Concordance of in vivo reflectance confocal microscopy and horizontal-sectioning histology in skin tumours.

BACKGROUND: In vivo reflectance confocal microscopy (RCM) enables the study of architectural and cytological aspects in horizontal sections, which closely correlate with histologic features. However, traditional histopathological vertical sections cannot totally reproduce the image of the in vivo RCM horizontal section. OBJECTIVE: To evaluate the concordance between in vivo RCM and histopathologic transverse sections for melanocytic lesions, basal cell carcinoma and seborrheic keratoses. METHODS: Prospectively collected benign melanocytic and non-melanocytic tumours diagnosed by dermoscopy were evaluated for common RCM features and compared to histopathology in horizontal sections with haematoxylin and eosin staining. RESULTS: A total of 44 skin tumours including 19 melanocytic lesions (nine compound, five junctional and five intradermal nevi), 12 basal cell carcinomas and 13 seborrheic keratoses were collected in the Department of Dermatology of Hospital Clinic of Barcelona. The RCM features that had statistically significant agreement with the histopathological horizontal sections were the preserved and visible honeycomb pattern, well defined DEJ, small bright particles, dermal nests, tumour islands and dark silhouettes, clefting, collagen bundles, thickened collagen bundles and cytologic atypia. CONCLUSIONS: Histopathology evaluation of horizontal sections of skin tumours can be correlated with main RCM findings. The results of this study have improved the understanding and interpretation of RCM features in relation to skin tumours, thus reinforcing the utility of RCM as a diagnostic tool.

Anisakidosis en peces frescos comercializados en tres ciudades de la Región del Bío Bío, Chile / Anisakidosis in fresh fish commercialized in three cities of the Bío Bío Region, Chile

INTRODUCCIÓN: La anisakidosis humana es una zoonosis transmitida por alimentos, causada por la ingestión de carne de pescado parasitada por nematodos anisákidos. Investigaciones sobre la presencia de anisákidos en pescados comercializados, sin cocción o congelación previa, en la región centro sur de Chile son escasas. OBJETIVO: Identificar nematodos anisákidos en catorce especies de peces marinos, obtenidos por pesca artesanal y comercializados en Concepción, Talcahuano y Lebu, ciudades de la Región del Bío Bío, Chile. MÉTODO: Entre los años 2018 y 2020, se examinó en busca de anisákidos a 334 pescados marinos frescos. RESULTADOS: Se identificó larvas de Anisakis spp. y Pseudoterranova sp. en ejemplares de siete y cuatro especies de peces, respectivamente. La mayoría de las larvas se encontraron vivas y ubicadas a nivel visceral. CONCLUSIÓN: La mayoría de las especies de peces que resultaron positivas son reconocidos hospederos intermediarios de estos parásitos. La presencia de anisákidos en la musculatura de estas especies indica que su preparación, en forma ahumada o cruda, es un riesgo para salud pública, recomendándose comprar estos productos en forma eviscerada y/o congelada, junto a promover su cocción.

BACKGROUND: Human anisakidosis is a food-borne zoonosis, caused by the intake of fish meat parasitized by anisakid nematodes. Research of anisakids parasites in commercialized fish, without previous cooking or freezing, in the south central region of Chile is scarce. AIM: To identify anisakid nematodes in fourteen species of marine fish, obtained by artisanal fishing and commercialized in Concepción, Talcahuano and Lebu, cities from Bío Bío Region, Chile. METHODS: During 2018 to 2020, we examinated for anisakids to 334 fresh marine fishes. RESULTS: Larvae of Anisakis spp. and Pseudoterranova sp. were identified in specimens of seven and four fish species, respectively. Most of the larvae were found alive and located at the visceral level. CONCLUSION: Most of the positive fish species are recognized intermediate hosts for these parasites. The presence of anisakids in the musculatura of these species indicates that their preparation, in smoked or raw form, is a risk to public health, and it is recommended to buy these products in gutted and / or frozen form, together with promoting their cooking.

Multisystemic inflammatory syndrome related to COVID-19, with latent tuberculosis in bone marrow, and satisfactory response to tocilizumab, in a 7-year-old boy.

