Automated region growing-based segmentation for trabecular bone structure in fresh-frozen human wrist specimens.

Bone strength depends on both mineral content and bone structure. Measurements of bone microstructure on specimens can be performed by micro-CT. In vivo measurements are reliably performed by high-resolution peripheral computed tomography (HR-pQCT) using dedicated software. In previous studies from our research group, trabecular bone properties on CT data of defatted specimens from many different CT devices have been analyzed using an Automated Region Growing (ARG) algorithm-based code, showing strong correlations to micro-CT.The aim of the study was to validate the possibility of segmenting and measuring trabecular bone structure from clinical CT data of fresh-frozen human wrist specimens. Data from micro-CT was used as reference. The hypothesis was that the ARG-based in-house built software could be used for such measurements.HR-pQCT image data at two resolutions (61 and 82 µm isotropic voxels) from 23 fresh-frozen human forearms were analyzed. Correlations to micro-CT were strong, varying from 0.72 to 0.99 for all parameters except trabecular termini and nodes. The bone volume fraction had correlations varying from 0.95 to 0.98 but was overestimated compared to micro-CT, especially at the lower resolution. Trabecular separation and spacing were the most stable parameters with correlations at 0.80-0.97 and mean values in the same range as micro-CT.Results from this in vitro study show that an ARG-based software could be used for segmenting and measuring 3D trabecular bone structure from clinical CT data of fresh-frozen human wrist specimens using micro-CT data as reference. Over-and underestimation of several of the bone structure parameters must however be taken into account.

Bounding tractogram redundancy.

Introduction: In tractography, redundancy poses a significant challenge, often resulting in tractograms that include anatomically implausible streamlines or those that fail to represent the brain's white matter architecture accurately. Current filtering methods aim to refine tractograms by addressing these issues, but they lack a unified measure of redundancy and can be computationally demanding. Methods: We propose a novel framework to quantify tractogram redundancy based on filtering tractogram subsets without endorsing a specific filtering algorithm. Our approach defines redundancy based on the anatomical plausibility and diffusion signal representation of streamlines, establishing both lower and upper bounds for the number of false-positive streamlines and the tractogram redundancy. Results: We applied this framework to tractograms from the Human Connectome Project, using geometrical plausibility and statistical methods informed by the streamlined attributes and ensemble consensus. Our results establish bounds for the tractogram redundancy and the false-discovery rate of the tractograms. Conclusion: This study advances the understanding of tractogram redundancy and supports the refinement of tractography methods. Future research will focus on further validating the proposed framework and exploring tractogram compression possibilities.

Analysis of the Rheological Properties of Natural Hydraulic Lime-Based Suspensions for Sustainable Construction and Heritage Conservation.

Natural hydraulic lime (NHL)-based binders play a crucial role in preserving cultural heritage structures, ensuring integrity and longevity. Beyond traditional uses, these binders exhibit potential for integration into both non-structural and structural components, being compatible with innovative manufacturing processes such as digital fabrication. Meticulously designed grouts, with applicability in their fresh and hardened states, are essential for heritage stability. This study explores the relationships between mineral additions, chemical admixtures, and lime for grout formulations, aiming to advance our understanding and inform the optimization of materials for heritage restoration. Key questions include the influence of natural volcanic pozzolan (NVP) and metakaolin (MK) on rheology and the impact of varying ratios of superplasticizer on NHL-based grout's rheological behavior. This systematic evaluation of rheological parameters aims to innovate mix designs, expanding NHL-based binders' applicability in construction and science. Our hypotheses suggest that well-designed lime grout formulations, incorporating NVP and MK, can enhance rheological properties, addressing challenges in sustainable construction and heritage conservation. This research provides valuable insights for optimizing lime-based materials, fostering advancements in heritage restoration, and promoting wider NHL-based binder adoption in diverse construction applications.

Asymmetry in Cortical Thickness of the Heschl's Gyrus in Unilateral Ear Canal Atresia.

