The Usefulness of Intraepithelial Lymphocyte Immunophenotype Testing for the Diagnosis of Coeliac Disease in Clinical Practice.

BACKGROUND: The diagnosis of coeliac disease (CD) in adults is based on clinical, serological and histological criteria. The inappropriate performance of intestinal biopsies, non-specificity of mild histological lesions and initiation of a gluten-free diet (GFD) before biopsy may hamper the diagnosis. In these situations, determining the intraepithelial lymphogram of the duodenum by flow cytometry (IEL-FC) can be helpful. OBJECTIVES: To describe the clinical scenarios in which the IEL-FC is used and its impact on the diagnosis of CD. METHODS: All adult patients with suspected CD at three tertiary centres for whom the duodenal histology and IEL-FC were available were identified. Catassi and Fasano's diagnostic criteria and changes to a CD diagnosis after the IEL-FCs were collected. RESULTS: A total of 348 patients were included. The following indications for an IEL-FC formed part of the initial study for CD (38%): negative conventional work-up (32%), already on a GFD before duodenal biopsies (29%) and refractoriness to a GFD (2%). The IEL-FC facilitated a definitive diagnosis in 93% of patients with an uncertain diagnosis who had had a conventional work-up for CD or who were on a GFD before histology. CONCLUSIONS: The IEL-FC facilitates the confirmation or rejection of a diagnosis of CD in clinical scenarios in which a conventional work-up may be insufficient.

Corrección del artefacto producido en imágenes tomográficas en equipos odontológicos / Correction of the artifact produced in tomographic images in dental equipment

Objetivo: disminuir el efecto de artefacto que generan objetos de alta densidad mediante la utilización de filtros de distintos materiales y espesores, ubicados en lugares estratégicos del tomógrafo. Material y métodos: se utilizaron filtros de aluminio y de cobre ubicados en lugares estratégicos en el equipo tomográfico. Se realizaron cortes oblicuos en piezas dentarias con restauraciones metálicas y en implantes; se midió la extensión del artefacto en ancho y alto en cada adquisición tomográfica. Resultados: se hallaron diferencias significativas respecto a la disminución de la dispersión de acuerdo con cada filtro con respecto a la no utilización de estos elementos. Conclusión: la utilización de filtros logró disminuir el efecto de artefacto en estructuras de alta densidad, obteniendo una mejor calidad de imagen para el diagnóstico, permitiendo que el software pueda reconstruir una imagen real (AU)

Objective: to diminish the artifact effect generated by high density objects by using filters of different materials and thickness, located in strategic places of the tomograph. Material and methods: aluminum and copper filters located in strategic places in the tomographic equipment were used. Oblique cuts were made on dental pieces with metal restorations and implants; the extension of the artifact in width and height was measured in each tomographic acquisition. Results: significant differences were found regarding the decrease of the dispersion according to each filter with respect to the non-use of these elements. Conclusion: the use of filters achieves to diminish the artifact effect in structures of high density, obtaining a better image quality for the diagnosis, allowing the software to reconstruct a real image (AU)

Regulation of tumor angiogenesis by the crosstalk between innate immunity and endothelial cells.

Endothelial cells and immune cells are major regulators of cancer progression and prognosis. Endothelial cell proliferation and angiogenesis are required for providing nutrients and oxygen to the nascent tumor and infiltration of immune cells to the tumor is dependent on endothelial cell activation. Myeloid cells and innate lymphocytes have an important role in shaping the tumor microenvironment by crosstalking with cancer cells and structural cells, including endothelial cells. Innate immune cells can modulate the activation and functions of tumor endothelial cells, and, in turn, endothelial cell expression of adhesion molecules can affect immune cell extravasation. However, the mechanisms underlying this bidirectional crosstalk are not fully understood. In this review, we will provide an overview of the current knowledge on the pathways regulating the crosstalk between innate immune cells and endothelial cells during tumor progression and discuss their potential contribution to the development of novel anti-tumor therapeutic approaches.

Electromagnetic fields disrupt the pollination service by honeybees.

