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Spaceflight induces molecular, cellular and physiological shifts in astronauts and poses myriad biomedical challenges to the human body, which are becoming increasingly relevant as more humans venture into space1-6. Yet current frameworks for aerospace medicine are nascent and lag far behind advancements in precision medicine on Earth, underscoring the need for rapid development of space medicine databases, tools and protocols. Here we present the Space Omics and Medical Atlas (SOMA), an integrated data and sample repository for clinical, cellular and multi-omic research profiles from a diverse range of missions, including the NASA Twins Study7, JAXA CFE study8,9, SpaceX Inspiration4 crew10-12, Axiom and Polaris. The SOMA resource represents a more than tenfold increase in publicly available human space omics data, with matched samples available from the Cornell Aerospace Medicine Biobank. The Atlas includes extensive molecular and physiological profiles encompassing genomics, epigenomics, transcriptomics, proteomics, metabolomics and microbiome datasets, which reveal some consistent features across missions, including cytokine shifts, telomere elongation and gene expression changes, as well as mission-specific molecular responses and links to orthologous, tissue-specific mouse datasets. Leveraging the datasets, tools and resources in SOMA can help to accelerate precision aerospace medicine, bringing needed health monitoring, risk mitigation and countermeasure data for upcoming lunar, Mars and exploration-class missions.
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Chronic arsenic exposures are associated with multiple hematologic disturbances, including anemia. The goal of this study was to evaluate associations between arsenic exposures and hematological parameters among men and women who are chronically exposed to elevated levels of arsenic from drinking water. Hematologic analyses were performed on blood collected from 755 participants (45% male and 54% female) in the Health Effects of Arsenic Longitudinal Study (HEALS) cohort, Bangladesh. Herein, we used linear regression models to estimate associations between red blood cell (RBC) parameters (i.e., RBC counts, hematocrit (HCT), hemoglobin (Hgb), mean corpuscular volume (MCV), mean corpuscular hemoglobin (MCH), and mean corpuscular hemoglobin concentration (MCHC)) and measurements of arsenic exposure (urinary arsenic and urinary arsenic metabolites). Arsenic exposures showed trending associations with decreased RBC counts in both men and women, a positive association with MCV in males, and an inverse association with MCHC among males, but not among non-smoking females. Among men, those who smoked had stronger associations between arsenic exposures and MCHC than non-smoking males. Collectively, our results show that arsenic exposures affect multiple RBC parameters and highlight potentially important sex differences in arsenic-induced hematotoxicity.
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Arsénico , Adulto , Femenino , Humanos , Masculino , Arsénico/toxicidad , Estudios Longitudinales , Bangladesh/epidemiología , Eritrocitos , Índices de EritrocitosRESUMEN
In this study, the genetic differences and clinical impact of the carbapenemase-encoding genes among the community and healthcare-acquired infections were assessed. This retrospective, multicenter cohort study was conducted in Colombia and included patients infected with carbapenem-resistant Gram-negative rods between 2017 and 2021. Carbapenem resistance was identified by Vitek, and carbapenemase-encoding genes were identified by whole-genome sequencing (WGS) to classify the alleles and sequence types (STs). Descriptive statistics were used to determine the association of any pathogen or gene with clinical outcomes. A total of 248 patients were included, of which only 0.8% (2/248) had community-acquired infections. Regarding the identified bacteria, the most prevalent pathogens were Pseudomonas aeruginosa and Klebsiella pneumoniae. In the WGS analysis, 228 isolates passed all the quality criteria and were analyzed. The principal carbapenemase-encoding gene was blaKPC, specifically blaKPC-2 [38.6% (88/228)] and blaKPC-3 [36.4% (83/228)]. These were frequently detected in co-concurrence with blaVIM-2 and blaNDM-1 in healthcare-acquired infections. Notably, the only identified allele among community-acquired infections was blaKPC-3 [50.0% (1/2)]. In reference to the STs, 78 were identified, of which Pseudomonas aeruginosa ST111 was mainly related to blaKPC-3. Klebsiella pneumoniae ST512, ST258, ST14, and ST1082 were exclusively associated with blaKPC-3. Finally, no particular carbapenemase-encoding gene was associated with worse clinical outcomes. The most identified genes in carbapenemase-producing Gram-negative rods were blaKPC-2 and blaKPC-3, both related to gene co-occurrence and diverse STs in the healthcare environment. Patients had several systemic complications and poor clinical outcomes that were not associated with a particular gene.IMPORTANCEAntimicrobial resistance is a pandemic and a worldwide public health problem, especially carbapenem resistance in low- and middle-income countries. Limited data regarding the molecular characteristics and clinical outcomes of patients infected with these bacteria are available. Thus, our study described the carbapenemase-encoding genes among community- and healthcare-acquired infections. Notably, the co-occurrence of carbapenemase-encoding genes was frequently identified. We also found 78 distinct sequence types, of which two were novel Pseudomonas aeruginosa, which could represent challenges in treating these infections. Our study shows that in low and middle-income countries, such as Colombia, the burden of carbapenem resistance in Gram-negative rods is a concern for public health, and regardless of the allele, these infections are associated with poor clinical outcomes. Thus, studies assessing local epidemiology, prevention strategies (including trials), and underpinning genetic mechanisms are urgently needed, especially in low and middle-income countries.
