Relationship Between Facial Bone Dimensions, Orofacial Implant Position, and Esthetic Outcomes of Single-Tooth Implants.

PURPOSE: To investigate the association between the orofacial implant position distance (ID) and facial bone crest thickness (FBCT) in single-tooth implant crowns (STICs) placed in the esthetic zone and to predict the presence of facial bone above the implant shoulder, as well as its impact on Pink and White Esthetic Scores (PES and WES) and patient-related outcome measures (PROMs). MATERIALS AND METHODS: In this cross-sectional study, all patients treated with STICs in the esthetic zone between 2006 and 2013 with at least 12 months postloading were invited to enroll. CBCTs were used to assess ID and FBCT. Esthetic outcomes included the PES and WES. PROMs included a participant satisfaction questionnaire with 13 questions formulated for this study. Descriptive statistics and receiver operating characteristic curve analysis were used. The associations between ID, FBCT, esthetic outcomes, and PROMs were calculated. RESULTS: Data were available for 60 implants. Mean ID was 2.02 mm (SD = 0.77). Mean FBCT at the implant shoulder was 0.99 mm (SD = 0.98). FBCT was significantly associated with higher PES scores (P = .040), but not with WES scores (P = 0.149). FBCT was significantly associated with ID (P = .009), and implants positioned ≥ 1.6 mm palatal in relation to the adjacent teeth were likely to have higher FBCT. CONCLUSIONS: FBCT influences PES and is more predictable if implants are positioned ≥ 1.6 mm palatal in relation to the adjacent teeth.

Relationship between labial bone dimensions, labio-palatal implant position and esthetic outcomes of single tooth implants.

PURPOSE: To investigate the association between the oro-facial implant position distance (ID) and facial bone crest thickness (FBCT) in single-tooth implant crowns (STIC) placed in the esthetic zone, and predict presence of facial bone above the implant shoulder and its impact on Pink and White Esthetic Score (PES and WES) and patient related outcome measurements (PROMS). MATERIAL AND METHODS: In this cross-sectional study, all patients treated with STIC in esthetic zone between 2006 and 2013, with at least 12 months post-loading were invited to enroll. CBCTs were used to assess ID and FBCT. Esthetic outcomes included the PES and WES. PROMS measures included participants' satisfaction questionnaire with 13 formulated questions for this study. Descriptive statistics and ROC analysis were used. The association between ID, FBCT, esthetic outcomes and PROMS were calculated. RESULTS: Data was available for 60 implants. Mean ID was 2.02mm (SD=0.77). Mean FBCT at implant shoulder was 0.99mm (SD=0.98). FBCT was significantly associated with higher PES scores (P=0.040), but not with WES scores (P=0.149). FBCT was significantly associated with ID (P=0.009) and implants positioned ≥ 1.6mm palatal in relation to the adjacent teeth were likely to have higher FBCT. CONCLUSIONS: FBCT influences PES and is more predictable if implants are positioned ≥ 1.6mm palatal in relation to the adjacent teeth. Int J Prosthodont 2023. Doi: 10.11607/ijp.8052.

Criterios ASGE 2010 frente a 2019 para coledocolitiasis en pacientes llevados a colangiopancreatografía retrógrada endoscópica / 2010 vs. 2019 ASGE criteria for choledocholithiasis in patients undergoing endoscopic retrograde cholangiopancreatography

