Láser de baja potencia como coadyuvante en tratamiento endodóntico de pieza con reabsorción interna y lesión apical: reporte de un caso / Use of low level laser as an adjunct in endodontic treatment of teeth with internal resorption and apical lesión

La reabsorción radicular interna es infrecuente en dentición permanente, la mayoría de los casos se observan en dientes anteriores, su etiología no está del todo clara, es por esto que el tratamiento para este tipo de lesiones es la endodoncia. Se presenta el caso de una paciente sexo femenino, 38 años de edad, sin antecedes médicos relevantes, derivada para evaluación de diente 2.2 con mal pronóstico. El diagnóstico es de absceso apical agudo, pieza con reabsorción interna y lesión apical. Se realiza endodoncia con cementos biocerámicos y aplicación de láser terapéutico de 808 nm de longitud de onda, con parámetros específicos para acelerar la reparación del tejido óseo. La terapia de fotobiomodulación con láser de baja potencia parece ser útil como coadyuvante en el proceso de reparación ósea en piezas con lesión apical y reabsorción interna tratadas endodónticamente.

Internal root resorption is infrequent in permanent dentition, most cases are observed in anterior teeth, its etiology is not entirely clear, which is why the treatment for this type of lesion is endodontics.We present the case of a 38-year-old female patient, without relevant medical history, referred for evaluation of tooth 2.2 with a poor prognosis. Diagnosis Acute apical abscess, tooth with internal resorption and apical lesion. Endodontics are performed with bioceramic cements and the application of a 808 nm wavelength therapeutic laser, with specific parameters to accelerate bone tissue repair.Low-level laser photobiomodulation therapy appears to be useful as an adjunct in the bone repair process in endodontically treated teeth with apical lesion and internal resorption.

Talaromyces australis and Penicillium murcianum pigment production in optimized liquid cultures and evaluation of their cytotoxicity in textile applications.

In this work Talaromyces australis and Penicillium murcianum pigment production in liquid cultures and the cytotoxic effect of such pigments on skin model cells were studied. Response surface methodology (RSM) was used to optimize culture conditions aiming to increase pigment production in malt extract and peptone-glucose-yeast extract medium. Cytotoxicity of fungal pigments and also from lixiviates of wool fabrics dyed with T. australis and P. murcianum pigment was evaluated on mammalian cell lines HEK293 and NIH/3T3. Results showed that variations on initial pH, NaCl and peptone, resulted in increments up to 188.2% for red pigment of T. australis and 107.4% for yellow pigment of P. murcianum, regarding non-optimized conditions. Tested fungi also showed great differences in culture conditions for the maximum pigment production, with P. murcianum requiring an alkaline medium (initial pH 9) supplemented with NaCl and T. australis an acidic medium (initial pH 5) without addition of salt. The cytotoxicity assays provided evidences on the safe nature of these natural pigments when used for textile applications. The cytotoxicity assay showed that the threshold of toxicity, given by the lowest IC50 value (0.21 g L-1) was more than double of the concentration of pigment required to dye the wool samples. In addition, cytotoxicity of lixiviates depicted no toxic effect over tested cells.

Complementary and Integrative Medicine Use in Individuals Seeking Conventional Medical Oncology Care in Chile: Prevalence and Patient Characteristics.

PURPOSE: Complementary and integrative medicine (CIM) use during cancer care has increased in Western medical settings. Little is known about interest in and use of CIM approaches by oncology patients in Chile and South America. PATIENTS AND METHODS: Patients presenting for conventional outpatient or inpatient medical oncology care at the Clinica Alemana in Santiago, Chile, from March to June 2017 were asked to complete a survey about their interest in and use of CIM approaches. Goals included determining the prevalence of CIM use and exploring associations between CIM use and patient characteristics. Statistical analyses included a two-tailed t test for continuous variables, Fischer's exact test for categorical variables, and logistic regression for association between CIM use and other variables. RESULTS: Of 432 patients surveyed, 66.9% were diagnosed with breast cancer, 84.8% were women, the majority of patients (58.1%) were between age 40 and 60 years, and 51.5% (n = 221) reported CIM use. No association was found between CIM use and the sociodemographic variables of sex, age, education, or income. In all, 44.6% of patients with breast cancer reported CIM use compared with 64.8% of patients with other cancer types (P > .001). Most commonly reported types of CIM used included herbals (49.1%), vitamins and minerals (40.8%), and prayer or meditation (40.4%). Most frequent reasons for CIM use were to "do everything possible" (72%) and to "improve my immune function" (67.8%). Most patients (43.4%) reported starting CIM use at the time of cancer diagnosis, with only 55.4% sharing information regarding CIM use with their medical team. CONCLUSION: The majority of patients surveyed reported engaging in CIM use, with just over half the users communicating with their oncology team about their CIM use. Increased awareness of regional differences in CIM use may help increase communication regarding this subject and contribute to improved outcomes.