Paediatric inflammatory multisystem syndrome temporally associated with COVID-19 (PIMS-TS) or multisystem inflammatory syndrome in children (MIS-C) is a new acute-onset systemic inflammatory disease, which mainly affects children. Latent tuberculosis infection (LTBI) is characterized by the presence of immune sensitization to Mycobacterium tuberculosis (MTB) in the absence of any clinical or radiological evidence of active disease. We present a child with MIS-C related to COVID-19, with latent TB in the bone marrow, and satisfactory response to tocilizumab. It is important to pay attention in the investigation of TB cases in countries with a high prevalence of tuberculosis, especially when opting for immunusuppression.

Detección de ooquistes de Cryptosporidium parvum (Apicomplexa: Cryptosporidiidae) en ejemplares de cholga Aulacomya ater, extraídas desde la costa de la Región del Bío Bío, Chile / Detection of Cryptosporidium parvum (Apicomplexan: Cryptosporidiidae) oocyst in Aulacomya ater specimen, extracted from to the coast Bio Bio Region, Chile

Resumen Introducción: El bivalvo Aulacomya ater (cholga), es uno de los moluscos de mayor consumo en la población chilena. Sin embargo, existe evidencia de contaminación fecal hídrica provocada por los cauces que llegan al mar, aumentando la probabilidad de contaminación por Cryptosporidium parvum, el que genera criptosporidiosis en el ser humano. Objetivo: Determinar la presencia de C. parvum en cholgas extraídas desde la Región del Bío Bío (Chile). Material y Métodos: Se seleccionaron 55 cholgas provenientes de un centro de cultivo y de un banco natural de extracción. Estas muestras, fueron procesadas en el laboratorio y se evaluó la presencia de elementos ácido-alcohol resistentes. Las muestras positivas, se analizaron por inmunofluorescencia directa, con anticuerpo específicos contra C. parvum. Resultados: 16,4% del total de las muestras tenían ooquistes de C. parvum. Conclusiones: Por primera vez se describe C. parvum en A. ater provenientes de las costas chilenas, siendo este molusco un posible vehículo de transmisión de criptosporidiosis a la población y a sus animales depredadores. Además, la presencia de C. parvum refleja la contaminación fecal hídrica en las costas evaluadas. Actualmente estamos monitoreando otras zonas de extracción de este molusco.

Abstract Background: The bivalve Aulacomya ater (cholga), is one of the most consumed mollusks by the population. However, there is evidence of fecal water contamination caused by causes that affect the sea, increasing the probability of contamination by the Cryptosporidium parvum, which generates cryptosporidiosis in people. Aim: To determine the presence of C. parvum in cholga extracted from the Bio Bio Region (Chile). Methods: Fifty-five cholgas were selected from a cultivation center and a natural extraction bank. These samples were processed in the laboratory and the presence of acid-alcohol resistant elements was evaluated. Positive samples were analyzed by direct immunofluorescence with anti-C. parvum antibody. Results: 16.4% of the total samples were affected by the oocysts of C.parvum. Conclusions: For the first time we described C. parvum in A. ater from the Chilean coast, being this mollusk a possible vehicle for transmission of cryptosporidiosis to the population and their predatory animals. Furthermore, the presence of C. parvum reflects fecal water contamination on the evaluated coasts. We are currently monitoring other extraction areas for this mollusk.

COVID-19: Initial experience of an international group of hand surgeons.

The emergence of the COVID-19 pandemic has severely affected medical treatment protocols throughout the world. While the pandemic does not affect hand surgeons at first glance, they have a role to play. The purpose of this study was to describe the different measures that have been put in place in response to the COVID-19 pandemic by hand surgeons throughout the world. The survey comprised 47 surgeons working in 34 countries who responded to an online questionnaire. We found that the protocols varied in terms of visitors, health professionals in the operating room, patient waiting areas, wards and emergency rooms. Based on these preliminary findings, an international consensus on hand surgery practices for the current viral pandemic, and future ones, needs to be built rapidly.

