Comparación de prótesis removibles parciales y totales entregadas según sus características clínicas en el servicio de odontología del hospital nacional de geriatría y gerontología, en el período de tiempo comprendido del 1 de enero 2005 al 31 de diciembre del 2008 / Comparison of partial and total removable prosthesis delivered according to their clinical characteristics in the dentistry service of the national hospital of geriatry and gerontology, in the period under january 1 of 2005 to december 31 of 2008

RESUMEN Objetivo: Comparar la cantidad y características de las prótesis dentales removibles parciales y totales, en el servicio de odontología del Hospital Nacional de Geriatría y Gerontología, en el periodo de tiempo comprendido del 1 de enero 2005 al 31 de diciembre 2008, equivalentes a 326 expedientes. Se tomó la base de datos del servicio de odontología de consulta externa especializada de los pacientes atendidos de los años 2005 al 2008, en los cuales se entregaron un total de 2786 prótesis dentales removibles. Materiales y métodos: Con base en el dato anterior se seleccionó la muestra no aleatoria a conveniencia hasta alcanzar el tamaño de 599 prótesis entregadas, examinando 326 expedientes del periodo de enero del 2005 a diciembre del 2008, con un nivel de confianza de 99% y un error de muestreo de 0.0466. La recolección de datos se realizó por medio del programa Microsoft Excel donde se utilizó una tabla en la que se anotó el número de expediente, fecha de inicio y conclusión de prótesis, tipo de prótesis, cantidad y color de prótesis, edad, género y domicilio del paciente por distrito, cantón y provincia. El procesamiento se realizó por medio de estadística descriptiva utilizando cuadros y gráficos. Resultados: Se determinó que el mayor porcentaje de rango de edad de personas que solicitaron prótesis removibles fue de 62 a 65 años, independiente si eran prótesis totales o parciales, los pacientes que requirieron dos prótesis fueron 273 de 326, en su mayoría los pacientes solicitaron prótesis totales para un total de 372 de 599 prótesis entregadas. De la guía de color utilizada en el HRBC los colores más requeridos fueron los tonos claros blanco amarillentos que corresponde al número 62 y 65; de los expedientes analizados la mayoría de los pacientes residían en San José con un total de 200 pacientes. Se concluye que el mayor porcentaje de edentulismo que se presento es el edentulismo total con un 62%, la prótesis más utilizada es la prótesis total superior removible y en su mayoría los pacientes requieren dos prótesis, con respecto al color no es concluyente para este estudio debido a los datos no disponibles en los expedientes analizados.

ABSTRACT Objective: Compare the quantity and characteristics of partial and total removable dental prostheses, in the dentistry service of the National Hospital of Geriatrics and Gerontology, in the period from January 1, 2005 to December 31, 2008. The database of the specialized outpatient dentistry service of the patients treated from 2005 to 2008 was taken, in which a total of 2786 removable dentures were delivered. Materials and methods: Based on the previous data, the non-random sample was selected for convenience until reaching the size of 599 protheses of 326 files, with a confidence level of 99% and a sampling error of 0.0466. Data collection was carried out through the Microsoft Excel program where a table was used in which the file number, date of start and conclusion of the prosthesis, type of prosthesis, amount and color of prosthesis, age, gender and address were used of the patient by district, canton and province. The processing was carried out by means of descriptive statistics using tables and graphs. Results: It was determined that the highest percentage of the age range of people who requested removable prostheses was 62 to 65 years, the patients that required two prostheses were 273 of 326. In their majority, the patients requested total prostheses for a total of 372 of 599 prostheses delivered. Of the color guide used in the HRBC, the most requested colors were the light yellowish-white tones corresponding to the number 62 and 65; of the files analyzed, most of the patients resided in San José with a total of 200 patients. Conclusion: It is concluded that the highest percentage of edentulism that is presented is total edentulism with 62%, the most commonly used prosthesis is the removable upper total prosthesis and for the most part patients require two prostheses, with respect to color it is inconclusive for this study due to data not available in the analyzed files.

In vivo acid etching effect on bacteria within caries-affected dentin.

Acid etching procedures may disrupt residual bacteria and contribute to the success of incomplete caries removal followed by adhesive restoration. This study evaluated the in vivo effect of acid etching on cariogenic bacterial activity within affected dentin after minimally invasive treatment of caries lesions. Twenty-eight carious permanent teeth received standardized selective caries removal and random acid etch treatment (E) or not (NE) prior to adhesive restoration. Baseline and 3-month dentin biopsies were collected. The number of bacteria and activity of total bacterial cells and Streptococcus mutans were determined by quantitative PCR and RT-PCR. No statistically significant differences were observed in total bacterial number and activity between E and NE treatments (p > 0.3008). For NE, however, the residual S. mutans bacterial cells were reduced (p = 0.0027), while the activity per cell was significantly increased (p = 0.0010) after reentry at 3 months after restoration. This effect was not observed in group E. Although no significant differences were found between groups, this study suggests that acid etching of affected dentin prior to adhesive restoration may directly or indirectly have an inhibitive effect on the activity of residual cariogenic bacteria. Further research is required to investigate this potential effect.

Endothelial progenitor cells in cell-based therapy for cardiovascular disease.

