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Objetivos: Evaluar mediante microscopia quirúrgica la presencia del segundo conducto mesiovestibular (MV2) en el piso de la cámara pulpar de los primeros molares superiores, determinar su abordabilidad, establecer el calibre de lima que llegó al tercio apical y tipificar radiovisiográficamente su morfología se-gún la clasificación de Weine. Materiales y métodos: Se utilizaron 48 primeros molares superiores huma-nos extraídos. Sé tomaron radiovisografías preope-ratorias (Carestream 5200) en sentido orto radial y mesio-distal. Se realizó apertura y se localizó entra-da del MV2 con microscopio quirúrgico (Newton MEC XXI, Argentina) a 16 x. Se cateterizó MV1 y MV2 con limas tipo K #10 y #15 (Dentsply Maillefer). Se cortó raíz distovestibular para mejorar visualización ra-diovisográfica. Se tomó conductometria en sentido mesio-distal para establecer la tipología. Se compa-raron frecuencias y porcentajes mediante test de Chi-cuadrado con corrección de Yates, prueba exac-ta de Fisher y test z para diferencia de proporcio-nes. Se calcularon intervalos de confianza 95% para porcentajes mediante método score de Wilson. Re-sultados: El 54% (26 casos) presentó MV2. De los 26 MV2, el 77% (20 casos) fueron abordables, porcen-taje significativamente mayor al 23% no abordable (z=3,62; P<0,05). Al hacer cateterismo, hubo asocia-ción significativa entre tipo de conducto (MV1 y MV2) y calibre de lima que llegó al tercio apical (Chi-cua-drado=29,12; gl=1; P<0,05). La tipología I (58%) fue significativamente mayor que las tipologías II (21%) y III (21%) (P<0,05 para ambas comparaciones). Con-clusión: El alto porcentaje de piezas que presentó MV2 evidencia la importancia clínica de detectarlo y tratarlo correctamente. Dado el alto porcentaje de piezas donde fue abordable, se concluye que el clíni-co debe tener conocimiento, destreza y la tecnología necesaria para poder abordarlo. Si bien la tipología I (58%) fue la más encontrada, cuando el MV2 termina en foramen independiente (tipo III), su omisión puede conducir al fracaso del tratamiento (AU))

Objectives: To evaluate by surgical microscopy the presence of second mesiobuccal canal (MB2) in the pulp chamber floor of the maxillary first molars, determine its approachability, establish the caliber of the file that reached the apical third, and radiographically typify its morphology according to Weine ́s classification. Materials and methods: 48 extracted human maxillary first molars were used. Preoperative radiovisographies (Carestream 5200) were taken in ortho-radial and mesio-distal direction. Coronal access was made and the entrance of MB2 was located with a surgical microscope (Newton MEC XXI, Argentina) at 16x. MB1 and MB2 were catheterized with K files #10 and #15 (Dentsply Maillefer). Distobuccal root was cut to improve radiovisographic visualization. Conductometry was taken in mesio-distal direction to establish the typology. Frequencies and percentages were compared using Chi-square test with Yates correction, Fisher's exact test and z test for difference in proportions. 95% confidence intervals were calculated for percentages using Wilson score method. Results: 54% (26 cases) presented MB2. Of the 26 MB2, 77% (20 cases) were approachable, a significantly higher percentage than those not approachable (z=3.62; P<0.05). When performing catheterization, there was a significant association between type of canal (MB1 and MB2) and file caliber that reached the apical third (Chi-square=29.12; df=1; P<0.05). Typology I (58%) was significantly higher than typologies II (21%) and III (21%) (P<0.05 for both comparisons). Conclusion: The high percentage of specimens that showed MB2 evidence the clinical importance of detecting and treating it correctly. Given the percentage of pieces where it was approachable (77%), it is concluded that the clinician must have the knowledge, skill and necessary technology to be able to approach it. Although typology I (58%) was the most found, when MB2 ends an independent foramen (type III), its omission can lead to treatment failure (AU)