We assessed the effect that electromagnetic field (EMF) exerts on honeybees' pollination efficiency using field and laboratory experiments. First, we measured levels of gene and protein expression in metabolic pathways involved in stress and behavioral responses elicited by EMF. Second, we assessed the effect of EMF on honeybee behavior and seed production by the honeybee-pollinated California poppy and, lastly, by measuring the consequences of pollination failure on plants' community richness and abundance. EMF exposure exerted strong physiological stress on honeybees as shown by the enhanced expression of heat-shock proteins and genes involved in antioxidant activity and affected the expression levels of behavior-related genes. Moreover, California poppy individuals growing near EMF received fewer honeybee visits and produced fewer seeds than plants growing far from EMF. Last, we found a hump-shaped relationship between EMF and plant species richness and plant abundance. Our study provides conclusive evidence of detrimental impacts of EMF on honeybee's pollination behavior, leading to negative effects on plant community.

Fotobiomodulación con láser de baja intensidad en el tratamiento integral ortodóntico: reporte de un caso / Photobiomodulation with low intensity laser in comprehensive orthodontic treatment: report of a case

El apiñamiento dental es una maloclusión frecuen-te y junto con los requerimientos de estética dental son una causa habitual de la solicitud de tratamien-to ortodóncico. El tiempo que demanda y las moles-tias que pudiera ocasionar el tratamiento produce inquietud en los pacientes y un esfuerzo de los or-todoncistas para optimizar el tiempo y prevenir los efectos adversos. Los tratamientos odontológicos multidisciplinarios permiten una mejor respuesta estética, funcional y de estabilidad post tratamiento. El tiempo de alineación dentaria y finalización, en los pacientes tratados con láser de baja intensidad po-dría mejorar tanto los índices gingivales como la res-puesta al dolor. Adicionalmente, las corticales óseas de los pacientes con ortodoncia tratados con láser, podrían verse menos afectadas en comparación con las de los pacientes no tratados. Se presenta un caso de fotobioestimulación con láser de baja intensidad aplicado en un paciente en fase de alineación, que forma parte de un estudio prospectivo aleatorizado que se desarrolla en la FOUBA y fue aprobado por el comité de Ética de la institución. El paciente aceptó y firmó el consentimiento informado. Finalizada la etapa de alineación, se evaluó la efectividad de la te-rapia con láser de baja intensidad actualmente de-nominada fotobiomodulación en incisivos superiores en la fase de alineación para acelerar el movimiento dentario, la respuesta gingival, el dolor, el estado de la cortical alveolar vestibular y la estética del perfil (AU)

Dental crowding, which is a frequent malocclusion, and dental aesthetic requirements are a common cause for requesting orthodontic treatment. The time that the treatment requires and the inconvenience that it could cause worries the patient and makes orthodontists strive to optimize time and prevent adverse effects. Multidisciplinary treatments would allow a better aesthetic, functional and post-treatment stability response. The dental alignment and completion time in patients treated with low-intensity laser could improve both gingival indices and response to pain. Additionally, the bone cortical of orthodontic patients treated with laser could be less affected compared to those of untreated patients. A case of low-intensity laser photobiostimulation applied to a patient in the alignment phase is presented, which is part of a prospective randomized study carried out at FOUBA and was approved by the institution's Ethics Committee. The patient accepted and signed the informed consent. After the alignment phase, the effectiveness of low-level laser therapy actually called photobiomodulation in upper incisors in the alignment phase is evaluated to accelerate tooth movement; the gingival response; the pain; the vestibular alveolar cortical and the aesthetics of the profile (AU)

Remodelling the surface of thioredoxin from Escherichia coli by grafting an iron-binding site from the CyaY protein family.