Migration of noble gas tracers at the site of an underground nuclear explosion at the Nevada National Security Site.

As part of an underground gas migration study, two radioactive noble gases (37Ar and 127Xe) and two stable tracer gases (SF6 and PFDMCH) were injected into a historic nuclear explosion test chimney and allowed to migrate naturally. The purpose of this experiment was to provide a bounding case (natural transport) for the flow of radioactive noble gases following an underground nuclear explosion. To accomplish this, soil gas samples were collected from a series of boreholes and a range of depths from the shallow subsurface (3 m) to deeper levels (~160 m) over a period of eleven months. These samples have provided insights into the development and evolution of the subsurface plume and constrained the relative migration rates of the radioactive and stable gas species in the case when the driving pressure from the cavity is low. Analysis of the samples concluded that the stable tracer SF6 was consistently enriched in the subsurface samples relative to the radiotracer 127Xe, but the ratios of SF6 and 37Ar remained similar throughout the samples.

Spirocercosis in red fox (Vulpes vulpes) in a natural reserve located in a meso-Mediterranean area.

Spirocerca lupi Rudolphi 1809 (Nematoda Spirocercidae) has an indirect cycle involving intermediate and paratenic hosts, having domestic or wild canids as the main definitive hosts. The most frequent pathology affecting dogs is a granulomatous tumor-like growth containing adults in the oesophagus and aorta. There are very few references about the presence of nodules in the stomach. There is scant information about the epidemiology of this disease in wild red foxes in meso-Mediterranean areas. In this work we report on the natural infection of wild red foxes by Spirocerca lupi and the damage produced in the stomach wall in an area where contact with other potential definitive hosts (canids) is very rare. From July 2015 to November 2016, 61 red foxes were sampled. 18.03% of the stomach walls examined had nodules containing Spirocerca lupi adults and eggs. The prevalence of infection was similar for young and adult groups (23.81 and 18.18%; χ2 = 0.25; df = 1; P = 0.6171) and it was higher in females than in males (25.81 versus 10.00%, χ2 = 2.58; df = 1; P = 0.1082). The red fox population in the area seems to be well established judging from their age distribution and the fact that they could be captured all year round. It would appear that in the absence of other main definitive host S. lupi population is able to survive just parasitizing red foxes. Pathologic effects of this parasite on red foxes seems to show some differences related to domestic dogs. These results also indicates as predator control programs can maintain suitable host populations with reduced level of infection.

SECOND LATIN AMERICAN INTERCOMPARISON ON INTERNAL DOSE ASSESSMENT.

Internal dosimetry intercomparisons are essential for the verification of applied models and the consistency of results'. To that aim, the First Regional Intercomparison was organised in 2005, and that results led to the Second Regional Intercomparison Exercise in 2013, which was organised in the frame of the RLA 9/066 and coordinated by Autoridad Regulatoria Nuclear of Argentina. Four simulated cases covering intakes of (131)I, (137)Cs and Tritium were proposed. Ninteen centres from thirteen different countries participated in this exercise. This paper analyses the participants' results in this second exercise in order to test their skills and acquired knowledge, particularly in the application of the IDEAS Guidelines. It is important to highlight the increased number of countries that participated in this exercise compared with the first one and, furthermore, the improvement in the overall performance. The impact of the International Atomic Energy Agency (IAEA) Projects since 2003 has led to a significant enhancement of internal dosimetry capabilities that strengthen the radiation protection of workers.

Core Content for Undergraduate Medical Education in Spain: Recommendations of the Instructors' Group of the Spanish Academy of Dermatology and Venereology (AEDV).