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Antibacterianos , Proteínas Bacterianas , Bacterias Gramnegativas , Infecciones por Bacterias Gramnegativas , Pseudomonas aeruginosa , beta-Lactamasas , Humanos , Colombia/epidemiología , beta-Lactamasas/genética , beta-Lactamasas/metabolismo , Proteínas Bacterianas/genética , Proteínas Bacterianas/metabolismo , Estudios Retrospectivos , Masculino , Femenino , Infecciones por Bacterias Gramnegativas/microbiología , Infecciones por Bacterias Gramnegativas/epidemiología , Persona de Mediana Edad , Bacterias Gramnegativas/genética , Bacterias Gramnegativas/enzimología , Bacterias Gramnegativas/aislamiento & purificación , Bacterias Gramnegativas/efectos de los fármacos , Bacterias Gramnegativas/clasificación , Antibacterianos/farmacología , Pseudomonas aeruginosa/genética , Pseudomonas aeruginosa/efectos de los fármacos , Pseudomonas aeruginosa/enzimología , Adulto , Klebsiella pneumoniae/genética , Klebsiella pneumoniae/enzimología , Klebsiella pneumoniae/efectos de los fármacos , Klebsiella pneumoniae/aislamiento & purificación , Pruebas de Sensibilidad Microbiana , Anciano , Infección Hospitalaria/microbiología , Infección Hospitalaria/epidemiología , Carbapenémicos/farmacología , Infecciones Comunitarias Adquiridas/microbiología , Infecciones Comunitarias Adquiridas/epidemiología , Secuenciación Completa del Genoma , Adolescente , Adulto JovenRESUMEN
Objetivo: Describir la experiencia en cirugía colorrectal resectiva laparoscópica en mayores de 75 años durante los años 2004 a 2019 en Clínica INDISA. Material y Método: Estudio transversal de las cirugías electivas por vía laparoscópica en mayores de 75 años, en los que se realizó anastomosis colorrectal, basado en el registro clínico electrónico. Resultados: Un total de 48 cirugías completamente laparoscópicas, la mayoría por cáncer colorrectal (CCR) (89,6%), mostraron indicadores de calidad óptima en la cosecha ganglionar en el 73,2%. Con una mediana de estadía de 6 días y una mortalidad a 30 días de 2,1% (un caso), comparable a las series internacionales. Discusión: El abordaje laparoscópico en pacientes ancianos tiene beneficios por sobre la vía abierta y presenta morbimortalidad aceptable. El balance intraoperatorio entre riesgo/seguridad quirúrgica y pronóstico oncológico es un factor a tener en cuenta en la toma de decisiones, junto con las patologías inherentes al grupo etario y la reserva funcional de cada paciente en particular. Conclusión: Se trata de la primera serie nacional de pacientes sobre 75 años sometidos a cirugía colorrectal resectiva electiva vía laparoscópica. Es factible y seguro en estos pacientes realizar cirugía mínimamente invasiva con morbimortalidad aceptable. La edad por sí sola no representa una contraindicación para la cirugía colorrectal laparoscópica. Es necesario contar con estudios de mayor volumen para conocer mejor la realidad nacional y los resultados a largo plazo.
