Chitosan-based endodontic irrigation solutions and TGF-ß1 treatment: Creating the most favourable environment for the survival and proliferation of stem cells of the apical papilla in vitro.

BACKGROUND: The dental pulp's environment is essential for the regulation of mesenchymal stem cells' homeostasis and thus, it is of great importance to evaluate the materials used in regenerative procedures. AIM: To assess in vitro (i) the effect of chitosan nanoparticles, 0.2% chitosan irrigation solution, Dual Rinse®, 17% EDTA, 10% citric acid and 2.5% NaOCl on DSCS viability; (ii) the effect of different concentrations of TGF-ß1 on DCSC proliferation; and (iii) whether treatment with TGF-ß1 following exposure to the different irrigation solutions could compensate for their negative effects. METHODOLOGY: (i) DSCS were treated with three dilutions (1:10, 1:100 and 1:1000) of the six irrigation solutions prepared in DMEM for 10 and 60 min to assess the effect on viability. (ii) The effect of different concentrations (0, 1, 5 and 10 ng/mL) of TGF-ß1 on DCSC proliferation was assessed at 1, 3 and 7 days. (iii) The proliferative effect of TGF-ß1 following 10-min exposure to 1:10 dilution of each irrigation solution was also tested. We used MTT assay to assess viability and proliferation. We performed statistical analysis using Prism software. RESULTS: (i) The different endodontic irrigation solutions tested showed a significant effect on cell viability (p ≤ .0001). Significant interactions between the endodontic irrigation solutions and their dilutions were also found for all parameters (p ≤ .0001). Chitosan nanoparticles and 0.2% chitosan irrigation solution were the least cytotoxic to DSCS whilst 2.5% NaOCl was the most cytotoxic followed by 17% EDTA. (ii) TGF-ß1 at concentrations of 1 and 5 ng/mL resulted in significantly higher proliferation compared to the control group. (iii) Exposure to 17% EDTA or 2.5% NaOCl for 10 min was sufficient to make DSCS cells refractory to the proliferative effects of TGF-ß1. DSCS groups treated with TGF-ß1 following exposure to chitosan nanoparticles, 0.2% chitosan irrigation solution, Dual Rinse® and 10% CA demonstrated significantly higher proliferation compared to non-TGF-ß1-treated groups (p ≤ .0001, p ≤ .0001, p ≤ .0001 and p = .01 respectively). CONCLUSIONS: The current study offers data that can be implemented to improve the outcome of regenerative endodontic procedures by using less toxic irrigation solutions and adding TGF-ß1 to the treatment protocol.

Update on chelating agents in endodontic treatment: A systematic review.

Background: The aim of this review was to assess the evidence regarding the most commonly used chelating agents in terms of efficacy, erosive potential, cytotoxicity, interaction, antimicrobial effect, impact on sealers adhesion, and release of growth factors. Material and Methods: MEDLINE (PubMed) database, Cochrane Library and Scopus were searched up to January 14, 2023, including studies with one or more of the following chelating agents: 17% EDTA, 9% and 18% HEDP, 10% and 20% citric acid, 2%-2.25% peracetic acid and 7% maleic acid. In addition, the reference lists of all selected articles were also checked to identify additional relevant studies. Articles published in English and available in full-text were selected. The quality of studies was assessed using the modified CONSORT checklist guide and the Cochrane Collaboration tool. Results: The electronic search yielded 538 citations, 56 of which were included. The articles included had moderate and low evidence values. Among 56 articles included, 55 were in vitro studies and one was a randomized clinical trial. Among the in vitro studies, 15 evaluated efficacy and dentin erosion, 12 evaluated interaction with other endodontic irrigants, 9 tested antimicrobial effect, 4 evaluated cytotoxicity in hamster and rat lung cells, 9 evaluated intervention in adhesion of filling materials and 8 focused on release of growth factors and on behavior of stem cells in regenerative endodontic. The RCT tested antimicrobial effect. Conclusions: 17% EDTA is the most effective in smear layer removal and in releasing growth factors on regenerative endodontics. However, the current incorporation of 9% and 18% etidronic acid has shown optimal results due to its compatibility with sodium hypochlorite and its capability on avoiding smear layer formation through a continuous chelation action. Despite these preliminary findings, methodological standardization between studies is required and in vivo studies are necessary to confirm in vitro studies. Key words:Chelating Agents, Smear Layer, Systematic Review, Endodontics, Root Canal Irrigants.

Engineering a Microphysiological Model for Regenerative Endodontic Studies.

