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INTRODUCTION AND AIMS: Surgical or endoscopic treatments play an essential role in the management of achalasia. The probability of adverse events in the performance of said treatments is a relevant aspect, when establishing the risk-benefit balance. The present study aimed to establish the association between serious adverse events and the performance of those procedures, in adult patients with achalasia. MATERIALS AND METHODS: A systemic search of randomized and nonrandomized clinical trials, retrospective cohorts, and cases series on adult patients with achalasia that underwent laparoscopic Heller myotomy (LHM), peroral endoscopic myotomy (POEM), or endoscopic balloon dilation, that reported serious adverse events, was carried out on the Medline, CENTRAL, and EBSCO databases. Serious adverse events were defined as: death at 30 days, Clavien-Dindo grade III or higher classification, esophageal or gastric perforation, pneumothorax, mucosal tear, leakage, emphysema, pneumonia, and chest pain. The methodology included the PRISMA guidelines for reporting systematic reviews. RESULTS: Thirty-five studies were found that reported information on 1,276 patients that underwent POEM, 5,492 that underwent LHM, and 10,346 that underwent endoscopic balloon dilation. The proportions of adverse events for the three techniques were 3.6, 4.9, and 3.1%, respectively. DISCUSSION AND CONCLUSIONS: The 3 therapeutic interventions evaluated had similar proportions of adverse events. There were few reports of death at 30 days as an outcome and the lack of standardization in reporting adverse events in the studies analyzed was prominent.

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The Asociación Mexicana de Hepatología A.C. carried out the Consensus on the Management of Complications of Cirrhosis of the Liver in Pediatrics to provide physicians with useful information for treating said complications. A group of pediatric gastroenterologists and experts in nutrition, nephrology, and infectious diseases participated and reviewed the medical literature. The Delphi method was applied to obtain the level of agreement on the statements that were formulated. The statements were sent to the participants to be analyzed and voted upon, after which they were discussed in virtual sessions, and the final versions were produced. The aim of the consensus results was to issue indications for the management of pediatric patients with liver cirrhosis, to prevent or control complications.

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Resumen Introducción: La osteonecrosis de los maxilares asociada a medicamentos (OMAM) se define como la presencia de hueso necrótico expuesto de los maxilares en pacientes con historia de tratamiento farmacológico antirresortivo o antiangiogénico. Se describen diferentes estadios se severidad, con tratamiento conservador para estadios 0 y I, y tratamiento médico-quirúrgico para II-III. Objetivo: Describir los factores desencadenantes, opciones de tratamiento médico-quirúrgico y resultados en pacientes con OMAM estadios II-III. Material y Método: Estudio retrospectivo, descriptivo, de pacientes diagnosticados con OMAM estadios II y III que requirieron manejo médico-quirúrgico en la Red de Salud UC-Christus entre los años 2007 y 2018. Resultados: Todos los pacientes presentaron historia de tratamiento con bifosfonatos intravenosos. La mayoría de los registros de seguimiento de pacientes estuvo disponible para su análisis. El tratamiento consistió en aseo quirúrgico, decorticación y secuestrectomía. Se reportó disminución de la sintomatología con resolución parcial en la mitad de los casos y cierre completo de la exposición ósea en los restantes. Conclusión: Sugerimos que el tratamiento médico-quirúrgico en pacientes con OMAM en etapas II y III es efectivo en términos de disminución de sintomatología y control de infección. Sin embargo, es necesario realizar nuevos estudios prospectivos, con mayor cantidad de pacientes y tiempo de seguimiento.

Abstract Introduction: Medication-associated osteonecrosis of the jaws (MRONJ) is defined as the presence of exposed necrotic bone of the jaws in patients with a history of antiresorptive or antiangiogenic drug treatment. Different stages of severity are described, with conservative treatment for stages 0 and I, and medical-surgical treatment for II-III. Aim: To describe the triggers, medical-surgical treatment options and outcomes in patients with stage II-III MRONJ. Material and Method: Retrospective, descriptive study of patients diagnosed with MRONJ stages II and III that required medical-surgical management in the UC-Christus Health Network between 2007 and 2018. Results: All patients had a history of treatment with intravenous bisphosphonates. Most of the patient follow-up records were available for analysis. Treatment consisted of surgical grooming, decortication, and sequestrectomy. A decrease in symptoms was reported with partial resolution in half of the cases, and complete closure of bone exposure in the remainder. Conclusion: We suggest that medical-surgical treatment in patients with MRONJ in stages II and III is effective in terms of reducing symptoms and controlling infection. However, it is necessary to carry out new prospective studies, with a greater number of patients and follow-up time.