Objective: To describe the experience in laparoscopic resective colorectal surgery in older than 75 years old, during 2004 to 2019 in INDISA Clinic. Material and Methods: It's a transversal study about all the elective laparoscopic surgeries with colorectal anastomosis in elderly people, based on electronic clinical records. Results: 48 full laparoscopic surgeries, the majority by colorectal cancer (89.6%) shows optimal quality indicators about nodal harvest in 73.2%. The median duration of hospital stay after surgery was 6 days with 30 days mortality of 2.1%. These results are comparable to the international reports. Discussion: The laparoscopic approach in elderly patients has benefits over the open approach with acceptable morbility and mortality. The intraoperatory balance between surgical risk/security and oncologic prognostic it's a factor to consider in the decision-making process besides the morbility by the age and the own functional reserve. Conclusion. It's the first series in Chile about over 75 years patients with laparoscopic resective colorectal surgery. Is feasible and secure to do minimal invasive surgery with acceptable morbility and mortality. Only the age isn't a contraindication to laparoscopic colorectal surgery. It's necessary more studies with mayor number of patients to known better the national results and long-term results.
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Introducción: La hemorroidectomía produce un intenso dolor postoperatorio recomendándose la analgesia multimodal para su manejo, manteniéndose como problema no resuelto. El objetivo fue evaluar la efectividad analgésica de tres combinaciones farmacológicas para el dolor post-hemorroidectomía. Materiales y Método: Estudio clínico prospectivo, aleatorizado, realizado en Clínica INDISA, entre diciembre 2019 y diciembre 2021, incluyendo pacientes con indicación de hemorroidectomía electiva. Se excluyeron hemorroidectomías asociadas a otro procedimiento quirúrgico, embarazadas/lactancia, reacciones adversas a medicamentos (RAM) a los fármacos en estudio, enfermedades hepáticas, renales o alteraciones/discapacidades mentales. Grupo I (control): Ketorolaco, Tramadol, Paracetamol. Grupo II: Grupo I y Nifedipino 0,2% tópico. Grupo III: Buprenorfina en parche 10 mcg/hora, Paracetamol y Ketorolaco. Asociado a régimen rico en fibra, polietilenglicol, baños de asiento y omeprazol. Se utilizó estadística descriptiva y analítica usando Chi-cuadrado, ANOVA-Bonferroni, Test de Kruskal Wallis, Wilcoxon y Fisher. Software R, utilizando un alfa del 5%. Resultados: De 117 pacientes, se enrolaron 39 = Grupo I, 41 = Grupo II y 37 = Grupo III. No hubo diferencias en la efectividad analgésica (p = 0,45). Para las RAM se observó que los pacientes con Buprenorfina tuvieron más náuseas (p = 0,08), vómitos (p = 0,04), dermatitis (p < 0,001) y prurito (p = 0,006). Discusión y Conclusiones: No hubo diferencias significativas para la efectividad analgésica post-hemorroidectomía al comparar los grupos de estudio. El uso de nifedipino tópico se recomienda como complemento a la terapia multimodal al mejorar los resultados sin aumentar las RAM. El uso de buprenorfina presentó más RAM sin mejores resultados como analgésico. El principal determinante para el alivio del dolor fue el tiempo transcurrido desde la cirugía.
Introduction: Hemorrhoidectomy produces intense postoperative pain, recommending multimodal analgesia for its management, remaining as an unresolved problem. The aim of this study was to evaluate the analgesic effectiveness of three pharmacological combinations for post-hemorrhoidectomy pain. Material and Method: A prospective, randomized clinical study, conducted at the INDISA Clinic, between December 2019 and December 2021, including patients with an indication for elective hemorrhoidectomy. Hemorrhoidectomies associated with another surgical procedure, pregnant/lactating women, adverse drug reactions (ADRs) to the study drugs, liver and kidney diseases, or mental disorders/disabilities were excluded. Group I (control): Ketorolac, Tramadol, Paracetamol. Group II: Group I and Nifedipine 0.2% topical. Group III: Buprenorphine patch 10 mcg/hour, Paracetamol and Ketorolac. Associated with a diet rich in fiber, polyethylene glycol, sitz baths, and omeprazole. Descriptive and analytical statistics were used using Chi-square, ANOVA-Bonferroni, Kruskal Wallis, Wilcoxon and Fisher test. Software R, using an alpha of 5%. Of 117 patients, 39 = Group I, 41 = Group II and 37 = Group III were enrolled. Results: There were no differences in analgesic effectiveness (p = 0.45). For the ADRs, it was observed that the patients with Buprenorphine had more nausea (p = 0.08), vomiting (p = 0.04), dermatitis (p < 0.001) and itching (p = 0.006). Discussion and Conclusion: There were no significant differences for post-hemorrhoidectomy analgesic effectiveness when comparing the study groups. The use of topical nifedipine is recommended as a complement to multimodal therapy as it improves results without increasing adverse drugs reaction (ADR).The use of buprenorphine presented more ADR without better results as an analgesic.The main determinant for pain relief was the time elapsed since surgery.