Dental pulp infections are common buccal diseases. When this happens, endodontic treatments are needed to disinfect and prepare the root canal for subsequent procedures. However, the lack of suitable in vitro models representing the anatomy of an immature root canal hinders research on regenerative events crucial in endodontics, such as regenerative procedures. This study aimed to develop a 3D microphysiological system (MPS) to mimic an immature root canal and assess the cytotoxicity of various irrigating solutions on stem cells. Utilizing the Dental Stem Cells SV40 (DSCS) cell line derived from human apical papilla stem cells, we analyzed the effects of different irrigants, including etidronic acid. The results indicated that irrigating solutions diminished cell viability in 2D cultures and influenced cell adhesion within the microphysiological device. Notably, in our 3D studies in the MPS, 17% EDTA and 9% 1-hydroxyethylidene-1, 1-bisphosphonate (HEBP) irrigating solutions demonstrated superior outcomes in terms of DSCS viability and adherence compared to the control. This study highlights the utility of the developed MPS for translational studies in root canal treatments and suggests comparable efficacy between 9% HEBP and 17% EDTA irrigating solutions, offering potential alternatives for clinical applications.

Dental Stem Cells SV40, a new cell line developed in vitro from human stem cells of the apical papilla.

AIM: To establish and fully characterize a new cell line from human stem cells of the apical papilla (SCAPs) through immortalization with an SV40 large T antigen. METHODOLOGY: Human SCAPs were isolated and transfected with an SV40 large T antigen and treated with puromycin to select the infected population. Expression of human mesenchymal surface markers CD73, CD90 and CD105 was assessed in the new cell line named Dental Stem Cells SV40 (DSCS) by flow cytometry at early and late passages. Cell contact inhibition and proliferation were also analysed. To evaluate trilineage differentiation, quantitative polymerase chain reaction and histological staining were performed. RESULTS: DSCS cell flow cytometry confirmed the expression of mesenchymal surface markers even in late passages [100% positive for CD73 and CD90 and 98.9% for CD105 at passage (P) 25]. Fewer than 0.5% were positive for haematopoietic cell markers (CD45 and CD34). DSCS cells also showed increased proliferation when compared to the primary culture after 48 h, with a doubling time of 23.46 h for DSCS cells and 40.31 h for SCAPs, and retained the capacity to grow for >45 passages (150 population doubling) and their spindle-shaped morphology. Trilineage differentiation potential was confirmed through histochemical staining and gene expression of the chondrogenic markers SOX9 and COL2A1, adipogenic markers CEBPA and LPL, and osteogenic markers COL1A1 and ALPL. CONCLUSIONS: The new cell line derived from human SCAPs has multipotency, retains its morphology and expression of mesenchymal surface markers and shows higher proliferative capacity even at late passages (P45). DSCS cells can be used for in vitro study of root development and to achieve a better understanding of the regenerative mechanisms.

Ultra-narrow optical linewidths in rare-earth molecular crystals.

Rare-earth ions (REIs) are promising solid-state systems for building light-matter interfaces at the quantum level1,2. This relies on their potential to show narrow optical and spin homogeneous linewidths, or, equivalently, long-lived quantum states. This enables the use of REIs for photonic quantum technologies such as memories for light, optical-microwave transduction and computing3-5. However, so far, few crystalline materials have shown an environment quiet enough to fully exploit REI properties. This hinders further progress, in particular towards REI-containing integrated nanophotonics devices6,7. Molecular systems can provide such capability but generally lack spin states. If, however, molecular systems do have spin states, they show broad optical lines that severely limit optical-to-spin coherent interfacing8-10. Here we report on europium molecular crystals that exhibit linewidths in the tens of kilohertz range, orders of magnitude narrower than those of other molecular systems. We harness this property to demonstrate efficient optical spin initialization, coherent storage of light using an atomic frequency comb, and optical control of ion-ion interactions towards implementation of quantum gates. These results illustrate the utility of rare-earth molecular crystals as a new platform for photonic quantum technologies that combines highly coherent emitters with the unmatched versatility in composition, structure and integration capability of molecular materials.

Characteristics and mortality of Mexican patients with COVID-19 and mechanical ventilation.

