CIGB-258, a peptide derived from human heat-shock protein 60, decreases hyperinflammation in COVID-19 patients.

Hyperinflammation distinguishes COVID-19 patients who develop a slight disease or none, from those progressing to severe and critical conditions. CIGB-258 is a therapeutic option for the latter group of patients. This drug is an altered peptide ligand (APL) derived from the cellular stress protein 60 (HSP60). In preclinical models, this peptide developed anti-inflammatory effects and increased regulatory T cell (Treg) activity. Results from a phase I clinical trial with rheumatoid arthritis (RA) patients indicated that CIGB-258 was safe and reduced inflammation. The aim of this study was to examine specific biomarkers associated with hyperinflammation, some cytokines linked to the cytokine storm granzyme B and perforin in a cohort of COVID-19 patients treated with this peptide. All critically ill patients were under invasive mechanical ventilation and received the intravenous administration of 1 or 2 mg of CIGB-258 every 12 h. Seriously ill patients were treated with oxygen therapy receiving 1 mg of CIGB-258 every 12 h and all patients recovered from their severe condition. Biomarker levels associated with hyperinflammation, such as interleukin (IL)-6, IL-10, tumor necrosis factor (TNF-α), granzyme B, and perforin, significantly decreased during treatment. Furthermore, we studied the ability of CIGB-258 to induce Tregs in COVID-19 patients and found that Tregs were induced in all patients studied. Altogether, these results support the therapeutic potential of CIGB-258 for diseases associated with hyperinflammation. Clinical trial registry: RPCEC00000313.

The Relationship Between Verified Organ Donor Designation and Patient Demographic and Medical Characteristics.

Previous studies on the correlates of organ donation consent have focused on self-reported willingness to donate and on self-reported medical suitability to donate. However, these may be subject to social desirability bias and inaccurate assessments of medical suitability. The authors sought to overcome these limitations by directly verifying donor designation on driver's licenses and by abstracting comorbid conditions from electronic health records. Using a cross-sectional study design, they reviewed the health records of 2070 randomly selected primary care patients at a large urban safety-net medical system to obtain demographic and medical characteristics. They also examined driver's licenses that were scanned into electronic health records as part of the patient registration process for donor designation. Overall, 943 (46%) patients were designated as a donor on their driver's license. On multivariate analysis, donor designation was positively associated with age 35-54 years, female sex, nonblack race, speaking English or Spanish, being employed, having private insurance, having an income >$45 000, and having fewer comorbid conditions. These demographic and medical characteristics resulted in patient subgroups with donor designation rates ranging from 21% to 75%. In conclusion, patient characteristics are strongly related to verified donor designation. Further work should tailor organ donation efforts to specific subgroups.

Manifestaciones bucales de los pacientes sometidos a raioterapia en cabeza y cuello: pautas de atención odontológica / Oral manifestations of patients undergoing radiotherapy in head and neck: dental care guidelines

El cáncer de cabeza y cuello representa uno de los principales problemas oncológicos, tanto por su elevada mortalidad, como por las secuelas de su tratamiento. La radioterapia constituye una alternativa importante en el tratamiento de muchas de las lesiones que se presentan en esta región anatómica, ya sea que se utilice como único recurso o en combinación con otras modalidades terapéuticas; sin embargo, los efectos de la radiación no solo afectan a las células malignas, sino que ésta es también absorbida por los tejidos bucales y peribucales sanos, particularmente por aquellos con mayor capacidad de renovación celular. Presentándose lesiones bucales durante y después de la radiación, específicamente mucositis, xerostomía (suelen aparecer a los pocos días del inicio del tratamiento, con dosis superiores a 1500 cGy), disgeusia, ageusia, disfagia, infecciones, caries, gingivitis, periodontitis y osteoradionecrosis (dosis mayores a 5000 cGy). Estas lesiones disminuyen la calidad de vida de estos pacientes y en ocasiones pueden interferir en la continuidad de la radioterapia, poniendo en riesgo su vida. Por lo tanto es importante incluir a estos pacientes en protocolos de atención odontológica preventiva, donde se realice examen bucal individualizado que indique la necesidad de tratamiento y posteriores revisiones periódicas que refuercen las medidas preventivas adoptadas, siempre en conjunto con el oncólogo tratante. El objetivo de esta investigación es realizar una revisión de la literatura determinando las manifestaciones bucales más frecuentes que presentan este tipo de pacientes y de este modo establecer un protocolo de atención odontológica.

