Bdellovibrio reynosensis sp. nov., from a Mexico soil sample.

A novel predatory bacterium, strain LBG001T, has been isolated from Reynosa, Mexico. The 16S rRNA shares approximately 97 % sequence identity with many reported strains in the genus Bdellovibrio including the type strain Bdellovibrio bacteriovorus HD100T. Phylogenetic trees based on the 16S rRNA gene and on 30 concatenated housekeeping genes or core genes showed that LBG001T is on a separate branch from the B. bacteriovorus group. LBG0001T has a genome size of 3 582 323 bp with a G+C content of 43.1 mol %. The average nucleotide identity, average amino acid identity and digital DNA-DNA hybridization values with other members of the genus Bdellovibrio (<79, <72 and <17 %, respectively) qualifies the strain to represent a new species in the genus. Strain LBG001T formed visible plaques on all 10 tested Gram-negative bacterial species. The phenotypic characteristics, phylogenetic analysis and genomic taxonomic studies support the classification of the strain as representing a new species for which the name Bdellovibrio reynosensis sp. nov. is proposed. The type strain is LBG001T(=ATCC TSD-288T =CM-CNRG 0932T).

Right Ventricular Structure and Function in Idiopathic Pulmonary Fibrosis with or without Pulmonary Hypertension.

AIMS: To elucidate right ventricular (RV) function in patients with idiopathic pulmonary fibrosis (IPF) with and without pulmonary hypertension (PH) and its relation to other features of the disease. METHODS AND RESULTS: Clinical evaluation, standard Doppler echo, Doppler myocardial imaging (DMI), and 2D strain echocardiography (STE) of RV septal and lateral walls were performed in 52 IPF patients (66.5 ± 8.5 years; 27 males) and in 45 age- and sex-comparable controls using a commercial US system (MyLab Alpha, Esaote). Pulmonary artery mean pressure (mPAP) was estimated by standard echo Doppler. RV global longitudinal strain (RV GLS) was calculated by averaging RV local strains. The IPF patients were divided into 2 groups by noninvasive assessment of PH: no PH (mPAP<25 mmHg; 36 pts) and PH (mPAP ≥25 mmHg; 16 pts). Left ventricular diameters and ejection fraction were comparable between controls and IPF, while GLS was impaired in IPF (P < 0.01). RV end-diastolic diameters, wall thickness andmPAP were increased in IPF patients with PH. In addition, pulsed DMI detected in PH IPF impaired myocardial RV early diastolic (Em) peak velocity. Also peak systolic RV strain was reduced in basal and middle RV lateral free walls in IPF, as well as RV GLS (P < 0.0001). The impairment in RV wall strain was more evident when comparing controls with the no PH group than comparing the no PH group with the PH group. By multivariate analysis, independent association of RV strain with both six-minute walking test distance (P < 0.001), mPAP (P < 0.0001), as well as with forced vital capacity (FVC) % (P < 0.005) in IPF patients were observed. CONCLUSIONS: Impaired RV diastolic and systolic myocardial function were present even in IPF patients without PH, which indicates an early impact on RV function and structure in patients with IPF.

Extended-Spectrum ß-Lactamase-Producing Escherichia coli Isolated from Food-Producing Animals in Tamaulipas, Mexico.

Extended-spectrum ß-lactamase (ESBL)-producing E. coli has become an important global problem for the public health sector. This study aims to investigate the E. coli antimicrobial resistance profile among living food-producing animals in Tamaulipas, Mexico. A total of 200 fecal samples were collected from bovines, pigs, chickens and sheep. A total of 5.0% of the strains were phenotypically confirmed as ESBL producers. A high percentage of phenotypic antimicrobial resistance was observed against gentamicin (93.3%), tetracycline (86.6%) and streptomycin (83.3%). The gentamicin-resistant strains showed MDR, distributed among 27 resistance patterns to different antimicrobials. The antimicrobial resistance gene tet(A) was detected in 73.3% of isolates, aadA1 in 60.0% and sul2 in 43.3% of strains. The blaCTX-M gene was found in 23.3% of strains. The virulence gene hlyA was detected in 43.3% of isolates; stx1 and stx2 were not detected in any strain. The phylotyping indicated that the isolates belonged to groups A (33.3%), B1 (16.6%), B2 (40.0%) and D (10.0%). These results show that food-producing animals might be a reservoir of ESBL-producing bacteria and may play a role in their spread.

