To what extent is oral and maxillofacial surgery educational content posted on Instagram?

Hashtags on Instagram help users globally search for posts to their liking. This study aimed to determine who posts the most popular oral and maxillofacial surgery (OMS) hashtags on Instagram and to evaluate the impact of educational content. The posts were analyzed for the type of post and differences between content creators when posting OMS-related content. This cross-sectional study evaluated OMS content categorized by 36 hashtags. The top 9 posts with each hashtag were evaluated based on the type of content creator, if it was a video or picture, and if it was educational or for marketing purposes. 6 million posts existed among 36 hashtags. Regarding the categories of person/organization posting the content (US or non-US oral and maxillofacial surgeon, residency program, patient, and 'other'), the top posts (N = 295) were posted by 'other' and the least by 'residency program'. Among the posts by non-US oral and maxillofacial surgeons, there was 3.8-fold more marketing content, while among the posts by US oral and maxillofacial surgeons, there was 2-fold more educational content. Educational posts achieved the highest engagement in terms of 'likes'. This study highlights how oral and maxillofacial surgeons can educate the general population and expand their reach.

A CFD approach to understand nasoseptal perforations.

INTRODUCTION: Nasoseptal perforations (NSP) are becoming common in the modern world, and can cause a wide variety of symptoms, including a sensation of nasal obstruction, epistaxis, crusting, dryness, headache, nasal pain and a whistling sound. There is an extensive range of surgical treatment techniques, but reported results were rarely statistically significant. The lack of consistent surgical results may be related to the lack of knowledge about the pathophysiology of NSP and how they affect the nasal flow. Computational fluid dynamics (CFD) has proved to be a very useful tool to study nasal function. METHODS: We have used CFD software (the program MECOMLAND® and the Digbody® tool for virtual surgery) to investigate the behaviour of the parameters R-[Formula: see text] based on CFD results, when four subjects underwent virtual surgery to induce a septal perforation: two subjects with healthy noses and two patients suffering from nasal airway obstruction. For each case a CFD study was performed, before and after creating an anterior (close to nostrils) or a posterior (close to choanae) NSP. RESULTS: In all cases analyzed, a posterior septal perforation did not result in a significant volumetric flow rate [Formula: see text] through the perforation between nasal passages. However, for anterior defects only in those nasal cavities considered diseased or unhealthy, high values of [Formula: see text] were found. CONCLUSION: The induced NSP only rendered significant flow alterations in noses with preexisting nasal airway obstruction alterations, whereas in nasal cavities considered as normal the creation of a NSP did not produce significant differences between both sides. We strongly suggest that this finding can explain the variety of symptoms and the number of asymptomatic patients bearing NSP.

DigBody®: A new 3D modeling tool for nasal virtual surgery.

BACKGROUND AND PURPOSE: Recent studies have demonstrated that a significant number of surgical procedures for nasal airway obstruction (NAO) have a high rate of surgical failure. In part, this problem is due to the lack of reliable objective clinical parameters to aid surgeons during preoperative planning. Modeling tools that allow virtual surgery to be performed do exist, but all require direct manipulation of computed tomography (CT) or magnetic resonance imaging (MRI) data. Specialists in Rhinology have criticized these tools for their complex user interface, and have requested more intuitive, user-friendly and powerful software to make virtual surgery more accessible and realistic. In this paper we present a new virtual surgery software tool, DigBody®. METHODS: This new surgery module is integrated into the computational fluid dynamics (CFD) program MeComLand®, which was developed exclusively to analyze nasal airflow. DigBody® works directly with a 3D nasal model that mimics real surgery. Furthermore, this surgery module permits direct assessment of the operated cavity following virtual surgery by CFD simulation. RESULTS: The effectiveness of DigBody® has been demonstrated by real surgery on two patients based on prior virtual operation results. Both subjects experienced excellent surgical outcomes with no residual nasal obstruction. CONCLUSIONS: This tool has great potential to aid surgeons in modeling potential surgical maneuvers, minimizing complications, and being confident that patients will receive optimal postoperative outcomes, validated by personalized CFD testing.

Experience and Security of the Hand-Assisted Laparoscopic Nephrectomy of a Living Donor in a Public Health Center.