Head and neck cancer represents one of the major oncological problems, both for its high mortality, as for the sequelae of their treatment. Radiotherapy constitutes an important alternative in the treatment of many of the injuries that occur in this anatomic region, either is used as the only resource or in combination with other therapeutic modalities; However, the effects of the radiation not only affect malignant cells, but it is also absorbed by oral and perioral healthy tissues, particularly by those with greater capacity for cellular renewal. Presenting oral lesions during and after radiation, specifically mucositis, xerostomia (typically appear a few days after the start of treatment, with doses greater than 1500 cGy), dysgeusia, ageusia, dysphagia, infections, tooth decay, gingivitis, periodontitis and osteoradionecrosis (greater than 5000 cGy dose). These lesions decrease the quality of life of these patients and sometimes can interfere with the continuity of radiotherapy putting his life at risk. It is therefore important to include these patients in preventive dental care protocols, to make individualized oral exam that indicates the need for treatment and subsequent periodic reviews to strengthen preventive measures, always in conjunction with the treating oncologist. The objective of this research is to conduct a review of the literature by determining the most frequent oral manifestations that presents this kind of patient, and thereby establish a dental care protocol.

Manejo odontológico en pacientes con terapia antiagregante plaquetaria / Dental treatment in patients with anti-platelet (anti-aggregating) therapy

La terapia antiagregante plaquetaria se considera hoy en día esencial en aquellos pacientes que poseen riesgo de presentar accidentes cerebrovasculares, formación de trombos y en la colocación de prótesis valvular o stents coronarios, ésta permite la profilaxis ante cualquier evento tromboembólico que se pueda presentar; indiscutiblemente uno de sus efectos secundarios es la tendencia al sangrado, por lo tanto esto hace relevante conocer las consecuencias en la práctica odontológica habitual para evitar accidentes y prevenir hemorragias postoperatorias. El objetivo de este trabajo es presentar los fármacos más usados dentro de esta terapia, su mecanismo de acción y la elaboración de un protocolo definido para la atención adecuada de este tipo de pacientes.

Anti-platelet therapy is nowadays considered essential for those patients who are at risk to sustain strokes (cerebro-vascular events), thrombus formation, as well as in cases of coronary valvular prostheses (stents). This therapy allows prophylaxis before any possible thrombo-embolic event. Tendency to bleeding is doubtlessly one of its secondary effects. It therefore becomes relevant to be knowledgeable with consequences that might be encountered in common dental practice so as to avoid accidents and prevent post-operative bleeding (hemorrhage). The aim of the present study was to present drugs most used in this therapy, discuss their mechanism of action and to develop a defined protocol for the proper care of these patients.

Efecto del Polypodium leucotomos como adjuvante en la repigmentación inducida con UVB de banda estrecha en pacientes con vitíligo / Effects of oral Polypodium leucotomos extract as adjuvant in the treatment of vitiligo with narrow-band UVB

Uno de los tratamientos considerado altamente eficaz para el vitíligo es la fototerapia UVB de banda estrecha, pero sus efectos adversos limitan su uso. Por otro lado el Polypodium leucotomos con acciones fotoinmunoprotectora y antioxidante, disminuye la fototoxicidad de la radiación ultravioleta. El objetivo de este estudio es determinar si P. leucotomos: bloquea o aumenta el efecto terapéutico de UVB de banda estrecha. Es un ensayo clínico doble ciego que incluye pacientes con vitíligo a quienes se les indica fototerapia UVB de banda estrecha. Trece pacientes con vití-ligo ingresan al estudio. La media de edad en años fue 27 ± 12. La media del tiempo de evolución de la enfermedad fue de 8 ± 10 meses. De los 13pacientes, 8 (62%) terminan el estudio, de los cuales, 4 recibieron el Polypodium leucotomos (Grupo A) y 4 recibieron placebo (Grupo B). Los pacientes del grupo A, iniciaron con una media de despigmentación de 26 ± 13% y terminaron con 6 ± 4% de despigmentación, alcanzando una media derepigmentación de 76,93%; mientras que los pacientes del grupo B iniciaron con una media de despigmentación de 35 ± 21% y terminaron con una media de despigmentación de 16 ± 17%, con una media de repigmentación de 54,29%.Creemos que podemos emplear el Polypodium leucotomos, acompañando a cualquier terapia UV ya que sus efectos terapéuticos no se ven afectados y al contrario se agrega el beneficio de disminuir la fototoxicidad, especialmente en vitíligo porque el Polypodium leucotomos aportaría con sus acciones inmumoduladoras beneficio a la repigmentación (AU)

