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Background: Gutta-percha (Gp) is an inert thermoplastic polymer used as a filling to replace the dental pulp space, which has been reformulated to improve its three-dimensional sealing properties. Therefore, this study aimed to analyze the physical, chemical and thermal properties of two types of gutta-percha filling. As well as measuring the temperature distribution along the cone at the time of cutting through an in-situ test. Material and Methods: Two commercially available brands of gutta-percha point were investigated: Conform Fit TM Gutta-Percha for ProTaper Gold® (PTG) (Dentsply Sirona), and Hygenic Gutta-Percha (Coltene whaledent). Differential scanning calorimetry (DSC) and thermogravimetric analysis (TGA) were selected for the thermal characterization of materials, and Fourier Transform Infrared Spectroscopy (FT-IR) for the chemical analysis of Gp cones. Regarding temperature distribution, it was evaluated using a thermographic camera (FLIR ONE® PRO by MicroUSB P/N 435-0011-01) at 0 to 20 s after the cutting process (n=11/group). Results: Both materials have three fusion endotherms associated with the three crystalline phases of Gp, with similar temperatures but enthalpies that differ by 60%, the fusion enthalpy being higher for Conform Fit. In the chemical characterization, elements such as Zn, C, O, Ba, S and Si were found in both materials but in different proportions. Regarding the content of fillers, the Conform Fit presented around 30% of Gp polymer and 25% for the Hygenic. The morphological characterization shows a microtexturized coating in the form of bars on a micrometric scale for the Conform Fit, which could favor a better three-dimensional seal. In addition to that, in heat transfer studies they showed greater temperature control. Conclusions: The characterization of the materials allowed us to see the variation in terms of their composition and configuration to the Gp cones of two commercial brands. These variations directly modify the thermal behavior of the material. Key words:Gutta-percha, Conform Fit, Infrared thermography, Differential Scanning Calorimetry, Infrared Spectroscopy.

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ABSTRACT: The optimization of resources and time in the production of quality seedlings within a legal framework is of vital importance for greenhouse vegetable crops. This study evaluated the electrical conductivity of the nutrient solution and its effect on the survival and growth of bell pepper and tomato seedlings propagated by cuttings. The electrical conductivities evaluated were 0.92, 1.25, 1.50, and 1.75 dS m-1. The experiment was conducted using a randomized complete block design with four replicates. The number of rooted plants, stem diameter, root length, number of leaves, leaf area, dry weight of leaves, stem, root, and total were determined. In addition, the following indices were determined: stem root index, slenderness index, leaf area ratio, specific leaf area, and pre-transplant horticultural quality index. In both crops, the highest number of rooted cuttings was obtained with the lowest electrical conductivity. Meanwhile, the average electrical conductivity favored leaf number, leaf area, biomass, and seedling quality indices. These results showed that the production of bell pepper and tomato seedlings can be done by cuttings using Stenier nutrient solution at electrical conductivities of 1.25 to 1.50 dS m-1 without affecting seedling quality.

RESUMO: A otimização de recursos e tempo na produção de mudas de qualidade dentro de um quadro legal é de vital importância para as hortaliças em estufa. O objetivo deste trabalho foi avaliar a condutividade elétrica da solução nutritiva e seu efeito na sobrevivência e no crescimento de mudas de pimentão e tomate propagadas por estaquia. As condutividades elétricas avaliadas foram 0,92, 1,25, 1,50 e 1,75 dS m-1. O experimento foi conduzido em delineamento de blocos ao acaso com quatro repetições. Foram determinados o número de plantas enraizadas, diâmetro do caule, comprimento da raiz, número de folhas, área foliar, massa seca das folhas, caule, raiz e total. Além disso, foram determinados os seguintes índices: índice de raiz do caule, índice de esbeltez, razão de área foliar, área foliar específica e índice de qualidade hortícola pré-transplante. Em ambas as safras, o maior número de estacas enraizadas foi obtido com a menor condutividade elétrica. Já a condutividade elétrica média favoreceu os índices de número de folhas, área foliar, biomassa e qualidade das mudas. Esses resultados mostram que a produção de mudas de pimentão e tomate pode ser feita por meio de estacas com solução nutritiva de Stenier em condutividades elétricas de 1,25 a 1,50 dS m-1 sem afetar a qualidade das mudas.