HYPOTHESIS: Unilateral congenital conductive hearing impairment in ear canal atresia leads to atrophy of the gray matter of the contralateral primary auditory cortex or changes in asymmetry pattern if left untreated in childhood. BACKGROUND: Unilateral ear canal atresia with associated severe conductive hearing loss results in deteriorated sound localization and difficulties in understanding of speech in a noisy environment. Cortical atrophy in the Heschl's gyrus has been reported in acquired sensorineural hearing loss but has not been studied in unilateral conductive hearing loss. METHODS: We obtained T1w and T2w FLAIR MRI data from 17 subjects with unilateral congenital ear canal atresia and 17 matched controls. Gray matter volume and thickness were measured in the Heschl's gyrus using Freesurfer. RESULTS: In unilateral congenital ear canal atresia, Heschl's gyrus exhibited cortical thickness asymmetry (right thicker than left, corrected p = 0.0012, mean difference 0.25 mm), while controls had symmetric findings. Gray matter volume and total thickness did not differ from controls with normal hearing. CONCLUSION: We observed cortical thickness asymmetry in congenital unilateral ear canal atresia but no evidence of contralateral cortex atrophy. Further research is needed to understand the implications of this asymmetry on central auditory processing deficits.

A deep learning model for brain age prediction using minimally preprocessed T1w images as input.

Introduction: In the last few years, several models trying to calculate the biological brain age have been proposed based on structural magnetic resonance imaging scans (T1-weighted MRIs, T1w) using multivariate methods and machine learning. We developed and validated a convolutional neural network (CNN)-based biological brain age prediction model that uses one T1w MRI preprocessing step when applying the model to external datasets to simplify implementation and increase accessibility in research settings. Our model only requires rigid image registration to the MNI space, which is an advantage compared to previous methods that require more preprocessing steps, such as feature extraction. Methods: We used a multicohort dataset of cognitively healthy individuals (age range = 32.0-95.7 years) comprising 17,296 MRIs for training and evaluation. We compared our model using hold-out (CNN1) and cross-validation (CNN2-4) approaches. To verify generalisability, we used two external datasets with different populations and MRI scan characteristics to evaluate the model. To demonstrate its usability, we included the external dataset's images in the cross-validation training (CNN3). To ensure that our model used only the brain signal on the image, we also predicted brain age using skull-stripped images (CNN4). Results: The trained models achieved a mean absolute error of 2.99, 2.67, 2.67, and 3.08 years for CNN1-4, respectively. The model's performance in the external dataset was in the typical range of mean absolute error (MAE) found in the literature for testing sets. Adding the external dataset to the training set (CNN3), overall, MAE is unaffected, but individual cohort MAE improves (5.63-2.25 years). Salience maps of predictions reveal that periventricular, temporal, and insular regions are the most important for age prediction. Discussion: We provide indicators for using biological (predicted) brain age as a metric for age correction in neuroimaging studies as an alternative to the traditional chronological age. In conclusion, using different approaches, our CNN-based model showed good performance using one T1w brain MRI preprocessing step. The proposed CNN model is made publicly available for the research community to be easily implemented and used to study ageing and age-related disorders.

Prevalencia de disfunción sexual en gestantes en control prenatal en una institución hospitalaria en Rionegro, Colombia, 2020-2021 / Prevalence of sexual dysfunction among pregnant women attending prenatal care at a hospital in Rionegro, Colombia, 2020-2021