INTRODUCTION: COVID-19-associated mortality in patients who require mechanical ventilation is unknown in the Mexican population. OBJECTIVE: To describe the characteristics of Mexican patients with COVID-19 who required mechanical ventilation. METHODS: Observational cohort study carried out in an intensive care unit from March 25 to July 17, 2020. Data were obtained from a prospective database and electronic medical records, and were analyzed with the chi-square test, Fisher's exact test or Mann-Whitney's U-test. RESULTS: One hundred patients required mechanical ventilation; median age was 56 years, 31 % were females and 97 % were Latin American. Most common comorbidities were obesity (36 %), diabetes (26 %), hypertension (20 %), and chronic or end-stage kidney disease (10 %). At the end of the analysis, 11 patients remained in the ICU, 31 had been discharged alive and 58 (65.2 %) died; survivors were younger, had lower scores on severity and organ dysfunction scales, lower levels of C-reactive protein at ICU admission, were less likely to receive hemodialysis and vasopressors, and had longer hospital and ICU stays. CONCLUSIONS: This study adds information on the presentation and results of SARS-CoV-2-infected patients who require mechanical ventilation.

INTRODUCCIÓN: La mortalidad por COVID-19 en quienes requieren ventilación mecánica se desconoce en la población mexicana. OBJETIVO: Describir las características de pacientes mexicanos con COVID-19 que requirieron ventilación mecánica. MÉTODOS: Estudio de cohorte observacional en una unidad de terapia intensiva, del 25 de marzo al 17 de julio de 2020. Los datos se obtuvieron de una base de datos prospectiva y de registros clínicos electrónicos; fueron analizados con c2, prueba exacta de Fisher o prueba U de Mann-Whitney. RESULTADOS: Cien pacientes recibieron ventilación mecánica, la edad media fue de 56 años, 31 % era del sexo femenino y 97 %, latinoamericano. Las comorbilidades más comunes fueron obesidad (36 %), diabetes (26 %), hipertensión (20 %) y enfermedad renal crónica o renal terminal (10 %). Al término del análisis, 11 pacientes permanecían en la UCI, 31 egresaron vivos y 58 (65.2 %) fallecieron; los sobrevivientes fueron más jóvenes, con menores puntuación en las escalas de gravedad y disfunción orgánica, menores niveles de proteína C reactiva al ingreso a la UCI, menor propensión a hemodiálisis, necesidad de, necesidad de vasopresores y con mayor estancia hospitalaria y en la UCI. CONCLUSIONES: Este estudio agrega información sobre la presentación y resultados de pacientes con ventilación mecánica infectados con SARS-CoV-2.

Dynamic control of Purcell enhanced emission of erbium ions in nanoparticles.

The interaction of single quantum emitters with an optical cavity enables the realization of efficient spin-photon interfaces, an essential resource for quantum networks. The dynamical control of the spontaneous emission rate of quantum emitters in cavities has important implications in quantum technologies, e.g., for shaping the emitted photons' waveform or for driving coherently the optical transition while preventing photon emission. Here we demonstrate the dynamical control of the Purcell enhanced emission of a small ensemble of erbium ions doped into a nanoparticle. By embedding the nanoparticles into a fully tunable high finesse fiber based optical microcavity, we demonstrate a median Purcell factor of 15 for the ensemble of ions. We also show that we can dynamically control the Purcell enhanced emission by tuning the cavity on and out of resonance, by controlling its length with sub-nanometer precision on a time scale more than two orders of magnitude faster than the natural lifetime of the erbium ions. This capability opens prospects for the realization of efficient nanoscale quantum interfaces between solid-state spins and single telecom photons with controllable waveform, for non-destructive detection of photonic qubits, and for the realization of quantum gates between rare-earth ion qubits coupled to an optical cavity.

Optical spin-state polarization in a binuclear europium complex towards molecule-based coherent light-spin interfaces.

The success of the emerging field of solid-state optical quantum information processing (QIP) critically depends on the access to resonant optical materials. Rare-earth ion (REI)-based molecular systems, whose quantum properties could be tuned taking advantage of molecular engineering strategies, are one of the systems actively pursued for the implementation of QIP schemes. Herein, we demonstrate the efficient polarization of ground-state nuclear spins-a fundamental requirement for all-optical spin initialization and addressing-in a binuclear Eu(III) complex, featuring inhomogeneously broadened 5D0 → 7F0 optical transition. At 1.4 K, long-lived spectral holes have been burnt in the transition: homogeneous linewidth (Γh) = 22 ± 1 MHz, which translates as optical coherence lifetime (T2opt) = 14.5 ± 0.7 ns, and ground-state spin population lifetime (T1spin) = 1.6 ± 0.4 s have been obtained. The results presented in this study could be a progressive step towards the realization of molecule-based coherent light-spin QIP interfaces.