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The optimization of resources and time in the production of quality seedlings within a legal framework is of vital importance for greenhouse vegetable crops. This study evaluated the electrical conductivity of the nutrient solution and its effect on the survival and growth of bell pepper and tomato seedlings propagated by cuttings. The electrical conductivities evaluated were 0.92, 1.25, 1.50, and 1.75 dS m-1. The experiment was conducted using a randomized complete block design with four replicates. The number of rooted plants, stem diameter, root length, number of leaves, leaf area, dry weight of leaves, stem, root, and total were determined. In addition, the following indices were determined: stem root index, slenderness index, leaf area ratio, specific leaf area, and pre-transplant horticultural quality index. In both crops, the highest number of rooted cuttings was obtained with the lowest electrical conductivity. Meanwhile, the average electrical conductivity favored leaf number, leaf area, biomass, and seedling quality indices. These results showed that the production of bell pepper and tomato seedlings can be done by cuttings using Stenier nutrient solution at electrical conductivities of 1.25 to 1.50 dS m-1 without affecting seedling quality.

A otimização de recursos e tempo na produção de mudas de qualidade dentro de um quadro legal é de vital importância para as hortaliças em estufa. O objetivo deste trabalho foi avaliar a condutividade elétrica da solução nutritiva e seu efeito na sobrevivência e no crescimento de mudas de pimentão e tomate propagadas por estaquia. As condutividades elétricas avaliadas foram 0,92, 1,25, 1,50 e 1,75 dS m-1. O experimento foi conduzido em delineamento de blocos ao acaso com quatro repetições. Foram determinados o número de plantas enraizadas, diâmetro do caule, comprimento da raiz, número de folhas, área foliar, massa seca das folhas, caule, raiz e total. Além disso, foram determinados os seguintes índices: índice de raiz do caule, índice de esbeltez, razão de área foliar, área foliar específica e índice de qualidade hortícola pré-transplante. Em ambas as safras, o maior número de estacas enraizadas foi obtido com a menor condutividade elétrica. Já a condutividade elétrica média favoreceu os índices de número de folhas, área foliar, biomassa e qualidade das mudas. Esses resultados mostram que a produção de mudas de pimentão e tomate pode ser feita por meio de estacas com solução nutritiva de Stenier em condutividades elétricas de 1,25 a 1,50 dS m-1 sem afetar a qualidade das mudas.

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INTRODUCTION: Nanoparticles (NPs) have been widely studied as an alternative to antibiotic use due to their antimicrobial properties at lower concentrations. Enterococcus faecalis is a facultative Gram-positive microorganism inhabiting the gastrointestinal tract of humans and animals. It can also be present in other environments such as the oral cavity, water, sewage, soil and food. AIMS: We evaluated whether E. faecalis could develop resistance to silver NPs (AgNPs) after exposure to sublethal concentrations of the NPs. METHODS AND RESULTS: Proteomic analyses revealed that different pathways were activated during the acquired resistance under sublethal concentrations, and selected genes were validated by qPCR. CONCLUSIONS: The results of this study showed that E. faecalis is capable of generating resistance to AgNPs. SIGNIFICANCE AND IMPACT OF THE STUDY: To avoid the generation of resistance against AgNPs, future use of these NPs should be combined with other NPs prepared with different metals to prevent the dissemination of resistant strains.

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BACKGROUND: Two polymorphisms in the macrophage migration inhibitory factor (MIF) gene have been associated with inflammatory diseases (-794 CATT5-8 and -173G>C); however, so far there are no reports of studies related to oral health. OBJECTIVES: To genotype the -794 CATT5-8 and -173G>C MIF polymorphisms in Mexican patients with apical periodontitis as a genetic risk of exacerbation. MATERIAL AND METHODS: The study involved 120 patients with apical periodontitis: 60 with a diagnosis of acute apical periodontitis (Group A) and 60 without previous episodes of exacerbation (Group B). Allelic discrimination was performed from peripheral blood DNA; the repeat polymorphism -794 CATT5-8 was genotyped with sequencing, while the -173G>C polymorphism was determined using real-time polymerase chain reaction (RT-PCR) using TaqMan probes. The associations between MIF polymorphisms, haplotypes and the risk of exacerbated apical periodontitis were assessed. RESULTS: The allele CATT7 was associated with the risk of a stage of acute inflammation (OR = 4.13; 95% CI = 1.82-9.63; p =< 0.001). Regarding the -173G >C polymorphism, a process of inflammation exacerbation was only associated with the CC genotype (OR = 4.1; 95% CI = 1.02-20.84; p = 0.045). The analysis of the haplotype showed that the combination CATT7/C increases the risk of exacerbation of apical periodontitis (OR = 3.57; 95% CI = 1.038-13.300; p = 0.021). CONCLUSIONS: The polymorphisms -794 CATT5-8 and -173G>C MIF seem to significantly influence the development of a state of exacerbated inflammation in patients with apical periodontitis.