RESUMEN Objetivo: Describir la prevalencia de la disfunción sexual en un grupo de mujeres gestantes y hacer una exploración de posibles factores asociados a la disfunción sexual en estas mujeres. Materiales y métodos: Estudio descriptivo y trasversal en mujeres gestantes cuyas edades son de 15 años o más, con actividad sexual en la gestación, que asistieron al control prenatal en el Hospital San Juan de Dios de Rionegro entre los meses de enero y marzo del 2021. Se excluyeron pacientes con limitaciones o discapacidad cognitiva, o clasificadas con trastorno mental según la Organización Mundial de la Salud (OMS), gestantes con patologías crónicas, placentarias, ovulares, hemorrágicas e infecciosas, y las pacientes cuya gestación fue resultado de violencia sexual. Se aplicó el cuestionario Índice de Función Sexual Femenina (FSFI), se midieron variables sociodemográficas y de salud sexual y reproductiva. Los resultados se expresan en frecuencias absolutas y relativas para las variables cualitativas y medianas, y rangos intercuartílicos para las variables cuantitativas. Resultados: La mediana de edad fue de 27,5 años (RIC: 21,3-31,0); de edad gestacional 28,5 semanas (RIC: 21,3-34,8). Tras la aplicación del FSFI, 37 mujeres (37,7%) tuvieron disfunción sexual (puntaje < 26,5). La mediana del puntaje de las participantes sin disfunción sexual fue de 29,4 (RIC 26,8-32), mientras que por el lado de las que tienen disfunción sexual fue de 22,3 (RIC 20-24). La media del puntaje para cada dominio fue: deseo: 3,6 (RIC: 3,0-4,2); excitación: 4,5 (RIC: 3,6-5,1); lubricación: 4,8 (RIC: 3,9-5,4); orgasmo: 4,4 (RIC: 3,6-5,2); dolor: 4,4 (RIC: 3,6-6,0); y satisfacción: 5,4 (RIC: 4,8-6,0). Fueron factores protectores no tener hijos ni cesáreas previas. La ausencia de compañero y menor edad estuvieron asociados a disfunción sexual. Conclusión: La disfunción sexual se presenta en por lo menos un tercio de las gestantes, especialmente en el tercer trimestre. En la práctica clínica diaria se hace necesario abordar la disfunción sexual, ya que se puede contribuir desde el abordaje de la educación a un problema que puede afectar las relaciones de pareja y la calidad de vida. Es fundamental generar nuevas investigaciones que incluyan la evaluación de la efectividad y seguridad de estrategias educativas en este grupo poblacional con disfunción sexual.

ABSTRACT Objective: To describe the prevalence of sexual dysfunction in a group of pregnant women, and to explore potential factors associated with this condition in this population. Material and methods: Descriptive cross-sectional study in pregnant women 15 years of age and older, sexually active during gestation, receiving prenatal care at the San Juan de Dios Hospital in Rionegro between January and March, 2021. The exclusion criteria were patients with disabilities or cognitive impairment, or classified as having a mental disorder according to the World Health Organization (WHO); pregnant women with chronic, placental, ovulation, hemorrhagic or infectious conditions; and patients whose pregnancy was the result of sexual assault. The Female Sexual Function Index (FSFI) questionnaire was applied, and sociodemographic and sexual and reproductive health variables were measured. Results are expressed as absolute and relative frequencies for qualitative variables, and as medians and interquartile ranges for quantitative variables. Results: The mean age in years was 27.5 (IQR: 21.331.0) and the mean gestational age was 28.5 weeks (IQR: 21.3-34.8). After administering the FSFI, it was found that 37 women (37.7%) had sexual dysfunction (score < 26.5). The median scores for the participants without sexual dysfunction and those with sexual dysfunction were 29.4 (IQR 26.8-32) and 22.3 (IQR 20-24), respectively. The mean scores for each domain were: desire 3.6 (IQR: 3.0-4.2); arousal 4.5 (IQR: 3.65.1); lubrication 4.8 (IQR: 3.9-5.4); orgasm 4.4 (IQR: 3.6-5.2); pain 4.4 (IQR: 3.6-6.0); and satisfaction 5.4 (IQR: 4.8-6.0). The total score (p<0.05) was better in older women and those with one or more children. Conclusion: Sexual dysfunction occurs at least in one-third of pregnant women, especially during the third trimester. Sexual dysfunction should be considered in daily clinical practice, given that approaching the topic from an education perspective can help reduce a problem that affects the couple and quality of life. It is critical to undertake additional research that includes assessment of the effectiveness and safety of educational strategies in this population with sexual dysfunction.

Espondilodiscitis cervical por Streptococcus agalactiae y síndrome de Parsonage-Turner secundario / Cervical spondylodiscitis caused by Streptococcus agalactiae and Parsonage-Turner syndrome

La espondilodiscitis por Streptococcus agalactiae es infrecuente, ya que éste es un microrganismo clásicamente patógeno en el periodo gestacional y perinatal. Sin embargo se está produciendo un aumento en la incidencia de infecciones invasivas en adultos inmunocompetentes. Asimismo, el síndrome de Parsonage-Turner o neuritis braquial aguda es una entidad clínica poco frecuente, caracterizada por dolor y debilidad muscular de la extremidad superior. Presentamos el caso de un varón de 50 años con bacteriemia por S. agalactiae, espondilodiscitis cervical y neuritis braquial secundaria y revisamos la literatura.