Neonatal Antibiotic Treatment Can Affect Stool Pattern and Oral Tolerance in Preterm Infants.

Preterm neonates are at high risk of infectious and inflammatory diseases which require antibiotic treatment. Antibiotics influence neonatal gut microbiome development, and intestinal dysbiosis has been associated with delayed gastrointestinal transit. Neonates who take less time to pass meconium have a better tolerance to enteral feeding. We analyzed the effect of neonatal antibiotic treatment on the stool pattern and oral tolerance in 106 preterm infants < 33 weeks gestational age. Neonates were classified in 3 groups according to neonatal antibiotic (ABT) treatment days: no antibiotics, 3−7 d ABT, and ≥8 d ABT. Preterm infants from the ≥8 d ABT group took longer to pass meconium and to start green and yellow stools, took longer to reach 100 and 150 mL/kg/day, and reached reduced volumes in enteral feeds at day of life 14 and 28 than infants from no ABT and 3−7 d ABT groups. Multiple linear regression models showed that neonatal antibiotic treatment, birth weight, invasive mechanical ventilation, surfactant, enteral feeding start day, neonatal parenteral nutrition, and neonatal fasting days are associated with the stool pattern and oral tolerance in preterm infants.

A Case of Unilateral Hyperlucency of the Lung: a Rare Adult Occurrence of Swyer-James-MacLeod Syndrome.

Swyer-James-MacLeod syndrome is a rare pulmonary disorder that exhibits unilateral hyperlucency of a part of or the entire lung and because it is usually asimptomatic the diagnostic of this illness is discovered accidentally after a chest X-ray. Although the cause of this disorder is not completely understood, most authors believe that this is due to late sequela of infectious bronchiolitis that occurs during childhood. The symptoms presented by the individuals are often scarce at the moment of diagnostic, but a history of recurrent episodes of pulmonary infection accompanied by dyspnea, hemoptysis and/or chronic productive cough should raise the suspicion for such a diagnosis. Swyer-James-MacLeod syndrome can be interpreted as asthma or pulmonary embolism and this can result in inappropriate therapy. This case report describes a 38-year-old patient with chronic respiratory symptoms diagnosed on the findings of the chest X-ray and high resolution CT.

Susceptibilidad antimicrobiana en Pseudomona spp, en el Hospital General Docente Cuenca-Ecuador / Antimicrobial susceptibility in Pseudomona spp, in the General Teaching Hospital Cuenca-Ecuador / Suscetibilidade antimicrobiana em Pseudomona spp, no Hospital Geral Escola Cuenca-Ecuador

La Pseudomona aeruginosa es un patógeno nosocomial por excelencia; la aparición de cepas multidrogoresistentes (MDR) y extremodrogoresistentes (XDR) cada vez es más frecuente y genera gran preocupación; el uso indiscriminado de antibióticos ha ocasionado esta situación. El objetivo de este estudio fue conocer los diferentes perfiles de resistencia que presentan los aislados objetos de estudio según su procedencia, ya sea a nivel intrahospitalario o de origen comunitario además de caracterizar los principales mecanismos de resistencia y antibiotipos. La presente investigación fue de tipo documental, descriptiva, de corte transversal, para lo cual se utilizó los datos acumulados de susceptibilidad reportados por el departamento de microbiología del Hospital General Docente durante el enero de 2015 hasta diciembre de 2019. Se encontró que en este hospital existe una mayor prevalencia de resistencia a aminoglucósidos (20-25%), fluoroquinolonas (22-25%) y carbapenémicos (19-21%); siendo P. aeruginosa la especie más prevalente. Respecto al tipo de carbapenemasas que son las de interés clínico por su limitante opción terapéutica, se identificó una cepa con fenotipo compatible con metalobetalamasa, se presume que el mecanismo de resistencia predominante fue impermeabilidad. No se identificaron cepas PDR, pero el 21,6% se mostraron con un perfil MDR, aisladas principalmente en los servicios hospitalarios al igual que las cepas XDR.

