Hallmarks of Alzheimer disease are evolving relentlessly in Metropolitan Mexico City infants, children and young adults. APOE4 carriers have higher suicide risk and higher odds of reaching NFT stage V at ≤ 40 years of age.

Exposures to fine particulate matter (PM2.5) and ozone (O3) above USEPA standards are associated with Alzheimer's disease (AD) risk. Metropolitan Mexico City (MMC) residents have life time exposures to PM2.5 and O3 above USEPA standards. We investigated AD intra and extracellular protein aggregates and ultrastructural neurovascular pathology in 203 MMC residents age 25.36 ±â€¯9.23 y. Immunohistochemical methods were used to identify AT8 hyperphosphorilated tau (Htau) and 4G8 (amyloid ß 17-24). Primary outcomes: staging of Htau and amyloid, per decade and cumulative PM2.5 (CPM2.5) above standard. Apolipoprotein E allele 4 (APOE4), age and cause of death were secondary outcomes. Subcortical pretangle stage b was identified in an 11month old baby. Cortical tau pre-tangles, neurofibrillary tangles (NFT) Stages I-II, amyloid phases 1-2, Htau in substantia nigrae, auditory, oculomotor, trigeminal and autonomic systems were identified by the 2nd decade. Progression to NFT stages III-V was present in 24.8% of 30-40 y old subjects. APOE4 carriers have 4.92 times higher suicide odds (p = 0.0006), and 23.6 times higher odds of NFT V (p < 0.0001) v APOE4 non-carriers having similar CPM2.5 exposure and age. Age (p = 0.0062) and CPM2.5 (p = 0.0178) were significant for developing NFT V. Combustion-derived nanoparticles were associated with early and progressive damage to the neurovascular unit. Alzheimer's disease starting in the brainstem of young children and affecting 99.5% of young urbanites is a serious health crisis. Air pollution control should be prioritised. Childhood relentless Htau makes a fundamental target for neuroprotective interventions and the first two decades are critical. We recommend the concept of preclinical AD be revised and emphasize the need to define paediatric environmental, nutritional, metabolic and genetic risk factor interactions of paramount importance to prevent AD. AD evolving from childhood is threating the wellbeing of our children and future generations.

APOE Peripheral and Brain Impact: APOE4 Carriers Accelerate Their Alzheimer Continuum and Have a High Risk of Suicide in PM2.5 Polluted Cities.

This Review emphasizes the impact of APOE4-the most significant genetic risk factor for Alzheimer's disease (AD)-on peripheral and neural effects starting in childhood. We discuss major mechanistic players associated with the APOE alleles' effects in humans to understand their impact from conception through all life stages and the importance of detrimental, synergistic environmental exposures. APOE4 influences AD pathogenesis, and exposure to fine particulate matter (PM2.5), manufactured nanoparticles (NPs), and ultrafine particles (UFPs) associated with combustion and friction processes appear to be major contributors to cerebrovascular dysfunction, neuroinflammation, and oxidative stress. In the context of outdoor and indoor PM pollution burden-as well as Fe, Ti, and Al alloys; Hg, Cu, Ca, Sn, and Si UFPs/NPs-in placenta and fetal brain tissues, urban APOE3 and APOE4 carriers are developing AD biological disease hallmarks (hyperphosphorylated-tau (P-tau) and amyloid beta 42 plaques (Aß42)). Strikingly, for Metropolitan Mexico City (MMC) young residents ≤ 40 y, APOE4 carriers have 4.92 times higher suicide odds and 23.6 times higher odds of reaching Braak NFT V stage versus APOE4 non-carriers. The National Institute on Aging and Alzheimer's Association (NIA-AA) framework could serve to test the hypothesis that UFPs and NPs are key players for oxidative stress, neuroinflammation, protein aggregation and misfolding, faulty complex protein quality control, and early damage to cell membranes and organelles of neural and vascular cells. Noninvasive biomarkers indicative of the P-tau and Aß42 abnormal protein deposits are needed across the disease continuum starting in childhood. Among the 21.8 million MMC residents, we have potentially 4 million APOE4 carriers at accelerated AD progression. These APOE4 individuals are prime candidates for early neuroprotective interventional trials. APOE4 is key in the development of AD evolving from childhood in highly polluted urban centers dominated by anthropogenic and industrial sources of pollution. APOE4 subjects are at higher early risk of AD development, and neuroprotection ought to be implemented. Effective reductions of PM2.5, UFP, and NP emissions from all sources are urgently needed. Alzheimer's Disease prevention ought to be at the core of the public health response and physicians-scientist minority research be supported.

