Prognostic Value of Liquid-Biopsy-Based Biomarkers in Upper Tract Urothelial Carcinoma.

Currently, there are no reliable prognostic factors to determine which upper tract urothelial carcinoma (UTUC) patients will progress after radical nephroureterectomy (RNU). We aim to evaluate whether liquid-biopsy-based biomarkers (circulating tumor cells (CTCs), cell-free DNA (cfDNA), and circulating tumor DNA (ctDNA)) were able to predict clinical outcomes in localized UTUC patients undergoing RNU. Twenty patients were prospectively enrolled between 2021 and 2023. Two blood samples were collected before RNU and three months later. CTCs and cfDNA were isolated and evaluated using the IsoFlux system and Quant-iT PicoGreen dsDNA kit, respectively. Droplet digital PCR was performed to determine ctDNA status. Cox regression analysis was performed on CTCs, cfDNA, and ctDNA at two different follow-up time points to examine their influence on tumor progression and cancer-specific survival (CSS). During a median follow-up of 18 months, seven (35%) patients progressed and three (15%) died. Multivariate analysis demonstrated that cfDNA levels three months after RNU are a significant predictor of tumor progression (HR = 1.085; p = 0.006) and CSS (HR = 1.168; p = 0.029). No associations were found between CTC enumeration and ctDNA status with any of the clinical outcomes evaluated. The evaluation of cfDNA levels in clinical practice could improve the disease management of UTUC patients.

Tumor-Agnostic Circulating Tumor DNA Testing for Monitoring Muscle-Invasive Bladder Cancer.

Circulating tumor DNA (ctDNA) has recently emerged as a real-time prognostic and predictive biomarker for monitoring cancer patients. Here, we aimed to ascertain whether tumor-agnostic ctDNA testing would be a feasible strategy to monitor disease progression and therapeutic response in muscle-invasive bladder cancer (MIBC) patients after radical cystectomy (RC). Forty-two MIBC patients who underwent RC were prospectively included. Blood samples from these patients were collected at different follow-up time points. Two specific mutations (TERT c.1-124C>T and ATM c.1236-2A>T) were analyzed in the patients' plasma samples by droplet digital PCR to determine their ctDNA status. During a median follow-up of 21 months, 24% of patients progressed in a median of six months. ctDNA status was identified as a prognostic biomarker of tumor progression before RC and 4 and 12 months later (HR 6.774, HR 3.673, and HR 30.865, respectively; p < 0.05). Lastly, dynamic changes in ctDNA status between baseline and four months later were significantly associated with patient outcomes (p = 0.045). In conclusion, longitudinal ctDNA analysis using a tumor-agnostic approach is a potential tool for monitoring MIBC patients after RC. The implementation of this testing in a clinical setting could improve disease management and patients' outcomes.

Assessment of aggressive bladder cancer mutations in plasma cell-free DNA.

Background and aims: The spatial and temporal genetic heterogeneity of bladder cancer (BC) makes challenging to find specific drivers of metastatic disease, thus preventing to determine those BC patients at high risk of tumor progression. Our aim was to identify DNA mutations providing aggressive behavior to bladder tumors and analyze them in patients' cell-free DNA (cfDNA) during their follow-up after radical cystectomy (RC) in order to monitor tumor evolution. Methods: Six BC patients who underwent RC and presented disease progression during their follow-up were included. Next-generation sequencing was used to determine somatic mutations in several primary tumor and metastatic specimens from each patient. Shared DNA mutations between primary bladder tumor and metastatic sites were identified in cfDNA samples through droplet digital PCR. Results: Besides BC genetic heterogeneity, specific mutations in at least one of these genes -TERT, ATM, RB1, and FGFR3- were found in primary tumors and their metastases in all patients. These mutations were also identified in the patients' cfDNA at different follow-up time points. Additionally, the dynamic changes of these mutations in cfDNA allowed us to determine tumor evolution in response to treatment. Conclusion: The analysis of BC mutations associated with poor prognosis in plasma cfDNA could be a valuable tool to monitor tumor evolution, thus improving the clinical management of BC patients.