Pseudomonas aeruginosa is a nosocomial pathogen par excellence; the appearance of multidrug resistant (MDR) and extreme drug resistant (XDR) strains is becoming more frequent and is causing great concern; the indiscriminate use of antibiotics has caused this situation. The objective of this study was to know the different resistance profiles presented by the isolated objects of study according to their origin, either at the intrahospital level or of community origin, in addition to characterizing the main resistance mechanisms and antibiotypes. The present investigation was of a documentary, descriptive, cross-sectional type, for which the accumulated susceptibility data reported by the microbiology department of the General Teaching Hospital from January 2015 to December 2019 was used. It was found that in this hospital there is a higher prevalence of resistance to aminoglycosides (20-25%), fluoroquinolones (22-25%) and carbapenems (19-21%); being P. aeruginosa the most prevalent species. Regarding the type of carbapenemases that are of clinical interest due to their limiting therapeutic option, a strain with a phenotype compatible with metallobetalamase was identified, it is presumed that the predominant resistance mechanism was impermeability. No PDR strains were identified, but 21.6% were shown with an MDR profile, isolated mainly in hospital services as well as the XDR strains.

Pseudomonas aeruginosa é um patógeno nosocomial por excelência; o aparecimento de cepas multirresistentes (MDR) e extremamente resistentes aos medicamentos (XDR) está se tornando mais frequente e causando grande preocupação; o uso indiscriminado de antibióticos tem causado essa situação. O objetivo deste estudo foi conhecer os diferentes perfis de resistência apresentados pelos objetos isolados de estudo de acordo com sua origem, seja em nível intra-hospitalar ou de origem comunitária, além de caracterizar os principais mecanismos de resistência e antibióticos. A presente investigação foi do tipo documental, descritiva, transversal, para a qual foram utilizados os dados de suscetibilidade acumulada reportados pelo departamento de microbiologia do Hospital Geral Universitário no período de janeiro de 2015 a dezembro de 2019. Verificou-se que neste hospital há maior prevalência de resistência aos aminoglicosídeos (20-25%), fluoroquinolonas (22-25%) e carbapenêmicos (19-21%); sendo P. aeruginosa a espécie mais prevalente. Em relação aos tipos de carbapenemases de interesse clínico devido à sua opção terapêutica limitante, foi identificada uma cepa com fenótipo compatível com metalobetalamase, presume-se que o mecanismo de resistência predominante foi a impermeabilidade. Nenhuma cepa PDR foi identificada, mas 21,6% mostraram ter um perfil MDR, isolado principalmente em serviços hospitalares, bem como as cepas XDR.

TB or not TB in HIV infection.

The progression of tuberculosis (TB) is significantly faster in patients with HIV infection. TB is also the main cause of death for HIV-infected individuals, resulting in fatality for 1 of 3 patients. We present the case of a 26-year-old male who arrived at the hospital having previously been diagnosed with HIV in 2014, but was not compliant to the ARV treatment prescribed. The patient presented with acute onset of fever, cough, hemoptysis and malaise. Investigations such as sputum samples and a lymph node biopsy revealed the presence of M. tuberculosis in optic microscopy, which led to a diagnosis of pulmonary and ganglionary TB. As one of the first opportunistic infections that occur in HIV-infected individuals, TB may be one of the earliest clues of an HIV infection. Current guidelines recommend that all individuals diagnosed with HIV should also undertake testing for TB infections.

Histopatología, inmunohistoquímica y metástasis en pacientes con carcinoma basocelular: Revisión Narrativa / Histopathology, immunohistochemistry, and metas-tasis in patients with basal cell carcinoma: A bibliographic review / Histopatologia, imunohistoquímica e metástases em pacientes com carcinoma basocelular: revisão narrativa

Introducción: El carcinoma basocelular (CBC)es una de las neoplasias más comunes de la piel. En nuestro país, por su localización, representa una entidad patológica de gran importancia, por la radiación ultravioleta elevada, que es inversamente proporcional a la latitud geográfica en la que nos encontramos en Ecuador. El objetivo del presente trabajo es revisar las características claves que distinguen al Carcinoma basocelular, y actualizar los conocimientos, incluyendo la evidencia disponible en hallazgos histopatológicos, marcadores de inmunohistoquímica y metástasis en esta patología