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The increase in bacterial resistance to one or several antibiotics has become a global health problem. Recently, nanomaterials have become a tool against multidrug-resistant bacteria. The metal and metal oxide nanoparticles are one of the most studied nanomaterials against multidrug-resistant bacteria. Several in vitro studies report that metal nanoparticles have antimicrobial properties against a broad spectrum of bacterial species. However, until recently, the bacterial resistance mechanisms to the bactericidal action of the nanoparticles had not been investigated. Some of the recently reported resistance mechanisms include electrostatic repulsion, ion efflux pumps, expression of extracellular matrices, and the adaptation of biofilms and mutations. The objective of this review is to summarize the recent findings regarding the mechanisms used by bacteria to counteract the antimicrobial effects of nanoparticles.

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We describe the complete mitochondrial genome sequence of the Black Lion Tamarin, an endangered primate species endemic to the Atlantic Rainforest of Brazil. We assembled the Leontopithecus chrysopygus mitogenome, through analysis of 523M base pairs (bp) of short reads produced by next-generation sequencing (NGS) on the Illumina Platform, and investigated the presence of nuclear mitochondrial pseudogenes and heteroplasmic sites. Additionally, we conducted phylogenetic analyses using all complete mitogenomes available for primates until June 2017. The single circular mitogenome of BLT showed organization and arrangement that are typical for other vertebrate species, with a total of 16618 bp, containing 13 protein-coding genes, 22 transfer RNA genes, 2 ribosomal RNA genes, and 1 non-coding region (D-loop region). Our full phylogenetic tree is based on the most comprehensive mitogenomic dataset for Callitrichidae species to date, adding new data for the Leontopithecus genus, and discussing previous studies performed on primates. Moreover, the mitochondrial genome reported here consists of a robust mitogenome with 3000X coverage, which certainly will be useful for further phylogenetic and evolutionary analyses of Callitrichidae and higher taxa.

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RESUMEN Introducción y objetivos: El propósito es evaluar los resultados de la aplicación del algoritmo inverso para el diagnóstico de sífilis gestacional en el Servicio de Medicina Preventiva del Instituto Nacional Materno Perinatal de Lima, entre 2011 al 2017. Método: Estudio observacional, descriptivo y retrospectivo. Revisión de los resultados de los exámenes del Algoritmo inverso de sífilis gestacional. La Prueba Rápida de Sífilis (PRS) se utilizó como tamizaje, su positividad obligaba a efectuar la RPR, cuya reactividad definía la actividad de la enfermedad cuando era igual o mayor de 8 diluciones, títulos menores obligaban al seguimiento serológico. Resultado: Se tamizaron 46,880 embarazadas, la incidencia de sífilis activa fue de 1.02 por mil tamizadas, la frecuencia de títulos menores alcanzó el 29.33% de las positivas al PRS y la discordancia entre PRS y RPR el 57.87%, el seguimiento serológico fue insuficiente (7.27%), al igual que la evaluación de las parejas y/o contactos sexuales de las gestantes con sífilis activa (4.17%). Conclusión: El algoritmo permite un diagnóstico rápido y la instauración oportuna de la terapia antibiótica, pero su fiabilidad se optimizará con la sistematización de los controles de calidad internos y externos, seguimiento serológico sistemático, planificación de la estrategia que asegure la evaluación serológica y tratamiento de las parejas y/o contactos sexuales, y en los casos de discordancia, el algoritmo debe incluir otra prueba treponémica.