Spondylodiscitis caused by streptococcus agalactiae has been traditionally considered an infrequent disease since S. agalactiae is a pathogenic microorganism conventionally in gestational and perinatal period. However it is producing an increase in the incidence of invasive infections in immunocompetent adults. Also Parsonage-Turner syndrome or brachial radiculitis is a rare disorder and is characterized by pain followed by weakness in the distribution of the upper brachial plexus. We report one case and review the literature.

Utilidad de la evaluación formativa en cursos clínicos integrativos en estudiantes de pregrado de medicina / Perception of medical students about formative assessments during clinical courses

Background: Formative evaluation is a range of formal assessment employed by professors during the teaching process in order to modify curriculum activities, to improve student attainment. For students, it is helpful to evaluate their learning process. Although recommended, it is seldom used. Aim: To evaluate the perception and performance of medical students subjected to formative assessments during an integrative clinical course. Material and Methods: Fourth year medical students that participated in a multiple choice formative assessment, similar to the final exam during 2007 and 2008, responded a survey about the usefulness and quality of such assessment. Student achievement was expressed as the percentage of correct answers of the tests. Results: The formative assessment was answered by 99% of students. In 2007 97% of students considered the experience as excellent or very good and 92% evaluated it as useful or very useful. During 2008 the figures were 89% and 79%. The students outlined that this assessment oriented their study, allowed them to discover their weaknesses and have a perception of the degree of difficulty of the final exam. Over 90% of students that took the formative evaluation, improved their academic achievement. Conclusions: Formative assessments are well evaluated by medical students and improve their academic achievement.

Desarrollo y validación de un instrumento en Español para evaluar el desempeño de docentes clínicos a través de las percepciones de sus estudiantes / An instrument in Spanish to evaluate the performance of clinical teachers by students

Background: The modernization of clinical teaching has called for the creation of faculty development programs, and the design of suitable instruments to evaluate clinical teachers’ performance. Aim: To report the development and validation of an instrument in Spanish designed to measure the students’ perceptions of their clinical teachers’ performance and to provide them with feedback to improve their teaching practices. Material and Methods: In a process that included the active participation of authorities, professors in charge of courses and internships, clinical teachers, students and medical education experts, we developed a 30-item questionnaire called MEDUC30 to evaluate the performance of clinical teachers by their students. The internal validity was assessed by factor analysis of 5,214 evaluations of 265 teachers, gathered from 2004 to 2007. The reliability was measured with the Cronbach’s alpha coefficient and the generalizability coefficient (g). Results: MEDUC30 had good content and construct validity. Its internal structure was compatible with four factors: patient-centered teaching, teaching skills, assessment skills and learning climate, and it proved to be consistent with the structure anticipated by the theory. The scores were highly reliable (Cronbach’s alpha: 0.97); five evaluations per teacher were sufficient to reach a reliability coefficient (g) of 0.8. Conclusions: MEDUC30 is a valid, reliable and useful instrument to evaluate the performance of clinical teachers. To our knowledge, this is the first instrument in Spanish for which solid validity and reliability evidences have been reported. We hope that MEDUC30 will be used to improve medical education in Spanish-speaking medical schools, providing teachers a specific feedback upon which to improve their pedagogical practice, and authorities with valuable information for the assessment of their faculty.

Mejoría en las habilidades de comunicación escrita de estudiantes de medicina: impacto de un taller de escritura / A workshop to improve written communication skills of medical students

Background: Despite being among the best academically prepared of the country, many medical students have difficulties to communicate in writing. In 2005, the School of Medicine at the Pontificia Universidad Católica de Chile introduced a writing workshop in the undergraduate curriculum, to enhance the students' writing skills. Aim: To describe the workshop and its impact on the writing skills of 3 cohorts of students. Material and methods: This 30-h workshop used a participative methodology with emphasis on deliberate practice and feedback. Students worked in small groups with a faculty member specially trained in writing. The qualities of the essays written before and after the workshop were compared. Essays were rated by a professional team that used an analytic rubric to measure formal aspects of text writing as well as more complex thinking processes. Results: There was a significant improvement in the quality of the texts written after the workshop; the main changes occurred in argumentation, and in paragraph and text structure. This improvement was inversely proportional to the initial level of performance, and independent of gender Conclusions: A writing workshop based on deliberate practice and personalized feedback is effective to enhance the writing proficiency of medical students. Due to its design, this workshop could be useful for students of other careers and universities.