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Introduction: The differences in the scores observed in the attention, memory and executive functions regarding the use of a cognitive rehabilitation program in patients with long-standing schizophrenia are analysed. Method: The participants were selected through a nonprobability sampling with a purposive sample ofcritical cases (n = 31). It is a causal research, which considers a quasi-experimental design of two groups (experimental and control) with pre and postintervention measures. To measure the variables, the TMTA & B, WAIS, ROCF and the Stroop P & C tests were administered. Results: The intervention had a clinically significant impact on the domains of visual spatial attention and the executive function (speed of verbal information processing), given by the differences caused by the post-intervention means. There were only statistically significant differences of means in the post-test scores for the Rey-Osterrieth complex figure test, in the Memory-Time variable, whose treatment has a low impact and false negative rates higher than initially expected. At the same time, regarding the variability of the scores, there were not statistically significant differences for any of the variables analysed. Conclusions: Training the identification of symbols, using memories of details of projected images and simple words association, in a group-competition context with playful elements, have a clinically relevant impact on the rehabilitation of the visual spatial attention and the speed of verbal information processing of patients with long-standing schizophrenia. The statistically significant differences of means require to be considered with care.

Introducción: Se analizan las diferencias en las puntuaciones observadas en atención, memoria y función ejecutiva en función de un programa de rehabilitación cognitiva en pacientes con esquizofrenia de larga data. Método: Los participantes fueron seleccionados mediante un muestreo noprobabilístico con una muestra intencional de casos críticos (n = 31). Investigación explicativa, con diseño cuasi experimental de dos grupos (experimental y control) y medidas pre y post intervención. Para medir las variables se administraron los test TMT A y B, WAIS, F.C. de Rey, STROOP P y C. Resultados: La intervención tuvo un impacto clínicamente significativo en el Dominio de la Atención focalizada visual y en el Dominio Ejecutivo (velocidad de procesamiento de información verbal) dado por las diferencias de medias post intervención. Sólo existieron diferencias de medias estadísticamente significativas en los puntajes post test para la Figura Compleja de Rey en la variable Memoria-Tiempo, cuyo tratamiento tiene un impacto bajo y tasas de falsos negativos superiores a las esperadas. A su vez, respecto a la variabilidad de las puntuaciones, no se observaron diferencias estadísticamente significativas para ninguna de las variables analizadas. Conclusiones: Entrenar identificando símbolos, recuerdos de detalles de imágenes proyectadas, asociación de palabras simples, en contextos de competición entre grupo con elementos lúdicos, tiene un impacto clínicamente relevante en la rehabilitación de la atención focalizada visual y en la velocidad de procesamiento de información verbal en sujetos con esquizofrenia de larga data. Las diferencias de medias estadísticamente significativas detectadas requerirían ser consideradas con precaución.

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BACKGROUND: A large proportion of acute respiratory tract infections (ARTI) remain without etiologic diagnosis, reason why new pathogens are investigated continuously. Human bocavirus (HBoV) was discovered in 2005, as a new member of Parvoviridae family and proposed to cause ARTI. AIM: To know the prevalence of HBoV among pediatric populations hospitalized for ARTI in two provinces of Argentina: Santa Fe and Tucuman; and to describe epidemiological and clinical aspects associated to its detection. MATERIALS AND METHODS: We studied nasopharyn-geal aspirates of patients younger than 5 years old that were hospitalized during 2013 due ARTI. HBoV DNA was assayed using PCR described by Allander et al. Traditional virnses were studied by immunofluorescence. Personal, clinical and epidemiological data were collected in a standardized form. RESULTS: The HBoV was detected in 7% of the samples and was prevalent in spring and summer and in children younger of 2 years old. Other respiratory viruses were detected in 22% of HBoV positive samples. DISCUSSION: We detected HBoV in these two provinces of Argentina. Further studies should be performed to determine if it's a recent infection or prolonged viral shedding.

