Repeatability of the human eye compared to an intraoral scanner in dental shade matching.

OBJECTIVE: The purpose of this investigation was to compare the repeatability of an intraoral scanner (3Shape TRIOS) with the traditional visual method for dental shade matching in patients and to assess the influence of ambient lighting and the observer's sex and experience on visual shade matching. An additional aim was to determine the color dimension for which repeatability is greater with both the visual method and intraoral scanner. METHODS: Thirty observers (15 men and 15 women), grouped by professional experience, selected the shade of the right maxillary central incisor in 10 patients on three different occasions under different ambient lighting conditions (twice under studio clinic lighting and once under natural light). The same procedure was repeated using an intraoral scanner. All shades were selected based on the VITA Toothguide 3D-MASTER. The repeatability of each observer and the intraoral scanner were recorded for each color dimension (hue, chroma, and value). RESULTS: The TRIOS intraoral scanner obtained a mean repeatability of 86.66% in dental shade matching compared to 75.22% achieved by the visual method. Ambient lighting had a direct effect on the repeatability of the shade selection for the visual method, whereas the observer's sex and clinical experience did not. For the visual method, the repeatability in dental shade matching depended on the dimension studied, with the best results in value, followed by hue and chroma; however, such dependence was not detected for the intraoral scanner. CONCLUSIONS: The TRIOS intraoral scanner ensured better repeatability than the visual method in dental shade matching.

Evaluación De Las Habilidades De La Corteza Prefrontal: La Escala Efeco Ii-Vc Y Ii-Vr / Evaluation Of The Skills Of The Prefrontal Cortex: The Efeco Ii-Vc And Ii-Vr

Resumen La corteza pre-frontal es la base de las habilidades mentales de mayor complejidad del desarrollo humano. En su proceso de evaluación, la escala EFECO brinda un importante aporte para valorar su estado. En investigaciones previas se ha estudiado esta escala con su configuración de 67 ítems, narrativa centrada en el déficit y evaluación de 8 funciones ejecutiva. En esta investigación se presentan los siguientes aportes: una nueva versión de la escala, centrada en su narrativa en la habilidad ejecutiva, propuesta de ítems para valorar la función ejecutiva de verificación y una versión resumida de la escala en 42 ítems. En el estudio participaron 118 adultos saludables entre 18 y 25 años de edad (M edad = 20.72, DE = 1.65). En los resultados se encontró que la escala EFECO II-VC (versión modificada y completa) obtuvo como consistencia interna α = .96 y sus sub-escalas consistencia interna entre α = .64 y .81. La escala EFECO II-VR (versión modificada y resumida) obtuvo α = .94 y sus sub-escalas entre α = .68 y .79. La consistencia interna de los factores en los que se engloban las funciones ejecutivas se presentaron adecuados: el sistema supervisor de la cognición II-VC α = .93 y II-VR α = .70, mientras que el sistema supervisor de la conducta II-VC α = .93 y II-VR α = .81. Las correlaciones entre las funciones ejecutivas valoradas con ambas escalas fueron entre medianas y grandes r = .36 y .94. Se cierra el trabajo discutiendo el aporte clínico y científico de la modificación de la escala EFECO.

Abstract The pre-frontal cortex is the basis of the most complex mental abilities of human development. In its evaluation process, the EFECO scale provides an important contribution to assess its status. In previous investigations this scale has been studied with its configuration of 67 items, narrative focused on the deficit and evaluation of 8 executive functions. This research presents a new version of the scale, centered on its narrative in executive ability, proposed items to assess executive verification function and a summarized version of 42 items. The study included 118 healthy adults between 18 and 25 years of age (M age = 20.72, SD = 1.65). In the results it was found that the EFECO II-VC scale (modified and complete version) obtained as internal consistency α = .96 and its sub-scales internal consistency between α = .64 and .81. The EFECO II-VR scale (modified and summarized version) obtained α = .94 and its sub-scales between α = .68 and .79. The internal consistency of the factors in which the executive functions are included were adequate: the supervisory system of cognition II-VC α = .93 and II-VR α = .70, while the supervisor system of behavior II- VC α = .93 and II-VR α = .81. The correlations between the executive functions assessed with both scales were between medium and large r = .36 and .94. The work is closed discussing the clinical and scientific contribution of the modification of the EFECO scale.

