Importancia de la apropiada selección de aditamentos protésicos sobre implantes para conservar el estado de salud gingival: reporte de caso / Importance of the appropriate selection of prosthetic attachments on implants to preserve the state of gingival health: case report

Introducción: La rehabilitación oral en pacientes edéntulos parciales que requieren implantes dentales ha incrementado su demanda en los últimos años, convirtiéndose en un tratamiento de rutina, donde procedimientos quirúrgicos y protésicos tienen un éxito considerable. En algunos casos estas complicaciones se resuelven de forma simple, en otros, se necesita de una mejor planificación. Objetivo: Modificar y complementar el plan de tratamiento del paciente como solución definitiva al posicionamiento equivocado de los implantes dentales oseo integrados. Presentación del Caso: Paciente de 64 años, hombre, asistió a Centro de Atención Odontológica de la Universidad de Las Américas (CAO/UDLA), para terminar tratamiento odontológico de especialidad, rehabilitación de cuatro implantes colocados en zona 1.6 (Mis: C1 4.20 x 13mm); 1.4 (Mis: C1 3.75x11.50 mm); 1.2 (Mis: C1 3.75 x 11.50 mm); 2.1 (Mis: C1 4.20 x 11.50 mm), a examen clínico se pudo observar prótesis acrílica transicional inmediata desadaptada e inestable oclusalmente como resultado de proceso de cicatrización de tejidos, pérdida de piezas dentales postero-inferiores (3.6; 3.7; 4.6 y 4.7).La angulación equivocada de los implantes anteriores obligó la necesidad de corregirla mediante el uso de aditamentos rotacionales Multi-unit rectos de 2 mm altura en implantes 1.6; 1.4, aditamentos anti rotacionales tipo Multi-unit angulados de 1 mm de altura a 30º para los implantes 1.2 y 2.1 con healingcaps para proteger el aditamento de la acumulación de placa bacteriana y facilitar la higienización e inserción de la prótesis múltiple. Conclusiones: Los aditamentos colocados modificaron y complementaron la rehabilitación de los implantes incluso en la zona anterior donde se encontró tejido mucoso insuficiente que cubra de forma completa el aditamento elegido. (AU)

Introduction: Oral rehabilitation in partial edentulous patients who require dental implants has increased its demand in recent years, becoming a routine treatment, where surgical and prosthetic procedures have considerable success In some cases these complications are resolved simply, in others. Aims: Better planning is needed modify and complement the patient’s treatment plan as a definitive solution to the wrong positioning of osseointegrated dental implants. Presentation of the Case: Patient of 64 years, man, attended the Dental Care Center of the University of the Americas (CAO / UDLA), to finish specialty dental treatment, rehabilitation of four implants placed in zone 1.6 (Mis: C1 4.20 x 13mm); 1.4 (Mis: C1 3.75x11.50 mm); 1.2 (Mis: C1 3.75 x 11.50 mm); 2.1 (Mis: C1 4.20 x 11.50 mm), On clinical examination, immediate transitional acrylic prosthesis could be observed maladapted and occlusally unstable as a result of tissue healing process, loss of postero-inferior teeth (3.6; 3.7; 4.6 and 4.7). The wrong angulation of the previous implants forced the need to correct it through the use of 2 mm high straight Multi-unit rotational attachments in implants 1.6; 1.4, angled Multi-unit anti-rotational attachments from 1 mm high to 30 mm for implants 1.2 and 2.1 with healing caps to protect the attachment from the accumulation of bacterial plaque and facilitate the sanitization and insertion of the multiple prosthesis. Conclusions: The attachments placed modified and complemented the rehabilitation of the implants even in the anterior area where insufficient mucous tissue was found to completely cover the chosen attachment. (AU)

Isolation of Escherichia coli and Klebsiella pneumoniae strains producing extended-spectrum ß-lactamases from dog urine of the Metropolitan Area of the Aburrá Valley (Antioquia, Colombia) / Aislamiento de Escherichia coli y Klebsiella pneumoniae productoras de betalactamasas de espectro extendido a partir de orina de perros del Área metropolitana del Valle de Aburrá (Antioquia, Colombia)