Introduction: Basal cell carcinoma BCC is one of the most common skin neoplasms. In our country, because of its location, it represents a pathological entity of great importance, due to the high ultraviolet radiation, that is inversely proportional to the geographical latitude we are in Ecuador. This paper objective is to review the key features that distinguish basal cellcarcinoma, and update knowledge, including the available evidence on histopathological findings, immunohistochemical markers and metastasis in this pathology.

Introdução: Carcinoma basocelular O CBC é uma das neoplasias cutâneas mais comuns. Em nosso país, por sua localização, representa uma entidade patológica de grande importância, devido à alta radiação ultravioleta, que é inversamente proporcional à latitude geográfica em que nos encontramos no Equador. O objetivo deste artigo é revisar as principais características que distinguem o carcinoma basocelular e atualizar o conhecimento, incluindo as evidências disponíveis sobre achados histopatológicos, marcadores imunohistoquímicos e metástases nessa patologia.

Surgical and Anatomical Particularities and Difficulties in Histopathological Sampling for Superior Vena Cava Syndrome.

The superior vena cava syndrome is due to the increased venous pressure in the upper torso, neck and head, caused by the obstruction of the superior vena cava. Both external and internal factors cause obstruction (95% are malign causes), and the most severe manifestation is represented by cerebral edema that can even lead to coma. The diagnostic algorithm for the superior vena cava syndrome is widely known. There are many controversies and discussions about the safety of histopathological sampling. The purpose of this paper is to assess such risks, the complication rate and the diagnostic yield of surgical sampling, by analyzing the 26 interventions performed in our clinic. Although the complication rate was higher than that observed in the absence of the superior vena cava syndrome, surgery remains mandatory for a rapid histopathological diagnosis, therefore demanding a protocol that must include a mandatory extemporaneous exam of the biopsy.

Factores laborales y estrés percibido en los conductores de buses medellín, 2017

Introducción. el estrés es una respuesta adaptativa física y psicológica ante las demandas y amenazas del entorno. Sumar el estrés al espacio laboral, tiene consecuencias sobre la calidad de vida laboral de los trabajadores. Métodos. estudio observacional descriptivo de corte transversal. Muestra de 278 conductores, con un nivel de confianza del 98%, un margen error del 5% y una proporción esperada del 50%. Para la selección de los participantes se realizó un muestreo aleatorio simple. Se utilizó la escala de la EEP-10. Se realizó un análisis univa-riado y bivariado. Resultados. se encontró una correlación positiva y significativa (0,232 y valor p=0,000) entre la edad y el porcentaje de no control de estrés y asociación entre la variable porcentaje de control de estrés con la ruta de buses que conduce el conductor (valor p=0,019). Conclusiones. los conductores de buses están expuestos a una serie de condiciones desfavorables que pueden poner en peligro su salud y generar algún tipo de estrés.

Introduction. Stress is an adaptive physical and psychological response to the demands and threats of the environment. Add stress to a workplace, has consequences on the quality of work environment for workers. Methods. Descriptive, cross-sectional observational study. Sample of 278 subjects, with a confidence level of 98%, an error margin of 5% and an expected proportion of 50%. In order to select the participants, a simple random sampling was carried out. The scale of the EEP-10 was applied. A univariate and bivariate analysis was performed. Results. A positive and significant correlation (0.232 and p value = 0.000) was found between age and the percentage of non-stress control, and association between the percentage of stress control variable and the bus route taken by drivers (p value). = 0.019). Conclusions. Bus drivers are exposed to different unfavorable conditions that can endanger their health and generate some kind of stress.