Análise anátomo-radiográfica da persistência do Forame de Huschke / Anatomic and radiograph study of the persistence of Foramen of Huschke

OBJETIVO: o objetivo neste trabalho é avaliar e localizar o Forame de Huschke. FORMA DE ESTUDO: anatômico. MATERIAL E MÉTODO: utilizando materiais de contraste como a Guta percha e o sulfato de bário, através de técnicas radiográficas extrabucais, como a panorâmica, submentovértex e a tomografia linear lateral corrigida para a Articulação Têmporo-mandibular, em quatro crânios, onde foi verificada clinicamente a presença do Forame de Huschke. RESULTADO: Os resultados obtidos mostraram que o Forame de Huschke pôde ser observado em crânios secos após a sua evidenciação por meio de material de contraste nestas técnicas radiográficas.

Pruebas de provocación bronquial con ejercicio y con histamina en niños asmáticos / Bronchial provocation tests with exercise and with histamine in asthmatic children

Con el propósito de comparar el rendimiento de las pruebas de provocación bronquial con ejercicio físico y con histamina en el diagnóstico de asma bronquial, se estudiaron 31 niños asmáticos entre 5 y 14 años. El ejercicio consistió en carrera al aire libre durante ocho minutos. La histamina se administró por aerosol durante respiración tranquila. La obstrucción bronquial post-ejercicio se midió con la máxima caída del VEF1 a los 5, 10 y 15 minutos después del esfuerzo. Se consideró positiva una caída máxima superior al 10%. En la prueba de histamina secalculó la Pc20 o concentración de histamina que produce un 20% de caída del VEF1. En 97% de los niños disminuyó la Pc20 con histamina (X 1,37 mg/ml +/- 1,8 DS)comparado con sólo un 74% de reducciones significativas del VEF1 post ejercicioi(X 21,37 +/- 17,32 DS). Se encontró una correlación significativa r=0,408 p < 0,05 entre Pc20 histamina y máxima caída VEF1 post-ejercicio. La Pc20 histamina serelacionó significativamente con el VEF1 previo a la prueba (r=0,464 p <0,01) encambio la caída del VEF1 post ejercicio no estuvo relacionada con el VEF1 previo(r=0,161). Los resultados demuestran el mayor rendimiento de la prueba de histamina comparada con el ejercicio en el diagnóstico de asma bronquial en el niño, y sugieren que este último no es un buen índice para demostrar heperreactividad bronquial en el niño

Prueba de provocación con ejercicio respirando aire frío y seco en el diagnóstico de asma bronquial en niños / Provocation test with exercise inspiring cold and dry air in the diagnosis of asthma in

El propósito de este trabajo fue estudiar si el enfriamiento del aire inspirado aumenta la sensibilidad diagnóstica de la provocación con ejercicio en asmáticos. Catorce niños fueron sometidos a dos pruebas de ejercicio en bicicleta ergométrica: una respirando aire ambiente (EAA) otra aire frío y seco (EAFS) (temperaturas de 22,1 + ou - 0,6 y - 12,4 + ou - 6,0-C respectivamente). El volumen espiratorio forzado del primer segundo (VEF1) basal; la intensidad del ejercicio y la ventilación durante el ejercicio fueron similares en ambas condiciones. La caída del VEF1 fue significativamente mayor con EAFS (16,9 + ou - 15,2 vs 4,8 + ou - 7,3% p < 0,01). Diez niños presentaron caídas del VEF1 superiores al 10% con EAFS; en cambio sólo 3 niños las tuvieron con EAA (p < 0,01). Todos los niños tuvieron pruebas de provocación con histamina anormales. Se concluye que, aun cuando el aire frío aumentó la intensidad de la obstrucción bronquial provocada por el ejercicio en asmáticos, la sensibilidad diagnóstica fue baja, lo que contrasta con la sensibilidad de la prueba de provocación con histamina, que fue capaz de identificar a todos los niños asmáticos. La prueba de provocación con histamina es, por lo tanto, de mayor utilidad en el diagnóstico de asma bronquial en niños que las pruebas de ejercicio

