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INTRODUCTION: Respectful maternity care (RMC) is fundamental to women's and families' experience of care and their decision about where to give birth. Studies from multiple countries describe the mistreatment of women during facility-based childbirth, though only a small number of studies from Guatemala have been published. Less information is available on women's negative and positive experiences of childbirth care and health workers' perceptions and experiences of providing maternity care. METHODS: As part of a program implemented in the Western Highlands of Guatemala to improve quality of reproductive maternal newborn and child health care, a mixed methods assessment was conducted in three hospitals and surrounding areas to understand women's and health workers' experience and perceptions of maternity care. The quantitative component included a survey of 31 maternity health workers and 140 women who had recently given birth in these hospitals. The qualitative component included in-depth interviews (IDIs) and focus group discussions (FGDs) with women and maternity health workers and managers. RESULTS: Women reported a mix of positive and negative experiences of childbirth care related to interpersonal and health system factors. 81% of surveyed women reported that health workers had treated them with respect while 21.4% of women reported verbal abuse. Fifty-five percent and 12% of women, respectively, reported not having access to a private toilet and bath or shower. During IDIs and FGDs, many women described higher rates of verbal abuse directed at women who do not speak Spanish. A regression analysis of survey results indicated that speaking Ixil or K'iche at home was associated with a higher likelihood of women being treated negatively during childbirth in a facility. Health worker survey results corroborated negative aspects of care described by women and also reported mistreatment of health workers by clients and families (70.9%) and colleagues (48.2%). CONCLUSIONS: This study adds to the literature on women's experience of institutional childbirth and factors that influence this experience by triangulating experience and perceptions of both women and health workers. This assessment highlights opportunities to address mistreatment of both women and health workers and to build on positive care attributes to strengthen RMC for all women.

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RESUMEN: La irrupción de los implantes óseo integrados y su posterior validación, a comienzos de los años '80, aportó sin duda un utilísimo recurso en la rehabilitación oral. Lamentablemente, en gran medida debido a los costes económicos involucrados, a pesar de alentadores augurios, no han devenido en una alternativa terapéutica concreta para la gran mayoría de los pacientes desdentados. El edentulismo parcial de maxilas, clases Kennedy I y II, con remanencia de todos o parte de los dientes del sextante 2, en su mayoría casos de sustancial complejidad, léase clases III del Índice Diagnóstico Prostodóntico, genera un desafío protésico a solventar en relación a la retención y satisfacción estética de los pacientes. Presentamos en este reporte dos de estos casos, rehabilitados mediante prótesis metálicas "convencionales", en los cuales creemos logramos conjugar acertadamente ambas variables, combinando complejos retentivos RMC y facetas retentivas friccionales.

ABSTRACT The emergence of osseointegrated implants and their further validation, at the beginning of the 80's, contributed undoubtedly to oral rehabilitation as a very useful resource. Unfortunately, mainly because of the economic costs involved and despite an encouraging initial augury, they have not become in a specific therapeutic alternative for the vast majority of edentulous patients. Partial edentulism of maxillae, Kennedy's class I, & II, with all or a few teeth remaining at the sextant 2, mostly class III PDI, substantially compromised denture-supporting anatomy, generate a prosthetic challenge to overcome regarding retention and aesthetic satisfaction of these patients. In this report, we display two of them, which we believe have been successfully managed in order to fulfill both variables, by means of "conventional" removable metallic prostheses combining MGR's clasps and frictional retentive facets.

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Vascular rings which can cause symptoms related the trachea and esophagus compression occur in less than 1% of all cardiovascular malformations. Double incomplete aortic arch with right-sided aorta and aberrant left subclavian artery is the rarest one, and its present in 0.04-0.1% of autopsy series. A case of this malformation with a Kommerell's Diverticulum is presented. This diverticulum has risk of severe complications such as dissection and/or rupture.

Los anillos vasculares pueden causar síntomas relacionados a compresión de tráquea y esófago y ocurren en menos del 1% de todas las malformaciones cardiovasculares. El doble arco aórtico incompleto con arco aórtico a la derecha y arteria subclavia izquierda aberrante es la forma más rara y se presenta en el 0.04 a 0.1% de las series de autopsia. Se presenta un caso de esta malformación con un divertículo de Kommerell. El divertículo tiene riesgo de complicaciones severas como disección y/o ruptura.