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INTRODUCTION AND AIMS: Even though the term hepatocellular carcinoma designates the most common type of primary liver cancer, the disease has a high level of heterogeneity due to its etiology, geographic variation, behavior, and association with specific genetic alterations. The aim of the present study was to establish, through a cluster analysis, the clinical characteristics that enable homogeneous conglomerates to be defined. MATERIALS AND METHODS: An exploratory cluster analysis was developed utilizing the K-means method for sub-classifying 119 cases of patients with hepatocellular carcinoma. Sixty-two of those patients met the inclusion criteria, as well as none of the exclusion criteria. For the cluster analysis, an n-dimensional space was defined, in which n was equal to the number of variables included in the study (n = 17). The spatial coordinates corresponded to any possible magnitude between the minimum and maximum values of the variables analyzed (age, sex, tumor volume, AFP, AST, DB, Alb, Na, INR, Cr, HBV, HCV, OH, NASH, cirrhosis, multiple tumors, and neotumor). RESULTS: Four patterns with homogeneous clinical characteristics were identified, in which age at presentation, history of hepatitis B virus infection, altered liver profile with cholestatic dominance, and low albumin levels were associated with an apparently worse outcome. CONCLUSIONS: How heterogeneity in hepatocellular carcinoma could be reduced was shown through utilizing an unsupervised learning method to define specific subgroups, in whom known pathophysiologic mechanisms could better explain tumor behavior and define the determining prognostic factors related to the subgroups.

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INTRODUCTION AND OBJECTIVE: Even though the term hepatocellular carcinoma designates the most common type of primary liver cancer, the disease has a high level of heterogeneity due to its etiology, geographic variation, behavior, and association with specific genetic alterations. The aim of the present study was to establish, through a cluster analysis, the clinical characteristics that enable homogeneous conglomerates to be defined. MATERIALS AND METHODS: An exploratory cluster analysis was developed utilizing the K-means method for sub-classifying 119 cases of patients with hepatocellular carcinoma. Sixty-two of those patients met the inclusion criteria, as well as none of the exclusion criteria. For the cluster analysis, an n-dimensional space was defined, in which n was equal to the number of variables included in the study (n = 17). The spatial coordinates corresponded to any possible magnitude between the minimum and maximum values of the variables analyzed (age, sex, tumor volume, AFP, AST, DB, Alb, Na, INR, Cr, HBV, HCV, OH, NASH, cirrhosis, multiple tumors, and neotumor). RESULTS: Four patterns with homogeneous clinical characteristics were identified, in which age at presentation, history of hepatitis B virus infection, altered liver profile with cholestatic dominance, and low albumin levels were associated with an apparently worse outcome. CONCLUSION: How heterogeneity in hepatocellular carcinoma could be reduced was shown through utilizing an unsupervised learning method to define specific subgroups, in whom known pathophysiologic mechanisms could better explain tumor behavior and define the determining prognostic factors related to the subgroups.

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Neoplasic transformation is a continuous process that occurs in the body. Even before clinical signs, the immune system is capable of recognizing these aberrant cells and reacting to suppress them. However, transformed cells acquire the ability to evade innate and adaptive immune defenses through the secretion of molecules that inhibit immune effector functions, resulting in tumor progression. Hormones have the ability to modulate the immune system and are involved in the pathogenesis of autoimmune diseases, and cancer. Hormones can control both the innate and adaptive immune systems in men and women. For example androgens reduce immunity through modulating the production of pro-inflammatory and anti-inflammatory mediators. Women are more prone than men to suffer from autoimmune diseases such as systemic lupus erythematosus, psoriasis and others. This is linked to female hormones modulating the immune system. Patients with autoimmune diseases consistently have an increased risk of cancer, either as a result of underlying immune system dysregulation or as a side effect of pharmaceutical treatments. Epidemiological data on cancer incidence emphasize the link between the immune system and cancer. We outline and illustrate the occurrence of hormone-related cancer and its relationship to the immune system or autoimmune diseases in this review. It is obvious that some observations are contentious and require explanation of molecular mechanisms and validation. As a result, future research should clarify the molecular pathways involved, including any causal relationships, in order to eventually allocate information that will aid in the treatment of hormone-sensitive cancer and autoimmune illness.

