Resumen El presente estudio se enfocó en comparar la adhesión y proliferación de fibroblastos de ligamento periodontal humano (hPDL) en secciones transversales de raíces previamente obturadas con dos técnicas de obturación diferentes: obturación hidráulica empleando cono único de gutapercha y BioRoot RCS como sellador (HO), y obturación de condensación de onda continua y AH-Plus como sellador (CWC). Los selladores se usaron en un modelo in vitro que simula la interacción entre los tejidos periodontales y los materiales de obturación. Los conductos radiculares fueron instrumentados, esterilizados y obturados. La muestra se compuso de un total de 15 raíces con la técnica BioRoot RCS/HO y 15 raíces con la técnica AH-Plus/CWC. Las células de hPDL fueron sembradas en condiciones estándar de cultivo sobre las raíces seccionadas. Los resultados fueron obtenidos a intervalos de 4 y 24h para adhesión celular, y a los 3,5,7,14 y 21 días de cultivo para proliferación celular. La adhesión celular a las 4 y 24 horas mostró ser diferente para ambas técnicas en comparación con el grupo control, siendo más importante en el grupo BioRoot RCS/HO. La diferencia en la proliferación entre grupos se observó a los 14 días de cultivo, únicamente para el grupo BioRoot RCS/HO; Sin embargo para el día 21 ambas técnicas mostraron mayor proliferación celular que el grupo control, con mejor respuesta para el grupo BioRoot RCS/HO. Este estudio ha demostrado que ambos selladores de conductos permiten la adhesión y crecimiento de fibroblastos de ligamento periodontal, siendo el grupo BioRoot RCS/HO el que mostró mayor biocompatibilidad.

Abstract The present study aimed to compare the adhesion and proliferation of human periodontal ligament fibroblasts (hPDL) in transverse sections of the teeth sealed with two different obturation techniques, BioRoot RCS/hydraulic obturation (HO) and AH-Plus/continuous-wave condensation (CWC). The techniques were tested using an in vitro model to simulate the interaction between periodontal tissues and the materials. The root canals were instrumented and sterilized. A total of 15 samples were obturated with BioRoot RCS/HO and 15 samples with AH-Plus/CWC. Then, roots were sectioned to obtain obturated teeth slices, and hPDL cells were seeded onto the root slices. The results were obtained at intervals of 4 and 24h for cell adhesion; and at 3,7,14, and 21 days for cell proliferation. Empty cell culture plates were use as controls. The cell adhesion was increased at 4 and 24h for both groups, with an increased response observed in the BioRoot RCS/HO group (p<0.05). The difference in cell proliferation was also found between experimental groups. After 14 days of culture, BioRoot RCS/HO group showed an increase response than control and AH-Plus/CWC groups (p<0.05), and after 21 days both groups behaved better than control group, with an increased response observed in the BioRoot RCS/HO group. This study demonstrated that both root canal sealers allow the attach and growth of periodontal ligament fibroblasts, with an increased biological response in the BioRoot RCS/HO group.

ABSTRACT Objective Placenta accreta spectrum (PAS) is a cause of massive obstetric hemorrhage and maternal mortality. The application of family-centered delivery techniques (FCDTs) during surgery to treat this disease is infrequent. We evaluate the implementation of FCDTs during PAS surgeries. Methods This was a prospective, descriptive study that included PAS patients undergoing surgical management over a 12-month period. The patients were divided according to whether FCDTs were applied (group 1) or not (group 2), and the clinical outcomes were measured. In addition, hospital anesthesiologists were surveyed to evaluate their opinions regarding the implementation of FCDTs during the surgical management of PAS. Results Thirteen patients with PAS were included. The implementation of FCDTs during birth was possible in 53.8% of the patients. The presence of a companion during surgery and skin-to-skin contact did not hinder interdisciplinary management in any case. Conclusion Implementation of FCDTs during PAS care is possible in selected patients at centers with experience in managing this disease.