BACKGROUND: Skin problems are among the most frequent reasons for seeking medical attention in primary care. In recent years, as a result of the process of adapting medical curricula to the requirements of the European Higher Education Area, the amount of time students spend learning the concepts of dermatology has been reduced in many universities. MATERIAL AND METHODS: In order to reach a consensus on core content for undergraduate education in dermatology, we sent a survey to the 57 members of the instructors' group of the Spanish Academy of Dermatology and Venereology (AEDV), asking their opinions on what objectives should be set for a dermatology course in Spain. A total of 131 previously selected objectives were listed. We then applied the Delphi method to achieve consensus on which ones the respondents considered important or very important (score≥4 on a Likert scale). RESULTS: Nineteen responses (33%) were received. On the second round of the Delphi process, 68 objectives achieved average scores of at least 4. The respondents emphasized that graduates should understand the structure and functions of the skin and know about bacterial, viral, and fungal skin infections, the most common sexually transmitted diseases (STDs), and the 4 main inflammatory dermatoses. Students should also learn about common complaints, such as itching and bald patches; the management of dermatologic emergencies; purpura and erythema nodosum as signs of internal disease; and the prevention of STDs and skin cancer. During clinical clerkships students should acquire the communication skills they will need to interview patients, write up a patient's medical history, and refer the patient to a specialist. CONCLUSIONS: The AEDV's group of instructors have defined their recommendations on the core content that medical faculties should adopt for the undergraduate subject of dermatology in Spain.

EURADOS IC2012N: FURTHER INFORMATION DERIVED FROM AN EURADOS INTERNATIONAL COMPARISON OF NEUTRON PERSONAL DOSEMETERS.

In 2012, the European Radiation Dosimetry Group (EURADOS) performed an intercomparison for neutron dosemeters that are intended to measure personal dose equivalent, Hp(10). A total of 31 participants registered with 34 dosimetry systems. The irradiation tests were chosen to provide the participants with useful information on their dosimetry systems, i.e. linearity, reproducibility, responses for different energies and angles and to simulated workplace fields. This paper gives details of the extensive information derived from the exercise.

Spin-Current to Charge-Current Conversion and Magnetoresistance in a Hybrid Structure of Graphene and Yttrium Iron Garnet.

The use of graphene in spintronic devices depends, among other things, on its ability to convert a spin excitation into an electric charge signal, a phenomenon that requires a spin-orbit coupling (SOC). Here we report the observation of two effects that show the existence of SOC in large-area CVD grown single-layer graphene deposited on a single crystal film of the ferrimagnetic insulator yttrium iron garnet (YIG). The first is a magnetoresistance of graphene induced by the magnetic proximity effect with YIG. The second is the detection of a dc voltage along the graphene layer resulting from the conversion of the spin current generated by spin pumping from microwave driven ferromagnetic resonance into a charge current, which is attributed to the inverse Rashba-Edelstein effect.

Agencia de autocuidado en pacientes hipertensos del Hospital Erasmo Meoz / Self care agency in patients with hypertension of the Erasmo Meoz Hospital / Administração de autocuidado em pacientes com hipertensão do Hospital Erasmo Meoz

El propósito del estudio fue determinar la capacidad de agencia de autocuidado de los hipertensos usuarios del servicio de \r\nconsulta externa del Hospital Universitario Erasmo Meoz en San José de Cúcuta (Colombia). Se realizó un estudio descriptivo, \r\ntransversal con abordaje cuantitativo durante el primer semestre del 2012. Mediante muestreo no probabilístico fueron seleccio\r\n-\r\nnados 200 hipertensos a quienes se les aplicó el cuestionario de evaluación de la capacidad de agencia de autocuidado en el \r\npaciente hipertenso.\r\nA nivel global se encontró que un porcentaje representativo de los encuestados (62,5%) presentó mediana capacidad de agencia \r\nde autocuidado; el 37,0% alta capacidad y baja un 0,5%. Estos resultados guardan correspondencia con el comportamiento de las \r\nrespuestas dadas por los participantes a la gran mayoría de los ítems que componen el instrumento. Además plantean un impor\r\n-\r\ntante desafío para la enfermería en la definición de estrategias de intervención asistencial y educativa que motiven y apoyen a las \r\npersonas hipertensas, para que sean autosuficientes frente a su propio cuidado, con capacidad de tomar sus propias decisiones y \r\nde solventar de manera autónoma sus necesidades en el manejo de su enfermedad.