Fall Risk, Sleep Behavior, and Sleep-Related Movement Disorders in Young Urbanites Exposed to Air Pollution.

BACKGROUND: Quadruple aberrant hyperphosphorylated tau, amyloid-ß, α-synuclein, and TDP-43 pathology had been documented in 202/203 forensic autopsies in Metropolitan Mexico City ≤40-year-olds with high exposures to ultrafine particulate matter and engineered nanoparticles. Cognition deficits, gait, equilibrium abnormalities, and MRI frontal, temporal, caudate, and cerebellar atrophy are documented in young adults. OBJECTIVE: This study aimed to identify an association between falls, probable Rapid Eye Movement Sleep Behavior Disorder (pRBD), restless leg syndrome (RLS), and insomnia in 2,466 Mexican, college-educated volunteers (32.5±12.4 years). METHODS: The anonymous, online study applied the pRBD and RLS Single-Questions and self-reported night-time sleep duration, excessive daytime sleepiness, insomnia, and falls. RESULTS: Fall risk was strongly associated with pRBD and RLS. Subjects who fell at least once in the last year have an OR = 1.8137 [1.5352, 2.1426] of answering yes to pRBD and/or RLS questions, documented in 29% and 24% of volunteers, respectively. Subjects fell mostly outdoors (12:01 pm to 6:00 pm), 43% complained of early wake up hours, and 35% complained of sleep onset insomnia (EOI). EOI individuals have an OR of 2.5971 [2.1408, 3.1506] of answering yes to the RLS question. CONCLUSION: There is a robust association between falls, pRBD, and RLS, strongly suggesting misfolded proteinopathies involving critical brainstem arousal and motor hubs might play a crucial role. Nanoparticles are likely a significant risk for falls, sleep disorders, insomnia, and neurodegenerative lethal diseases, thus characterizing air particulate pollutants' chemical composition, emission sources, and cumulative exposure concentrations are strongly recommended.

A stromal progenitor and ILC2 niche promotes muscle eosinophilia and fibrosis-associated gene expression.

Despite the well-accepted view that chronic inflammation contributes to the pathogenesis of Duchenne muscular dystrophy (DMD), the function and regulation of eosinophils remain an unclear facet of type II innate immunity in dystrophic muscle. We report the observation that group 2 innate lymphoid cells (ILC2s) are present in skeletal muscle and are the principal regulators of muscle eosinophils during muscular dystrophy. Eosinophils were elevated in DMD patients and dystrophic mice along with interleukin (IL)-5, a major eosinophil survival factor that was predominantly expressed by muscle ILC2s. We also find that IL-33 was upregulated in dystrophic muscle and was predominantly produced by fibrogenic/adipogenic progenitors (FAPs). Exogenous IL-33 and IL-2 complex (IL-2c) expanded muscle ILC2s and eosinophils, decreased the cross-sectional area (CSA) of regenerating myofibers, and increased the expression of genes associated with muscle fibrosis. The deletion of ILC2s in dystrophic mice mitigated muscle eosinophilia and impaired the induction of IL-5 and fibrosis-associated genes. Our findings highlight a FAP/ILC2/eosinophil axis that promotes type II innate immunity, which influences the balance between regenerative and fibrotic responses during muscular dystrophy.

Brainstem Quadruple Aberrant Hyperphosphorylated Tau, Beta-Amyloid, Alpha-Synuclein and TDP-43 Pathology, Stress and Sleep Behavior Disorders.