BACKGROUND: Hand-assisted laparoscopic nephrectomy (HALDN) is currently the procedure of choice for obtaining living donor kidneys for transplantation. In our institution, it has been the standard procedure for 5 years. Previous studies have shown the same function of the graft as that obtained by open surgery, with a lower rate of bleeding and no differences in complications. We sought to demonstrate the experience and safety of HALDN compared with open donor nephrectomy in healthy donors for kidney transplantation. METHODS: A retrospective analytical observational study was conducted, reviewing the records of the living donors for kidney transplant undergoing open donor nephrectomy or HALDN in our center from March 1, 2009, to March 1, 2016. Renal function was assessed by the estimated glomerular filtration rate by the Modification of Diet in Renal Disease method before and after donation, as well as bleeding (mL), and complications (according to Clavien), performing a comparative analysis between the two techniques using parametric or nonparametric tests. RESULTS: A total of 179 living donor nephrectomies were performed during the study period-31 open donor nephrectomy (17.3%) and 148 HALDN (82.7%)-without relevant baseline differences, except for creatinine. HALDN has a shorter surgical time (156,473 ± 87.75 minutes vs 165,484 ± 69.95 minutes) and less bleeding (244.59 ± 416.08 mL vs 324.19 ± 197.986 mL) and a shorter duration of hospital stay (3.74 ± 1.336 days vs 4.75 ± 1.226 days). There were no significant differences in surgical complications at 30 days, or graft loss reported; there were 3 conversions (1.7%) from the HALDN to the open technique. There were no differences in renal function in the donors or recipients at the 5th day or the month after surgery. CONCLUSIONS: Laparoscopic nephrectomy has replaced open surgery as the gold standard for living kidney donors. HALDN is a safe and feasible procedure when compared with open donor nephrectomy, achieving a shorter surgical time with less bleeding, and no difference in the number of complications. This procedure lowers costs by decreasing the duration of the hospital stay, making is feasible to perform it at any institution with appropriately trained personnel.

Biomarcadores Salivales en Pacientes Diagnosticados con Fibrosis Quística, Concepción, 2016 / Salivary Biomarkers in Patients Diagnosed with Cystic Fibrosis, Concepción, 2016

RESUMEN: El odontólogo como profesional integral del área de la salud, debe tener conocimiento acerca de distintas manifestaciones bioquímicas que pueden tener repercusión en la cavidad oral. El objetivo del trabajo fue determinar las manifestaciones bioquímicas y alteraciones en biomarcadores salivales en la cavidad oral producto de la fibrosis quística o del consumo crónico de medicamentos para el tratamiento de la FQ. Se seleccionó un total de cinco personas con fibrosis quística y cuatro personas sanas, pertenecientes a la ciudad de Concepción en la Octava Región de Chile. Se midió pH salival, capacidad buffer, concentración de proteínas totales, tasa de flujo salival estimulado y se determinó presencia de ciertas enzimas salivales en pacientes que padecen la enfermedad. Se pudo evidenciar que el pH salival en sujetos con fibrosis quística tiende a ser mayor a los valores de referencia, la tasa de flujo salival es mucho menor al igual que la capacidad buffer, la concentración de proteínas totales en saliva se encuentra igual a los valores de referencia y se determinó la presencia biomarcadores salivales a través de la técnica de electroforesis. La fibrosis quística afecta de muchas formas a las personas que la padecen, genera cambios a nivel de los biomarcadores salivales como también en la cavidad oral, por lo que el odontólogo debe estar capacitado para identificar estos cambios y poder tratar de la mejor manera a todo tipo de paciente.