ABSTRACT Escherichia coli and Klebsiella pneumoniae are the most common pathogens causing urinary tract infections in humans and animals. Close contact between humans and companion animals can facilitate the spread of multidrug resistant pathogens between both species. The objective of the research was to characterize extended-spectrum ß-lactamases (ESBL) -producing E. coli and K. pneumoniae isolated from dogs with urinary tract infections in the metropolitan area of Valle del Aburrá (Antioquia, Colombia). Three-hundred seventy-one urine samples collected from March 2018 to March 2019 in a veterinary clinical laboratory were analyzed. E. coli and K. pneumoniae isolates were detected in chromogenic agar and identified by biochemical tests. Susceptibility testing was performed by disc diffusion and ESBL production was evaluated by the double disk test in all isolates. MIC determination of ESBL-positive isolates were performed on the automated VITEK®2 system. Multiple PCR was used for the detection of CTX-M beta-lactamases (group 1, 2, 9 and 8/25), SHV, TEM, and AmpC of plasmid origin in ESBL-positive isolates. In total 22 out 371 isolates were positive for ESBL production by double disc test, 11 E. coli (ESBL-Ec) and 11 K. pneumoniae (ESBL-Kp). The multiple PCR detected CTX-M group 1 in the 22 ESBL-positive isolates. Multi-drug resistance was observed in all ESBL-producing isolates. In conclusion, a high frequency of antibiotic multi-resistance was found in ESBL-Ec and ESBL-Kp. The main ESBL detected was CTX-M group 1, which also prevails in human isolates.

RESUMEN Escherichia coli y Klebsiella pneumoniae son los patógenos más comunes causantes de infecciones en tracto urinario en humanos y animales. El contacto estrecho con los animales de compañía puede favorecer la diseminación de patógenos multiresistentes entre ambas especies. El objetivo de la investigación fue caracterizar E. coli (Ec -BLEE) y K. pneumo-niae (Kp -BLEE) productores de betalactamasas de espectro extendido provenientes de aislados de caninos con infecciones del tracto urinario del Área Metropolitana del Valle de Aburrá. 371 muestras de orina de caninos colectadas entre marzo de 2018 y marzo 2019 en un laboratorio clínico veterinario fueron analizadas. E. coli y K. pneumoniae se detectaron en agar cromogénico y se identificaron mediante pruebas bioquímicas. La prueba de susceptibilidad se realizó por difusión en disco y la producción de BLEE se evaluó por test de doble disco en todos los aislados. La determinación de la CIM en aislados positivos a BLEE se realizó en el sistema automatizado VITEK®2. Se utilizó PCR múltiple para la detección de betalactamasas tipo CTX-M (grupo 1, 2, 9 y 8/25), SHV, TEM y AmpC de origen plasmídico en aislados positivos a BLEE. Un total de 22 de 371 aislados fueron positivos a BLEE por test de doble disco, 11 E. coli (Ec -BLEE) y 11 K. pneumoniae (Kp-BLEE). La PCR detectó CTX-M grupo 1 en los 22 aislados positivos a BLEE. Se observó multirresistencia en todos los aislamientos productores de BLEE. En conclusión, se encontró una alta frecuencia de multirresistencia en Ec-BLEE y Kp-BLEE. La principal BLEE detectada fue CTX-M grupo 1, que también predomina en aislados humanos.

Effectiveness of Physical Exercise on Alzheimer's disease. A Systematic Review.

OBJECTIVE: A systematic review of randomized controlled trials was conducted to determine the effect of physical exercise on physical-functional capacity, cognitive performance, neuropsychiatric symptoms, and quality of life in a population of older people with Alzheimer´s disease. DATA SOURCES: Pubmed, Scopus, PEDro, Web of Science, CINAHL, Cochrane Library, grey literature and a reverse search from inception to April 2021 were searched to identify documents. STUDY SELECTION: Publications investigating the effect of any type of physical exercise-based intervention in any of its multiple modalities on physical-functional capacity, cognitive performance, neuropsychiatric symptoms, and quality of life were searched. DATA EXTRACTION: The data were extracted into predesigned data extraction tables. Risk of bias was evaluated through the PEDro scale and its internal validity scale. DATA SYNTHESIS: A total of 8 different randomized controlled trials with a total sample of 562 non-overlap Alzheimer disease patients between 50-90 years and a mean age of 75.2 ± 3.9 years were eligible for analyses. Physical-functional capacity was evaluated in 6 of 8 studies and cognitive performance was evaluated in 5 of 8 studies, all of them showed improvements in these variables when compared with the controls, except for two studies in physical-functional capacity and one study for cognitive performance. In the physical-functional capacity and cognitive performance variables, aerobic physical exercise was used in isolation, or in a multimodal way, combining aerobic, strength and balance exercise, from 2 to 7 weekly sessions with doses between 30 and 90 minutes, and a duration of the program comprised of 9 weeks to 6 months. Neuropsychiatric symptoms and quality of life were evaluated in 2 of 8 studies, which the intervention groups experienced significant improvements when compared with the control groups, except for one study that found similar differences in quality of life between both groups. In the neuropsychiatric symptoms and quality of life variables, only aerobic physical exercise was used, in a more homogeneous way, from 2 to 3 weekly sessions with doses of 30 to 60 minutes, and a total program duration of 9 to 16 weeks. CONCLUSIONS: Despite the scarcity of studies, especially those based on multimodal proposals, and the heterogeneity in the protocols, this systematic review found moderate to limited evidence that aerobic physical exercise on its own or combined in a multimodal program that also includes strength and balance exercise can be a useful tool in the management of patients with Alzheimer's disease with the aim of maintaining and/or improving physical-functional capacity and cognitive performance. In addition, this review found moderate evidence of the positive impact that aerobic physical exercise could have in reducing neuropsychiatric symptoms and improving quality of life in patients with Alzheimer´s disease. PROSPERO registration number: CRD42021229891.