Quadruple aberrant hyperphosphorylated tau (p-τ), amyloid-ß peptide, alpha-synuclein and TDP-43 brainstem and supratentorial pathology are documented in forensic ≤40y autopsies in Metropolitan Mexico City (MMC), and p-τ is the major aberrant protein. Post-traumatic stress disorder (PTSD) is associated with an elevated risk of subsequent dementia, and rapid eye movement sleep behavior disorder (RBD) is documented in PD, AD, Lewy body dementia and ALS. This study aimed to identify an association between PTSD and potential pRBD in Mexico. An anonymous online survey of 4502 urban college-educated adults, 29.3 ± 10.3 years; MMC, n = 1865; non-MMC, n = 2637, measured PTSD symptoms using the Impact of Event Scale-Revised (IES-R) and pRBD symptoms using the RBD Single-Question. Over 50% of the participants had IES-R scores ≥33 indicating probable PTSD. pRBD was identified in 22.6% of the participants across Mexico and 32.7% in MMC residents with PTSD. MMC subjects with PTSD had an OR 2.6218 [2.5348, 2.7117] of answering yes to the pRBD. PTSD and pRBD were more common in women. This study showed an association between PTSD and pRBD, strengthening the possibility of a connection with misfolded proteinopathies in young urbanites. We need to confirm the RBD diagnosis using an overnight polysomnogram. Mexican women are at high risk for stress and sleep disorders.

QuantiMus: A Machine Learning-Based Approach for High Precision Analysis of Skeletal Muscle Morphology.

Skeletal muscle injury provokes a regenerative response, characterized by the de novo generation of myofibers that are distinguished by central nucleation and re-expression of developmentally restricted genes. In addition to these characteristics, myofiber cross-sectional area (CSA) is widely used to evaluate muscle hypertrophic and regenerative responses. Here, we introduce QuantiMus, a free software program that uses machine learning algorithms to quantify muscle morphology and molecular features with high precision and quick processing-time. The ability of QuantiMus to define and measure myofibers was compared to manual measurement or other automated software programs. QuantiMus rapidly and accurately defined total myofibers and measured CSA with comparable performance but quantified the CSA of centrally-nucleated fibers (CNFs) with greater precision compared to other software. It additionally quantified the fluorescence intensity of individual myofibers of human and mouse muscle, which was used to assess the distribution of myofiber type, based on the myosin heavy chain isoform that was expressed. Furthermore, analysis of entire quadriceps cross-sections of healthy and mdx mice showed that dystrophic muscle had an increased frequency of Evans blue dye+ injured myofibers. QuantiMus also revealed that the proportion of centrally nucleated, regenerating myofibers that express embryonic myosin heavy chain (eMyHC) or neural cell adhesion molecule (NCAM) were increased in dystrophic mice. Our findings reveal that QuantiMus has several advantages over existing software. The unique self-learning capacity of the machine learning algorithms provides superior accuracy and the ability to rapidly interrogate the complete muscle section. These qualities increase rigor and reproducibility by avoiding methods that rely on the sampling of representative areas of a section. This is of particular importance for the analysis of dystrophic muscle given the "patchy" distribution of muscle pathology. QuantiMus is an open source tool, allowing customization to meet investigator-specific needs and provides novel analytical approaches for quantifying muscle morphology.

The impact of tooth brushing versus tooth brushing and chlorhexidine application to avoid postoperative pneumonia in children.

BACKGROUND: The pathogenesis of postsurgical pneumonia is a complicated and multifactorial process, in which elements like oral bacteria, orotracheal intubation, and dental hygiene play an important role. The objective of this study was to evaluate the efficacy of 2 types of oral hygiene interventions in decreasing cases of postsurgical pneumonia. METHODS: In pediatric patients scheduled for surgery, a quasi-experimental study was carried out over a 2-year period to evaluate the efficacy of 2 types of oral hygiene interventions. There were 2 groups of intervention with 1 group for comparison. Intervention groups were tooth brushing by a dentist (intervention group 1) and dental brushing by parents + chlorhexidine gluconate (intervention group 2). Data from the year with no oral hygiene interventions were used as the baseline group. RESULTS: A total of 2,535 surgical procedures were followed. Baseline group incidence of postoperative pneumonia was 10 per 1,000 surgeries, 0.2 per 1,000 surgeries in the intervention group 1 (P = .04), and 0.8 per 1,000 surgeries in the intervention group 2. Intervention group 1 was protective against postoperative pneumonia (odds ratio, 0.06; P = .02; 95% confidence interval, 0.033-0.079), but there was no benefit with intervention group 2 (odds ratio, 0.87; P = .599; 95% confidence interval, 0.52-1.46). CONCLUSIONS: Dental brushing performed before surgery by a pediatric dentist was effective in reducing the incidence of postoperative pneumonia in pediatric patients.