ABSTRACT: The dentist as an integral health professional must have knowledge of various biochemical manifestations that may have repercussions on the oral cavity. The objective of the study was to determine the biochemical manifestations and salivary biomarker alterations in the oral cavity resulting from cystic fibrosis or chronic consumption of drugs for the treatment of CF. We selected a total of five people with cystic fibrosis and four healthy people, from the city of Concepcion in the eighth region of Chile. Salivary pH, buffer capacity, total protein concentration, stimulated salivary flow rate and the presence of certain salivary enzymes were measured in patients suffering from the disease. It was observed that the salivary pH in subjects with cystic fibrosis tends to be higher than the reference values, the salivary flow rate and buffer capacity are less than normal, the total protein concentration in saliva is equal to the reference values and the presence of salivary biomarkers was determined through the electrophoresis technique. Cystic fibrosis affects those who suffer the disease in many ways, it generates changes at the salivary biomarker level, as well as in the oral cavity. The dentist must therefore, be able to identify these changes in order to treat them in the best possible approach for all types of patients.

New CFD tools to evaluate nasal airflow.

Computational fluid dynamics (CFD) is a mathematical tool to analyse airflow. As currently CFD is not a usual tool for rhinologists, a group of engineers in collaboration with experts in Rhinology have developed a very intuitive CFD software. The program MECOMLAND® only required snapshots from the patient's cross-sectional (tomographic) images, being the output those results originated by CFD, such as airflow distributions, velocity profiles, pressure, temperature, or wall shear stress. This is useful complementary information to cover diagnosis, prognosis, or follow-up of nasal pathologies based on quantitative magnitudes linked to airflow. In addition, the user-friendly environment NOSELAND® helps the medical assessment significantly in the post-processing phase with dynamic reports using a 3D endoscopic view. Specialists in Rhinology have been asked for a more intuitive, simple, powerful CFD software to offer more quality and precision in their work to evaluate the nasal airflow. We present MECOMLAND® and NOSELAND® which have all the expected characteristics to fulfil this demand and offer a proper assessment with the maximum of quality plus safety for the patient. These programs represent a non-invasive, low-cost (as the CT scan is already performed in every patient) alternative for the functional study of the difficult rhinologic case. To validate the software, we studied two groups of patients from the Ear Nose Throat clinic, a first group with normal noses and a second group presenting septal deviations. Wall shear stresses are lower in the cases of normal noses in comparison with those for septal deviation. Besides, velocity field distributions, pressure drop between nasopharynx and the ambient, and flow rates in each nostril were different among the nasal cavities in the two groups. These software modules open up a promising future to simulate the nasal airflow behaviour in virtual surgery intervention scenarios under different pressure or temperature conditions to understand the effects on nasal airflow.

Miasis cutánea por Cochliomyia hominivorax asociada a dermatitis seborreica: case report / Cutaneous myiasis due to Cochliomyia hominivorax associated with seborrheic dermatitis

Myiasis is an infestation of tissues and organs of humans and animals by Diptera larvae (flies, horseflies, mosquitoes). They are located at different body sites, and classified clinically as cutaneous, visceral and cavitary. We report a 26-year-old woman with a history of seborrheic dermatitis and recent trip to Brazil. She presented with a seven days history of suppurating wounds in the parieto-occipital area of the scalp. At physical examination we found three ulcers of approximately 1.5 cm each, with multiple mobile larvae inside. The obtained larvae were analyzed, identifying Cochliomyia hominivorax larvae at L2 and L3 stages. The patient was managed successfully with oral antimicrobials and local cleansing. The screwworm Cochliomyia hominivorax in our country is rare. Known risk factors are wounds, poor personal hygiene, extreme ages, psychiatric disorders, presence of specific dermatosis such as psoriasis and seborrheic dermatitis, among others.

Outcome of radiosurgery treatment with a linear accelerator in patients with trigeminal neuralgia. / Resultados de la aplicación de radiocirugía con acelerador lineal en pacientes con neuralgia del trigémino.