The purpose of this study was to determine the capacity for \r\nself-care agency of hypertensive patients of the Hospital \r\nUniversitario Erasmo Meoz outpatient service in San José de \r\nCúcuta (Colombia). A descriptive, cross-sectional study with a \r\nqualitative approach was performed during the first semester \r\nof 2012. In a non-probabilistic sample a questionnaire was \r\nadministered to 200 hypertensive patients to evaluate the \r\nability of self-care agency in hypertensive patients.\r\nGlobally, it was found that a representative percent of the \r\nrespondents (62.5%) had a medium capacity for auto-care \r\nagency; 37% high capacity and 0.5% had low. These results are \r\nin line with the results of the answers given by the participants \r\nin the great majority of the items that make up the instru\r\n-\r\nment. In addition, the results represented a major challenge for \r\nnursing in defining of intervention strategies for assistance and \r\neducational intervention that encourage and supports people \r\nwith hypertension, to become auto sufficient in their own care, \r\nwith capacity to make their own decisions and to solve in an \r\nautonomous way their needs in the handling of their illness.

O propósito do estudo foi determinar a capacidade da admi\r\n-\r\nnistração de autocuidado dos pacientes hipertensos do \r\nserviço de consulta externa do Hospital Universitário Erasmo \r\nMeoz, em San José de Cúcuta (Colômbia). Foi realizado um \r\nestudo descritivo, transversal com abordagem quantitativa \r\ndurante o primeiro semestre de 2012. Por meio de amos\r\n-\r\ntragem não probabilística foram selecionados 200 hipertensos, \r\nque receberam o questionário de avaliação da capacidade de \r\nadministração de autocuidado no paciente hipertenso.\r\nA nível global descobriu-se que uma percentagem represen\r\n-\r\ntativa dos respondentes, 62,5%, apresentou capacidade média \r\nda agência de autocuidado, 37,0%, capacidade alta e 0,5%, \r\nbaixa. Estes resultados correspondem ao comportamento das \r\nrespostas dadas pelos participantes para a maioria dos itens \r\nque compõem o instrumento. Além disso, expõem um impor\r\n-\r\ntante desafio para a enfermagem na definição de estratégias \r\nde intervenção assistencial e educativa que motivem e apoiem \r\nas pessoas hipertensas, para que sejam autossuficientes \r\nquanto ao seu próprio cuidado, capazes de tomar suas próprias \r\ndecisões e resolver de forma autônoma suas necessidades na \r\ngestão de sua doença.

Experiencia de diez años en resecciones hepáticas / Ten years experience in hepatic resections

Revisamos experiencia reciente y resultados obtenidos con resecciones hepáticas mayores en pacientes referidos a nuestra institución. Revisión retrospectiva de historias clínicas de pacientes entre agosto de 1998 y agosto de 2008, con el objetivo de precisar el tipo de cirugía efectuada, indicaciones principales, complicaciones y morbimortalidad operatoria. 22 pacientes cuyas historias estuvieron disponibles para revisión. La principal indicación de cirugía fueron neoplasias malignas 86,4% de los casos, las metástasis de carcinoma colorrectal (7) la primera indicación seguida de hepatocarcinoma (4). Otras indicaciones incluyeron: colangiocarcinomas perifericos (2), metástasis de tumores neuroendocrinos (2), diversas lesiones benignas (3) otros tumores (4). La hepatectomía derecha y segmentectomías anatómicas fueron los más frecuentes con un 27,3 % cada uno, seguidos de segmentectomía lateral izquierda (II y III) en 19%. El tiempo operatorio promedio fue 270,4 min (rango: 180-560 min). El promedio de estancia hospitalaria fue 7,7 días (rango:4-30). El 8% de nuestros pacientes no requirió estancia posoperatoria inmediata en UTI. La tasa de complicaciones fue 44,5% siendo el derrame pleural reactivo y el sangrado posoperatorio más frecuentes. La tasa de reintervención fue 18,2%. La mortalidad global fue 9% (2/22), y la inherente al procedimiento quirúrgico 4,5% (1/22). Las resecciones hepáticas mayores son un procedimiento relevante en el armamento del cirujano oncólogo dedicado al tratamiento de neoplasias digestivas, la morbimortalidad operatoria en nuestra institución es similar a otros centros de mayor volumen a nivel internacional.