Mild Cognitive Impairment and Dementia Involving Multiple Cognitive Domains in Mexican Urbanites.

Exposures to fine particulate matter PM2.5 and ozone O3 are associated with Alzheimer's disease (AD) risk. Mexico City residents have lifetime exposures to PM2.5 and O3 above annual USEPA standards and their brains contain high redox, combustion, and friction-derived magnetite nanoparticles. AD pathological changes with subcortical pre-tangle stages in infancy and cortical tau pre-tangles, NFT Stages I-II, and amyloid phases 1-2 are identified by the 2nd decade. Given their AD continuum, a reliable identification of cognitive impairment is of utmost importance. The Montreal Cognitive Assessment (MoCA) was administered to 517 urbanites, age 21.60±5.88 years, with 13.69±1.28 formal education years, in Mexican PM2.5 polluted cities. MoCA score was 23.92±2.82, and 24.7% and 30.3% scored ≤24 and ≤22, respectively (MCI≤24, AD≤22). Cognitive deficits progressively targeted Visuospatial, Executive, Language, and Memory domains, body mass index (BMI) impacting total scores negatively (p = 0.0008), aging driving down Executive, Visuospatial, and Language index scores (p < 0.0001, 0.0037, and 0.0045), and males performing better in Executive tasks. Average age for AD MoCA scores was 22.38±7.7 years. Residency in polluted cities is associated with progression of multi-domain cognitive impairment affecting 55% of Mexican seemingly healthy youth. Normal BMI ought to be a neuroprotection goal. MoCA provides guidance for further mandatory neuropsychological testing in young populations. Identifying and lowering key neurotoxicants impacting neural risk trajectories in the developing brain and monitoring cognitive performance would greatly facilitate multidisciplinary early diagnosis and prevention of AD in high risk young populations. Cognitive deficits hinder development of those representing the force moving the country in future years.

Oral diseases in children with acute lymphoblastic leukemia with chemotherapy treatment / Alteraciones bucodentales en niños con leucemia linfoblástica aguda bajo tratamiento con quimioterapia

Background: Pediatric patients with acute lymphoblastic leukemia (ALL) usually develop oral manifestations due to the disease itself, as well as side effects of chemotherapy that severely affect their health and quality of life. The aim of this paperis to determine the prevalence of oral diseases in pediatric all patients with and without chemotherapy and its relation to the different phases of chemotherapy. Methods: A cross-sectional observational study was conducted in 103 pediatric patients with all between 3-15 years. They were classified into groups: without chemotherapy and with chemotherapy at phase of consolidation, enhancement, maintenance and monitoring. Clinical diagnosis was performed and gingival inflammation index (IMPA) and caries criteria (dmf and DMF) were applied. Results: The prevalence oral manifestations in the chemotherapy group were mucositis (98%), ulcers (90%), gingivitis (86%) and candidiasis (78%). The induction phase related with mucositis: RM = 7.6, 95%CI: 4.4-13, p = 0.0001; candidiasis: OR = 103, 95%CI: 13.0-818, p = 0.0001; gingivitis: OR = 16.2, 95%CI: 5.5-47, p = 0.0001; ulcers OR = 61.5, 95%CI: 8.7-432, p = 0.0001. Conclusions: The frequency and severity of oral diseases was hight and associated with the induction phase of chemotherapy, altering the overall nutrition and health of children.