Pectinaria chilensis NILSSON, 1928 (POLYCHAETA: PECTINARIIDAE): taxonomic characterization, new distributional records and ecological notes from the chilean coast

Se revisa Pectinaria chilensis de la costa de Chile a partir de ejemplares recolectados en fondos blandos sublitorales, entre 45 y 93m de profundidad, en cuatro localidades del norte de Chile. Estos especímenes fueron comparados con ejemplares recolectados a 17m de profundidad en Coronel, Golfo de Arauco, Chile, localidad tipo de la especie. Se incluye una caracterización taxonómica, ilustraciones, y nuevas localidades en la distribución geográfica de la especie. Se provee información del hábitat (batimetría, tipo de sedimento, contenido de materia orgánica total y O2 disuelto de fondo) y se incluye una clave para diferenciar las dos especies de Pectinariidae registradas en Chile.

The taxonomy, geographical distribution, and ecological aspects of Pectinaria chilensis are reviewed. Specimens were collected in sublittoral soft bottoms, between 45 and 93m depth, at four localities in northern Chile. These specimens are compared with individuals collected from 17m depth at Coronel, Gulf of Arauco, Chile, the type locality of the species. A taxonomic characterization, illustrations and a list of new localities in the geographical distribution of this species are presented. Ecological information (bathymetry, sediment type, total organic matter content and dissolved O2 concentration of sea water above the bottom) is included, as well as a key for differentiating the two Pectinariidae species registered in Chile to date.

Revisa-se Pectinaria chilensis da costa do Chile a partir de exemplares recolhidos em fundos brandos sub-litorais, entre 45 e 93m de profundidade, em quatro localidades ao norte do Chile. Estes espécimes foram comparados com exemplares recolhidos a 17m de profundidade em Coronel, Golfo de Arauco, Chile, localidade padrão da espécie. Se inclui uma caracterização taxonômica, ilustrações, e novas localidades na distribuição geográfica da espécie. Se fornece informação do hábitat (batimetria, tipo de sedimento, conteúdo de matéria orgânica total e O2 dissolvido de fundo) e se inclui uma clave para diferenciar as duas espécies de Pectinariidae registradas no Chile.

Paradigmas sobre el diagnóstico, abordaje y tratamiento de la problemática drogadictiva / Paradigms about the diagnosis, management and treatment of the problem drogadictiva

El objetivo central del presente trabajo de investigación consistió en conocer, mediante entrevistas semiestructuradas los paradigmas que los psicólogos que trabajaron en el campo de la drogadependencia tienen sobre el diagnóstico, abordaje y tratamiento de las problemáticas drogadictivas. Este trabajo se encuadro dentro de los estudios de tipo exploratorio. Se realizó en primer lugar un rastreo teórico bibliográfico sobre la clínica psicológica de la drogadicción mas un trabajo de campo, con los resultados de ambos se buscó similitudes y diferencias para conocer e inferir los paradigmas pretendidos. En el análisis se encontró con que la multifactorialidad está siempre presente tanto a la hora de diagnosticar como de tratar la problemática, se planteó que el trabajo grupal y la abstinencia son elementos importantes en el tratamiento pero no fundamentales ni centrales y quedo en claro que para resolver una problemática ligada al consumo de sustancia hay que ir mas allá de la simple relación con la sustancia para abordar y trabajar sobre la trama subjetiva subyacente a ese hábito toxico.

The main objective of this research was to determine, through semi-structured interviews paradigms that psychologists working in the field of drug dependency have on the diagnosis, management and treatment of problematic addicts. This work forms part of exploratory studies. We performed first a theoretical scan of the literature on the psychological clinic of the drug over a field, with the results of both similarities and differences to understand and infer the intended paradigms. The analysis found that the multifactorial nature is always present both in the diagnosis and to treat the problem. It was suggested that the group work and abstinence are important but not central elements in the basic treatment and it was clear that solve a problem linked to substance abuse should go beyond the simple relationship with the substance to address and work on the plot underlying subjective toxic habit.

