Development of ISB 1442, a CD38 and CD47 bispecific biparatopic antibody innate cell modulator for the treatment of multiple myeloma.

Antibody engineering can tailor the design and activities of therapeutic antibodies for better efficiency or other advantageous clinical properties. Here we report the development of ISB 1442, a fully human bispecific antibody designed to re-establish synthetic immunity in CD38+ hematological malignancies. ISB 1442 consists of two anti-CD38 arms targeting two distinct epitopes that preferentially drive binding to tumor cells and enable avidity-induced blocking of proximal CD47 receptors on the same cell while preventing on-target off-tumor binding on healthy cells. The Fc portion of ISB 1442 is engineered to enhance complement dependent cytotoxicity, antibody dependent cell cytotoxicity and antibody dependent cell phagocytosis. ISB 1442 thus represents a CD47-BsAb combining biparatopic targeting of a tumor associated antigen with engineered enhancement of antibody effector function to overcome potential resistance mechanisms that hamper treatment of myeloma with monospecific anti-CD38 antibodies. ISB 1442 is currently in a Phase I clinical trial in relapsed refractory multiple myeloma.

Minimally invasive versus open pancreatoduodenectomy for pancreatic and peri-ampullary neoplasm (DIPLOMA-2): study protocol for an international multicenter patient-blinded randomized controlled trial.

BACKGROUND: Minimally invasive pancreatoduodenectomy (MIPD) aims to reduce the negative impact of surgery as compared to open pancreatoduodenectomy (OPD) and is increasingly becoming part of clinical practice for selected patients worldwide. However, the safety of MIPD remains a topic of debate and the potential shorter time to functional recovery needs to be confirmed. To guide safe implementation of MIPD, large-scale international randomized trials comparing MIPD and OPD in experienced high-volume centers are needed. We hypothesize that MIPD is non-inferior in terms of overall complications, but superior regarding time to functional recovery, as compared to OPD. METHODS/DESIGN: The DIPLOMA-2 trial is an international randomized controlled, patient-blinded, non-inferiority trial performed in 14 high-volume pancreatic centers in Europe with a minimum annual volume of 30 MIPD and 30 OPD. A total of 288 patients with an indication for elective pancreatoduodenectomy for pre-malignant and malignant disease, eligible for both open and minimally invasive approach, are randomly allocated for MIPD or OPD in a 2:1 ratio. Centers perform either laparoscopic or robot-assisted MIPD based on their surgical expertise. The primary outcome is the Comprehensive Complication Index (CCI®), measuring all complications graded according to the Clavien-Dindo classification up to 90 days after surgery. The sample size is calculated with the following assumptions: 2.5% one-sided significance level (α), 80% power (1-ß), expected difference of the mean CCI® score of 0 points between MIPD and OPD, and a non-inferiority margin of 7.5 points. The main secondary outcome is time to functional recovery, which will be analyzed for superiority. Other secondary outcomes include post-operative 90-day Fitbit™ measured activity, operative outcomes (e.g., blood loss, operative time, conversion to open surgery, surgeon-reported outcomes), oncological findings in case of malignancy (e.g., R0-resection rate, time to adjuvant treatment, survival), postoperative outcomes (e.g., clinically relevant complications), healthcare resource utilization (length of stay, readmissions, intensive care stay), quality of life, and costs. Postoperative follow-up is up to 36 months. DISCUSSION: The DIPLOMA-2 trial aims to establish the safety of MIPD as the new standard of care for this selected patient population undergoing pancreatoduodenectomy in high-volume centers, ultimately aiming for superior patient recovery. TRIAL REGISTRATION: ISRCTN27483786. Registered on August 2, 2023.

Virus de la leucemia e inmunodeficiencia felina: un estudio retrospectivo en clínicas veterinarias particulares en Bogotá y Chía (Colombia), 2015-2019 / Leukemia viruses and feline immunodeficiency: a retrospective study in private veterinary clinics in Bogotá and Chía (Colombia), 2015-2019