Coronary Artery Diseases (CAD) is the first mortality cause in industrialized countries. The possibility of regenerating myocardium injured tissue using the cell therapy is a promising option to regenerate cardiac tissue. Currently, a variety of adult stem/ progenitor cells are undergoing clinical evaluation, but it is very important to study and characterize the bone marrow-derived progenitor/ stem cells, the main source of cells used for human cardiac repair, before their clinical use. Bone marrow-derived endothelial progenitor cells (EPC) home sites of ischemia and differentiate into endothelial cells, increase the neovascularization of ischemic tissue. Moreover recently, it has been observed that EPC can be able to differentiate or transdifferentiate to like-adult cells resident in cardiac tissues. The characterization of phenotype EPC is complex, because express hematopoietic stem cells (CD133 and/or CD34) and endothelial markers such as vascular endothelial growth factor receptor 2 (KDR). Several studies described subpopulation of EPC expressing CD34+D133+KDR+ phenotype in literature, but some other authors suggest other phenotype. The EPC capacity of mobilization or recruitment/ homing to ischemic tissue areas by cytokines are reviewed. Finally are described clinical studies in CAD using bone marrow-derived progenitor cells permitting human cardiac tissue repair.

[Simultaneous pulmonar, laryngeal and lingual affectation by Mycobacterium tuberculosis]. / Afectación simultánea pulmonar, laríngea y lingual por Mycobacterium tuberculosis.

The incidence of tuberculosis has lately increased in developed countries. The most frequent affectation is the pulmonar one and in the ORL area the laryngeal. The lingual affectation is exceptional. We present a case of a man 39 years old, with bilateral pulmonar, left vocal cord and mobile tongue affectation, negative Mantoux, positive spit culture and presence of acido-alcohol resistent bacillus in lingual and laryngeal biopsies. After antituberculosis treatment during 6 months the laryngeal and lingual lesions disappeared. We have only found two cases published of simultaneous tuberculosis in these three localisations in the last 30 years.

Ruptured gastrointestinal stromal tumors: radiologic findings in six cases.

BACKGROUND: Gastrointestinal stromal tumors (GISTs) are characterized by the expression of c-KIT (antigen CD 117) and are the most common mesenchymal tumors of the digestive tract. An important complication, although infrequently described in the literature, is the rupture of these tumors with accompanying hemoperitoneum. METHODS: We performed a retrospective evaluation of the clinical history and radiologic records of 23 patients with a diagnosis of GIST and anatomopathologic and immunohistochemical confirmation at our hospital between 1999 and 2004. RESULTS: In five cases there was rupture of the primary tumor (four gastric and one jejunal). In all five cases ultrasonographic and computed tomographic examinations showed a heterogenic tumor of laminated or whirled appearance, associated with echogenic or dense ascites. No relation was found between histologic criteria of malignancy and the rupture. Four patients underwent surgical intervention, three of them urgently. Two of five patients died. There was a sixth case with rupture of a hepatic metastasis, with accompanying hemoperitoneum and subcapsular hematoma. This patient died at 3 months, after recurrence of bleeding. CONCLUSIONS: The finding of a heterogeneous tumor of laminated or whirled appearance associated with ascites with characteristics compatible with hemoperitoneum in an appropriate context must lead to a suspicion of the existence of a ruptured GIST.

[Creatine kinase increases after coronary interventions]. / Elevaciones de la creatincinasa tras intervencionismo coronario.

INTRODUCTION AND OBJECTIVES: Percutaneous revascularization has led to an important change in the treatment of patients with symptomatic ischemic heart disease in recent years. There is controversy concerning the incidence and prognostic significance of postprocedural increases in creatine kinase. The aim of this study was to assess the incidence of these elevations and the related factors and to observe the prognosis of patients with and without creatin kinase elevations. METHODS: We reviewed 447 patients in whom an angioplasty was done in our department from January 1997 to June 1998, excluding 138 patients with myocardial infarction in the previous four days or unsuccessful angioplasty. Creatine kinase was measured in all patients at 0, 4, 8 and 24 hours after angioplasty. We analyzed the incidence of elevated levels of creatine kinase following coronary surgery and the characteristics of the patients in comparison with a control group made up of patients who, at a similar time had undergone a similar angioplasty procedure including, a similar vessel and type of lesion, and equivalent left ventricular function but without elevated serum levels of creatine kinase. Major adverse coronary events were defined as: cardiac death, nonfatal myocardial infarction, new revascularization and unstable angina in which hospitalization was required. RESULTS: Out of 309 patients studied, an elevation in creatine kinase was observed in 24 patients (7.7%). Complications related to the procedure were found in 50% of these elevations, most of which involved side branch occlusion. There were no differences with respect to the demographical or anatomical characteristics of the lesions in the groups studied. During the follow-up of 9.5 months, complications were observed in 37.5% of the group of patients with elevated creatine kinase levels and in 20% of the control group, but this difference did not achieve statistical significance. CONCLUSIONS: Creatine kinase elevations are produced in 7.7% of the patients after coronary angioplasty. Complications related to the procedure were observed in 50% of the cases, most being side branch occlusion and no complications were seen in the remaining patients. Continuous measurement of creatine kinase after angioplasty shows a low sensitivity for detecting complications during follow-up. New, more sensitive and specific cardiac markers, such as troponin, could define this group of patients.

[Large myxoma of the right atrium]. / Mixoma de gran tamaño en la aurícula derecha.

We describe the case of a patient in whom two-dimensional echocardiography, performed due to dissociated cholestasis and jugular ingurgitation, demonstrated a huge mass in the right atrium which prolapsed in the right ventricle. Intraoperative transesophageal echocardiography was performed to further assess the dimension and characteristics of the mass and to discard the involvement of associated structures. The patient underwent a cardiopulmonary bypass surgery and the mass (12 * 5 cm) was removed without complications. Histologic examination confirmed the diagnosis of myxoma. This case is of interest because of the size of the mass, and is centered in the diagnosis following clinical suspicion due to the pattern of dissociated cholestasis and jugular ingurgitation leading to surgery to prevent the potential embolic complications.