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Resumen El trabajo problematiza sobre el uso de metáforas biomédicas para interpretar fenómenos del mundo social contemporáneo. A partir de la Teoría Lingüística Cognitiva y la Crítica Postcolonial se analizan las metáforas del "Cuerpo Social" y la "Semántica Inmunitaria" como productos históricos de transformaciones tecnológicas y socio-políticas cuyo carácter es altamente conflictivo. Este tipo de metáforas evocarían una secuencia unilineal de examen/diagnóstico/terapia social que facilitaría cierto manejo centralizado y racional del poder. Se concluye que ciencias biomédicas, ciencias sociales y esfera pública del Norte Global compartirían una matriz metafórica asociada a una racionalidad moderna (capitalista/colonial/patriarcal) plegada sobre sí misma, que comienza, sin embargo, a ser progresivamente fisurada por "otras metáforas" producidas en el Sur Global.
Resumo O artigo discute o uso de metáforas biomédicas para interpretar os fenômenos do mundo social contemporâneo. Utilizam-se a Teoria Linguística-Cognitiva e a Crítica Pós-Colonial das Ciências para analisar as metáforas do "Corpo Social" e a "Semântica Imune" da bibliografia selecionada como produtos históricos de transformações tecnológicas e sociopolíticas, cujo caráter é altamente controverso. Este tipo de metáforas evoca uma sequência unilinear de exame/diagnóstico/terapia que socialmente facilitaria uma gestão centralizada e racional do poder. Conclui-se que Ciências Biomédicas, Ciências Sociais e esfera pública do Norte Global compartilham uma matriz metafórica comum associada com a racionalidade moderna (capitalista /colonial/patriarcal) dobrada sobre si mesma, mas que começa gradualmente a ser fissurada por "outras metáforas" produzidas no Sul global.
Abstract This paper problematizes the use of biomedical metaphors to interpret the contemporary social world. Using the Cognitive Linguistic Theory and the Postcolonial Studies of Sciences, it analyzes the metaphors of the "Social Body" and the "Immunitarian Semantics" from a selected bibliography as historical products of technological and socio-political transformations of conflicting characteristics. This kind of metaphors evokes a sequence of examination/diagnosis/social-therapy that facilitates a centralized and rational management of power. Finally, the text suggests that Biomedical Sciences, Social Sciences, and the public sphere of the Global North share a common metaphoric matrix associated with the modern (capitalist/colonial/ patriarchal) rationality, folded over itself, which progressively begins to be fissured by "other metaphors" produced in Global South.
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Humanos , Controles Informales de la Sociedad , Ciencias Sociales , Formación de Concepto , Conocimiento , Metáfora , Percepción Pública de la Ciencia , Ciencias de la SaludRESUMEN
Resumen En las últimas décadas las Tecnologías Informáticas han sido incorporadas a los sistemas de atención sanitaria, de la mano de la conformación de "redes asistenciales" que deben integrar distintos niveles, instituciones y agentes. En Chile, el régimen de "Garantías Explicitas en Salud" (GES) se vincula a estas reformas modernizadoras del Estado, cuya meta es mejorar la eficiencia del gasto público. El presente trabajo analiza críticamente el desarrollo e implementación del "Sistema de Información para la Gestión de Garantías en Salud" (SIGGES) incorporando metodologías propias de los Estudios Sociales de la Ciencia y Tecnología, y se propone un diseño de "etnografía del dispositivo". Como principales resultados, se evidencia que esta tecnología informática tiene un rol central en la estabilización de la política modernizadora en salud, que pone la gestión administrativa por sobre la integralidad de los cuidados. El SIGGES actúa como mediador entre múltiples niveles y agentes en salud para medir la productividad del sistema, vinculado al financiamiento, con lo cual modifica actividades clínicas y procesos de subjetivación, haciendo que se privilegien prestaciones curativas sobre preventivas y de promoción, patologías GES sobre No-GES, y conglomerados urbanos sobre zonas rurales.
