Smoke signals: monitoring illicit cigarettes and smoking behaviour in Colombia to support tobacco taxes.

BACKGROUND: A street cross-sectional survey in 2016 with a representative sample of 1697 smokers in five Colombian cities was used to estimate the penetration of illicit cigarettes (PIC). The first wave was collected 3 months before a 100% increase in tobacco excise tax, and a second wave collected data 9 months after tax reform was effective. OBJECTIVE : Analyse changes after a cigarette tax increase in PIC, prices and smoking behaviour patterns for five Colombian cities (63% of the market). Smoking behaviour includes consumption intensity, presentation (stick/pack) and place of purchase. METHODS : Repeated street cross-sectional survey with smokers' self-report on smoking behaviour, last purchase information and direct observation of smokers' packs. Sampling frame: smokers, men and women, aged 12 years or older, all income levels, resident in the five cities with the highest number of smokers representing 63% of cigarette market share (Bogotá, Medellín, Cali, Cartagena and Cúcuta) with 1 733 316 smokers in 2013. Sample size was 1697 per wave, with confidence level 95%, margin of error 3.5% for Bogotá and Medellín and 5% for the other three cities. Smokers in second wave match first wave's location, sex and age group. Illicit cigarettes were identified based on brand, health warnings and price. RESULTS : After the tax hike, the average real price of a 20-stick pack increased by 28.2% and by 23.1% for loose cigarettes. Illicit cigarettes represented 3.4% of total cigarette consumption in 2016 and increased to 6.4% in 2017, lower than the current industry estimate of 18%. Consumption intensity decreased: the proportion of heavy smokers (more than 10 cigarettes per day) wentdown from 37% in 2016 to 26% in 2017. CONCLUSION: After the tax increase, Colombia's PIC remained at low levels, and there is enough space for new tobacco tax hikes.

Timing of seed dispersal and seed dormancy in Brazilian savanna: two solutions to face seasonality.

Background and Aims: The relationship between fruiting phenology and seed dispersal syndrome is widely recognized; however, the interaction of dormancy classes and plant life-history traits in relation to fruiting phenology and seed dispersal is understudied. Here we examined the relationship between fruiting season and seed dormancy and how this relationship is modulated by dormancy classes, dispersal syndromes, seed mass and seed moisture content in a Brazilian savanna (cerrado). Methods: Dormancy classes (non-dormancy and physical, morphological, morphophysiological, physiological and physiophysical dormancy) of 34 cerrado species were experimentally determined. Their seed dispersal syndrome (autochory, anemochory, zoochory), dispersal season (rainy, dry, rainy-to-dry and dry-to-rainy transitions), seed mass and moisture contents, and the estimated germination date were also determined. Log-linear models were used to evaluate how dormancy and dormancy classes are related to dispersal season and syndrome. Key Results: The proportions of dormant and non-dormant species were similar in cerrado. The community-estimated germination date was seasonal, occurring at the onset of rainy season. Overall, anemochorous non-dormant species released seeds during the dry-to-rainy transition; autochorous physically dormant species dispersed seeds during the dry season and rainy-to-dry transition; zoochorous species dispersed non-dormant seeds during the dry and rainy seasons, while species with morphological, morphophysiological or physiological dormancy dispersed seeds in the transitional seasons. Seed mass differed among dispersal seasons and dormancy classes, but seed moisture content did not vary with dispersal syndrome, season or dormancy class. Conclusions: The beginning of the rainy season was the most favourable period for seed germination in cerrado, and the germination phenology was controlled by both the timing of seed dispersal and seed dormancy. Dormancy class was influenced by dispersal syndrome and season. Moreover, dormancy avoided seed germination during the rainy-to-dry transition, independently of dispersal syndrome. The variability of dormancy classes with dispersal syndrome allowed animal-dispersed species to fruit all year round, but seeds germinated only during the rainy season. Conversely, seasonally restricted wind-dispersal species dispersed and germinated their non-dormant seeds only in the rainy season.

Measuring illicit cigarette trade in Colombia.