Resumo Objetivo O espectro da placenta acreta (do inglês placenta accreta spectrum - PAS) é causa de hemorragia obstétrica maciça e mortalidade materna. A aplicação de técnicas de parto centrado na família (do inglês family-centered delivery techniques - FCDTs) durante a cirurgia para tratar esta doença é pouco frequente. Avaliamos a implementação das FCDTs durante as cirurgias do PAS. Métodos Estudo prospectivo e descritivo que incluiu pacientes com PAS submetidos a tratamento cirúrgico durante um período de 12 meses. Os pacientes foram divididos de acordo com a aplicação de FCDTs (grupo 1) ou não (grupo 2), e os resultados clínicos foram medidos. Além disso, anestesiologistas hospitalares foram entrevistados para avaliar suas opiniões sobre a implementação das FCDTs durante o manejo cirúrgico do PAS. Resultados Foram incluídos 13 pacientes com PAS. A implementação de FCDTs durante o parto foi possível em 53,8% das pacientes. A presença do acompanhante durante a cirurgia e o contato pele a pele não prejudicou o manejo interdisciplinar em nenhum caso. Conclusão A implementação de FCDTs durante o atendimento do PAS é possível em pacientes selecionados em centros com experiência no manejo dessa doença.

Resumo Objetivo Recomenda-se o encaminhamento imediato de pacientes com fatores de risco para espectro placentário acreta (PAS, na sigla em inglês) para centros especializados, favorecendo assim o diagnóstico precoce e o manejo interdisciplinar. No entanto, erros diagnósticos são frequentes, mesmo em centros de referência (CRs). Buscou-se avaliar o desempenho do diagnóstico pré-natal para PAS em um hospital latino-americano. Métodos Um estudo descritivo retrospectivo incluindo pacientes encaminhados por suspeita de SAP foi realizado. Os dados dos exames de imagem do pré-natal foram comparados com os diagnósticos finais (intraoperatórios e/ou histológicos). Resultados Foram incluídos 162 pacientes no presente estudo. A idade gestacional mediana no momento da primeira ultrassonografia suspeita de PAS foi de 29 semanas, mas as pacientes chegaram ao CR de PAS com 34 semanas. A frequência de resultados falso-positivos nos hospitais de referência foi de 68,5%. Sessenta e nove pacientes foram operadas com base na suspeita de PAS com 35 semanas e houve 28,9% de falso-positivos no CR. Em 93 pacientes, o diagnóstico de PAS foi descartado no CR, com frequência de falso-negativos de 2,1%. Conclusão O diagnóstico pré-natal de PAS é melhor no CR. Entretanto, mesmo nestes centros, resultados falso-positivos são comuns; portanto, a confirmação intraoperatória do diagnóstico de SAP é essencial.

Abstract Objective The immediate referral of patients with risk factors for placenta accreta spectrum (PAS) to specialized centers is recommended, thus favoring an early diagnosis and an interdisciplinary management. However, diagnostic errors are frequent, even in referral centers (RCs). We sought to evaluate the performance of the prenatal diagnosis for PAS in a Latin American hospital. Methods A retrospective descriptive study including patients referred due to the suspicion of PAS was conducted. Data from the prenatal imaging studies were compared with the final diagnoses (intraoperative and/or histological). Results A total of 162 patients were included in the present study. The median gestational age at the time of the first PAS suspicious ultrasound was 29 weeks, but patients arrived at the PAS RC at 34 weeks. The frequency of false-positive results at referring hospitals was 68.5%. Sixty-nine patients underwent surgery based on the suspicion of PAS at 35 weeks, and there was a 28.9% false-positive rate at the RC. In 93 patients, the diagnosis of PAS was ruled out at the RC, with a 2.1% false-negative frequency. Conclusion The prenatal diagnosis of PAS is better at the RC. However, even in these centers, false-positive results are common; therefore, the intraoperative confirmation of the diagnosis of PAS is essential.

Resumo Objetivo O espectro da placenta accreta é uma patologia grave, cujo tratamento é recomendado emcentros de excelência. Esses hospitais não são fáceis de encontrar em países de baixa e média renda. Procuramos descrever o processo de diagnóstico prénatal, tratamento cirúrgico, e análise histológica pós-natal em um hospital de referência de baixa renda com recursos limitados. Métodos Foi realizado um estudo descritivo, retrospectivo, incluindo pacientes com diagnóstico pré ou intraoperatório de espectro da placenta accreta. Foram estudados os resultados clínicos das pacientes, bem como os resultados da ultrassonografia prénatal e a correlação com o diagnóstico patológico pós-natal. Resultados No total, 129 pacientes foram incluídas. Quarenta e oito delas tiveramum diagnóstico de ultrassom do espectro da placenta accreta pré-natal (37,2%). Nos 81 (62,8%) restantes, o diagnóstico foi intraoperatório. Embora a histerectomia tenha sido realizada em todos os casos, um terço deles (31%) não tinha estudo histológico do útero. Em 40% dos pacientes que tiveram estudo histológico, o espectro da placenta accreta não foi relatado pelo patologista. Conclusão A frequência do diagnóstico pré-natal e a disponibilidade de estudos histológicos pós-natais foram muito baixas na população estudada. A habilidade cirúrgica, favorecida por um alto fluxo de pacientes, é um fator importante para evitar complicações em ambientes com recursos limitados.