Resumen Los virus de inmunodeficiencia y leucemia felina representan un problema de gran envergadura para los felinos domésticos debido a la multiplicidad de sintomatologías que manifiestan. El objetivo del presente estudio fue establecer, retrospectivamente, la prevalencia en la presentación de ViLeF y VIF en pacientes de seis clínicas de pequeños animales en Bogotá y Chía, en relación con factores como su edad, raza y género. Se realizó un estudio transversal y retrospectivo, mediante la recopilación de datos de 1.014 historias clínicas de pacientes felinos que ingresaron a seis clínicas de la ciudad de Bogotá y Chía, para determinar la prevalencia de VIF y ViLeF y la asociación de estas con factores como edad, género y raza, entre 2015 y 2019, a través de la prueba OR. La detección de los virus se realizó mediante una prueba rápida basada en inmunocromatografía. La mayor prevalencia para cada enfermedad por año fue: 12,3% para VIF en 2012 y 18% para ViLeF en 2019. Los machos presentaron mayores seroprevalencias para ambas enfermedades durante la mayoría los años evaluados. Factores como raza (criolla: VIF: 1,85; ViLeF: 2,01), género (macho: VIF: 1,53 OR; ViLeF: 1,64) y edad (> 7 años: VIF: 3,82; ViLeF: 3,21) se relacionaron positivamente con la presentación de ambas enfermedades en la población felina evaluada.

Abstract Immunodeficiency virus and feline leukemia virus represent major problems for domestic felines due to the multiplicity of symptoms they manifest. The objective of the present study was to establish, retrospectively, the prevalence in the presentation of FeLV and FIV in patients from six small animal clinics in Bogota and Chia, related to factors such as age, race, and gender. A cross-sectional and retrospective study was carried out, collecting data from 1.014 clinical records of feline patients who were admitted to six clinics in the city of Bogota and Chia, to determine the prevalence of FIV and FeLV and their association with factors such as age, gender, and race, between 2015 and 2019 through the OR test. The detection of the viruses was carried out through a rapid test based on immunochromatography. The highest prevalence for each disease per year was 12,3% for FIV in 2012 and 18% for FeLV in 2019. Males presented higher seroprevalences for both diseases during most of the years evaluated. Factors such as race (Creole: FIV: 1,85; FeLV: 2,01), gender (male: FIV: 1.53 OR, FeLV: 1,64), and age (> 7 years: FIV: 3.82; FeLV: 3.21) were positively related to the presentation of both diseases in the feline population evaluated.

El buceo recreativo y la otorrinolaringología: ¿qué sabemos y deberíamos saber? / Recreational diving and otolaryngology: what do we know and should we know?

El buceo recreativo es una práctica cada vez más popular en la población mundial, sin embargo, no está exenta de riesgos. A medida que transcurre una inmersión, el buzo es susceptible a una serie de cambios de presión que afectan las distintas cavidades que contienen aire dentro del cuerpo humano, tales como el oído, cavidades paranasales y los pulmones. Existe un gran espectro de patologías asociadas al buceo, explicándose la mayoría de ellas por el barotrauma asociado, cuya gravedad depende de la magnitud del daño asociado, pudiendo presentar desde manifestaciones a nivel local, así como también a nivel sistémico. Las patologías otológicas suelen ser las más frecuentes y el principal motivo de consulta en este tipo de pacientes. Sin embargo, las afecciones otoneurológicas, rinosinusales, de vía aérea y sistémicas pueden ser comunes dependiendo de cada perfil de buceo. Actualmente no existen recomendaciones locales sobre esta práctica, por lo que el conocimiento de la fisiología, fisiopatología y el tratamiento de las patologías otorrinolaringológicas asociadas deben ser conocidas a medida que este deporte se vuelve cada vez más popular. Se realizó una revisión de la literatura sobre las distintas afecciones otorrinolaringológicas con el fin de sistematizarlas y elaborar recomendaciones para establecer una práctica segura.

Recreational diving is an increasingly popular practice in the world; however, it is not without risks. As a dive progresses, the diver is susceptible to a series of pressure changes that affect the air-containing cavities, such as the ear, paranasal cavities, and lungs. There is a large spectrum of pathologies associated with diving, most of them being explained by associated barotrauma, the severity of which depends on the magnitude of the associated damage, could present local manifestations, as well as at systemic level. Otological pathologies are usually the most frequent and the main reason for consultation in this type of patients, however, otoneurological, rhinosinusal, airway and systemic conditions can be common depending on each diving profile. Currently there are no local recommendations on this practice, therefore, knowledge of the physiology, pathophysiology and treatment of associated otorhinolaryngological pathologies should be known as this sport becomes increasingly popular. A review of the literature on the different ear, nose and throat conditions was carried out in order to systematize them and develop recommendations to establish a safe practice.

The challenge of quantifying screening colonoscopy quality: Development and psychometric properties of the Colonoscopy Quality Score instrument.