In this work, we have designed and generated a Fe(III)-binding protein with thiol oxidoreductase activity. The consensus iron-binding motif EExxED from the frataxin protein family was grafted on a model peptide and on the surface of thioredoxin (TRX) from E. coli. We investigated metal interactions with a family of peptides containing the motif EExxED or altered versions obtained by removing negatively charged residues: EExxEx, xExxED, and xExxEx. The interaction of the metal ion with the peptides was studied by circular dichroism, and our results indicated that the motif EExxED retained its functional properties and also that this motif is able to bind Ga(III) and Al(III). The interaction of the grafted TRX with iron(III) was investigated by NMR, showing that the motif was functional in the context of the protein structure, and also the binding of two equivalents of Fe(III) per TRX molecule was stable in a non-chelating neutral buffer. Protein conformation, stability, and enzymatic activity were studied by applying experimental and computational approaches. Interestingly, the thiol oxidoreductase activity was modulated by interaction with Ga(III), a Fe(III) mimetic ion. Furthermore, the design of functional proteins with both functions, oxidoreductase activity and metal-ion binding ability, should consider the reorganisation of the electrostatic network. Similarly, studying the crosstalk and electrostatic balance among different metal-binding sites may be critical.

Use of the Demirjian method to estimate dental age in panoramic radiographs of patients treated at the Buenos Aires University School of Dentistry / Utilización del Método de Demirjian para estimación de la edad dental en radiografías panorámicas de pacientes atendidos en la Facultad de Odontología de la Universidad de Buenos Aires

ABSTRACT The aim of this study was to determine the difference between real age (RA) and dental age (DA) in boys and girls from the Autonomous City of Buenos Aires (C.A.B.A.) by analyzing digital panoramic radiographs from the database of the Imaging Department at the Buenos Aires University School of Dentistry, using the Demirjian Method (DM). The sample consisted of 508 panoramic radiographs of 6- to 14-year old Argentines (268 female and 240 male). The Demirjian method was used to estimate dental age from each panoramic radiograph, and the Wilcoxon test was applied to perform a comparative analysis with the real age recorded in the image database. Average RA was 9.36 years (SD 2.11), and average DA according to the Demirjian method was 10.45 years (SD 2.31). For females, RA was 9.25 (SD 2.12), and DA according to the DM was 10.40 years (SD 2.41). For males, RA was 9.46 (SD 2.10), and DA according to the DM was 10.50 years (SD 2.22). An inter-class correlation coefficient (ICC) calculated as a correlation measure between dental age and real age was ICC = 1.09%. The ICC was 1.04% for the males and 1.15% for females. Significant differences were found between DA and RA (p <0.01) in general and according to sex. Real age was found to be lower than dental age in the study population from Buenos Aires City.

RESUMEN El objetivo del presente trabajo fue determinar la diferencia entre la edad real (ER) y la edad dental (ED) en niños y niñas de la Ciudad de Buenos Aires analizando radiografías panorámicas digitales de la base de datos de la Cátedra de Diagnóstico por imágenes FOUBA, utilizando el Método Demirjian (MD). La muestra consistió en 508 radiografías panorámicas (268 del sexo femenino y 240 del sexo masculino) en una población argentina de 6 a 14 años de edad. Se realizó el cálculo de la edad dental en cada una de ellas, conforme el método de Demirjian. Se efectuó un análisis comparativo con la ER proveniente de la base de datos, utilizando la prueba de Wilcoxon. En las 508 panorámicas se estimó la ED. Se pudo establecer que la ER en promedio es 9.36 años con un desviación estándar (DS) de 2,11 y que la edad según el método de Demirjian es 10,45 años con una DS de 2,31. Para el sexo femenino se obtuvo una ER de 9,25 y una DS de 2,12 y según MD es de 10,40 años con una DS de 2,41. Para el sexo masculino se obtuvo una ER de 9,46 y una DS de 2,10 y según MD es de 10,50 años con una DS de 2,22. Se obtuvo un coeficiente de correlación inter-clase (CCI), como medida de correlación entre edad dental y real, de (CCI 1,09%). El CCI para el sexo masculino fue de (CCI 1,04 %) y en el caso del sexo femenino fue de (CCI 1,15%). Se hallaron diferencias significativas entre ED y ER (p<0,01) en general y también para ambos sexos. Se pudo evidenciar que la edad real es menor que la edad dental en la población de la Ciudad de Buenos Aires.