Abstract Objective Placenta accreta spectrum (PAS) is a serious diseases, and the recommendation is that the treatment is conducted in centers of excellence. Such hospitals are not easy to find in low- and middle-income countries. We seek to describe the process of prenatal diagnosis, surgical management, and postnatal histological analysis in a low-income country referral hospital with limited resources. Methods A descriptive, retrospective study was carried out including patients with a pre- or intraoperative diagnosis of PAS. The clinical results of the patients were studied as well as the results of the prenatal ultrasound and the correlation with the postnatal pathological diagnosis. Results In total, 129 patients were included. Forty-eight of them had a prenatal PAS ultrasound diagnosis (37.2%). In the remaining 81 (62.8%), the diagnosis was intraoperative. Although hysterectomy was performed in all cases, one-third of the patients (31%) did not have a histological study of the uterus. In 40% of the patients who had a histological study, PAS was not reported by the pathologist. Conclusion The frequency of prenatal diagnosis and the availability of postnatal histological studies were very low in the studied population. Surgical skill, favored by a high flow of patients, is an important factor to avoid complications in settings with limited resources.

ABSTRACT In dentistry, the use of dosimeters is not frequently to evaluate the patient radiation; however, through dosimetry, we can maintain a better control of the amount of radiation emitted to patients, radiation doses and the tissue radiosensitivity, to prevent at any time the posible harmful effects of ionizing radiation (deterministic effects), however the stochastic effects can be developed and presented with any doce of radiation. In this study we will focus on orthopantomographies that are diagnostic auxiliaries prior to dental treatment.

RESUMEN En la práctica odontológica, en la toma de radiografías no es común la colocación de dosímetros en los pacientes, sin embargo, por medio de la dosimetría podemos mantener un mejor control de la cantidad de radiación que es emitida a los pacientes, de la dosis de radiación y de la sensibilidad del tejido frente a la radiación, para así prevenir en algún momento los posibles efectos nocivos de la radiación ionizante; puesto que en odontología se encuentran por debajo las dosis umbral requeridas para producir reacciones tisulares (efectos deterministas), sin embargo, los efectos estocásticos pueden desarrollarse y presentarse con cualquier dosis de radiación. En este estudio nos enfocaremos en las ortopantomografías que son auxiliares de diagnóstico previo a un tratamiento odontológico.

Exploited stocks of the west coast of the Baja California peninsula inhabit in a complex habitat of rocky reefs characterized by high diversity of seaweeds in the kelp forest. In these fishing grounds, there is intense fishing activity, inducing changes in the structure of the benthic community, such as habitat deterioration and biomass reduction of species with high commercial value such as the California spiny lobster (Panulirus interruptus). The impact of climate was explored and a low but significant correlation between the Southern Oscillation Index and the one-year-old recruits and with the number of adults was found. The lobster fishery of this area extracts 85-92% of the total catch of the Pacific coast of the peninsula. An updated stock assessment including socio-economic optimum fishing strategies were explored using a simulation model under 3 possible scenarios as management targets. The fishing strategies were simulated by changing fishing mortality and the age of first catch. It is expected that these results will emerge in proposals for the management of the spiny lobster fishery in the study area.

Poblaciones explotadas en la costa oeste de la península de Baja California ocupan hábitats complejos de arrecifes rocosos que se caracterizan por su elevada diversidad de especies de algas que conforman estos bosques de macroalgas. En esta zona se desarrolla una intensa actividad pesquera, induciendo cambios en la estructura de la comunidad bentónica, deterioro del hábitat y reducción de la biomasa de especies de alto valor comercial como la langosta roja (Panulirus interruptus). El impacto del clima fue explorado y se encontró una correlación baja pero significativa entre el Índice de Oscilación del Sur con el número de reclutas de un año de edad y con el número de adultos. La pesquería de langosta en esta zona, contribuye con el 85-92% de la captura total de la costa Pacífico de la península. Se exploró una evaluación actualizada de la población que incluyó distintas estrategias óptimas de pesca con variables socio-económicas, mediante un modelo de simulación bajo 3 posibles escenarios como objetivos de gestión. Las estrategias de pesca fueron simuladas cambiando la mortalidad por pesca y la edad de primera captura. Se espera que estos resultados sirvan de base para proponer estrategias de gestión de la pesca de la langosta en el área de estudio.