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Background: A large proportion of acute respiratory tract infections (ARTI) remain without etiologic diagnosis, reason why new pathogens are investigated continuously. Human bocavirus (HBoV) was discovered in 2005, as a new member of Parvoviridae family and proposed to cause ARTI. Aim: To know the prevalence of HBoV among pediatric populations hospitalized for ARTI in two provinces of Argentina: Santa Fe and Tucuman; and to describe epidemiological and clinical aspects associated to its detection. Materials and Methods: We studied nasopharyn-geal aspirates of patients younger than 5 years old that were hospitalized during 2013 due ARTI. HBoV DNA was assayed using PCR described by Allander et al. Traditional virnses were studied by immunofluorescence. Personal, clinical and epidemiological data were collected in a standardized form. Results: The HBoV was detected in 7% of the samples and was prevalent in spring and summer and in children younger of 2 years old. Other respiratory viruses were detected in 22% of HBoV positive samples. Discussion: We detected HBoV in these two provinces of Argentina. Further studies should be performed to determine if it’s a recent infection or prolonged viral shedding.

Introducción: Un alto porcentaje de las infecciones respiratorias agudas (IRA) permanece sin diagnostico etiológico, por lo cual se investigan nuevos patógenos continuamente. Bocavirus humano (HBoV) fue descubierto en 2005, como un nuevo miembro de la familia Parvoviridae y propuesto como causante de IRA. Objetivos: Investigar la prevalencia de HBoV en niños bajo 5 años de edad, hospitalizados por IRA en dos provincias de Argentina: Santa Fe y Tucumán y describir aspectos epidemiológicos y clínicos asociados a su detección. Materiales y Métodos: Se estudiaron retrospectivamente los aspirados nasofaríngeos (ANF) de pacientes bajo 5 años de edad, con diagnóstico de IRA, hospitalizados durante el año 2013. La presencia de HBoV se detectó mediante la RPC de punto final descripta por Allander y cols. Los virus tradicionales se estudiaron mediante inmunofluorescencia. Datos personales, clínicos y epidemiológicos se recolectaron en una planilla estandarizada. Resultados: HBoV fue detectado en 7% de las muestras con prevalencia en primavera y verano; y principalmente en pacientes bajo 2 años de edad. Se registró co-detecciones en 22% de los casos. Discusión: Hemos detectado HBoV en estas dos provincias de Argentina; estudios posteriores deberán efectuarse para determinar si se trata de una infección reciente o una excreción prolongada del virus.

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A thematic review of research in cognitive reabilitation of patients with schizophrenia is presented with the purpose of systematizing a contribution to the generation of intervention proposals for early stages of the disorder. Sudies are reviewed between 2004-2013 based on the "PubMed.gov" and "Scielo.org" search engines. Forty-two papers were found and 19 were selected, applying as inclusion criteria research with control groups that show positive results in the rehabilitation of attention, memory, and executive function. Furthermore, the aim is to get to know the cognitive rehabilitation program on which that research is based in order to appreciate its approach and its emphases. The results show a corpus of interventions which, in spite of their diversity, have a significant impact on the patients' cognitive and psychosocial functioning. The main predictors of good results are low age, low degree of cognitive deterioration, and low use of antipsychotic medication at the time of intervention. Improvement of executive functioning appears to be the best predictor of the patients' functionality in everyday activities. An impact is also seen of cognitive improvement on relevant clinical indicators: functioning in everyday activities, social adjustment, and clinical indices associated with a decrease of the observed symptoms. It is concluded that these results, together with research in which it is estimated that the alteration of the course of the schizophrenia requires early and multimodal work, imply the need to generate therapeutic proposals from the first episodes where the cognitive rehabilitation of the patient cannot be absent.

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Mammalian cells regulate iron levels tightly through the activity of iron-regulatory proteins (IRPs) that bind to RNA motifs called iron-responsive elements (IREs). When cells become iron-depleted, IRPs bind to IREs present in the mRNAs of ferritin and the transferrin receptor, resulting in diminished translation of the ferritin mRNA and increased translation of the transferrin receptor mRNA. Likewise, intestinal epithelial cells regulate iron absorption by a process that also depends on the intracellular levels of iron. Although intestinal epithelial cells have an active IRE/IRP system, it has not been proven that this system is involved in the regulation of iron absorption in these cells. In this study, we characterized the effect of overexpression of the ferritin IRE on iron absorption by Caco-2 cells, a model of intestinal epithelial cells. Cells overexpressing ferritin IRE had increased levels of ferritin, whereas the levels of the transferrin receptor were decreased. Iron absorption in IRE-transfected cells was deregulated: iron uptake from the apical medium was increased, but the capacity to retain this newly incorporated iron diminished. Cells overexpressing IRE were not able to control iron absorption as a function of intracellular iron, because both iron-deficient cells as well as iron-loaded cells absorbed similarly high levels of iron. The labile iron pool of IRE-transfected cell was extremely low. Likewise, the reduction of the labile iron pool in control cells resulted in cells having increased iron absorption. These results indicate that cells overexpressing IRE do not regulate iron absorption, an effect associated with decreased levels of the regulatory iron pool.