SUMMARY Introduction and objectives: The purpose is to evaluate the results of the application of the inverse algorithm for the diagnosis of gestational syphilis in the Preventive Medicine Service of the National Maternal and Perinatal Institute of Lima, between 2011 and 2017. Method: Observational, descriptive and retrospective study. The results of the diagnostic tests applying the inverse algorithm gestational syphilis were reviewed. The Rapid Syphilis Test (PRS)) was used as a screening, its positivity required to perform the RPR, whose reactivity defined the activity of the disease when it was equal to or greater than 8 dilutions, minor titers required serological follow-up. Result: The incidence of active syphilis was 1.02 per thousand screened, the frequency of minor titres reached 29.33% of those positive for PRS and the discordance between PRS and RPR was 57.87%, serological follow-up was insufficient (7.27%), as well as the evaluation of sexual partners and / or contacts of pregnant women with active syphilis (4.17%). Conclusion: The algorithm allows a rapid diagnosis and the timely establishment of antibiotic therapy, but its reliability will be optimized with the systematization of internal and external quality controls, systematic serological monitoring, strategy planning to ensure the serological evaluation and treatment of couples and / or sexual contacts, and in cases of discordance, the algorithm must include another treponemal test.

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As the world's population grows to a projected 11.2 billion by 2100, the number of people living in low-lying areas exposed to coastal hazards is projected to increase. Critical infrastructure and valuable assets continue to be placed in vulnerable areas, and in recent years, millions of people have been displaced by natural hazards. Impacts from coastal hazards depend on the number of people, value of assets, and presence of critical resources in harm's way. Risks related to natural hazards are determined by a complex interaction between physical hazards, the vulnerability of a society or social-ecological system and its exposure to such hazards. Moreover, these risks are amplified by challenging socioeconomic dynamics, including poorly planned urban development, income inequality, and poverty. This study employs a combination of machine learning clustering techniques (Self Organizing Maps and K-Means) and a spatial index, to assess coastal risks in Latin America and the Caribbean (LAC) on a comparative scale. The proposed method meets multiple objectives, including the identification of hotspots and key drivers of coastal risk, and the ability to process large-volume multidimensional and multivariate datasets, effectively reducing sixteen variables related to coastal hazards, geographic exposure, and socioeconomic vulnerability, into a single index. Our results demonstrate that in LAC, more than 500,000 people live in areas where coastal hazards, exposure (of people, assets and ecosystems) and poverty converge, creating the ideal conditions for a perfect storm. Hotspot locations of coastal risk, identified by the proposed Comparative Coastal Risk Index (CCRI), contain more than 300,00 people and include: El Oro, Ecuador; Sinaloa, Mexico; Usulutan, El Salvador; and Chiapas, Mexico. Our results provide important insights into potential adaptation alternatives that could reduce the impacts of future hazards. Effective adaptation options must not only focus on developing coastal defenses, but also on improving practices and policies related to urban development, agricultural land use, and conservation, as well as ameliorating socioeconomic conditions.

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Objetivo: evaluar la capacidad de BiodentineTM para resistir la microfiltración cuando es usado como material de retroobturación medianteun sistema de transporte de fluidos computarizado. Metodología: En este estudio se utilizaron 60 raíces de dientes unirradiculares, se instrumentaron y obturaron con el sistema de cono único estandarizadodel sistema ProTaper (Dentsply, Maillefer, Suiza) con ultrasonido,utilizando el sellador de conductos radiculares Silco (Silva-Collyan SLP,México). Se hizo la preparación de la cavidad retrógrada con ultrasonidoutilizando la punta E31D del sistema Retro Kit (NSK Company, Japón),con un diámetro de 2 mm. Se llevó a cabo la retroobturación con cada uno de los cementos a evaluar; grupo 1: bturados con Biodentine™ (Septodont, Francia), grupo 2: obturados con MTA Gris (Angelus™, Londrina PR, Brasil), grupo 3: control. Se utilizó un software creado específi camente para evaluar microfi ltración; éste, por medio de sensores infrarrojos, detecta la variación de voltaje de una burbuja de aire dentro de un capilar. El programa expresa el tiempo que tarda la burbuja en pasar por el segundo sensor (mm/min), los cuales se convierten a μL/min, para después expresarlos en unidades de fi ltración, realizándosemediciones en un solo lapso. Resultados: La evaluación en este estudio de la microfi ltración apical de Biodentine™ y MTA Gris Angelus™, arrojó resultados favorables para ambos; se comprobó que no existe diferencia signifi cativa en cuanto a la microfiltración entre ellos; sin embargo, ambos materiales mostraron diferentes características en cuanto a su manipulación, tiempo de fraguado y porosidad. No se presentódiferencia estadísticamente significativa entre los grupos (p = 0.256) U Mann-Whitney y Kruskal Wallis. Conclusión: El Biodentine™ y TA Gris AngelusTM presentan un comportamiento óptimo para la obturación retrógrada. Se requiere realizar otros estudios en cuanto a la interfase con la estructura dentinaria.

