Interdisciplinary innovative approach to an aggressive ossifying fibroma case: Integrating 3D surgery and customized reconstruction in maxillofacial and dental care.

Aggressive ossifying fibroma is a benign fibro-osseous disorder characterized by its aggressive behavior, which complicates its management. In this article, we present a case involving the recurrence of this condition in the maxillary region, with orbital and dental involvement, in a patient who had previously undergone surgery and reconstruction with a microvascularized free fibula flap. A multidisciplinary approach involving maxillofacial surgery and dentistry was employed to deliver a customized and entirely satisfactory solution for the patient. The use of 3D surgery was integral to our approach, encompassing pre-surgical digital planning and the transfer of this planning to the operating room via navigation software. Customized surgical cutting guides facilitated precise resection, while a personalized polyether ether ketone (PEEK) prosthesis was utilized for reconstruction of the malar and infraorbital region. Pre-prosthetic computer-aided design/computer-aided manufacturing (CAD/CAM) surgery, along with dental rehabilitation using transepithelial abutments and dental prostheses on a titanium framework, were employed for dental restoration. During the postoperative period, mobility in the reconstructed maxilla was observed due to the loss of support from the initial reconstruction plate. This was addressed by replacing the plate with a custom-made titanium plate, designed to accommodate the location of the transepithelial abutments and prevent disruption of the dental rehabilitation. This case demonstrates the potential of new technologies when applied within the collaborative framework of maxillofacial surgeons and dentists, enabling effective and definitive solutions in complex reconstruction cases. Key words:Aggressive ossifying fibroma; 3D surgery; customized reconstruction; complex dental reconstruction.

Partial-accelerated irradiation with stereotactic radiotherapy at a dose of 30 Gy in 5 fractions in early breast cancer.

PURPOSE: To evaluate feasibility of accelerated partial breast irradiation (APBI) using stereotactic radiotherapy (SBRT) Thirty Gy delivered in 5 fractions for patients with early breast cancer. METHODS: Between January 1st, 2018, and December 31s, 2022, we conducted 117 treatments for patients with early-stage breast cancer. All patients underwent conservative surgery followed by APBI using stereotactic external beam radiotherapy. We analyzed local, regional, distant control, overall survival, toxicity, and cosmetic outcomes. RESULTS: The average age was 62 years. 21.3% ductal and 78.7% invasive carcinomas. Regarding the PTV volume, the median was 198.8 cc (38-794 cc). Treatments were completed in all cases. The median follow-up period was of 21 months (1-62 months). Regarding acute toxicity, no Grade 3-4 toxicities were recorded. One patient experienced Grade 2 neuropathic pain. One patient developed subacute fibrosis and two patients developed telangiectasia as subacute and chronic toxicity. Cosmetic results were "good" or "very good" in 96.3% of cases. None of the patients relapsed at any level (local, regional, or distant) and overall survival during follow.up was 100%. CONCLUSION: APBI with SBRT 30 Gy in 5 fractions in early-stage breast cancer is a feasible technique, very-well tolerated and has excellent oncologic and cosmetic outcome during our follow-up period.

Life cycle assessment of routinely used endoscopic instruments and simple intervention to reduce our environmental impact.

OBJECTIVES: GI endoscopy units represent the third largest producers of medical waste. We aimed to determine endoscopic instrument composition and life cycle assessment (LCA) and to assess a sustainability proposal based on a mark on the instruments that identifies parts can be safely recycled or 'green mark'. DESIGN: Material composition analysis and LCA of forceps, snares and clips from four different manufacturers (A-D) were performed with four different methods. Carbon footprint from production, transportation and end of life of these instruments was calculated. In 30 consecutive procedures, we marked the contact point with the working channel. 5 cm away from that point was considered as green mark. One-week prospective study was conducted with 184 procedures evaluating 143 instruments (75 forceps, 49 snares and 19 haemoclips) to assess the efficacy of this recyclable mark. RESULTS: Composition from different manufacturers varied widely. Most common materials were high global warming potential (GWP) waste (polyethylene, polypropylene and acrylonitrile) and low GWP waste (stainless steel). Significant differences were found for the forceps (0.31-0.47 kg of CO2 equivalent (CO2-eq)) and haemoclips (0.41-0.57 kg CO2-eq) between the manufacturers. Green mark was established 131.26 cm for gastroscope and 195.32 cm for colonoscope. One-week activity produced 67.74 kg CO2-eq. Applying our sustainability intervention, we could reduce up to 27.44% (18.26 kg CO2-eq). This allows the recycling of 61.7% of the instrument total weight (4.69 kg). CONCLUSION: Knowledge of carbon footprint is crucial to select the most sustainable alternatives because there are large variations between brands. A mark to identify recyclable parts could reduce our environmental impact significantly.

