Estudo quantitativo e descritivo, com uma amostra não probabilística a conveniência, conformada por 46 processos observados durante o turno matutino em três serviços de hospitalização. Resultados Encontrou-se que o 96% dos processos observados revelaram um nível de prevenção médio para as extubaçãos não programadas. Avaliando o índice de eficiência global do indicador, obteve-se um resultado do 59.8%, o qual mostra que as ações para prevenir uma extubação não programada cumprem-se em uma porcentagem muito baixa. Conclusões Identificou-se uma omissão de funções pelos profissionais da saúde na prevenção deste evento, pelo que se propus um plano de melhora para a instituição com o propósito de diminuir os eventos relacionados às extubaçãos.

Friction, lubrication, and in situ mechanics of poroelastic cellulose hydrogels.

The tribology between biphasic materials is challenging to predict and interpret due to the interrelationship between mechanical properties, microstructure and movement of the fluid phase contained within. A new approach is presented to deconvolute these effects for cellulose hydrogels, which have a fibrous network that is akin to the microstructure of articular cartilage and plant cell walls. This is achieved by developing a tribo-rheological technique that uniquely incorporates in situ mechanical characterisation (compression-relaxation and small amplitude oscillatory shear) immediately prior to measuring the tribological response between pairs of hydrogels. A radial pressure gradient is generated upon compression-relaxation of the poroelastic hydrogels that results in a non-uniform film thickness at the interface between them. Simulations of this process show that contact between gels occurs in an outer annulus region. Accounting for the predicted contact area between hydrogels varying in cellulose density and pectin solution viscosity causes measured tribology data to collapse onto a single curve; the apparent static friction between hydrogel tribopairs increases with the storage modulus of the hydrogels according to a power law with exponent 0.67. The method is used to compare the influence of plant cell wall polysaccharides, xyloglucan and arabinoxylan, on the interactive forces between cellulose fibres; xyloglucan is found to reduce the static friction between the hydrogels while arabinoxylan had no significant effect. The methodologies presented should provide a new framework for studying the friction between gels and other biphasic soft materials and polymeric surface films.

Desarrollo de un Simulador de los Experimentos Clásicos y Actualizados de Fijación de Voltaje de Hodgkin y Huxley / Developing a simulation program for classic and updated Hodgkin and Huxley's voltage clamp experiments

Resumen: Los estudios de Hodgkin y Huxley fueron el punto de partida de la generación de modelos matemáticos que explican, reproducen y predicen los resultados experimentales del comportamiento de los canales iónicos sensibles a voltaje del axón. Los altos costos de estos experimentos impiden su implementación en la práctica docente de licenciatura. Una alternativa didáctica son los experimentos virtuales mediante simuladores computacionales. En este trabajo se presenta el desarrollo de un simulador que reproduce paso a paso los experimentos clásicos de Hodgkin y Huxley sobre las conductancias de los canales dependientes de voltaje del axón gigante de calamar. El simulador fue desarrollado en lenguaje Visual Basic ver 5.0 para ambiente Wiindows® . Está formado de cuatro módulos: (1) simulación de corrientes iónicas; (2) experimentos clásicos de Hodgkin y Huxley; (3) versión actual del modelo; (4) potenciales de acción. Consta de pantallas de interfaz que permiten simular y calcular los valores de las variables relacionadas con la conductancia de los canales. El usuario puede realizar una cantidad ilimitada de experimentos virtuales que le facilitarán la comprensión del tema.

Abstract: Hodgkin and Huxley ́s works were the starting point to generating mathematical models for explain, reproduce the experimental results and predict the behavior of voltage-sensitive ion channels in the axon. The high costs of these experiments avoid its implementation in teaching degree. An educational alternative is virtual experiments using computer simulations. In this work the development of a simulator that reproduces step by step the classic experiments of Hodgkin and Huxley on the conductance of voltage-dependent channels in squid giant axon is presented. The simulator was developed in Visual Basic language, ver 5.0 for Windows environment. It consists of four modules: (1) ionic currents simulation; (2) classical Hodgkin and Huxley ́s experiments; (3) current version model; (4) action potentials. It comprises connecting interface screens that allow simulate and compute the values of the variables associated with the channel conductance. The user can perform an unlimited number of virtual experiments that will facilitate the understanding of the subject.

Ultrasonic characterization of GRC with high percentage of fly ash substitution.