In-depth characterization of a new patient-derived xenograft model for metaplastic breast carcinoma to identify viable biologic targets and patterns of matrix evolution within rare tumor types.

Metaplastic breast carcinoma (MBC) is a rare breast cancer subtype with rapid growth, high rates of metastasis, recurrence and drug resistance, and diverse molecular and histological heterogeneity. Patient-derived xenografts (PDXs) provide a translational tool and physiologically relevant system to evaluate tumor biology of rare subtypes. Here, we provide an in-depth comprehensive characterization of a new PDX model for MBC, TU-BcX-4IC. TU-BcX-4IC is a clinically aggressive tumor exhibiting rapid growth in vivo, spontaneous metastases, and elevated levels of cell-free DNA and circulating tumor cell DNA. Relative chemosensitivity of primary cells derived from TU-BcX-4IC was performed using the National Cancer Institute (NCI) oncology drug set, crystal violet staining, and cytotoxic live/dead immunofluorescence stains in adherent and organoid culture conditions. We employed novel spheroid/organoid incubation methods (Pu·MA system) to demonstrate that TU-BcX-4IC is resistant to paclitaxel. An innovative physiologically relevant system using human adipose tissue was used to evaluate presence of cancer stem cell-like populations ex vivo. Tissue decellularization, cryogenic-scanning electron microscopy imaging and rheometry revealed consistent matrix architecture and stiffness were consistent despite serial transplantation. Matrix-associated gene pathways were essentially unchanged with serial passages, as determined by qPCR and RNA sequencing, suggesting utility of decellularized PDXs for in vitro screens. We determined type V collagen to be present throughout all serial passage of TU-BcX-4IC tumor, suggesting it is required for tumor maintenance and is a potential viable target for MBC. In this study we introduce an innovative and translational model system to study cell-matrix interactions in rare cancer types using higher passage PDX tissue.

[Low-intensity extracorporeal shock wave therapy for erectile dysfunction: A systematic review]. / Traitement de la dysfonction érectile par ondes de choc extracorporelles de faible intensité : revue de la littérature.

INTRODUCTION: Our purpose was to assess the efficacy of low intensity extracorporeal shock waves (SW) for the treatment of organic erectile dysfunction (ED). METHODS: A systematic review of the literature published between 2000 and 2020 was conducted using the PRISMA methodology. We used Medline data with the following key words (MesH): "extracorporeal shock wave therapy"; "erectile dysfunction"; "sexuality". RESULTS: Nineteen articles were selected: thirteen randomised controlled trial and six meta-analyses. Most of them studied vascular etiology. Low intensity SW is beneficial ED is evaluated by the IIEF, EHS scores and penile hemodynamic. CONCLUSION: SW may have a theoretical impact on the vascular etiology of organic DE. Their use in this context is supported by the European Society of urology and the European Society of sexual medecine. However, there are discrepancies in current data to establish a protocol to follow in daily practice.

Combined 1-Deoxynojirimycin and Ibuprofen Treatment Decreases Microglial Activation, Phagocytosis and Dopaminergic Degeneration in MPTP-Treated Mice.