Introdução. O estresse é uma resposta física e psicológica adaptativa às demandas e ameaças do meio ambiente. Adicionar estresse ao local de trabalho, tem consequências sobre a qualidade de vida no trabalho dos empregados. Métodos. Estudo observacional descritivo, transversal. Amostra de 278 motoristas, com nível de confiança de 98%, margem de erro de 5% e proporção esperada de 50%. Para a seleção dos participantes, foi realizada uma amostragem aleatória simples. A escala do EEP-10 foi utilizada. Uma análise univariada e bivariada foi realizada. Resultados. Uma correlação positiva e significativa (0,232 e valor-p = 0,000) entre a idade e a percentagem de no controle do estresse e associação entre a variável porcentagem de controle de estresse com a rota de ônibus assignada ao motorista (valor-p = 0,019). Conclusões. Os motoristas de ônibus são expostos a uma série de condições desfavoráveis que podem comprometer sua saúde e gerar algum tipo de estresse.

Facetas de desgaste dental en conductores de buses de una empresa de Medellín 2017 / Dental wear facets in drivers of buses of a company of Medellin 2017

El objetivo principal delestudiofueidentificar las facetas de desgaste dental de los conductores de busde una empresa de Medellín. Este fue un estudio de corte transversal,con unenfoque empírico analítico de alcance correlacional y de diseño no experimental. A través deun cálculo probabilístico se tomó una muestra de278 conductores con un nivel de confianza del 98%, un margen error del 5% y una proporción esperada del 50%.Cada participante diligencióuna encuesta,y posteriormentese realizóuna valoración clínica dental. A partir de los datos se hicieronanálisisunivariado, bivariado y multivariado. En los resultados huboasociación estadísticamente significativa con la variable "ruta en la que conduce"(p=0,01), siendo la respuesta afirmativa a esta la única que se encuentra en la ecuación. Esta misma se presenta como factor protector (0,33 ­IC 0,14­0,80). La mayoría delosconductores (82,3%) manifestaronfacetas de desgaste dental.En relación conla clasificación,el grado 1fue el que más prevaleció. La razón del desgaste está dada por procesos multifactoriales,por lo que es muy importantedetectarlas facetasa tiempo para evitar un daño en la estructura dental

The main objective of this study was to identify the facets of dental wear of bus drivers in a company in Medellin. It was a cross-sectional study, with an empirical analytical approach of correlational scope and non-experimental design. Through a probabilistic calculation, a sample of 278 drivers was taken with a confidence level of 98%, an error margin of 5% and anexpected proportion of 50%. Each participant completed a survey and then a dental clinical assessment was made. Univariate, bivariate and multivariate analysis weremade from the data. In the results there was a statistically significant association, withthe variable route in which it leads (p = 0.01), with the affirmative response to this variable being the only one found in the equation. This is presented as a protective factor (0.33-CI 0.14-0.80). As a conclusion of this study, the great majority of drivers (82.3%) presented facets of dental wear, and according to the classification, grade 1 was the most prevalent. The reason for the wear is given by multifactorial processes, so it is vital to detect them in time to avoid damage to the tooth structure.

Efecto de barnices fluorados sobre el esmalte erosionado a través de microscopia de fuerza atómica: Estudio in vitro / Efeitos de vernizes fluoretados em esmalte erodido mediante microscopia de força atômica: Estudo in vitro / Effect of fluoride varnishes on eroded enamel by atomic force microscopy: In vitro study

Objetivo: Evaluar el efecto de diferentes barnices fluorados sobre el esmalte erosionado a través de Microscopia de Fuerza Atómica (MFA). Materiales y métodos: Se utilizaron 30 muestras de esmalte de incisivos bovinos sin lesiones de caries defectos estructurales o fracturas, fueron divididas en 3 grupos (N=10): G1 control negativo, G2 Duraphat (Colgate) y G3 Clinpro White Varnish (3M ESPE). El MFA equipado con una punta de no contacto, con parámetros de rugosidad media (Ra) y rugosidad media cuadrática (Rrms), con imágenes de un área de 50x50 micras a una resolución de 256x256 pixeles y 0,5 Hz. Se midió la rugosidad inicial, luego se realizó desafío erosivo con Sprite Zero y remineralización con saliva artificial, después de 4 ciclos de erosión y remineralización se midió la rugosidad del esmalte como protección mecánica y al 1, 2, 3 y 4 días como protección química. Los datos se analizaron estadísticamente con las pruebas de ANOVA, Tukey y T de Student con un nivel de significancia al 5%. Resultados: El test de ANOVA mostró una diferencia en los grupos de barnices de flúor en el 2º, 3º y 4º día en comparación con el grupo control (p <0,05). El test de Tukey mostró una diferencia entre Duraphat y Clinpro en valores de Ra (p = 0,03) y Rrms (p = 0,05) en el 4°día. La T de Student demostró que no hay diferencias para Clinpro en Ra (p = 0,14) y Rrms (p = 0,13) desde los valores iniciales hasta el 4º día. Conclusión: Clinpro White Varnish tiene una mejor acción para reducir la rugosidad superficial en la superficie del esmalte cuando se somete a desafíos ácidos.