Resumen Introducción: con la actualización de las guías de la American Society for Gastrointestinal Endoscopy (ASGE) 2019, los criterios para los pacientes con sospecha de coledocolitiasis se volvieron más estrictos a la hora de elegir quienes deben ser llevados directamente a colangiopancreatografía retrógrada endoscópica (CPRE). El objetivo de este estudio fue comparar a los pacientes llevados directamente a CPRE según las guías ASGE de 2010 frente a la guía de 2019. Métodos: estudio retrospectivo de las CPRE realizadas entre enero de 2016 y diciembre de 2018 que evaluó el rendimiento diagnóstico de las variables paraclínicas y ecográficas de forma individual y en conjunto para comparar su sensibilidad, especificidad, valores predictivos y precisión de la probabilidad alta según guías de 2019 y de 2010 respecto a la presencia de cálculos en las CPRE. Resultados: 386 pacientes se llevaron a CPRE por sospecha de coledocolitiasis, 84,5% fueron procedimientos terapéuticos. El grupo de probabilidad alta presentó mayor tasa de CPRE terapéutico: 89,3% según las guías de 2019 frente a las de 2010 con 86,3% (p < 0,001). La sensibilidad y especificidad de la probabilidad alta según las guías de 2010 fueron del 86,8% y 25,0%, respectivamente, con un valor predictivo positivo (VPP) del 86,3% y una precisión del 77,2%. La probabilidad alta según las guías de 2019 mostró una menor sensibilidad (74%), pero mayor especificidad (51,7%), un VPP del 89,3% y una precisión del 70,7%. Conclusiones: la implementación de las guías ASGE 2019 sobre las indicaciones para la realización de la CPRE debe considerarse teniendo en cuenta los recursos de los centros hospitalarios, sobre todo en países de bajos y medianos ingresos. Las guías ASGE 2010 presentan una buena sensibilidad y precisión para orientar la realización de la CPRE.

Abstract Introduction: With the update of the American Society for Gastrointestinal Endoscopy (ASGE) 2019 guidelines, the criteria for patients with suspected choledocholithiasis became stricter when choosing who should be taken directly to endoscopic retrograde cholangiopancreatography (ERCP). This study aimed to compare patients taken directly to ERCP according to the 2010 vs. 2019 ASGE guidelines versus the 2019 guide. Materials and methods: A retrospective study of ERCPs performed between January 2016 and December 2018 evaluated the diagnostic performance of paraclinical and ultrasound variables individually and collectively to compare their sensitivity, specificity, predictive values, and high probability precision according to 2019 and 2010 guidelines regarding the presence of stones in ERCPs. Results: 386 patients underwent ERCP due to suspicion of choledocholithiasis; 84.5% were therapeutic procedures. The high probability group had a higher rate of therapeutic ERCP: 89.3% according to the 2019 guidelines compared to those of 2010 with 86.3% (p < 0.001). The sensitivity and specificity of high probability according to the 2010 guidelines were 86.8% and 25.0%, respectively, with a positive predictive value (PPV) of 86.3% and an accuracy of 77.2%. According to the 2019 guidelines, high probability showed lower sensitivity (74%) but higher specificity (51.7%), a PPV of 89.3%, and an accuracy of 70.7%. Conclusions: The implementation of the ASGE 2019 guidelines on the indications for ERCP should consider the resources of hospitals, especially in low- and middle-income countries. The ASGE 2010 guidelines show good sensitivity and precision to guide the performance of ERCP.

Generation of two hiPSC lines (UMILi027-A and UMILi028-A) from early and late-onset Congenital Central hypoventilation Syndrome (CCHS) patients carrying a polyalanine expansion mutation in the PHOX2B gene.

Congenital Central Hypoventilation Syndrome (CCHS) is a rare disorder of the autonomic nervous system (ANS), characterized by inadequate control of autonomic ventilation and global autonomic dysfunction. Heterozygous polyalanine repeat expansion mutations in exon 3 of the transcription factor Paired-like homeobox 2B (PHOX2B) gene occur in 90% of CCHS cases. In this study, we describe the generation and characterization of two human induced pluripotent stem cell (hiPSC) lines from female CCHS patients carrying a heterozygous + 5 alanine expansion mutation. The generated iPSC lines show a normal karyotype, express pluripotency markers and are able to differentiate into the three germ layers.

Actin reorganization at the centrosomal area and the immune synapse regulates polarized secretory traffic of multivesicular bodies in T lymphocytes.

