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Objetivo: Determinar las preferencias del paciente respecto a los recursos físicos y humanos de un centro dental privado en Lima Perú. Materiales y métodos: Se realizó un estudio cuantitativo descriptivo con carácter retrospectivo sobre una base de datos con información previamente recolectada empleando encuestas anónimas a una población de pacientes con fines de gestión. Dichas encuestas se recabaron en su momento en el lapso de dos años y fueron aplicadas de modo incidental en el Centro Odontológico Americano Las Gardenias. Se solicitó el permiso a la institución y se contó con la aprobación del Comité Institucional de Ética en Investigación de la Universidad Científica del Sur. Se realizó el análisis estadístico con el que se encontró las frecuencias y porcentajes de cada preferencia, se determinó el grado de asociación entre las variables con el test Chi cuadrado con nivel de significancia de P < 0.05 y se realizó una regresión logística para medir la influencia de la edad y el género del paciente sobre sus preferencias. Resultados: La información de 618 encuestas evidenció un nivel promedio de manifestación de preferencias de 80,91%, siendo que el horario para la cita, la delegación de funciones en el personal asistente y la privacidad de los ambientes fueron las preferencias que evidenciaron mayores frecuencias con valores de 91,75%, 89% y 89% respectivamente. La regresión logística identificó que la edad del paciente podría ser un factor que influye sobre las preferencias del día de la semana a ser atendido. Conclusiones: Los pacientes que requieren atención odontológica evidencian un alto grado de preferencias en relación a los recursos físicos y humanos del centro dental.

The huge variety of viruses affecting swine represents a global threat. Since vaccines against highly contagious viruses last several days to induce protective immune responses, antiviral strategies for rapid control of outbreak situations are needed. The baculovirus Autographa californica multiple nucleopolyhedrovirus (AcMNPV), an insect virus, has been demonstrated to be an effective vaccine vector for mammals. Besides the ability to display or transduce heterologous antigens, it also induces strong innate immune responses and provides IFN-mediated protection against lethal challenges with viruses like foot-and-mouth disease virus (FMDV) in mice. Thus, the aim of this study was to evaluate the ability of AcMNPV to induce IFN production and elicit antiviral activity in porcine peripheral blood mononuclear cells (PBMCs). Our results demonstrated that AcMNPV induced an IFN-α-mediated antiviral activity in PBMCs in vitro. Moreover, the inoculation of AcMNPV in piglets led to the production of type I and II IFNs in sera from inoculated animals and antiviral activities against vesicular stomatitis virus (VSV) and FMDV measured by in vitro assays. Finally, it was demonstrated that the pseudotyping of AcMNPV with VSV-G protein, but not the enrichment of the AcMNPV genome with specific immunostimulatory CpG motifs for the porcine TLR9, improved the ability to induce IFN-α production in PBMCs in vitro. Together, these results suggest that AcMNPV is a promising tool for the induction of IFNs in antiviral strategies, with the potential to be biotechnologically improved.

El crecimiento que experimenta la carrera de Estomatología de la Universidad Científica del Sur favorece su consolidación en el medio y genera una serie retos, frente a los cuales, desde el interior de la institución, se reconoce a la investigación como un eje muy importante. Dicha línea de acción surge no solamente porque el mencionado concepto es el núcleo mismo de la naturaleza científica de nuestra disciplina, sino también porque así lo sustentan las tendencias del ámbito de la garantía de la calidad educativa y el marco legal...