Inflammation is a predominant aspect of neurodegenerative diseases and experimental studies performed in animal models of Parkinson's disease (PD) suggesting that a sustained neuroinflammation exacerbates the nigrostriatal degeneration pathway. The central role of microglia in neuroinflammation has been studied as a target for potential neuroprotective drugs for PD, for example nonsteroidal anti-inflammatory drugs (NSAIDs) and matrix metalloproteinases (MMP) inhibitors that regulates microglial activation and migration. The aim of this study was to investigate the neuroprotective response of the iminosugar 1-deoxynojirimycin (1-DNJ) and compare its effect with a combined treatment with ibuprofen. MPTP-treated mice were orally dosed with ibuprofen and/or 1-DNJ 1. Open-field test was used to evaluate behavioral changes. Immunohistochemistry for dopaminergic neurons marker (TH+) and microglia markers (Iba-1+; CD68+) were used to investigate neuronal integrity and microglial activation in the substantia nigra pars compacta (SNpc). The pro-inflammatory cytokines TNF-α and IL-6 were analysed by qPCR. Treatments with either 1-DNJ or Ibuprofen alone did not reduce the damage induced by MPTP intoxication. However, combined treatment with 1-DNJ and ibuprofen prevents loss of mesencephalic dopaminergic neurons, decreases the number of CD68+/ Iba-1+ cells, the microglia/neurons interactions, and the pro-inflammatory cytokines, and improves behavioral changes when compared with MPTP-treated animals. In conclusion, these data demonstrate that the combined treatment with a MMPs inhibitor (1-DNJ) plus an anti-inflammatory drug (ibuprofen) has neuroprotective effects open for future therapeutic interventions. Graphical Abstract MPTP (1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine) is a protoxicant that, after crossing the Blood Brain Barrier, is metabolized by astrocytic MAO-B to MPDP+, a pyridinium intermediate, which undergoes further two-electron oxidation to yield the toxic metabolite MPP+ (methyl-phenyltetrahydropyridinium) that is then selectively transported into nigral neurons via the mesencephalic dopamine transporter. In this study, we demonstrated that MPTP induced death of dopaminergic neurons, microgliosis, increase of gliapses, motor impairment and neuroinflammation in mice, which were inhibited by combined 1-deoxynojirimycin and ibuprofen treatment.

Myocardial Inflammatory Changes Before and After Antiretroviral Therapy Initiation in People With Advanced Human Immunodeficiency Virus Disease.

Because of the high frequency of late presentation of human immunodeficiency virus (HIV) disease in our population, we decided to explore the presence of myocarditis among people with HIV infection and advanced immunosuppression (less than 200 CD4+ cells/µL) and to describe the inflammatory changes observed after combined antiretroviral therapy initiation in an observational, longitudinal, prospective cohort. We performed both cardiovascular magnetic resonance imaging and doppler transthoracic echocardiogram.

[Extracorporeal shock wave therapy for Peyronie's disease]. / Traitement de la maladie de Lapeyronie par ondes de choc extracorporelles.

INTRODUCTION: The efficiency of extracorporeal shock waves (SW) for Peyronie's disease (PD) is controversial. METHODS: A systematic review of the literature published between 2000 and 2019 was conducted using the PRISMA methodology. We used Medline data with the following. KEYWORDS: "extracorporeal shock wave therapy" ; "Peyronie's disease"; "Sexuality"; Penile erection. RESULTS: Thirteen articles were selected. Our review showed that SW were beneficial in terms of pain. Regarding plaques size and penile curvature, the results remain divergent. CONCLUSION: SW may be useful in the management of pain in selected patients with PD. Its effectiveness on plaques size and penile curvature needs to be demonstrated through controlled and randomized trials. The population has to be targeted, and the treatment protocol must also be standardized.

[Prostatic urethral lift using Urolift® system for benign prostatic hyperplasia: 7years experience]. / Pose d'implants Urolift® intra-prostatique pour hyperplasie bénigne de la prostate : résultats après 7 ans d'expérience.

INTRODUCTION: Urolift® system is a mini-invasive technique, proposed as an alternative treatment for classic surgery of benign prostatic hyperplasia (BPH). Our objective was to report the results of Urolift® system in our center after 7years experience. PATIENTS AND METHODS: Urolift® implants were proposed between February 2012 and March 2019 for patients presenting symptomatic BPH in our center, as an alternative for classic surgery. The efficacy was evaluated with questionnaires about lower urinary tract symptoms (IPSS) and its impact on quality of life (IPSS-QdV). Tolerance was evaluated with questionnaires about erectile (IIEF5) and ejaculatory function (MSHQ-EjD) and complication rate. Survival without additional treatment was assessed using Kaplan-Meier method. RESULTS: Forty patients were treated during this period, with a median follow-up of 32months [12-67]. Three months after the procedure, IPSS and IPSS-QdV were significantly improved (respectively 8 [4-11] vs 20 [17-24]; P<0.0001 and 2 [1-2] vs 5 [4-6]; P<0.0001). MSHQ-EjD and IIEF5 were not modified (respectively 13 [11-14] vs 12 [9-13]; P=0.69 and 21 [18-23] vs 21 [18-23]; P=0.13). Two patients (5%) experienced a urinary retention and needed a bladder catheter. No complication with a Clavien-Dindo score>2 were reported. Survival without additional treatment at 5years was 63%. CONCLUSION: Urolift® implants improved significantly the lower urinary tract symptoms in our population, with a good tolerance profile. More than 60% of the patients did not need an additional treatment after 5years of follow-up. LEVEL OF EVIDENCE: 3.