Treatment of symptomatic macromastia in a breast unit. Outcomes analysis of breast reduction using BREAST-Q.

INTRODUCTION: The BREAST-Q (breast reduction module) is a specific and validated questionnaire to evaluate breast reduction in the treatment of symptomatic macromastia, offering information on their quality of life and degree of satisfaction. METHODS: Prospective study of a cohort of 34 patients treated by bilateral breast reduction in a breast unit in 2017-2020 surveyed with the Spanish version of BREAST-Q version 2. The statistical study to assess the effect of reduction, changes from the pre to postoperative scores of the domains were performed using the Wilcoxon signed rank test. Statistical significance was determined with p values ​​<0.05. RESULTS: The mean time elapsed from surgery to the postoperative survey was 16 (SD 9) months. Post-surgical complications or sequelae occurred in 14 (42%) patients with 23 events. The preoperative scores, median and interquartile range, in satisfaction with the breasts (28, 26), psychological (33, 14), physical (42, 19) and sexual (34, 14) well-being improved in the postoperative survey to (82, 15), (81.29), (82, 30) and (90, 38), respectively. These changes were statistically significant, p < 0.001. CONCLUSIONS: The first application of the BREAST-Q in its version in Spanish for Spanish women in patients with symptomatic macromastia treated surgically in a breast unit shows that breast reduction improves the quality of life of patients and that they are very satisfied with the outcome of the surgery and its surgeon, although the information received should clearly be improved.

Mandibular Torus as a New Index of Success for Mandibular Advancement Devices.

BACKGROUND: In obstructive sleep apnoea (OSA), treatment with mandibular advancement devices (MADs) reduces patients' Apnoea-Hypopnoea index (AHI) scores and improves their sleepiness and quality of life. MADs are non-invasive alternatives for patients who cannot tolerate traditional continuous positive airway pressure (CPAP) therapy. The variability of responses to these devices makes it necessary to search for predictors of success. The aim of our study was to evaluate the presence of mandibular torus as a predictor of MAD efficacy in OSA and to identify other potential cephalometric factors that could influence the response to treatment. METHODS: This was a retrospective cohort study. The study included 103 patients diagnosed of OSA who met the criteria for initiation of treatment with MAD. Structural variables were collected (cephalometric and the presence or absence of mandibular torus). Statistical analysis was performed to evaluate the existence of predictive factors for the efficacy of MADs. RESULTS: A total of 103 patients who were consecutively referred for treatment with MAD were included (89.3% men); the mean age of the participants was 46.3 years, and the mean AHI before MAD was 31.4 (SD 16.2) and post- MAD 11.3 (SD 9.2). Thirty-three percent of patients had mandibular torus. Torus was associated with a better response (odds ratio (OR) = 2.854 (p = 0.035)) after adjustment for sex, age, body mass index (BMI; kg/m2), the angle formed by the occlusal plane to the sella-nasion plane (OCC plane to SN), overinjection, and smoking. No cephalometric predictors of efficacy were found that were predictive of MAD treatment success. CONCLUSIONS: The presence of a mandibular torus practically triples the probability of MAD success. This is the simplest examination with the greatest benefits in terms of the efficacy of MAD treatment for OSA.

Intestinal parasitosis in children from a rural Caribbean area in Colombia / Parasitosis intestinal en niños de una zona rural del Caribe de Colombia

Abstract In Colombia, the prevalence of intestinal parasitosis varies throughout its regions, social classes, and living conditions. We performed a cohort study (2017-2018) on children from 1-10 years old in El Cedro, Ayapel, Colombia. We tested a convenience sampling of those who accepted and signed the consent form. The National Intestinal Parasite Survey was applied; feces and water source sampling were tested for coprological and microbiology analysis, respectively. Education and pharmacologic treatment to the minor and co-inhabitants were performed. After the recruiting, we followed up at 7 and 12 months. Statistical analysis was performed using IBM® SPSS22. Participants 47, 61,7% male, average age 5,7 years. The caretakers had a low educational background. The monthly income of 72,3% of households was < USD 87. The coprological test showed 61,7% with at least one type of parasite; 32,2% with two or more. Trichuris trichiura was the most frequent. Water sources were positive for Escherichia coli. The population tested showed a high frequency of parasitic infection. We did not find a reduction of intestinal parasitosis with educa tion and pharmacologic treatment at the end of the follow-up. It must be necessary to impact social determinants of public health to achieve intestinal parasitosis control.