Introducción: los pacientes pediátricos con leucemia linfoblástica aguda habitualmente desarrollan manifestaciones bucales debidas a la propia enfermedad, así como por efectos secundarios de la quimioterapia (QT) que afectan severamente su salud y calidad de vida. El objetivo de este trabajo fue determinar la prevalencia de patologías bucales en pacientes pediátricos con leucemia linfoblástica aguda (LLA) con y sin tratamiento QT, así como su relación con las fases del tratamiento QT. Métodos: se realizó un estudio transversal, observacional y analítico en pacientes pediátricos con LLA de 3 a 15 años. Se clasificaron en varios grupos: sin tratamiento, con tratamiento QT en fase de inducción, consolidación, intensificación, mantenimiento y vigilancia. Se realizó un examen clínico de los tejidos bucales y se aplicaron los índices de inflamación gingival (IPMA) y caries (ceod y CPOD). Resultados: el grupo bajo QT presentó mucositis (98%), úlceras (90%), gingivitis (86%) y candidiasis (78%). La fase de inducción se asoció con la presencia de mucositis: RM = 7.6, IC95%: 4.4-13, p = 0.0001; candidiasis: RM = 103, IC95%: 13.0-818, p = 0.0001; gingivitis: RM = 16.2, IC95%: 5.5-47, p = 0.0001; úlceras RM = 61.5, IC95%: 8.7-432, p = 0.0001. Conclusiones: la mayor frecuencia y severidad de las patologías bucodentales se asociaron a la fase de inducción, alterando la alimentación y la salud integral de los niños.

Prevalence of oral lesions in Mexican children with perinatally acquired HIV: association with immunologic status, viral load, and gender.

It has been proposed that HIV-related oral lesions (HIV-ROL) have a significant diagnostic and prognostic value for human immunodeficiency virus (HIV) infection in adult patients. However, in HIV-infected children, the relation between HIV-ROL and immune and virologic status is not well established. The principal objective of this paper is to assess the prevalence of HIV-related oral lesions (HIV-ROL) in Mexican HIV-infected children in relation to their immunologic status, viral load, and gender. Forty-eight HIV-infected children from Immunodeficiency Clinic, Child's Hospital of México, México City, were examined for oral pathology. The data obtained from medical records were: name, gender, age, route of infection, CD4 lymphocytes cells count/mL, HIV-1-RNA level of copies/mL (viral load), and type and time of treatment. The prevalence of HIV-ROL was 29.2%. Oral candidosis was the most prevalent oral lesion (20.8%) followed by periodontal and gingival disease (4.2%), herpes simplex (2.1%), and parotid enlargement (2.1%). There was no association between the prevalence of HIV-ROL and gender, immunological status, or viral load. The most frequent clinical form of oral candidosis was erythematous candidosis (12.5%, N = 6). Our results do not suggest a direct relationship between prevalence of HIV-ROL, severe immunodepression, and/or viral load > 100000 copies in this population.

Neutropenia cíclica. Reporte de un caso / Cyclic neutropenia. Clinical case report

La neutropenia cíclica ocurre debido a que los niveles de producción celular por parte de las células madre de la médula ósea fluctúan, es decir, cambian durante el ciclo; aunque el número es recurrentemente bajo, su función es normal. Fue descrita por primera vez por Leale en 1910, con carácter autosómico dominante. Se presenta aproximadamente cada 21 días con un rango de 14 a 36 días durando un total de 3 a 6. Durante el periodo en el que existen pocos neutrófilos circulantes, el paciente es susceptible a las infecciones. Dentro del cuadro clínico se presentan: susceptibilidad a infecciones, cuadros febriles, fatiga, úlceras orales, impétigo, aumento de ganglios linfáticos, periodontitis, estomatitis. Es importante manejar estomatológicamente a estos pacientes, previa interconsulta con médico tratante, prevenir cuadros infecciosos bajo un esquema profiláctico a base de amoxicilina 50 mg/kg peso o clindamicina 20 mg/kg peso, revisar biometría hemática reciente (máximo 10 días previos al tratamiento); en tratamientos de urgencia se manejará de forma conservadora el dolor e infección; uso de enjuagues con clorhexidina al 0.12% y solución Philadelphia en caso de ser necesario.

