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Introducción: el síndrome de bandas amnióticas abarca una variedad de anomalías congénitas que incluyen la deformación, disrupción y malformación de múltiples órganos. Este síndrome tiene diferentes manifestaciones clínicas al nacimiento, como anillos formados por la constricción de las bandas, amputaciones de extremidades y malformaciones craneofaciales. La incidencia es de aproximadamente 1 en 1,200- 15,000 nacidos vivos. Objetivo: realizar la descripción de un paciente femenino de 4 meses de edad que acude al servicio de cirugía oral y maxilofacial del Hospital del Niño DIF Pachuca, Hidalgo, México. La paciente presenta deformidad en la región geniana que se extiende desde el labio superior hasta la región infraorbitaria de lado derecho, pit paracomisural derecho y fisura Tessier 7. Conclusión: se da el diagnóstico final de deformidad maxilofacial a causa del síndrome de bandas amnióticas y la paciente recibe tratamiento médico-quirúrgico con un resultado satisfactorio.

La miositis osificante es una rara entidad caracterizada por depósito de hueso heterotópico en tejidos blandos, siendo su principal ubicación el músculo, se han descrito dos variantes: miositis osificante progresiva y miositis osificante traumatica (MOT). El objetivo de este artículo es reportar el primer caso de MOT diagnosticado en México, en paciente femenina de 11 años de edad, quien posterior a enucleación de quiste dentígero desarrolló limitación progresiva a la apertura oral, dolor y trismus, al examen físico sin palpación de masas o deformidades dentro de la cavidad, con apertura oral de 0 mm; en el estudio tomográfico y de reconstrucción se identifica imagen hiperdensa bien definida compatible con calcificación a nivel del músculo pterigoideo medial. Se llevó a resección de lesión, confirmándose diagnostico por histopatología. Paciente actualmente en vigilancia clínica y apoyo con fisioterapia, sin datos de recurrencia.

The Akt-like kinase of Leishmania spp. is a cytoplasmic orthologous protein of the serine/threonine kinase B-PKB/human-Akt group, which is involved in the cellular survival of these parasites. By the application of a computational strategy we obtained two specific inhibitors of the Akt-like protein of L. panamensis (UBMC1 and UBMC4), which are predicted to bind specifically to the pleckstrin domain (PH) of the enzyme. We show that the Akt-like of Leishmania panamensis is phospho-activated in parasites under nutritional and thermic stress, this phosphorylation is blocked by the UBMC1 and UMBC2 and such inhibition leads to cell death. Amongst the effects caused by the inhibitors on the parasites we found high percentage of hypodiploidy and loss of mitochondrial membrane potential. Ultrastructural studies showed highly vacuolated cytoplasm, as well as shortening of the flagellum, loss of nuclear membrane integrity and DNA fragmentation. Altogether the presented results suggest that the cell death caused by UMBC1 and UMBC4 may be associated to an apoptosis-like process. The compounds present an inhibitory concentration (IC50) over intracellular amastigotes of L. panamensis of 9.2±0.8μM for UBMC1 and 4.6±1.9μM for UBMC4. The cytotoxic activity for UBMC1 and UBMC4 in human macrophages derived from monocytes (huMDM) was 29±1.2μM and >40μM respectively. Our findings strongly support that the presented compounds can be plausible candidates as a new therapeutic alternative for the inhibition of specific kinases of the parasite.