Resumen En Colombia, la prevalencia de parasitosis intestinal varía por regiones, clases sociales, condiciones de vida. Realizamos estudio de cohorte (2017-2018) en niños de 1-10 años en El Cedro, Ayapel, Colombia. Muestra por conveniencia, se incluyeron aquellos que aceptaron y firmaron el consentimiento. Se aplicó la Encuesta Nacional de Parásitos Intestinales; se analizaron muestras de heces y fuentes de agua para análisis coprológico y microbiológico, respectivamente. Se realizó educación y tratamiento farmacológico al menor y cohabitantes. Después del reclutamiento, seguimiento a los 7 y 12 meses. El análisis estadístico se realizó con IBM® SPSS22. Participantes 47, 61,7% hombres, promedio de edad 5,7 años. Cuidadores con bajo nivel educativo, ingreso mensual del 72,3% de los hogares fue <USD 87. La población analizada mostró una alta frecuencia de infección parasitaria, un 61,7% con al menos un tipo de parásito; 32,2% con dos o más. Trichuris trichiura fue el más frecuente. Las fuentes de agua fueron positivas para Escherichia coli. Al final del seguimiento, no se redujo la frecuencia de la parasitosis intestinal a pesar de educación y tratamiento farmacológico. Se requiere incidir en los determinantes sociales y de salud pública para lograr el control de las parasitosis intestinales.

From Dresden to the world: images of the German Hygiene Museum's relations with Latin America, 1911-1933 / De Dresden para o mundo: imagens das relações do Museu Alemão de Higiene com a América Latina, 1911-1933

Abstract As of the nineteenth century, the number of world fairs and hygiene exhibitions grew significantly. This phenomenon was linked to the experience of modernity and the emergence of bacteriology, when different cities were sanitized with the aim of combating urban diseases and epidemics. For the purpose of sanitary education and hygiene propaganda, many objects and pictures were displayed in hygiene exhibitions and museums, such as the International Hygiene Exhibition of 1911 and the German Hygiene Museum, both in Dresden. The goal of this article is to analyze a chapter of the international history of health through images that portray the connections between the German Hygiene Museum and Latin American countries between 1911 and 1933.

Resumo A partir do século XIX, o número de exposições universais e de exposições de higiene cresceu significativamente. Esse fenômeno estava ligado à experiência da modernidade e ao surgimento da bacteriologia, quando diferentes cidades foram higienizadas com o objetivo de combater doenças e epidemias urbanas. Visando à educação sanitária e à propaganda da higiene, inúmeros objetos e imagens foram exibidos em exposições e museus de higiene, como na Exposição Internacional de Higiene de 1911 e no Museu Alemão de Higiene, ambos em Dresden. O objetivo deste artigo é analisar um capítulo da história internacional da saúde por meio de imagens que retratam as conexões entre o Museu Alemão de Higiene e os países latino-americanos de 1911 a 1933.

Risky Behaviours of Spanish University Students: Association with Mediterranean Diet, Sexual Attitude and Chronotype.

The most common drugs that are consumed by young people are alcohol and tobacco, which are especially prevalent in universities. These risk behaviours can be determined by a series of intrinsic and extrinsic factors. The aim of this study was to evaluate the consumption of alcohol and tobacco by Spanish university students and the relationship between the Mediterranean diet, sexual attitudes and opinions, and chronotype. A multicentre observational study enrolled 457 students from two public universities in Spain. The study period was from December 2017 to January 2018. The majority of the participants consumed alcohol (90.2%), tobacco consumption was low (27.2%), with a high percentage of students (78.6%) having a low dependence on nicotine. The surveyed students demonstrated a high adherence to the Mediterranean diet, which was shown to be associated with less risky alcohol consumption. The Mediterranean diet is a part of healthy lifestyle, and avoiding heavy drinking results in the intention to maintain such a lifestyle. In addition, unhealthy eating habits (skipping breakfast, eating sweets and pastries daily, and fast-food consumption) had a tendency to induce risky alcohol consumption. Therefore, to promote healthy lifestyle habits, it is considered important to establish programs that promote healthy diets in university settings and to evaluate them periodically.

[Prevalence of anogenital condylomas in patients with HIV infection in a center for sexually transmitted infections in Leon, Guanajuato, Mexico]. / Prevalencia de condilomas ano-genitales en pacientes con infección por VIH en un centro para infecciones de transmisión sexual en León, Guanajuato, México.