Cyclic neutropenia occurs due to the fluctuation of cellular production levels of bone marrow stem cells. This is to say, they change during the cycle, and although numbers are recurrently low, function is normal. Cyclic neutropenia was first described by Leale in 1910 with dominant autosomal character. It manifests approximately every 21 days, with range of 14 to 36 days, lasting 3-6 days per episode. During the time when there are few circulating neutrophils, the patient is susceptible to infections. The clinical picture of this process includes: susceptibility to infection, feverish conditions, oral ulcers, impetigo, increased lymph nodes, periodontitis and stomatitis. It is important to stomatologically handle these patients; after inter-consultation with treating physician, prevent infection in a prophylactic scheme based on amoxicillin 50 mg/per kg weight or clindamycin 20 mg/per kg weight, review recent blood count results (maximum ten days before treatment). In emergency treatments pain and infection will be handled conservatively, with use of 0.12% chlorhexidine mouthwashes and Philadelphia solution when necessary.

Hiperplasia multiepitelial focal: tratamiento comparativo, ácido glicirricínico contra nitrógeno líquido / Focal multiepithelial hyperplasia: comparative treatment, glycyrrhizinic acid versus liquid nitrogen

La hiperplasia multiepitelial focal (HMF), se caracteriza por la aparición de lesiones múltiples en la mucosa de la cavidad bucal en población pediátrica y se asocia con la presencia del virus papiloma humano. Actualmente no existe un tratamiento de elección, el más empleado es el nitrógeno líquido (NL), pero es doloroso e incómodo para el paciente. Es por eso la necesidad de buscar nuevas alternativas de tratamiento, cuidando de ser menos invasivos, como el ácido glicirricínico (AG). Objetivo: Comparar la eficacia del AG contra el NL en la HMF en pacientes entre los 5 a 13 años de edad, en el HIM. Determinar las características clínico-epidemiológicas y los efectos adversos. Material y métodos: Ensayo clínico controlado aleatorizado. Se dividió en dos grupos. Grupo A tratado con la aplicación de AG cuatro veces al día con dos disparos del atomizador por un mes. Un grupo B tratado con NL una vez al mes por tres meses. Resultados: Se estudiaron 20 pacientes en edad pediátrica, 11 masculinos y 9 femeninos; 12 con familiares afectados. La topografía más frecuente fue el labio inferior. El grupo tratado con AG tuvo una eficacia de 63% en comparación con NL que tuvo una eficacia del 81%. Sólo se observaron efectos adversos sistémicos con NL. Se obtuvo una p de 0.075 (7.5%). Conclusiones: Se comprobó la eficacia del AG, a pesar de que fue menor que con NL. Se puede utilizar como un tratamiento coadyuvante para disminuir las lesiones, con mínimos efectos adversos locales.

In pediatric population, focal multiepithelial hyperplasia (FMH) is characterized by the onset of multiple lesions in the mucosa of the mouth; it is associated to the human papillomavirus. Presently, no special treatment is preferred, the most widely used is liquid nitrogen (LN) treatment, nevertheless, this is an uncomfortable and painful treatment for the patient. This would prompt us to look for new, less invasive treatment alternatives such as use of glycyrrhizinic acid (GA). Aim: To compare GA efficiency versus LN in FMH in Mexico Children's Hospital patients (HIM) aged 5 to 13 years. To determine clinical epidemiological characteristics as well as adverse effects. Material and methods: The present was a randomized controlled clinical trial. It was divided into two groups: group A was treated with GA applications, four times a day, two atomizer shots, for one month. Group B was treated with LN once a month for three months. Results: 20 pediatric-age patients were studied, out of which 11 were male and 9 female. 12 patients had relatives afflicted with the disease. Most frequent topography was the lower lip. Efficiency of group treated with GA was 63% when compared to group treated with LN which exhibited 81% efficiency. Systemic diverse effects were only observed with use of LN. 0.075 p was obtained (7.5%). Conclusions: GA efficiency was ascertained although it was lesser than that of LN. GA can be used as an adjuvant treatment in order to decrease lesions, it elicits minimal local adverse effects.