Purpose: To evaluate the effect of different fluoride varnishes on eroded enamel through Atomic Force Microscopy (AFM). Materials and Methods: 30 samples of bovine incisor enamel without carious lesions, defective structure or fractures were divided into 3 groups (N = 10): G1: negative control, G2: Duraphat® (Colgate) and G3: Clinpro™ White Varnish (3M ESPE). The AFM was used, equipped with a non-contact tip with parameters such as average roughness (Ra) and the mean square roughness (Rrms) at an area for images of 50 x 50 microns with a resolution of 256 X 256 pixels and 0.5 Hz. First, the initial roughness was measured, then an erosive trail was carried out with Sprite Zero and remineralization with artifi-cial saliva. After 4 cycles of erosion and remineralization, the roughness of enamel as mechanic protection was measured and at 1, 2, 3 and 4 days as chemical protection. Data were analyzed statistically with ANOVA, Tukey and Student T with a significance level of 5%. Results: The ANOVA test showed a difference in the groups of fluoride varnishes on the 2nd, 3rdand 4th day in comparison with the control group (p <0.05). The Tukey test showed a difference between Duraphat® and Clinpro™ in the values of Ra (p = 0.03) and Rrms (p = 0.05) on the 4th day. The Student's T test showed no difference for Clinpro™ in Ra (p = 0.14) and Rrms (0.13) from the initial values until 4th day. Conclusion: Clinpro™ White Varnish shows better results to reduce surface roughness in the enamel when subjected to acidic trails.

Objetivo: Avaliar o efeito de diferentes vernizes fluoretados no esmalte erodido por meio de microscopia de força atômica (MFA). Materiais e Métodos: Foram selecionadas 30 amostras de esmalte de incisivos bovinos sem cárie, defeitos de estrutura ou fraturas, foram divididas em 3 grupos (n = 10): G1: controle negativo, G2: Duraphat (Colgate) e G3: Clinpro White Varnish (3M ESPE). Foi utilizado MFA, equipado com uma ponta de não contato. Determinaram-se parâmetros fotográficos como a rugosidade média (Ra) e rugosidade média quadrática (Rrms) da superfície, com imagens de uma área de 50 x 50 microns com uma resolução de 256 X 256 pixels e 0,5 Hz. Em primeiro lugar procedeu-se realizar a medição da rugosidade inicial, foi realizada o desafio erosivo com Sprite Zero e remineralização com saliva artificial, após 4 ciclos de erosão e remineralização foi medido a rugosidade do esmalte foi medida como proteção mecânica e ao 1, 2, 3 e 4 dias como proteção química. Os dados foram analisados estatisticamente com ANOVA, Tukey T de Student com um nível de significância de 5%. Resultados: O Teste de ANOVA mostrou uma diferença dos grupos de vernizes fluoretados no 2º, 3º e 4º dia em comparação com o grupo controle (p <0,05). O Teste de Tukey mostrou uma diferença entre Duraphat e Clinpro nos valores de Ra (p = 0,03) e Rrms ao 4° dia (p = 0,05). O teste T de Student não mostrou nenhuma diferença para Clinpro em Ra (p = 0,14) e Rrms (0,13) dos valores iniciais até ao dia 4. Conclusão: O Verniz Clinpro White Varnish tem melhor ação na redução da rugosidade da superfície do esmalte quando foi submetido à desafios ácidos.