A patient previously diagnosed with cerebral mucormycosis attended the Endodontics Clinic of the Graduate and Research School, National School of Dentistry, National University of Mexico (UNAM). This article presents variations in the clinical handling of the patient; stress is made on the importance of preserving the greatest number of teeth in the mouth to thus achieve better stability of the palatal obturator and establish suitable phonation and mastication functions.

Se presenta en la Clínica de Endodoncia de la División de Estudios de Postgrado e Investigación (DEPeI) de la Facultad de Odontología (UNAM) una paciente diagnosticada con mucormicosis rinocerebral; en este artículo se presentan las variaciones en el manejo clínico de esta paciente y la importancia de mantener el mayor número de órganos dentales en boca para una mejor estabilidad del obturador palatino, tanto para las funciones de fonación como de masticación adecuadas.

At present, the training of professionals in Higher Education challenges docents to incorporate in their teaching practice, not only expertise of pure disciplinary content, it also calls for associated aptitudes of didactic knowledge to guide the disciplinary knowledge. This study intends to contribute new teaching methodologies in the form of didactic software for Histology students in the Nursing Degree program, Faculty of Health Sciences of the Universidad Autónoma De Chile. These interactive modules were created as support for traditional classes and practical steps with microscopic observation. For the development of the first module, a total of 200 images were digitalized in JPG format. From those images presentations with personal animation were realized, which were then converted to Adobe Flash Player thus creating the first software entitled "Histological Module". We incorporated functional information to the initial module of histological preparation in addition to concept maps. This innovation was particularly attractive and we decided to modify the initial software, thereby creating the second program entitled "Histo-functional Module". To compare student perception on both modules a previously validated, voluntary and anonymous opinion survey was carried out that included questions on factors related to: content, motivation, utility, quality and quantity. Responses were evaluated by Likert scale. Results objectively reflected the favorable acceptance that the histo-functional Module has had on the part of our students. This is probably the result of this software integrating knowledge of structures and their function, affording it meaning and facilitating learning as well as motivating students in the study of histology.

Actualmente, la formación de profesionales en la Educación Superior desafía a los docentes a incorporar en sus prácticas de enseñanza no solamente el dominio de contenido disciplinario puro, además, les exige competencias asociadas a la apropiación de conocimientos didácticos para guiar el saber disciplinario. El siguiente estudio pretende aportar con nuevas metodologías de aprendizaje en forma de softwares didácticos para los estudiantes que cursan la asignatura de Histología, de la carrera de Enfermería, Facultad de Ciencias de Salud de la Universidad Autónoma de Chile. Estos módulos interactivos se crearon como apoyo a las clases tradicionales de pasos prácticos con observación al microscopio. Para desarrollar el primer módulo, un total de 200 imágenes fueron digitalizadas a formato JPG. A partir de estas imágenes se realizaron presentaciones con animación personalizada, la que fue llevada al programa Adobe Flash Player creando así al primer software titulado "Módulo Histológico". Al módulo inicial incorporamos información funcional de las preparaciones histológicas, además de mapas conceptuales. Esta innovación resultó especialmente atractiva y decidimos modificar el primer software, creando el segundo programa titulado "Modulo Histofuncional". Para comparar la percepción de los estudiantes sobre ambos módulos se realizó una encuesta de opinión voluntaria y anónima, previamente validada, que contenía preguntas sobre factores relacionados con: contenido, motivación, utilidad, calidad y cantidad. Las respuestas fueron evaluadas a través de una escala de Likert. Los resultados reflejaron objetivamente la recepción favorable que ha tenido el Modulo Histofuncional por parte de nuestros estudiantes. Esto, probablemente, debido a que este software logra integrar el conocimiento de las estructuras con su función, entregando significancia, facilitando el aprendizaje y motivando a los alumnos en el estudio de la Histología.