INTRODUCTION: An overview of the effectiveness of radiosurgery in patients diagnosed with trigeminal neuralgia with an analysis of potential predictors of good outcome. METHODS: All patients treated with linear accelerator radiosurgery between 2004 and 2011 were analysed. A dose of 60Gy dose was administered 1 to 2mm from the root entry zone with a maximum isodose of 20% delivered to the brainstem. Clinical results for pain control and any side effects were analysed at 12 and 36 months (BNI score). RESULTS: The study included 71 patients (mean follow-up 50.5 months). Pain improvement at 12 months was observed in 68.11% of the total (28.98% with BNI score i-ii; 39.12% with BNI score iii) and at 36 months in 58.21% (23.88% BNI score i-ii; 34.32% BNI score iii). Average recovery time was 3.69 months and the relapse rate was 44.68%. Patients with typical pain displayed statistically significant differences in improvement rates at 12 and at 36 months (P<047 and P<.002). Onset of improvement was analysed using Kaplan-Meyer plots. Statistically significant differences were observed between patients with typical and atypical pain at 36 months (P<.012) in Kaplan-Meyer plots. Side effects were recorded in 15 patients (20.89%), including 9 cases of facial numbness (13.43%); only 2 cases were clinically relevant (2.98%). CONCLUSION: According to our results, radiosurgery is an effective treatment for trigeminal neuralgia, with few side effects. Typical pain seems to be a good predictor of pain relief.

Evaluación de una intervención educativa de enfermería dirigida a cuidadores principales de pacientes crónicos / Evaluation of an educational program for caregivers of patients with chronic diseases / Avaliação de uma intervenção educativa de enfermaria para cuidadores primários de pacientes crônicos

Es frecuente que los cuidadores principales de enfermos crónicos se conviertan en el "enfermo invisible", en la medida en que la atención y el \r\ncuidado están mayormente enfocados en el paciente, lo cual vulnera aspectos físicos, emocionales, espirituales y económicos de la persona que \r\ncuida. El objetivo de este estudio descriptivo con enfoque cualitativo es evaluar los resultados de implementar un programa educativo de inter\r\n-\r\nvención dirigido a 19 cuidadores principales de personas con enfermedad crónica, en seis delegaciones de la ciudad de Toluca, Estado de México. El estudio se desarrolló en tres etapas: diagnóstico, intervención y evaluación. Para impartir el programa educativo se realizaron visitas domiciliarias \r\nque se registraron en la bitácora de campo. \r\nEl programa denominado Cuidando a Cuidadores, se basa en los tres indicadores propuestos por \r\nNkongho: conocimiento, valor y paciencia. Consta de tres módulos, y en cada uno se realizaron tres tallerescon los 19 cuidadores,previo consen\r\n-\r\ntimiento informado. Los participantes expresaron haber adquirido conocimientos necesarios para el cuidado de su familiar; las dinámicas les \r\npermitieron reconocer fortalezas, debilidades, miedos, inseguridades y frustraciones; además, manifestaron sentirse satisfechos con el acom\r\n-\r\npañamiento y guía del equipo de salud que participó. Se puede afirmar que ser cuidador principal de un enfermo crónico es una experiencia \r\nque transforma la vida y requiere conocimiento, valor y paciencia para ejercer su tarea de manera hábil; esto puede incrementarse si se recibe \r\norientación por parte de los profesionales de enfermería

Regularly, the primary caregivers of chronically ill patients \r\nbecome the "invisible ill", to the extent that the attention and \r\ncare are mostly focused on the sick patiente, violating physical, \r\nemotional, spiritual and economic aspects of the caregiver. This \r\nproject analizes the results obtained from the implementation \r\nof an educational intervention program aimed at 19 primary \r\ncaregivers of people with chronic disease, in six delegations \r\nfrom the city of Toluca, State of Mexico. It was a descriptive \r\nstudy with a qualitative methodological approach. It was \r\ncarried out in three stages: diagnosis, intervention and evalua\r\n-\r\ntion. In order to provide the educational program, home visits \r\nwere performed using the log field. The program consisted \r\nof three modules, being imparted in workshops to the 19 \r\ncaregivers, with informed consent prior to the program. The \r\nresults were the following: Caregivers expressed that they had \r\nacquired knowledge required for the care of their family, the \r\ndynamics allowed them to recognize strengths, weaknesses, \r\nfears, insecurities and frustrations; they said they were satis\r\n-\r\nfied with the support and guidance of the health team that \r\nparticipated. It can be said that to be a primary caregiver for a \r\nchronically ill person is an experience that transforms life and \r\nrequires knowledge, courage and patience to perform their \r\nduties skillfully; these gratification may also be increased if you \r\nreceive guidance from nurses.