Complications associated with inferior alveolar nerve reposition technique for simultaneous implant-based rehabilitation of atrophic mandibles. A systematic literature review.

INTRODUCTION: Surgical inferior alveolar nerve (IAN) reposition techniques offer an alternative approach to implant-based rehabilitation in patients with severe mandibular atrophy The aim of this systematic review, was to determine the complications associated with the technique and to determine which of two variants (lateralization or transposition) is less invasive. MATERIALS AND METHODS: An electronic search was conducted in databases complimented by a manual search to identify clinical studies investigating complications derived from these surgical techniques. Only studies of adult humans, published in English during the last seven years were included. The initial search located 78 articles, of which seven were included in analysis on the basis of the following characteristics: four investigated inferior alveolar nerve lateralization (IANL), one inferior alveolar nerve transposition (IANT), and two investigated both reposition techniques. RESULTS: This review included data from 289 patients who were recruited for lateralization (N=319) or transposition surgery (N=33) making a total of 352 reposition procedures. Five patients (1.73%) suffered persistent damage to the IAN at the end of the follow-up periods. The overall implant survival rate was 99.26% of a total of 817 implants. The most common complications were neurosensory problems, mandibular fracture, infection, implant loss, and insufficient anatomical reconstruction of the atrophic mandible; neurosensory complications (hypoesthesia, paraesthesia, and hyperesthesia caused by traumatic damage to the nerve) were the most prevalent. CONCLUSIONS: Lateralization of the inferior alveolar nerve would appear to be less invasive as it produces lower percentages of persistent neurosensory disorders (1.56%) than transposition (12.12%). Nevertheless, both techniques offer a viable approach to implant placement in edentulous atrophic mandibles, obtaining predictable clinical and radiological results after 5 years implant loading.

Tyrosine kinase inhibitors in iodine-refractory differentiated thyroid cancer: experience in clinical practice.

PURPOSE: The aim of this study is to describe our clinical experience with tyrosine kinase inhibitors (TKIs) and to evaluate their efficacy and tolerability in patients with iodine-refractory differentiated thyroid cancer (DTC). METHODS: There were 17 patients (47.1% women, mean age: 65.7) with DTC iodine-refractory (9 papillary, 2 follicular and 3 Hürthle cell), treated with TKIs: 16 with sorafenib and 1 with lenvatinib as first-line treatment; 7 required second-line treatment (4 lenvatinib and 3 axitinib). Primary endpoints were progression-free survival (PFS) and radiographic response (determinate at 3, 6, 12, 18, and 24 months after the initiation of treatment) and second endpoints were determining differences in baseline characteristics depending on clinical course and describing toxicities and tolerability. RESULTS: Median PFS was 18 months. During the first 24 months of treatment with TKIs PR rate was 35.3% (only 5.8% ≥ 6 months) and SD ≥ 6 months was observed in 58.8%. There were no significant differences in baseline characteristics between patients with good and poor evolution. Adverse events (AEs) were present in 100% of patients, but most of them were grade 1 and 2. CONCLUSIONS: In our population of patients with iodine-refractory DTC, treatment with sorafenib, lenvatinib, and axitinib allows the stabilization of the disease in a high percentage of cases, with acceptable tolerability.

Fuelling the mechanisms of asthma: Increased fatty acid oxidation in inflammatory immune cells may represent a novel therapeutic target.

BACKGROUND: Increasing evidence has shown the close link between energy metabolism and the differentiation, function, and longevity of immune cells. Chronic inflammatory conditions such as parasitic infections and cancer trigger a metabolic reprogramming from the preferential use of glucose to the up-regulation of fatty acid oxidation (FAO) in myeloid cells, including macrophages and granulocytic and monocytic myeloid-derived suppressor cells. Asthma is a chronic inflammatory condition where macrophages, eosinophils, and polymorphonuclear cells play an important role in its pathophysiology. OBJECTIVE: We tested whether FAO might play a role in the development of asthma-like traits and whether the inhibition of this metabolic pathway could represent a novel therapeutic approach. METHODS: OVA- and house dust mite (HDM)-induced murine asthma models were used in this study. RESULTS: Key FAO enzymes were significantly increased in the bronchial epithelium and inflammatory immune cells infiltrating the respiratory epithelium of mice exposed to OVA or HDM. Pharmacologic inhibition of FAO significantly decreased allergen-induced airway hyperresponsiveness, decreased the number of inflammatory cells, and reduced the production of cytokines and chemokines associated with asthma. CONCLUSIONS AND CLINICAL RELEVANCE: These novel observations suggest that allergic airway inflammation increases FAO in inflammatory cells to support the production of cytokines, chemokines, and other factors important in the development of asthma. Inhibition of FAO by re-purposing existing drugs approved for the treatment of heart disease may provide a novel therapeutic approach for the treatment of asthma.