New applications of non-destructive techniques (NDT) with ultrasonic tests (attenuation and velocity by means of ultrasonic frequency sweeps) have been developed for the characterization of fibre-reinforced cementitious composites. According to new lines of research on glass-fibre reinforced cement (GRC) matrix modification, two similar GRC composites with high percentages of fly ash and different water/binder ratios will be studied. Conventional techniques have been used to confirm their low Ca(OH)(2) content (thermogravimetry), fibre integrity (Scanning Electron Microscopy), low porosity (Mercury Intrusion Porosimetry) and good mechanical properties (compression and four points bending test). Ultrasound frequency sweeps allowed the estimation of the attenuation and pulse velocity as functions of frequency. This ultrasonic characterization was correlated successfully with conventional techniques.

Interpreting atomic force microscopy nanoindentation of hierarchical biological materials using multi-regime analysis.

We present a novel Multi-Regime Analysis (MRA) routine for interpreting force indentation measurements of soft materials using atomic force microscopy. The MRA approach combines both well established and semi-empirical theories of contact mechanics within a single framework to deconvolute highly complex and non-linear force-indentation curves. The fundamental assumption in the present form of the model is that each structural contribution to the mechanical response acts in series with other 'mechanical resistors'. This simplification enables interpretation of the micromechanical properties of materials with hierarchical structures and it allows automated processing of large data sets, which is particularly indispensable for biological systems. We validate the algorithm by demonstrating for the first time that the elastic modulus of polydimethylsiloxane (PDMS) films is accurately predicted from both approach and retraction branches of force-indentation curves. For biological systems with complex hierarchical structures, we show the unique capability of MRA to map the micromechanics of live plant cells, revealing an intricate sequence of mechanical deformations resolved with precision that is unattainable using conventional methods of analysis. We recommend the routine use of MRA to interpret AFM force-indentation measurements for other complex soft materials including mammalian cells, bacteria and nanomaterials.

Treatment of childhood acute lymphoblastic leukemia in central America: a lower-middle income countries experience.

BACKGROUND: Five Asociación de Hemato-Oncología de Centroamérica (AHOPCA) countries have used an adapted BFM-based protocol for childhood acute lymphoblastic leukemia (ALL). PROCEDURE: In the AHOPCA-ALL 2008 protocol, patients were stratified by age, white blood cell count, immunophenotype, central nervous system involvement, day 8 prednisone response, and morphologic bone marrow response to induction therapy. Patients at Standard Risk (SR) received a three-drug induction regimen, a reinduction phase, and maintenance with protracted intrathecal therapy. Those at Intermediate (IR) and High Risk (HR) received, in addition, daunorubicin during induction therapy, a consolidation phase and two or three reinduction phases respectively. RESULTS: From August 2008 through July 2012, 1,313 patients were enrolled: 353 in SR, 548 in IR, 412 in HR. During induction therapy, 3.0% of patients died, 2.7% abandoned treatment, 1.1% had resistant ALL, and 93.2% achieved morphological complete remission (CR). Deaths and abandonment in first CR occurred in 2.7% and in 7.0% of patients, respectively. The relapse rate at a median observation time of 2.1 years was 15.0%. At 3 years, the event-free survival (EFS) and overall survival (OS), with abandonment considered as an event, were 59.4% (SE 1.7) and 68.2% (SE 1.6). Three-year EFS was 68.5% (SE 3.0), 62.1% (SE 2.6), and 47.8% (SE 3.2) for SR, IR, and HR groups. Adolescents had a significantly higher relapse rate (P = 0.001). CONCLUSIONS: This experience shows that common international studies are feasible in lower-middle income countries. Toxic deaths, abandonment of treatment, and relapses remain major obstacles to the successful treatment. Alternative treatment strategies may be beneficial.

Proceso de formación para el liderazgo en un programa de enfermería: concepciones de estudiantes y docentes / Process for leadership training program in nursing: concepts of students and teachers / Processos de formação para liderança em programa de emfermagem: conceitos de estudantes e professores