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Cells tightly regulate iron levels through the activity of iron regulatory proteins (IRPs) that bind to RNA motifs called iron responsive elements (IREs). When cells become iron-depleted, IRPs bind to IREs present in the mRNAs of ferritin and the transferrin receptor, resulting in diminished translation of the ferritin mRNA and increased translation of the transferrin receptor mRNA. Similarly, body iron homeostasis is maintained through the control of intestinal iron absorption. Intestinal epithelia cells sense body iron through the basolateral endocytosis of plasma transferrin. Transferrin endocytosis results in enterocytes whose iron content will depend on the iron saturation of plasma transferrin. Cell iron levels, in turn, inversely correlate with intestinal iron absorption. In this study, we examined the relationship between the regulation of intestinal iron absorption and the regulation of intracellular iron levels by Caco-2 cells. We asserted that IRP activity closely correlates with apical iron uptake and transepithelial iron transport. Moreover, overexpression of IRE resulted in a very low labile or reactive iron pool and increased apical to basolateral iron flux. These results show that iron absorption is primarily regulated by the size of the labile iron pool, which in turn is regulated by the IRE/IRP system.

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Cells tightly regulate iron levels through the activity of iron regulatory proteins (IRPs) that bind to RNA motifs called iron responsive elements (IREs). When cells become iron-depleted, IRPs bind to IREs present in the mRNAs of ferritin and the transferrin receptor, resulting in diminished translation of the ferritin mRNA and increased translation of the transferrin receptor mRNA. Similarly, body iron homeostasis is maintained through the control of intestinal iron absorption. Intestinal epithelia cells sense body iron through the basolateral endocytosis of plasma transferrin. Transferrin endocytosis results in enterocytes whose iron content will depend on the iron saturation of plasma transferrin. Cell iron levels, in turn, inversely correlate with intestinal iron absorption. In this study, we examined the relationship between the regulation of intestinal iron absorption and the regulation of intracellular iron levels by Caco-2 cells. We asserted that IRP activity closely correlates with apical iron uptake and transepithelial iron transport. Moreover, overexpression of IRE resulted in a very low labile or reactive iron pool and increased apical to basolateral iron flux. These results show that iron absorption is primarily regulated by the size of the labile iron pool, which in turn is regulated by the IRE/IRP system.

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In vertebrates, body Fe homeostasis is maintained through the regulation of its intestinal absorption. In addition, because Fe is both essential and toxic, intracellular Fe levels are tightly regulated. Consequently, intestinal epithelial cells are in the unique position of being responsible simultaneously for the regulation of body Fe absorption and the regulation of their intracellular Fe levels to remain viable. We tested the hypothesis that the regulation of transepithelial Fe transport and the regulation of intracellular Fe levels are sensitive to a common effector. To this end, we used a recently developed protocol to obtain cultured intestinal epithelial cells with defined intracellular Fe concentrations. In these cells we tested Fe absorption and Fe regulatory protein (IRP) activities. We found that transepithelial Fe transport was inversely related to 20-200 microM intracellular Fe and that Caco-2 cells expressed Fe regulatory protein-1 and Fe regulatory protein-2 activities. Fe regulatory protein-1 activity, Fe regulatory protein-2 mass, transferrin receptor density, and ferritin levels were regulated by intracellular Fe in the same range (20-200 microM) that affected transepithelial Fe transport. These results suggest that a common Fe-responsive factor regulates both intracellular Fe levels and Fe absorption by Caco-2 cells.