Desde la Bioética y empleando los principios de la calidad en salud y de la seguridad del paciente, se listan los diferentes argumentos que apoyan la necesidad de implementar de forma sólida los procedimientos de supervisión y auditoría interna en el centro dental para identificar, prevenir y manejar los diferentes niveles de fracaso que se dan en el ámbito terapéutico de la Odontología

Here we describe the clinical, microbiological, epidemiological, and molecular characterization of an outbreak of multidrug-resistant Acinetobacter baumannii (MRAB) involving 5 patients admitted to the internal medicine ward of our hospital. Over a 6-week period, 5 MRAB isolates were recovered from 5 patients, including 1 with fatal meningitis, 3 with skin and soft tissue infections, and 1 with respiratory colonization. One sample obtained during environmental monitoring in the ward was A. baumannii-positive. According to the pulsed-field gel electrophoresis typing results, the strains isolated from all patients and the environmental sample belonged to a single clone, identified as ST79 by multilocus sequence typing. The blaOXA-24 and blaOXA-51 carbapenemases were detected in all isolates. Four patients died, but only the death of the meningitis patient was probably related to the A. baumannii infection. The infection source was probably the hands of the healthcare workers because the outbreak strain was isolated from the surface of a serum container. The results of the present study revealed the importance of strict adherence to control measures by all healthcare workers because the consequences of noncompliance can be very serious.

Patagium retraction is one of the most common problems after long–term periods of immobilization due to bandaging for injury treatment or loss of motion related to chronic pathology. Physiotherapy technics in protocolized treatments involve thermotherapy, laser, ultrasound, Z–massage, manual therapy, stretching, and kinesiotherapy. These treatments, followed by strength and endurance enhancement, allow improvement of full range of motion, propioceptive training, neuromuscular awareness, and avoid the development of fibrotic tissue, calcifications, and tie downs. The success of the evolution process was tested with goniometry, centimetric measurements, percentage score assessment, and imaging tools. This study was developed on a basis of 200 wild birds under treatment at the GREFA Wildlife Hospital of Madrid, Spain.

Here we describe the clinical, microbiological, epidemiological, and molecular characterization of an outbreak of multidrug-resistant Acinetobacter baumannii (MRAB) involving 5 patients admitted to the internal medicine ward of our hospital. Over a 6-week period, 5 MRAB isolates were recovered from 5 patients, including 1 with fatal meningitis, 3 with skin and soft tissue infections, and 1 with respiratory colonization. One sample obtained during environmental monitoring in the ward was A. baumannii-positive. According to the pulsed-field gel electrophoresis typing results, the strains isolated from all patients and the environmental sample belonged to a single clone, identified as ST79 by multilocus sequence typing. The blaOXA-24 and blaOXA-51 carbapenemases were detected in all isolates. Four patients died, but only the death of the meningitis patient was probably related to the A. baumannii infection. The infection source was probably the hands of the healthcare workers because the outbreak strain was isolated from the surface of a serum container. The results of the present study revealed the importance of strict adherence to control measures by all healthcare workers because the consequences of noncompliance can be very serious.

Ureteral-intestinal anastomosis represent on important problem in patients undergoing radical cystectomy with urinary diversion using intestinal segments, either small or large intestine. With the incorporation of laser technology in urology, new therapeutic possibilities have been opened for the section of these ureteral intestinal stenosis. Various types of laser had been employed to perform the incision, Nd:YAG, KTP:YAG, Ho:YAG, Er:YAG, and Th:YAG. The experience is limited in terms of use and results don't give clear therapeutic orientation. The section of ureteral-intestinal stenosis with laser has advantages and disadvantages, but the application of this energy source with various techniques of endoscopic section, such as the Lovaco's technique of endoluminal invagination and endoureterotomy gives satisfactory results in the short-midterm.

OBJETIVOS Las estenosis ureterointestinales representan un problema importante en los pacientes sometidos a una cistectomia radical y una derivacion urinaria utilizando segmento intestinal, bien sea este intestino delgado o grueso. Con la incorporacion de la tecnologia laser en la urologia, se han abierto unas posibilidades terapeuticas para la seccion de estas estenosis ureterointestinales. Se han empleado distintos tipos de laser para realizar la incision que son el Nd:YAD, el KTP:YAG, el Ho: YAG, el Er:YAG y el Th:YAG. La experiencia es limitada con respecto a su uso y los resultados no conllevan orientaciones terapeuticas claras. La seccion de las estenosis ureterointestinales mediante el laser tiene ventajas e inconvenientes, pero la aplicacion de esta fuente de energia junto con distintas tecnicas de seccion endoscopica, como la tecnica de endoureterotomia mediante invaginacion endoluminal de F. Lovaco proporciona unos resultados satisfactorios a corto-medio plazo.