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INTRODUCTION AND AIMS: The controlling nutritional status (CONUT) score has previously been shown to be useful for nutritional assessment and the prediction of several inflammatory and neoplastic diseases. The aim of the present study was to evaluate the potential use of the CONUT score as a method for nutritional screening and predicting severity in ulcerative colitis (UC). MATERIALS AND METHODS: The study was conducted on 60 patients diagnosed with UC. Demographic, clinical, and biochemical patient characteristics were collected from their clinical records, and disease severity was assessed using the Truelove and Witts scale (TWS). The risks for malnutrition were evaluated through the nutritional risk index and the CONUT score. RESULTS: More than 90% of the UC patients presented with malnutrition risk, according to the scores analyzed. Patients with a high (>6points) CONUT score presented with moderate-to-severe activity on the TWS. A higher CONUT score was also associated with an increase in C-reactive protein (CRP) (P=.002) and erythrocyte sedimentation rate (ESR) (P=.009). The data analysis was performed utilizing the SPSS version 19 program. CONCLUSIONS: The CONUT score could be a promising tool for evaluating nutritional status in UC patients and predicting UC severity.

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Resumen Introducción: La osteonecrosis de los maxilares asociada a medicamentos (OMAM) es una patología que involucra la exposición necrótica de hueso maxilar o mandibular, relacionada al uso de fármacos antirresortivos y antiangiogénicos, con una prevalencia de 0,94%-13% en pacientes oncológicos y con osteoporosis que hacen uso de ellos. Objetivo: Determinar la prevalencia de osteonecrosis de los maxilares en pacientes en tratamiento con bifosfonatos intravenosos (BFIV) en el Centro del Cáncer de la Red de Salud UC-Christus, Santiago de Chile. Material y Método: Se analizaron los datos de pacientes que recibieron tratamiento de bifosfonatos intravenoso entre marzo y septiembre de 2016, con seguimiento por los equipos tratantes. Se consideró para la extracción de datos el género, edad, diagnóstico primario, bifosfonato intravenoso utilizado, tiempo de seguimiento, presencia de metástasis óseas y diagnóstico de OMAM. Resultados: Se obtuvo una muestra de 143 pacientes, con una relación hombre:mujer de 1:2; promedio de edad de 63,2 años; 78% de ellos fueron tratados con ácido zoledrónico y un 22% con pamidronato. Del total de pacientes un 1,4% (n = 2) desarrolló OMAM. Ambos casos con diagnóstico de cáncer de mama en tratamiento con ácido zoledrónico, lo que corresponde al 1,8% de los pacientes en tratamiento con este fármaco. Conclusión: Si bien la OMAM es una patología infrecuente, esta se presenta con alta morbilidad y es de manejo complejo. La prevención y tratamiento de focos infecciosos odontogénicos de pacientes antes, durante o después del tratamiento con BFIV es fundamental para prevenir su desarrollo.

Abstract Introduction: Medication-related osteonecrosis of the jaw (MRONJ) is a disease involving exposition of necrotic maxillary and mandibular bone and it's related to antiresorptive and antiangiogenic drugs, with a prevalence that variates from 0,94%-13% in oncologic and osteoporosis patients treated with them. Aim: To determine the prevalence of MRONJ in patients that underwent treatment with intravenous bisphosphonates (IVBP) at Centro del Cancer de la Red de Salud UC-CHRISTUS of Santiago, Chile. Material and Method: Data from patients who received intravenous bisphosphonate treatment between March and September 2016 were analyzed, with follow-ups by their treating teams. Data extraction considered gender, age, primary diagnosis, intravenous bisphosphonate used, follow up time, bone metastases and diagnosis of MRONJ. Results: A sample of 143 patients was obtained with a men:women ratio of 1:2; an average age of 63,2 years, 78% of the patients were treated with zoledronic acid and 22% of the patients with pamidronate. From the total number of patients,1.4% (n = 2) developed MRONJ, both cases had breast cancer as primary diagnosis and in treatment with zoledronic acid, which corresponds to 1.8% of patients being treated with this drug. Conclusion: Although MRONJ is an infrequent disease, it presents high morbidity and complex management. Prevention and treatment of odontogenic infectious foci in patients before, during and after treatment with IVBP drugs is fundamental to prevent this pathology.

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INTRODUCTION: The aim of this study is to evaluate the cost-effectiveness and impact of gene-expression assays (GEAs) on treatment decisions in a real-world setting of early-stage breast cancer (ESBC) patients. METHODS: This is a regional, prospective study promoted by the Council Health Authorities in Madrid. Enrolment was offered to women with estrogen receptor-positive, human epidermal growth factor receptor 2-negative, node-negative or micrometastatic, stage I or II breast cancer from 21 hospitals in Madrid. Treatment recommendations were recorded before and after knowledge of tests results. An economic model compared the cost-effectiveness of treatment, guided by GEAs or by common prognostic factors. RESULTS: 907 tests (440 Oncotype DX® and 467 MammaPrint®) were performed between February 2012 and November 2014. Treatment recommendation changed in 42.6% of patients. The shift was predominantly from chemohormonal (CHT) to hormonal therapy (HT) alone, in 30.5% of patients. GEAs increased patients' confidence in treatment decision making. Tumor grade, progesterone receptor positivity and Ki67 expression were associated with the likelihood of change from CHT to HT (P < 0.001) and from HT to CHT (P < 0.001). Compared with current clinical practice genomic testing increased quality-adjusted life years by 0.00787 per patient and was cost-saving from a national health care system (by 13.867€ per patient) and from a societal perspective (by 32.678€ per patient). CONCLUSION: Using GEAs to guide adjuvant therapy in ESBC is cost-effective in Spain and has a significant impact on treatment decisions.