Quiste dentígero: correlación de examen imagenológico con diagnóstico de certeza / Dentigerous cyst: corelation between the imaging examination and diagnostic certainty

Se presenta un caso clínico de quiste dentígero, asociado a un tercer molar inferior izquierdo retenido, que concurre a la Cátedra de Diagnóstico por Imáge- nes de la Facultad de Odontología de la Universidad de Buenos Aires. El paciente, de 53 años de edad, es de sexo femenino. Se utiliza la tomografía de haz cónico para diagnosticar presuntivamente dicha patolo- gía. Posteriormente, se realiza biopsia para obtener una muestra y ser enviada para realizar los estudios anatomopatológicos, que corroboran el presuntivo diagnóstico. Basado en lo expuesto, se analiza al quis- te dentígero según ubicación, sexo, edad y maxilar; habiendo realizado una revisión de la literatura (AU)

A clinical case of a dentigerous cyst associated with a retained lower left third molar is presented. The 53-year-old patient is female. Cone beam tomography is used to presumptively diagnose said pathology. Subsequently, a biopsy is performed to obtain a sample and be sent to perform pathological studies that corroborate the presumptive diagnosis. Based on the above, the dentigerous cyst is analyzed according to location, sex, age and maxilla; having carried out a review of the literature (AU)

From celiac disease to coccidia infection and vice-versa: The polyQ peptide CXCR3-interaction axis.

Zonulin is a physiological modulator of intercellular tight junctions, which upregulation is involved in several diseases like celiac disease (CeD). The polyQ gliadin fragment binds to the CXCR3 chemokine receptor that activates zonulin upregulation, leading to increased intestinal permeability in humans. Here, we report a general hypothesis based on the structural connection between the polyQ sequence of the immunogenic CeD protein, gliadin, and enteric coccidian parasites proteins. Firstly, a novel interaction pathway between the parasites and the host is described based on the structural similarities between polyQ gliadin fragments and the parasite proteins. Secondly, a potential connection between coccidial infections as a novel environmental trigger of CeD is hypothesized. Therefore, this report represents a promising breakthrough for coccidian research and points out the potential role of coccidian parasites as a novel trigger of CeD that might define a preventive strategy for gluten-related disorders in general. Also see the video abstract here: https://youtu.be/oMaQasStcFI.

Molecular and Structural Parallels between Gluten Pathogenic Peptides and Bacterial-Derived Proteins by Bioinformatics Analysis.

Gluten-related disorders (GRDs) are a group of diseases that involve the activation of the immune system triggered by the ingestion of gluten, with a worldwide prevalence of 5%. Among them, Celiac disease (CeD) is a T-cell-mediated autoimmune disease causing a plethora of symptoms from diarrhea and malabsorption to lymphoma. Even though GRDs have been intensively studied, the environmental triggers promoting the diverse reactions to gluten proteins in susceptible individuals remain elusive. It has been proposed that pathogens could act as disease-causing environmental triggers of CeD by molecular mimicry mechanisms. Additionally, it could also be possible that unrecognized molecular, structural, and physical parallels between gluten and pathogens have a relevant role. Herein, we report sequence, structural and physical similarities of the two most relevant gluten peptides, the 33-mer and p31-43 gliadin peptides, with bacterial pathogens using bioinformatics going beyond the molecular mimicry hypothesis. First, a stringent BLASTp search using the two gliadin peptides identified high sequence similarity regions within pathogen-derived proteins, e.g., extracellular proteins from Streptococcus pneumoniae and Granulicatella sp. Second, molecular dynamics calculations of an updated α-2-gliadin model revealed close spatial localization and solvent-exposure of the 33-mer and p31-43 peptide, which was compared with the pathogen-related proteins by homology models and localization predictors. We found putative functions of the identified pathogen-derived sequence by identifying T-cell epitopes and SH3/WW-binding domains. Finally, shape and size parallels between the pathogens and the superstructures of gliadin peptides gave rise to novel hypotheses about activation of innate immunity and dysbiosis. Based on our structural findings and the similarities with the bacterial pathogens, evidence emerges that these pathologically relevant gluten-derived peptides could behave as non-replicating pathogens opening new research questions in the interface of innate immunity, microbiome, and food research.

Wearable Robotic Gait Training in Persons with Multiple Sclerosis: A Satisfaction Study.