Abstract In the last decades, computer technologies have been incorporated into health care systems, through the conformation of "healthcare networks" that must integrate different levels, institutions and agents. In Chile, the system of "Explicit Guarantees in Health" (GES) is linked to these modernizing reforms of the State, whose goal is to improve the efficiency of public spending. This work critically analyzes the development and implementation of the "Information System for the Management of Guarantees in Health" (SIGGES) incorporating methodologies from the Social Studies of Science and Technology, and proposing a "device ethnography" design. As main results, the evidence shows that this information technology has a central role in the stabilization of modernizing health policy, which places administrative management over the integrality of care: SIGGES acts as a mediator between multiple levels and agents in health to measure the productivity of the system, linked to financing, with which modifies clinical activities and processes of subjectivation, privileging curative benefits on preventive and promotion, pathologies GES on No-GES, and urban conglomerates on rural areas.
Resumo Nas últimas décadas, as tecnologias da informação foram incorporadas aos sistemas de saúde por meio da criação de "redes assistenciais", que devem integrar diferentes níveis, instituições e agentes. No Chile, o regime de "garantias explícitas em saúde" (GES) liga-se a essas reformas modernizadoras do Estado, cujo objetivo é melhorar a eficiência dos gastos públicos. Este trabalho analisa criticamente o desenvolvimento e implementação do "Sistema de Informação para a Gestão de Garantias em Saúde" (SIGGES), incorporando metodologias dos Estudos Sociais de Ciência e Tecnologia, e propõe um desenho de "etnografia do dispositivo". Como principais resultados, fica evidente que esta tecnologia da informação tem papel central na estabilização da política de saúde modernizadora, que deixa a gestão administrativa acima da integralidade do cuidado: o SIGGES atua como um mediador entre vários níveis e agentes em saúde para medir a produtividade do sistema, vinculada ao financiamento, com o qual modifica atividades clínicas e processos de subjetivação, privilegiando serviços curativos em vez de preventivos e de promoção; patologías GES em vez de No-GES, e centros urbanos em detrimento de áreas rurais.
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Chile , Gestión en Salud , Investigación Cualitativa , Eficiencia , Sistemas Nacionales de Salud/organización & administración , Registros Electrónicos de Salud/organización & administración , Gestión de la Información en Salud/organización & administración , Sistemas de Información en Salud/organización & administraciónRESUMEN
Objetivo: Determinar el comportamiento in vitro del colágeno de la unión amelo-dentinaria en premolares humanos sometidos a altas temperaturas. Materiales y métodos:Estudio descriptivo pseudo-experimental in vitro de corte transversal que determinó, a través de microscopía electrónica de barrido, el comportamiento físico del colágeno de la unión amelodentinaria en 60 premolares humanos sometidos a altas temperaturas (200°C, 400°C, 600°C, 800°C y 1.000°C), para proporcionar evidencia científica que permita emplear la separación del esmalte y la dentina como un marcador fehaciente repetitivo de utilidad en los procesos de identificación odontológica y documentación de la necropsia médico-legal para el caso de cadáveres o restos humanos que resulten quemados, carbonizados o incinerados. Resultados:Se observa que el diseño micro-estructural del patrón reticular de colágeno de la dentina en relación con los cristales de hidroxiapatita resulto afectado conforme aumentaba la temperatura. Conclusiones: En conjunto, la alteración del patrón reticular del colágeno y los cambios micro-estructurales de la hidroxiapatita de calcio (fusión y sinterización de las nano-esferas de fosfato octa-cálcico) de la dentina y del esmalte, explican la separación gradual y progresiva de estos dos tejidos a nivel de la unión amelo-dentinaria.