One of the considered highly efficient treatments against vitiligo is narrow band UV-B phototherapy, but their adverse effects limit its use. On the other hand, Polypodium leucotomos with photoimmunoprotection and antioxidant actions decrease the phototoxicity of the ultraviolet radiation. The objective of this study is to determine if P. leucotomos: blocks or increase the therapeutic effect of the UV-B narrow band. This is a double blind clinical study that involves patients with vitiligo which UV-B narrow band phototherapy has been prescribed. Thirteen patients with vitiligo were enrolled to the study. The mean of age was 27 ± 12. The mean of the number of spots was 8 ± 6. The mean of the evolution time was8 ± 10 months. From the thirteen patients, five patients (38%) dropped out the research and 8 (62%) finished it. From the 8 patients who finished the study, 4 received P. leucotomos (grup A) and 4 received placebo (grup B). The group A started with a mean of depigmentation area of 35 ± 21%, and finished with a mean of depigmentation of 16 ± 17%. The group B started with a depigmentation mean of 26 ± 13% and finished with 6 ± 4%.We believe that we could employ the P. leucotomos, combined with any ultraviolet therapy due to its therapeutic effects are not affected, and it adds the benefit to diminish the phototoxicity, specially in vitiligo because P. leucotomos would contribute with its immunomodulating actions (AU)

Implementation of a joint protocol for the management of thyroid nodules with a cytological diagnosis of follicular lesion of undetermined significance: experience in one hospital.

BACKGROUND: Follicular lesion of undetermined significance (FLUS) was introduced for fine needle aspiration (FNA) cytology in which there is insufficient evidence to classify the lesion as follicular neoplasm/suspicious of follicular neoplasm or suspicious for malignancy. The recommended management was repeat FNA and correlation with clinical and radiological data. In 2009 we started a joint clinicopathological protocol to improve management of FLUS, recommending follow-up with repeat FNA at 6months. The aim of this study was to report on the audit of results of this protocol. METHODS: We reviewed the medical records of the patients with FLUS at a single hospital. Between 2007 and 2010 we found 135 cases with this diagnosis (3.6%). We only had long enough follow-up information for the 95 patients that were included in the present study. RESULTS: FLUS was diagnosed in 74 FNAs before protocol implementation (3.2%) and 61 FNAs after (4.2%), with follow-up of 46 and 49 patients, respectively. Before 2009, 38/46 (82.6%) patients had surgical excisions, compared with 32/49 (65.3%): a significant reduction of 17% in the number requiring surgery (P=0.05). We have also shown a reduction in the median time to surgery (11.9 versus 2.9 months). Despite the joint protocol, the FNA was only repeated in two patients. The histological diagnoses were similar in the two periods of time: 31.6% and 31.3% follicular adenomas; 13.1% and 3.1% (P=0.2) papillary carcinoma (follicular variant). CONCLUSIONS: Implementation of a joint protocol reduced the number of surgical operations in patients with FLUS but in most cases FNA was not repeated as recommended. Excision was justified in one-third of operated patients. Less than 15% of lesions were malignant, which is in accordance with previous reports in the literature.

Manejo odontológico del paciente con enfermedad pulmonar obstructiva crónica y asma bronquial / Dental management of chronic obstructive pulmonary disease and patients with bronchial asthma