Gamma passing rates of daily EPID transit images correlate to PTV coverage for breast cancer IMRT treatment plans.

PURPOSE: The use of the transit image obtained with the electronic portal-imaging device (EPID) is becoming an extended method to perform in-vivo dosimetry. The transit images acquired during each fraction can be compared with a predicted image, if available, or with a baseline image, usually the obtained in the first fraction. This work aims to study the dosimetric impact of the failing fractions and to evaluate the appropriateness of using a baseline image in breast plans. MATERIAL AND METHODS: Twenty breast patients treated in a Halcyon were retrospectively selected. For each patient and fraction, the treatment plan was calculated over the daily CBCT image. For each fraction, the differences respect to the treatment plan values of OARs and PTV dosimetric parameters were analyzed: ΔDmean , ΔD95%, ΔD98%, ΔD2%, ΔV36Gy, ΔV38.5Gy, and ΔV43.5Gy. Daily fractions were ranked according to the differences found in the dosimetric parameters between the treatment plan and the daily CBCT to establish the best fraction. The daily transit images acquired in every fraction were compared to the first fraction using the global gamma index with the Portal Dosimetry tool. The comparison was repeated using the best fraction image as a baseline. We assessed the correlation of the dosimetric differences obtained from the CBCT images-based treatment plans with the gamma index passing rates obtained using first fraction and best fraction as baseline. RESULTS: Average values of -11.6% [-21.4%, -3.3%] and -3.2% [-1.0%, -10.3%] for the ∆PTVD98% and ∆PTVD95% per every 10% decrease in the passing rate were found, respectively. When using the best fraction as baseline patients were detected with failing fractions that were not detected with the first fraction as baseline. CONCLUSION: The gamma passing rates of daily transit images correlate with the coverage loss parameters in breast IMRT plans. Using first fraction image as baseline can lead to the non-detectability of failing fractions.

Cell-Free DNA as a Prognostic Biomarker for Monitoring Muscle-Invasive Bladder Cancer.

Cell-free DNA (cfDNA) has recently emerged as a real-time biomarker for diagnosis, monitoring and prediction of therapy response in tumoral disease. Here, we evaluated cfDNA as a prognostic biomarker for monitoring muscle-invasive bladder cancer (MIBC) patients at different follow-up time points. Blood samples from 37 MIBC patients who underwent radical cystectomy (RC) were collected at cystectomy and 1, 4, 12 and 24 months later. Plasma cfDNA amount and fragmentation patterns were determined. Four mutations were analyzed in cfDNA to detect circulating tumor DNA (ctDNA) during patient follow-up. During a median follow-up of 36 months, 46% of patients progressed; median time to progression was 10 months. cfDNA levels and ctDNA status four months after RC were identified as independent prognostic biomarkers of tumor progression (HR 5.290; p = 0.033) and cancer-specific survival (HR 4.199; p = 0.038), respectively. Furthermore, ctDNA clearance four months after RC was significantly associated with patients' clinical outcomes. In conclusion, cfDNA levels and ctDNA status four months after RC have prognostic implications in MIBC patients. In addition, cfDNA monitoring is useful to predict patient outcomes after RC. cfDNA analysis in the clinical setting could greatly improve MIBC patient management.

Prognostic Gene Expression-Based Signature in Clear-Cell Renal Cell Carcinoma.

The inaccuracy of the current prognostic algorithms and the potential changes in the therapeutic management of localized ccRCC demands the development of an improved prognostic model for these patients. To this end, we analyzed whole-transcriptome profiling of 26 tissue samples from progressive and non-progressive ccRCCs using Illumina Hi-seq 4000. Differentially expressed genes (DEG) were intersected with the RNA-sequencing data from the TCGA. The overlapping genes were used for further analysis. A total of 132 genes were found to be prognosis-related genes. LASSO regression enabled the development of the best prognostic six-gene panel. Cox regression analyses were performed to identify independent clinical prognostic parameters to construct a combined nomogram which includes the expression of CERCAM, MIA2, HS6ST2, ONECUT2, SOX12, TMEM132A, pT stage, tumor size and ISUP grade. A risk score generated using this model effectively stratified patients at higher risk of disease progression (HR 10.79; p < 0.001) and cancer-specific death (HR 19.27; p < 0.001). It correlated with the clinicopathological variables, enabling us to discriminate a subset of patients at higher risk of progression within the Stage, Size, Grade and Necrosis score (SSIGN) risk groups, pT and ISUP grade. In summary, a gene expression-based prognostic signature was successfully developed providing a more precise assessment of the individual risk of progression.