TCC (graduação) - Universidade Federal de Santa Catarina, Centro Sócio Econômico, Administração. A Comunidade que Sustenta a Agricultura (CSA) é uma é uma das alternativas para se cooperar com pequenos agricultores e recebendo troca alimentos frescos, limpos e da estação. Visando ir de encontro ao modelo da monocultura, o CSA vem trabalhando no desenvolvimento e manutenção de sistemas de cooperados que entre si cooperam, o que beneficia uma cadeia tanto no aspecto econômico, social e ambiental. A comunidade que sustenta a agricultura tem, obviamente, uma cadeia de abastecimento, do contrário, seria impossível produzir e escoar os alimentos. O objetivo deste estudo é analisar uma CSA, em Florianópolis, acerca das dificuldades da cadeia de suprimentos. Para isso, usou-se a metodologia de entrevista com roteiro semiestruturado e observação, tendo como método um estudo de caso. Com isso, pode-se perceber que a maior dificuldade encontrada dentro da cadeia de suprimentos é a falta de cooperação dos chamados co-agricultores, onde deveriam, de acordo com a filosofia do CSA - participar mais ativamente das estratégias e do operacional. Este estudo contribui, então, para o grupo de CSA estudado, como forma de melhorar suas práticas e, desta forma, continuar desenvolvendo ações sustentáveis. The community suported agriculture (CSA) is one of the alternatives to cooperating with small farmers and receiving fresh, clean and seasonal food. Aiming at meeting the monoculture model, CSA has been working on the development and maintenance of cooperative systems, which benefits a large chain in the economic, social and environmental aspects. The community suported agriculture obviously has a supply chain, otherwise it would be impossible to produce and dispose of food. In this sense, the objective of this article is to analyze a CSA in Florianopolis about the supply chain difficulties. For this, we used the interview methodology with semi-structured script, having as strategy a case study. With this, the biggest difficulty encountered within the supply chain is the lack of cooperation of so-called co-farmers, where they should, according to the CSA philosophy - participate more actively in strategies and operational. Since there is only one person, with little help, with more assignments within the supply chain, other problems are beginning to emerge.

Class III malocclusion is one of the most common deformities that requires correction through orthodontic-surgical treatment. These patients present different facial patterns depending on the occlusal plane angulation. These patients may benefit from surgical manipulation of the occlusal plane, because only bite correction does not always lead to the improvement of the facial deformity. The purpose of this paper is to show the surgical manipulation of the occlusal plane in Class III patients based on five features: 1) facial type, 2) upper incisor display at rest, 3) dental exposure during smile, 4) soft tissue support, and 5) chin projection. The surgical manipulation of the occlusal plane can improve the esthetic outcome in the treatment of class III deformities, and careful evaluation of the five features described could be a helpful planning method.

Hypertrophy of the masticatory muscles is characterized by generalized enlargement of the muscular tissue that affects the facial esthetic and may or not be accompanied by pain [1-3]. This condition can be congenital, but more often it is acquired. The origin has been attributed to muscle hyperactivity and parafunctionsoriginated from stressful lifestyle that causes bruxing or clenching [2,3]. Masseteric muscle hypertrophy is a relative common clinical entity that can affect one or both sides and is also thought to causesecondary enlargement of the mandibular angle as a result of functional remodeling. Temporalis muscle hypertrophy is a rare clinical entity and only a few cases are reported. More often, it presents a bilateral involvement and is usually associated with masseteric hypertrophy [3]. The aim of this report is to present a case of bilateral temporalis and masseteric muscles hypertrophy treated surgically

Antibiotic treatment for septic shock is generally prescribed on an empirical basis using broad-spectrum antibiotics. Molecular diagnostic techniques can detect the presence of microbial DNA in blood within a few hours and facilitate early, targeted treatment. The aim of this study was to evaluate the economic impact of a real-time polymerase chain reaction technique, LightCycler SeptiFast (LSC), in patients with sepsis. A cost-minimisation study was carried out in patients admitted with a diagnosis of severe sepsis or septic shock to the intensive care unit of a university hospital. The stay in the intensive care unit, hospital admission, 28-day and six-month mortality, and the economic cost of the clinical process were also evaluated. The study involved 48 patients in the LSC group and 54 patients in the control group. The total cost was €42,198 in the control group versus €32,228 in the LCS group with statistically significant differences (P

This article describes the surgical and orthodontic treatment of a 12-year-old boy with a significant deformity and functional involvement caused by hemifacial microsomia. The left mandibular ramus and condyle were hypoplastic and abnormal in form and location. The lower third of the face was increased, with mandibular retrusion and significant facial asymmetry. He had difficulties in speaking and chewing and problems related to his facial appearance, which caused severe psychosocial disturbances. The patient received orthodontic treatment and temporomandibular joint reconstruction with a costochondral graft on the left side while he was still growing. Three-year follow-up records are presented.