Objective: To determine the behavior in vitro of collagen at the dentine-enamel junction of human premolars subjected to high temperatures. Materials and methods: Pseudo-experimental descrip-tive study, in vitro, cross-sectional, that determined by Scanning Electron Microscopy (SEM), the physical behavior of collagen at the dentine-enamel junction in 60 human premolars subjected to high temperatures (200°C, 400°C, 600°C, 800°C and 1000°C) to provide scientific evidence that allows to employ the separation of enamel and dentin as a reliable repetitive marker, useful in dental identification processes and documentation of medical-legal autopsy for bodies or human remains that were burned, charred or incinerated. Results: It was observed that the micro-structural design of reticular collagen pattern of the dentin in relation to hydroxyapatite crystals, was affected with increasing temperature. Conclusions: In general, alteration of reticular collagen pattern and the micro-structural changes of calcium hydroxyapatite (melting and sintering of the nano-spheres of octa-calcium phosphate) of dentin and enamel, explains the gradual and progressive separation of both tissues in dentine-enamel junction level.
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Introducción: La implementación de modelos animales para el estudio de los tejidos dentales y periodontales de dientes articulados en sus alvéolos sometidos a altas temperaturas permite el establecimiento de parámetros repetitivos que contribuyen con los procesos de identificación. Objetivo: Describir los cambios radiográficos de los tejidos dentales y periodontales de cerdo (Sus domesticus) sometidos a altas temperaturas. Material y métodos: Se realizó un estudio observacional descriptivo de naturaleza pseudo-experimental in vitro para observar los cambios radiográficos de los tejidos dentales y periodontales en 60 dientes de cerdo doméstico sometidos a altas temperaturas (200, 400, 600, 800 y 1,000 ºC). Resultados: Los tejidos dentales y periodontales estudiados presentan gran resistencia a las altas temperaturas sin variar considerablemente su microestructura, de tal manera que los cambios físicos (estabilidad dimensional, fisuras, grietas y fracturas) que ocurren en la medida que aumenta la temperatura pueden describirse a través de radiografía convencional. Conclusiones: El análisis radiográfico de los dientes articulados en sus respectivos alvéolos se constituye en un mecanismo para determinar la temperatura a la cual estuvo sometido un diente, lo que puede ser empleado durante el proceso de identificación odontológica y documentación de la necropsia médico-legal para el caso de cadáveres o restos humanos quemados, carbonizados e incinerados. El cerdo doméstico (Sus domesticus) se constituye en un modelo animal experimental adecuado para estudiar dichos cambios; sin embargo, se recomienda realizar un estudio en dientes humanos articulados en su respectiva unidad alveolar, para determinar si los hallazgos radiográficos descritos se repiten y son extrapolables.
Introduction: The implementation of animal models for the study of periodontal and dental tissues of teeth articulated into their sockets and subjected to high temperatures allows the establishment of repetitive parameters which might contribute to identification processes. Aim: To describe radiographic changes of pig's (Sus domesticus) periodontal and dental tissues subjected to high temperatures. Material and methods: An in vitro pseudo-experimental, descriptive and observational study was undertaken in order to assess radiological changes of periodontal and dental tissues of 60 domestic pig's teeth which had been subjected to high temperatures (200, 400, 600, 800 and 1,000 ºC). Results: The dental and periodontal tissues subject of this research article presented strong resistance to high temperatures without considerable variation of their micro-structure. Thus, physical changes (dimensional stability, fissures, cracks and fractures) which took place as temperature increased, could be described using a conventional X-ray. Conclusions: Radiographic examination of teeth articulated in their sockets can be established as a mechanism to determine the temperature at which the tooth was subjected. This could be used in processes of dental identification and medical-legal autopsy documentation in cases of burned, carbonized or incinerated human remains. Domestic pigs (Sus domesticus) can be regarded as a suitable experimental animal models to study the aforementioned changes. Nevertheless, a study involving human teeth articulated in their own socket is recommended in order to determine whether the radiographic findings herein described are replicated and can be extrapolated.