Encefalopatía hiperamoniémica secundaria a infección urinaria por germen productor de ureasa: Caso clínico pediátrico / Hyperammonemic encephalopathy due to urinary tract infection by urea splitting bacteria: A pediatric case report

El incremento del amonio en sangre, hiperamoniemia, es pasible de provocar compromiso neurológico al atravesar la barrera hematoencefálica. La causa más frecuente y conocida de hiperamoniemia es la alteración en la función hepática. Sin embargo, se deben considerar otras patologías, de menor frecuencia y poco conocidas. La infección del tracto urinario por gérmenes productores de ureasa debe ser contemplada a pesar de ser infrecuente en pediatría. Se reporta el caso de un niño con encefalopatía aguda grave, con niveles elevados de amonio en sangre, en quien, luego de descartar otros diagnósticos diferenciales, se asumió el cuadro como hiperamoniemia secundaria a infección del tracto urinario por Corynebacterium riegelii, un germen productor de ureasa. Se implementaron medidas generales de tratamiento para la encefalopatía hiperamoniémica y tratamiento antibiótico específico, con buena evolución el paciente.

Elevated level of ammonia in the blood, defined as hyperammonemia, is feasible to cause neurological symptoms when crossing the blood-brain barrier. The most frequent and studied cause of hyperammonemia is liver failure. Nevertheless, other less frequent and known etiologies must be considered. Urinary tract infection caused by urea-splitting bacteria, despite being unusual in pediatric patients, must be taken into account. We report a pediatric patient with severe acute encephalopathy and high levels of ammonia in blood. After ruling out other causes of hyperammonemia, it was assumed secondary to urinary tract infection by Corynebacterium riegelii, a ureasplitting bacteria. General treatment for hyperammonemic encephalopathy was established, as well as specific treatment with antibiotics. The patient evolved favorably.

[Hyperammonemic encephalopathy due to urinary tract infection by urea splitting bacteria. A pediatric case report]. / Encefalopatía hiperamoniémica secundaria a infección urinaria por germen productor de ureasa. Caso clínico pediátrico.

Elevated level of ammonia in the blood, defined as hyperammonemia, is feasible to cause neurological symptoms when crossing the blood-brain barrier. The most frequent and studied cause of hyperammonemia is liver failure. Nevertheless, other less frequent and known etiologies must be considered. Urinary tract infection caused by urea-splitting bacteria, despite being unusual in pediatric patients, must be taken into account. We report a pediatric patient with severe acute encephalopathy and high levels of ammonia in blood. After ruling out other causes of hyperammonemia, it was assumed secondary to urinary tract infection by Corynebacterium riegelii, a ureasplitting bacteria. General treatment for hyperammonemic encephalopathy was established, as well as specific treatment with antibiotics. The patient evolved favorably.

El incremento del amonio en sangre, hiperamoniemia, es pasible de provocar compromiso neurológico al atravesar la barrera hematoencefálica. La causa más frecuente y conocida de hiperamoniemia es la alteración en la función hepática. Sin embargo, se deben considerar otras patologías, de menor frecuencia y poco conocidas. La infección del tracto urinario por gérmenes productores de ureasa debe ser contemplada a pesar de ser infrecuente en pediatría. Se reporta el caso de un niño con encefalopatía aguda grave, con niveles elevados de amonio en sangre, en quien, luego de descartar otros diagnósticos diferenciales, se asumió el cuadro como hiperamoniemia secundaria a infección del tracto urinario por Corynebacterium riegelii, un germen productor de ureasa. Se implementaron medidas generales de tratamiento para la encefalopatía hiperamoniémica y tratamiento antibiótico específico, con buena evolución el paciente.

Periorquitis meconial: A propósito de un caso / Meconium periorchitis: A case report

La periorquitis meconial es infrecuente. En el feto, está abierto el conducto peritoneo vaginal y, ante una perforación intestinal por cualquier causa (atresia intestinal, vólvulo, entre otras), se produce una peritonitis meconial. El contenido intestinal puede pasar hacia la cavidad vaginal escrotal. La peritonitis meconial puede resolverse espontáneamente y sin consecuencias. Restos calcificados de este evento pueden quedar en la cavidad peritoneal y/o en el escroto. En el recién nacido, se observará un hidrocele y una masa palpable intraescrotal, ecográficamente heterogénea y con calcificaciones. La periorquitis meconial o vaginalitis meconial se resuelve espontáneamente. Su desconocimiento podría llevar a cirugías innecesarias en el neonato. Se presenta el caso de un paciente de 33 días de vida con una masa escrotal, en quien se realizó una cirugía exploratoria. El diagnóstico anatomopatológico fue de periorquitis meconial.

