The embryonic Stem cell Test (EST) is a validated assay for testing embryotoxicity in vitro. The total duration of this protocol is 10 days, and its main end-point is based on histological determinations. It is suggested that improvements on EST must be focused toward molecular end-points and, if possible, to reduce the total assay duration. Five days of exposure of D3 cells in monolayers under spontaneous differentiation to 50 ng/mL of the strong embryotoxic 5-fluorouracil or to 75 μg/mL of the weak embryotoxic 5,5-diphenylhydeantoin caused between 20 and 74% of reductions in the expression of the following genes: Pnpla6, Afp, Hdac7, Vegfa, and Nes. The exposure to 1 mg/mL of nonembryotoxic saccharin only caused statistically significant reductions in the expression of Nes. These exposures reduced cell viability of D3 cells by 15, 28, and 34%. We applied these records to the mathematical discriminating function of the EST method to find that this approach is able to correctly predict the embryotoxicity of all three above-mentioned chemicals. Therefore, this work proposes the possibility of improve EST by reducing its total duration and by introducing gene expression as biomarker of differentiation, which might be very interesting for in vitro risk assessment embryotoxicity.

Eosinophilic polymorphic and pruritic eruption associated with radiotherapy (EPPER) is a rare entity that appears in oncological patients after radiotherapy. We describe two patients with breast tumour who presented with EPPER in a different area from the one that had been irradiated. One of them needed different types of treatment, topical and systemic corticosteroids, antihistamines and narrowband ultraviolet B. The other one responded to the application of topical corticosteroids. We suggested that this eruption could be more frequent than has been reported.

RESUMENIntroducción: La Hiperplasia Fibrosa Inflamatoria es una alteración caracterizada por un agrandamiento del tejido conectivo; se considera una lesión reactiva ya que se presenta como respuesta a una irritante crónico local; es una lesión común en pacientes adolescentes y de edad adulta debido a que su etiología principal se asocia a maloclusión, al uso de aparatología protésica u ortodóntica mal ajustada, así como a la presencia de biofilm. Sin embargo, la población infantil, principalmente en dentición mixta, no está exenta de presentar esta alteración, aunque en menor proporción. Objetivo: Presentar el caso clínico de un paciente en dentición mixta que presenta una Hiperplasia Fibrosa Inflamatoria con el fin de presentar las características clínicas e histopatológicas de la lesión, enfatizando la importancia de un temprano y correcto diagnóstico. Presentación del Caso: Paciente masculino de 8 años de edad que se presenta a la clínica por presentar lesiones cariosas y malposición dental. A la exploración se observa un agrandamiento gingival localizado, en el órgano dentario 41. Se decide tomar una biopsia de la lesión para establecer el diagnóstico. Conclusión: Debido a que existen varias lesiones con características clínicas muy similares a las que presentaba el paciente, es necesario conocer los diagnósticos diferenciales, así como realizar el diagnóstico temprano de la lesión para poder llevar a cabo un tratamiento eficaz y adecuado. Rev. Clin. Periodoncia Implantol. Rehabil. Oral Vol. 4(2); 74-79, 2011.Palabras clave: Hiperplasia, biofilm, maloclusión dental, agrandamiento gingival. ABSTRACT Introduction:The Inflammatory Fibrous Hyperplasia (IFH) is a disorder consisting in a connective tissue overgrowth; it is considered a reactive lesion because it appears in response to a chronic and local irritant; this is a very common oral lesion in adolescents and adults, its etiology is associated with dental malocclusion, use of over-extended prosthetic and orthodontic appliances, and with the presence of biofilm (plaque). Nevertheless, child population, mainly patients in mixed dentition, are not exempt from presenting this lesion, in a lower proportion, though. Objective: The aim of this case report is to present the clinical case of a patient in mixed dentition, who displays an Inflammatory Fibrous Hyperplasia, with the purpose of showing the clinical and histopathological features of this lesion, emphasizing the importance of an early and correct diagnosis. Case Report: A 8 year-old male patient, was referred to the Pediatric Dentistry Clinic of the Division of Post-graduate studies and Research, of the School of Dentistry, UNAM, for showing decay lesions and dental malposition. Clinical examination revealed a localized gingival over-growth associated to the teeth 41. It was decided to take a biopsy of the lesion to establish the final diagnosis. Conclusion: Because there are numerous lesions with pretty similar clinical features to the ones the patient presented, it is imperative and essential to know th...

1. Case managers can play a key role in correct assignment of patient status through the use of the CMAP. 2. Hospitals that were successful in implementing the protocol had highly involved senior management, stable corporate environments, physician buy-in, physician champions, policies for mandatory use within the facilities, support from all team members, and "out-of-the-box" thinking for case management coverage. 3. Staffs at hospitals that implemented the protocol indicate they are well positioned for the Recovery Audit Contractor program, which began as a 3-year demonstration project and is now being implemented. It will be in place nationally by 2010.

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