Survival study and factors associated with mortality in Chilean patients on peritoneal dialysis infected with SARS-CoV-2.

The Covid-19 pandemic has been responsible for millions of deaths worldwide. Patients with comorbidities- such as those on peritoneal dialysis (PD)- present higher morbidity and mortality than the general population. We prospectively evaluated all Chilean patients on PD (48 centres) and followed those who had Covid-19 from the beginning of the Covid-19 pandemic in Chile (March 2020) to January 2021 (start of vaccination campaign). We described demographic history, comorbidities, factors related to infection, need for hospitalisation and death due to Covid-19. During the study period, 106 adults on PD were infected by SARS-CoV-2, with a mean age of 53.1 (±16.3) and of which 53.9% were female. From that group, 54.8% required hospitalisation and 24.5% (n = 26) died due to Covid-19. Most of the patients (63.4%) were infected at home and 22.8% during hospitalisation for other reasons. There was a significant association for Covid-19 mortality with: being ≥60 years old, diabetes, time on PD ≥5 years, need for hospitalisation and hospital-acquired infection. At 90 days of follow-up, all deaths associated to Covid-19 occurred before 40 days. We conclude that patients on PD without Covid-19 vaccination have a high mortality and need for hospitalisation associated to Covid-19. To avoid this negative outcome, it is necessary to intensify strategies to avoid contagion, especially in those ≥60 years old, with diabetes and/or ≥5 years spent on PD.

Leaf Thermal and Chemical Properties as Natural Drivers of Plant Flammability of Native and Exotic Tree Species of the Valparaíso Region, Chile.

Forest fires are one of the main environmental threats in Chile. Fires in this Mediterranean climate region frequently affect native forests and exotic plantations, including in several cases urban and rural settlements. Considering the scarcity of information regarding the fire response dynamics of tree species that are frequently affected by fires, this study aims to establish a flammability classification according to the evolution of the fire initiation risk presented by the most affected forest species in the Valparaíso region. Three exotic species, Eucalyptus globulus, Pinus radiata, and Acacia dealbata, and two native species, Cryptocarya alba and Quillaja saponaria, were studied. Flammability assays indicate that E. globulus, A. dealbata, and C. alba are extremely flammable, whereas P. radiata and Q. saponaria are flammable. Furthermore, E. globulus and A. dealbata have the highest heating values while Q. saponaria has the lowest values. The extreme flammability of E. globulus, A. dealbata, and C. alba indicates a high susceptibility to ignite. Furthermore, the high heat of combustion of E. globulus and A. dealbata can be associated with a high energy release, increasing the risk of fires spreading. In contrast, Q. saponaria has the lowest predisposition to ignite and capacity to release heat. Accordingly, this work shows that all studied tree species contain organic metabolites that are potentially flammable (sesquiterpenes, aliphatic hydrocarbons, alcohol esters, ketones, diterpenes, and triterpenes) and can be considered as drivers of flammability in vegetation. Finally, these preliminary results will aid in the construction of more resilient landscapes in the near future.

Manejo quirúrgico conservador de fractura mandibular parasinfisiaria en pre-escolar / Conservative surgical management of mandible fracture in pre-school children

Comparado con la población adolescente y adulta, las fracturas del esqueleto facial y región maxilomandibular, son poco comunes en el paciente pediátrico, especialmente en pre-escolares menores de 5 años. Las fracturas de los huesos de la región facial en el niño son una entidad patológica muy especial, ya que los pacientes de esta edad están en procesos de crecimiento y desarrollo, los maxilares presentan corticales muy delgadas, y en su espesor se encuentran los gérmenes dentarios permanentes en desarrollo y dientes en proceso de erupción. Existen y se han descrito diferentes estrategias de abordaje clínico, pero el enfoque y acercamiento con una terapia conservadora es lo más importante, antes de utilizar técnicas más agresivas como la utilización de fijación rígida con placas de titanio y tornillos. El conocimiento adecuado de los principios biológicos que regulan el crecimiento y desarrollo del esqueleto facial en los niños es esencial para minimizar riesgos y alteraciones en los gérmenes permanentes, anquilosis de las articulaciones temporomandibulares y el crecimiento del esqueleto facial propiamente tal. Este reporte clínico muestra y describe el tratamiento de un niño pre-escolar de 5 años, con fractura parasinfisiaria mandibular expuesta, la cual fue tratada con técnica de reducción no invasiva y estabilización con férula de alambre/composite, y férula interproximal. El alto potencial osteogénico del tejido óseo en niños, permite y favorece un manejo no quirúrgico de estas lesiones. Además, se destaca la importancia de la intervención con un manejo interdisciplinario con diferentes especialidades.

Compared with adult and adolescent population, fractures to facial skeleton and maxillomandibular region are uncommon in paediatric patient, especially in pre-school children under 4-5 years-old. Paediatric bone facial fractures are a particular pathology because it occurs in bone that is at growing process, presence of thin cortical bone, teeth buds development and partially erupted permanent teeth. Require different clinical treatments strategies, so conservative approach is advocated before the use of internal rigid fixation with plates and screws. The knowledge of growing and developmental biologic principles of the facial skull in children is essential to minimize the risks and disturbances at the permanent tooth buds, TMJ ankylosis and facial skeletal growth. This case report showed and described a 5-year-old boy that sustained open fracture of the mandible, whom was successfully treated by close reduction technique with wire composite and proximal splints. The high osteogenic potential of paediatric bone tissue allows non surgical management of these injuries. Moreover, the importance of interdisciplinary management with different specialists is presented.

Subcutaneous emphysema secondary to dental treatment: case report.

Subcutaneous emphysema is a relatively rare complication of dental treatment, although increasingly due to the use of high pressure air instruments. Many cases go unrecognized or are misdiagnosed. Majority of patients with this complication resolve spontaneously after 5 to 10 days, however some can advance to potentially life-threatening complications. A case of subcutaneous emphysema during restorative procedure in a 52-year-old woman was treated in the Docent Odontological Clinic of the Frontera University is presented. The differential diagnosis and management of this condition is discussed. Our purpose is not to add one more case of emphysema to literature, but to show dentists that in simple restorative procedures using air pressure instruments, they could be exposed to this complication.