Meconium periorchitis is uncommon. In the unborn child the peritoneum vaginal canal is open and, secondary to intestinal perforation due to any cause (intestinal atresia, volvulus, and others), meconium peritonitis occurs. The intestinal content reaches the scrotal vaginal cavity. Meconium peritonitis can heal spontaneously and without consequences. Calcified remnants of this event may remain in the peritoneal cavity and/or scrotum. In the newborn, a hydrocele and scrotal mass can be observed; the ultrasound will show a heterogeneous image with calcifications. Meconium periorchitis or meconium vaginalitis resolves spontaneously. The lack of awareness of this disease could lead to unnecessary surgery in the newborn. We present a 33 days old patient with a scrotal mass in whom surgery was performed with the pathological diagnosis of meconium periorchitis.

[Meconium periorchitis: A case report]. / Periorquitis meconial: A propósito de un caso.

Meconium periorchitis is uncommon. In the unborn child the peritoneum vaginal canal is open and, secondary to intestinal perforation due to any cause (intestinal atresia, volvulus, and others), meconium peritonitis occurs. The intestinal content reaches the scrotal vaginal cavity. Meconium peritonitis can heal spontaneously and without consequences. Calcified remnants of this event may remain in the peritoneal cavity and/or scrotum. In the newborn, a hydrocele and scrotal mass can be observed; the ultrasound will show a heterogeneous image with calcifications. Meconium periorchitis or meconium vaginalitis resolves spontaneously. The lack of awareness of this disease could lead to unnecessary surgery in the newborn. We present a 33 days old patient with a scrotal mass in whom surgery was performed with the pathological diagnosis of meconium periorchitis.

[Orthostatic hypotension: an unusual manifestation of pheochromocytoma]. / Hipotensión ortostática: una manifestación sugerente de feocromocitoma.

Pheochromocytoma, though an uncommon cause of hypertension, can be a lethal condition. Because of this it is mandatory to diagnose it or rule it out in presence of suggestive symptoms. Typical symptoms are palpitations, sweating, severe headaches and hypertension. However, there are other suggestive symptoms of this dangerous endocrine entity, one of which is the orthostatic hypotension. We report the case of a 65 years old female patient with long standing hypertension in whom the pheochromocytoma was suspected after episodes of orthostatic hypotension. Although this manifestation was described almost fifty years ago, its frequency and pathophysiology has not yet been well established and fully elucidated. Moreover, it has meaningful implications in relation to preoperatory management and the timing of surgery.

Long-term automated peritoneal dialysis in patients with refractory congestive heart failure.

Patients with severe congestive heart failure (CHF), mainly class IV on the New York Heart Association (NYHA) scale, became refractory to standard medical therapy. The factor that favored that evolution was renal insufficiency with inadequate renal perfusion. Our objectives in the present study were to make a preliminary assessment of the usefulness of automated peritoneal dialysis (APD) for the treatment of volume overload in those patients. Our study was carried out in the peritoneal dialysis unit of the clinical hospital of Pontificia Universidad Católica de Chile. We studied 3 non uremic patients with refractory CHF secondary to ischemic cardiomyopathy, severe secondary lung hypertension (> 70 mmHg), and associated moderate renal insufficiency. The patients (2 women and 1 man) ranged in age from 55 years to 68 years. A Tenckhoff double-cuff peritoneal catheter was placed in each patient, and peritoneal dialysis was carried out using the nightly intermittent peritoneal dialysis (NIPD) modality. The treatment used was appropriate to obtain a gradual removal of fluids: dialysate dextrose at 1.5% and 2.5%, 4-5 cycles, and total volume of 10-12 L per night. All three patients were able to remain at home, with no signs of hypervolemia. The frequency and length of hospitalizations decreased on average from 59 days pre-APD to 37 days post-APD. No hospitalizations for cardiac problems occurred, and the mean survival was 11 months (range: 6-22 months). This preliminary observation suggests that APD could be offered as an effective treatment for helping to remove fluids in patients with refractory CHF, reducing the number and length of hospitalizations, and improving quality of life.