Nucleotides and nucleoside signaling in the regulation of the epithelium to mesenchymal transition (EMT).

The epithelium-mesenchymal transition (EMT) is an important process of cell plasticity, consisting in the loss of epithelial identity and the gain of mesenchymal characteristics through the coordinated activity of a highly regulated informational program. Although it was originally described in the embryonic development, an important body of information supports its role in pathology, mainly in cancerous and fibrotic processes. The purinergic system of inter-cellular communication, mainly based in ATP and adenosine acting throughout their specific receptors, has emerged as a potent regulator of the EMT in several pathological entities. In this context, cellular signaling associated to purines is opening the understanding of a new element in the complex regulatory network of this phenotypical differentiation process. In this review, we have summarized recent information about the role of ATP and adenosine in EMT, as a growing field with high therapeutic potential.

Minimally invasive repair of Morgagni hernia - A multicenter case series.

Children may benefit from minimally invasive surgery (MIS) in the correction of Morgagni hernia (MH). The present study aims to evaluate the outcome of MIS through a multicenter study. National institutions that use MIS in the treatment of MH were included. Demographic, clinical and operative data were analyzed. Thirteen patients with MH (6 males) were operated using similar MIS technique (percutaneous stitches) at a mean age of 22.2±18.3 months. Six patients had chromosomopathies (46%), five with Down syndrome (39%). Respiratory complaints were the most common presentation (54%). Surgery lasted 95±23min. In none of the patients was the hernia sac removed; prosthesis was never used. In the immediate post-operative period, 4 patients (36%) were admitted to intensive care unit (all with Down syndrome); all patients started enteral feeds within the first 24h. With a mean follow-up of 56±16.6 months, there were two recurrences (18%) at the same institution, one of which was repaired with an absorbable suture; both with Down syndrome. The application of MIS in the MH repair is effective even in the presence of comorbidities such as Down syndrome; the latter influences the immediate postoperative recovery and possibly the recurrence rate. Removal of hernia sac does not seem necessary. Non-absorbable sutures may be more appropriate.

Colangiocarcinoma hepático en un felino y hallazgos anatomopatólogicos, y clínicos compatibles con peritonitis infecciosa felina / Hepatic cholangiocarcinoma in a feline and anatomopathologic and clinical findings, compatible with Feline Infectious Peritonitis

Se presentan los hallazgos patomorfológicos de colangiocarcinoma hepático (CGC) con efusión peritoneal en un gato doméstico geronte y se relaciona con la sintomatología clínica y los hallazgos anatomopatológicos compatibles con la peritonitis infecciosa felina (PIF). Se atendió en la clínica veterinaria de la Universidad de los Llanos un paciente felino de 8 años de edad, criollo, con aumento de la silueta abdominal y depresión. Clínicamente se encontró deshidratación del 7%, hipotermia (37.2°C), mucosas pálidas, disnea y hepatomegalia. Mediante abdominocentesis se obtuvo un exudado no séptico y un cuadro citológico compatible con CGC con células columnares bajas dispuestas en panal de abeja, presentando anisocariosis, hipercromacia moderada, citoplasmas claros y vacuolados acompañados de un fondo sucio inflamatorio y hemorrágico con detritos celulares. En el análisis radiográfico se observó hepatomegalia con un patrón de punteado característico de formación neoplásica y ascitis. A la necropsia se presentó hemotórax e hidropericardio, ascitis y nódulos neoplásicos blancos duros al corte en el 45% del parénquima hepático y un patrón nodular sobre la superficie visceral del estomago, intestinos delgado, grueso y mesenterio. Las muestras se fijaron en formalina buferada al 10%, se procesaron mediante métodos rutinarios para microscopía óptica. Por histopatología se diagnosticó CGC moderadamente diferenciado con intensa desmoplasia. Citológica e histopatológicamente se evidenció un CGC hepático con efusión peritoneal que se relacionó con la sintomatología clínica y los hallazgos anatomopatológicos compatibles con la PIF.