T-cell receptor stimulation induces the convergence of multivesicular bodies towards the microtubule-organizing centre (MTOC) and the polarization of the MTOC to the immune synapse (IS). These events lead to exosome secretion at the IS. We describe here that upon IS formation centrosomal area F-actin decreased concomitantly with MTOC polarization to the IS. PKCδ-interfered T cell clones showed a sustained level of centrosomal area F-actin associated with defective MTOC polarization. We analysed the contribution of two actin cytoskeleton-regulatory proteins, FMNL1 and paxillin, to the regulation of cortical and centrosomal F-actin networks. FMNL1 ß phosphorylation and F-actin reorganization at the IS were inhibited in PKCδ-interfered clones. F-actin depletion at the central region of the IS, a requirement for MTOC polarization, was associated with FMNL1 ß phosphorylation at its C-terminal, autoregulatory region. Interfering all FMNL1 isoforms prevented MTOC polarization; nonetheless, FMNL1 ß re-expression restored MTOC polarization in a centrosomal area F-actin reorganization-independent manner. Moreover, PKCδ-interfered clones exhibited decreased paxillin phosphorylation at the MTOC, which suggests an alternative actin cytoskeleton regulatory pathway. Our results infer that PKCδ regulates MTOC polarization and secretory traffic leading to exosome secretion in a coordinated manner by means of two distinct pathways, one involving FMNL1 ß regulation and controlling F-actin reorganization at the IS, and the other, comprising paxillin phosphorylation potentially controlling centrosomal area F-actin reorganization. ABBREVIATIONS: Ab, antibody; AICD, activation-induced cell death; AIP, average intensity projection; APC, antigen-presenting cell; BCR, B-cell receptor for antigen; C, centre of mass; cent2, centrin 2; cIS, central region of the immune synapse; CMAC, CellTracker™ Blue (7-amino-4-chloromethylcoumarin); cSMAC, central supramolecular activation cluster; CTL, cytotoxic T lymphocytes; DAG, diacylglycerol; DGKα, diacylglycerol kinase α; Dia1, Diaphanous-1; dSMAC, distal supramolecular activation cluster; ECL, enhanced chemiluminescence; ESCRT, endosomal sorting complex required for traffic; F-actin, filamentous actin; Fact-low cIS, F-actin-low region at the centre of the immune synapse; FasL, Fas ligand; FMNL1, formin-like 1; fps, frames per second; GFP, green fluorescent protein; HBSS, Hank's balanced salt solution; HRP, horseradish peroxidase; ILV, intraluminal vesicles; IS, immune synapse; MFI, mean fluorescence intensity; MHC, major histocompatibility complex; MIP, maximal intensity projection; MVB, multivesicular bodies; MTOC, microtubule-organizing centre; NS, not significant; PBL, peripheral blood lymphocytes; PKC, protein kinase C; PKCδ, protein kinase C δ isoform; PLC, phospholipase C; PMA, phorbol myristate acetate; Pol. Index, polarization index; pSMAC, peripheral supramolecular activation cluster; PSF, point spread function; ROI, region of interest; SD, standard deviation; shRNA, short hairpin RNA; SEE, Staphylococcus enterotoxin E; SMAC, supramolecular activation cluster; TCR, T-cell receptor for antigen; T-helper (Th); TRANS, transmittance; WB, Western blot.

Randomized clinical trial comparing PEG-based synthetic to porcine-derived collagen membrane in the preservation of alveolar bone following tooth extraction in anterior maxilla.