BACKGROUND: By 2016, tobacco industry provided the only illicit trade estimates in Colombia and used these to discourage tax increases since the 1990s. To establish the viability of a threefold hike in the excise tax, policy makers needed unbiased estimates of the illicit cigarette. OBJECTIVE: To estimate the size of illicit cigarette trade in five Colombian cities (63% of the market), analyse characteristics of smokers of illicit cigarettes and compare market share results with one industry-funded survey. METHODS: Street cross-sectional survey with smokers' self-report on consumption pattern, last purchase information and direct observation of smoker's packs. Sampling frame: smokers, men and women, 12 years old or older, all income levels, resident in five Colombian cities (Bogotá, Medellín, Cali, Cartagena and Cúcuta) with 1 733 316 smokers in 2013. Sample size 1697, simple random sample by city, sampling weights based on age groups and cities. Confidence level 95%, margin of error 3.5% for Bogotá and Medellín and 5% for the other three cities. Data collection period: 24 August-14 September 2016. RESULTS: Illicit cigarettes represent 3.5% of consumption in the five cities, a much lower estimate than the industry data. There are significant differences across cities, with Bogotá at the bottom (1.5%) and Cúcuta at the top (22.8%). CONCLUSION: The low overall penetration of illicit cigarettes in Colombia indicates that the industry's warnings against tax increases are not justified. The limited importance of tax levels as determinant of consumption of illicit cigarettes is also suggested by the differences across cities, all of them with the same tax regime.

Human Coronary Artery Endothelial Cell Response to Porphyromonas gingivalis W83 in a Collagen Three-Dimensional Culture Model.

P. gingivalis has been reported to be an endothelial cell inflammatory response inducer that can lead to endothelial dysfunction processes related to atherosclerosis; however, these studies have been carried out in vitro in cell culture models on two-dimensional (2D) plastic surfaces that do not simulate the natural environment where pathology develops. This work aimed to evaluate the pro-inflammatory response of human coronary artery endothelial cells (HCAECs) to P. gingivalis in a 3D cell culture model compared with a 2D cell culture. HCAECs were cultured for 7 days on type I collagen matrices in both cultures and were stimulated at an MOI of 1 or 100 with live P. gingivalis W83 for 24 h. The expression of the genes COX-2, eNOS, and vWF and the levels of the pro-inflammatory cytokines thromboxane A2 (TXA-2) and prostaglandin I2 (PGI2) were evaluated. P. gingivalis W83 in the 2D cell culture increased IL-8 levels at MOI 100 and decreased MCP-1 levels at both MOI 100 and MOI 1. In contrast, the 3D cell culture induced an increased gene expression of COX-2 at both MOIs and reduced MCP-1 levels at MOI 100, whereas the gene expression of eNOS, vWF, and IL-8 and the levels of TXA2 and PGI2 showed no significant changes. These data suggest that in the collagen 3D culture model, P. gingivalis W83 induces a weak endothelial inflammatory response.

Morphology, ecophysiology and germination of seeds of the neotropical tree Alibertia patinoi (Rubiaceae).

Alibertia patinoi (Rubiaceae) is of economic and cultural importance for communities in the Colombian Pacific and Amazon regions, where it is cultivated and mature fruits are highly appreciated and consumed. Since there is a lack of knowledge of the seed physiology of this species, we describe here the germination behavior and morphometry of seeds of Alibertia patinoi, and relate them to its habitat. Fruits were collected from a mixed food crop and a commercial plantation in Guaimía village, Buenaventura, Colombia, a tropical rain forest area. We measured length, width, thickness, mass (n = 1 400), and moisture content of seeds (n = 252). Primary dormancy tests were conducted (n = 200), followed by imbibition (n=252) and germination dynamics, under different conditions of light and temperature specific to understory and forest clearings (n = 300 seeds). Finally, seed storage behavior was established (n = 100 seeds). We observed that size and mass of seeds had a narrow range of values that did not differ within or among fruits and that the species did not exhibit primary dormancy. The seeds are recalcitrant, and recently harvested seeds exhibited higher seed moisture content (ca. 44%) and continuous metabolism. The seed germination percentage was observed to be higher under the specific dense canopy forest light and temperature conditions; furthermore, neither enriched far-red light nor darkness conditions inhibited germination. We concluded that rapid germination could be the establishment strategy of this species. Also, the physiological traits (i.e., rapid germination rate, low germination requirements, absence of primary dormancy, and recalcitrant behavior) and seed size and mass, suggest that A. patinoi is adapted to conditions of mature tropical rain forests.