Wearable exoskeletons have showed improvements in levels of disability and quality of life in people with neurological disorders. However, it is important to understand users' perspectives. The aim of this study was to explore the patients' and physiotherapists' satisfaction from gait training with the EKSO GT® exoskeleton in people with multiple sclerosis (MS). A cross-sectional study with 54 participants was conducted. Clinical data and self-administered scales data were registered from all patients who performed sessions with EKSO GT®. To evaluate patients' satisfaction the Quebec User Evaluation with Assistive Technology and Client Satisfaction Questionnaire were used. A high level of satisfaction was reported for patients and for physiotherapists. A moderate correlation was found between the number of sessions and the patients' satisfaction score (rho = 0.532; p < 0.001), and an excellent correlation between the physiotherapists' time of experience in neurology rehabilitation and the satisfaction with the possibility of combining the device with other gait trainings approaches (rho = 0.723; p = 0.003). This study demonstrates a good degree of satisfaction for people with MS (31.3 ± 5.70 out of 40) and physiotherapists (38.50 ± 3.67 out of 45 points) with the EKSO GT®. Effectiveness, safety and impact on the patients' gait were the most highly rated characteristics of EKSO GT®. Features such as comfort or weight of the device should be improved from the patients' perspectives.

Aplicación forense de tecnología radiográfica dental portátil en Argentina: estado actual y perspectivas futuras / Forensic application of portable dental radiographic technology in Argentina: current status and future prospects

Objetivos: Mensurar los niveles de radiación de fuga y dispersión emanada a través de los blindajes y estructuras plomadas del tubo de rayos X de la unidad dental portátil NOMAD, controlando la retrodispersión con el uso del escudo protector de acrílico plomado adaptado en el extremo final del tubo localizador plomado. Se midieron las tasas de exposición dispersadas mediante un detector tipo Geiger-Müller y una cámara de ionización con respuesta en el rango de energías aportadas en diagnóstico por imágenes para la medición de la exposición directa y determinación posterior de las dosis. Se utilizó un fantomas diseñado para diagnóstico odontológico, sopesando la radiación en diferentes angulaciones de operación del equipo NOMAD, simulando los gestos posturales de odontólogos, radiólogos y sujetos a identificar. Se controlaron las tasas de exposición para determinar los valores de las dosis aportadas en las zonas significativas corporales más radiosensibles del operador del equipo. Se obtuvo como resultado que la retrodispersión en el cristalino del ojo del operador fue significativamente menor cuando el fantomas estaba acostado, mientras que a nivel de gónadas resultó más baja con el cuerpo sentado. La tasa de dosis máxima de radiación dispersa que impactó en los operadores fue de 350.8 micro Sieverts por hora (uSv/h) en la zona de gónadas, por cada radiografía tomada sin el uso del delantal de goma plomada, reduciéndose a 4.38 micro Sieverts por hora (uSv/h) al utilizarlo (AU)

Pleomorphic dermal sarcoma: a retrospective study of 16 cases in a dermato-oncology centre and a review of the literature.

BACKGROUND: Relatively little is known about the true aggressive potential of pleomorphic dermal sarcoma (PDS) or optimal management strategies. OBJECTIVE: To describe the outcomes of 16 cases of PDS treated at our hospital (14 with modified Mohs micrographic surgery [M-MMS] and two with conventional surgery) and establish an adequate plan for management. MATERIALS & METHODS: We reviewed 16 PDS cases treated at our hospital between October 2007 and June 2019 and compared our results with the available evidence. RESULTS: In total, 69% of cases had recurred after initial conventional surgery, M-MMS led to local disease control in 83% of cases, and 19% of patients developed metastasis. Combining all published PDS cases with ours, we calculated an overall metastasis rate of 12%, and an overall recurrence rate of 35% after conventional surgery and 17% after M-MMS. CONCLUSION: PDS is more aggressive than previously estimated, with an overall metastatic rate of 12%. Despite high recurrence rates with previous conventional surgery (69%), M-MMS achieved a good rate of local disease control (83%). Given the potential aggressivity of PDS and the importance of clear surgical margins, M-MMS appears to be more adequate than conventional excision. Staging studies and close monitoring are warranted in PDS patients, for which we propose a management algorithm.

Colorectal Signet Ring Cell Carcinoma in a Young Pregnant Woman.