Prognostic implication of TERT promoter mutation and circulating tumor cells in muscle-invasive bladder cancer.

PURPOSE: Current clinical prognostic factors are not accurate enough to identify and monitor those muscle-invasive bladder cancer (MIBC) patients at high risk of progression after radical cystectomy (RC). Here, we determined genetic alterations in the tumor and circulating tumor cell (CTC) enumeration to find biomarkers useful for the management of MIBC after RC. METHODS: Thirty-nine MIBC patients undergoing RC were included. Tumoral tissue DNA was analyzed by next generation sequencing. CTCs were isolated from blood collected before RC and one, four and 12 months later. RESULTS: Sixteen (41%) patients progressed in a median time of 8.5 months and 11 (69%) of these patients harbored the TERT c.-124C > T mutation. All progressive patients harboring the TERT c.-124C > T mutation presented a significant increase in CTC number 12 months after RC compared to those without the mutation. Additionally, CTC number at 12 months was identified as an independent prognostic biomarker for tumor progression and cancer specific survival (CSS). Ten (63%) progressive patients showed an increment of CTC number with a median anticipation period of four months compared with imaging techniques. CONCLUSIONS: The TERT c.-124C > T mutation could be considered a biomarker of aggressivity. CTC enumeration is a useful tool for identifying MIBC patients at high risk of progression and CSS after RC and for detecting tumor progression earlier than imaging techniques.

Clinicopathological and Molecular Prognostic Classifier for Intermediate/High-Risk Clear Cell Renal Cell Carcinoma.

The probability of tumor progression in intermediate/high-risk clear cell renal cell carcinoma (ccRCC) is highly variable, underlining the lack of predictive accuracy of the current clinicopathological factors. To develop an accurate prognostic classifier for these patients, we analyzed global gene expression patterns in 13 tissue samples from progressive and non-progressive ccRCC using Illumina Hi-seq 4000. Expression levels of 22 selected differentially expressed genes (DEG) were assessed by nCounter analysis in an independent series of 71 ccRCCs. A clinicopathological-molecular model for predicting tumor progression was developed and in silico validated in a total of 202 ccRCC patients using the TCGA cohort. A total of 1202 DEGs were found between progressive and non-progressive intermediate/high-risk ccRCC in RNAseq analysis, and seven of the 22 DEGs selected were validated by nCounter. Expression of HS6ST2, pT stage, tumor size, and ISUP grade were found to be independent prognostic factors for tumor progression. A risk score generated using these variables was able to distinguish patients at higher risk of tumor progression (HR 7.27; p < 0.001), consistent with the results obtained from the TCGA cohort (HR 2.74; p < 0.002). In summary, a combined prognostic algorithm was successfully developed and validated. This model may aid physicians to select high-risk patients for adjuvant therapy.

Differential gene expression profile between progressive and de novo muscle invasive bladder cancer and its prognostic implication.

This study aimed to ascertain gene expression profile differences between progressive muscle-invasive bladder cancer (MIBC) and de novo MIBC, and to identify prognostic biomarkers to improve patients' treatment. Retrospective multicenter study in which 212 MIBC patients who underwent radical cystectomy between 2000 and 2019 were included. Gene expression profiles were determined in 26 samples using Illumina microarrays. The expression levels of 94 genes were studied by quantitative PCR in an independent set of 186 MIBC patients. In a median follow-up of 16 months, 46.7% patients developed tumor progression after cystectomy. In our series, progressive MIBC patients show a worse tumor progression (p = 0.024) and cancer-specific survival (CSS) (p = 0.049) than the de novo group. A total of 480 genes were found to be differently expressed between both groups. Differential expression of 24 out of the 94 selected genes was found in an independent cohort. RBPMC2 and DSC3 were found as independent prognostic biomarkers of tumor progression and CALD1 and LCOR were identified as prognostic biomarkers of CSS between both groups. In conclusion, progressive and de novo MIBC patients show different clinical outcome and gene expression profiles. Gene expression patterns may contribute to predict high-risk of progression to distant metastasis or CSS.