In recent years there has been increasing interest in the use of alternative therapies for healing wounds. Bee honey is an ancient natural medicine that has been used in the treatment of wounds and ulcers, while Vitamin C improves the epidermal barrier and reduces wound contraction. The aim of this study is to support treatment with honey associated with oral vitamin C as an alternative and efficient healing treatment, in type AB-B burns. For this study, twelve guinea pigs (Cavia porcellus) were used. The animals were distributed in groups A (without Vitamin C) and B (with Vitamin C). While under anesthetic effect burn of 1.7 mm in diameter was caused in the right dorsal region, subsequent healing was treated with honey. At the same time a burn of similar characteristics was caused in the left dorsal region, treated with Ringer serum being used as control. Biopsies were obtained from both lesions at days 6, 10 and 14 post injury. Results showed granular tissue formation, fibroblast activation, and reepitalization is more rapid in group B, where vascularized tissue and organized collagen fibers were observed at day 14 post injury similar to control (biopsy in healthy animal). These results confirm that the use of Ulmo honey associated with oral Vitamin C improves regeneration in this type of wound, achieving effective, rapid and good quality healing.

En los últimos años se ha incrementado el interés por el uso de terapias alternativas para la curación de heridas. La miel de abeja es una antigua medicina natural que ha sido utilizada en el tratamiento de heridas y úlceras, mientras la vitamina C mejora la barrera epidérmica y reduce la contracción de heridas. Este estudio pretende avalar el tratamiento con miel asociada a vitamina C oral como curación alternativa y eficiente en quemaduras tipo AB-B. Se utilizaron 12 cuyes (Cavia porcellus). Los animales se distribuyeron en grupos A (sin Vitamina C) y B (con Vitamina C). Bajo efectos anestésicos se provocó una quemadura de 1.7 mm de diámetro en la región dorsal derecha, que fue tratada con curaciones con miel. Al mismo tiempo, se provocó una quemadura de similares características en la región dorsal izquierda, tratada con suero Ringer, siendo utilizada como control. De ambas lesiones se obtuvieron biopsias a los 6, 10 y 14 días post injuria. Nuestros resultados muestran que la formación de tejido granular, activación de fibroblastos, y reepitelización es más rápida en el grupo B, donde se observó un tejido vascularizado y fibras colágenas organizadas en el día 14 post injuria, similar al control (biopsia de animal sano). Estos datos confirman que la utilización de la miel de ulmo asociada a Vitamina C oral mejora la regenaración de este tipo de heridas, logrando una cicatrización efectiva, rápida y de buena calidad.

Embryonic stem cells are a population of cells located in the blastocyst, commited to specific differentiation according to spatial and temporal factors such as age and place of final location. Despite the final fate of hematic cells, hemopoietic cells retain a relative degree of plasticity dependent on environmental factors. Mesenchymal cells are a well differentiated population of bone marrow derived non hemopoietic cells with totipotential properties. The medical interest of such totipotentiality rests in the potential of such cells to repair damaged tissues. Particularly neuronal differentiation from progenitors obtained from mesenchymae non hemopoietic cells offers a new possibility in the field of neural transplantation and tissue engineering to repair functional entities in the nervous system.

Las células troncales embrionarias son totipotentes y se encuentran en pequeño número en el blastocisto donde pueden expandirse en forma indiferenciada durante un corto tiempo y de acuerdo al sitio donde se alojan, ellas adquirirán determinados fenotipos de diferenciación. Las células hemopoyéticas troncales se caracterizan por poseer un gran potencial proliferativo, cuyo modelo de regulación es jerárquico. Ellas retienen, a lo largo de su existencia, un cierto grado de plasticidad, lo cual hace que se puedan diferenciar en distintos tipos de células o de tejidos no hemopoyéticos, de acuerdo al microambiente donde se encuentran o bien a la presencia de ciertos factores estimulantes. En trabajos recientes se han podido aislar, por adherencia al plástico, en cultivo in vitro de médula ósea, células no hemopoyéticas que fueron llamadas mesenquimales por su semejanza con el tejido mesenquimal del embrión. Estas células, in vitro, pueden ser inducidas hacia nuevas líneas celulares, que se diferenciarán en nuevos tejidos. Las expectativas del beneficio terapéutico del transplante de médula ósea como el de células mesenquimales en enfermedades no hemopoyéticas son grandes, porque al utilizar tejidos o células autólogas, se evitan los graves problemas del rechazo inmunológico. En el caso del tejido nervioso la problemática de una fuente adecuada de donantes hace el tema especialmente interesante.