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Vascular rings which can cause symptoms related the trachea and esophagus compression occur in less than 1% of all cardiovascular malformations. Double incomplete aortic arch with right-sided aorta and aberrant left subclavian artery is the rarest one, and its present in 0.04-0.1% of autopsy series. A case of this malformation with a Kommerell's Diverticulum is presented. This diverticulum has risk of severe complications such as dissection and/or rupture.

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Background: Promoting L6 rat myoblast cell (L6 RMC) survival in the pro-apoptotic environment is critical to myoblastcell replacement for skeletal muscle degenerative disease therapy. Tanshinol (Danshensu), one of the principal bioactivecomponents in salvia miltiorrhiza bunge, has been used widely in skeletal muscle system (SMS) diseases treatment andserves as an antioxidant to protect myoblast cells against oxidative stress. The present study was undertaken to investigatethe protective effects of Tanshinol on L6 RMC injury induced by hydrogen peroxide (H2O2). After challenge with 100 µMH2O2 for 1h, loss of cell viability and excessive apoptotic cell death were observed in cultured L6 RMC, tanshinol treatmentconferred protective effects against the loss of cellular viability in a concentration-dependent manner.Materials, Methods & Results: L6 rat myoblast cells (L6 RMC) were maintained DMEM containing 4.5 g/L glucose andsupplemented with 10% (v/v) fetal bovine serum (FBS), 100 U/mL penicillin and 100 µg/mL streptomycin on tissue culturefl asks in a 37°C humidifi ed atmosphere of 95% air and 5% CO2. Cells were subcultured every 2-3 days. The cells werestained with SABC-Cy3 fl uorescence and measured by counting the nuclei. L6 RMC viability was determined by MTTassay in 96-well plates. The cells were counter-stained with H & E staining and Hoechst 33342 fl uorescent staining. Cellcycle phase distribution and apoptosis rates were detected by fl ow cytometry. Western blot were repeated three times, andqualitatively similar results were obtained. L6 RMC were pretreated with Tanshinol 375, 187.5, 93.75 mg/mL for 24 h,followed by treatment of 1000, 500, 100 µM H2O2 for 1h (P < 0.05) with viability by MTT method. Tanshinol 187.5 mg/mL pretreatment was protected in L6 RMC from H2O2-induced apoptosis with H&E staining and Hoechst 33342 fl uorescent...

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Background: Promoting L6 rat myoblast cell (L6 RMC) survival in the pro-apoptotic environment is critical to myoblastcell replacement for skeletal muscle degenerative disease therapy. Tanshinol (Danshensu), one of the principal bioactivecomponents in salvia miltiorrhiza bunge, has been used widely in skeletal muscle system (SMS) diseases treatment andserves as an antioxidant to protect myoblast cells against oxidative stress. The present study was undertaken to investigatethe protective effects of Tanshinol on L6 RMC injury induced by hydrogen peroxide (H2O2). After challenge with 100 µMH2O2 for 1h, loss of cell viability and excessive apoptotic cell death were observed in cultured L6 RMC, tanshinol treatmentconferred protective effects against the loss of cellular viability in a concentration-dependent manner.Materials, Methods & Results: L6 rat myoblast cells (L6 RMC) were maintained DMEM containing 4.5 g/L glucose andsupplemented with 10% (v/v) fetal bovine serum (FBS), 100 U/mL penicillin and 100 µg/mL streptomycin on tissue culturefl asks in a 37°C humidifi ed atmosphere of 95% air and 5% CO2. Cells were subcultured every 2-3 days. The cells werestained with SABC-Cy3 fl uorescence and measured by counting the nuclei. L6 RMC viability was determined by MTTassay in 96-well plates. The cells were counter-stained with H & E staining and Hoechst 33342 fl uorescent staining. Cellcycle phase distribution and apoptosis rates were detected by fl ow cytometry. Western blot were repeated three times, andqualitatively similar results were obtained. L6 RMC were pretreated with Tanshinol 375, 187.5, 93.75 mg/mL for 24 h,followed by treatment of 1000, 500, 100 µM H2O2 for 1h (P < 0.05) with viability by MTT method. Tanshinol 187.5 mg/mL pretreatment was protected in L6 RMC from H2O2-induced apoptosis with H&E staining and Hoechst 33342 fl uorescent...(AU)

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