INTRODUCTION AND AIMS: Colonoscopy quality is measured by the degree in which the examination increases the likelihood of obtaining adequate results on health. Our aim was to develop an instrument for evaluating the quality of screening colonoscopies, taking into account the performance of endoscopists and endoscopy units. MATERIALS AND METHODS: Mixed methodology was employed. The first stage (qualitative) consisted of a Medline search, from which a group of experts developed the quality score items. The second stage (quantitative) utilized a modified Delphi technique to reach consensus (3 rounds). We evaluated the psychometric properties of the instrument (reliability and construct validity) in elective screening colonoscopies (in patients ≥ 50 years of age), performed within the January-April 2017 time frame. RESULTS: A final instrument with 8 items was produced: (1) the Boston Bowel Preparation Scale score; (2) cecal intubation rate; (3) colonoscopy withdrawal time; (4) image documentation; (5) adenoma detection rate; (6) endoscopic surveillance planning; (7) perforation rate, and (8) continuous improvement programs. The instrument was evaluated in 323 colonoscopies performed by 31 endoscopists and found to be one-dimensional and reliable (Cronbach's alpha 0.76). Performance was compared between endoscopists (center 1) and an expert endoscopist from another center (center 2): Boston Bowel Preparation Scale score 8.3 vs. 7.36 (P < .001), cecal intubation rate 93.5 vs. 96%, colonoscopy withdrawal time 14.8 vs. 8.4 min (P < .001), and adenoma detection rate 34 vs. 52.2% (P < .001), respectively. CONCLUSION: The Colonoscopy Quality Score is a reliable and valid instrument for evaluating screening colonoscopy quality. Its results could be adapted to the usual endoscopic report to adjust monitorization frequency post-colonoscopy.

The challenge of quantifying screening colonoscopy quality: Development and psychometric properties of the Colonoscopy Quality Score instrument. / El desafío de cuantificar la calidad de la colonoscopia de tamizaje: el desarrollo y las propiedades psicométricas de la Escala de Calidad en Colonoscopia.

INTRODUCTION AND AIMS: Colonoscopy quality is measured by the degree in which the examination increases the likelihood of obtaining adequate results on health. Our aim was to develop an instrument for evaluating the quality of screening colonoscopies, taking into account the performance of endoscopists and endoscopy units. MATERIALS AND METHODS: Mixed methodology was employed. The first stage (qualitative) consisted of a Medline search, from which a group of experts developed the quality score items. The second stage (quantitative) utilized a modified Delphi technique to reach consensus (3 rounds). We evaluated the psychometric properties of the instrument (reliability and construct validity) in elective screening colonoscopies (in patients≥50 years of age), performed within the January-April 2017 time frame. RESULTS: A final instrument with 8 items was produced: 1) the Boston Bowel Preparation Scale score; 2) cecal intubation rate; 3) colonoscopy withdrawal time; 4) image documentation; 5) adenoma detection rate; 6) endoscopic surveillance planning; 7) perforation rate, and 8) continuous improvement programs. The instrument was evaluated in 323 colonoscopies performed by 31 endoscopists and found to be one-dimensional and reliable (Cronbach's alpha 0.76). Performance was compared between endoscopists (center 1) and an expert endoscopist from another center (center 2): Boston Bowel Preparation Scale score 8.3 vs. 7.36 (P<.001), cecal intubation rate 93.5 vs. 96%, colonoscopy withdrawal time 14.8 vs. 8.4min (P<.001), and adenoma detection rate 34 vs. 52.2% (P<.001), respectively. CONCLUSION: The Colonoscopy Quality Score is a reliable and valid instrument for evaluating screening colonoscopy quality. Its results could be adapted to the usual endoscopic report to adjust monitorization frequency post-colonoscopy.

Resultados auditivos del tratamiento quirúrgico de la otoesclerosis en el departamento de otorrinolaringología de la Pontificia Universidad Católica de Chile / Auditory results of surgical treatment of otosclerosis in the department of otolaryngology of the Pontificia Universidad Católica de Chile

RESUMEN Introducción: La otoesclerosis representa la causa de hipoacusia de conducción más común en adultos jóvenes. Las opciones de tratamiento incluyen amplificación mediante audífonos o resolución quirúrgica a través de cirugías como estapedectomía total o parcial, estapedostomía o implante coclear. Objetivo: Describir los resultados del tratamiento quirúrgico de la otoesclerosis en el Departamento de Otorrinolaringología del Hospital Clínico de la Pontificia Universidad Católica de Chile entre los años 1999 y 2018. Material y método: Se realizó un estudio de cohorte no concurrente con revisión de fichas clínicas y protocolos operatorios de pacientes atendidos en nuestro centro. Se registraron y analizaron las características biodemográficas de los pacientes, técnicas quirúrgicas, resultados auditivos, complicaciones, necesidad de reintervención y uso de audífono. Resultados: De un total de 78 pacientes sometidos a estapedectomía parcial (platinectomía parcial) o estapedostomía se incluyeron finalmente 37 quienes tenían datos clínicos completos, lo que corresponde al 47,4% del total. En ambos tipos de cirugía el promedio de gap óseo-aéreo varió de 30,8 dB en el preoperatorio a 13,9 dB en el posoperatorio lo cual es estadísticamente significativo. El promedio de variación de la vía aérea, éste fue mayor en el grupo de pacientes operados de estapedostomía, sin existir diferencias estadísticamente significativas al realizar test no paramétricos. Conclusión: Las características demográficas y los resultados auditivos obtenidos en nuestro centro son comparables con los descritos en la literatura. No existen diferencias significativas en cuanto al tipo de cirugía y la frecuencia y tipo de complicaciones, aunque se observan mejores resultados auditivos en los pacientes operados de estapedostomía.