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This report reviews the experience of the World Fertility Surveys and the Demographic and Health Surveys (DHS) in collecting community-level data on family planning. It assesses the validity of the community data for Peru that were collected via a service availability module, much like that which is used for the DHS, through a comparison with data from the Situation Analysis. The analysis indicates that the knowledgeable informant, the main source of information about family planning in each community for the service availability module, may not be an accurate source of data. Information about the availability of family planning services is more reliable when it is obtained by means of visits to service sites. However, given cost considerations, sampling problems, and analysis issues, routine linkage of Situation Analyses to household surveys such as the DHS is not recommended at this time.

PIP: Using data from the 1992 Demographic and Health Survey (DHS) in Peru, population researchers compared family planning data obtained by knowledgeable informants with family planning data from visits to health facilities to assess the validity of community data. The data were based on a total number of 239 clusters. 92.5% of the responses about the presence of hospitals were consistent. The situation analysis (SA) field team found three hospitals, while the knowledgeable informants said that 21 hospitals existed within a 5 km radius. 69% of responses about the presence of clinics and medical posts were consistent. The SA field team found 95 clinics or medical posts, while the knowledgeable informants said that there were 123. The consistency rate for pharmacies was 77%. The field team identified 23 pharmacies, while the informants claimed that there were 67. 60.6% of responses by the informants about the presence of any health provider were consistent with information obtained from an SA questionnaire. The consistency rate was highest for midwives (93.2%) and lowest for birth attendants (54.7%). These findings show that the knowledgeable informant in Peru is often not a reliable source of family planning data. Yet the service availability module assumes that the key informant is the main source of family planning information in each community. The findings also suggest that field visits to service delivery points generate more reliable family planning data. Nevertheless, the researchers did not recommend routine linkage of SAs to household surveys (e.g., DHS) due to relatively high costs, sampling problems, and analysis issues.

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This report presents the results of an operations research project to increase male involvement in family planning in Peru. Two community-based distribution (CBD) programs, PROFAMILIA of Lima and CENPROF of Trujillo, Peru, recruited male contraceptive distributors and compared their performance to that of female distributors recruited at the same time. Both programs found it harder to recruit men than women as distributors. Program supervisors, who were women, were less comfortable with men than with other women, even though there were no differences in distributor compliance with program norms. Male distributors were more likely to serve male clients and sell male methods (condoms), while female distributors were more likely to serve female clients and sell female methods (pills). Men sold as much or more total couple-years of protection than did women, and they recruited as many or more new acceptors. Gender was found to exert an impact on method mix independent of other distributor characteristics, such as age, education, marital status, and number of living children. The study suggests that family planning programs can influence method mix and client characteristics by recruiting men as CBD distributors.

PIP: The findings of an operations research (OR) project designed to compare the effectiveness of male vs. female contraceptive distributors in Peru are reported. The OR project was conducted by 2 private, nonprofit family planning agencies that have community-based distribution (CBD) programs: PROFAMILIA in Lima and CENPROF in Trujillo. The OR project sought to test 3 hypotheses: 1) male distributors would sell more condoms and female distributors would sell more oral contraceptives; 2) male distributors would serve more male clients and female distributors would serve more female clients; and 3) male distributors would sell less contraceptive protection than female distributors. Between 1987 and January 1988, the 2 agencies recruited new male and female distributors to serve in the project. Both agencies had a more difficult time recruiting male than female distributors. PROFAMILIA recruited 38 men and 171 women, while CENPROF recruited 52 men and 94 women. All but one of the supervisors in both agencies were female. The supervisors generally regarded the male distributors with skepticism, but the study found no significant difference in the reporting compliance of male and female distributors. The project confirmed hypotheses 1 and 2. In both agencies men sold twice as many condoms as did women, and women sold more oral contraceptives; and male distributors were more likely to serve men, while female distributors were more likely to serve women. The 3rd hypothesis, however, was unsupported. Men sold as much or more contraceptive protection than did women and recruited as many or more new acceptors. It is concluded that men can be effective CBD distributors, and that CBD programs can influence method and client mix by recruiting more men as distributors.

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Presentamos cuatro casos de psoriasis pustulosa, tratados mediante un ácido retinóico aromático y en los que hemos podido observar unos resultados espectaculares.

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