Características y mortalidad en pacientes mexicanos con COVID-19 y ventilación mecánica / Characteristics and mortality of Mexican patients with COVID-19 and mechanical ventilation

Resumen Introducción: La mortalidad por COVID-19 en quienes requieren ventilación mecánica se desconoce en la población mexicana. Objetivo: Describir las características de pacientes mexicanos con COVID-19 que requirieron ventilación mecánica. Métodos: Estudio de cohorte observacional en una unidad de terapia intensiva, del 25 de marzo al 17 de julio de 2020. Los datos se obtuvieron de una base de datos prospectiva y de registros clínicos electrónicos; fueron analizados con c2, prueba exacta de Fisher o prueba U de Mann-Whitney. Resultados: Cien pacientes recibieron ventilación mecánica, la edad media fue de 56 años, 31 % era del sexo femenino y 97 %, latinoamericano. Las comorbilidades más comunes fueron obesidad (36 %), diabetes (26 %), hipertensión (20 %) y enfermedad renal crónica o renal terminal (10 %). Al término del análisis, 11 pacientes permanecían en la UCI, 31 egresaron vivos y 58 (65.2 %) fallecieron; los sobrevivientes fueron más jóvenes, con menor puntuación en las escalas de gravedad y disfunción orgánica, menores niveles de proteína C reactiva al ingreso a la UCI, menor propensión a hemodiálisis y necesidad de vasopresores y con mayor estancia hospitalaria y en la UCI. Conclusiones: Este estudio agrega información sobre la presentación y resultados de pacientes con ventilación mecánica infectados con SARS-CoV-2.

Abstract Introduction: COVID-19 associated mortality in patients who require mechanical ventilation is unknown in the Mexican population. Objective: To describe the characteristics of Mexican patients with COVID-19 who required mechanical ventilation. Methods: Observational cohort study carried out in an intensive care unit from March 25 to July 17, 2020. Data were obtained from a prospective database and electronic medical records, and were analyzed with the chi-square test, Fisher’s exact test or Mann-Whitney’s U-test. Results: One hundred patients required mechanical ventilation; median age was 56 years, 31 % were females and 97 % were Latin American. Most common comorbidities were obesity (36 %), diabetes (26 %), hypertension (20 %), and chronic or end-stage kidney disease (10 %). At the end of the analysis, 11 patients remained in the ICU, 31 had been discharged alive and 58 (65.2 %) died; survivors were younger, had lower scores on severity and organ dysfunction scales, lower levels of C-reactive protein at ICU admission, were less likely to receive hemodialysis and vasopressors, and had longer hospital and ICU stays. Conclusions: This study adds information on the presentation and results of SARS-CoV-2-infected patients who require mechanical ventilation.

A Frequency-Multiplexed Coherent Electro-optic Memory in Rare Earth Doped Nanoparticles.

Quantum memories for light are essential components in quantum technologies like long-distance quantum communication and distributed quantum computing. Recent studies have shown that long optical and spin coherence lifetimes can be observed in rare earth doped nanoparticles, opening exciting possibilities over bulk materials, e.g., for enhancing coupling to light and other quantum systems, and material design. Here, we report on coherent light storage in Eu3+:Y2O3 nanoparticles using the Stark echo modulation memory (SEMM) quantum protocol. We first measure a nearly constant Stark coefficient of 50 kHz/(V/cm) across a bandwidth of 15 GHz, which is promising for broadband operation. Storage of light is then demonstrated with an effective coherence lifetime of 5 µs. Pulses with two different frequencies are also stored, confirming frequency-multiplexing capability, and are used to demonstrate the memory high phase fidelity. These results open the way to nanoscale optical quantum memories with increased efficiency, bandwidth, and processing capabilities.

Defect Engineering for Quantum Grade Rare-Earth Nanocrystals.

Nanostructured systems that combine optical and spin transitions offer new functionalities for quantum technologies by providing efficient quantum light-matter interfaces. Rare-earth (RE) ion-doped nanoparticles are promising in this field as they show long-lived optical and spin quantum states. However, further development of their use in highly demanding applications, such as scalable single-ion-based quantum processors, requires controlling defects that currently limit coherence lifetimes. In this work, we show that a post-treatment process that includes multistep high-temperature annealing followed by high-power microwave oxygen plasma processing advantageously improves key properties for quantum technologies. We obtain single crystalline Eu3+:Y2O3 nanoparticles (NPs) of 100 nm diameter, presenting bulk-like inhomogeneous line widths (Γinh) and population lifetimes (T1). Furthermore, a significant coherence lifetime (T2) extension, up to a factor of 5, is successfully achieved by modifying the oxygen-related point defects in the NPs by the oxygen plasma treatment. These promising results confirm the potential of engineered RE NPs to integrate devices such as cavity-based single-photon sources, quantum memories, and processors. In addition, our strategy could be applied to a large variety of oxides to obtain outstanding crystalline quality NPs for a broad range of applications.