[{"text": "Esta investigación cualitativa se realizó con el objetivo de caracterizar las concepciones de estudiantes y docentes \r\nsobre el proceso de formación en liderazgo en un programa de enfermería de una universidad de Bogotá. Se partió \r\ndel concepto de liderazgo en enfermería como "el proceso que promueve la mejora de las condiciones de salud y vida \r\nde la población, el logro de objetivos de cuidado propios de la profesión y el alcance de las metas propuestas en los \r\nservicios de salud" (1).\r\nMediante entrevista semiestructurada realizada a cuatro estudiantes de último año y cuatros docentes, se concluyó \r\nque los estudiantes reconocen que la formación en el pregrado de alguna manera contribuye al desarrollo del liderazgo \r\nmediante diferentes actividades y metodologías pedagógicas como trabajos en grupo y estudios de casos, entre otras, \r\ny consideran las prácticas formativas como el escenario por excelencia para lograrlo. Ellos también valoran de manera \r\npositiva estrategias extracurriculares como las asesorías psicológicas y las realizadas por algunos docentes, así como \r\nla oportunidad de ser representantes de grupo. Señalan que el proyecto de vida, que se desarrolla transversalmente en \r\nel plan de estudios, es un apoyo que ha incidido de una manera importante en el logro de este objetivo. Todas estas \r\nestrategias están encaminadas, en su gran mayoría, al fortalecimiento del liderazgo personal. Aunque los estudiantes \r\nreconocen su influencia, creen que deben fortalecerse de una forma intencionada para mejorar su impacto. Por su parte \r\nlos docentes reconocen, además de las prácticas formativas, la actitud y el ejemplo docente como lo más importante \r\nen la formación para el liderazgo. Sin embargo, estas posturas educativas no fueron reconocidas por los estudiantes.", "_i": "es"}, {"text": "Qualitative research was conducted with the aim of \r\ncharacterizing the views of students and teachers about \r\nthe process of leadership training in a nursing program in \r\na University of Bogotá. We considered nursing leadership \r\nas "the process that promotes the improvement of health \r\nand living conditions of the population, the achievement \r\nof the objectives related to professional care, and the \r\nreaching of the proposed targets in health services" (1).\r\nThrough semi-structured interviews with four seniors \r\nand four teachers, it was concluded that students recog\r\n-\r\nnize that undergraduate training in some degree has \r\nhelped in the development of leadership, by means of \r\ndifferent activities and teaching methods such as group \r\nwork and case studies, among others. Formative prac\r\n-\r\ntice is considered by the students the best way to achieve \r\nthat purpose. The students identified and considered that \r\nsome non-pedagogical strategies, such as the psycholo\r\n-\r\ngical counseling done by some teachers, as well as the \r\nopportunity to be representatives of the group, are very \r\nimportant. They also indicate among these strategies \r\nthe project of life that is carried across the curriculum, \r\nas a support that helps to achieve positive results. All of \r\nthese measures strengthen personal leadership. Although \r\nthe students recognized their influence, they considered \r\nthat these strategies should be strengthened intentionally \r\nin order to enhance their impact. Meanwhile, teachers \r\nrecognize that besides the formative practices, the atti\r\n-\r\ntude and example of the teacher is the most important \r\naspect in a leadership formation. However the students \r\ndid not recognize this educational stance.", "_i": "en"}, {"text": "Uma investigação qualitativa foi realizada com objetivo \r\nde caracterizar os conceitos de estudantes e professores\r\nsobre o processo de formação e liderança em um programa \r\nde enfermagem de uma universidade de Bogotá. Parte do \r\nconceito de liderança de enfermagem o "processo que \r\npromove a melhora das condições de saúde e vida da \r\npopulação, o alcance de objetivos de cuidados próprios \r\nda profissão e o alcance das metas propostas nos serviços \r\nde saúde" (1).\r\nPerante entrevista semi-estruturada realizada com \r\n4 estudantes do último ano e 4 professores, pode-se \r\nconcluir que os alunos reconhecem que a graduação \r\ntem contribuído de certa forma com o desenvolvimento \r\nde liderança. Desde atividades diferentes, metodologias \r\npedagógicas como trabalhos em grupos e estudos de \r\ncasos, até outras que praticas construtivas, são excelentes \r\ncenários para esta formação. Há também estratégias \r\nnão pedagógicas consideradas de grande importância, \r\ncomo assessorias psicológicas realizadas por alguns \r\ndocentes, e a oportunidade de representar um grupo. \r\nTambém identificam dentro destas o projeto de vida que \r\né levado transversalmente no Plano de Estudos, como \r\num apoio que tem sido muito importante para esse \r\nobjetivo. A maioria dessas medidas são encaminhadas \r\nao fortalecimento de liderança pessoal. Apesar de ter a \r\ninfluência reconhecida, acreditam que ainda devem ser \r\naprimorados para melhorar seu impacto. Ademais, os \r\nprofessores mencionam práticas além das citadas acima: \r\na atitude e o exemplo docente, como o mais importante \r\npara a formação de liderança. Entretanto, essas posturas \r\neducativas não foram reconhecidas pelos estudantes.", "_i": "pt"}]

Natural history of pyuria and microhematuria after prostate surgery.