Introduccion La infeccion por Candida se ha convertido en un importante problema de salud en todo el mundo. La epidemiologia de la candidemia se ha modificado considerablemente por la emergencia de las especies de Candida no-albicans. Esta variacion tiene especial importancia en la eleccion de la profilaxis y tratamiento empirico. Los metodos bioquimicos y los basados en biologia molecular presentan limitaciones para la identificacion correcta de las especies de Candida. El objetivo de este estudio es demostrar la capacidad del sistema de espectrometria de masas MALDI-TOF para la identificacion de estas especies y compararlo con la tecnologia utilizada en la actualidad. Metodos Se incluyeron todos los aislados recogidos durante dos anos (n=73) de Candida no-albicans procedentes de muestras invasivas. La identificacion se realizo mediante los sistemas Vitek-2 YST y API CAUX. Las identificaciones del MALDI-TOF se hicieron con el sistema Axima Confidence (Shimadzu Corporation), utilizando el software Shimadzu Launchpad y la base de datos SARAMIS (AnagnosTec GmbH). Las discrepancias se resolvieron mediante PCR multiplex LightCycler SeptiFast, PCR especifica de C. glabrata y digestion enzimatica con BanI del fragmento SADH en los aislados de C. parapsilosis. Resultados De los 73 aislados de Candida no-albicans, los metodos bioquimicos identificaron de forma concluyente 67 a nivel de especie y 6 a nivel de genero. El sistema MALDI-TOF obtuvo identificaciones a nivel de especie en todas ellas. La correlacion en la especie de todos los aislados estudiados fue del 85,07%, llegando al 94,52% si se estudia la correlacion entre la identificacion obtenida mediante metodos bioquimicos junto con los metodos empleados para el analisis de las discrepancias. En los aislados de C. parapsilosis, el sistema MALDI-TOF obtuvo una identificacion de C. orthopsilosis en tres de ellos, confirmandose por digestion con BanI del fragmento SADH. Conclusion En este estudio se ha demostrado la utilidad de la espectrometria de masas (sistema MALDI-TOF) para dotar al laboratorio de microbiologia de una mayor eficiencia y fiabilidad para la identificacion a nivel de especie de los aislados de Candida no-albicans. Ademas de mostrar su posible utilidad para la identificacion de especies relacionadas como C. parapsilosis, orthopsilosis y metapsilosis.

Antecedentes Las herramientas genotipicas basadas en el analisis de la region V3 de la envuelta viral se perfilan como la alternativa a los ensayos fenotipicos para la determinacion del tropismo del VIH por los receptores de quimiocinas CCR5 y CXCR4 en la practica clinica. Este trabajo evalua la concordancia entre los distintos algoritmos de interpretacion genotipica actualmente disponibles en pacientes VIH infectados con subtipo B versus subtipos no-B. Metodos Se seleccionaron pacientes VIH positivos, procedentes del Complexo Hospitalario Universitario de Santiago de Compostela (CHUS), Espana. A partir de muestras de plasma, se amplifico y secuencio la region V3 de la envuelta viral. El tropismo viral se determino usando 8 algoritmos genotipicos distintos. La concordancia entre los distintos predictores se evaluo calculando el indice de concordancia kappa. El subtipo genetico fue determinado por analisis filogenetico. Resultados Se incluyeron un total de 92 pacientes, 72 infectados por subtipo B y 20 por no-B. En pacientes con subtipo B, se obtuvieron valores significativos de kappa para todas combinaciones posibles (n=28) entre los algoritmos genotipicos analizados. La mejores valores entre predictores no relacionados se obtuvieron para webPSSMSINSI/WetcatPART (k: 0,771) y webPSSMSINSI/geno2pheno (k: 0,574). En subtipos no-B solo se obtuvieron valores significativos para 13 combinaciones, correspondiendo los mejores a PSSMX4R5/WetcatPART (k: 0,600) y PSSMSINSI/Charge rule (k: 0,590). Conclusion Existe una alta concordancia entre los distintos algoritmos genotipicos utilizados para la determinacion del tropismo viral en pacientes infectados con subtipo B, especialmente con webPSSMSINSI y geno2pheno o Wetcat. Sin embargo, la concordancia general de los algoritmos para subtipos no-B es menor. Esta falta de consenso podria justificarse por la baja prevalencia de los subtipos no B tienen en las bases de datos empleadas para el entrenamiento de los predictores genotipicos.