Review the recent experience and results of major hepatic resections of patients treated at our institution. Retrospective review of clinical records patients submitted to major hepatic resection inten years, between August 1998 to August 2008, with descriptive statistics of type of surgery, indications, complications and surgical related morbimortality. Twenty two patients with complete clinical records for review were included. The main indication for surgery were malignant neoplasms in 86,4% of the cases,being colorectal liver metastasis (7) the first one followed by hepatocarcinomas (4). Other indications included:The periferic colanghiocarcinomas (2), metastasis from neuroendocrine tumors (2), varied beningn lesions (3)and other tumors (4). Right hepatectomy and anatomical segmentectomies were the most frequent procedures 27.3% each, followed by left lateral segmentectomy (II - III) in19% of the cases. Medium operative time was 270.4 min (range: 180-560 min). Mean hospital stay was 7.7 days (range: 4-30). 8% of the patients did not required post operative ICU care. Complications rate was 44.5% being reactive pleural effusion and postoperative bleedingthe most frecuent ones. Reintervention rate was 18.2%, global mortality 9% (2/22), and surgical related mortality was 4.5% (1/22). Major hepatic resections are a relevant procedure in the armament of surgical oncologists dedicated to treatment of digestive neoplasms, the number of such procedures done at public institutions are limited. Operative morbimortality in our institution is similar to other major volume centers.

Necrotising pneumonia caused by Lactococcus lactis cremoris.

Lactococcus lactis cremoris is a facultative anaerobic, gram-positive coccus whose natural host is bovine livestock. It may form part of the normal human bacterial flora found in the oropharynx, the gastrointestinal tract and the vagina. This bacterium is essential in the food industry, where it is used in milk fermentation to obtain cheese, yoghurt, etc. Exposure to unpasteurised dairy products has thus been recognised as a risk factor for infection by this organism. It is generally considered to be non-pathogenic, although it appears that pathogenicity may be emerging. We present an atypical case of necrotising pneumonia caused by L. lactis cremoris.

Video endoscopic inguinal lymphadenectomy: surgical and oncological results.

INTRODUCTION: We evaluated the reproducibility of video endoscopic inguinal lymphadenectomy (VEIL) and we report our initial experience in the treatment of penile cancer with palpable inguinal lymph nodes. MATERIAL AND METHODS: From July 2006 to November 2010 were conducted 33 VEIL in 20 patients as complementary treatment for penile cancer in two referral hospitals in Latin America. We analyzed the epidemiological and clinical characteristics of patients and surgical and oncologic outcomes. RESULTS: Fifty-five percent of the patients included were clinical stage N0 and 45% were N +. Thirteen patients underwent bilateral VEIL and the remaining seven underwent VEIL unilateral and conventional open surgery in the contralateral limb. The average operative time for VEIL was 119 minutes and mean resected lymph nodes was 8 per lymphadenectomy. The overall complication rate was 33.2%. No patient had skin necrosis. The lymphatic complication rate was 27.2%. Of the 6 cases in which the saphenous vein was preserved (18.2%) there were no lymphatic complications (P=,2). The overall survival rate was 80% and cancer-specific survival was 90%. Mean follow-up was 20 months. CONCLUSIONS: VEIL in the adjunctive treatment of penile cancer is safe, reproducible and may be an alternative to conventional lymphadenectomy. Patients with palpable lymphadenopathy also may benefit from this technique. Oncological results seem to be adequate however require longer follow-up to be confirmed.

