Actinomyces en endodoncia / Actinomyces in endodontics

Aunque el tratamiento endodóncico convencional es clínicamente eficaz en la mayoría de los casos, algunos de estos tratamientos no dan los resultados en principio esperados. El factor más común asociado con la falta de curación es la presencia de microorganismos en la infección periapical y en el interior de los conductos radiculares. En este sentido, la presencia de cepas de actinomices se han asociado con algunos de estos casos de terapia endodoncia con evolución clínica no satisfactoria; éstas son bacterias baciliformes grampositivas, anaerobias y no ácido- resistentes. En esta revisión analizamos el perfil microbiológico de este agente, su incidencia en los conductos radiculares y su posible papel patogénico en la patología de la pulpa y de los tejidos periapicales, mostrando su importancia en el contexto global de la Endodoncia (AU)

Conventional endodontic treatment is clinically effective in most cases, but some of these treatments do not showed the expected results. The most common factor associated with lack of healing is the presence of microorganisms in the periapical infection and its presence within root canal, In this sense, the presence of strains of actinomyces have been associated with some of these cases of endodontic therapy with clinical unsatisfactory results. These bacteria are rod-shaped, gram positive, anaerobic, and not acid-resistant. This review covers the microbiological profile of actinomyces, their presence on root canals and their possible pathogenic in the pathology of the pulp and periapical tissue, showing its importance in the global context in endodontic (AU)

Diagnóstico y tratamiento de las lesiones benignas de la mama en el embarazo / Diagnosis and treatment of benign breast lesions during pregnancy

Objetivo. Estudiar retrospectivamente el diagnóstico y tratamiento de la patología benigna de la mama durante el embarazo y puerperio realizado en nuestra Unidad. Revisamos la literatura existente al respecto.Materiales y métodos. De enero de 2001 a marzo de 2005 diagnosticamos un total de 91 mujeres (gestantes o puérperas) con patología mamaria benigna manifestada como nódulo palpable o clínica inflamatoria, con un rango de edad de 23-36. En todos los casos se realizóecografía y citología diagnóstica, siendo necesaria la realización de biopsia percutánea con aguja gruesa en tres ocasiones. En el caso de los abscesos se procedió también a su drenaje. Todo se realizó tras la obtención del correspondiente consentimiento informado.Resultados. En 28 casos (30%) se detectaron tumoraciones: fibroadenomas (12), adenomas de lactancia (9), galactoceles (5) y papilomas (2). El tratamiento fue conservador con seguimiento ecográfico, salvo en un caso que precisó tratamiento quirúrgico en el tercer trimestre. En 63 ocasiones (70%) la patología fue inflamatoria, evidenciándose abscesos en 24 (38%), de los cuales se drenaron con aguja fina 16 y concatéter pig-tail 3, según protocolo, atendiendo a su tamaño (menor o mayor de 3 cm). En 5 casos se realizó drenaje quirúrgico.Conclusiones. La patología benigna más frecuente durante la gestación es la inflamatoria, que se maneja satisfactoriamente con antibióticos y drenaje percutáneo, siendo el resultado estético mejor. La ecografía es la técnica diagnóstica de elección junto con la citología y sólo en casos dudosos realizaremos biopsia percutánea por el riesgo de fístulas

Objectives. To retrospectively study the diagnosis and treatment of benign breast disease during pregnancy and breastfeeding at our department. To review the relevant literature.Materials and methods. From January 2001 to March 2005, a total of 91 pregnant or breastfeeding women (age range: 23-36 years) were diagnosed with benign breast pathology. All patients presented with palpable nodules or inflammatory symptoms. Ultrasound-guided fineneedle cytology was performed in all cases and percutaneous core biopsy was considered necessary in three cases. Abscesses were drained when present. Patients provided their informed consent before all procedures.Results. Tumors were detected in 28 cases (30%): fibroadenomas (n = 12), lactating adenomas (n = 9), galactoceles (n = 5), and papillomas (n = 2). Conservative treatment with ultrasound follow-up was employed in all cases except one, which required surgical treatment in the third trimester. On 63 occasions (70%), the pathology was inflammatory, including abscesses in 24 cases (38%); abscesses were drained using fine-needle aspiration (n = 16) or pig-tail catheter (n = 3), according to protocol, depending on the size of the abscess (less than or greater than 3 cm). In 5 cases the abscesses were drained surgically.Conclusions. The most common benign breast pathology during pregnancy is inflammatory and is satisfactorily managed with antibiotics and percutaneous drainage with good esthetic results. Ultrasound is the diagnostic technique of choice, together with cytology; percutaneous biopsy is only performed in uncertain cases to minimize the risk of fistulas. Management of tumors after histological confirmation should be conservative with close follow-up. These tumors cause no problems for the child, the mother, or breastfeeding