BACKGROUND: Condylomas are the most frequent sexually transmitted infection worldwide, and thus, have a close relation to HIV infection. The site and serology vary, and some pose higher risk of malignancy. AIM: To describe the prevalence, characteristics and associated factors to the presence of anogenital condylomas in patients with HIV/AIDS. METHODS: Descriptive cross-sectional study conducted in the period from June to December 2014. Adult HIV/AIDS positive patients from "CAPASITS" in Leon, Mexico, from both sexes were included. A questionnaire was performed that included: identification data, and risk factors related to anogenital condylomas. Anogenital area was examined for condylomas. Descriptive statistics were carried out according to the type and distribution of the variables, and the CD4 lymphocyte medians of patients with and without condylomas were compared using U- Mann-Whitney test. RESULTS: A total of 213 HIV/AIDS patients were included; 181 (85%) were male. The prevalence of anogenital condylomas was 30% (IC95%: 23-36%), predominating in the anal region, observed in 21% of the cases. A significant difference was found between median CD4 cell count of patients with and without condylomas (425 vs 510 CD4/mL, p= 0.034). CONCLUSION: A high prevalence of patients with anogenital condylomas was obtained. The presence of condylomas was higher in patients with lower CD4 count. Considering the high prevalence, the application of the vaccine is recommended in this patient group.

Revisión, diseño y construcción de un instrumento de medición para evaluar las competencias laborales del personal farmacéutico ambulatorio / Review, design, and construction of a measuring instrument to assess the labor competencies of outpatient pharmacy staff

Resumen Introducción: La medición y evaluación de las competencias laborales, en el personal farmacéutico ambulatorio, debe combinar aspectos relacionados con los conocimientos (que sabe), habilidades (como lo hace) y actitudes (de que modo lo hace). Objetivo: Identificar y seleccionar las directrices y recomendaciones sobre las competencias laborales que requiere el personal farmacéutico ambulatorio, y construir un instrumento para su medición. Métodos: Se realizó una revisión estructurada en dos fases: a) se revisaron y seleccionaron las funciones/dominios, los criterios de desempeño (habilidades y actitudes), los conocimientos, los marcos de competencias establecidas a nivel internacional, y los instrumentos de medición reportados en la literatura; y b) se identificaron las competencias laborales necesarias de acuerdo con la normatividad colombiana y con los procesos de los Establecimientos Farmacéuticos ambulatorios (droguerías y farmacias-droguerías). Finalmente, se construyó el instrumento de medición por un panel de expertos. Resultados: Se identificaron las competencias laborales establecidas por las organizaciones de regulación internacional. Se revisaron 993 artículos que reportaban la medición y evaluación de las competencias, seleccionándose y analizándose 9 referencias. Se analizaron los marcos de competencias de diferentes países. Se analizaron las regulaciones en Colombia sobre el tema. El instrumento construido contiene 101 competencias distribuidas en los siguientes componentes: a) suministro de cuidados al paciente; b) personales; c) solución de problemas; y d) gestión y organización. Conclusión: Directrices y recomendaciones internacionales, además, la normatividad colombiana para identificar las competencias laborales que requiere el personal farmacéutico para el correcto funcionamiento de los Establecimientos Farmacéuticos ambulatorios, y partir de esto, se construye un instrumento de medición para evaluarlas.

Abstract Introduction: The measurement and evaluation of labor competencies, in outpatient pharmacy staff, must combine aspects related to knowledge (who knows), skills (as it does) and attitudes (in what way it does). Objective: Identify and select the guidelines and recommendations on labor competencies required by outpatient pharmacy staff and build an instrument for their measurement. Methodology: A structured review was carried out in two phases: a) the functions/ domains, performance criteria (skills and attitudes), knowledge, competency frameworks established internationally, and measurement instruments reported were reviewed and selected in the literature; and b) the necessary labor competencies were identified in accordance with Colombian regulations and with the processes of the outpatient Pharmaceutical Establishments (drugstores and pharmacies-drugstores). Finally, the measuring instrument was built by a panel of experts. Results: Labor competencies established by international regulation organizations. were identified. A total of 993 articles were reviewed that reported the measurement and evaluation of competencies, selecting and analyzing 9 references. Competency frameworks from different countries were analyzed. The regulations in Colombia on the subject were analyzed. The constructed instrument contains 101 competencies distributed in the following components: a) provision of patient care; b) personal; c) troubleshooting; and d) management and organization. Conclusion: The international guidelines and recommendations were reviewed and analyzed, in addition, the Colombian regulations to identify the labor competencies required by the pharmacy staff for the correct functioning of the outpatient Pharmaceutical Establishments, and from this, an instrument was built of measurement to evaluate them.