Nanoparticles from culture media are internalized by in vitro-produced bovine embryos and its depletion affect expression of pluripotency genes.

Extracellular vesicles are nanoparticles secreted by cell and have been proposed as suitable markers to identify competent embryos produced in vitro. Characterizing EVs secreted by individual embryos is challenging because culture medium itself contributes to the pool of nanoparticles that are co-isolated. To avoid this, culture medium must be depleted of nanoparticles that are present in natural protein source. The aim of this study was to evaluate if the culture medium subjected to nanoparticle depletion can support the proper in vitro development of bovine embryos. Zygotes were cultured in groups on depleted or control medium for 8 days. Nanoparticles from the medium were characterized by their morphology, size and expression of EVs surface markers. Isolated nanoparticles were labelled and added to depleted medium containing embryos at different developmental stages and evaluated after 24 hours at 2, 8-16 cells, morula and blastocyst stages. There were no statistical differences on blastocyst rate at day 7 and 8, total cell count neither blastocyst diameter between groups. However, morphological quality was better in blastocysts cultured in non-depleted medium and the expression of SOX2 was significantly lower whereas NANOG expression was significantly higher. Few nanoparticles from medium had a typical morphology of EVs but were positive to specific surface markers. Punctuated green fluorescence near the nuclei of embryonic cells was observed in embryos from all developmental stages. In summary, nanoparticles from culture medium are internalized by in vitro cultured bovine embryos and their depletion affects the capacity of medium to support the proper embryo development.

Manejo odontológico de pacientes con el síndrome de Ehlers-Danlos. Revisión narrativa / Dental management in patients with Ehlers-Danlos syndrome. Narrative review

Resumen El síndrome de Ehlers-Danlos es una enfermedad hereditaria, producida por mutaciones cromosómicas que pueden llegar a tener un comportamiento autosómico dominante, recesivo o ligado al cromosoma X. Se caracteriza por defectos en las enzimas encargadas de la estructura y síntesis de colágeno. En vista de los 20 tipos de colágeno que existen, este síndrome es extremadamente heterogéneo tanto en su presentación clínica como en su progresión y evolución. Dentro de los signos y síntomas habituales encontramos la hiperlaxitud articular, hiperelasticidad de la piel e hiperequimosis de los vasos sanguíneos. Con relación a las complicaciones que pueden presentar estos pacientes, encontramos dislocaciones articulares, fragilidad en la piel, dolor articular, ruptura de grandes vasos sanguíneos, dificultad en la cicatrización y, en consecuencia, mayor incidencia de procesos infecciosos y de cicatrices poco estéticas. Presenta una incidencia de 1 caso cada 2.500-5.000 nacidos vivos. Por ello, es fundamental que el odontólogo se encuentre familiarizado con el manejo médico-dental de estos pacientes, a fin de estar preparado para brindarles un tratamiento adecuado y responder ante las posibles complicaciones que se pueden presentar. En esta revisión se emplearon resultados extraídos manualmente de artículos, indexados en las bases de datos PUBMED y EBSCO, que respondían a la búsqueda de los términos Ehlers-Danlos syndrome, dental management y oral surgery. El objetivo fue describir el manejo médico-odontológico del paciente con síndrome de Ehlers-Danlos hasta la fecha.

Abstract Ehlers-Danlos syndrome is a hereditary disease, produced by chromosomal mutations that can have an autosomal behavior, which can be dominant, recessive or X-linked. It is characterized by defects in the enzymes responsible for the structure and synthesis of collagen. In view of the 20 existent types of collagen, this syndrome is extremely heterogeneous in its clinical presentation, as well as in its progression and evolution. Within the usual signs and symptoms, we find joint hyperlaxity, skin hyperelasticity and hyper-ecchymosis of the blood vessels. Regarding the complications that these patients can present, we find joint dislocations, skin fragility, joint pain, rupture of large blood vessels, difficulty in healing and, consequently, a higher incidence of infectious processes and unsightly scars. It presents an incidence of 1 case every 2.500-5.000 live births. Therefore, it is essential that the dentist is familiar with the medical-dental management of these patients, in order to be prepared to provide them with adequate treatment and respond to possible complications that may arise. In this review, results were manually extracted from articles, indexed in the PUBMED and EBSCO databases, that respond to the search for the terms Ehlers-Danlos syndrome, dental management and oral surgery. The aim was describing the medical-dental management of patients with Ehlers-Danlos syndrome to date.

