Derechos económicos, sociales y culturales, política pública y justiciabilidad

El presente documento, contiene la edición de la segunda parte de las discusiones sostenidas en el Foro sobre Derechos Económicos, Sociales y Culturales (DESC), auspiciado por la Comisión Económica para América Latina y el Caribe (CEPAL) y la Fundación Social, y que tuvo lugar en Bogota en noviembre de 2001. Los participantes en este foro, provienen de distintas disciplinas, son abogados, economistas, administradores públicos, sociólogos, historiadores, filósofos y periodistas. Se desempeñan en distintas actividades en el sector público, la academia, la rama judicial, ONG y organismos internacionales, y no todos comparten la misma aproximación teórica a los temas del derecho, la política o la economía. Esta relación de las discusiones reseña el debate acerca del alcance de la justiciabilidad de los derechos económicos, sociales y culturales y de las decisiones de política económica, que tienen impacto sobre dichos derechos. Los panelistas hicieron interesantes afirmaciones que ratifican diferentes visiones, a partir de las ópticas jurídica y económica, y dan lugar a sugestivas convergencias y divergencias.

Cervical tularaemia in a non-endemic area

Tularemia is a zoonotic disease caused by Francisella tularensis. The microorganism is transmitted to humans by contact with, or ingestion of, infected animal tissues, by insect bites, consumption of contaminated food or water, or from inhalation of aerolized bacteria. In this report we describe a case of tularemia presenting with multiple cervical lymphadenitis in Asturias (Spain). Final diagnosis was established based on a serological test. The patient was successfully managed with surgery and streptomycin for 2 weeks. The ulceroglandular form of tularemia should be considered in the differential diagnosis of cervical lymphadenitis, particularly in those not responding to penicillin treatment. To our knowledge, this is the first case described in Asturias, a north coast county of Spain

Use of autologous skin equivalents with artificial dermal matrix (Integra) in donor site coverage in radial forearm free flaps: preliminary cases

Purpose: The radial forearm flap is one of the most commonly used methods for intraoral reconstruction in oral carcinoma surgery. One of its disadvantages is the residual functional and unaesthetic defect in the donor site. The objective of this report is to describe preliminary cases of a novel method to cover such donor sites based on the use of autologous skin equivalents (ASEs) and an artificial dermal matrix (Integra, Prim, Barcelona, Spain). Materials and Methods: The donor sites of 2 patients were treated with the artificial dermal matrix after raising a radial forearm flap. A skin biopsy and a blood sample were taken to construct an ASE. After 3 weeks, the ASE was applied over the dermal template and left to heal. The functional and esthetic results were recorded. Results: Good functional and esthetic results were achieved, with correct wrist motility, although a natural skin color could not be achieved. Neither the Integra nor the ASE was rejected. Total wound coverage was achieved at 4 months, and completely normal skin was observed at 6 months. Conclusions: This technique of combining an artificial dermal matrix with an ASE could be an alternative method to cover the donor sites of radial forearm flaps

Modeling, simulation and application of bacterial transduction in genetic algorithms

At present, all methods in Evolutionary Computation are bioinspired by the fundamental principles of neo-Darwinism, as well as by a vertical gene transfer. Virus transduction is one of the key mechanisms of horizontal gene propagation in microorganisms (e.g. bacteria). In the present paper, we model and simulate a transduction operator, exploring the possible role and usefulness of transduction in a genetic algorithm. The genetic algorithm including transduction has been named PETRI (abbreviation of Promoting Evolution Through Reiterated Infection). Our results showed how PETRI approaches higher fitness values as transduction probability comes close to 100%. The conclusion is that transduction improves the performance of a genetic algorithm, assuming a population divided among several sub-populations or ?bacterial colonies?

Immunohistochemical comparative study of the odontogenic keratocysts and other odontogenic lesions

Objectives: The present study was undertaken to compare the pattern of expression of EGFR, cyclin D1, Ki-67, p-53 and carcinoembryonic antigen (CEA) in the epithelial lining of odontogenic keratocysts, dentigerous cysts, radicular cysts and ameloblastomas. Methods: four micrometers, formalin-fixed, paraffin-embedded tissue sections from 11 odontogenic keratocysts, 10 dentigerous cysts, 10 radicular cysts and 10 ameloblastomas were immunohistochemically studied. Results: There were statistically significant differences between cyclin D1 expression in odontogenic keratocysts and radicular cysts (p= 0.001) and ameloblastomas (p= 0.04). The differences in CEA expression between the four studied lesions were statistically significant (p< 0.0005). Proliferating cells were significantly more prevalent in odontogenic keratocysts (p< 0.0005) with a mean percentage of Ki-67 positively stained nuclei of 40%. In dentigerous cysts this mean was of 17%, of 15.5% in RC and of 7.8 in ameloblastomas. Conclusion: Some of these findings could support the theory that odontogenic keratocysts are neoplastic in origin, but other results clearly support that these lesions are developmental cysts with some neoplastic properties because of the high intrinsic growth potential