La enfermedad pulmonar obstructiva crónica (EPOC) abarca todas aquellas enfermedades respiratorias que cursan con obstrucción no totalmente reversible del flujo aéreo. La limitación es progresiva y está asociada a una respuesta inflamatoria. La denominación de fenotipo se utiliza para referirse a formas clínicas de los pacientes con EPOC, describiéndose: 1. No agudizador, con enfisema o bronquitis crónica, 2. Mixto EPOC-asma, 3. Agudizador con enfisema y 4. Agudizador con bronquitis crónica. La superposición de los síntomas hace difícil el diagnóstico, y para la mayoría de los pacientes, el tabaquismo es el factor etiológico más importante. La obstrucción de las vías bronquiales en el asma es esencialmente reversible, pero muchos años de exacerbaciones recurrentes puede producir una obstrucción permanente debido al remodelado de las vías respiratorias. La inflamación crónica esta asociada a un aumento en la hiperreactividad de la vía aérea que conduce a episodios recurrentes de sibilancias, disnea, opresión torácica y tos, particularmente en la noche o temprano en la mañana. Estos episodios se asocian generalmente a la obstrucción generalizada pero variable en el flujo aéreo pulmonar que es frecuentemente reversible espontáneamente o con tratamiento. El cuidado rutinario de la salud bucal puede ser proporcionado en el consultorio del odontólogo, siempre y cuando éste tenga conocimientos sólidos sobre las enfermedades pulmonares y preste especial atención tanto a la evaluación de riesgos como a las precauciones que deben ser necesarias para prevenir exacerbaciones agudas dentro de la consulta. El objetivo de este trabajo es realizar una revisión bibliográfica de la EPOC y el asma bronquial, estableciendo su etiología, características clínicas, tratamiento médico y manejo odontológico del paciente que sufre estas enfermedades

Chronic obstructive pulmonary disease (COPD) includes all those respiratory diseases that curse with not fully reversible obstruction of the airflow. The limitation is progressive and its associated with a inflammatory response. The denomination of phenotype is used to refer to clinical forms of COPD patients, describing: 1. No peaking, emphysema or chronic bronchitis, 2. Mixed COPD-asthma, 3. Peaking with emphysema and 4. Peaking with chronic bronchitis. The superposition of the symptoms makes the diagnosis difficult, and for most patients, smoking is the most important etiologic factor. The bronchial airway obstruction in asthma is essentially reversible, but many years of recurrent exacerbations can produce a permanent obstruction due to airway remodelling. Chronic inflammation is associated with increased airway hyper responsiveness that leads to recurrent episodes of wheezing, breathlessness, chest tightness and coughing, particularly at night or early in the morning. These episodes are usually associated with widespread but variable obstruction in lung airflow that is often reversible either spontaneously or with treatment. Routine care of oral health can be provided in the dentist's office, as long as it has a solid understanding of lung diseases and pay special attention to both risk assessment as to the precautions that must be necessary to prevent acute exacerbations in the consult. The objective of this paper is to make a literature review of COPD and bronchial asthma, establishing its etiology, clinical characteristics, medical treatment and dental management of the patient who is suffering these diseases

Manejo odontológico del paciente con enfermedad renal crónica terminal: revisión bibliográfica / Dental management of patients with chronic renal disease: a review

La enfermedad renal avanzada es la incapacidad de los riñones para excretar los productos de desecho del organismo, concentrar la orina y conservar los electrolitos, que trae como consecuencia manifestaciones sistémicas que provocan patologías bucales entre otras entidades. El objetivo de esta investigación es realizar una revisión bibliográfica destacando las manifestaciones bucales más importantes, el manejo y cuidados que debe tener el odontólogo al momento de atender a un paciente que presente este trastorno

Advanced renal disease is the inability of the kidneys to excrete waste products from the body, concentrate urine and conserve electrolytes, which results in systemic manifestations that cause oral pathologies among others. The objective of this research is to review literature highlighting the most important oral manifestations, management and care that should the dentist have when treating a patient with this disorder

Elective surgery in patients with congenital coagulopathies and inhibitors: experience of the National Haemophilia Centre of Venezuela.