Removal of area CA3 from hippocampal slices induces postsynaptic plasticity at Schaffer collateral synapses that normalizes CA1 pyramidal cell discharge.

Neural networks that undergo acute insults display remarkable reorganization. This injury related plasticity is thought to permit recovery of function in the face of damage that cannot be reversed. Previously, an increase in the transmission strength at Schaffer collateral to CA1 pyramidal cell synapses was observed after long-term activity reduction in organotypic hippocampal slices. Here we report that, following acute preparation of adult rat hippocampal slices and surgical removal of area CA3, input to area CA1 was reduced and Schaffer collateral synapses underwent functional strengthening. This increase in synaptic strength was limited to Schaffer collateral inputs (no alteration to temporoammonic synapses) and acted to normalize postsynaptic discharge, supporting a homeostatic or compensatory response. Short-term plasticity was not altered, but an increase in immunohistochemical labeling of GluA1 subunits was observed in the stratum radiatum (but not stratum moleculare), suggesting increased numbers of α-amino-3-hydroxy-5-methyl-4-isoxazolepropionic acid receptors and a postsynaptic locus of expression. Combined, these data support the idea that, in response to the reduction in presynaptic activity caused by removal of area CA3, Schaffer collateral synapses undergo a relatively rapid increase in functional efficacy likely supported by insertion of more AMPARs, which maintains postsynaptic excitability in CA1 pyramidal neurons. This novel fast compensatory plasticity exhibits properties that would allow it to maintain optimal network activity levels in the hippocampus, a brain structure lauded for its ongoing experience-dependent malleability.

Calidad de vida en pacientes chilenas sobrevivientes de cáncer de mama / Quality of life in Chilean breast cancer survivors

Background: Quality of Life (QOL) assessment may evaluate the impact of diseases and their treatment on the overall well-being of patients. Aim: To assess QOL in Chilean breast cancer survivors. Patients and Methods: Ninety one female breast cancer patients aged 60 ± 10 years, who finished their oncologic treatment at least a year prior to the assessment, who were disease free and in medical follow-up were included in the study. They completed the European Organization for Research and Treatment of Cancer (EORTC) QLQ-C30 core questionnaire and the breast cancer module QLQ-BR23. Results: Forty eight percent of respondents were long term survivors (more than five years). Global QOL scores were high (73.6 ± 18.2), emotional scale had the lowest scores in QLQ-C30 functional scales (72.1). Symptoms with the highest scores were: Insomnia (= 21.2), pain (= 20.8), and fatigue (= 19.1). Body image, sexual function, and concern about the future were the most relevant problems. Body image was superior in patients with breast-conserving surgery (p = 0.008), and cognitive function was better in patients in early disease stage (p = 0.03) and in those with more than five years of survival (p = 0.04). Conclusions: Even when global QOL scores were high, some symptoms were prevalent. Awareness about these problems and symptoms should improve their diagnosis and treatment.

[Quality of life in Chilean breast cancer survivors]. / Calidad de vida en pacientes chilenas sobrevivientes de cáncer de mama.

BACKGROUND: Quality of Life (QOL) assessment may evaluate the impact of diseases and their treatment on the overall well-being of patients. AIM: To assess QOL in Chilean breast cancer survivors. PATIENTS AND METHODS: Ninety one female breast cancer patients aged 60 ± 10 years, who finished their oncologic treatment at least a year prior to the assessment, who were disease free and in medical follow-up were included in the study. They completed the European Organization for Research and Treatment of Cancer (EORTC) QLQ-C30 core questionnaire and the breast cancer module QLQ-BR23. RESULTS: Forty eight percent of respondents were long term survivors (more than five years). Global QOL scores were high (73.6 ± 18.2), emotional scale had the lowest scores in QLQ-C30 functional scales (72.1). Symptoms with the highest scores were: Insomnia (= 21.2), pain (= 20.8), and fatigue (= 19.1). Body image, sexual function, and concern about the future were the most relevant problems. Body image was superior in patients with breast-conserving surgery (p = 0.008), and cognitive function was better in patients in early disease stage (p = 0.03) and in those with more than five years of survival (p = 0.04). CONCLUSIONS: Even when global QOL scores were high, some symptoms were prevalent. Awareness about these problems and symptoms should improve their diagnosis and treatment.

[Validation of BR23 questionnaire for the assessment of quality of life of breast cancer patients in Chile]. / Calidad de vida en cáncer de mama: validación del cuestionario BR23 en Chile.