Spontaneous fracture of the mandibular genial tubercles : a case report

Fracture of the mandibular genial tubercles is an uncommon pathology affecting edentulous patients with severe maxillary atrophy. Usually occurs spontaneously which complicates the diagnosis. Their importance lies in the functional alterations, which occur as a consequence of the disinsertion of the genihyoid and genioglossus muscles. The treatment of fracture of the genial tubercles is controversial, including no surgical intervention, excision of the avulsed bone fragments, and muscular repositioning. There have been only 11 cases reported in the literature of this fracture, most of them spontaneous. We present a difficult diagnosis situation of spontaneous fracture of the genial tubercles in an 86-year-old edentulous female with a painful sublingual and submental hematoma and anterior cervical echimosis. Computerized Tomography should be made to confirm the diagnosis. Surgical treatment was not necessary, and follow-up at 6 months revealed complete symptomatic recovery, and full return of function

Papillary cystadenoma and cystadenocarcinoma of salivary glands : two unusual entities

Cystadenoma and cystadenocarcinoma are rare salivary gland tumours histologically characterized by prominent cystic and frequently papillary growth. We present two cases of cystadenoma of a minor salivary gland (upper lip) and parotid cystadenocarcinoma respectively, captured between 834 salivary gland tumors studied in our hospital from 1980 to 2004. The authors review the clinical, histological, and biological features of these two unusual tumours, and differential diagnosis with other salivary glands neoplasms. Both entities usually reveal papillary proliferation of the epithelial lining and are composed of cells that possess bland cytomorphologic features. Differentiation of tumour types depends largely on the identification of actual infiltration of salivary gland parenchyma or surrounding connective tissue by either cystic or solid epithelium in cystadenocarcinomas. Step sections of a borderline tumour may yield unequivocal evidence of invasion. The authors discuss the problematic diagnosis between these rare neoplasms and with other tumours and compare histological findings of these two entities

Adenoma sebáceo de la glándula parótida

Los tumores de las glándulas salivales constituyen un área importante de la patología oral y maxilofacial. La mayor parte de las neoplasias glandulares salivales son benignas, representando las malignas entre el 15 y el 32% del total. La localización más común de estas entidades es la glándula parótida, en la que asientan hasta el 80% de todos los casos. En este artículo se presenta un caso de adenoma sebáceo salival, de localización parotídea. El tumor, formado por células epiteliales que tapizan conductos, exhibe amplias áreas de diferenciación sebácea y zonas con metaplasia oncocítica. El patrón histológico es predominantemente quístico, observándose cavidades rellenas con material sebáceo. Si bien la presencia de glándulas sebáceas en las glándulas salivales es frecuente, las neoplasias exclusivamente formadas por las mismas son muy infrecuentes. Dada su rareza, este tumor plantea problemas diagnósticos diferenciales con otras entidades benignas y malignas. Su tratamiento implica la extirpación de la lesión, lo que generalmente involucra la eliminación de la glándula en la que ha surgido. El presente caso constituye el séptimo publicado de esta entidad.Tumors of the salivary glands constitute an important field of oral and maxillofacial pathology. The majority of salivary gland neoplasms are benign, with malignant salivary tumors accounting for 15 to 32 percent. The most common site for salivary gland tumors is the parotid gland, accounting up to 80 percent of all cases. This article reports the pathologic picture in a case of sebaceous adenoma of the parotid gland. The tumor was composed of epithelial cells lining ducts and closely associated with broad areas of sebaceous differentiation. The growth pattern was predominantly cystic, with cavities filled with sebaceous material. Areas of oncocytic metaplasia were also seen. The presence of sebaceous glands in salivary neoplasms is frequent, however, and in spite of this, salivary neoplasms constituted partially or entirely of these cells are rarely observed. To the surgeon and pathologist, the major problem in dealing with sebaceous adenoma is the recognition of this rare entity, avoiding confusing with other more aggressive neoplasms. The treatment involves surgical excision. The addition of the current case to the previously published data brings the total number of parotid sebaceous adenoma to seven

Chondrosarcoma of the temporomandibular joint : a case report and review of the literature

Chondrosarcoma is a malignant tumor characterized by the formation of cartilage, but not bone, by tumor cells. Only 5% to 10% of chondrosarcomas occur in the head and neck, representing 0.1% of all head and neck neoplasms, with the larynx and the maxillo-nasal region being the most common sites. This report describes an unusual case of chondrosarcoma in a 54-year-old man who presented with pain and swelling in the left preauricular area. Computed tomography demonstrated a soft tissue mass in the left temporomandibular joint without causing erosion of the adjacent bony structures. The tumor was treated by excision in a single block with perilesional tissues, preserving the facial nerve. Histopathologic examination revealed chondrocytes with irregular nuclei with S-100 immunocytochemical staining positive in 30% of the tumor. The diagnosis was a grade I chondrosarcoma. There was no evidence of disease at the 16-month follow-up. The occurrence of chondrosarcoma in the temporomandibular joint (TMJ) is an exceptional event, with only 16 cases described. We report a case of this unusual entity and review the literature