Muitas vezes, os cuidadores primários de pacientes crônicos se \r\ntornam o "paciente invisível", na medida em que a atenção e \r\nos cuidados são principalmente focados no doente, violando \r\naspectos físicos, emocionais, espirituais e econômicos do \r\ncuidador. Este projeto aborda os resultados obtidos na imple\r\n-\r\nmentação de um programa de intervenção educacional \r\nvoltado para 19 cuidadores primários de pessoas com doença \r\ncrónica, em seis delegações da cidade de Toluca, Estado do \r\nMéxico. O estudo era realizado em três etapas: diagnóstico, \r\nintervenção e avaliação. A fim de orientar sobre o programa \r\neducativo, foram realizadas visitas domiciliares, utilizando \r\no diário de campo. O programa consistiu de três módulos, \r\nconferindo-se oficinas aos 19 cuidadores, com prévio consen\r\n-\r\ntimento informado. Os cuidadores expressaram ter adquirido \r\nconhecimentos necessários para o cuidado de seu familiar \r\ne as dinâmica lhes permitiram reconhecer forças, fraquezas, \r\nmedos, inseguranças e frustrações. Eles disseram que estavam \r\nsatisfeitos com o apoio e orientação da equipe de saúde que \r\nparticipou. Pode-se dizer que ser o cuidador primário de um \r\npaciente crónico é uma experiência que transforma a vida e \r\nexige conhecimento, coragem e paciência para exercer as suas \r\nfunções com habilidade, podendo se aperfeiçoar se receber a \r\norientação de profissionais de enfermagem.

Sistema de Apoyo Experimental para el Reconocimiento Visual y el Nombrado de Objetos / Experimental support system for visual recognition and object nomination

Resumen: En la práctica clínica relacionada con la rehabilitación cognitiva, perceptual y del lenguaje, es habitual emplear como estímulos representaciones de objetos en dos dimensiones como dibujos o fotografías para que sean identificados por los pacientes. Ello supone una limitación, puesto que la presentación de objetos en tres dimensiones, dada su mayor riqueza visual, facilita su identificación y podría apoyar procesos de rehabilitación. Objetivo: Diseñar una configuración experimental para conocer el grado en que las modalidades de presentación de estímulos afectan el reconocimiento visual de objetos. Materiales y Métodos: Se diseñó un sistema de bajo costo para mostrar estímulos en tres modalidades: imágenes, videos y objetos reales. Fueron seleccionados 80 objetos, controlando las variables de manipulabilidad, edad de adquisición, familiaridad, complejidad visual y frecuencia léxica. Se realizó una prueba piloto utilizando el sistema con cinco personas sanas y se midieron los tiempos de reacción en la nominación de los objetos. Resultados: Las diferencias en los tiempos de reacción entre las modalidades observadas apoyan la influencia de la modalidad de presentación en el reconocimiento de objetos. Conclusiones: Las propiedades de volumen de los objetos permitirían la exploración de características que las fotografías no tendrían; razón por la cual, los tiempos de reacción para los objetos reales y los videos fueron menores. Son valiosos los aportes que ofrecen una alternativa de bajo costo para la visualización y el reconocimiento de objetos.

Abstract: A wide variety of stimuli or objects such as drawings or photographs are used in cognitive perceptual and language rehabilitation. However, the presentation of objects in three dimensions, due to the visual richness, facilitates the identification and could support the rehabilitation process. Objective: Design an experimental setup to determine the extent to which the modality of presentation of objects affects the visual recognition of objects. Materials and methods: A low-cost experimental system was designed in order to show the stimulus in three ways: images, videos and real objects. Eighty objects were selected and variables as manipulability, age of acquisition, familiarity, visual complexity, agreement on the label and lexical frequency were controlled. A pilot study was conducted using the system in five healthy participants and the reaction time to identify objects was measured. Results: The findings reveal that the differences in reaction times between the modalities of presentation support the influence of the mode of presentation in object recognition. Conclusions: The volume object properties could allow the exploration of characteristics that the photographs would not have. This may be why the reaction time to identify real objects or videos was lower. Low-cost alternatives for the visualization and object recognition are valuable in cognitive perceptual and language rehabilitation.