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PURPOSE: There is limited evidence on the efficacy and safety of anti-programmed cell death protein 1 (PD-1)-/anti-programmed death-ligand 1 (PD-L1)-based immunotherapy in the elderly, particularly those aged over 75 years. METHODS/PATIENTS: The clinical response and toxicity profile of anti-PD-1-/anti-PD-L1-based immunotherapy in patients aged over 75 years were assessed in this retrospective observational study conducted in the Medical Oncology Service of a tertiary level hospital. The associations among clinical responses, adverse events, and geriatric syndromes were evaluated. RESULTS: In total, 20 patients aged between 75 and 94 years were evaluated. Pembrolizumab and nivolumab were the most commonly used drugs. A clinical benefit (stable disease, partial response or complete response) was documented in 13 patients (65%). This proportion was 80% in patients aged between 75 and 79 years, and 50% in those aged over 79 years (p = 0.236). The adverse events were similar to those reported in younger patients. At least one clinical adverse event (cAE) and one laboratory adverse event (lAE) was reported in 75% and 55% of patients, respectively. Polypharmacy was observed for all patients and multi-morbidity in 95%. Patients without gait disorders showed more responses to immunotherapy. The number of lAEs was significantly associated with the number of commonly prescribed drugs (slope = 0.218, p = 0.010), the Eastern Cooperative Oncology Group score, and the number of cAEs. CONCLUSIONS: The elderly can obtain benefits from anti-PD-1-/anti-PD-L1-based immunotherapy. The toxicity profile was similar to that reported in younger counterparts.

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Hydroxyapatite (HA) is widely used as a biomaterial for bone repair and metallic prostheses coating. The main limitations of the current commercial synthetic hydroxyapatite compounds include high cost and decreased availability, especially for veterinary medicine purposes. Additionally, it is thought that HA biocompatibility and bioactivity could be enhanced by the addition of metal compounds. The objective of this work was to compare the subcutaneous tissue response of commercial and engineered hydroxyapatite obtained from the bovine femur diaphysis mixed with different concentrations of hexa-hydrated Zinc Nitrate in rabbits. Twenty-Five New Zealand female rabbits were used. Five treatments were done according to HA composition (commercial HA, no Zn-HA, 0.1M Zn, 0.2M Zn, and 0.3M Zn). Each treatment was evaluated at five time-points (8, 15, 30, 60 and 90 days post-implantation). Histopathologic analysis was performed to assess inflammation by polymorphonuclear cells infiltration, neovascularization, and fibrosis. Results obtained in this work suggest that general inflammation decreased after 60 days of implantation regardless of Zn concentration. Fibrosis score was increased in the commercial HP compared to control and Zn-hydrated HA. This paper shows that bovine hydroxyapatite is a biocompatible material regardless of nitrate Zinc concentration and has the same properties of commercial hydroxyapatite.(AU)

A hidroxiapatita (HA) é amplamente utilizada como biomaterial para reparo ósseo e revestimento de próteses metálicas. As principais limitações dos atuais compostos comerciais de hidroxiapatita sintética incluem alto custo e menor disponibilidade, especialmente para fins de medicina veterinária. Além disso, acredita-se que a biocompatibilidade e a bioatividade da HA poderiam ser aumentadas pela adição de compostos metálicos. O objetivo deste trabalho foi comparar a resposta tecidual subcutânea de hidroxiapatita comercial e da obtida da diáfise do fêmur bovino misturada com diferentes concentrações de nitrato de zinco hexa-hidratado em coelhos. Foram utilizadas 25 coelhas fêmeas Nova Zelândia. Cinco tratamentos foram feitos de acordo com os compostos de HA (HA comercial, no Zn-HA, 0,1M Zn, 0,2M Zn e 0,3M Zn). Cada tratamento foi avaliado em cinco momentos (oito, 15, 30, 60 e 90 dias após a implantação). A análise histopatológica foi realizada para avaliar a inflamação por infiltração de células polimorfonucleares, neovascularização e fibrose. Os resultados obtidos neste trabalho sugerem que a inflamação geral diminuiu após 60 dias de implantação, independentemente da concentração de Zn. O escore de fibrose foi aumentado na HA comercial comparada com o controle e com a HA hidratada com Zn. Este trabalho mostra que a hidroxiapatita bovina é um material biocompatível independentemente da concentração de nitrato de zinco e possui as mesmas propriedades da hidroxiapatita comercial.(AU)