Structure Analysis of Amyloid Aggregates at Lipid Bilayers by Supercritical Angle Raman Microscopy.

The amyloid-ß peptide is correlated with Alzheimer's disease and is assumed to cause toxicity by its interaction with the neuron membrane. A custom-made microscope objective based on the supercritical angle technique was developed by our group, which allows investigation of interfacial events by performing surface-sensitive and low-invasive spectroscopy. Applied to Raman spectroscopy, this technique was used to collect information about the structure of polypeptides that interact with a supported lipid bilayer. Notably, the conformation used by amyloid-ß(1-40) and amyloid-ß(1-42) when interacting directly with or next to the supported lipid bilayer was characterized. We observed two distinct secondary structures, α-helix and ß-sheet, which were exhibited by the peptide. These two structures were detected simultaneously. The propensity of the peptide to fold into these structures seemed dependent on both their number of amino acids and their proximity with the supported lipid bilayer. The α-helix structure was observed for amyloid-ß(1-42) fragments that were closer to the lipid bilayer. Peptides that were located further away from the bilayer favored the ß-sheet structure. Amyloid-ß(1-40) was less prone to adopt the α-helix secondary structure.

Amyloid-ß Peptide-Lipid Bilayer Interaction Investigated by Supercritical Angle Fluorescence.

The understanding of the interaction between the membrane of neurons and amyloid-ß peptides is of crucial importance to shed light on the mechanism of toxicity in Alzheimer's disease. This paper describes how supercritical angle fluorescence spectroscopy was applied to monitor in real-time the interaction between a supported lipid bilayer (SLB) and the peptide. Different forms of amyloid-ß (40 and 42 amino acids composition) were tested, and the interfacial fluorescence was measured to get information about the lipid integrity and mobility. The results show a concentration-dependent damaging process of the lipid bilayer. Prolonged interaction with the peptide up to 48 h lead to an extraction and clustering of lipid molecules from the surface and a potential disruption of the bilayer, correlated with the formation of peptide aggregates. The natural diffusion of the lipid was slightly hindered by the interaction with amyloid-ß(1-42) and closely related to the oligomerization of the peptide. The adsorption and desorption of Amyloid-ß was also characterized in terms of affinity. Amyloid-ß(1-42) exhibited a slightly higher affinity than amyloid-ß(1-40). The former was also more prone to aggregate and to adsorb on the bilayer as oligomer.

Diagnóstico de leucemia mieloide aguda en gestante / Diagnosis of acute myeloid leukemia in pregnant

Objetivo: manifestar la importancia del control analítico durante el embarazo y hacer un buen diagnóstico diferencial ante una anemia, ya que nos lleva a diagnósticos como el de Leucemia. También muestra la importancia de un diagnóstico temprano y manejo multidisciplinar para obtener el mejor pronóstico y fetal. Descripción del caso: paciente de 38 años, gestante de 33 semanas, en seguimiento por anemia macrocítica y trombopenia en analítica del primer trimestre. Tras estudios, se diagnostica de Leucemia Mieloide Aguda, como síntomas, astenia y gingivorragia leve. Se decide administrar ciclo de maduración pulmonar fetal y finalizar gestación para iniciar cuanto antes el tratamiento. Conclusiones: es muy importante el control analítico durante el embarazo y hacer un buen diagnóstico de la anemia para poder hacer un diagnóstico precoz de problemas como la Leucemia, en los que es crucial el tiempo y poder hacer el mejor manejo multifactorial dependiendo de la edad gestacional

Objective: To demonstrate the importance of analytical control during pregnancy and make a good differential diagnosis in the face of anemia, as it leads to diagnoses such as Leukemia. It also shows the importance of an early diagnosis and multidisciplinary management to obtain the best prognosis and fetal. Case description: 38-year-old patient, pregnant woman of 33 weeks, followed by macrocytic anemia and thrombocytopenia in the first trimester. After studies, Acute Myeloid Leukemia is diagnosed as symptoms, asthenia and mild gingivorrhagia. It was decided to administer a fetal lung maturation cycle and finish gestation to start the treatment as soon as possible. Conclusions: It is very important the analytical control during pregnancy and make a good diagnosis of anemia to be able to make an early diagnosis of problems such as Leukemia, in which time is crucial and can make the best multifactorial management depending on gestational age