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Objective: To describe the macroscopic changes of titanium and fiberglass posts cemented in human premolars subjected to high temperatures for forensic purposes. Materials and methods: An in Vitro experimental study was conducted to observe the macroscopic physical changes of dental tissues (enamel, dentine and cement), of materials of conventional endodontic use (gutta-percha Wave One® Maillefer Dentsply ®, endodontic cement with epoxic resin Top Seal® Maillefer Dentsply®), posts cement Relyx TM ARC 3M ESPE®) and of the titanium posts (Tenax® Endodontic Post System Coltene®) and fiberglass posts (Tenax® Fiber Trans Coltene®) in 124 human teeth, exposed to five ranks of temperature 200ºC, 400ºC, 600ºC, 800ºC, 1000ºC (three teeth at each temperature). Results: The studied tissues and dental materials used in this study, offer great resistance to high temperatures, exhibiting considerably variation of their macrostructure, in a way that the physical changes (dimensional stability, fissures, cracks, fractures, texture, color, carbonization and incineration) can serve to identify them and to associate such changes to each rank of specific temperature. Conclusion: The titanium and fiberglass posts cemented in human premolars offer great resistance to the action of high temperatures. In the same way, they present specific changes associated to the dental tissues that can contribute with the process of identification and medico-legal necropsy of a corpse or burned, incinerated or carbonized human rests.
Objetivo: Describir los cambios macroscópicos de postes de titanio y de fibra de vidrio cementados en premolares humanos sometidos a altas temperaturas con fines forenses. Materiales y métodos: Se realizó un estudio experimental in Vitro para observar los cambios físicos macroscópicos de los tejidos dentales (esmalte, dentina y cemento), de los materiales de uso endodóncio (Gutapercha Wave One® Dentsply Maillefer® y material de obturación Top Seal® Dentsply Maillefer®), material de cementación de los postes (Relyx TM ARC 3M ESPE®) y de los postes de titanio (Tenax® Endodontic Post System Coltene®) y fibra de vidrio (Tenax® Fiber Trans Coltene®) en 30 dientes humanos, sometidos a cinco rangos de temperatura 200ºC, 400ºC, 600ºC, 800ºC, 1000ºC. Resultados: Los tejidos y los materiales dentales estudiados en esta investigación, presentan gran resistencia a las altas temperaturas sin variar considerablemente su macroestructura, de tal manera que los cambios físicos (estabilidad dimensional, fisuras, grietas, fracturas, textura, color, carbonización e incineración) pueden llegar identificarse y asociarse a cada rango de temperatura específico. Conclusión: Los postes de titanio y de fibra de vidrio cementados en premolares humanos presentan gran resistencia a la acción de altas temperaturas, y los cambios específicos asociados a los tejidos dentales pueden contribuir con el proceso de identificación y la documentación de la necropsia médicolegal de un cadáver o restos humanos que hayan resultado quemados, incinerados o carbonizados.
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Animales , Odontología , Odontología Forense , Periodoncio , Sus scrofa , Calor , Acondicionamiento de Tejidos DentalesRESUMEN
Objetivo: Describir los cambios físicos macros-estructurales de los tejidos dentales (esmalte, dentina y cemento) y periodonta - les (mucosa oral, hueso compacto alveolar y hueso esponjoso alveolar) de cerdo doméstico sometidos a altas temperaturas. Materiales y métodos: Se realizó un estudio observacional descriptivo de naturaleza pseudo-experimental in Vitro para observar los cambios físicos macro-estructurales de los tejidos dentales y periodontales en 25 dientes de cerdo doméstico sometidos a altas temperaturas (200ºC, 400ºC, 600ºC, 800ºC, 1000ºC). Resultados: Los tejidos dentales y pe - riodontales estudiados presentan gran resistencia al someterse a altas tempe - raturas sin variar considerablemente su macro-estructura. A 200°C hay cambios de color y aparecen fisuras en esmalte. A 400°C aumentan las fisuras y hay sepa - ración entre los tejidos duros, iniciando la carbonización. A 600°C las fracturas en los tejidos dentales y hueso son más evidentes. A 800°C inicia incineración de los tejidos. A 1000°C no hay evidencia de tejidos blandos, hay estallido de la corona y fragmentación del tejido óseo. Conclusiones: El análisis macroscópico de los dientes de cerdo doméstico articulados en sus respectivas unidades alveolo-den- tarias se constituye en un modelo experi - mental que simula de manera fehaciente el comportamiento de los tejidos dentales y periodontales al ser sometidos a altas temperaturas, sin embargo, se recomienda realizar un estudio en dientes humanos ar - ticulados en su respectiva unidad alveolar, para determinar si dichos cambios se repi- ten y son extrapolables, para ser empleados en procesos de identificación odontológica y documentación de la necropsia médico- legal en el caso de cadáveres o restos huma - nos quemados, carbonizados o incinerados...(Au)