To perform a study on the surgical work of Abulcasis in the field of urology, to know the surgical tools and different techniques used, as well as the innovations applied to solve some features of urological diseases.The part on urology from the book XXX by Tasrif, the edition from Strasbourg in 1532 was reviewed and translated from Latin.The author does not refer much to the clinical features of the various pathologies of the genitourinary apparatus; he focuses instead on the surgical treatment of them. The author usually used the "cautery" mainly to control hemorrhage in various operations. Some of these surgical practices are being used nowadays.Abulcasis was the first doctor born in Spain that studied the surgical treatment of urological diseases and performed a graphic study on the tools used. He introduced technical innovations on different operations and described for the first time the vesical lithotomy on women, and vesical and urethral lithotripsy.

OBJETIVOS Realizar un estudio de la obra quirurgica de Abulcasis en el campo de la Urologia, conocer el instrumental y las diferentes tecnicas empleadas asi como las innovaciones introducidas para solucionar algunos aspectos de la patologia urologica METODOS Se ha revisado y traducido del latin la parte urologica del libro XXX del Tasrif utilizando la edicion editada en Estrasburgo en 1532. RESULTADOS El autor apenas se refiere a los aspectos clinicos de las diferentes patologias del aparato genitourinario centrandose en el tratamiento quirurgico de las mismas. Utiliza con asiduidad el cauterio sobre todo para controlar la hemorragia en las diferentes intervenciones. Se puede comprobar que algunos pasos quirurgicos se continuan practicando en la actualidad. CONCLUSIONES Abulcasis es el primer medico nacido en Espana que estudia el tratamiento quirurgico de la patologia urologica y que hace un estudio grafico del instrumental utilizado. Aporta innovaciones tecnicas en diversas intervenciones y describe por primera vez la talla vesical en la mujer, la litotricia vesical y uretral.

To perform a long-term evaluation of 15 patients with unilateral essential hematuria, with the aim of determining the causes of bleeding and the response to endoscopic treatment. To design a diagnostic-therapeutic algorithm for patients with unilateral essential hematuria.We retrospectively review the clinical data of 15 patients with unilateral essential hematuria evaluated by rigid ureterorenoscopy (15 cases), flexible ureteropyelocalycoscopy (15 cases) and percutaneous nephroscopy (3 cases). In 4 patients electric fulguration of the pyelocalicial lesions was carried out.14 of the 15 patients were successfully treated endoscopically. Only one patient presented recurrence of the hematuria. Mean follow-up time was 64 months (4-168 months). No patient suffered any relevant complication secondary to the endoscopic treatment.The cause of bleeding in patients with unilateral essential hematuria is determined only in a few, but endoscopic treatment is successful in a high percentage of cases. We consider that upper urinary tract endoscopy, mainly flexible ureteropyelocalycoscopy, has strongly impacted the diagnosis and treatment of essential unilateral hematuria. We present a new diagnostic-therapeutic algorithm, based on the usefulness of flexible instrumentation.