Parto a través de rotura uterina posterior en una paciente con pesario de Arabin / Vaginal birth through posterior uterine breaking in Arabin pessary carrier patient

Resumen ANTECEDENTES: El parto pretérmino es una causa importante de morbilidad y mortalidad materno-fetal. El pesario cervical es un método eficaz para prevenir el parto pretérmino en pacientes con cuello uterino corto. CASO CLÍNICO: Paciente de 38 años, de 34.3 semanas de embarazo, que acudió a consulta por hidrorrea y dolor abdominal. Entre sus antecedentes ginecoobstétricos refirió la colocación de un pesario de Arabin a partir de la semana 20 del embarazo, por diagnóstico de cuello uterino corto (14 mm). La exploración médica reveló: cuello uterino cerrado y formado, con desgarro de 2 cm en la cara posterior uterina, indicándose cesárea de urgencia. Cinco minutos después tuvo aumento importante de dolor abdominal, objetivándose la cabeza fetal en IV plano de Hodge, por lo que se decidió la asistencia mediante parto en el área quirúrgica. Nació un varón de 2045 g, con Apgar 9/10, que ingresó al área de neonatología. Posteriormente se comprobó el desgarro ístmico-cervical, de aproximadamente 7 cm, con prolongación ascendente medial de 4 cm, que se suturó sin contratiempos. El puerperio inmediato y tardío transcurrieron con normalidad. Un año después del parto la paciente se encuentra en excelente estado de salud. CONCLUSIÓN: La rotura uterina en pacientes con pesario es una complicación extremadamente rara. Hasta la fecha no existe un esquema de tratamiento óptimo. Se prefiere una conducta conservadora, sobre todo si existe deseo reproductivo, e individualizar cada caso.

Abstract BACKGROUND: Preterm delivery is an important cause of maternal-fetal morbimortality. The cervical pessary is an effective method to prevent preterm birth in patients with short cervix. CLINICAL CASE: A 38-year-old patient, 34.3 weeks pregnant, attended the clinic due to hidrhorea and abdominal pain. Among his gynecological and obstetric history he referred to the placement of Arabin pessary from week 20 of pregnancy, by diagnosis of short cervix (14 mm). The medical examination revealed: Cervix closed and formed, with a 2 cm tear in the posterior uterine side, indicating an emergency caesarean section. Five minutes later, there was a significant increase in abdominal pain, with the fetal head being seen in the IV plane of Hodge. Therefore, it was decided to assist with delivery in the surgical area. A newborn male, 2045 g, was obtained with Apgar 9 / 10, who entered the neonatology area. Subsequently, the isthmic-cervical tear, of approximately 7 cm, with a medial ascending extension of 4 cm, which was sutured without incident, was confirmed. The immediate and delayed puerperium proceeded normally. One year after the obstetric event, the patient is in excellent health. CONCLUSIONS: Uterine rupture associated to pessary is an extremely rare complication. To date there is no optimal treatment scheme. A conservative behavior is preferred, especially if there is a reproductive desire, and each case is individualized.

Tumor neuroectodérmico recidivante. A propósito de un caso y revisión bibliográfica / Recurrent neuroectodermal tumor. A case report and literatura review

Resumen ANTECEDENTES: La relación entre cáncer y embarazo supone 0.07% de las complicaciones gestacionales. Cuando estas situaciones coinciden el tratamiento del tumor se dificulta. El tumor neuroectodérmico primitivo es una neoplasia relacionada con el sarcoma de Ewing y su incidencia es excepcional durante el embarazo. CASO CLÍNICO: Paciente de 34 años, con 36.3 semanas de embarazo, que ingresó a la unidad hospitalaria por dolor abdominal irradiado al miembro inferior derecho. A la exploración física se palpó una tumoración de gran dimensión en la fosa iliaca derecha. La ecografía abdominal objetivó una imagen compatible con un mioma. La resonancia magnética reportó una masa de 16 x 13 x 17 cm, retroperitoneal, paravertebral, coincidente con tumor neuroectodérmico, sarcoma y tumor neurogénico. La paciente tuvo parto eutócico, sin administración de analgesia epidural, del que nació una niña de 2950 g, con Apgar 8-9. Se efectuó una biopsia por aspiración con aguja gruesa, que reportó un tumor neuroectodérmico primitivo. El tratamiento consistió en quimioterapia con protocolo VAC (vincristina, dactinomicina y ciclofosfamida [14 ciclos]) y adriamicina (6 a 8 ciclos de inducción). Actualmente padece dolor neuropático en la pierna derecha y permanece en rehabilitación, con tratamiento médico. CONCLUSIONES: Los tumores neuroectodérmicos primitivos son neoplasias excepcionales durante el embarazo. Se requieren estudios complementarios para conocer la relación exacta entre este tipo de tumores y el embarazo, y de esta forma establecer el protocolo de tratamiento adecuado.