Bisphosphonates are compounds used in the treatment of various metabolic and malignant bone diseases. The relation between the use of bisphosphonates and ostenonecrosis of the jaws as an adverse effect of the drug has been intensely discussed during the last few years, and up to this moment, there is no consensus concerning an ideal treatment modality for this condition. Nevertheless, there is an agreement among researchers that the standard goal for controlling jaw osteonecrosis is to prevent it. Otherwise, the rationale for a randomized controlled trial is that current treatment has proven to be suboptimal, and no consensus has been reached yet on the best strategies to repair the exposed bone once bone necrosis is developed. This article is focused on reporting a case of moderate osteonecrosis of the upper jaw induced by bisphosphonates and discusses a possible role for surgical debridement associated to platelet-rich plasma, hyperbaric oxygen therapy, and the cessation of the bisphosphonate use in managing this type of lesion. Moreover, the dentist, the oral surgeon, and the oncologist need to work together to reach better outcomes.

Un nuevo test multiplex basado en una reaccion en cadena de polimerasa en tiempo real LightCycler Septi- Fast® permite la identificacion de 25 especies bacterianas y fungicas directamente desde la sangre. El test SeptiFast® ha sido utilizado para el diagnostico etiologico rapido de la endocarditis infecciosa, pero no ha sido ensayado directamente sobre las vegetaciones cardiacas de pacientes intervenidos por endocarditis infecciosa. Se realizo un estudio prospectivo para analizar 15 muestras de tejido valvular con endocarditis infecciosa activa utilizando SeptiFast® y comparando su sensibilidad con el hemocultivo, el cultivo del tejido valvular y el SeptiFast® en sangre. La sensibilidad del SeptiFast® del tejido valvular fue del 100%, confirmo el diagnostico obtenido mediante hemocultivo en 13 casos y proporciono el diagnostico etiologico en 2 casos con hemocultivo negativo. La sensibilidad de SeptiFast en el tejido valvular fue superior al cultivo convencional de las vegetaciones y al SeptiFast en sangre.

The principle of safeguarding the anonymity of a person is essential to ensure respect for freedom of speech. This is because in certain cases, said principle makes it easy for the speaker to reserve its sources, omit the identity of the person subject of a news report or even maintain its own identity a secret. In this sense, the principle of safeguarding the anonymity of a person can operate as grounds for excluding the criminal, civil and social liability of a speaker when he is accused of violating the constitutional rights to privacy, good name and honor a person. This essay explores the jurisprudential overview of this principle in Colombia.

Las redes P2P les permiten a millones de usuarios en Internet descargar archivos que, al menos en teoría, deberían protegerse por las normas sobre derecho de autor. La reacción de la industria del entretenimiento ha sido iniciar múltiples procesos judiciales en contra de los usuarios de esta tecnología, en diferentes partes del mundo. Uno de los medios que con mayor frecuencia se ha empleado para este propósito ha sido el descubrimiento de la identidad de los usuarios a través de sus direcciones IP, mediante órdenes impartidas por jueces a los proveedores de servicio de Internet. Sin embargo, esta práctica constituye una manifiesta y comprobada violación de derechos constitucionales como el habeas data y la privacidad. P2P networks allow millions of Internet users to download files that, at least in theory, ought to be protected by the laws of copyright. The entertainment industry's reaction has been to file multiple lawsuits against users of this technology in different parts of the world. One of the measures by which the latter has been achieved has been the discovery of users' identities through their IP addresses by means of judicial orders given to internet service providers. Nevertheless, this practice constitutes a manifest and proven violation of constitutional rights such as habeas data and privacy.

With a novel real-time multiplex polymerase chain reaction test, the LightCycler SeptiFast® test, 25 bacterial and fungal species can be identified directly in blood. The SeptiFast® test has been used for rapid etiologic diagnosis in infectious endocarditis using blood samples but has not been evaluated directly on cardiac vegetations in patients being treated for infectious endocarditis. We prospectively analyzed 15 samples of heart valve tissue with active infectious endocarditis using the SeptiFast® test and compared the test's sensitivity with that of blood culture, valve tissue culture, and the SeptiFast® test in blood. The sensitivity of the SeptiFast test in heart valve tissue was 100%. The test results confirmed the diagnosis obtained using blood culture in 13 cases and identified the pathogen in 2 cases where blood culture tested negative. The sensitivity of the SeptiFast® test in heart valve tissue was greater than that obtained with conventional culture of vegetations or with the SeptiFast test in blood.