Manejo odontológico de pacientes con el síndrome de Ehlers-Danlos: revisión narrativa / Dental management in patients with Ehlers-Danlos syndrome: a narrative review

El síndrome de Ehlers-Danlos es una enfermedad heredita- ria, producida por mutaciones cromosómicas que pueden llegar a tener un comportamiento autosómico dominante, recesivo o ligado al cromosoma X. Se caracteriza por defectos en las enzi- mas encargadas de la estructura y síntesis de colágeno. En vista de los 20 tipos de colágeno que existen, este síndrome es extre- madamente heterogéneo tanto en su presentación clínica como en su progresión y evolución. Dentro de los signos y síntomas habituales encontramos la hiperlaxitud articular, hiperelastici- dad de la piel e hiperequimosis de los vasos sanguíneos. Con relación a las complicaciones que pueden presentar es- tos pacientes, encontramos dislocaciones articulares, fragilidad en la piel, dolor articular, ruptura de grandes vasos sanguíneos, dificultad en la cicatrización y, en consecuencia, mayor inci- dencia de procesos infecciosos y de cicatrices poco estéticas. Presenta una incidencia de 1 caso cada 2.500-5.000 na- cidos vivos. Por ello, es fundamental que el odontólogo se encuentre familiarizado con el manejo médico-dental de estos pacientes, a fin de estar preparado para brindarles un trata- miento adecuado y responder ante las posibles complicacio- nes que se pueden presentar. En esta revisión se emplearon resultados extraídos manual- mente de artículos, indexados en las bases de datos PUBMED y EBSCO, que respondían a la búsqueda de los términos Ehlers-Danlos syndrome, dental management y oral surgery. El objetivo fue describir el manejo médico-odontológico del paciente con síndrome de Ehlers-Danlos hasta la fecha (AU)

Ehlers-Danlos syndrome is a hereditary disease, produced by chromosomal mutations that can have an autosomal behavior, which can be dominant, recessive or X-linked. It is characterized by defects in the enzymes responsible for the structure and syn- thesis of collagen. In view of the 20 existent types of collagen, this syndrome is extremely heterogeneous in its clinical presentation, as well as in its progression and evolution. Within the usual signs and symptoms, we find joint hyperlaxity, skin hyperelasticity and hyper-ecchymosis of the blood vessels. Regarding the complications that these patients can pres- ent, we find joint dislocations, skin fragility, joint pain, rupture of large blood vessels, difficulty in healing and, consequently, a higher incidence of infectious processes and unsightly scars. It presents an incidence of 1 case every 2.500-5.000 live births. Therefore, it is essential that the dentist is familiar with the medical-dental management of these patients, in order to be prepared to provide them with adequate treatment and re- spond to possible complications that may arise. In this review, results were manually extracted from ar- ticles, indexed in the PUBMED and EBSCO databases, that respond to the search for the terms Ehlers-Danlos syndrome, dental management and oral surgery. The aim was describing the medical-dental management of patients with Ehlers-Dan- los syndrome to date (AU)

Mucormicosis de cabeza y cuello: Actualización en el diagnóstico y manejo médico-quirúrgico. Una revisión narrativa / Mucormycosis of the head and neck: Update on diagnosis and medical-surgical management. A narrative review

Resumen La mucormicosis, es una patología de baja prevalencia, rápidamente progresiva y de alta mortalidad que engloba un amplio espectro de infecciones del tipo oportunistas, causada por hongos de la familia Mucoraceae, Lichtheimiaceae, Thamnidiaceae, Cunninghamellaceae, Syncephalastraceae y Radiomycetaeae. Actualmente es la tercera causa de infección fúngica invasiva, posterior a la candidiasis y aspergilosos, siendo su presentación clínica más frecuente la rinocerebral de origen paranasal, cuyo síntoma característico es la rinosinusitis aguda bacteriana con proyección a los dientes antrales, de rápido avance y fatalidad. En esta revisión se emplearon resultados extraídos manualmente de artículos indexados en las bases de datos MEDLINE y EBSCO a raíz de la búsqueda de los términos mucormycosis, oral surgery y patient care management con el objetivo de entregar una visión actualizada de la literatura, respecto al diagnóstico y tratamiento de la mucormicosis de cabeza y cuello.