Observaciones y experimentación de nuevos cepillos dentales Colgate-Plus / Observations and experimentations of new dental brushes Colgate-Plus

Se presenta una investigación comparativa, experimental y clínica sobre la bondad de los cepillos dentales Colgate-Plus doble acción adulto y junior contra cepillos dentales al azar (globales) en una población de 200 estudiantes de odontología. Se valoran variables de edad y sexo y luego se interpretan parámetros de tipo odontológico y de tipo cosmético. Los cepillos dentales evaluado en el estudio salen bien evaluados, teniendo una aceptación de un 93.5 por ciento y porcentajes comparativos superiores en casi todos los parámetros contra los otros cepillos.

Curva dosis-respuesta a metacolina en niños normales hijos de asmáticos / Dose-response curves to methacholine in son of asthmatics normal children

Entre los parientes en primer grado de los enfermos conasma bronquial se ha demostrado una mayor prevalencia de esta enfermedad, la que crecería gradualmente hasta alcanzar cifras del orden de 43 por ciento a los 65 años. Con el propósito de establecer si los hijos de padres asmáticos(HPA) presentan alteraciones en la forma y posición de su curva dosis respuesta a metacolina, estudiamos 16 HPA y 16 controles sin antecedentes familiares de asma, escogidos por presentar edad (8,07 + - 0,45 años de edad, X + - ES)y hábito tabáquico familiar (3,8+ - 1,3 vs 2,9 + - 1,22 cigarrillos diarios)similares al grupo HPA. Ninguno de los niños presentaba enfermedades cardiorrespiratorias crónicas ni agudas durante los dos meses previos al estudio. Se efectuó una prueba de provocación administrando metacolina desde 0,03 hasta máxima (M), la posiciónde la curva a través de la dosis acumulativa que causa un 50 por ciento de M (ED50)y la PC20. No se observó diferencias significativas en M(39,8 promedio 3,89 vs 33,6 promedio 3,84 por ciento VEF1), enlogED50 (-1,29 + - 0,18 vs -1,22 + - 0,17mg)ni el logPC20(0,70 + - 0,22 vs 0,71 + - 0,22 mg/ml) al compararlas con su curva dosis-respuesta a metacolina respecto a niños sin antecedentes familiares de asma, lo que sugiere que la capacidad cantráctil de su músculo liso, las cargas que éste debe vencer y los factores que amplifican la respuesta de sus vías aéreas sonnormales en el estudio preasmático y que las alteraciones observadas en asmáticos serían adquiridas, probablemente por influencias ambientales

Efecto del triclosán-gantrez en un dentífrico sobre la placa y gingivitis alrededor de implantes oseointegrados. Estudio clínico comparativo / Effect of triclosan-gantrez toothpaste on plaque and gingivitis surrounding an osseointegrated implant. A clinical comparative study

De un universo total de 100 pacientes que debían tener un implante oseointegrado como mínimo, sin contemplar el tipo de implante, y luego de llenar formularios de inclusión-exclusión, así como también un examen de tejidos duros y blandos, se escogieron los primeros sesenta y, luego de firmar un formato de consentimiento, se les vinculó al estudio. Todos recibieron de un solo odontólogo examinador un examen de placa bacteriana alrededor del implante utilizando el método de Quingley-Hein (modificación Turesky) y uno de evaluación gingival, con el procedimiento de Loe-Silness, alrededor de la zona periimplantar. Una vez efectuado esto, se los dividió al azar en dos grupos de treinta personas cada uno. Un (grupo experimental) recibió el dentífrico triclosán-gantrez, y el otro (grupo control) un dentífrico placebo. Los tubos de dentífricos no tenían más identificación que una S y una U, y sólo en la compañía conocían lo que cada uno de ellos contenía. Esto identifica al estudio como clínico doble ciego. Todos fueron instruidos para cepillarse con el mismo tipo de cepillo dental, sin cambiar hábitos, pero en los sesenta días de duración del estudio no podrían realizar ningún tipo de enjuagatorios. En los resultados, vemos cómo el dentífrico U (triclosán-gantrez) es significativamente superior al placebo, dentífrico S, tanto en el promedio de la reducción de placa bacteriana, como en la de gingivitis (ver gráficas y tablas)