Elective surgery in patients with congenital haemophilia with inhibitors carries a high risk of bleeding. However, inhibitor patients also have a high risk of haemarthroses and other orthopaedic complications, and surgery could improve their quality of life. Successful elective surgery has been reported in inhibitor patients under haemostatic cover with plasma-derived activated prothrombin complex concentrate (pd-aPCC) or recombinant activated factor VII (rFVIIa). Recombinant FVIIa has recently become available in Venezuela and, unlike pd-aPCC, has not been associated with an anamnestic response. The aim of this study was to assess our experience using rFVIIa as a first-line and sustained treatment in elective invasive surgical procedures at the National Haemophilia Centre in Venezuela. Surgical procedures were classified as major or minor, under haemostatic cover with rFVIIa. A total of 13 patients (12 with haemophilia A with high-responding inhibitors and one with von Willebrand's disease type 3) underwent a total of 19 surgical procedures under rFVIIa cover. Thirteen procedures were classified as major surgeries. Intraoperative haemostasis was achieved in the majority of patients. Only two patients required an additional dose of rFVIIa, at 30 min and 75 min, respectively, with good results. Postoperative haemostasis was considered effective in 16 of 18 (89%) of the procedures in haemophilia A patients. Treatment was considered to be ineffective in two patients because of excessive postoperative bleeding. Data from the study provide no safety concerns, and demonstrate that rFVIIa provides effective haemostatic cover in elective surgery in patients with inhibitors; research is ongoing to determine the optimal dose for such procedures.

Demographic, health services and socio-economic factors associated with pulmonary tuberculosis mortality in Los Altos Region of Chiapas, Mexico.

BACKGROUND: Chiapas is one of the Mexican states having the highest rates of Pulmonary Tuberculosis (PTB), due to the numerous factors impeding its management and control (poverty, poor housing and nutrition, shortage of health resources, among others). OBJECTIVES: To analyse the PTB mortality of a cohort of patients in Los Altos Region of Chiapas, who had been diagnosed with PTB from January 1, 1998 to December 31, 2002; and, to identify demographic, socioeconomic and health services utilization factors, associated with death from PTB. METHODS: Analysis of a cohort of patients aged over 14 years diagnosed with PTB in the above mentioned period (n = 431) in Los Altos region of Chiapas. The records of the Tuberculosis Programme were reviewed, and patients were located through a search attempting to locate them in their homes. Those found alive were interviewed and asked to provide sputum samples. In the case of deceased patients, a verbal autopsy was obtained from a member of their family. RESULTS: The records of the PTB Programme in the area were incomplete and erroneous in many cases. The results of the home follow-up visits were: 208 (48%) patients located alive, five of whom were still PTB positive (three with multi-drug resistance); 145 (34%) could not be located and 78 (18%) had already died. Apparently, in at least 40 cases, the deaths were associated with PTB. Of these forty, 33 (83%) died without having received any medical care. The factors associated with dying from PTB were: 45 and over years of age (OR = 1.3; 95% CI = 0.98-1.3), 0-3 schooling years (OR = 3.3; 95% CI = 1.1-9.6), engaged in agriculture (OR = 2.2; 95% CI = 1.1-4.4), not living in main villages of their municipality (OR = 1.2; 95% CI = 1.0-1.3), living in a rural community (OR = 2.7; 95% CI = 1.1-6.8), not having been treated in DOTS (OR = 1.2; 95% CI = 1.0-1.3) and having defaulted from treatment (OR = 11.5; 95% CI = 5.3-24.8). CONCLUSIONS: The high rate of mortality due to PTB observed constitutes a serious public health problem deserving attention. There is an urgent need to evaluate and restructure the Tuberculosis Programme in the studied area.

Chemical synoviorthesis with oxytetracycline clorhydrate (Emicine) in recurrent haemarthrosis.

This is a non-controlled experimental prospective clinical study that evaluates the satisfactory results in the chemical synovectomy (synoviorthesis) with oxytetracycline clorhydrate (Emicine, Lab. Pfizer Ltda, Guarulhos, Sao Paulo, Brazil) in recurrence haemarthrosis in different joints, demonstrating that it is an effective method in the treatment of these recurrent haemarthrosis in haemophilia. 84 patients of whom 77 concluded the full course of treatment. 82 joints were injected. The dosage injected was 5 cm(3) of the drug (25 mg) in 5 cm(3) of anaesthesia for the knee, 2 cm(3) with 1 cm(3) of anaesthesia for the elbow and 1 cm(3) plus 1 cm(3) of anaesthesia for the ankle. These injections were administered once weekly with a reinforcement in 1 month. In case of failure the same can be administered repeatedly. Subjective parameters included pain, range of movement and use of the joint involved. Pain decreased from a mean of 6.5 to 0.9 (Likert scale). Range of movement increased from 5.9 to 9 and joint use increased from 5.9 to 9.2. Objective parameters included joint diameter and range of movement. Range of movement for flexion and extension improved from 72.2 and 149.2 to 73.7 and 167, respectively, for the knees. From 57.3 and 160 to 66.6 and 170, respectively, for the shoulder. And, from 22.7 and 10.8 to 34 and 18.6, respectively, for the ankle. This procedure has multiple advantages such as immediate therapeutic effect, short period of treatment, easy technique, much less AHF coverage (30% above coagulation level), less costly than radiocolloid treatment, which make it a perfect alternative treatment for developing countries.