Uso del láser terapéutico en el control del dolor en ortodoncia / Use of laser therapy in pain control in orthodontics

Objetivo: Determinar si el láser de baja frecuencia (LLLT) es efectivo en disminuir la percepción del dolor posterior a la aplicación de separaciones molares para ortodoncia. Material y Método: Se realizó un ensayo clínico aleatorizado con enmascaramiento simple en 30 alumnos entre 16 y 20 años, a quienes se les aplicó separaciones elásticas entre los molares permanentes. Los voluntarios fueron designados en dos grupos: 15 pacientes en el grupo experimental quienes fueron tratados con LLLT (Photon Lase, DMC USA Corp.) por 30 segundos en cada molar permanente derecho y 15 pacientes en el grupo control quienes recibieron como placebo la colocación del láser inactivo con el mismo protocolo empleado en el grupo experimental. En total 30 dientes fueron incluidos en cada grupo. La percepción del dolor fue evaluada a las 3, 12, 24 horas y a los días 2, 3, 4, 5 y 7 posterior a la aplicación de LLLT a través de un cuestionario estándar de autollenado haciendo uso de la escala visual análoga del dolor (EVA). Resultados: El 61.6 por ciento de los pacientes del grupo de control presentó algún grado de dolor durante el periodo de seguimiento en comparación del 38.64 por ciento del grupo experimental (p=0.004). Si bien la intensidad del dolor alcanzó su punto máximo a las 12 horas las diferencias de los promedios entre ambos grupos también fue estadísticamente significativa (<0.001). Conclusión: El LLLT demostró ser una herramienta útil en el control del dolor posterior a la aplicación de separaciones molares.

Objective: To determine the effectiveness of low-level laser therapy (LLLT) to decrease the perception of pain after application of orthodontic molar separations. Material and Methods: We performed a randomized single-blind in 30 students between 16 and 20 years who were administered elastic separation between the permanent molars. Volunteers were assigned into two groups: 15 patients in the experimental group who were treated with LLLT (Photon Lase, DMC USA Corp.) for 30 seconds on each permanent right molar and 15 patients in the control group who received placebo-like placement inactive laser with the same protocol used in the experimental group. Altogether 30 teeth were included in each group. Pain perception was assessed at 3, 12, 24 hours and 2, 3, 4, 5 and 7 after application of LLLT through a standard questionnaire using the visual analogue scale of pain (EVA). Results: 61.6 percent of patients in the control group had some degree of pain during the follow-up period in comparison with the 38.64 percent of the experimental group (p =0.004). Although pain intensity peaked at 12 hours the mean differences between groups was statistically significant (<0.001). Conclusion: LLLT proved to be a useful tool in controlling pain after the application of separation molars.

[Infection by human papilloma virus amongst female inmates in a social re-adaptation centre in South-West Mexico]. / Infección por el Virus del Papiloma Humano en mujeres recluidas en Centros de Readaptación Social en el sureste de México.

INTRODUCTION: The aim of this work is describe the epidemiology of HVP amongst female inmates. MATERIAL AND METHODS: A total of 82 women were studied in a cross sectional study. Epidemiological data were collected through a direct interview. Samples of cervical cells were taken. HPV and genotypes were identified by molecular test. RESULTS: Global HPV prevalence was 20.7%. Fifteen different genotypes were identified 60% low risk HPV, 26.7% high risk HPV and 13.3% were not classified in any of the two groups. Types 6/11 were the most common. 23.5% (04/17) of HPV positives samples had multiple infections, 3 with 2 genotypes and one with 3. Association between infection with HPV and smoking was found, p= 0.0258, OR 3.79 IC 95% (1.01-15.58).

Factores de riesgo asociados a la sífilis congénita en tres instituciones desalud de Sincelejo (Colombia) / Risk factors associated with congenital syphilis in three health institutions in