Objective: To evaluate, using computational fl uid dynamics, the ability of BiodentineTM to resist microleakage when used as a retro-sealing material. Methodology: In this study, 60 single-rooted teeth were used, which were biomechanically prepared and fi lled using the standardized ProTaper single-cone technique (Dentsply, Maillefer, Switzerland) and ultrasound, using Silco root-canal sealer (Silva-Collyan, SLP, Mexico). The retrograde cavity was prepared using ultrasound and a Retro Kit (NSK Company, Japan) E31D 2 mm-diameter tip. Retrograde fi lling was performed using each of the sealers to be evaluated, as follows: group 1: sealed with BiodentineTM (Septodont, France); group 2: sealed with Grey MTA (AngelusTM, Londrina PR, Brazil); group 3: control. A specially designed software was used, which measures microleakage by using infrared sensors to detect changes in voltage in an air bubble within a capillary tube. The software expresses the time it takes (mm/min) for the bubble to pass through the second sensor, then converts these measurements into μL/min to express the rate of leakage. All of the measurements are taken considering a single interval. Results: The results of the evaluation of the apical microleakage of BiodentineTM and MTA Grey AngelusTM obtained in this study were, in both cases, favorable, proving that there is no signifi cant difference between the two in this respect. However, the characteristics of each in terms of their handling, setting time, and porosity differed. No statistically signifi cant difference between the Mann-Whitney U group and the Kruskal-Wallis group was found (p = 0.256). Conclusion: The performance of Bio-dentineTM and Gray MTA AngelusTM is ideal for retrograde fi lling pur-poses. Further studies are needed, including SEM analysis, in order to determine the quality of the seal, with respect to the interface formed with the dentin structure.

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BACKGROUND: Biologic indicator tests (BIs) are considered the most meaningful way to verify sterilization. OBJECTIVE: To monitor the cycles of sterilization using BIs in dry heat sterilizers and steam autoclaves and to identify the causes of failures in the cycles of sterilization in dental offices in San Luis Potosí, México. METHODS: An invitation to participate was sent to 400 dental offices, and 206 practitioners of 200 dental offices were included. A questionnaire was given to each of the participants, asking for the following information: sterilizer type, operational parameters used (eg, temperature, pressure, and length of exposure), frequency of sterilization cycles per day, use of BIs, and maintenance procedures of the sterilizer. Two hundred thirty sterilizers were monitored using BIs. The sterilizers with positive results were monitored a second and third time to identify the cause of the failure. RESULTS: Twenty-two percent of practitioners (n = 46) used BIs, and 17% (n = 39) of the sterilizers reported positive results (bacterial growth). The detected failures were a mistake in the procedure (eg, temperature, time, or pressure), an absence of supervision of the procedure performed by the assistant, and improper maintenance. CONCLUSIONS: There are opportunities to increase information on infection control, to improve the adoption of standard quality control methods for sterilization as a routine process, to improve training on proper testing, and standardize processes.

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OBJECTIVE: To analyze the number of articles of Revista Médica del Instituto Mexicano del Seguro Social (Rev Med Inst Mex Seguro Soc) in the Scopus database and describe principal quantitative bibliometric indicators of scientific publications during the period between 2005 to 2013. METHODS: Scopus database was used limited to the period between 2005 to 2013. The analysis cover mainly title of articles with the title of Revista Médica del Instituto Mexicano del Seguro Social and its possible modifications. For the analysis, Scopus, Excel and Access were used. RESULTS: 864 articles were published during the period between 2005 to 2013 in the Scopus database. We identified authors with the highest number of contributions including articles with the highest citation rate and forms of documents cited. We also divided articles by subjects, types of documents and other bibliometric indicators which characterize the publications. CONCLUSIONS: The use of Scopus brings the possibility of analyze with an external tool the visibility of the scientific production published in the Revista Médica del IMSS. The use of this database also contributes to identify the state of science in México, as well as in the developing countries.