Colorectal cancer during pregnancy is one of the less common neoplasms with an incidence of 0.8 in 100,000 pregnancies. Primary colonic signet ring cell carcinoma is a weird variety, characterized by a poor histologic differentiation, with a high morbidity-mortality rate. The case of a 24-year-old patient with a 22-week-old pregnancy and colorectal cancer stage IV in palliative state is presented, with a devastating result. Early diagnosis represents a challenge because of the presentation form and the histologic aggressiveness of this disease. We suggest that colorectal cancer during pregnancy must be treated by a multidisciplinary team.

Exploring the conformational transition between the fully folded and locally unfolded substates of Escherichia coli thiol peroxidase.

Thiol peroxidase from Escherichia coli (EcTPx) is a peroxiredoxin that catalyzes the reduction of different hydroperoxides. During the catalytic cycle of EcTPx, the peroxidatic cysteine (CP) is oxidized to a sulfenic acid by peroxide, then the resolving cysteine (CR) condenses with the sulfenic acid of CP to form a disulfide bond, which is finally reduced by thioredoxin. Purified EcTPx as dithiol and disulfide behaves as a monomer under near physiological conditions. Although secondary structure rearrangements are present when comparing different redox states of the enzyme, no significant differences in unfolding free energies are observed under reducing and oxidizing conditions. A conformational change denominated fully folded (FF) to locally unfolded (LU) transition, involving a partial unfolding of αH2 and αH3, must occur to enable the formation of the disulfide bond since the catalytic cysteines are 12 Å apart in the FF conformation of EcTPx. To explore this process, the FF → LU and LU → FF transitions were studied using conventional molecular dynamics simulations and an enhanced conformational sampling technique for different oxidation and protonation states of the active site cysteine residues CP and CR. Our results suggest that the FF → LU transition has a higher associated energy barrier than the refolding LU → FF process in agreement with the relatively low experimental turnover number of EcTPx. Furthermore, in silico designed single-point mutants of αH3 enhanced locally unfolding events, suggesting that the native FF interactions in the active site are not evolutionarily optimized to fully speed-up the conformational transition of wild-type EcTPx.

Quiste dentígero: presentación de un caso clínico y revisión de la literatura / Dentigerous cyst: report of a clinical case and review of the literature

Introduccion: según la clasificación de la oms de 1992, el quiste dentígero o folicular se clasifica dentro de los quistes de desarrollo odontogénicos. Este se origina en la evolución de un germen dentario. La pieza dentaria, generalmente, se encuentra en íntima relación con la membrana quística, adherida al límite amelocementario. El crecimiento es lento y continuo. Radiográficamente se observa una imagen radiolúcida, definida y unilocular. Afecta con más frecuencia al sexo masulino y la proporción de pacientes de 6 a 7 años con quistes dentígero es de solo 9.1%. Caso clínico: paciente masculino de 6 años concurre a la consulta con su abuela presentando inflamación facial del maxilar superior derecho, asintomática. Luego del examen clínico se le solicita una radiografía panorámica. Por su severidad, se le solicita una tomografía computada y se lo deriva para su intervención quirúrgica y análisis de la muestra. Conclusion: el odontólogo clínico debe realizar la anamnesis e inspección clínica y ante la sospecha de una patología, debe solicitar un estudio radiográfico y/o tomográfico complementario. Se puede observar que durante el recambio dentario, es frecuente la presentación de lesiones patológicas que si no son diagnosticadas a tiempo estas podrían malignizarse y llevar al paciente a grandes resecciones quirúrgicas (AU)

Introduction: according to the who classification of 1992, the dentigerous or follicular cyst is classified within the odontogenic development cysts. This originates in the evolution of a dental germ. The dental piece is usually in close relation with the cystic membrane, adhered to the amelocementary limit. The growth is slow and continuous. Radiographically, a radiolucent, defined and unilocular image is observed. It affects the masculine sex more frequently and the proportion of patients from 6 to 7 years with dentigerous cysts is only 9.1%. Clinical case: a 6-year-old male patient attended the consultation with his grandmother presenting facial inflammation of the right upper jaw, asymptomatic. After the clinical examination, a panoramic radiograph is requested. Due to its severity, a tomography where it is then transferred for its surgical intervention and sample analysis. Conclusion: the clinical dentist must perform the anamnesis and clinical inspection and, if pathology is suspected, he or she must request a complementary radiographic and / or tomographic study. In odontopediatry, during dental replacement, it is common the presentation of pathological lesions that if not diagnosed in time they could be malignant and take the patient to large surgical resections (AU)

Primary Meningococcal Septic Arthritis Case Report and Literature Review of an Unusual Manifestation of Meningococcal Disease.