OBJECTIVE: Urinalysis alterations are common after prostatic surgery. However, time to normalization has not been established. Presence of pyuria and microhematuria can lead to unnecessary diagnostic procedures. The objective of this study is to determine the time to normalization for both parameters. MATERIAL AND METHODS: We reviewed medical records of patients who underwent prostatic surgery without infectious complications during follow-up. We included patients who underwent transurethral resection of the prostate (TURP) with either monopolar or bipolar energy, or open prostatectomy (OP). Kaplan-Meier curves were used to determine the time of persistence of both parameters. ANOVA was used to compare the 3 groups according to the type of surgery. We analyzed the impact of preoperative use of 5-α-reductase inhibitors, and searched for a correlation between the weight of resected tissue and persistence of both parameters. RESULTS: 85 patients were analyzed: 44 underwent monopolar TURP, 27 bipolar TURP, and 14 OP. Persistence of pyuria was significantly longer than microhematuria with a median of 274 days vs. 176 days. Neither the use of monopolar or bipolar energy, nor the use of preoperative 5α-reductase inhibitors affected the persistence time. We found a positive correlation between the resected tissue weight and the persistence of leukocyturia after endoscopic surgery: 23 g was the best cut-off point. CONCLUSIONS: Pyuria persists longer than microhematuria regardless of the type of surgery. There is a correlation between the resected tissue weight and the persistence of pyuria. The presence of pyuria and microhematuria after prostatic surgery is not always a pathological finding.

Chlamydia psittaci genotype B in a pigeon (Columba livia) inhabiting a public place in San José, Costa Rica.

Human chlamydiosis is a zoonotic disease of avian origin caused by Chlamydia psittaci. The highest infection rates have been detected in parrots (Psittacidae) and pigeons (Columbiformes), the latter most frequently carry the genotypes B and E. These genotypes have been shown to also infect humans. Because pigeons (Columba livia) cohabit with humans in urban areas, C. psittaci present in the dust from dry feces of infected pigeons may be transmitted by inhalation and represent a significant public health problem. Between 2012 and 2013 a total of 120 fecal samples were collected from pigeons at four public places (Plaza de la Cultura, Parque Morazán, Parque Central de Guadalupe, Plaza de las Garantías Sociales) in San José, Costa Rica. A nested polymerase chain reaction (PCR) was used to amplify a region of the outer membrane protein A gene of C. psittaci. Only one sample was positive in PCR and the positive sample was further subjected to sequencing and genotyping. Sequencing identified this sample as C. psittaci genotype B. This study is the first report to show the presence of this organism in pigeons of Costa Rica, and shows that the infected pigeons may represent a significant risk for humans who visit public places that are inhabited by pigeons.

Economía del tabaco / Tobacco economics

La ciencia ha demostrado inequívocamente que el consumo de tabaco y la exposición al humo de este, son causa de mortalidad, morbilidad y discapacidad y representan un riesgo inminente para la salud pública a nivel mundial. Muchos gobiernos dudan en adoptar medidas legales y políticas necesarias para disminuir el consumo de tabaco, por temor a las consecuencias económicas negativas que tales medidas podrían implicar. La producción, exportación e importación de tabaco son una parte ínfima de la economía costarricense. El control estricto del tabaco no produciría una pérdida neta de empleos; la teoría económica dicta que se verificaría un cambio en los patrones de consumo, el cual implicaría un aumento de empleos en otras áreas de la economía nacional. Existe evidencia de países de alto, mediano y bajo ingreso, que demuestra que el aumento del precio de los cigarrillos por medio del incremento de impuestos induce a la disminución en el consumo y previene el inicio del fumado, especialmente en la población joven. Además, se genera un aumento en ingresos fiscales como consecuencia de los impuestos. La evidencia prueba que el contrabando de tabaco está íntimamente relacionado con el nivel de corrupción existente en el país, por eso con el aumento o disminución de impuestos, los cambios en el contrabando no son significativos. Hay evidencia de que no existen pérdidas económicas por ventas, ni disminución en empleos en hoteles, bares y restaurantes, al implementar la ley de espacios 100 por ciento libres de humo.

Arsenic speciation in edible alga samples by microwave-assisted extraction and high performance liquid chromatography coupled to atomic fluorescence spectrometry.