Necesidad de tratamiento ortodóntico en escolares de 11 a 12 años de la Institución Educativa Mariscal Gamarra del Cusco - Perú, 2019 / Necessidade de tratamento ortodôntico em escolares de 11 a 12 anos na Instituição Educacional Mariscal Gamarra em Cusco - Peru, 2019 / Need for orthodontic treatment in schoolchildren aged 11 to 12 at the Mariscal Gamarra Educational Institution in the city of Cusco - Peru, 2019

Resumen: Objetivo: Caracterizar la necesidad de tratamiento ortodóntico en su componente de salud dental y estético en escolares de 11 a 12 años de la Institución Educativa Mariscal Gamarra del Cusco - Perú, 2019. Materiales y métodos: La muestra estuvo constituida por 142 escolares de una institución educativa estatal, se usó el Índice de Necesidad de Tratamiento Ortodóntico (INTO) con sus dos componentes. El Componente de Salud Dental (CDS) es realizado por el Odontólogo y el Componente Estético (CE) es percibido por el paciente. Resultados: Se obtuvo 15,49% sin necesidad de tratamiento y 33.10% de leve necesidad de tratamiento y 28,87% moderada necesidad de tratamiento en su Componente de Salud Dental y el 74,65% se presentó sin necesidad de tratamiento en su Componente Estético. Conclusión: Al examen por parte del profesional casi la mitad de los estudiantes no necesitan tratamiento y por otro lado, tres de cuatro estudiantes se perciben sin necesidad de tratamiento de ortodoncia.

Resumo: Objetivo: Caracterizar a necessidade de tratamento ortodôntico em seu componente de saúde dental e estética em escolares de 11 a 12 anos de idade na Instituição Educacional Mariscal Gamarra de Cusco - Peru, 2019. Materiais e métodos: A amostra foi composta por 142 estudantes de uma instituição de ensino estadual, o Índice de Necessidades de Tratamento Ortodôntico (INTO), com seus dois componentes. O componente de saúde bucal (CDS) é realizado pelo dentista e o componente estético (CE) é percebido pelo paciente. Resultados: foram obtidos 15,49% sem necessidade de tratamento e 33,10% para uma leve necessidade de tratamento e 28,87% para uma necessidade moderada de tratamento em seu Componente de Saúde Bucal e 74,65% apresentaram sem a necessidade de tratamento em seu Componente Estético. Conclusão: No exame realizado pelo profissional, quase metade dos estudantes não necessita de tratamento e, por outro lado, três em cada quatro percebem a si mesmos sem a necessidade de tratamento ortodôntico.

Abstract: Objective: To describe the need for orthodontic treatment in its dental and aesthetic health components in schoolchildren aged 11 to 12 at the Mariscal Gamarra Educational Institution of Cusco - Peru, 2019. Materials and methods: The sample consisted of 142 schoolchildren from a public school. The Index of Orthodontic Treatment Need (IOTN) was used with the two components; the Dental Health Component, determined by the dentist, and the Aesthetic Component, as perceived by the patient. Results: According to the results, 15.49% did not need any treatment, 33.10% had a slight need for treatment, and 28.87% a moderate need for treatment in the Dental Health component; 74.65% presented no need for treatment in the Aesthetic Component. Conclusion: Almost half the students did not need any treatment as reported after the health professional exam. On the other hand, three out of four students showed no need for orthodontic treatment.

Diarrea y desnutrición en paciente trasplantado renal: un caso de infección por criptosporidiosis / Diarrhea and malnutrition in kidney transplant recipient: A case of infection by cryptosporidiosis

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Light-stick: A problem of marine pollution in Brazil.

