Peripheral desmoplastic ameloblastoma : histopathological and immunohistochemical profile of a case

In this study we present a rare case of peripheral desmoplastic ameloblastoma and discuss its clinical features, histopathology, and inmunoshistochemical profile. This article reports a new case of this unusual neoplasm in a 66 year-old woman in which the main complaint was an asymptomatic swelling located in the right body of mandible. Histopathological findings were similar to the two previously reported cases of this tumor. Positive immunohistochemical stain for laminin V and type IV collagen suggests an inductive effect of the epithelium over the stroma while the low index of p53 protein and Ki-67 expression in epithelium and stromal cells, as well as CD138 uniform positive-stain in epithelial cells, support the benign biological behavior of this lesion. Including this new case, currently there are only three reports of this rare neoplasm. Reports of new cases of peripheral desmoplastic ameloblastoma are necessary for a better understanding of the origin and behavior of this particular subtype of ameloblastoma

Dendritic cell deficiencies persist seven months after SARS-CoV-2 infection

Severe Acute Respiratory Syndrome Coronavirus (SARS-CoV)-2 infection induces an exacerbated inflammation driven by innate immunity components. Dendritic cells (DCs) play a key role in the defense against viral infections, for instance plasmacytoid DCs (pDCs), have the capacity to produce vast amounts of interferon-alpha (IFN-α). In COVID-19 there is a deficit in DC numbers and IFN-α production, which has been associated with disease severity. In this work, we described that in addition to the DC deficiency, several DC activation and homing markers were altered in acute COVID-19 patients, which were associated with multiple inflammatory markers. Remarkably, previously hospitalized and nonhospitalized patients remained with decreased numbers of CD1c+ myeloid DCs and pDCs seven months after SARS-CoV-2 infection. Moreover, the expression of DC markers such as CD86 and CD4 were only restored in previously nonhospitalized patients, while no restoration of integrin β7 and indoleamine 2,3-dyoxigenase (IDO) levels were observed. These findings contribute to a better understanding of the immunological sequelae of COVID-19

Clínica jurídica de acción social

Memoria ID-0032. Ayudas de la Universidad de Salamanca para la innovación docente, curso 2017-2018

Mis casos clínicos de especialidades odontológicas

Libro que muestra la atención de casos clínicos particulares referente a las diferentes especialidades odontológicasLibro que muestra la atención de casos clínicos particulares referente a las diferentes especialidades odontológicasUniversidad Autónoma de Campeche Universidad Autónoma del Estado de Hidalgo Universidad Autónoma del Estado de Méxic

Mortality from gastrointestinal congenital anomalies at 264 hospitals in 74 low-income, middle-income, and high-income countries: a multicentre, international, prospective cohort study