Alteraciones bucales presentes en pacientes con diabetes mellitus tipo II que asisten al área de endocrinología del Hospital Rosales / Oral disorders present in patients with type II diabetes mellitus attending the endocrinology area of Hospital Rosales

En la actualidad existen enfermedades que por sus características pueden presentar manifestaciones bucales, una de ellas es la Diabetes Mellitus; Es una patología particularmente interesante, porque una vez diagnosticada, es controlable mediante modificaciones en la dieta y la actividad física, por lo tanto se considera que altos índices de complicaciones secundarias, indican, entre otros problemas en la calidad de atención o porque los pacientes no asisten a los controles y otros asisten y no atienden indicaciones. En El Salvador, hay un porcentaje considerable de la población que padece esta enfermedad, con una prevalencia bastante alta. Esta investigación expresa cuales son las infecciones bacterianas, virales y micóticas, así como otras alteraciones bucales más frecuentes en pacientes con Diabetes Tipo II, que asisten a consulta externa del área de encinología del Hospital Nacional Rosales. Un dato importante que debe tomar en cuenta el Odontólogo es que las infecciones a nivel de la Cavidad Bucal suele provocar una pérdida en el control metabólico de la diabetes esto debido a que las infecciones generan un estado de estrés que aumenta la deficiencia de insulina como consecuencia las defensas orgánicas no controlan bien la infección. Dentro de las alteraciones bucales que más comúnmente se asocian a la Diabetes Mellitus tipo 2 son: Infecciones Bacterianas, Infecciones Virales, Infecciones Micóticas y otras alteraciones.

At present there are diseases that due to their characteristics can present oral manifestations, one of them is Diabetes Mellitus; It is a particularly interesting pathology, because once diagnosed, it is controllable through modifications in diet and physical activity, therefore it is considered that high rates of secondary complications indicate, among other problems in the quality of care or because patients do not they attend the controls and others attend and do not attend indications. In El Salvador, there is a considerable percentage of the population that suffers from this disease, with a fairly high prevalence. This research expresses which are the bacterial, viral and fungal infections, as well as other most frequent oral alterations in patients with Type II Diabetes, who attend the outpatient consultation of the encinology area of ​​the Hospital Nacional Rosales. An important fact that the dentist must take into account is that infections at the level of the oral cavity usually cause a loss in metabolic control of diabetes, this because infections generate a state of stress that increases insulin deficiency as a consequence organic defenses do not control infection well. Among the oral alterations that are most commonly associated with Type 2 Diabetes Mellitus are: Bacterial Infections, Viral Infections, Fungal Infections and other alterations.

Abuso sexual en pediatría: factores epidemiológicos / Sexual abuse in pediatrics: epidemiologics factors

Introducción. Objetivo: dar a conocer los antecedentes, dinámica familiar, cuadro clínico y repercusiones del abuso sexual en un grupo de niños víctimas de abuso sexual. Material y métodos. Se incluyeron en forma prospectiva 153 pacientes que tuvieron el diagnóstico de abuso sexual en cualquiera de sus formas y que fueron atendidos en el HOspital General Dr. Manuel Gea González, durante el período de un año. Resultados. Existió predominio del sexo femenino (70.5 por ciento) y se afectó principalmente al grupo de preescolares. La mayoría de las familias eras disfuncionales o se encontraban desintegradas y sólo el 34 por ciento de los padres se encontraban casados. El abuso se dio en repetidas ocasiones y se llevó a cabo en mayor frecuencia en el domicilio de la víctima (49.7 por ciento), siendo el vecino el principal agresor (29.4 por ciento), seguido del padrastro (17.6 por ciento). El reporte del abuso por parte de la víctima se dio tardíamente en la mayoría de los casos, ya que sólo el 39 por ciento lo hizo en el primer mes. La respuesta de los padres al evento fue principalmente de preocupación (43.2 por ciento) y de sobreprotección (22.8 por ciento). Las manifestaciones clínicas en el paciente fueron principalmente: irritabilidad (18.9 por ciento), agresividad (14.4 por ciento) y masturbación (10.4 por ciento). Conclusión. Existen indicadores en los niños que deben hacer sospechar abuso sexual; se resalta la impotencia del diagnóstico temprano para brindar un tratamiento oportuno y limitar el daño