Abstract Mucormycosis is a low-prevalence, rapidly progressive and high-mortality pathology that encompasses a wide spectrum of opportunistic infections caused by fungi of the Mucoraceae, Lichtheimiaceae, Thamnidiaceae, Cunninghamellaceae, Syncephalastraceae, and Radiomycetaeae. It is currently the third cause of invasive fungal infection, after candidiasis and aspergillosis, with its most frequent clinical presentation being rhinocerebral of paranasal origin, whose characteristic symptom is acute bacterial rhinosinusitis with projection to the antral teeth, with rapid progression and fatality. In this review, manually extracted results from articles indexed in the MEDLINE and EBSCO databases were used following the search for the terms mucormycosis, oral surgery and patient care management with the aim of providing an updated view of the literature regarding the diagnosis and treatment of mucormycosis of the head and neck.

Mucormicosis de cabeza y cuello: actualización en el diagnóstico y manejo médico-quirúrgico. Una revisión narrativa / Mucormycosis of the head and neck: update on diagnosis and medical-surgical management. A narrative review

La mucormicosis, es una patología de baja preva- lencia, rápidamente progresiva y de alta mortalidad que engloba un amplio espectro de infecciones del tipo opor- tunistas, causada por hongos de la familia Mucoraceae, Lichtheimiaceae, Thamnidiaceae, Cunninghamellaceae, Syncephalastraceae y Radiomycetaeae. Actualmente es la tercera causa de infección fúngica invasiva, posterior a la candidiasis y aspergilosos, siendo su presentación clínica más frecuente la rinocerebral de origen paranasal, cuyo síntoma característico es la rinosinusitis aguda bacteriana con proyección a los dientes antrales, de rápido avance y fatalidad. En esta revisión se emplearon resultados extraídos ma- nualmente de artículos indexados en las bases de datos MED- LINE y EBSCO a raíz de la búsqueda de los términos mu- cormycosis, oral surgery y patient care management con el objetivo de entregar una visión actualizada de la literatura, respecto al diagnóstico y tratamiento de la mucormicosis de cabeza y cuello (AU)

Mucormycosis is a low-prevalence, rapidly progres- sive and high-mortality pathology that encompasses a wide spectrum of opportunistic infections caused by fungi of the Mucoraceae, Lichtheimiaceae, Thamnidiaceae, Cunningha- mellaceae, Syncephalastraceae, and Radiomycetaeae. It is currently the third cause of invasive fungal infection, after candidiasis and aspergillosis, with its most frequent clinical presentation being rhinocerebral of paranasal origin, whose characteristic symptom is acute bacterial rhinosinusitis with projection to the antral teeth, with rapid progression and fatality. In this review, manually extracted results from articles indexed in the MEDLINE and EBSCO databases were used following the search for the terms mucormycosis, oral sur- gery and patient care management with the aim of providing an updated view of the literature regarding the diagnosis and treatment of mucormycosis of the head and neck

Quiste inflamatorio con tejido calcificado: presentación de un caso clínico / Inflammatory cyst with calcified tissue: presentation of a clinical case

Objetivo: Describir un caso de quiste odontogénico in- flamatorio cuya presentación imagenológica no es la habitual. Caso clínico: Acude a la clínica profesional de Pato- logía Oral de la Universidad Andrés Bello una paciente de género femenino de 13 años, sin antecedentes mórbidos, con un hallazgo radiográfico de lesión mixta ubicada entre los premolares inferiores derechos. Es derivada al posgrado de cirugía oral y maxilofacial para que le realicen una biopsia excisional de la lesión con una hipótesis diagnóstica de tumor odontogénico adenomatoide. Una vez realizado el estudio histopatológico, se define la lesión como quiste odontogénico inflamatorio, que por las características clínicas-radiográficas podría corresponder con un quiste residual de un diente tem- poral. Debido a la variabilidad en la presentación clínica e ima- genológica de las lesiones quísticas maxilofaciales, el estudio anatomopatológico es imprescindible para un correcto diag- nóstico y tratamiento (AU)