OBJECTIVES: The objective of this randomized controlled trial was to compare alveolar ridge preservation using a bone substitute material and covered with a synthetic or porcine collagen membrane. MATERIALS AND METHODS: Thirty-two sockets in the aesthetic maxillary region of 30 patients were randomized into two groups. Randomization was stratified according to bone wall defect. Flapless technique was used, and sockets were grafted with bi-phasic calcium phosphate particulate bone substitute and covered by synthetic polyethylene glycol (PEG; test group) or porcine-derived collagen membrane (CM; control group). No primary closure was attempted. A cone beam computed tomography (CBCT) scan was performed immediately after the surgical procedure and repeated 22 weeks later. OnDemand3D was used to superimpose scan images and assess changes. The mean vertical and horizontal percentage bone loss were calculated and implants placed after 6 months with or without additional augmentation. RESULTS: There were no baseline differences between groups or dropouts. The mean percentage loss at the labial plate and at the coronal part of the sockets was statistically significantly lower in the test group compared with controls (-2.86% [SD = 13.48] versus 7.42% [SD = 11.95]; 13.45% [SD = 11.97] versus 28.59% [SD = 16.97]). Implants were placed after 6 months, and there was no difference in need for further augmentation between PEG (n = 5) or CM (n = 4). CONCLUSION: Sites treated with PEG membrane showed less percentage loss in horizontal and vertical measurements in this trial.

Protein Kinase C δ Regulates the Depletion of Actin at the Immunological Synapse Required for Polarized Exosome Secretion by T Cells.

Multivesicular bodies (MVB) are endocytic compartments that enclose intraluminal vesicles (ILVs) formed by inward budding from the limiting membrane of endosomes. In T lymphocytes, ILVs are secreted as Fas ligand-bearing, pro-apoptotic exosomes following T cell receptor (TCR)-induced fusion of MVB with the plasma membrane at the immune synapse (IS). In this study we show that protein kinase C δ (PKCδ), a novel PKC isotype activated by diacylglycerol (DAG), regulates TCR-controlled MVB polarization toward the IS and exosome secretion. Concomitantly, we demonstrate that PKCδ-interfered T lymphocytes are defective in activation-induced cell death. Using a DAG sensor based on the C1 DAG-binding domain of PKCδ and a GFP-PKCδ chimera, we reveal that T lymphocyte activation enhances DAG levels at the MVB endomembranes which mediates the association of PKCδ to MVB. Spatiotemporal reorganization of F-actin at the IS is inhibited in PKCδ-interfered T lymphocytes. Therefore, we propose PKCδ as a DAG effector that regulates the actin reorganization necessary for MVB traffic and exosome secretion.

Imaging the Human Immunological Synapse.

The purpose of the method is to generate an immunological synapse (IS), an example of cell-to-cell conjugation formed by an antigen-presenting cell (APC) and an effector helper T lymphocyte (Th) cell, and to record the images corresponding to the first stages of the IS formation and the subsequent trafficking events (occurring both in the APC and in the Th cell). These events will eventually lead to polarized secretion at the IS. In this protocol, Jurkat cells challenged with Staphylococcus enterotoxin E (SEE)-pulsed Raji cells as a cell synapse model was used, because of the closeness of this experimental system to the biological reality (Th cell-APC synaptic conjugates). The approach presented here involves cell-to-cell conjugation, time-lapse acquisition, wide-field fluorescence microscopy (WFFM) followed by image processing (post-acquisition deconvolution). This improves the signal-to-noise ratio (SNR) of the images, enhances the temporal resolution, allows the synchronized acquisition of several fluorochromes in emerging synaptic conjugates and decreases fluorescence bleaching. In addition, the protocol is well matched with the end point cell fixation protocols (paraformaldehyde, acetone or methanol), which would allow further immunofluorescence staining and analyses. This protocol is also compatible with laser scanning confocal microscopy (LSCM) and other state-of-the-art microscopy techniques. As a main caveat, only those T cell-APC boundaries (called IS interfaces) that were at the right 90° angle to the focus plane along the Z-axis could be properly imaged and analyzed. Other experimental models exist that simplify imaging in the Z dimension and the following image analyses, but these approaches do not emulate the complex, irregular surface of an APC, and may promote non-physiological interactions in the IS. Thus, the experimental approach used here is suitable to reproduce and to confront some biological complexities occurring at the IS.

Social inequalities in oral cancer literacy in an adult population in a multicultural deprived area of the UK.