INTRODUCTION: Primary meningococcal septic arthritis (PMSA) is an unusual manifestation of meningococcal disease. It is defined as the presence of acute septic arthritis without association with meningitis or the classic meningococcemia and isolation of Neisseria meningitidis in synovial fluid and blood culture. Diagnosis and early treatment, combining antibiotic and joint drainage, are fundamental. CASE PRESENTATION: We present the case of a healthy 17-year-old male who presented with history of an acute onset, painful knee accompanied by fever. N. meningitidis was cultured from the synovial fluid. He was treated with arthroscopic lavage and intravenous ceftriaxone for 2 weeks. He was discharged 7 days after admission receiving outpatient intravenous ceftriaxione for 6 days and was ultimately transitioned to oral ciprofloxacin for 2 weeks thereafter. At the final follow-up visit, he had returned to sports activity with a normal knee joint. LITERATURE REVIEW: We have done an exhaustive literature review in PubMed. Forty-four articles were included, with a total of 46 patients, to which we added ours. We collected the available demographic data, analytical values, culture tests, treatment, and evolution. PURPOSES AND CLINICAL RELEVANCE: This case illustrates an unusual presentation of N. meningitidis infection. Diagnostic suspicion is essential. Joint washing and antibiotics are the mainstays of treatment. Early and proper treatment prevents complications and mortality. Our main objective was to evaluate the diagnostics tools and treatment in PMSA. As a secondary objective, we evaluated the cases with negative cultures in order to evaluate the criteria for the diagnostic suspicion of PMSA.

Resolución de clase II mordida profunda con distalamiento molar mini-iimplantoasistida: reporte de caso clínico / Resolution of a class II deep bite with mini-implant-assisted molar distal movement; report of a clinical case

En todos los tratamientos ortodónticos, el primer objetivo a cumplir es alinear y nivelar las piezas dentales. Para tal fin, deberíamos generar espacio dentro del arco dentario. Existen tres procedimientos diferentes para lograr este objetivo, según el grado de apiñamiento dental o Índice de nance, que son los siguientes: a) stripping o desgaste interproximal, b) exodoncia de piezas dentales y c) distalamiento. La distalización de los molares es una de las técnicas más antiguas de la terapéutica ortodóntica y se han empleado distintos recursos terapéuticos para tal fin, como pendulum, jig de jans, first class, entre otros; cada uno con sus ventajas y desventajas. La introducción de los mini-implantes dentro de nuestra especialidad ha revolucionado en forma drástica los conceptos de anclaje, brindándonos movimientos dentarios sin generar efectos colaterales indeseables. El objetivo de este caso clínico, es mostrar la utilización de un Orthorama modificado y mini-implantes como distaladores de los molares superiores (AU)

Frenectomía lingual láser asistida como coadyuvante del tratamiento de ortopedia maxilar / Laser-assissted lingual frenectomy as a coadjuvant to maxillary orthopedic treatment

La aplicación del LÁSER (light amplification of stimulation emision of radiation) en las áreas de la medicina y la odontología viene demostrando una constante evolución, brindándonos alternativas a los tratamientos convencionales. Los láseres quirúrgicos de tejidos blandos muestran grandes ventajas comparados a los procedimientos habituales de corte, ya sea con bisturí frío o electrobisturí. La mínima necesidad de anestesia, la analgesia intra y postoperatoria, la coagulación inmediata, la cicatrización por segunda, el efecto bactericida, la ausencia de puntos de sutura, el confort postoperatorio, son algunas de las ventajas que hacen que la cirugía con láser sea una opción indiscutible que está ganando terreno entre los profesionales de la salud (AU)