Objetivo: analizar la visibilidad de la Revista Médica del Instituto Mexicano del Seguro Social (Rev Med Inst Mex Seguro Soc) en la base de datos Scopus y describir los principales indicadores bibliométricos cuantitativos de la producción científica publicados durante el periodo 2005-2013. Métodos: para el análisis se utilizó la base de datos Scopus y se limitó el periodo de búsqueda a los años 2005-2013. La estrategia de búsqueda se ejecutó en los campos específicos de Título de la Publicación (Source Title) con el término Revista Médica del Instituto Mexicano del Seguro Social y sus posibles variantes, asícomo el número ISSN de la revista. Para el análisis de los datos obtenidos se utilizaron las herramientas de Scopus y los programas Excel y Access. Resultados: se encontraron 864 trabajos publicados durante el periodo 2005-2013 que fueron incluidos en Scopus. Se identificaron los autores con mayor producción científica y mayor número de citas acumuladas a sus trabajos, asícomo las principales revistas que citan a la Rev Med Inst Mex Seguro Soc. Se describen las principales áreas temáticas, tipos de documentos y otros indicadores bibliométricos que caracterizan a la publicación. Conclusiones: el uso de Scopus brinda la posibilidad de analizar con una herramienta externa al IMSS la visibilidad de la producción científica publicada en la Revista Médica del IMSS, además de que contribuye a identificar el estado de la ciencia en México y de los países en vías desarrollo.

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El siguiente estudio comparativo de casos y controles tiene como objetivo comparar el nivel de inserción periodontal entre individuos fumadores y no fumadores para determinar la influencia que tiene el hábito tabáquico sobre el periodonto. Se utilizó una muestra de 1738 sitios periodontales específicos obtenidos de 50 sujetos de 19 a 59 años de edad, pertenecientes al Liceo Aníbal Pinto de Temuco, Chile, quienes presentaron un Examen de Salud Preventivo del Adulto Normal. Cada sitio periodontal fue sometido a un sondaje periodontal a través del cual se determinó el nivel de inserción. Además se determino el carácter fumador o no fumador de cada individuo y la frecuencia de este hábito en el primer grupo. Los datos fueron analizados mediante la prueba Chi – cuadrado con p< 0,05. Los resultados obtenidos indican que los individuos fumadores presentan una mayor pérdida de inserción periodontal que los no fumadores y en directa asociación con la frecuencia del hábito de fumar.

The following cases and controls study has as aim compare the level of periodontal insertion between smoking and not smoking individuals to determine the influence of the smoke on the periodontum. There was used a sample of 1738 specifics periodontal sites obtained of 50 subjects between 19 to 59 years old, from the Aníbal Pinto Lyceum of Temuco, Chile, who had received a normal Preventive Examination of Health of the Adult. Every periodontal site was submitted to a periodontal sounding to determinate insertion level. In addition it was determinate the smoking or not smoking character of every individual and the frequency of this habit in the first group. The information were analyzed by Chi - square test with p < 0,05.The results indicate that the smoking individuals present a major loss of periodontal insertion that not smokers and in direct association with the frequency of the smoking habit.

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El presente caso clinico, tratad de demostrar la utilidad de la Colecistostomia Percutanea en el tratamiento de la colecistitis aguda, tanto en pacientes con relativo buen estado general, pero portadores de patologia de base cardiocirculatoria o respiratoria, que hace de ellos pacientes de alto riesgo quirurgico asi como en pacientes severamentes enfermos en los que se presenta la colecistopatia complicando cuadros de disfuncion multisistemica, grandes quemados insuficientes renales, shock septico, y otros, ya sea como complicacion o como foco primario en todos los cuales la cirugia seria imperativa, sin embargo los riesgos inherentes a esta ultima, en las circunstancias citadas, elevarian las cifras de morbimortalidad a rangos prohibitivos. Merced a un optimo aprovechamiento del arsenal de medios de auxilio diagnostico-terapeutico por imagens con los que la medicina cuenta actualmente, se han desarrollado tecnics minimamente invasivas con una incidencia minima de complicaciones, una de ellas es precisamente la COLECISTOSTOMIA PERCUTANEA POR PUNCION, (1) motivo del presente articulo que versa un cuadro de colecistitis aguda en un paciente septico, patologia que fue manejada por el metodo en cuestion.

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