Abstract BACKGROUND: The relationship between cancer and pregnancy accounts for 0.07% of gestational complications. This aspect makes treatment difficult and has a negative impact on pregnant patients. The primitive neuroectodermal tumor is a neoplasm related to Ewing's sarcoma and its incidence is exceptional during pregnancy. CLINICAL CASE: A 34-year-old patient, 36.3 weeks pregnant, who was admitted to the hospital unit due to abdominal pain radiating to the right lower limb. Physical examination revealed a large tumor in the right iliac fossa. The abdominal ultrasound showed an image compatible with a myoma. Magnetic resonance imaging revealed a mass of 16 x 13 x 17 cm, retroperitoneal, paravertebral, coinciding with neuroectodermal tumor, sarcoma and neurogenic tumor. The patient had eutocic delivery, without administration of epidural analgesia, from which a girl of 2950 g was born, and Apgar 8/9. An aspiration biopsy was performed with a thick needle, which reported a primitive neuroectodermal tumor. The treatment consisted of chemotherapy with VAC protocol (vincristine, dactinomycin and cyclophosphamide [14 cycles]) and adriamycin (6 to 8 induction cycles). He currently suffers from neuropathic pain in the right leg and remains in rehabilitation, with medical treatment. CONCLUSIONS: Primitive neuroectodermal tumors are exceptional neoplasms during pregnancy. Complementary studies are required to know the exact relationship between this type of tumors and pregnancy, and in this way establish the appropriate treatment strategy.

Manejo quirúrgico-endodóncico de una reabsorción cervical invasiva clase III empleando composite / Endo-surgical management of a class III invasive cervical resorption using composite

La reabsorción cervical invasiva (RCI) es un tipo de reabsorción radicular insidiosa y agresiva que se origina en la superficie radicular externa. Típicamente, suele pasar inadvertida puesto que en la mayoría de los casos es asintomática. El uso de la tomografía computarizada con haz cónico (CBCT) mejora el diagnóstico y la planificación y la utilización dental mejora la realización del tratamiento. El objetivo principal de un tratamiento óptimo de ICR es la eliminación e inactivación del proceso de reabsorción y la reconstrucción del defecto. Entre los materiales empleados en la literatura para el sellado del defecto, el composite parece ser una opción válida. En el presente caso clínico se describe el tratamiento combinado quirúrgico-endodóncico de una reabsorción cervical invasiva clase III de Heithersay sellada con composite. Después de un año de seguimiento, el paciente se mostraba asintomático y la rarefacción ósea peri radicular ha disminuido significativamente no existiendo recidiva de la reabsorción

Invasive cervical resorption (ICR) is an aggressive type of radicular resorption that originates in the external radicular surface. It can typically go unnoticed since it is often asymptomatic. The use of cone beam computed tomography (CBCT) increases in a greater diagnostic and planning and a dental microscope increases the proper execution of the treatment. The main objective of an optimal treatment of ICR is the elimination and inactivation of the resorptive process, and the reconstruction of the defect. Among the dental material used in the literature for sealing the defect, composite seems to be a valid option. The present case-report describes a combined surgical and endodontic treatment of a Heithersay class III invasive cervical resorption sealed with dental composite. A one-year follow-up shows the patient to be asymptomatic, and the bone rarefaction to have decreased significantly, with no evidence of a resorption recurrence

Influence of age on tolerability, safety and effectiveness of subdermal contraceptive implants.