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Hydroxyapatite (HA) is widely used as a biomaterial for bone repair and metallic prostheses coating. The main limitations of the current commercial synthetic hydroxyapatite compounds include high cost and decreased availability, especially for veterinary medicine purposes. Additionally, it is thought that HA biocompatibility and bioactivity could be enhanced by the addition of metal compounds. The objective of this work was to compare the subcutaneous tissue response of commercial and engineered hydroxyapatite obtained from the bovine femur diaphysis mixed with different concentrations of hexa-hydrated Zinc Nitrate in rabbits. Twenty-Five New Zealand female rabbits were used. Five treatments were done according to HA composition (commercial HA, no Zn-HA, 0.1M Zn, 0.2M Zn, and 0.3M Zn). Each treatment was evaluated at five time-points (8, 15, 30, 60 and 90 days post-implantation). Histopathologic analysis was performed to assess inflammation by polymorphonuclear cells infiltration, neovascularization, and fibrosis. Results obtained in this work suggest that general inflammation decreased after 60 days of implantation regardless of Zn concentration. Fibrosis score was increased in the commercial HP compared to control and Zn-hydrated HA. This paper shows that bovine hydroxyapatite is a biocompatible material regardless of nitrate Zinc concentration and has the same properties of commercial hydroxyapatite.(AU)

A hidroxiapatita (HA) é amplamente utilizada como biomaterial para reparo ósseo e revestimento de próteses metálicas. As principais limitações dos atuais compostos comerciais de hidroxiapatita sintética incluem alto custo e menor disponibilidade, especialmente para fins de medicina veterinária. Além disso, acredita-se que a biocompatibilidade e a bioatividade da HA poderiam ser aumentadas pela adição de compostos metálicos. O objetivo deste trabalho foi comparar a resposta tecidual subcutânea de hidroxiapatita comercial e da obtida da diáfise do fêmur bovino misturada com diferentes concentrações de nitrato de zinco hexa-hidratado em coelhos. Foram utilizadas 25 coelhas fêmeas Nova Zelândia. Cinco tratamentos foram feitos de acordo com os compostos de HA (HA comercial, no Zn-HA, 0,1M Zn, 0,2M Zn e 0,3M Zn). Cada tratamento foi avaliado em cinco momentos (oito, 15, 30, 60 e 90 dias após a implantação). A análise histopatológica foi realizada para avaliar a inflamação por infiltração de células polimorfonucleares, neovascularização e fibrose. Os resultados obtidos neste trabalho sugerem que a inflamação geral diminuiu após 60 dias de implantação, independentemente da concentração de Zn. O escore de fibrose foi aumentado na HA comercial comparada com o controle e com a HA hidratada com Zn. Este trabalho mostra que a hidroxiapatita bovina é um material biocompatível independentemente da concentração de nitrato de zinco e possui as mesmas propriedades da hidroxiapatita comercial.(AU)

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RESUMEN Introducción: La patología sinusal inflamatoria e infecciosa puede comprometer la mucosa sinusal maxilar, etmoidal, esfenoidal o frontal, y su etiología es variada. Se ha observado que la patología odontológica es uno de los factores causales de la sinusitis maxilar, con una incidencia del 10% al 40% según diversas series de casos. El diagnóstico y tratamiento se debe realizar de manera interdisciplinaria entre las especialidades de otorrinolaringología y de cirugía maxilofacial. Se elaboró un documento descriptivo sobre la sinusitis odontogénica y orientador sobre su manejo, de acuerdo a una revisión de la literatura. Se realizaron búsquedas en las bases de datos PubMed, Lilacs y Google Académico, utilizando términos relevantes para la sinusitis odontogénica, con el fin de elaborar el documento. Se utilizaron 43 artículos, todos publicados desde el año 1986 hasta la fecha. Se concluye que la sinusitis odontogénica difiere tanto en la clínica como en la microbiología de otras enfermedades sinusales. El tratamiento se basa en el trabajo interdisciplinario e incluye cirugía endoscópica funcional, realizada por el otorrinolaringólogo, en conjunto con el tratamiento odontológico, siendo fundamental la buena comunicación entre ambos equipos.