Aim: To present a case of inflammatory odontogenic cyst with unusual imaging presentation. Clinical case: A 13-year-old female patient, with no history of morbidity, with a radiographic finding of a mixed lesion located between the lower right premolars. The patient visited the professional Oral Pathology clinic of the Andrés Bello University and was referred to postgraduate oral and maxillofacial surgery for an excisional biopsy of the lesion, with a diagnostic hypothesis of adenomatoid odontogenic tu- mor. After the histopathological study, the lesion was defined as an inflammatory odontogenic cyst, which, based on clini- cal-radiographic characteristics, could be a residual cyst of a primary tooth. Due to the variability in the clinical and imaging pres- entation of maxillofacial cystic lesions, anatomopathological study is essential for correct diagnosis and treatment (AU)

Manejo odontológico del paciente diabético: revisión narrativa / Dental management of the diabetic patient. Narrative review

La diabetes mellitus es una enfermedad metabólica caracterizada por altos niveles de glucosa en sangre y defectos en la producción y/o la acción de la insulina. La hiperglucemia crónica puede derivar en complicaciones metabólicas y vasculares como micro- y macroangiopatías y alteraciones en el metabolismo de lípidos y proteínas. Los pacientes diabéticos mal controlados o no controlados presentan signos y síntomas evidenciables a nivel bucal. En el mundo, alrededor del 8,8% de los adultos de entre 20 y 79 años padecen este trastorno endócrino, y se estima que para el año 2045 unos 629 millones de personas de este rango etario tendrán diabetes. Por ello, es fundamental que el odontólogo se encuentre familiarizado con el manejo médico de estos pacientes, a fin de estar preparado para brindarles un tratamiento adecuado y responder a las emergencias médicas que se presenten durante su atención. En esta revisión se emplearon resultados extraídos manualmente de artículos indexados en las bases de datos MEDLINE y EBSCO que responden a la búsqueda de los términos diabetes mellitus, dental management, oral surgery y HbA1c, con el objetivo de describir el manejo médico-odontológico del paciente diabético hasta la fecha (AU)

Diabetes Mellitus is a metabolic disease characterized by high blood glucose levels and defects in the production and/or the use of insulin. Chronic hyperglycemia can lead to metabolic and vascular complications. Vascular complications include micro and macroangiopathies. The metabolic disorders are: alterations of lipid and protein metabolism. Patients with poorly controlled or uncontrolled diabetes present symptoms that are evident in the oral cavity. Around 8.8% of adults between 20-79 years old, worldwide, have this endocrine disorder and it is estimated that by 2045, 629 million people in this age group, will have diabetes. Therefore, it is essential for dentists to be familiar with the medical management of these patients, in order to provide adequate treatment and eventual management of medical emergencies that may occur during dental treatment. The present review used data extracted manually from articles indexed in the MEDLINE and EBSCO databases, using the terms: Diabetes mellitus, Dental Management, Oral Surgery and HbA1c. The following article aims to describe the medical/dental management of the diabetic patient updated to date (AU)

Absceso epidural posterolateral y compresión radicular: una rara complicación del absceso retrofaríngeo / Posterolateral epidural abscess and root compression: a rare complication of retropharyngeal abscess