Google Trends on Obesity, Smoking and Alcoholism: Global and Country-Specific Interest.

Unhealthy habits or lifestyles, such as obesity, smoking, and alcohol consumption, are involved in the development of non-communicable diseases. The aim of this study was to analyze different communities' interest in seeking obesity, smoking, and alcohol-related terms through relative search volumes (RSVs) of Google Trends (GT). Internet search query data on obesity, smoking, and alcohol-related terms were obtained from GT from the period between 2010 and 2020. Comparisons and correlations between different topics were calculated considering both global searches and English-, Spanish-, and Italian-speaking areas. Globally, the RSVs for obesity and alcohol-related terms were similar (mean RSVs: 76% and 77%), but they were lower for smoking (65%). High RSVs were found in winter for obesity and smoking-related terms. Worldwide, a negative correlation was found between alcohol and smoking terms (r = -0.72, p < 0.01). In Italy, the correlation was positive (r = 0.58). The correlation between obesity and alcohol was positive in all the cases considered. The interest of global citizens in obesity, smoking, and alcohol was high. The RSVs for obesity were globally higher and correlated with alcohol. Alcohol and smoking terms were related depending on the area considered.

Prevalencia de condilomas ano-genitales en pacientes con infección por VIH en un centro para infecciones de transmisión sexual en León, Guanajuato, México / Prevalence of anogenital condylomas in patients with HIV infection in a center for sexually transmitted infections in Leon, Guanajuato, Mexico

INTRODUCCIÓN: Los condilomas son la infección de transmisión sexual más frecuente en el mundo y tiene estrecha relación con la infección por VIH. La topografía y la serología son variables, y algunos presentan mayor riesgo de malignización. OBJETIVO: Describir la prevalencia, características clínicas, topográficas y factores asociados a la presencia de condilomas ano-genitales en pacientes con infección por VIH/SIDA en Guanajuato. MATERIAL Y MÉTODOS: Estudio descriptivo y transversal realizado entre junio y diciembre de 2014. Se incluyeron pacientes adultos con infección por VIH/SIDA, de ambos sexos, del CAPASITS León, México. Se aplicó un cuestionario que incluyó: datos de identificación, y factores de riesgo relacionados a los condilomas ano-genitales, y se les revisó dicha región corporal en busca de condilomas. Se realizó estadística descriptiva de acuerdo al tipo y distribución de las variables y se compararon las medianas de linfocitos T CD4 (LTCD4+) de los pacientes, con y sin condilomas, con la prueba U- Mann-Whitney. RESULTADOS: Se incluyeron 213 pacientes con infección por VIH/SIDA, 181 (85%) hombres. La prevalencia de condilomas ano-genitales fue de 30% (IC95%:23-36%), con mayor frecuencia en la región anal, con 21% de los casos. Encontramos una diferencia significativa entre las medianas en el recuento de linfocitos LTCD4+ en los pacientes, con y sin condilomas, (425 vs 510 LTCD4+/mL, p = 0,034). CONCLUSIONES: Se obtuvo una prevalencia alta de pacientes con condilomas ano-genitales. La presencia de condilomas fue mayor en pacientes con menor recuento de linfocitos LTCD4+. Considerando la elevada prevalencia, se recomienda la aplicación de la vacuna en este grupo de pacientes.

BACKGROUND: Condylomas are the most frequent sexually transmitted infection worldwide, and thus, have a close relation to HIV infection. The site and serology vary, and some pose higher risk of malignancy. AIM: To describe the prevalence, characteristics and associated factors to the presence of anogenital condylomas in patients with HIV/AIDS. METHODS: Descriptive cross-sectional study conducted in the period from June to December 2014. Adult HIV/AIDS positive patients from "CAPASITS" in Leon, Mexico, from both sexes were included. A questionnaire was performed that included: identification data, and risk factors related to anogenital condylomas. Anogenital area was examined for condylomas. Descriptive statistics were carried out according to the type and distribution of the variables, and the CD4 lymphocyte medians of patients with and without condylomas were compared using U- Mann-Whitney test. RESULTS: A total of 213 HIV/AIDS patients were included; 181 (85%) were male. The prevalence of anogenital condylomas was 30% (IC95%: 23-36%), predominating in the anal region, observed in 21% of the cases. A significant difference was found between median CD4 cell count of patients with and without condylomas (425 vs 510 CD4/mL, p= 0.034). CONCLUSION: A high prevalence of patients with anogenital condylomas was obtained. The presence of condylomas was higher in patients with lower CD4 count. Considering the high prevalence, the application of the vaccine is recommended in this patient group.