Light-sticks are used as bait in surface long-line fishing, to capture swordfish and other large pelagic predators. When discharged in the ocean, it may reach the beaches. The traditional Brazilian community of Costa dos Coqueiros, Bahia, use light-sticks as a medicine for rheumatism, vitiligo and mycoses. It may affect the marine life when its content leak in the open ocean. This work evaluated and identified the acute and chronic toxicity of the light-stick. A high acute toxicity was observed in the mobility/mortality of Artemia sp.; in the fertilization of sea urchin eggs, and a high chronic toxicity in the development of the pluteus larvae of the same sea urchin. The main compounds that probably caused toxicity were the volatiles such as the fluorescent PAH and oxidants such as the hydrogen peroxide. Its disposal in the open ocean is a potential threat for marine life.

Importancia y gravedad de las infecciones oportunistas en el postrasplante renal: caso de absceso cerebral por Nocardia carnea y otras coinfecciones / Importance and gravity of opportunistic infections in renal transplant recipient: A case of Nocardia carnea brain abscess and other co-infections

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Perfil clínico de los pacientes que sufren complicaciones/efectos adversos tras una cirugía mayor ortopédica / Clinical profile of patients who present complications adverse effects after major orthopedic surgery

OBJETIVO: conocer el perfil clínico de pacientes que sufren complicaciones/efectos adversos en el postoperatorio de cirugía mayor ortopédica en la unidad. MÉTODO: estudio descriptivo observacional longitudinal realiza- do en la planta de Traumatología del Hospital 12 de Octubre, de Madrid. Se estudiaron pacientes ingresados para cirugía traumatológica, mayores de 18 años, sin deterioro cognitivo e intervenidos de artroplastia o reparación de fractura de cadera. Se recogieron datos de la historia clínica mediante una hoja de registro de las siguientes variables: edad, sexo, diagnóstico, procedimiento, antecedentes, estancia; como variable resultado fue la aparición de complicaciones (infección, trombosis venosa profunda y/o sangrado) o efecto adverso (estreñimiento, úlcera por presión, caída y/o síndrome confusional agudo). RESULTADOS: se estudiaron 134 pacientes con una edad media de 73 años (10,9) siendo el 64,2% mujeres y 35,8% hombres. La mediana [RIC] de estancia fue de 9 [8-13] días. El 63,4% de los pacientes tuvo complicaciones/efectos adversos, siendo más habitual el estreñimiento que afectó al 44,8%. Se encontró significación estadística entre presentar complicación/efecto adverso y la edad, sexo, diagnóstico y estancia, sin embargo, no se describió asociación con el procedimiento y con padecer patología previa. CONCLUSIONES: el perfil de pacientes que sufre complicación/ efecto adverso en el postoperatorio de cirugía mayor ortopédica en la unidad sería: mujer de 74 años con diagnóstico de coxartrosis y su estancia se prolongaría 10 días

OBJECTIVE: to learn the clinical profile of those patients who present complications / adverse effects during the postoperative period after major orthopaedic surgery in the hospital unit. METHOD: a descriptive, observational, longitudinal study conducted in the Orthopedic Surgery ward of the Hospital 12 de Octubre, in Madrid. The study included those patients hospitalized for orthopaedic surgery who were over 18 years of age, had no cognitive deterioration, and had undergone an arthroplasty or hip fracture repair. Clinical record data were collected through a form with the following variables: age, gender, diagnosis, procedure, past history, hospital stay: the outcome variable was the development of complications (infection, deep vein thrombosis and/or bleeding) or adverse effect (constipation, pressure ulcer, fall and/or acute confusional syndrome). RESULTS: the study included 134 patients with a mean 73 years of age (10.9); 64.2% of them were women and 35.8% were men. The median [IQR] of stay was 9 [8-13] days. A 63.4% of patients suffered complications/adverse effects; the most common was constipation, which appeared in 44.8% of patients. Statistical significance was found between the presentation of a complication/adverse effect and age, gender, diagnosis and hospital stay; however, there was no description of any association with the procedure and with presenting a previous condition. CONCLUSIONS: the profile of those patients who present a complication/adverse effect in the period after major orthopaedic surgery in the hospital unit would be: a 74-year-old woman with diagnosed coxarthrosis and a hospital stay prolonged to 10 days