OBJETIVOS Realizar una evaluacion a largo plazo de 15 pacientes con hematuria esencial unilateral, con el fin de determinar las causas del sangrado y la respuesta obtenida con el tratamiento endoscopico efectuado. Disenar un algoritmo diagnostico-terapeutico para los pacientes con hematuria esencial unilateral. METODOS Revisamos de forma retrospectiva los datos medicos de 15 pacientes con hematuria esencial unilateral que fueron evaluados mediante ureteroscopia rigida (15 casos), ureteropielocalicoscopia flexible (15 casos) y nefroscopia percutanea (3 casos). En 4 pacientes se realizo electrocoagulacion de las lesiones encontradas en el sistema pielocalicial. RESULTADOS De los 15 pacientes, 14 fueron tratados con exito mediante endoscopia. En un solo paciente se observo la recidiva de la hematuria. El tiempo de seguimiento medio (a estos pacientes) ha sido de 64 meses (rango 4 a 168 meses). Ningun paciente ha sufrido complicacion relevante en relacion con el tratamiento endoscopico. CONCLUSIONES En los pacientes con hematuria esencial unilateral la causa del sangrado se determina en pocos de ellos, pero el tratamiento endoscopico resulta exitoso en un alto porcentaje de casos. Consideramos que la endoscopia del tracto urinario superior, pero sobre todo, la ureteropielocalicoscopia flexible, ha impactado fuertemente en el diagnostico y tratamiento de la hematuria esencial unilateral. Exponemos un nuevo algoritmo diagnostico y terapeutico de esta entidad clinica, basado en la utilidad practica de la instrumentacion flexible.

Conventional renal cell carcinoma (CRCC) may appear in families with germline translocations involving chromosome 3, although a recurrent responsible gene has not been found. We recently described a family with CRCC and a constitutional t(3;8)(p14.1;q24.23), and we demonstrated that no genes were disrupted by the translocation breakpoints. In order to investigate the genetic origin and features of the CRCC tumors that occurred in this family, we have extended the pedigree up to four generations, and analyzed peripheral blood samples from 36 members, CRCC tumors, normal renal tissues, and a gastric tumor. (1) By means of comparative genomic hybridization (CGH), we have detected loss of the derivative chromosome carrying 3p in all CRCC but not in the corresponding normal renal tissue. In addition, by means of the fluorescence in situ hybridization technique, we have observed that not all tumoral cells lose the der(3p), which suggests that, previous to this loss, another hit should occur to initiate the transformation of normal into tumoral cells. (2) All known mechanisms of inactivation of the candidate von Hippel-Lindau (VHL) gene have been studied in the tumors, detecting alterations in 65% of them. This confirms that inactivation of the VHL gene is not always required to develop CRCC, and that (an)other suppressor gene(s) on 3p could be involved. (3) We discard FHIT as an alternative pathway to VHL. We have not found new candidate regions along 3p by using a 1-Mb resolution array-based CGH. (4) The tumorigenesis mechanism of a second gastric tumor developed in the probandus is different from that of CRCC.

An alternative model has been proposed for the development of clear-cell renal cell carcinoma (RCC) in families where chromosome 3 translocations segregate with the disease. In this model, the existence of a translocation involving chromosome 3 would favour the non-disjunctional loss of the derivative chromosome carrying the 3p segment. Additionally, subsequent somatic mutations in the VLH gene, located in 3p25-26, would inactivate this tumour suppressor gene. In the present work, we describe a new family with two clear-cell RCC affected members and a t(3;8)(p13;q24.1) translocation in two consecutive generations. We observed loss of the derivative chromosome carrying the 3p segment (der(8)) and somatic mutation of the VHL gene in the left-kidney tumoral tissue of the proband. His right-kidney tumour carried a different VHL mutation and loss of heterozygosity (LOH) was not detected. The mother of the proband was also clear-cell RCC-affected but the tumoral tissue analysed did not carry any VHL gene mutations. Another member of the family, a maternal aunt, had a papillary RCC and did not carry this translocation, the LOH on 3p or the VHL somatic mutations. Haplotype analysis of the three affected members revealed that they did not inherit a common region on 3p, confirming the different genetic origin of both tumour types. Finally, the presence of RCC in other non-available members of the family highlights the overall risk for RCC in families with chromosome 3 translocations. In the present work, we have confirmed the proposed mechanism for the development of clear-cell RCC in this family, although we cannot discard the existence of other genes, in addition to VHL, being involved in hereditary RCC.