ABSTRACT Introduction: Otosclerosis represents the most common cause of hearing loss in young adults. Treatment options include amplification with hearing aids or surgical resolution with surgeries such as total and partial stapedectomy, stapedostomy or cochlear implant. Aim: To describe the results of the surgical treatment of otosclerosis in the Otorhinolaryngology Department of the Clinical Hospital of the Pontificia Universidad Católica de Chile between the years 1999 and 2018 Material and method: A non-concurrent cohort study was performed with review of clinical files and operative protocols of patients seen in our center. The biodemographic characteristics of the patients, surgical techniques, auditory results, complications, need for reoperation and use of hearing aid were recorded and analyzed. Results: Of a total of 78 patients undergoing partial stapedectomy or stapedostomy, 37 were finally included, who had complete clinical data, which corresponds to 47.4% of the total. In both types of surgery, the average bone-air gap varied from 30.8 dB in the preoperative to 13.9 dB in the postoperative period, which is statistically significant. Regarding the average of variation of the airway, this was higher in the group of patients operated by stapedostomy without statistically significant differences when performing nonparametric tests. Conclusion: The demographic characteristics and the auditory results obtained in our center are comparable with those described in the literature. There are no significant differences in the type of surgery and the frequency and type of complications, although better hearing results are observed in patients operated by stapedostomy.

Effects of processing on structural, mechanical and biological properties of collagen-based substrates for regenerative medicine.

The aim of this work was to investigate the structural features of type I collagen isoforms and collagen-based films at atomic and molecular scales, in order to evaluate whether and to what extent different protocols of slurry synthesis may change the protein structure and the final properties of the developed scaffolds. Wide Angle X-ray Scattering data on raw materials demonstrated the preferential orientation of collagen molecules in equine tendon-derived collagens, while randomly oriented molecules were found in bovine skin collagens, together with a lower crystalline degree, analyzed by the assessment of FWHM (Full Width at Half Maximum), and a certain degree of salt contamination. WAXS and FT-IR (Fourier Transform Infrared) analyses on bovine collagen-based films, showed that mechanical homogenization of slurry in acidic solution was the treatment ensuring a high content of super-organization of collagen into triple helices and a high crystalline domain into the material. In vitro tests on rat Schwannoma cells showed that Schwann cell differentiation into myelinating cells was dependent on the specific collagen film being used, and was found to be stimulated in case of homogenization-treated samples. Finally DHT/EDC crosslinking treatment was shown to affect mechanical stiffness of films depending on collagen source and processing conditions.

Development of an E-learning System for the Endoscopic Diagnosis of Early Gastric Cancer: An International Multicenter Randomized Controlled Trial.

BACKGROUND: In many countries, gastric cancer is not diagnosed until an advanced stage. An Internet-based e-learning system to improve the ability of endoscopists to diagnose gastric cancer at an early stage was developed and was evaluated for its effectiveness. METHODS: The study was designed as a randomized controlled trial. After receiving a pre-test, participants were randomly allocated to either an e-learning or non-e-learning group. Only those in the e-learning group gained access to the e-learning system. Two months after the pre-test, both groups received a post-test. The primary endpoint was the difference between the two groups regarding the rate of improvement of their test results. FINDINGS: 515 endoscopists from 35 countries were assessed for eligibility, and 332 were enrolled in the study, with 166 allocated to each group. Of these, 151 participants in the e-learning group and 144 in the non-e-learning group were included in the analysis. The mean improvement rate (standard deviation) in the e-learning and non-e-learning groups was 1·24 (0·26) and 1·00 (0·16), respectively (P<0·001). INTERPRETATION: This global study clearly demonstrated the efficacy of an e-learning system to expand knowledge and provide invaluable experience regarding the endoscopic detection of early gastric cancer (R000012039).

Informed consent in colonoscopy: A comparative analysis of 2 methods.