Perfil de la unidad de cuidados intensivos del Hospital Regional de Temuco entre junio 2002 a junio 2003 / Profile of the intensive-care unit at the Regional Hospital of Temuco, between June 2002 to June 2003

Temuco's ICU is the only center who receives critical patients in all the ninth Region, which has a high number of mapuche population and the higher poverty index in Chile. Since 2002 Temuco has a new Critical Patient Unit. We wanted to show our reality from june 2002 to june 2003. Method: Discharges from the one year period described were visited and analized age sex, etnicity, procedence, admission diagnosis, Apache II, comorbility, hospitalization days, mechanical ventilation and mortality. Results: from 876 discharges in the study period, were obtained 369 (42 per cent) clinicals files with enough data for revision: 59 per cent male and 41 per cent female. Mean age 58,3 per cent (16-100), 17 per cent mapuche ethnicity. 71 per cent comorbility (Diabetes, Arterial hipertension, Chronic obstructive lung disease, Coronary cardiopathy). 44 per cent of the patient came from surgery, 28 per cent from Emergency room, 17 per cent UTI and 10 per cent from other services. Admission diagnosis were 33 per cent cardiovascular, 27 per cent sepsis, 14 per cent neurologic, 8 per cent digestive, 7 per cent respiratory, 5 per cent trauma and intoxication and 3 per cent others. Admission's Apache II was 16 (1-46). Hospitalization days were 6,5 per cent. 80 per cent of the admissions were patients who needed mechanical ventilation, mostly because of acute respiratory failure 45 per cent (ADRS, pneumonia, APE), post anesthesic respiratory depression 40 per cent (cardiosurgery, neurosurgery and emergency surgeries), neurological 6 per cent Mortality of 25 per cent. Conclusions: we are a high complex unit in part because of the complexity of the surgeries here perfomed, which needs post surgery ICU stay. Our mortality correlates with the scores obtained. Most of our admissions were for mechanical ventilation.

Un índice del tamaño pulmonar mejora la predicción de valores de referencia de PC20 metacolina en un grupo de niños y adultos normales chilenos / A index of lung volume improves the prediction of reference values of methacholine PC20 in normal chilean children and adults

Con el propósito de examinar la validez del límite inferior de lo normal de 8 mg/ml para la PC20 metacolina en individuos normales chilenos, estudiamos 79 sujetos, 39 hombres y 40 mujeres, con edades entre 6 y 75 años. Se excluyeron los sujetos con condiciones capaces de alterar la respuesta a metacolina. En todos se efectuó una espirometría y una prueba de provocación con metacolina hasta llegar a concentraciones de 256 mg/ml, obtener un plateau o una caída del VEF, de 40 por ciento o más respecto del valor basal La PC20 se calculó por interpelación. También se efectuó un prick test con 9 alergenos comunes, clasificando como atópicos a aquellos que reaccionaron con uno o más alergenos. Se obtuvo PC20 en 35 individuos (44 por ciento), 11 de los cuales (13,9 por ciento) presentaron PC20 por debajo de 8 mg/ml. Hubo mayor prevalencia de PC20 en mujeres que en hombres (51,1 por ciento vs 31,6 por ciento, p < 0,05). No hubo diferencias de PC20 entre atópicos y no atópicos. Los individuos en los que se obtuvo PC20 fueron signifícativamente menores (25,6 ñ 18,8 vs 41,4 ñ 18,6 años, p < 0,01) y tuvieron menores valores absolutos de CVF (3.232 ñ 1.017 vs 4.038 ñ 1.245 ml, p <.0,025) y VEF, (2.793 ñ 920 vs 3.405 ñ 1.073 ml, p < 0,05). El log PC20 se correlacionó significativamente con CVF, VEF, y talla. En una correlación múltiple paso a paso sólo CVF entró al modelo de predicción de PC20. Los niños más pequeños e individuos mayores, con menores CVF, tuvieron PC20 más bajas. Concluimos que el límite inferior de lo normal de 8 mg/ml es inadecuado para los individuos con CVF pequeña, independientemente de la edad, por lo que una predicción de PC20 que considere este factor mejorará la sensibilidad y la especificidad en el diagnóstico de hiperreactividad bronquial