Musculoskeletal interventional radiology: ultrasound and CT. / Intervencionismo en musculoesquelético. Ecografía y tac.

We aim to describe imaging-guided (ultrasound and CT) interventional techniques in the musculoskeletal system that can be performed by general radiologists, whether in hospitals, primary care clinics, private offices, or other settings. The first requirement for doing these procedures is adequate knowledge of the anatomy of the musculoskeletal system. The second requirement is to inform the patient thoroughly about the technique, the risks involved, and the alternatives available in order to obtain written informed consent. The third requirement is to ensure that the procedure is performed in accordance with the principles of asepsis in relation to the puncture zone and to all the material employed throughout the procedure. The main procedures that can be done under ultrasound guidance are the following: fine needle aspiration cytology (FNAC), core needle biopsy (CNB), diagnostic and/or therapeutic arthrocentesis, drainage of juxta-articular fluid collections, drainage of abscesses, drainage of hematomas, treatment of Baker's cyst, treatment of ganglia, treatment of bursitis, infiltrations and treatment of plantar fasciitis, plantar fibrosis, epicondylitis, Achilles tendinopathy, and Morton's neuroma, puncture and lavage of calcifications in calcifying tendinopathy. We also review the following CT-guided procedures: diagnosis of spondylodiscitis, FNAC of metastases, arthrography, drainages. Finally, we also mention more complex procedures that can only be done in appropriate settings: bone biopsies, treatment of facet joint pain, radiofrequency treatment.

Salud Mental y Educación en Chile: Una Integración Necesaria / Mental Health and Education in Chile: An Integration Needed

El siguiente trabajo da cuenta del lugar de la salud mental y su relación con el quehacer educativo. Se ubica la escuela como un agente socializante fundamental para la configuración de la sociedad y se discute la vinculación entre ésta y salud mental mediante los siguientes objetivos: 1) Identificar las principales problemáticas de salud mental que inciden negativamente en los principales miembros de la comunidad educativa (niños, niñas, jóvenes y docentes) y 2) Relevar la importancia de la salud mental en el quehacer educativo como una práctica ética y positiva para la obtención de resultados escolares y la formación integral de cada sujeto. Se concluyó que la integración trae beneficios para el quehacer educativo así como también para los miembros de la comunidad educativa en los lugares donde ésta se ha agenciado con mayor profundidad. Chile aún tiene esta tarea pendiente, enfatizando que la integración debiese apuntar además de lo ya realizado, a un pensar la escuela desde un quehacer saludable en términos de salud mental.

The following paper discusses how mental health is related to education. The school is understood as a key socializing agent for shaping society and the link between this and mental health is discussed through the following objectives: 1) Identifying the major mental health problems that adversely affect the core members of the educational community (children, young people and teachers) and 2) Highlighting the importance of mental health in the educational work as an ethical and positive practice for obtaining academic results and the integral development of each subject. It was concluded that integration brings benefits to the educational work as well as for members of the educational community in places where it has been more deeply ingrained. Chile still has this pending task, emphasizing that integra- tion ought to aim beyond what has already been done, to thinking about school from a mental health perspective.

Evaluación inmunológica de extractos de Ascaris Lumbricoides para las inmunoglobulinas IgA en el suero de individuos infectados / Immunological evaluation of extracts of ascaris lumbricoides for IgA immunoglobulins in serum of infected individuals