The use of long-acting contraceptive methods is on the rise. The aim of this study was to describe the main variables (effectiveness, tolerability, menstrual bleeding) associated with the use of subdermal contraceptive implants and to investigate the influence of age on these variables. This was a descriptive, retrospective, observational study of 221 cases of contraceptive implants inserted at a Spanish hospital between 2006 and 2015. The mean age of implant users was 31.2 ± 7.5 years. Effectiveness was 100% and good tolerability was recorded for 86.5%. Infrequent bleeding was the most common bleeding pattern, followed by amenorrhoea. Of the 221 implants inserted, 47.5% were removed. The main reasons were expiration (54.3%) and discomfort due to bleeding alterations and other adverse effects (25.7%). Nulliparity and weight gain were significantly associated with an increased probability of implant removal. This study shows that implants were highly effective, safe and well-tolerated in our population. The age of users had no influence on any of the study variables analysed. Impact Statement What is already known on this subject? Subdermal contraceptive implants are long-acting reversible contraceptives which are both safe and effective. What do the results of this study add? The age of users had no influence on any of the study variables analysed. Nulliparity and weight gain were significantly associated with an increased probability of implant removal. What are the implications of these findings for clinical practice and/or further research? Subdermal contraceptive implants were a safe and effective long-acting progestin contraceptive method for women from all age groups in our series because no significant age-related differences were observed for the tolerability, vaginal bleeding patterns, the effectiveness, the adverse effects or any other variables.

Controlled size reduction of rare earth doped nanoparticles for optical quantum technologies.

Rare earth doped nanoparticles with sub-wavelength size can be coupled to optical micro- or nano-cavities to enable efficient single ion readout and control, a key requirement for quantum processors and high-fidelity single-ion quantum memories. However, producing small nanoparticles with good dispersion and exploitable optical coherence properties, another key aspect for these applications, is highly challenging by most synthesis and nano-fabrication methods. We report here on the wet chemical etching of Eu3+:Y2O3 nanoparticles and demonstrate that a controlled size reduction down to 150 nm, well below the wavelength of interest, 580 nm, can be achieved. The etching mechanism is found to proceed by reaction with grain boundaries and isolated grains, based on obtained particles size, morphology and polycrystalline structure. Furthermore, this method allows maintaining long optical coherence lifetimes (T 2): the 12.5 µs and 9.3 µs values obtained for 430 nm initial particles and 150 nm etched particles respectively, revealing a broadening of only 10 kHz after etching. These values are the longest T 2 values reported for any nanoparticles, opening the way to new rare-earth based nanoscale quantum technologies.

Síndrome de obstrucción congénita de vía aérea superior: diagnóstico prenatal / Congenital high airway obstruction syndrome: prenatal diagnosis

Introducción: el síndrome de obstrucción congénita de la vía aérea superior (CHAOS) es una condición infrecuente que consiste en el estrechamiento severo u obstrucción completa de la vía aérea superior, de pronóstico nefasto en ausencia de intervención, y con hallazgos ecográficos característicos que conducirán al diagnóstico. Caso clínico: gestante en semana 20.3 que acude a la ecografía morfológica donde se evidencia pulmones aumentados de tamaño, hiperecongénicos, dilatación del árbol traqueobronquial, aplanamiento diafragmático y compresión cardiaca. Asocia ascitis e hidramnios. Con todo ello, se establece el diagnóstico del síndrome de obstrucción congénita. Discusión: el correcto diagnóstico prenatal del síndrome de obstrucción congénita, con hallazgos ecográficos constantes, es esencial para optimizar el manejo gestacional y planificar el tratamiento. La cesárea EXIT y la cirugía endoscópica se proponen entre las alternativas terapéuticas disponibles en la actualidad. Es imprescindible identificar la causa de la obstrucción, así en algunos casos muy seleccionados, la fetoscopia puede ser curativa. No obstante, la morbilidad y mortalidad en la mayor parte de casos es alta (AU)

Background: Congenital high airway obstruction syndrome is a rare life-threatening condition. It is characterized by severe narrowing or complete obstruction of the upper airway, grim prognosis in absence of intervention, and with characteristic sonographic findings that lead to diagnosis. Clinical case: Pregnant in week 20.3 that goes to the routine ultrasound that demonstrated enlarged echogenic lungs, dilated tracheobronchial tree, flattened diaphragms and cardiac compression. It associates fetal ascites and polyhydramnios. In all, the diagnosis established is congenital high airway. Discussion: The accurate prenatal diagnosis of congenital high airway, with constant sonographic findings, is essential to optimize gestational management and treatment planning. EXIT procedure and endoscopic surgery are proposed among the therapeutic alternatives available today. It is essential to identify the cause of the obstruction, as fetoscopy can be curative in some highly-selected cases. However, morbidity and mortality are high in most cases (AU)