BACKGROUND: Quality of Life assessment in oncologic patients evaluates the impact and sequels of the disease ana the adverse effects of available treatments. AIM: To validate in Chile the breast cancer specific-questionnaire (BR23) developed by the European Organization for Research and Treatment of Cancer (EORTC). PATIENTS AND METHODS: After performing a linguistic validation of the BR23 according to EORTC instructions, its psychometric properties were tested in 103 patients with breast cancer whose ages ranged from 34 to 83 years. Internal consistency of the scales was assessed using the Cronbach's alpha coefficient. The test-retest correlations of each scale (n = 83) were evaluated. The correlation of BR23 scales with SF36 version 2 and C30 version 3.0 scales was also assessed. The sensitivity and specificity of the instrument were analyzed using receiver operating characteristic curves (ROC). RESULTS: Alpha values showed acceptable levels of internal consistency, ranging between 0.702 and 0.917 in all scales of BR23. The statistical analysis revealed significant test-retest correlations in most scales of BR23. The correlations between BR23 and similar domains of C30 and SF36 questionnaires were also significant. The BR23 questionnaire demonstrated satisfactory levels of sensitivity and specificity when compared with the SF-36 scale. CONCLUSIONS: The BR23 questionnaire adapted for use in Chile is linguistically appropriate and psychometrically valid.

Calidad de vida en cáncer de mama: validación del cuestionario BR23 en Chile / Validation of BR23 questionnaire for the assessment of quality of life of breast cancer patients in Chile

Background: Quality of Life assessment in oncologic patients evaluates the impact ana sequels of the disease ana the adverse effects of available treatments. Aim: To validate in Chile the breast cáncer specific-questionnaire (BR23) developed by the European Organization for Research and Treatment of Cancer (EORTC). Patients and Methods: After performing a linguistic validation of the BR23 according to EORTC instructions, its psychometric properties were tested in 103 patients with breast cancer whose ages ranged from 34 to 83 years. Infernal consistency ofthe scales was assessed using the Cronbach's alpha coefficient. The test-retest correlations of each scale (n = 83) were evaluated. The correlation ofBR23 scales with SF36 version 2 and C30 version 3.0 scales was also assessed. The sensitivity and specificity of the instrument were analyzed using receiver operating characteristic curves (ROC). Results: Alpha values showed acceptable levels of internal consistency, ranging between 0.702 and 0.917 in all scales of BR23. The statistical analysis revealed significant test-retest correlations in most scales ofBR23. The correlations between BR23 and similar domains of C30 and SF36 questionnaires were also significant. The BR23 questionnaire demonstrated satisfactory levels of sensitivity and specificity when compared with the SF-36 scale. Conclusions: The BR23 questionnaire adapted for use in Chile is linguistically appropriate and psychometrically valid.

Reconstrucción mamaria postmastectomía: revisión de 28 casos / Postmastectomy breast reconstruction: review of 28 cases

El objetivo de este trabajo es evaluar las reconstrucciones mamarias operadas en el Hospital del Salvador y Hospital Luis Tisné, sus complicaciones y grado de satisfacción cosmética de las pacientes. Se analizan en forma retrospectiva 26 pacientes con mastectomía, a las que se les realizó reconstrucción mamaria inmediata o diferida usando colgajo musculocutáneo de recto abdominal (TRAM). Mediante una encuesta se evaluó el grado de satisfacción de las pacientes. En un período de 68 meses se operaron 28 reconstrucciones mamarias en 26 pacientes. Hubo un 14,2 por ciento de complicaciones, una necrosis parcial de colgajo, una necrosis parcial de la piel nativa de la mama, una dehiscencia de la sutura umbilical y una hernia de pared. Veinticinco pacientes evaluaron con nota 7 el resultado cosmético y una con nota 3. Se concluye que el TRAM es una buena técnica de reconstrucción mamaria con escasas complicaciones, buen resultado estético e importante grado de satisfacción de parte de las pacientes.

[Cost-benefit in the study of the dissemination of stage I and II in breast cancer]. / Costo beneficio del estudio de diseminación en estadios I y II del cáncer de mama.

BACKGROUND: Chest X ray, abdominal ultrasound and bone scintigraphy are usually requested to study a possible dissemination of breast carcinoma. AIM: To study the yield and costs of these exams in the study of dissemination of stage I and II breast carcinoma. MATERIAL AND METHODS: A retrospective analysis of patients operated for a breast carcinoma in a public surgical service. A chest X ray, abdominal ultrasound and bone scintigraphy was requested to all patients in the immediate postoperative period. Age, stage according to pathological TNM and costs per patient were registered. RESULTS: Of 210 women operated, 40 were in stage I (19%) and 85 in stage II (41%). Dissemination study was negative in all stage I patients and in all but two patients in stage II. The yield for detection of distant metastases in these patients was 0.9% for chest X ray, 0% for abdominal ultrasound and 0.9% for bone scintigraphy. The total cost of the study, in Chilean pesos, was $10,369,620 in a public hospital and $16,535,400 in a private clinic. DISCUSSION: Additional exams to detect distant metastases in early stages of breast carcinoma have a low yield and high costs.