Introducción: el absceso epidural posterolateral y la compresión radicular es una rara complicación del absceso retrofaríngeo (ARF). Se realizó el reporte de un caso con esta complicación extremadamente rara. Método: reporte de caso y revisión de la literatura (estudios radiológicos, historia y hallazgos clínicos). Se firmó consentimiento del paciente para la publicación. Resultados: paciente de 33 años remitido a nivel terciario de atención con un cuadro clínico de cervicalgia, odinofagia y fiebre. La tomografía axial computarizada (TAC) y la resonancia magnética nuclear (RMN) mostraron una colección retrofaríngea con compromiso epidural en el espacio medular cervical; en el examen físico se encontró odinofagia, cervicalgia, fiebre y pérdida de la fuerza muscular en el miembro superior derecho. El paciente fue llevado a manejo quirúrgico por otorrinolaringología y ortopedia para el drenaje de la colección; además, se le administró antibioticoterapia con cefepime y clindamicina por 21 días con buenos resultados; se consideró que el origen del absceso era idiopático. Conclusiones: el absceso epidural y la compresión radicular secundarias a un ARF es una rara y potencialmente mortal complicación de esta patología, con secuelas importantes en el paciente que la padece, que requiere un manejo médico-quirúrgico. En nuestro caso el manejo fue interdisciplinario, ya que integró otorrinolaringología, ortopedia, infectología y fisioterapia, lo que resultó en una evolución satisfactoria del paciente.

Introduction: posterolateral epidural abscess and radicular compression is a rare complication of retropharyngeal abscess (RFA), a case report with this extremely rare complication was made. Method: case report and review of the literature (radiological studies, clinical history, clinical findings) patient's consent was signed for the publication. Results: a 33-year-old patient referred at the tertiary care level with a clinical picture of cervicalgia, odynophagia and fever; CT and MRI showed retropharyngeal collection with epidural involvement in the cord cervical space, physical examination, odynophagia, cervicalgia, fever and loss of muscle strength in the right upper limb. Led to surgical management by ENT and orthopedics column for drainage of the collection; antibiotic therapy with cefepime, clindamycin for 21 days with good results; It was considered of idiopathic origin. Conclusions: epidural abscess and root compression secondary to an RFA is a rare and potentially fatal complication of this pathology with important sequelae in the patient, which requires medical-surgical management, in our case the management was integrated interdisciplinary otolaryngology, orthopedics, infectology, physiotherapy , with satisfactory evolution in the patient.

Fibro-odontoma ameloblástico: reporte de un caso / Ameloblastic fibro-odontoma: a case report

Objetivo: Presentar el caso de una patología poco común como es el fibro-odontoma ameloblástico (FOA), su manejo interdisciplinario y su resolución quirúrgica. Caso clínico: En este reporte de caso describimos un FOA en una paciente de 10 años, ubicado en el cuerpo mandibular derecho, asociado a las raíces de molares temporales que generó la retención de premolares. Se realizó la enucleación completa de la lesión, exodoncia de los temporales asociados y se decidió mantener los dientes definitivos y esperar su erupción espontánea. Es importante considerar la posibilidad de mantener el diente retenido si este no dificulta la exéresis de la lesión, ya sea para su erupción espontánea o rescate ortodóntico, lo cual es posible observar en este caso en el que se aprecia una evolución intraósea favorable. Con respecto al seguimiento, se recomienda el control a largo plazo con el fin de controlar la erupción del órgano dentario o la aparición de posibles recidivas (AU)

Aim: To present a clinical case of a rare pathology, the ameloblastic fibro odontoma (AFO), its interdisciplinary management and its surgical resolution. Clinical case: In this case report we describe an AFO in a 10-years-old patient, localized in the right hand side of the body of the mandible, associated with the roots of temporary molars that generated the retention of the premolars. Complete enucleation of the lesion and the extraction of the associated temporary molars were performed. It was decided to keep the permanent teeth and to wait for their spontaneous eruption. It is important to consider the possibility of keeping the retained teeth if it does not hinder the excision of the lesion, either for its spontaneous eruption or orthodontic rescue, which is possible to see in this case, in which a favorable intraosseous evolution is appreciated. With regard to follow-up, long-term monitoring is recommended in order to control the eruption of the dental organ or the appearance of possible recurrences (AU)

Estudio Comparativo de la Efectividad Antiinflamatoria Postoperatoria al usar Dexametasona Endovenoso Versus Ketoprofeno Endovenoso previo a la exodoncia de terceros Molares Mandibulares Incluidos