Introducción: El parásito Ascaris lumbricoides es el más grande de los nemátodos que parasita el intestino humano. En Venezuela, la infección por Ascaris lumbricoides es la geohelmintiasis de mayor importancia en zonas rurales, por su alta frecuencia y morbilidad. La infección estimula una respuesta de anticuerpos IgA, sin embargo se conoce poco sobre las proteínas responsables de la respuesta para este isotipo. La identificación de estas proteínas podría ayudar al diseño de pruebas para el diagnóstico y la detección en el medio ambiente o en individuos expuestos a este parásito. Nuestro trabajo se basó en identificar proteínas antigénicas en extractos y fracciones de A. lumbricoides para la respuesta especifica IgA en el suero de niños infectados. Materiales y métodos: Fueron evaluados 85 sueros de niños de ambos sexo entre 3 y 14 años de edad, de comunidades rurales del Estado Miranda. Los niños fueron clasificados según el resultado coprológico en tres grupos, Ascaris positivos en heces; Ascaris negativos con otras parasitosis y un grupo libre de parásitos en heces. Las proteínas fueron identificadas por Western Blot y el nivel de anticuerpos IgA medidos por ELISA. Resultados: Se detectaron en el extracto de A. lumbricoides un mínimo de 17 proteínas con pesos moleculares de entre 26 y 205 KDa aproximadamente, siendo reconocidas por el suero de los niños infectados proteínas de 205, 148, 95, 75 y 45KDa. Conclusiones: El presente trabajo permitió medir los niveles de anticuerpos específicos IgA anti-Ascaris e identificar las proteínas responsables de la respuesta IgA.

Introduction: The parasite Ascaris lumbricoides is the largest nematode parasitizing the human intestine. In Venezuela, infection with Ascaris lumbricoides is the most important STH in rural areas, because of its high frequency and morbidity. Infection stimulates an antibody IgA response, however little is known about the proteins responsible for this isotype. The identification of these proteins could aid the design of tests for the diagnosis and detection in the environment or individuals exposed to this parasite. Our work was based on the identification of antigenic proteins in extracts and fractions of A. lumbricoides for specifi c IgA antibody response in serum of infected children. Materials and Methods: A total of 85 sera from children (boys and girls) between 3 and 14 years old, from rural communities in Miranda State. Children were classifi ed according to the stool results in three groups, Ascaris positive in stool; negative for Ascaris, but with other parasites and a group no parasites in feces. Proteins were detected by Western blotting and the IgA antibody levels measured by ELISA. Results: We detected in the extract of A. lumbricoides at least 17 proteins with molecular weights of between 26 and 205 kDa and were recognized by the sera of infected children, proteins of 205, 148, 95, 75 and 45kDa children. Conclusions: This study allowed us to measure the levels of specific IgA anti-Ascaris and identify the proteins responsible of this response.

Assessing the impact of As-Cd-Pb metal mixture on cell transformation by two-stage Balb/c 3T3 cell assay.

Human beings are exposed to metals as a consequence of various industrial activities, including glass production, agrochemical production, metallurgy and battery manufacture. New data about the possible mechanisms involved in the carcinogenic activity of these metals are constantly being reported. Exposure to complex mixtures of metals is more likely to occur than exposure to a single metal alone. Among these elements, arsenic, cadmium and lead are ubiquitous air and water pollutants that continue to threaten the quality of public health around the world. The aim of the present study was to evaluate the capability of a mixture of 2 µM NaAsO2, 2 µM CdCl2 and 5 µM Pb(C2H3O2)2·3H2O at relevant epidemiological concentrations to induce cell transformation processes. Transforming potential was determined by a murine two-stage Balb/c 3T3 cell assay. Cell viability, reactive oxygen species (ROS), DNA damage, cell cycle analysis, senescence, generation time and metallothionein expression were also evaluated. The results showed that the metal mixture induced morphological cell transformation only when acting as initiator stimuli of the process. A decrease in cell viability was observed at the promotion stage, a time during which ROS increase, especially when a metal mixture was applied as a promoter stimulant. Changes in DNA damage were not observed throughout the assay; however, we observed G1 cell cycle arrest. The metal mixture, acting as a promoter, is capable of inducing senescence, but metals employed as initiators with 12-O-tetradecanoylphorbol-13-acetate as a promoter are capable of causing avoidance of senescence and triggering the transformation potential of the cells.

Immune complexes and persistent high levels of serum vitamin B12.