Morbimortalidad asociada a la disfagia en pacientes ingresados en un hospital general universitario

RESUMEN Introducción: La disfagia tiene una morbimortalidad importante en pacientes hospitalizados. Objetivos: principal; describir las características de los pacientes con disfagia hospitalizados y, secundarios; cuantificar y analizar la prevalencia de mortalidad y de reingresos. Metodología: Estudio transversal descriptivo de las hospitalizaciones por disfagia durante el año 2015 en un Hospital General Universitario. Resultados: Se evaluaron 431 historias clínicas. La edad de los pacientes fue de 83,21 (DE 11,4) años, el 52,5% fueron mujeres y el 47,2% varones; la estancia media fue de 11,1 (DE 7,99) días. En el 71,2 % de los casos la disfagia fue por afectación de la fase orofaríngea. En el 80,51% de los casos se diagnosticaron complicaciones respiratorias: 48,12% neumonía aspirativa por líquidos, 40,05 % neumonitis química por aspiración y 11,81% neumonía aspirativa por sólidos. La mortalidad general asociada a las complicaciones respiratorias respecto del total de los casos de disfagia fue del 24,49%. El 50,48% de los pacientes con neumonía aspirativa fallecieron. La principal causa de la disfagia fue las enfermedades neurológicas (un 77,25%). La mortalidad fue significativamente mayor en las mujeres - 42,3% frente al 7,8% - (p < 0,01) y esta diferencia se mantuvo tras ajustar el resultado por edad: OR 9,937, IC95%: 5,446; 18,131. El 13,10% de los pacientes reingresaron al menos en una ocasión. Los pacientes de geriatría presentaron un mayor número de reingresos por número de ingresos. Discusión: las enfermedades neurológicas fueron la principal causa de disfagia. La mortalidad fue significativamente mayor en las mujeres.

ABSTRACT Introduction: Dysphagia is an important associated morbidity and mortality in hospitalized patient. Objectives: Main; to describe the characteristics of patients admitted for dysphagia and secondary; quantify and analyze the prevalence of mortality and readmissions. Methodology: Cross-sectional study descriptive revenues by dysphagia during the year 2015 in a University General Hospital. Results: 431 records were evaluated. The age of the patients was 83,21 (11.4), 52.5% women and 47.2% male; the average stay was 11.1 (7.99) days. In 71,2% of cases the dysphagia was involvement of the oropharyngeal phase. 80.51% of cases were diagnosed respiratory complications. The percentage distribution of these complications were: in 48.12% aspiration pneumonia due to fluids, in 40.05% chemical aspiration pneumonitis and in 11.81% aspiration pneumonia due to solids. The overall mortality associated with respiratory complications compared to the total of cases of dysphagia was 24.49%. 50.48% of patients diagnosed with aspiration pneumonia died. The main cause of dysphagia was neurological diseases (77.25%). Mortality was significantly higher in women - 42.3% of women compared with 7.8% of males - (p < 0.01) and this difference remained after adjusting the result by age: OR 9,937, 95% CI: 5,446; 18,131. 13.10% of patients re-entered at least on one occasion. Patients of geriatric unit that presented in greater number of readmissions by admissions. Discussion: neurological diseases were the main cause of dysphagia. Mortality was significantly higher in women

Role of cone-beam computed tomography (CBCT) in diagnosis and treatment planning of two-rooted maxillary lateral incisor with palatogingival groove. Case report.

BACKGROUND: The embryonic root groove is an anatomical abnormality that starts in the cingulum and extends longitudinally down the long axis root towards the apex. This developmental anomaly is more frequently reported in maxillary lateral incisors. Gu YC in 2011 established three types of radicular grooves depending on its severity. According to this classification, type III presents a greater diagnostic and therapeutic complexity. The prevalence of palatogingival grooves in maxillary lateral incisors ranges from 1.9 to 14%. This case report provides valuable information about the diagnosis and treatment plan of palatogingival grooves with Cone-beam computed tomography (CBCT) scan. CASE REPORT: The patient was referred to the University Dental Clinic of European University of Valencia, with recurrent abscesses at the upper right lateral incisor region for the last two years. Palpation and percussion tests were positive for tooth 1.2. There was no clinical history of caries or previous trauma. Periapical radiography showed periapical radiolucent lesions located, not only in the apical area of tooth 1.2, but also in tooth 1.3. Both teeth had previously been endodontically treated. Periodontal probing showed normal values. CBCT scan was perfomed in order to establish a definitive diagnosis and appropriate treatment plan. DISCUSSION: The complex anatomy of the palatal root groove requires detailed knowledge of the internal root morphology for endodontic treatment success. This complementary tool allows a more accurate image of hard tissue structures, such as palatal grooves and/or accessory roots, in comparison to conventional periapical radiography. The treatment plan of this primary periodontal lesion with secondary endodontic involvement was as follows: periapical surgery combined with root amputation and sealing with MTA, and guided bone regeneration. Key words:Palatal radicular groove, palatogingival groove, maxillary lateral incisor, cone-beam computed tomography, endodontic-periodontal lesion, guided bone regeneration.