BACKGROUND: The manner in which informed consent is obtained varies. The aim of this study is to evaluate the level of knowledge about colonoscopy and comparing 2 methods of obtaining informed consent. MATERIALS AND METHODS: A comparative, cross-sectional, observational study was conducted on patients that underwent colonoscopy in a public hospital (Group A) and in a private hospital (Group B). Group A received information verbally from a physician, as well as in the form of printed material, and Group B only received printed material. A telephone survey was carried out one or 2 weeks later. RESULTS: The study included a total of 176 subjects (group A [n=55] and group B [n=121]). As regards education level, 69.88% (n=123) of the patients had completed university education, 23.29% (n= 41) secondary level, 5.68% (n=10) primary level, and the remaining subjects (n=2) had not completed any level of education. All (100%) of the subjects knew the characteristics of the procedure, and 99.43% were aware of its benefits. A total of 97.7% received information about complications, 93.7% named some of them, and 25% (n=44) remembered major complications. All the subjects received, read, and signed the informed consent statement before the study. There were no differences between the groups with respect to knowledge of the characteristics and benefits of the procedure, or the receipt and reading of the consent form. Group B responded better in relation to complications (P=.0027) and group A had a better recollection of the major complications (P<.0001). Group A had a higher number of affirmative answers (P<.0001). CONCLUSIONS: The combination of verbal and written information provides the patient with a more comprehensive level of knowledge about the procedure.

Evidencia y uso actual de toxina botulínica en patología otorrinolaringológica / Evidence and actual use of botulinum toxin in otolaryngology

A partir de los primeros usos terapéuticos de la toxina botulínica su utilización se ha extendido a variadas ramas de la medicina incluyendo la otorrinolaringología. Se considera un medicamento seguro en manos de profesionales capacitados y su utilización se realiza a través de un procedimiento mínimamente invasivo con efectos adversos leves y transitorios. Se usa en un amplio número de patologías otorrinolaringológicas y de cabeza y cuello. Actualmente la toxina botulínica A representa la primera línea de tratamiento en pacientes con disfonía espasmódica y distonía cervical. Existe evidencia de buen nivel que recomienda su uso para el manejo de sialorrea, temblor laríngeo, trastornos de la ATM, bruxismo y rinitis en casos seleccionados. Presenta buenos resultados en otras patologías como espasmo faringoesofágico, síndrome de Frey y tinnitus, sin embargo, todavía son necesarios más estudios.

Since the first therapeutic uses of botulinum toxin its role has extended to a wide range of medicine áreas including otolaryngology. It is considered a safe medication in the hands of trained professionals and its application represents a minimally invasive procedure with mild and transient adverse effects. It has been used in a wide range of otolaryngology and head and neck pathologies. Today botulinum toxin a represents the first choice of treatment for patients with spasmodic dysphonia and cervical dystonia. There is good evidence that supports its use for shialorrea, laryngeal tremor, temporomandibular joint disorders, bruxism and selected cases of rhinitis. For pharyngo-oesophageal spasm, Frey's syndrome and tinnitus there have been studies that show a beneficial effect however more studies are required for routine recommendation.

[Satisfaction with weight and characteristics of eating disorders in high school]. / Satisfacción con el peso y rasgos de trastorno del comportamiento alimentario en secundaria.

INTRODUCTION: The prevalence of diseases related to eating behaviour disorders has increased among adolescents. The objective of this study is to analyse the satisfaction with body weight of schoolchildren as regards their body mass index and the strategies used to control the diet. METHOD: A total of 1197 students from secondary education (12-18 years) answered a questionnaire on eating habits and body weight control. Their weight and height was measured and body mass index was calculated. RESULTS: More than two-thirds (68.1%) of students who had an adequate BMI were satisfied with their weight. Greater dissatisfaction with the weight is associated with overweight (OR=10.23) and obesity (OR=16.60). Students with overweight are on a diet consulting an expert such as a physician or even the family, whereas among schoolchildren with normal weight there is a large percentage on a diet on their own. A 13.87% of the schoolchildren have been undertaken Compensatory activities before excessive eating has been undertaken by 13.87% of the schoolchildren. An overweight BMI is associated, with more than twice the risk (OR>2.00), with the use of measures such as physical activity, vomiting, or fasting to compensate an excessive intake. CONCLUSIONS: Overweight and obese schoolchildren are more likely to be dissatisfied with their body, and are more likely to use ploys such as vomiting, in order to compensate for the excess intake.

An optimized table-top small-angle X-ray scattering set-up for the nanoscale structural analysis of soft matter.