Multiple dose toxicity study of the humanized anti-epidermal growth factor receptor monoclonal antibody h-R3 intravenously administered to Cercopithecus aethiops sabaeus monkeys.

The h-R3 is a humanized growth factor receptor monoclonal antibody (mAb) in development for the treatment of head and neck tumours in which malignant cells overexpress the Epidermal Growth Factor receptor. The present study was designed to evaluate the toxicity of repeated intravenous doses of the h-R3 mAb in a relevant species demonstrated by the avidin-biotin-peroxidase immunohistochemical (IHC) technique in skin biopsy samples from three Cercopithecus aethiops sabaeus monkeys (green monkeys). Additionally, 18 green monkeys were daily intravenously treated during 14 consecutive days. Monkeys were distributed into three experimental groups with three animals of each sex in each group. Group I received saline solution and served as control group; group II received 2.85 mg/kg of h-R3 mAb; and group III received 11.4 mg/kg of the h-R3 mAb. During the study there were no deaths, neither pathological clinical signs, or variations in the corporal weight curve. The electroneurophysiological and sanguine chemistry results did not evidence alterations related to the assay substance. Areas of haematomas, haemorrhages and inflammation, probably related with the administration procedure, were observed at the administration zones of all animals; this fact could also explain the increase in the neutrophil count of all animals at the end of the study. The electrocardiography study showed that in the 14 days of the study one female monkey, from the higher dose group, shifted its cardiac axis from +60 degrees to + 120 degrees; this finding could be interpreted as a right ventricular elongation due to the relative high daily administered volume. It is concluded that doses up to 11.4 mg/kg of h-R3, intravenously administered during 14 consecutive days to Cercopithecus aethiops sabaeus monkeys do not produce considerable toxic effects in the studied system.

Variations of lignocellulosic activities in dual cultures of Pleurotus ostreatus and Trichoderma longibrachiatum on unsterilized wheat straw.

Trichoderma spp., soil filamentous fungi, are antagonists that can cause great losses in mushroom production. We have investigated the influence of T. longibrachiatum on the production of lignocellulolytic enzymes by Pleurotus ostreatus during its vegetative growth on a straw-based cultivation substrate that either had been sterilized, pasteurized or not heat treated. The variations in the lignocellulolytic activities and the electrophoretic patterns in single and dual cultures were used as a tool for perturbation assessment. The various heat treatments of the wheat straw before inoculation affected both the bacterial populations and the abilities of T. longibrachiatum and P. ostreatus to colonize the substrate and to produce extracellar lignocellulolytic enzymes. Interactions between T. longibrachiatum and the microflora of the substrate led to a great decrease of hydrolytic activities due to reduced colonization of the substrate. Pleurotus ostreatus also was affected but it was less sensitive than T. longibrachiatum. As a consequence, in dual cultures with P. ostreatus, the competitive ability of T. longibrachiatum was reduced by bacteria in the substrates. The presence of total microflora or thermotolerant microflora increased the production of phenoloxidase activities by P. ostreatus, despite reduced colonization of the substrate. This contributed to the improvement of the competitive ability of P. ostreatus in the pasteurized substrate. Furthermore, a direct effect of bacteria on T. longibrachiatum also was observed. In sterilized substrate, both laccase and Mn-peroxydase activities were increased dramatically in dual cultures due to a faster production of a laccase isoform, which was stimulated by T. longibrachiatum.