Objetivo: Se Identificaron los factores de riesgo para sífilis congénita, relacionados con los antecedentes deinfecciones de transmisión sexual, las prácticas sexuales de la madre y su pareja, la asistencia al control prenatal,tratamiento para sífilis y vía del parto, en un grupo de puérperas, registradas en la IPS San Luis, las Américas y elHospital Universitario de Sincelejo entre los años 2007 a 2010. Metodología: Se desarrollo un estudio descriptivo y de corte con una selección muestral intencional de 34 madres cuyos hijos tuvieron pruebas de VDRL y FTA - abspositivos, que residían en Sincelejo y que fue posible su ubicación, quienes firmaron el consentimiento informado. Se aplicó un instrumento dirigido a la madre del niño con sífilis congénita, que fue tabulado en una base de SPSS 15.0.Resultados: Se encontró que la mayoría de las madres eran de estrato uno y dos, que no alcanzaron un nivel de educación media; 68,0% tenía entre 16 y 24 años de edad, 55,8% de los compañeros sexuales no se hizo la prueba para el diagnostico de Sífilis y 88,2% no usó preservativo antes ni durante el tratamiento. Conclusiones: La inasistencia o la asistencia irregular a las consultas prenatales y la poca adherencia a las medidas de protección sexual por parte de la pareja, fueron aspectos que interfirieron con un tratamiento eficaz de las gestantes. Los contactos de las madres infectadas y tratadas no están siendo diagnosticados en un alto porcentaje, lo que refleja una falla en el seguimiento a los contactos de las gestantes para evitar la reinfección.

Objectives: To identify risk factors for congenital syphilis associated with a history of sexually transmitted infections, sexual practices of the mother and her partner, attendance for prenatal care, treatment for syphilis and type of delivery, in a group of postpartum women, registered in San Luis, Las Americas IPS's and the Hospital Universitario de Sincelejo from 2007 to 2010. Methodology: We developed a descriptive and cross-sectional study with an intentional selection of 34 mothers whose children had VDRL and FTA-ABS positive, residing in Sincelejo and were possible to locate, that signed the informed consent. An instrument is directed to the mother of the child with congenital syphilis, which was tabulated on a foundation of SPSS 15.0. Results: We found that most mothers were in strata one and two, that did not reach the middle school level; 68,0% were between 16 and 24 years old, 55.8% of sexual partners did not test for the diagnosis of syphilis and 88.2% did not use condoms before or during the treatment. Conclusions: The absence or irregular attendance at the prenatal care program and poor adherence to protective measures of sexual partners, are issues that interfere with effective treatment for pregnant women. Thecontacts of the infected and treated mothers are not being diagnosed in a large percentage, reflecting a failure in the following up of the contact of pregnant women to avoid re-infection.

Individual and workplace monitoring measurements made after a 240Pu incident and during the clean-up operations.

On 3 August 2008, five glass vials containing around 7 GBq of (240)Pu in nitric acid solution burst in a laboratory operated by the IAEA in Seibersdorf, Austria. The vials were located in a fire-proof safe in the IAEA Safeguards Analytical Laboratory, and the release of the (240)Pu caused an air contamination in the room and in adjoining rooms. Immediate emergency work was carried out, which was then followed by a long period of clean-up operations. A large number of conventional individual and workplace monitoring measurements were carried out immediately after the incident and during the clean-up work. In addition, due to the fact that (240)Pu has a very low background presence in the environment, and that the IAEA laboratories operate an inductively coupled plasma mass spectrometry system capable of very low levels of detection of this radionuclide, a number of non-conventional measurements were made to detect (240)Pu on, for example, the photographic camera used to document the incident, on nasal swabs from the first responders, etc. Plastic beakers were left in the corridor of the controlled area to accumulate (240)Pu from precipitation to see whether it was possible to detect traces of the radionuclide. This paper presents the measurements obtained, and discusses their relevance to occupational radiation protection.

[Diagnostic utility of dermoscopy in pigmented actinic keratosis]. / Utilidad de la dermatoscopia en el diagnóstico de las queratosis actínicas pigmentadas.

The diagnosis of pigmented actinic keratosis can be complicated in clinical practice. The differential diagnosis with lentigo maligna melanoma can be difficult due to common clinical and dermoscopic characteristics. We present 5 cases of pigmented actinic keratosis in 4 patients. The most common dermoscopic finding was a grayish-brown granulation with a perifollicular distribution, present in all lesions, followed by rhomboidal structures in 4 cases, and an annular-granular pattern in 3. In no case were asymmetrical pigmented follicular openings observed. We draw attention to key findings that aid preoperative diagnosis of pigmented actinic keratosis.