Objective: To describe the physical chan- gesof macro-structural dental tissues (ena- mel, dentin and cement) and periodontal (oral mucous membrane, alveolar compact bone and cancellous alveolar bone) of domestic pig (Sus domesticus) expose to high temperatures. Materials and methods: This descriptive study observed the physical changes in ma - cro-structural dental tissues and periodontal in 25 teeth of domestic pigs subjected to high temperatures (200°C, 400°C, 600°C, 800°C and 1000°C). Results: Dental and periodontal tissues stu - died show great resistance when subjected to high temperatures without changing sig - nificantly their macro-structure. At 200°C no color changes and cracks appear in the enamel. At 400°C there was an increase of the fissure and no separation between the hard tissues, initiating carbonization. At 600°C fractures in the dental tissues and bone are most apparent. At 800°C burning of the tissues initiated. At 1000°C there was no evidence of soft tissue. Conclusions: Macroscopic analysis of the teeth articulated in their alveolar-dental units constitutes a experimental model that ssimulates the changes of dental and perio - dontal tissues expose to high temperature. It is recommended to conduct astudy on human teeth in their respective unit arti- culated alveolar to determine whether the macro-structural physical changes descri- bed are repeated and can be extrapolated, and which can eventually be used during the process of dental identification and documentation of the medical legal autopsy used in the case of bodies or human remains burned, charred and burned...(Au)
Asunto(s)
Animales , Odontología , Odontología Forense , Periodoncio , Sus scrofa , Acondicionamiento de Tejidos Dentales , Calor , PeriodoncioRESUMEN
Background: Gastric cancer is the first cause of death by cáncer in Chile. Quality of Life is a multidimensional construct that explores functionality and well-being, including physiological, psychological and social aspects. Aim: To assess Quality of Life of patients operated for gastric cancer. Patients and methods: The European Organization Research and Treatment of Cáncer Quality of Life Questionnaire (EORTC QLQ-30), translated into Spanish, was applied to 33 patients, aged 42 to 82 years (25 males), subjected to curative total or subtotal gastrectomy for gastric cancer, between January 2004 and December 2006. Results: The average lapse from the moment of the surgical intervention to the interview, was 52.2 weeks. Fifty five percent perceived their Quality of Life in the "good" category. Male patients and those with less than 6 months of surgery, obtained better scores in psychological aspects of quality of life. Conclusions: A high percentage of patients operated for gastric cancer qualified their quality of life as good in spite of the severity of the underlying disease and invasiveness of the intervention. This is probably explained by the importance of psychological factors that influence quality of life.
Asunto(s)
Adulto , Anciano , Anciano de 80 o más Años , Femenino , Humanos , Masculino , Persona de Mediana Edad , Gastrectomía/psicología , Calidad de Vida/psicología , Neoplasias Gástricas/cirugía , Chile , Encuestas y Cuestionarios , Estadísticas no Paramétricas , Neoplasias Gástricas/psicología , Factores de TiempoRESUMEN
La finalidad de este estudio fue demostrar que el cisticerco racemoso (CR) es, como el celulosos (CC), larva (metacestodo) de T. solium, hecho que se ha puesto en duda. CR sólo parasita el cerebro del hombre, en donde causa las formas más graves de cisticercosis cerebral. Para lograr este propósito se buscaron restos del escólex y los ganchos del rostelo en dos CR y en cuatro cisticercos de forma intermedia (CFI) que se extrajeron quirúrgicamente de los ventrículos cerebrales. Los CFI son parásitos que comparten características morfológicas y con CC y CR, ya que poseen gran desarrollo de la membrana pero conservan estructuras que aparentemente corresponden al escólex. Se hicieron corte histológicos seriados y observaciones con microscopios estereoscópico y electrónico de barrido. En CR fue posible localizar la corona de ganchos, y en los CFI las estructuras del escólex: conducto espiral, ventosas y ganchos. Se concluye que CC, CR y CFI son formas larvarias de T. solium