Path morphological findings are presented regarding hepatic cholangiocarcinoma (CGC) with peritoneal effusion in a elderly domestic cat; its relation with clinical symptoms and pathological findings consistent with feline infectious peritonitis (FIP). The veterinary clinic of the Universidad de los Llanos dealt with a feline patient 8 years old, criollo, with increased abdominal silhouette and depression. 7% dehydration, hypothermia (37.2°C), pale mucous membranes, dyspnea and hepatomegaly were determined clinically. A performed abdominocentesis presented nonseptic exudate and a cytological symptom consistent with CGC with low columnar cells arranged in a honeycomb structure, presenting anisokaryosis, moderate hipercromacia, clear cytoplasm and accompanied by a dirty inflammatory and hemorrhagic background with cellular debris. The radiographic analysis showed hepatomegaly with a dotted pattern characteristic of neoplastic and ascite formations. A necropsy showed hemothorax and hydropericardium, ascites and white solid neoplastic nodules in 45% of the liver parenchyma and nodular pattern on the visceral surface of the stomach, small, large and mesentery intestine. Samples were placed in 10% buffered formalin, processed by routine methods for optic microscopy. In relation to histopathology moderately differentiated CGC was diagnosed with intense desmoplasia. A hepatic CGC was evidenced Cytologicly as well as histopathológicly with peritoneal effusion that was associated with clinical symptoms and anatomopathological findings consistent with FIP.

Synthesis and photodynamic properties of adamantylethoxy Zn(II) phthalocyanine derivatives in different media and in human red blood cells.

Novel unsymmetrically substituted Zn(II) phthalocyanine bearing an adamantylethoxy group (AZnPc) was synthesized by the ring expansion reaction of boron(III) subphthalocyanine chloride with an appropriated phthalonitrile derivative (APc). Also, APc was used to obtain a new Zn(II) phthalocyanine bearing four adamantylethoxy groups (A(4)ZnPc) by cyclotetramerization reaction. The spectroscopic and photodynamic properties of these photosensitizers were compared with those of a Zn(II) phthalocyanine substituted by four methoxy groups (M(4)ZnPc) in different media. Similar results were obtained in N,N-dimethylformamide. However, a higher photodynamic activity was found for AZnPc in a biomimetic system formed by reverse micelles. This behavior was also observed in the presence of human red blood (HRB) cells, which were used as an in vitro cellular model. Thus, AZnPc was the most effective photosensitizer to produce HRB cells hemolysis. The photodynamic effect produced a decrease in the HRB cells osmotic stability leading to the release of hemoglobin. Studies of photodynamic action mechanism showed that photohemolysis of HRB cells was protected in the presence of azide ion, while the addition of mannitol produced a negligible effect on the cellular photodamage, indicating the intermediacy of O(2)((1)Δ(g)). Therefore, the presence of an adamantyl unit in the phthalocyanine macrocycle represents an interesting molecular architecture for potential phototherapeutic agents.

Prevalencia de neoplasias en caninos en la universidad de los Llanos, durante 2004 a 2007 / Prevalence of neoplasm in canines in the university of the Llanos, during 2004 to 2007

Objetivo. Describir y clasificar las enfermedades neoplásicas diagnosticadas en el laboratorio de Patología Veterinaria de la Universidad de los Llanos, desde enero de 2004 hasta junio de 2007. Materiales y métodos. Como fuente de información se utilizó la base de datos de las historias clínicas y de los exámenes de necropsia de la Clínica Veterinaria de la Universidad de los Llanos. Las muestras analizadas procedieron de especímenes obtenidos por biopsias y de tumores hallados durante necropsia. Se analizaron 322 casos clínicos, de los cuales 113 correspondieron a enfermedades neoplásicas (35%). Resultados. En general, la especie más afectada fue la canina (93 de 113 casos), siendo las razas mestizas las más afectadas (p<0.05) y el sistema orgánico más lesionado el cutáneo, con 68 casos (60.2%), seguido de la glándula mamaria con 13 casos (11.5%). Las neoplasias de mayor incidencia fueron carcinoma escamocelular (15 casos), tricoepitelioma (11 casos) y mastocitoma canino III (10 casos). Se observó una relación positiva entre la edad y la presentación de tumores (p<0.01); el sexo no fue un factor determinante para la presentación de la enfermedad (p>0.05). Conclusiones. Los tumores de piel fueron los de mayor incidencia, quizá por la mayor facilidad de diagnóstico durante la consulta clínica, comparados con otras neoplasias que afectan órganos y tejidos más profundos.

Health indicators in the European regions: expanding regional comparisons to the new countries of the European Union - ISARE III.