Errores de medicación en pacientes pediátricos en un hospital universitario en Medellín Colombia, un estudio de corte transversal / Medication errors in pediatric patients in an academic hospital in Medellin Colombia. A cross-sectional study

Resumen Introducción: Una tercera parte de los Errores en la atención en salud se ha relacionado a Errores de medicación; con una incidencia 3 veces mayor en pediatría con respecto a los pacientes adultos. Una estrategia recomendada para mejorar la gestión describe adoptar un sistema de notificación que permita la detección, identificación de causas e implementación de acciones enfocadas a la prevención. Objetivo: Determinar la prevalencia y caracterizar los errores de medicación en el servicio de pediatría reportados en el Sistema de notificación y gestión de riesgo clínico de un hospital universitario entre el 2017 y 2018. Metodología: Estudio de corte transversal. Se cuantificó la proporción de errores de medicación en el servicio de pediatría a partir de un informe del Sistema de notificación de riesgo clínico entre el año 2017 y 2018. Los errores de medicación se clasificaron por proceso de ocurrencia, tipo de error, subgrupo y gravedad. Para el análisis se utilizó estadística descriptiva. Resultados: Se generaron 669 reportes de eventos adversos, 376 (56,20%) estaban relacionados con medicamentos. La tasa calculada de errores fue 7,71 por cada 1000 paciente-días. La mayoría de los errores de medicación se clasificaron como Error sin daño (categoría B y C), 176 ambas subcategorías (352 total) para un 93,62% del total de errores. El proceso de prescripción reportó la mayoría de los errores 59,84%. Conclusiones: La mayoría de los errores de medicación reportados se relacionaron con la prescripción, clasificándose principalmente como errores sin daño. MÉD.UIS.2020;33(2):33-40.

Abstract Introduction: A third of medical errors has been related to medication errors. In the pediatric population, an incidence of medication errors 3 times higher compared to adults has been described. A recommended strategy to improve medication errors risk management describes the adoption of a notification system that allows detection, identification of causes and the implementation of activities focused on prevention. Objective: To determine the prevalence and to characterize medication errors in the pediatric service reported in the clinical risk management and notification system of an academic hospital in 2017 and 2018. Methodology: Cross-sectional study. The proportion of medication errors in the pediatric department was quantified from a report of the Clinical Risk notification System for 2017 and 2018. Medication errors were grouped according to process, type of error, subgroup and gravity. Descriptive statistics were used for the analysis. Outcomes: 669 reports of adverse events were generated in the pediatric service, 376 (56,20%) were related to medications. The error rate was 7,71 per-1000 patient days. Most of the errors were classified as Error without damage (category B and C), 176 both subcategories (total 352), representing 93,62 % of the total of errors. The prescription process was the one that most reported errors 59,84%. Conclusions: Most of the reported medication errors were related to the prescription. The main were classified in the errors without damage category. MÉD.UIS.2020;33(2):33-40.

Combustibles, comportamiento del fuego y emisiones en un pastizal y una sabana artificiales en Chiapas, México / Forest fuels, fire behavior and emissions in artificial grasslands and savannas in Chiapas, Mexico