Queratoquiste odontogenico: presentación de un caso clinico / Odontogenic keratocyst: report of a clinical case

Se presenta el caso clÝnico de una paciente de sexo femenino de 16 años de edad, la cual presenta un ligero aumento de volumen en la zona posteroinferior derecha con una evolución de 2 meses aproximadamente. La misma es intervenida quirúrgicamente obteniendo como resultado la presencia de un queratoquiste odontogÚnico. Es importante establecer el diagnóstico temprano de esta lesión, por tener el mßximo Ýndice de recidivas de todos los quistes odontogÚnicos

Ameloblastoma folicular / Follicular ameloblastoma

Se presenta un caso clÝnico de paciente de sexo femenino de 56 años de edad, la cual asiste al ervicio de cirugÝa estomatológica de la Facultad de OdontologÝa de la U.C.V., por presentar aumento de volumen y asÝmetrÝa facial en región posteroinferior izquierda. A la misma se le realizó biopsia incisional, con el resultado de ameloblastoma folicular

Clusters of drug involvement in Panama: results from Panama's 1996 National Youth Survey.

This report is based on the first epidemiological investigation of clustering of tobacco, alcohol, inhalant, and other drug involvement within individual schools using data from Panama's 1996 National Youth Survey on Alcohol and Drug Use. Clustering was estimated with the Alternating Logistic Regression method. Adjusted estimates of pair-wise cross-product ratios (PWCPR), a measure of clustering, show modest clustering (i.e. PWCPR>1.0) at the school level for tobacco smoking (PWCPR=1.41; 95% confidence interval, CI=1.22-1.64), alcohol consumption (PWCPR=1.33; 95% CI=1.22-1.45), use of inhalants, (PWCPR=1.35; 95% CI=1.07-1.69), and other drug use (PWCPR=1.38; 95% CI=1.14-1.68). These findings provide preliminary evidence that the odds of drug use among school-attending youths increase when another youth in the same school uses drugs, and suggest a new line of research on within-school diffusion that should include the identification of school-level factors that contribute to student drug use.

Labio y paladar hendidos / Cleft lip and palate

La hendidura palatina es una malformación de mucha importancia para el niño, por lo cual, hay que presentarle atención rápida para propiciar al paciente una alimentación más fácil, fonación correcta y en forma sostenida el desarrollo de la oclusión. Se presenta un caso donde se evidencia que la intervención a temprana edad del paladar duro deja como secuela el hipodesarrollo del maxilar superior. Esto complica el tratamiento para devolverle al paciente una anatomía correcta y funciones normales

First opportunities to try drugs and the transition to first drug use: evidence from a national school survey in Panama.

In recent evidence from the United States, there generally are no male-female differences in the probability of drug use among persons who report an opportunity to try the drugs. This is an important observation that might help us understand male-female differences in later drug use and dependence, but the observation needs to be replicated elsewhere. We begin this replication process using data from a 1996 national school survey of drug involvement among 6,477 students age 12-18 in Panama. We first examine the occurrence of an opportunity to use drugs by grade. We then follow these analyses with an examination of male-female differences in drug opportunity patterns. We found opportunities to use drugs and actual drug use to be greater at higher grade levels. Also, we found the probability of making a transition to use, given an opportunity, to be more likely among upper-grade students. Consistent with results observed in the United States, we found males in Panama to be more likely to have an opportunity to use marijuana, crack-cocaine, and other forms of cocaine, but not more likely than females to make a transition into drug use once an opportunity had occurred to try each drug. These findings are discussed in relation to the epidemiology and prevention of drug use in Panama and elsewhere, and future research on male-female differences in drug involvement.

Estimated occurrence of tobacco, alcohol, and other drug use among 12- to 18-year-old students in Panama: results of Panama's 1996 National Youth Survey on Alcohol and Drug Use.

This report provides the first epidemiological evidence on tobacco, alcohol, and other drug use among school students in Panama, using data from a student survey completed in 1996. Specifically, we examine sex, age, grade level, type of school, and urban-rural variations in the occurrence of tobacco, alcohol, and other drug use. Estimates of lifetime prevalence and past-year use of these products were obtained using data from Panama's 1996 National Youth Survey on Alcohol and Drug Use (n = 6,477). To account for the multistage sampling design of the survey, all estimates and respective standard errors are derived by the Taylor series approximation method using Epi Info 6.0 CSAMPLE software. In general, more males, more older students, and more students in higher grades have used licit and illicit drugs, even though male-female differences tend to be small. Public-private school differences and urban-rural trends vary depending on the drug. The findings of this study are discussed in relation to the epidemiology and prevention of drug use in Panama. Based on these data, we seek to provide information to be used by the Government of Panama in its planning for prevention programs directed toward students in Panamanian schools.