BACKGROUND: To report the level and correlates of oral cancer literacy in a deprived area of the UK. METHODS: This study is part of the East London Oral Health Inequality Study, which included a representative sample of adults 16-65 (n = 2343) years old living in Waltham Forest, Redbridge and Barking and Dagenham in 2009-10. This cross-sectional study adopted a multi-stage, stratified, random sampling approach. Data were collected through home visits by trained examiners and interviewers. Hierarchical logistic regression modelling was adopted. RESULTS: Only 26.7% participants were aware that a small lesion in the mouth can develop into oral cancer, and 39.5% were aware that early treatment could prevent a lesion from developing into oral cancer. Adjusted odds ratios confirmed the social gradient in awareness that a small lesion in the mouth can develop into oral cancer, even after adjusting for age, gender and ethnicity. Inequalities in awareness that a small lesion in the mouth can develop into oral cancer were significantly attenuated after forcing education level into the equation. Interestingly, adjusting for education cancelled the difference previously observed between manual/routine and professional/managerial occupations. CONCLUSIONS: Oral cancer literacy is poor among adults in Outer North East London, and we have identified particularly vulnerable sub-populations.

Interactive approach by pharmacy students to educate older adults on the safe use of over-the-counter medications.

OBJECTIVES: The objective of this study was to evaluate a pharmacy student-led interactive educational program for older adults on the safe use of over-the-counter (OTC) medications. METHODS: This was a prospective, interventional study evaluating an educational program covering 12 common OTC topics. Doctor of pharmacy students and a geriatric specialist faculty advisor developed and delivered a 30-minute presentation tailored to older adults, accompanied by various interactive learning methods, including a question and answer session. Following the program, participants completed a questionnaire to address the helpfulness and report intentions of behavior change. RESULTS: A total of 88 individuals attended the presentations, and 64 participants voluntarily completed the anonymous post-program survey; 91.8% of the participants indicated the intervention was either "very helpful" or "moderately helpful." The majority of subjects stated they would make changes to the way they use OTCs (79.3%) and discuss OTC use with their providers (88.3%). The three most beneficial topics included vitamins/minerals, reading a drug label, and sleep medications. CONCLUSION: An interactive educational program on the safe use of OTC medications was helpful and generated positive intentions regarding behavior change in OTC use among older adults.

Achiral endohedral functionality provides stereochemical control in Fe(II)-based self-assemblies.

Multicomponent Fe(II)-iminopyridine-based self-assemblies have been synthesized with variably sized internal functionality. Larger internal functions provide increased strain to the complex and confer diastereocontrol upon the assembly process. Complete diastereocontrol is possible upon the introduction of large achiral groups on the cavity interior.

Family structure, socioeconomic position and utilization of oral health services among Nigerian senior secondary school pupils.

OBJECTIVE: To test the relationship between socioeconomic position (SEP), family composition, number of siblings, and birth position in the family, and the utilization of oral health services by senior secondary school pupils in Ile-Ife, Nigeria. METHODS: A cross-sectional study design included senior secondary school pupils in the Central Local Government Area of Ile-Ife during 2007/2008. Sample size calculation was performed and 1,200 pupils were invited to participate. A multistage, stratified sampling technique was used. Data collection included a self-administered questionnaire. Data were analyzed using logistic regression. RESULTS: The response rate was 76 percent (n=1043). The mean age was 15.8 (standard deviation=1.9) and 49 percent were males. Only 22.5 percent of pupils had ever visited a dentist in their lives. Results from multivariate analyses showed that pupils attending free schools, those paying 1 to 10,000 naira (equivalent to US$ 63.31) and 10,000 to 19,000 naira (equivalent to US$ 120.29) were respectively 1.93, 1.87, and 2.74 times less likely to have attended a dentist in the past than pupils in more expensive schools. Pupils living with single mothers or without a parent were unlikely to have visited the dentist. Number of siblings and birth position in the family were not associated with utilization of oral health services. CONCLUSIONS: Adolescents from families with a low SEP growing up without their parents may need extra incentives to visit dentist.

One-to-one dietary interventions undertaken in a dental setting to change dietary behaviour.