OBJECTIVES: Most comparisons of health in Europe take place at the national level. However, there is increased interest in looking at health data at a sub-national level. This study aimed to establish the availability of health data at a regional level and to develop a methodology for the comparisons of health indicators at a sub-national level. In previous work on indicators at a regional level in the European Union, the authors recommended the development of such indicators. This paper takes into account the expansion of the European Union which took place in 2004. STUDY DESIGN: Observational study using routinely available data. METHODS: Similar to previous projects, a network of country correspondents was used and data were collected on a similar range of topics. In addition, a supplementary list of data was collected from one region of each country. RESULTS: Twenty-three countries out of the 25 member states of the European Union participated in the study. Where available, data were of relatively good quality. Data on mortality were most readily available, but data on important public health topics such as obesity were much more difficult to obtain. CONCLUSIONS: A database and a set of indicators for relevant sub-national areas of countries in the European Union, including new countries, were constructed. Data collection from the new countries was more straightforward due to the requirement for them to adhere to the nomenclature of territorial units for statistics (NUTS) levels. The lack of adherence to NUTS levels in the 'old' countries of the European Union continues to create problems. There remains an urgent need to introduce comprehensive sub-national data collection on important public health topics such as obesity and smoking.

Amenaza de parto prematuro. Rotura prematura de membranas. Corioamnionitis / Preterm labour. Premature rupture of membranes. Chorioamnionitis

Cuanto menor es la edad gestacional al nacer, mayores el riesgo de morbimortalidad perinatal y de morbilidadmaterna (aumento del número de cesáreas, metritispostparto). Es importante diagnosticar a tiempouna amenaza de parto prematuro (APP) para comenzarcon el tratamiento tocolítico y conseguir una maduraciónpulmonar fetal eficaz. También es necesario distinguirlo que es una verdadera de una falsa APP. Hayuna alta incidencia de sobrediagnóstico y de sobretratamientoy es frecuente la hospitalización prolongada.Con las pruebas que informan sobre la modificacióncervical y la dinámica uterina se puede establecer undiagnóstico certero que conlleve una conducta adecuada.La identificación temprana y la prevención primariano están tan desarrolladas como la actitud terapeútica,pero es importante tener en cuenta mecanismos paraidentificar pacientes de alto riesgo. Entre ellos estánlos antecendentes de parto pretérmino, signos y síntomas,modificación cervical, etc. La rotura prematurade membranas y la corioamnionitis conllevan riesgo departo pretérmino si se producen en edades gestacionestempranas(AU)

The lower the gestational age at birth, the greaterthe risk of perinatal morbidity and mortality and maternalmorbidity (increase in the number of caesareans,postnatal metritis). It is important for there to be a timelydiagnosis of threatened preterm labour (TPL) inorder to begin tocolytic treatment and to obtain efficientfoetal pulmonary maturity. It is also necessary todistinguish between a true and a false TPL. There is ahigh tendency of overdiagnosis and overtreatment andprolonged hospitalisation is frequent. With cervicalalteration and uterine dynamics tests it is possible toestablish an accurate diagnosis that will result in suitablemanagement. Early identification and primaryprevention are not as developed as the therapeutic attitude,but it is important to bear in mind mechanismsfor identifying high risk patients. They include antecedentsof preterm labour, signs and symptoms, cervicalalteration, etc. Premature rupture of membranes andchorioamnionitis involve the risk of preterm labour ifthey occur in early gestational ages(AU)

Confocal scanning optical microscopy of a 3-million-year-old Australopithecus afarensis femur.

Portable confocal scanning optical microscopy (PCSOM) has been specifically developed for the noncontact and nondestructive imaging of early human fossil hard tissues, which here we describe and apply to a 3-million-year-old femur from the celebrated Ethiopian skeleton, "Lucy," referred to Australopithecus afarensis. We examine two bone tissue parameters that demonstrate the potential of this technology. First, subsurface reflection images from intact bone reveal bone cell spaces, the osteocyte lacunae, whose density is demonstrated to scale negatively with body size, reflecting aspects of metabolism and organismal life history. Second, images of a naturally fractured cross section near to Lucy's femoral mid-shaft, which match in sign those of transmitted circularly polarized light, reveal relative collagen fiber orientation patterns that are an important indicator of femoral biomechanical efficacy. Preliminary results indicate that Lucy was characterized by metabolic constraints typical for a primate her body size and that in her femur she was adapted to habitual bipedalism. Limitations imposed by the transport and invasive histology of unique or rare fossils motivated development of the PCSOM so that specimens may be examined wherever and whenever nondestructive imaging is required.