Twelve commercially available edible marine algae from France, Japan and Spain and the certified reference material (CRM) NIES No. 9 Sargassum fulvellum were analyzed for total arsenic and arsenic species. Total arsenic concentrations were determined by inductively coupled plasma atomic emission spectrometry (ICP-AES) after microwave digestion and ranged from 23 to 126 µg g(-1). Arsenic species in alga samples were extracted with deionized water by microwave-assisted extraction and showed extraction efficiencies from 49 to 98%, in terms of total arsenic. The presence of eleven arsenic species was studied by high performance liquid chromatography-ultraviolet photo-oxidation-hydride generation atomic-fluorescence spectrometry (HPLC-(UV)-HG-AFS) developed methods, using both anion and cation exchange chromatography. Glycerol and phosphate sugars were found in all alga samples analyzed, at concentrations between 0.11 and 22 µg g(-1), whereas sulfonate and sulfate sugars were only detected in three of them (0.6-7.2 µg g(-1)). Regarding arsenic toxic species, low concentration levels of dimethylarsinic acid (DMA) (<0.9 µg g(-1)) and generally high arsenate (As(V)) concentrations (up to 77 µg g(-1)) were found in most of the algae studied. The results obtained are of interest to highlight the need to perform speciation analysis and to introduce appropriate legislation to limit toxic arsenic species content in these food products.

Gestación heterotópica en dos casos de embarazos espontáneos / Spontaneous heterotopic pregnancy

Gestación heterotópica se define como la coexistencia entre gestación intra y extrauterina. Su incidencia es baja en embarazos espontáneos, aumentando con las técnicas de reproducción asistida, por lo tanto, su diagnóstico precisa de un alto índice de sospecha. Presentamos dos casos, sin antecedentes de importancia, con gestación actual espontánea, que consultaron por dolor hipogástrico y goteo hemático. En la ecografía se objetivaron una gestación intrauterina detenida y una masa anexial compatible con gestación tubárica. Tras la sospecha de gestación heterotópica se realizó salpingectomía laparoscópica y legrado evacuador. La anatomía patológica confirmó el diagnóstico en las pacientes.

Heterotopic pregnancy consists of simultaneous intra and extra uterine pregnancy. The incidence is low in spontaneous pregnancies, but these pregnancies are more common when assisted reproductive technologies are used; therefore, diagnosis requires a high index of suspicion. We report two cases with no history of interest and a spontaneous pregnancy, who presented with hipogastric pain and spotting. An ultrasound scan showed an intrauterine gestational sac and adnexal mass consistent with ectopic pregnancy. As a heterotopic pregnancy was suspected, laparoscopic salpingectomy and curettage of the miscarriage were performed. Pathological analysis confirmed the diagnosis.

Comparative analysis of enzyme and pathway engineering strategies for 5FC-mediated suicide gene therapy applications.

Bacterial- and yeast- encoded cytosine deaminases (bCD and yCD, respectively) are widely investigated suicide enzymes used in combination with the prodrug 5-fluorocytosine (5FC) to achieve localized cytotoxicity. Yet characteristics such as poor turnover rates of 5FC (bCD) and enzyme thermolability (yCD) preclude their full therapeutic potential. We previously applied regio-specific random mutagenesis and computational design to create novel bCD and yCD variants with altered substrate preference (bCD(1525)) or increased thermostability (yCD(double), yCD(triple)) to aid in overcoming these limitations. Others have utilized pathway engineering in which the microbial enzyme uracil phosphoribosyltransferase (UPRT) is fused with its respective CD, creating bCD/bUPRT or yCD/yUPRT. In this study, we evaluated whether the overlay of CD mutants onto their respective CD/UPRT fusion construct would further enhance 5FC activation, cancer cell prodrug sensitivity and bystander activity in vitro and in vivo. We show that all mutant fusion enzymes allowed for significant reductions in IC(50) values relative to their mutant CD counterparts. However, in vivo the CD mutants displayed enhanced tumor growth inhibition capacity relative to the mutant fusions, with bCD(1525) displaying the greatest tumor growth inhibition and bystander activity. In summary, mutant bCD(1525) appears to be the most effective of all bacterial or yeast CD or CD/UPRT enzymes examined and as such is likely to be the best choice to significantly improve the clinical outcome of CD/5FC suicide gene therapy applications.

[Effectiveness of an intervention in schools to increase vaccination coverage in children aged 6]. / Aumentar la cobertura vacunal. Eficacia de una intervención en la escuela.

The management of the vaccination program is part of nursing competences. The main goal of this program is to vaccinate the whole population. There are some age groups in which vaccination coverage is represented by very low rates. Several methods can be used in order to increase such coverage and each professional shall use them according to the work environment. This article presents a simple and effective intervention applicable in any rural area--and probably in any environment--through schools, where all children regularly go. This program has been very useful for us to increase the vaccination coverage of children aged 6.