Summary Background Congenital anomalies are the fifth leading cause of mortality in children younger than 5 years globally. Many gastrointestinal congenital anomalies are fatal without timely access to neonatal surgical care, but few studies have been done on these conditions in low-income and middle-income countries (LMICs). We compared outcomes of the seven most common gastrointestinal congenital anomalies in low-income, middle-income, and high-income countries globally, and identified factors associated with mortality. Methods We did a multicentre, international prospective cohort study of patients younger than 16 years, presenting to hospital for the first time with oesophageal atresia, congenital diaphragmatic hernia, intestinal atresia, gastroschisis, exomphalos, anorectal malformation, and Hirschsprung’s disease. Recruitment was of consecutive patients for a minimum of 1 month between October, 2018, and April, 2019. We collected data on patient demographics, clinical status, interventions, and outcomes using the REDCap platform. Patients were followed up for 30 days after primary intervention, or 30 days after admission if they did not receive an intervention. The primary outcome was all-cause, in-hospital mortality for all conditions combined and each condition individually, stratified by country income status. We did a complete case analysis. Findings We included 3849 patients with 3975 study conditions (560 with oesophageal atresia, 448 with congenital diaphragmatic hernia, 681 with intestinal atresia, 453 with gastroschisis, 325 with exomphalos, 991 with anorectal malformation, and 517 with Hirschsprung’s disease) from 264 hospitals (89 in high-income countries, 166 in middleincome countries, and nine in low-income countries) in 74 countries. Of the 3849 patients, 2231 (58·0%) were male. Median gestational age at birth was 38 weeks (IQR 36–39) and median bodyweight at presentation was 2·8 kg (2·3–3·3). Mortality among all patients was 37 (39·8%) of 93 in low-income countries, 583 (20·4%) of 2860 in middle-income countries, and 50 (5·6%) of 896 in high-income countries (p<0·0001 between all country income groups). Gastroschisis had the greatest difference in mortality between country income strata (nine [90·0%] of ten in lowincome countries, 97 [31·9%] of 304 in middle-income countries, and two [1·4%] of 139 in high-income countries; p≤0·0001 between all country income groups). Factors significantly associated with higher mortality for all patients combined included country income status (low-income vs high-income countries, risk ratio 2·78 [95% CI 1·88–4·11], p<0·0001; middle-income vs high-income countries, 2·11 [1·59–2·79], p<0·0001), sepsis at presentation (1·20 [1·04–1·40], p=0·016), higher American Society of Anesthesiologists (ASA) score at primary intervention (ASA 4–5 vs ASA 1–2, 1·82 [1·40–2·35], p<0·0001; ASA 3 vs ASA 1–2, 1·58, [1·30–1·92], p<0·0001]), surgical safety checklist not used (1·39 [1·02–1·90], p=0·035), and ventilation or parenteral nutrition unavailable when needed (ventilation 1·96, [1·41–2·71], p=0·0001; parenteral nutrition 1·35, [1·05–1·74], p=0·018). Administration of parenteral nutrition (0·61, [0·47–0·79], p=0·0002) and use of a peripherally inserted central catheter (0·65 [0·50–0·86], p=0·0024) or percutaneous central line (0·69 [0·48–1·00], p=0·049) were associated with lower mortality. Interpretation Unacceptable differences in mortality exist for gastrointestinal congenital anomalies between lowincome, middle-income, and high-income countries. Improving access to quality neonatal surgical care in LMICs will be vital to achieve Sustainable Development Goal 3.2 of ending preventable deaths in neonates and children younger than 5 years by 2030

Las asociaciones de inmigrantes como sociedad civil: un análisis tridimensional

This article examines immigrant organizations from three perspectives: their relationships with public authorities, the system of relationships established among these organizations, and their degree of internal participation. My principal aim is to analyze the extent to which one can speak of a civil society in this domain. The study presented takes the case of immigrant organizations in Spain, focusing on those organizations that benefit from greater public recognition through the Forum for the Social Integration of Immigrants, a consultative body of the Government. In-depth interviews with chairpersons and workers in these organizations are combined with contributions from the literature on social movements, on ethnic mobilization and on social capital, to explain the Spanish situation. Connecting the dynamics of immigrant organizations with those of other social organizations in Spain, it is argued that the relationships established with public authorities are neither balanced out by a dense interorganizational network, nor harmonized by the active participation of their members. These factors work to the detriment of a true civil society in this domain, having negative implications for the organizations? capacity to act as creators of social capital, and for the integration of immigrants. This brings into question the role of the State in supporting immigrant organizations.Este artículo examina las organizaciones de inmigrantes con una perspectiva triple: desde el punto de vista de sus relaciones con las autoridades públicas, de las relaciones establecidas entre las propias asociaciones y de su grado de participación interna; con el objetivo de analizar hasta qué punto puede hablarse de sociedad civil en ese ámbito. El estudio aquí presentado toma como objeto de análisis las organizaciones de inmigrantes en España, centrándose en aquellas que gozan de un mayor reconocimiento público a través del Foro para la Integración Social de los Inmigrantes, órgano consultivo del Gobierno. Sobre la base de entrevistas en profundidad a líderes y trabajadores de estas organizaciones, se utilizan las contribuciones de la literatura sobre movimientos sociales, movilización étnica y capital social para explicar la situación actual. Sin dejar de relacionar las dinámicas de las organizaciones de inmigrantes con las del resto de organizaciones sociales en España, el artículo argumenta que las relaciones establecidas con los poderes públicos no se ven equilibradas por una red interorganizativa densa ni por una participación activa de sus miembros, y ello en detrimento de una auténtica sociedad civil en este ámbito. Esto tiene implicaciones negativas para la capacidad de las organizaciones para actuar como generadoras de capital social e integración de los inmigrantes, lo cual pone en cuestión el papel del Estado en su apoyo a las organizaciones de inmigrantes