ABSTRACT Introduction: Infectious and inflammatory sinus diseases have a varied etiology and can be associated to the maxillary, ethmoidal, sphenoidal and frontal sinuses. Dental pathology can be one of the etiological factors associated to maxillary sinus disease, with frequency rates of 10-40%. Diagnosis and treatment require interdisciplinary work, with participation of otorhinolaryngology and oral and maxillofacial surgery. The development of a descriptive document on odontogenic sinusitis and management guidelines according to literature review. Pubmed, Lilacs and Google Academic database were searched using terms relevant to odontogenic sinusitis, in order to prepare the document. 43 articles were used, all published from 1986 onwards. We conclude that odontogenic sinusitis differs clinically and microbiologically from other sinus pathologies. Treatment modalities are based upon interdisciplinary surgery, including functional endoscopic surgery done by otolaryngologists and dental treatment, being fundamental close communication between the two teams.

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In male goats, being in permanent visual contact with females in estrus does not prevent seasonal variation in certain endocrine hormone levels and sexual activities. In this study, we tested whether continuous and full contact with females in estrus prevented seasonal endocrinological variation in bucks. In 1 experiment (Exp. 1), we verified that the sudden introduction of goats in estrus increased the plasma concentrations of androgen in bucks during the nonbreeding season under our experimental conditions. In another experiment (Exp. 2), we tested the ability of estrous goats to prevent seasonal inhibition of LH and androgen secretions in bucks kept in permanent and full contact with them. In Exp. 1, 3 groups of bucks (n = 5 in each group) were isolated from females from the months of July to January. On January 27, one group continued being isolated from females; a second group was exposed to ovariectomized, untreated goats; and a third group was exposed to ovariectomized goats with induced estrus. Plasma androgen concentrations were determined every 2 h from 8 h before to 8 h after the introduction of females. The introduction of estrus-induced goats significantly increased androgen concentrations, which were higher than in the isolated bucks, as well as in those exposed to untreated goats (P < 0.05). In Exp. 2 (n = 5 per group), one group of bucks was isolated from females from October to July, whereas two other groups remained in contact with ovariectomized goats, either untreated or regularly induced to estrus. In the three groups of bucks, plasma concentrations of LH were determined once during the months of October, February, March, and June, whereas androgen concentrations were determined weekly from October to July. The mean plasma LH and androgen concentrations were low and did not differ among the groups of bucks during the normal seasonal period of sexual inactivity (P > 0.05). We conclude that full contact and sexual interactions with estrus-induced goats failed to stop the seasonality of LH and androgen plasma concentrations of bucks, although bucks could respond to the introduction of females by acute increases in plasma LH and androgen.

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Banana is the second largest export crop in Colombia. To meet the demand of international markets, high amounts of chemical fertilizers are required, which represent high costs and can be hazardous to the environment. Plant growth promoting rhizobacteria (PGPR) can, at least partially, replace chemical fertilizers. In this paper, we evaluated the effect of nine PGPR of the genera Bacillus and Pseudomonas on banana growth. Banana seedlings were produced through tissue culture and acclimatized in the greenhouse core. Plants were inoculated with the rhizobacteria and growth parameters (plant height, leaf number, leaf area, pseudostem thickness, root and shoot fresh weight, root and shoot dry weight) were assessed after 55 days. The two best performing PGPR, Bs006 and Ps006 previously identified as Bacillus amyloliquefaciens and Pseudomonas fluorescens, respectively, promoted banana growth similarly or even slightly superior to 100% chemical fertilization, and were selected for further characterization of root colonization by both eletron microscopy and confocal microscopy of fluorescence in situ hybridization (FISH)-stained root tissues. Both P. fluorescens Ps006 and B. amyloquifaciens Bs006 showed ability to colonize banana roots, but Bs006 appeared faster than Ps006 in the colonization dynamics. This work demonstrated that inoculation of rhizobacteria Bacillus amyloliquefaciens Bs006 and Pseudomonas fluorescens Ps006 could partially replace the chemical fertilization of tissue cultured banana plants, and therefore could be used for the formulation of a new biofertilizer.