Utilización de un sistema de derivación fecal en una paciente que desarrolla una fascitis necrotizante de la zona génito-perineal en una unidad de traumatología / Use of a faecal shunt system in an orthopaedic surgery unit in a patient with a necrotizing fasciitis of the perineal region

La fascitis necrotizante es una infección grave del tejido subcutáneo profundo que si no se trata de forma adecuada presenta una mortalidad muy elevada. El papel de los cuidados de enfermería puede ser determinante en su buena evolución como exponemos en este trabajo. Presentamos el caso de una paciente diabética de 80 años ingresada en la unidad de traumatología como consecuencia de la movilización de un clavo colocado en la cadera. Fue intervenida quirúrgicamente, debiendo permanecer durante el postoperatorio en decúbito supino con el miembro intervenido alineado e inmovilizado. Se utilizaron medidas evidenciadas en la prevención de úlceras por presión, a pesar de lo cual la paciente desarrolló una úlcera por presión en la zona sacra que se sobreinfectó y derivó en una fascitis necrotizante, extendiéndose por la zona perineal y vulvar siendo preciso su desbridamiento quirúrgico. La maceración y deterioro de la zona, producidas por la agresividad química de la presencia permanente de heces y la dificultad de mantener los apósitos adheridos, obligó a frecuentes curas hasta que se decidió utilizar un sistema de derivación fecal. La utilización de este sistema disminuyó claramente el número de curas y la dificultad de las mismas, lo que supuso considerables ventajas para la enferma y el personal de enfermería así como la favorable evolución de la herida. El uso de sistemas de derivación fecal puede ser beneficioso, utilizado de forma controlada, en enfermos inmovilizados por fracturas, con alteraciones del ritmo intestinal y con úlceras por decúbito (AU)

Necrotizing fasciitis is a severe infection of the subcutaneous tissue, with a higher mortality if treatment is not adequate. Nursing care can be fundamental in obtaining a good outcome of the healing process. We present a case of an 80 year-old diabetic patient admitted to our orthopaedic surgery unit as consequence of a screw displacement in her hip. She was operated on and had to be immobilized during the postsurgical period. Measures were applied to prevent bed sores in the sacral region. Despite these measures the patient developed a pressure sore that became infected, progressing to a necrotizing fasciitis of perineal and bulbar region, which required surgical curettage. Due to contact and exposure to faecal material it was decided to use a faecal shunt system. The number and difficulty of the wound treatments decreased using this system, which had significant advantages for the patient and nurses and for a favourable outcome of the wound. Employing faecal shunt systems could be useful when they are used earlier in patients immobilized due to orthopaedic surgery, with bowel movement changes and bed sore wounds (AU)

[Use of a faecal shunt system in an orthopaedic surgery unit in a patient with a necrotizing fasciitis of the perineal region]. / Utilización de un sistema de derivación fecal en una paciente que desarrolla una fascitis necrotizante de la zona génito-perineal en una unidad de traumatología.

Necrotizing fasciitis is a severe infection of the subcutaneous tissue, with a higher mortality if treatment is not adequate. Nursing care can be fundamental in obtaining a good outcome of the healing process. We present a case of an 80 year-old diabetic patient admitted to our orthopaedic surgery unit as consequence of a screw displacement in her hip. She was operated on and had to be immobilized during the postsurgical period. Measures were applied to prevent bed sores in the sacral region. Despite these measures the patient developed a pressure sore that became infected, progressing to a necrotizing fasciitis of perineal and bulbar region, which required surgical curettage. Due to contact and exposure to faecal material it was decided to use a faecal shunt system. The number and difficulty of the wound treatments decreased using this system, which had significant advantages for the patient and nurses and for a favourable outcome of the wound. Employing faecal shunt systems could be useful when they are used earlier in patients immobilized due to orthopaedic surgery, with bowel movement changes and bed sore wounds.