BACKGROUND: The dental care setting is an appropriate place to deliver dietary assessment and advice as part of patient management. However, we do not know whether this is effective in changing dietary behaviour. OBJECTIVES: To assess the effectiveness of one-to-one dietary interventions for all ages carried out in a dental care setting in changing dietary behaviour. The effectiveness of these interventions in the subsequent changing of oral and general health is also assessed. SEARCH METHODS: The following electronic databases were searched: the Cochrane Oral Health Group Trials Register (to 24 January 2012), the Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library 2012, Issue 1), MEDLINE via OVID (1950 to 24 January 2012), EMBASE via OVID (1980 to 24 January 2012), CINAHL via EBSCO (1982 to 24 January 2012), PsycINFO via OVID (1967 to 24 January 2012), and Web of Science (1945 to 12 April 2011). We also undertook an electronic search of key conference proceedings (IADR and ORCA between 2000 and 13 July 2011). Reference lists of relevant articles, thesis publications (Dissertations Abstracts Online 1861 to 2011) were searched. The authors of eligible trials were contacted to identify any unpublished work. SELECTION CRITERIA: Randomised controlled trials assessing the effectiveness of one-to-one dietary interventions delivered in a dental care setting. DATA COLLECTION AND ANALYSIS: Abstract screening, eligibility screening and data extraction decisions were all carried out independently and in duplicate by two review authors. Consensus between the two opinions was achieved by discussion, or involvement of a third review author. MAIN RESULTS: Five studies met the criteria for inclusion in the review. Two of these were multi-intervention studies where the dietary intervention was one component of a wider programme of prevention, but where data on dietary behaviour change were reported. One of the single intervention studies was concerned with dental caries prevention. The other two concerned general health outcomes. There were no studies concerned with dietary change aimed at preventing tooth erosion. In four out of the five included studies a significant change in dietary behaviour was found for at least one of the primary outcome variables. AUTHORS' CONCLUSIONS: There is some evidence that one-to-one dietary interventions in the dental setting can change behaviour, although the evidence is greater for interventions aiming to change fruit/vegetable and alcohol consumption than for those aiming to change dietary sugar consumption. There is a need for more studies, particularly in the dental practice setting, as well as greater methodological rigour in the design, statistical analysis and reporting of such studies.

Synthesis and properties of metal-ligand complexes with endohedral amine functionality.

A series of tetracationic M(2)L(4) palladium-pyridyl complexes with endohedral amine functionality have been synthesized. The complexes were analyzed by NMR techniques (including Diffusion NMR and 2D NOESY), electrospray ionization (ESI) mass spectrometry, and X-ray crystallography. The solid state analysis shows a large change in crystal morphology upon introduction of the endohedral amine groups, caused by deleterious interactions between the amines and the triflate counterions from the coordination process. Combination of different ligands allows analysis of ligand exchange rates via NMR analysis, with half-lives on the order of 3 h, independent of the donor properties of the ligand. Self-sorting behavior is observed, with more electron-rich ligands being favored. The amine-containing and extended complexes are strongly fluorescent, giving quantum yields of up to 83%.

Evaluación del ácido etilendiaminotetraacético y del mercaptoacético de sodio en la detección de metalo β-lactamasas en Pseudomonas aeruginosa mediante la técnica del disco combinado / Evaluation of ethylenediaminetetraacetic acid and sodium mercaptoacetic acid in the detection of metallo β-lactamases in Pseudomonas aeruginosa by the combined disk technique

Pseudomonas aeruginosa es un bacilo gramnegativo capaz de adquirir genes que codifican para la producción de metalo β-lactamasas (MBLs), las cuales son activas contra carbapenemos e inhibidas por agentes quelantes, como el ácido etilendiaminotetraacético (EDTA). Se determinó la efectividad del EDTA y del ácido mercaptoacético de sodio (SMA) en la detección de MBLs en 25 cepas de P. aeruginosa procedentes de diferentes hospitales y centros de investigación, empleando el método de discos combinados. Se evaluó el efecto de los antibióticos solos y combinados con EDTA, SMA o ambos. Se encontró que, mediante el aumento del diámetro de los halos de inhibición de los carbapenemos combinados con la mezcla EDTA/SMA (0,5 M/300 mg/mL) o sólo con EDTA (0,5 M), se pudieron diferenciar de manera clara y confiable las cepas productoras de MBLs de las no productoras, estableciéndose como punto de corte una diferencia de 5 mm o más entre los halos de inhibición del antibiótico sólo y combinado con el o los agentes quelantes.