The CD4+ T-cell reduction characteristic of human immunodeficiency virus type 1 (HIV-1) infection is thought to result, in addition to infected T-cell death, mainly from uninfected bystander T-cell apoptosis. Nevertheless, the immunological and virological mechanisms leading to T-cell death during HIV-1 infection are not yet fully understood. In the present study, we analysed the individual implication of the p38 mitogen-activated protein kinase (MAPK) isoforms (p38α, p38β, p38γ and p38δ) during apoptosis induced by HIV-1, taking into account that HIV-1 replication is known to be blocked by p38 inhibitors. For this purpose, we used the SupT1 cell line, where death induced by HIV-1 mainly occurs by uninfected bystander cell apoptosis. A variety of SupT1-based cell lines were constructed constitutively expressing, under the control of cytomegalovirus promoter (PCMV), each dominant-negative (dn) p38 isoform and each wild-type p38 isoform as a control. An enhanced green fluorescent protein marker gene, under the control of the HIV-1 promoter, was inserted in all of them. These cell lines were infected with HIV-1 and analysed by flow cytometry. We found that survival in SupT1-based cell lines infected by HIV-1 was increased by the p38αdn, p38γdn and p38δdn isoforms, but not by the p38βdn isoform. HIV-1 replication was delayed most by p38δdn and to a lesser extent by p38αdn and p38γdn. Moreover, these three isoforms, p38αdn, p38γdn and p38δdn, reduced apoptosis induced by HIV-1. These results suggest that, in SupT1-based cell lines, p38α, p38γ and p38δ, but not p38β, are implicated in both HIV-1 induced replication and apoptosis in infected and uninfected bystander cells.

Schistosomiasis is a parasitic disease caused by trematodes of the genus Schistosoma. Five species of Schistosoma are known to infect humans, out of which S. haematobium is the most prevalent, causing the chronic parasitic disease schistosomiasis that still represents a major problem of public health in many regions of the world and especially in tropical areas, leading to serious manifestations and mortality in developing countries. Since the 1970s, praziquantel (PZQ) is the drug of choice for the treatment of schistosomiasis, but concerns about relying on a single drug to treat millions of people, and the potential appearance of drug resistance, make identification of alternative schistosomiasis chemotherapies a high priority. Alkylphospholipid analogs (APLs), together with their prototypic molecule edelfosine (EDLF), are a family of synthetic antineoplastic compounds that show additional pharmacological actions, including antiparasitic activities against several protozoan parasites.We found APLs ranked edelfosineperifosineerucylphosphocholinemiltefosine for their in vitro schistosomicidal activity against adult S. mansoni worms. Edelfosine accumulated mainly in the worm tegument, and led to tegumental alterations, membrane permeabilization, motility impairment, blockade of male-female pairing as well as induction of apoptosis-like processes in cells in the close vicinity to the tegument. Edelfosine oral treatment also showed in vivo schistosomicidal activity and decreased significantly the egg burden in the liver, a key event in schistosomiasis.Our data show that edelfosine is the most potent APL in killing S. mansoni adult worms in vitro. Edelfosine schistosomicidal activity seems to depend on its action on the tegumental structure, leading to tegumental damage, membrane permeabilization and apoptosis-like cell death. Oral administration of edelfosine diminished worm and egg burdens in S. mansoni-infected CD1 mice. Here we report that edelfosine showed promising antischistosomal properties in vitro and in vivo.

Objetivo El objetivo del presente estudio es evaluar una tecnica rapida y sencilla de reaccion en cadena de la polimerasa (PCR) en tiempo real en LightCycler 2.0 revelada con SYBR-Green I, comparandola con otra tecnica de PCR en tiempo real que utiliza sondas FRET (fluorescence resonance energy transfer) para revelar la amplificacion. Metodos Los dos metodos de PCR en tiempo real se compararon utilizando muestras de plasma de pacientes inmunodeprimidos con sospecha clinica de enfermedad por citomegalovirus (CMV), de pacientes monitorizados sin sintomatologia, y de adultos sanos. El estudio se completo con otras muestras de plasma congeladas de casos positivos por antigenemia pp65, y con ADN de CMV de la cepa Towne (ATCC VR-977) obtenido de cultivo en MRC-5, con el que elaboramos una curva estandar para su cuantificacion. Resultados La PCR revelada con SYBR-Green I resulto ser claramente la mas rentable por su alta sensibilidad, rapidez y sencilla realizacion, ademas de su bajo coste. Conclusion La determinacion cuantitativa de ADN de CMV en plasma utilizando un metodo sensible, rapido y de bajo coste, como el que proponemos, supone una clara ventaja para el diagnostico y seguimiento de estos cuadros, especialmente en hospitales como el nuestro, donde en los ultimos anos se ha incrementado sensiblemente el numero de pacientes susceptibles de padecer esta infeccion oportunista.