The paper shows how a table top superbright microfocus laboratory X-ray source and an innovative restoring-data algorithm, used in combination, allow to analyze the super molecular structure of soft matter by means of Small Angle X-ray Scattering ex-situ experiments. The proposed theoretical approach is aimed to restore diffraction features from SAXS profiles collected from low scattering biomaterials or soft tissues, and therefore to deal with extremely noisy diffraction SAXS profiles/maps. As biological test cases we inspected: i) residues of exosomes' drops from healthy epithelial colon cell line and colorectal cancer cells; ii) collagen/human elastin artificial scaffolds developed for vascular tissue engineering applications; iii) apoferritin protein in solution. Our results show how this combination can provide morphological/structural nanoscale information to characterize new artificial biomaterials and/or to get insight into the transition between healthy and pathological tissues during the progression of a disease, or to morphologically characterize nanoscale proteins, based on SAXS data collected in a room-sized laboratory.

Relación entre hipoacusia y diabetes mellitus tipo 2 / Relationship between hearing loss and type 2 diabetes mellitus

Introducción: La diabetes mellitus tipo 2 es una enfermedad prevalente en nuestro país. Básicamente en esta, falla la regulación de la glicemia lo que puede provocar diversas complicaciones. Diversos estudios han encontrado que puede causar lesiones a largo plazo en el sistema auditivo pudiendo llegar a causar una hipoacusia de tipo neurosensorial. Objetivo: Conocer si pacientes con diabetes mellitus tipo 2 presentan una hipoacusia sensorio neural mayor de lo esperado. Material y método: Estudio transversal caso control. El grupo comparativo estuvo constituido por 45 pacientes con diabetes mellitus tipo 2 y con 53 pacientes sanos y que constituyen el grupo control. La edad de ambos grupos fluctuó entre 30 a 50 años. Los criterios de exclusión incluyeron a pacientes con trauma acústico, ototóxicos y antecedentes otológicos previos. Además se aplicó una encuesta y un examen otológico para descartar lesiones. A cada paciente se le realizó una audiometría tonal, siempre en las mismas condiciones y por el mismo examinador. Se analizaron en cada oído las frecuencias 128; 256; 512; 1.000; 2.000; 3.000; 4.000; 6.000; 8.000 Hz y el PTPy en intervalos de 5 dB en cada frecuencia. Para el análisis estadístico, se aplicó las pruebas de normalidad de Kolmogorov-Smirnov y Shapiro-Wilk y la prueba no paramétrica de Mann Whitney. Resultados: La media de las edades fue de 40,85 años con desviación estándar 6,33para los controles y 42,62 años con desviación estándar de 5,97 para el grupo de diabéticos. El tiempo de evolución promedio de diabetes fue de 5,03 años. En el análisis de la diferencia en los promedios tonales se observó un deterioro significativo (P <0,05) en el grupo de diabéticos con respecto a los controles en casi todas las frecuencias evaluados y también en el PTP en ambos oídos. La excepción a lo anterior solo se observó en la frecuencia 256 Hz del oído derecho. Conclusiones: Los pacientes con diabetes mellitus tipo 2 de nuestro estudio presentaron una pérdida auditiva tonal estadísticamente significativa al compararlos con el grupo control.

Introduction: Diabetes mellitus is a prevalent disease in Chile, in diabetes glucose dis-regulation can cause organ and system failure. Several studies have found that diabetes can also cause long-term injuries in the auditory system, causing neurosensorial hearing loss. Aim: To associate diabetes mellitus and the potential consequence of hearing loss determined by tonal audiometry. Material and method: Cross-sectional study case-control, with a N = 45 for diabetic patients and N=53 for control subjects, between 30 to 50 years old. We excluded patients with acoustic trauma, ototoxic use or previous otologic history. A questionnaire was applied and otologic examination was done to rule out injuries. Audiometry was performed, analyzing frequencies in each ear 128,256,512,1000,2000,3000,4000, 6000,8000 Hz and PTP. For statistical analysis we applied the nonparametric Mann Whitney test. Results: Mean age was 40.85 years old with standard deviation 6.33 for controls and 42.62years with standard deviation of 5.97 for cases, average duration of diabetes was of 5.03 years. In the analysis of the difference in average pitch there was a higher significant deterioration (P <0.05) in the diabetic group compared to controls in almost all frequency and PTP in both ears, except in the 256 Hz right ear. Conclusions: Patients with diabetes mellitus showed a hearing loss in tonal audiometry compared to individuals without diabetes mellitus.