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Resumen Introducción: El cáncer de células escamosas (CCE) es el segundo cáncer de piel más frecuente. Sin embargo, no hay publicaciones en Chile sobre el tema. Objetivo: Investigar características sociodemográficas y clínicas del CCE en la Región de Coquimbo, Chile. Material y Métodos: Serie de casos de pacientes con diagnóstico de CCE de piel tratados en el hospital de Coquimbo, entre enero de 2006 y diciembre de 2015. Criterios de inclusión: diagnóstico histológico definitivo de CCE de piel. Criterio de exclusión: 1.- seguimiento posoperatorio menor de 12 meses; 2.- operado en otro hospital; 3.- sometido a otro tratamiento previo a la cirugía; 4.- metástasis cutáneas de un CCE mucoso; 5.- CCE con metástasis a distancia. Variables independientes: edad, género, localización, tamaño, linfonodos comprometidos, residencia costera-interior. Variables dependientes: recurrencia, factores de recurrencia, letalidad. Análisis estadístico: descriptivo y analítico con el programa SSPS. Resultados: Se registraron 2.202 casos de cáncer de piel, 1.487 basocelular (67,5%), 181 melanomas (8,2%) y 534 CCE (24,2%). 236 pacientes tienen datos completos y constituyen el informe, 153 hombres (64,8%) y 83 mujeres (35,2%). Edad: 75,5 años ± 11,7 (extremos 46-94). La localización es: cabeza 158 casos (66,9%), otras áreas expuestas 47 (20%) y no expuestas 31 (14,1%). En cabeza la localización más frecuente es mejilla 40 casos (25%), frente 29 casos (12,3%). En 119 casos (50,4%) el cáncer se presenta ulcerado y en 117, no ulcerado (49,6%); diámetro del tumor 22 milímetros (rango 3-100 mm). En 10 casos hay linfonodos clínicos (4,2%). En 12 casos (5,9%) se extirpa LNC, 2 positivos. 201 casos presentan bordes histológicos libres (85,2%) y en 35 casos, borde comprometido (14,8%). Tasa de recurrencia local 8,5% (20 casos) y ganglionar 2,1% (5 casos). Recidiva del cáncer se asocia a borde histológico comprometido: P = 0,001, IC 95% 3,12-12,19 y ulceración p = 0,01, OR 4,63; IC 1,59-13,50. Seguimiento de 36 meses (rango 12-228). Letalidad 2,56%. Conclusión: El CCE de piel extirpado precozmente con confirmación histológica de erradicación tiene buen pronóstico.

Introduction: Squamous skin cancer (SSC) is the second most frequent skin cáncer, nevertheless reports about this issue are not published in Chile. Objetive: To investigate social, demographics, and clinic characteristics of SSC in semidesertic Coquimbo Region, Chile. Material and Methods: serie of patients diagnosed and treated in Coquimbo hospital between January 2006 and December 2015. Inclussion criteria: 1.- histopathological confirmation of SSC. Exclusion criteria: 1.- follow up lesser than 12 months; 2.- operated in another hospital; 3.- submitted to another treatment prior to surgery; 4.- skin metastasis of mucous squamous carcinoma; 5.- patients with distant metástasis. Independent variables: age, gender, tumor site, tumor size, clinical lymph nodes, shore or valley residency. Dependent variable: recurrency frecuence, factors of recurrency, letality. Statistical analysis: descriptive and analytical by SSPS program. Results: 2.202 skin cancer cases were registered, 1.487 basal cells carcinoma (67.5%), 181 melanoma (8.2%) and 534 squamous cells carcinoma (24.2%). 236 patients with complete data are included in this report. There were 153 men (64.8%), and 83 women (35.2%). Mean age was 75.5 years old ± 11.7 (range 46-94). Primary site was: head 158 patients (66.9%), other sun exposed areas 47 patients (20%), and non exposed areas 31 patients. Cheek and front were the most frequents head site with 40 cases (25%) and 29 cases (12.3%), respectively. In 119 cases (50.4%) SCC was ulcerated, and 117 cases was not; primary tumor diameter was 22 millimeters (range 3-100). Clinical lymph nodes were primarily positives in 10 patients, (4.2%). In 12 cases with negative lymph nodes, sentinel limph node was resected. 2 were positives. Histological borders were tumor free in 201 patients (85.2%) and, 35 cases (14.8%) had positive histological borders. Local recurrence incidence was 8.5% (20 cases). Limph nodes recurrence was 2.1% (5 cases). Cancer recurrence was associated with histological positive borders P = 0.001, IC 95% 3.12-12.19, and ulcerated tumor p = 0.01, OR 4.63; IC 1.59-13.50. Letality was 2.56%. Mean follow up was 36 months (range 12-228 months). Conclusions: SSC has a good prognosis when primary tumor is resected early, with free histological borders resection.