Durante las dos últimas décadas, el mundo ha sido testigo de cómo la protección jurídica debida a las creaciones del talento humano se encuentra en crisis, dada la expansión global de las telecomunicaciones a través de Internet. La posibilidad de realizar descargas directas de contenidos alojados en discos duros, servidores o, incluso, en la nube, modificó de manera abrupta el comportamiento social, permitiéndole a cualquier internauta obtener canciones, películas, videos o software, entre otros, sin necesidad de reconocer derechos a sus creadores. Millones de dólares en pérdidas dieron lugar a que la industria del entretenimiento buscara solución a este problema por medio de mecanismos de protección jurídica en contra de los usuarios de estos programas, con el objeto de impedir el constante enriquecimiento de los infractores. Lastimosamente, en ocasiones, estas medidas resultaron excesivas y los procedimientos solo han dado lugar a sentimientos de rechazo por parte del público y a una mala prensa. De igual manera se implementaron mecanismos tecnológicos que les permitieran a los autores obtener protección respecto de sus obras. Aunque con la implementación de otras medidas como la puesta en vigencia de normas o la posibilidad de pagar tarifas mínimas para tener acceso a las obras se creyó que los autores encontraban protección, esto realmente no ocurrió. La facilidad en el uso de estos programas permite perpetrar estas conductas de manera gratuita, pues basta simplemente conectar un computador a Internet para alcanzar el objetivo. Esta obra analiza los problemas que suscitan la utilización de la tecnología a través de redes P2P, el derecho a la cultura y a protección de los derechos de los titulares de obras protegidas.

The objective of the study was to assess the utility of the Frenchay Activities Index (FAI) to measure instrumental activities of daily living (IADL) and functional recovery in stroke patients compared to other measures such as Barthel Index (BI) and Scandinavian Stroke Scale (SSS). A cross-sectional descriptive analysis design was done. Ninety stroke survivors (41 women, 49 men; mean age 68 years) discharged from the Stroke Unit at San Carlos Hospital, Madrid, were assessed by BI at discharge and by BI and FAI 1-year after stroke. At discharge, 40% had total or severe disability (BI < or =60) and at 1-year 11.1%. FAI (mean value 36 +/ 11) correlated with Barthel index, capacity for walking, strength in upper limb and total SSS 1-year after stroke (p < 0.0001). Fifty-two per cent of stroke patients became independent in their ADL during the first year. BI was the strongest predictor of independence in FAI Social activities-category.

Background: Both cerebral hemispheres seem to contribute to motor recovery after stroke. We studied the effect of motor activity on cerebral blood flow in both hemispheres at different stages of stroke evolution. Methods: Thirty patients with hemiplegic stroke and 30 controls were included. Patients were examined within the first week (T1), 1 month (T2) and 6 months after stroke (T3). All subjects performed a 2-min sequential thumb-to-finger opposition task while blood flow velocities in both middle cerebral arteries were measured with transcranial Doppler ultrasonography (TCD). Results: Contralateral movement caused a higher increase in blood flow velocity than ipsilateral movement in controls (p < 0.0001). On the healthy side, patients showed a striking increase with ipsilateral movement (affected hand), which was similar to the increase with contralateral movement (normal hand) at all stages. On the damaged side, the increase with contralateral movement (affected hand) was low and was similar to the increase with ipsilateral movement (normal hand) at T1 and T2; however, at T3 the increase with contralateral movement was higher and the pattern of response was similar to that found in controls. Conclusions: TCD can trace the evolution of brain motor output following stroke. Compensatory activation of the healthy side of the brain may be already present soon after stroke, whereas function of the damaged side may improve during several months.