Pseudomanas aeruginosa is a gram negative bacillus capable of acquiring genes which code for metallo β-lactamase production (MBLs) which are active against carbapenems and inhibited by chelating agents such as ethylenediaminetetraacetic acid (EDTA). We determined the effectiveness of EDTA and sodium mercaptoacetic acid (SMA) in the detection of MBLs on 25 P. aeruginosa strains from different hospitals and research centers, using the combined disk technique. We evaluated the effect of the antibiotics alone and combined with EDTA, SMA, or both. We found that through the increase of the diameter of the inhibition halos of the carbapenems combined with an EDTA/SMA mixture (0.5 M/300 mg/mL) o with EDTA alone (0.5 M), we could differentiate in a clear and reliable way the MBLs producing from the non producing strains, establishing as cutoff point a difference of 5 mm or more between the antibiotic alone and the antibiotic combined with the chelating agent(s).

Hemangioma hepático tratado con Vincristina / Hepatic hemangioma treated with Vincristine

Los hemangiomas constituyen el tumor más frecuente en la infancia con una incidencia de 0.8 a 2.3 por ciento al nacimiento. A 80 por ciento de los niños se les manifiesta el hemangioma en el primer mes de vida. La incidencia es mayor en niñas, 3:1, de piel clara, pretérmino, menos de 1500g. Sólo 10 por ciento tienen antecedentes familiares. Sesenta por ciento se localizan en cabeza y cuello, 25 por ciento en tronco y 15 por ciento en extremidades. Se define como una neoplasia benigna compuesta por endotelio vascular hiperplásico y proliferativo. Son lesiones dinámicas que manifiestan una fase de proliferación, estabilización e involución. Se presenta un caso de una niña que presentaba un hemangioma hepático que hizo tórax restrictivo que fue tratada con esteroides orales, intravenosos, se embolizó el vaso nutricio y Vincristina con lo que se obtuvo una mejoría clínica e involución de la lesión. En el presente artículo se hace una revisión del manejo que aún es controversial.

Rabdomiosarcoma cardiaco / Cardiac rhabdomyosarcoma

Se presenta un caso de una paciente con un tumor maligno cardiaco que es una patología muy infrecuente. Al ingreso tenía 10 años de edad, fue referida por historia de un mes de dolor en epigastrio, que irradiaba al resto del abdomen y asociaba disnea progresiva de esfuerzos. Además tenía cardiomegalia, masa y derrame pericárdico. El diagnóstico histológico reportó rabdomiosarcoma de ventrículo derecho tipo alveolar. Se logró una resección completa y se dio quimioterapia. Presentó una recaída tardía que se trató con segunda línea de quimioterapia y radioterapia con lo que se logró una respuesta parcial y posteriormente presentó progresión de la enfermedad

Detection of Candida dubliniensis in patients with candidiasis in Caracas, Venezuela.

Candida species are responsible for 80% of all nosocomial fungal infections. In 1995 a new yeast species was described, Candida dubliniensis which shares with Candida albicans characteristics. We have studied 109 yeast isolates identified as C. albicans to investigate the presence of C. dubliniensis by microbiological studies and PCR using DUBR/DUBF primers. Positive results using microbiological tools were between 90 and 98%. Two morphological and physiological of the 80 DNA examined samples (2.5%) showed a PCR product of 288 bp which allow the identification of C. dubliniensis. This is the first report in Venezuela of identification of this species using a PCR approach.