Síndrome de Lemierre: reporte de un caso / Lemierre syndrome: a case report / Lemierre syndrome: A case report

El síndrome de Lemierre es una complicación muy poco frecuente de una infección orofaríngea, que progresa con tromboflebitis séptica secundaria e infecciones embólicas frecuentes. Presentamos el caso de una mujer de 20 años que inició un cuadro de odinofagia y fiebre, el cual progresó rápidamente a un absceso periamigdalino con trombosis de la vena yugular interna ipsilateral, embolias sépticas pulmonares y meningitis. Se manejó con drenaje del absceso por punción, terapia antibiótica de amplio espectro y anticoagulación respondiendo favorablemente, siendo dada de alta en buenas condiciones luego de 35 días de hospitalización. Con la terapia antimicrobiana, casos como éste son poco frecuentes, incluso a veces olvidados, pero dado su gravedad deben considerarse en cuadros faríngeos de evolución tórpida o ante la aparición de signos neurológicos o sépticos.

Lemierre syndrome is a rare complication of oropharyngeal infection which progresses with secondary septic thrombophlebitis and embolic infections. A 20 years-old woman started with odynophagia and fever, which progressed rapidly to a peritonsillar abscess with thrombosis of the ipsilateral internal jugular vein, septic pulmonary emboli and meningitis. She was managed with abscess drainage puncture, broad-spectrum antibiotic therapy and anticoagulant responding favorably, and was discharged in good condition after 35 days of hospitalization. Since the use of antimicrobial therapy, cases like these are rare, sometimes forgotten, but given its severity should be considered in pharyngeal torpid illness or at the onset of neurological signs or sepsis.

[Nutricional adequacy of students of compulsory secondary education in Badajoz]. / Adecuación nutricional de la ingesta de los estudiantes de secundaria de Badajoz.

OBJECTIVE: To evaluate nutricional adequacy of students of compulsory secondary education (ESO) in Badajoz, Spain. METHODS: We included 1197 students of ESO from 12 to 18 years old, 49.9% male and 50.1% female, which is a representative sample of this population. They filled in a food frequency questionnaire (FFQ) self-administered and previously validated in a pilot study. Nutrients were quantified from FFQ with a food composition table (Novartis, 2004) and nutritional Adequacy Index (AI) was calculated according to Spanish Recommended Dietary Allowances (RDA). Nutritional adequacy of a nutrient was measured by the following relation: mean daily intake of the nutrient / RDA of that nutrient * 100. RESULTS: Average caloric intake of secondary education students is not very high, protein AI is over 200%, and cholesterol over 150%, being appropriate the intake of carbohydrates and lipids. The intake of fiber, vitamin E and iodine was lower than 50% in both genders; the one of iron less than 90% in females and there were no other differences between both genders. Only 1% to 3% of students reach RDA of fiber, iodine and vitamin E, and 37.3% of female reach RDA of iron. Cholesterol dietary intake of 17.2% males and 25.3% females is high, and saturated fatty acids intake is high in 46.1% males and 50.0% females. CONCLUSIONS: Diet of students of secondary education in Badajoz is normocaloric, hyperproteic, appropriate in carbohydrates and lipids, without differences between genders; it is very deficient in fiber, iodine and vitamin E in both genders and deficient in iron in females. We can see their diet is far from Mediterranean diet, and this is why education plans about food intake are advised to the students and their families.

Timpanoplastía: revisión y experiencia de 4 años en el Hospital Clínico de la Universidad Católica de Chile / Tympanoplasty: review and experience of 4 years at the Hospital Clínico de la Universidad Católica de Chile

Introducción: Desde la introducción de esta técnica quirúrgica en la segunda mitad del siglo XIX ha habido múltiples publicaciones sobre diversas experiencias y nuevas técnicas a nivel nacional e internacional. En nuestro hospital esta cirugía es parte de la práctica clínica habitual. Objetivo: El objetivo general es revisar la experiencia en timpanoplastías en el Hospital Clínico de la Universidad Católica de Chile en los últimos 4 años. Los objetivos específicos son revisar la epidemiología de los pacientes intervenidos, las técnicas quirúrgicas utilizadas y los resultados anatómicos y audiológicos conseguidos. Material y método: Estudio retrospectivo y descriptivo. Se revisó la totalidad de las fichas y audiometrías de los pacientes sometidos a timpanoplastías que cumplieron criterios de inclusión y exclusión bien definidos. Se incluyeron sólo pacientes cuya cirugía fue realizada entre enero de 2007 y diciembre de 2010. Resultados: Se obtuvo éxito anatómico en 82,4 por ciento de nuestros pacientes, con una tasa de complicaciones de 17,57 por ciento. Con respecto a los resultados auditivos, se observó un éxito auditivo total de 87,08 por ciento, y sólo en 13 por ciento de los pacientes empeoró su audición. Conclusiones: Los resultados anatómicos y auditivos obtenidos son comparables a lo publicado en la literatura nacional en la última década. Nuestra experiencia muestra un buen rendimiento con las técnicas e injertos utilizados, así como un buen resultado en las cirugías realizadas por médicos residentes, similares a los obtenidos por médicos staff.