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El análisis del estado nutricional en la mujer embarazada es de vital importancia para el normal desarrollo del nuevo ser, así como para evitar complicaciones en su estado de salud de la mujer después del parto. La anemia por deficiencia de hierro es el padecimiento nutricional más frecuente en el mundo y se constituye en un reconocido problema de salud durante el embarazo, donde hasta un 50 a 60% de las mujeres embarazadas son afectadas por esta enfermedad en los países en desarrollo. El objetivo de este estudio fue determinar los valores de hematocrito y hemoglobina en mujeres gestantes como control prenatal y posnatal en el Centro de salud Nicolás Ortiz del municipio de Yotala. Es una investigación cuantitativa, descriptiva, transversal y retrospectiva realizado con 48 mujeres que acudieron a sus controles prenatal y después de parto. Entre los resultados se obtuvo que los valores de hematocrito se mantienen en las mujeres tanto en su control prenatal como posnatal. En relación a la hemoglobina, el 35% de las mujeres presentan valores inferiores a 11 g/dl, aumentando a 60% en el control posnatal. Siendo la clasificación de la anemia leve.

The analysis of the nutritional status in pregnant women is of vital importance for the normal development of the new being, as well as to avoid complications in their health status of women after childbirth. Iron deficiency anemia is the most frequent nutritional condition in the world and constitutes a recognized health problem during pregnancy, where up to 50 to 60% of pregnant women are affected by this disease in developing countries. The objective of this study was to determine hematocrit and hemoglobin values in pregnant women as a prenatal and postnatal control at the Nicolás Ortiz Health Center in the municipality of Yotala. It is a quantitative, descriptive, crosssectional and retrospective investigation conducted with 48 women who attended their prenatal and postpartum controls. Among the results, it was obtained that hematocrit values are maintained in women both in their prenatal and postnatal control. In relation to hemoglobin, 35% of women have values below 11 g / dl, increasing to 60% in postnatal control. Being the classification of mild anemia.

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Introducción: El tromboembolismo venoso (TEV) es una causa importante de morbimortalidad en la población hospitalaria y quirúrgica. Esta entidad tiene mecanismos fisiopatológicos bien definidos y descritos, además, de factores de riesgo que permiten una clasificación de los pacientes según diversos modelos de valoración, los cuales permiten adoptar medidas profilácticas. En el ámbito de la cirugía maxilofacial se han descrito bajos niveles de incidencia. Sin embargo, hay evidencia bastante limitada y representa un problema de salud al cual se le ha prestado poca atención en la literatura. Objetivo: El presente estudio tiene como objetivo conocer la incidencia de tromboembolismo venoso en pacientes sometidos a cirugía ortognática. Material y Método: Se evaluaron en forma retrospectiva fichas clínicas de 86 pacientes operados de cirugía ortognática entre octubre de 2006 y enero de 2016 en el Hospital Clínico de la Pontificia Universidad Católica de Chile. Se identificaron 2 casos de tromboembolismo pulmonar, lo cual corresponde a una incidencia de 2,6%. Sin embargo, no se obtuvo un espacio muestral suficiente para lograr identificar factores de riesgo específicos en esta población. Conclusiones: A pesar de la baja incidencia de TEV en pacientes sometidos a cirugía maxilofacial, es fundamental considerar el riesgo individual del paciente y el riesgo que implica la cirugía. La prolongación del tiempo quirúrgico, la estadía hospitalaria y la inmovilización prolongada pueden determinar un riesgo mayor de desarrollar este tipo de complicación, por lo tanto, es necesario considerarla y saber prevenirla de manera adecuada.

Introduction: Venous thromboembolism (VTE) is an important cause of morbidity and mortality in surgical patients. This entity has well defined and described pathophysiological mechanisms, in addition to risk factors that allow a classification of patients according to different assessment models, which allow to adopt prophylactic measures. In maxillofacial surgery, low levels of incidence have been described. However, there is quite limited evidence and represents a health problem that has received little attention in the literature. Objective: To determine the incidence of venous thromboembolism in patients undergoing orthognathic surgery. Material and Method: Retrospectively, 86 patients who underwent orthognathic surgery was evaluated between October 2006 and January 2016 at the Hospital Clínico de la Pontificia Universidad Católica de Chile. Two cases of pulmonary thromboembolism were identified, which corresponds to an incidence of 2.6%. Despite the low incidence of VTE in patients undergoing maxillofacial surgery, it is essential to consider the individual risk of the patient and the risk involved in surgery. The prolongation of surgical time, the hospital stay and prolonged immobilization can determine a greater risk of developing this type of complication, therefore it is necessary to consider it and know how to prevent it in an adequate way.

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Facial injuries are cause of consultation in emergency departments. The maxillofacial region contains several structures that are vital for life. Hence, an early assessment and management of facial injuries is important to avoid their consequential complications and eventual mortality. This article is a review of the literature about the emergency clinical assessment and management of traumatic facial injuries by non-specialists.

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