El origen del colgajo TRAM para reconstrución mamaria posmastectomía / The origin of the TRAM flap for breast reconstruction postmastectomy

La reconstrucción mamaria contribuye a superar las consecuencias físicas y psicológicas de la mastectomía y es la última etapa del tratamiento del cáncer de mama. Su evolución ha logrado un punto alto de desarrollo y dentro de ese desenvolvimiento, el cirujano plástico Enrique Gandolfo ha tenido una participación descollante, al defi nir el empleo del abdomen inferior mediante el colgajo musculocutáneo del recto abdominal. Esa técnica fue empleada por primera vez en julio de 1980. Se hace una descripción de la evolución de la idea y de los conocimientos previos a su concreción

The mammary reconstruction to help overcome the physical and psychological consequence of mastectomy and is the last step of breast cancer treatment. Its development become to high level. The Argentine plastic surgeon Enrique Gandolfo has contributed with the defi ning the use of inferior abdomen through TRAM fl ap. This technique was fi rst used in July 1980. The authors describe the evolution of this idea

Evaluation of the odd-even effect in limits of detection for electron microprobe analysis of natural minerals.

Limit of detection (LOD), being a fundamental quality parameter for analytical techniques, has been recently investigated and a systematic behavior has been observed for most odd-even element pairs for many techniques. However, to the best of our knowledge very few LOD data are available in published literature for electron microprobe analysis; these consist of three papers, two being on rare-earth elements and the third covering a large number of elements of atomic number between 21 and 92. These data confirm the systematic behavior of LODs for many odd-even pairs. To initiate to full this gap, we determined LODs for several major rock-forming chemical elements from Na to Fe with atomic numbers between 11 and 26, during the microprobe analysis of common minerals (olivine, plagioclase, pyroxene, amphibole, quartz, and opaques) in volcanic rocks. The odd-even effect of nuclear stability seems to be present in LOD data for most odd-even pairs investigated. Nevertheless, the experimental strategy concerning the reference materials, calibration procedure, and blank measurements, should be substantially modified to better evaluate the systematic behavior of LOD values in microprobe analysis.

Lesiones orales en niños VIH+/SIDA bajo dos diferentes tipos de terapias antirretrovirales / HIV/AIDS-associated oral lesions in children treatment with two anti-retroviral schemes

Introducción. Pacientes adultos VIH+/SIDA bajo terapia antirretroviral altamente activa (TAAA) que incluya inhibidores de proteasa VIH-1, muestran disminución de infecciones oportunistas, desconociéndose si las lesiones orales de niños VIH+/SIDA bajo TAAA muestran esta asociación. Objetivo: determinar si los niños VIH+/SIDA bajo TAAA muestran disminución de lesiones orales.Material y métodos. Veintiocho niños VIH+/SIDA (Clínica de Inmunodeficiencia, Hospital Infantil de México Federico Gómez) fueron incluidos en este estudio; 16 pacientes estuvieron bajo tratamiento con AZT+3TC+ritonavir, y 12 pacientes con tratamiento DDI+D4T. Todos los pacientes fueron oralmente examinados al inicio, 6 y 12 meses de tratamiento, determinándose la prevalencia de lesiones orales. Análisis estadístico: X2, exacta de Fisher, X2 de Mantel-Haenszel para tendencias.Resultados. Grupo AZT+3TC+ritonavir: prevalencia de lesiones orales: inicial=25 por ciento; 6 meses=12.5 por ciento, 12 meses=31.2 por ciento. Grupo DDI+D4T: prevalencia inicial de lesiones orales=41.6 por ciento; 6 meses=50 por ciento: 12 meses=33.3 por ciento. X2 de Mantel-Haenszel=4.3 (P=0.037).Conclusiones. Los niños VIH+/SIDA bajo TAAA aparentemente muestran disminución de lesiones orales.