INTRODUCTION: Patients with persistent high levels of serum vitamin B12 were often referred to Hematology departments. In this study, characteristic of patients with serum vitamin B12 levels higher than 2500 pmol/L (high B12) were studied. METHODS: Prevalence of high B12 was evaluated during a 10-month period. Samples with high B12 were incubated with polyethylene glycol (PEG) and a new measurement of vitamin B12 was carried out using the supernatant. As a pilot study, 26 frozen samples with high B12 were evaluated for changes in vitamin B12 after PEG. Moreover, a prospective study was carried out during three consecutive months. Size exclusion chromatography was employed to demonstrate the presence of immune complexes (ICs) with plasma vitamin B12-binding proteins in some serum samples with high B12. RESULTS: Prevalence of high B12 was 1.3%. Results from 26 frozen samples and from a prospective study (28 cases) showed that undergoing vitamin B12 treatment was the main cause of high B12. However, ICs were detected in 10 frozen samples and in seven cases (25%) of the prospective study, respectively. Serum vitamin B12 decreased to normal values after precipitation with PEG, and size exclusion chromatography confirmed ICs. An association with autoimmune or hematological disorders was observed. CONCLUSIONS: In patients with repeatedly high B12 levels, ICs were detected in approximately 25% of samples. Precipitation with PEG is an easy method to confirm the presence of ICs and to evaluate serum vitamin B12 levels in these patients.

Spinal surgery in the univentricular heart--is it viable?

INTRODUCTION: The management of patients with Fontan physiology who undergo scoliosis surgery is difficult. The purpose of this article was to describe our experience in the management of patients with Fontan circulation undergoing spinal surgery for correction of scoliosis. MATERIALS AND METHODS: This was a retrospective study including patients with Fontan physiology who underwent spinal orthopaedic surgery. Anaesthetic management, post-operative complications, paediatric intensive care unit and total hospital stay, and the need for blood transfusions were analysed. RESULTS: We identified eight children with Fontan physiology who had undergone spinal surgery from 2000 to 2010. All patients were receiving cardiac medications at the time of spinal surgery. The mean age at surgery was 14.8 years (range 12-21). In all, three patients needed inotropic support with dopamine (3, 5, and 8 µg/kg/min), which was started during surgery. During the immediate post-operative period, one patient died because of hypovolaemic shock caused by massive bleeding and dysrythmia. Mean blood loss during the post-operative period was 22.2 cc/kg (7.8-44.6). Surgical drainages were maintained for a mean time of 3 days (range 1-7). The mean hospital stay was 9.2 days (range 6-19). Pleural effusions developed in two patients. On follow-up, one patient presented with thoracic pseudarthrosis and another with a serohaematoma of the surgical wound. CONCLUSIONS: Spinal surgery in patients with Fontan circulation is a high-risk operation. These patients must be managed by a specialised team.

MRNA and miRNA expression patterns associated to pathways linked to metal mixture health effects.

Metals are a threat to human health by increasing disease risk. Experimental data have linked altered miRNA expression with exposure to some metals. MiRNAs comprise a large family of non-coding single-stranded molecules that primarily function to negatively regulate gene expression post-transcriptionally. Although several human populations are exposed to low concentrations of As, Cd and Pb as a mixture, most toxicology research focuses on the individual effects that these metals exert. Thus, this study aims to evaluate global miRNA and mRNA expression changes induced by a metal mixture containing NaAsO2, CdCl2, Pb(C2H3O2)2·3H2O and to predict possible metal-associated disease development under these conditions. Our results show that this metal mixture results in a miRNA expression profile that may be responsible for the mRNA expression changes observed under experimental conditions in which coding proteins are involved in cellular processes, including cell death, growth and proliferation related to the metal-associated inflammatory response and cancer.

Creencias y actitudes hacia la medicina tradicional Mexicana en las poblaciones de Zacualtipán y Pachuca, Hidalgo / Beliefs and attitudes towards traditional Mexican medicine in the towns of Zacualtipán and Pachuca, Hidalgo

La medicina tradicional ha resultado ser una práctica médica importante para la calidad de vida de las personas. No obstante su estudio desde la psicología social y cultural ha visto pocos frutos. A partir del presente ensayo se pretende mostrar el panorama general de la salud, la medicina y la medicina tradicional como una aproximación a tal estudio, de modo que se destaque la relevancia de este estudio por sus consecuencias en la salud, atendiendo a una aproximación sobre la conducta de las personas dirigidas a este tipo de prácticas médicas y el por qué, a pesar de tener al alcance los servicios de salud oficiales, acuden a este tipo de prácticas médicas.