Introducción: Se utilizan quemas como parte del manejo de pastos introducidos en Chiapas, lo cual puede derivar en incendios forestales. Objetivos: obtener la carga de combustibles, comportamiento del fuego, emisiones de CO2 y derivar aspectos de seguridad durante el combate de incendios en pastizales y sabanas artificiales de pasto jaragua (Hyparrhenia rufa Nees.), debido a la falta de información sobre estos temas. Métodos: Se estudiaron un pastizal y una sabana, ambos de pasto jaragua, en las comunidades California y Flores Magón, respectivamente, en la Reserva de la Biosfera La Sepultura. Se midieron cargas de combustibles previos y posteriores a las quemas. Se condujeron seis quemas prescritas (tres a favor de viento y pendiente y tres en contra), en cada uno de los dos tipos de vegetación analizados, y se midieron variables meteorológicas, así como variables de comportamiento del fuego. Las emisiones se estimaron multiplicando la carga de combustibles consumida por una constante de emisión. Resultados: En el pastizal las medias fueron: carga inicial, 6.214 t/ha; carga residual, 0.107 t/ha, emisión de CO2, 10.449 t/ha. Para la sabana, los valores alcanzaron: 14.119, 2.161 y 20.460 t/ha, respectivamente, sin diferencias para las cargas previas y posteriores a la quema entre las quemas. Para el pastizal, las quemas a favor alcanzaron: 3.92 m, 1.83 m y 22.3 m/min para longitud y profundidad de llama y velocidad de propagación, mientras que tales valores para las quemas en contra, fueron: 1.07 m, 0.23 m y 0.67 m/min, con diferencias entre tipos de quema. Para la sabana, las quemas a favor alcanzaron 5.89 m (longitud de llama), 1.53 m (profundidad de llama) y 45.5 m/min (velocidad de propagación), mientras que para las quemas en contra tales valores fueron: 2.21 m, 0.76 m y 2.8 m/min, respectivamente. En todos los casos se reportan diferencias significativas. Conclusiones: El comportamiento del fuego, en particular en la sabana estudiada, es peligroso, por lo cual una buena prescripción y mucha precaución deben preverse durante quemas controladas o prescritas. Asimismo, un combate directo por el frente del fuego puede resultar muy peligroso, por lo cual debe evitarse y mejor combatir por la cola del incendio y esperar a que el frente avance en contra del viento y pendiente para combatirlo.

Introduction: Burns are part of the management of introduced grasses in Chiapas, Mexico, and this may derive in forest fires. Objectives: To determine fuel load, fire behavior, CO2 emissions, and to get fire-fighting security issues for jaragua (Hyparrhenia rufa Nees.) grasslands and savannas. Methods: An artificial jaragua grassland and an artificial jaragua savanna were studied at the California and Flores Magón communities, respectively, in La Sepultura Biosphere Reserve. Were measured pre and post-fire fuel loads. Six prescribed burns (three heading and three backing fires) were conducted in each, grassland and savanna, and were measured meteorological as well as fire behavior variables. Emissions were estimated multiplying the consumed fuel load by an emission constant. Results: In the grassland, were obtained the following averages: fuel load, 6.214 t/ha; residual load, 0.107 t/ha, and CO2 emission, 10.449 t CO2/ha. For the savanna, were recorded 14.119, 2.161 and 20.460 t CO2/ha, respectively, without differences for the pre and post-fire fuel loads between heading and backing fires. For the grassland, the heading fires reached 3.92 m, 1.83 m and 22.3 m/min for flame length, flame depth and fire propagation rate, while for backing fires such values were, respectively: 1.07, 0.23 and 0.67 m/min, with significant differences. For the savanna, heading fires yielded 5.89 m (flame length), 1.53 m (flame depth) and 45.5 m/min (propagation rate), while for backing fires that values were 2.21, 0.76 and 2.8 m/min, also with significant differences. Conclusions: Under the studied environmental conditions, particularly in the savanna, fire behavior is dangerous so a good prescription and more care must be taken for conducting controlled or prescribed burns. For forest fires, direct firefighting by the head of the fire must be avoided, for is too dangerous; instead it is recommended a firefighting by the back of the fire as well as waiting for a backing fire-advance of it after the fire reaches a ridge.

Influence of tobacco, alcohol consumption, eating habits and physical activity in nursing students.

OBJECTIVE: to determine the consumption of alcohol, tobacco, eating habits, and physical activity among nursing students and to detect whether being a nursing student is a protective factor against these habits. METHOD: a questionnaire was used to collect information on age, academic year, sex, alcohol and tobacco consumption, physical activity, and healthy eating. An information sheet and informed consent form were given. The sample was composed of 264 students aged between 18-30 years from four academic years. RESULTS: of the total sample, 15.5% smoked, 83.7% consumed alcoholic beverages and 97.2% consumed over the weekend. The total of 68.6% did not practice exercises and 70.5% needed changes in their diet. CONCLUSION: nursing students have high levels of alcohol consumption and low levels of smoking compared with other studies. The higher the academic year, the lower the age of onset of tobacco consumption. The number of men who exercised was higher, which is considered a protective factor against alcohol and tobacco consumption and is related to a healthy diet. Smoking has a negative influence on diet. The students needed to change their diet. Finally, being a nursing student is not considered a protective factor against alcohol and tobacco consumption, nor having good eating habits and exercising.