Urgencias en Estomatología / Emergencies in estomatology

Las urgencias más frecuentes en la consulta del Odontopediatria son los traumatismos dentofaciales y los problemas de dolor de origen dental, ambos y la elección del mejor tratamiento implican un reto en el manejo del paciente. En el tratamiento de los traumatismos dento-faciales el objetivo principal es la conservación de los dientes y tejidos de soporte. La literatura nos remite a la clasificación de las fracturas para identificarlas y proporcionar un buen manejo; así se tiene que existe una clasificación de las fracturas de los tejidos duros del diente, para los tejidos de soporte de los mismos y su desplazamiento. Recibiendo especial atención cada una de ellas; pero indudablemente el operador deberá basar el tratamiento en su experiencia y preparación clínica, de aquí la importancia de revisar conceptos y clasificaciones propuestas de dichas fracturas. En cuanto a los problemas de dolor de origen dental, sin lugar a dudas una de las urgencias más frecuentes en la consulta dental es el signo inequívoco de una patología pulpar crónica aguda, que a su vez representa también un reto en el manejo y tratamiento debido a la complejidad del proceso y los microorganismos involucrados

Estilo de vida: imágenes de género y proyecto de vida en adolescentes embarazadas / Life style: gender images and life projet in pregnant adolescents

El presente trabajo tiene como objetivo relacionar las imágenes de género con el proyecto de vida en las adolescentes embarazadas. Se aplicó una encuesta psicososcial a 250 mujeres de hasta 18 años de edad que consultaron por el embarazo en el Hospital Materno Infantil "Mohibe Akil de Menen" de Gran Burg, Partido de General Sarmiento, provincia de Buenos Aires. Los datos muestran que estas jóvenes pertenecen a los sectores populares urbanos, que en su mayoría cursó solo los estudios básicos. El 88 por ciento no trabaja, el 90 por ciento no estudia y el 95 por ciento no participa en instituciones, hallándose en una situación de aislamiento social. Prevalecen imágenes de género tradicionales que privilegian que la mujer se dedique a los hijos y la casa y que dependa económica, social y emocionalmente del marido. Luego los proyectos de vida se ven empobrecidos, quedando reducidos a la maternidad y el matrimonio, que se ven como algo "natural", que inexorablemente tienen que ocurrir. Se hacen necesarias intervenciones que se dirijan a modificar las imágenes de género tradicionales que se asocian con el embarazo adolescente así como políticas sociales que posibilitan proyectos de vida que hagan al desarrollo personal, que favorezcan el estudio, el trabajo, el cuidado de los hijos, la participación, la recreación, etc

Prevalencia de lesiones orales en pacientes pediátricos mexicanos con infección por el virus de la inmunodeficiencia humana / HIV associated oral lesions in a group of Mexican children

Introducción. La infección del virus de la inmunodeficiencia humana (VIH) está caracterizada por una disminución progresiva de los CD4 hasta su total depleción. A las manifestaciones orales se les ha atribuido un importante valor diagnóstico y pronóstico para la enfermedad; sin embargo, la prevalencia de lesiones orales asociadas con el síndrome de inmunodeficiencia adquirida (LOAS) en pacientes pediátricos no está bien establecida. El objetivo del presente trabajo de investigación fue determinar la prevalencia de LOAS y su correlación clínica, inmunológica y viral en pacientes pediátricos VIH/SIDA. Material y métodos. Para este propósito fueron revisados 42 pacientes pediátricos (26 del sexo femenino y 16 del masculino) de la Clínica de Inmunodeficiencia del Hospital Infantil de México Federico Gómez. Resultados. La prevalencia encontrada de lesiones orales asociadas a SIDA fue de 38.1 por ciento, de éstas, la que se presentó con mayor frecuencia fue la candidiosis en la cual se incluyó de acuerdo a su presentación clínica en: candidiosis eritematosa (19 por ciento), candidiosis pseudomembranosa (11.9 por ciento) y queilitis angular (7.1 por ciento); el crecimiento parotídeo 4.7 por ciento, la xerostomía se observó en 7.1 por ciento, gingivitis y periodontitis asociada a VIH 4.7 por ciento, herpes labial en 2.4 por ciento y depapilación lingual 2.4 por ciento. Conclusiones. No se observó relación entre las lesiones bucales con la cantidad de CD4 ni tampoco con la carga viral; sin embargo, sí se encontró relación entre la clasificación clínica y la prevalencia de lesiones bucales. Se debe estudiar más ampliamente la utilidad de LAOS como marcadores pronósticos del SIDA en pacientes pediátricos.