Gingivitis en el Cusco: sus amenazas y modos de combatirlo / Gingivitis in Cusco: his threats and ways to combat

El artículo ha sido elaborado de acuerdo a las condiciones bucales que presenta un determinado grupo de personas. Su propósito es evaluar la presencia de enfermedades de encías, especialmente la Gingivitis que es la inflamación de las mismas. El estudio se elaboró durante el año 2009 y los resultados fueron altamente significativos en cuanto a Gingivitis se refiere, los cuales demuestran, que una mayoría de personas no se esmeran por un cuidado intenso de la cavidad bucal más que todo en las mujeres embarazadas que en su mayoría se encuentran entre los 16 a 35 años. Primero se define la Gingivitis como tal; su clasificación y sus manifestaciones, luego se define la Placa Dental Bacteriana como el factor desencadenante de la Gingivitis, asimismo se demuestra la detección de placa en el grupo estudiado utilizando la tinción de Fucsina. Luego se determina la incidencia de la gingivitis y finalmente se da a conocer métodos y medidas de prevención para la comunidad contra todas estas enfermedades bucales que abarcan principalmente a los tejidos blandos. A pesar de todo, la práctica dental envuelve el hecho de trabajar con personas, por lo tanto se requiere de un alto grado de conocimiento en técnicas dentales, así como de los factores sociales y psicológicos que presenta cada individuo.

The following article has been elaborated based on the results of a study conducted to a group of patients with oral health conditions. The purpose of this study was to evaluate the “gingivae disease”, particularly “Gingivitis” which is the inflammatory response of gingivae. This investigation was done throughout the year 2009 and the results found on “Gingivitis patients” were highly significant showing that most people do not mind taking intensive care of their oral health conditions. Moreover, pregnant women between 16 to 35 years old were the lease to be concerned about their oral hygiene. Firstly, I define “Gingivitis”, its classification and features. Secondly, I identify “Dental Plaque” as the potential cause of Gingivitis; therefore, its detection using the fuscin procedure. Then I determine the impact of Gingivitis on people and finally I describe preventive care as well as dental practice against all oral diseases that affect the oral health especially the soft tissues. Above all else, the practice of dentistry involves working with people; therefore, a high degree of technical skill is required, as well as social and psychological expertise on each human being.

Impacto de la Ley No 19.680 en la incidencia de quemaduras por fuegos artificiales / Impact of Law No 19.680 on the incidence of burns produced by fireworks

Preocupada por la alta frecuencia de quemaduras en niños producidas por el uso de fuegos artificiales durante las fiestas de navidad y año nuevo, la Corporación de Ayuda al Niño Quemado, Coaniquem, en asociación con el Ministerio de Salud, efectuó desde 1993 una campaña de prevención junto con una vigilancia epidemiológica de este accidente que se hizo extensiva a todo el país en 1997. Dicha campaña tuvo un leve efecto en su objetivo principal pero logró concientizar a la opinión pública sobre la importancia del problema y convenció a las autoridades sobre la conveniencia de modificar drásticamente la legislación que regula la fabricación y venta de estos productos. Habiéndose dictado una nueva ley que prohibió, en el año 2000, la venta de fuegos artificiales para uso personal en Chile, se quiso conocer el impacto de la medida para lo cual se comparó la incidencia de quemaduras infantiles ocurridas en las fiestas de fin de año, registradas a través de la vigilancia epidemiológica, de los tres años previos al cambio con los tres años posteriores a éste. Se observó una disminución de 85 por ciento en el número de casos y de un 3,8 por ciento de las hospitalizaciones. No hubo cambios en los fuegos artificiales usados ni en las localizaciones de las lesiones. La tenencia de los fuegos artificiales sólo pudo explicarse como consecuencia de comercio clandestino en todos los casos. La prohibición ha resultado muy efectiva, pero la venta ilegal obliga a continuar la campaña preventiva y efectuar una estricta fiscalización del cumplimiento de la ley.