[Diagnosis and treatment of benign breast lesions during pregnancy]. / Diagnóstico y tratamiento de las lesiones benignas de la mama en el embarazo.

OBJECTIVES: To retrospectively study the diagnosis and treatment of benign breast disease during pregnancy and breastfeeding at our department. To review the relevant literature. MATERIALS AND METHODS: From January 2001 to March 2005, a total of 91 pregnant or breastfeeding women (age range: 23-36 years) were diagnosed with benign breast pathology. All patients presented with palpable nodules or inflammatory symptoms. Ultrasound-guided fine-needle cytology was performed in all cases and percutaneous core biopsy was considered necessary in three cases. Abscesses were drained when present. Patients provided their informed consent before all procedures. RESULTS: Tumors were detected in 28 cases (30%): fibroadenomas (n = 12), lactating adenomas (n = 9), galactoceles (n = 5), and papillomas (n = 2). Conservative treatment with ultrasound follow-up was employed in all cases except one, which required surgical treatment in the third trimester. On 63 occasions (70%), the pathology was inflammatory, including abscesses in 24 cases (38%); abscesses were drained using fine-needle aspiration (n = 16) or pig-tail catheter (n = 3), according to protocol, depending on the size of the abscess (less than or greater than 3 cm). In 5 cases the abscesses were drained surgically. CONCLUSIONS: The most common benign breast pathology during pregnancy is inflammatory and is satisfactorily managed with antibiotics and percutaneous drainage with good esthetic results. Ultrasound is the diagnostic technique of choice, together with cytology; percutaneous biopsy is only performed in uncertain cases to minimize the risk of fistulas. Management of tumors after histological confirmation should be conservative with close follow-up. These tumors cause no problems for the child, the mother, or breastfeeding.

Control de calidad de un programa de detección, diagnóstico e intervención precoz de la hipoacusia en recién nacidos. Documento oficial de la comisión para la Detección de la Hipoacusia en Recién Nacidos (CODEPEH) / Quality control of an early detection, diagnosis and early intervention program for deafness in newborn. Official document of the Early Detection Comission of Deafness in Newborn (CODEPEH)

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[Clinical trial of 2 tobacco use cessation interventions in primary care]. / Ensayo clínico de dos intervenciones de deshabituación tabáquica en atención primaria.

OBJECTIVE: To study the efficacy of two types of intervention to stop tobacco dependency. DESIGN: Randomised clinical trial. SETTING: Primary care centre. PATIENTS AND OTHER PARTICIPANTS: Smokers recruited from among the health centre users through the preventive activities and health promotion programme. INDEPENDENT VARIABLE: type of intervention. General variables: age, sex, marital status, educational level, work situation, cohabitation with children, smokers at home, number of years smoking, type of tobacco. There were two types of intervention: a) Minimal Intervention (MI). b) Advanced Intervention (AI). 54 patients were included, with 6 losses. 21 were assigned at random to the MI group and 27 to the AI group. Progress was measured at 15 days, 1 month, 3 months, 6 months and a year. RESULTS: In the MI, 23.8% were abstinent at 15 days; the same percentage at one month and 3 months; 19% at 6 months; and 14.3% remained abstinent after a year. In the AI, 51.9% were abstinent at 15 days; 48.1% at both one and 3 months; 25.9% at 6 months; and 22.2% were still not smoking after a year. No significant differences between the two interventions were found in any of the observations. CONCLUSIONS: These data do not show that one intervention is better than the other. With the passage of time the effect of the intervention decreased in both groups.