Introduction: Since the introduction of this surgical technique in the second half of the nineteenth century, there have been many national and international publications on various experiences and new techniques. In our hospital this surgery is part of the routine clinical practice, so we decided to conduct this study to review our experience over the last 4 years. Aim: The general objective is to review the experience of tympanoplasty in the Hospital Clínico de la Universidad Católica de Chile in the last 4 years. The specific objectives are to review the epidemiology of patients undergoing this surgery, the surgical techniques used and the anatomical and audiological results achieved. Material and method: Descriptive and retrospective study. We reviewed all the clinical records and hearing tests in patients undergoing tympanplasty who met inclusion and exclusion criteria clearly defined. We only included patients whose surgery was performed between January 2007 and December 2010. Results: Anatomical success was archieved in 82.4 percent of our patients, with a complication rate of 17.57 percent. With regard to hearing results, there was a total audiological success of 87.08 percent and only 13 percent of our patients experienced worsening of their audition. Conclusions: The anatomical and audiological results obtained are comparable to those published in the national literature in the last decade. Our experience shows a good performance with the techniques and grafts used, and good results in surgeries performed by residents, similar to those obtained by staffs.

Estimación de riesgos y hábitos de uso de reproductores de música personal en una muestra de población chilena / Personal music player usage habits and risks in a Chilean population sample

Introducción: El uso irresponsable de reproductores de música personal ha sido determinado como una conducta de riesgo en salud, en relación al trauma acústico crónico que inducirían. La proporción de usuarios en niveles de riesgo, así como los factores que se relacionan con una escucha riesgosa no han sido evaluados en nuestro país. Objetivo: Describir características de uso de reproductores de música personal en una muestra chilena de población, estimando niveles de riesgo de trauma acústico e identificando factores de riesgo asociado. Material y método: Se aplicó un cuestionario a pacientes de consulta otorrinolaringológica, estudiantes universitarios y a contactos de redes sociales mediante versión on-line, indagando sobre conductas de uso de reproductores musicales. En base a datos de estudios anteriores se estimó el nivel de presión sonora y la dosis de ruido a la que cada usuario estaría expuesto según sus preferencias de uso. Resultados: De 508 encuestados el 12 por ciento superó la máxima exposición a ruido permitida por la legislación chilena. Los factores que más se correlacionaron con alcanzar niveles de riesgo fueron la intensidad del volumen escogida por el usuario (r =0,76), seguido por el tiempo de uso semanal (r =0,51) y, más débilmente, por el tipo de audífono utilizado (r =0,31). Destaca que ninguno de los encuestados que usan audífonos supraauriculares está en riesgo de desarrollar trauma acústico crónico. Discusión: Se estima que el trauma acústico recreacional sobrepasaría en los próximos años al trauma acústico ocupacional como problema de salud pública. Una proporción importante de usuarios estaría en niveles de riesgo. Los factores encontrados como determinantes de riesgo indican que las estrategias de intervención deben enfocarse hacia la escucha responsable por parte del usuario (escuchar al menor volumen confortable posible) más que en la implementación o selección de determinadas tecnologías.

Introduction: The irresponsible use of personal music players has been identified as an emerging health risk behavior related to the noise induced hearing loss they would produce. Listening habits and risk factors involved have not been assessed in our country. Aim: To assess personal music player usage habits in a Chilean sample, estimating noise-induced hearing loss and to identify risk factors. Material and method: A questionnaire was applied to patients attending ENT consult, university students and social networks contacts through on-line version. Listening habits were explored. Based on data from previous studies, we estimated the sound pressure level and the noise-dose to which each user would be exposed according to their specific listening preferences. Results: Of 508 respondents, 12 percent exceeded the maximum noise exposure allowable by Chilean law. The factors that stronger correlated with risk levels were the intensity chosen by the user by (r =0.76), followed by cumulative weekly listening time (r =0.51) and in a weaker relation, by type of headset used (r =0.31) nevertheless none of supra-auricular hearing devices reached risk levels. Discussion: It's estimated that in the next decade, music and recreational exposure will become the leading noise induced hearing loss source. One of each eight users exceeds maximum recommended levels. Risk factors analysis indicated that intervention strategies must focus on responsible listening by the user, lowering chosen-intensity, rather than selecting a specific type of player or earphone.