RESUMEN: La exodoncia de terceros molares incluidos conlleva la mayoría de las veces un cuadro inflamatorio agudo, dolor postoperatorio y trismus. En la actualidad, se han propuesto diversos protocolos farmacológicos con el fin de prevenir estas complicaciones, donde los más utilizados son los analgésicos y corticoides. Comparar Dexametasona y Ketoprofeno endovenoso previo a la cirugía de terceros molares mandibulares incluidos, en el control del edema, dolor y trismus. Se realizó un estudio experimental, analítico de corte transversal, autorizado por el comité de ética de la Universidad Andrés Bello. Se escogieron 30 sujetos que requerían exodoncia de terceros molares mandibulares incluidos, de forma aleatoria 15 sujetos recibieron Dexametasona 4 mg endovenoso y 15 Ketoprofeno 200 mg endovenoso 30 minutos antes de la intervención. El procedimiento quirúrgico fue estandarizado, se evaluó el edema facial, trismus y dolor postquirúrgico a los 2 y 7 días terminada la cirugía. Se presentó una diferencia estadísticamente significativa solo en 2 mediadas faciales, de las 5 tomadas, al comparar el porcentaje de edema a los 7 días postoperatorias entre ambos grupos experimentales. La mayoría del grupo Dexametasona presentó un edema de mayor volumen en comparación al grupo Ketoprofeno. En relación al dolor y trismus, sólo se observan diferencias significativas en la intensidad del dolor evaluada a los 7 días, siendo mayor en el grupo Ketoprofeno. En las otras variables medidas, la presencia de odontosección en la cirugía generó una diferencia estadísticamente significativa, siendo mayor el edema en los que se les realizó odontosección. Esta diferencia se vio principalmente en el grupo Ketoprofeno evaluado a los 2 días postoperatorios. El uso de cualquiera de los 2 fármacos está bien indicado para aliviar el dolor e inflamación en este tipo de cirugía. Pese a que el grupo tratado con Dexametasona presentó menor dolor, no fue una diferencia significativa en comparación al grupo con Ketoprofeno.

ABSTRACT: The extraction of included third molars most of the time involves an acute inflammatory picture, postoperative pain and trismus. At present, various pharmacological protocols have been proposed in order to prevent these complications, where the most widely used are analgesics and corticosteroids. Compare Dexamethasone and Ketoprofen used intravenously prior to surgery of mandibular third molars included, in the control of edema, pain and trismus. An experimental, analytical, cross- sectional study was carried out, authorized by the ethics committee of the Andrés Bello University. Thirty subjects who required extraction of included mandibular third molars were chosen, 15randomly received intravenous Dexamethasone 4 mg and 15 intravenous Ketoprofen 200 mg 30 minutes before the intervention. The surgical procedure was standardized, facial edema, trismus and postoperative pain were evaluated at 2 and 7 days after the surgery. There was a statistically significant difference only in 2 facial measures, of the 5 taken, when comparing the percentage of edema at 7 postoperative days between both experimental groups. Most of the Dexamethasone group had a larger volume ede- ma compared to the Ketoprofen group. In relation to pain and trismus, significant differences were only observed in the intensity of pain evaluated at 7 days, being greater in the Ketoprofen group. In the other variables measured, the presence of a dental section in the surgery generated a statistically significant difference, with the edema being greater in those who underwent a dental section. This difference was mainly seen in the Ketoprofen group evaluated at 2 postoperative days. The use of any of the 2 drugs is well indicated to alleviate the pain and inflammation of the patient generated by the trauma caused by this type of surgery. Although the group treated with Dexamethasone presented less pain, it was not a significant difference compared to the group with Ketoprofen.

Evaluación Comparativa de la Inflamación de Tejidos Blandos en Pacientes Sometidos a Exodoncias de Terceros Molares con y sin Uso de PRF

RESUMEN: La exodoncia de los terceros molares, es uno de los procedimientos ambulatorios más frecuente en la cirugía oral, donde habitualmente requiere de osteotomías y odontosección. Es por el cual, el manejo de la inflamación postoperatoria ha ido variando, con el fin de obtener mejores resultados con el menor riesgo posible. Comparar la eficacia de Dexametasona versus L- PRF en el control de la inflamación, dolor y trismus, en pacientes sin patologías basales sometidos a exodoncias de terceros molares inferiores incluidos y semi incluidos. Se realizó un estudio experimental clínico controlado aleatorizado, autorizado por el comité de ética de la Universidad Andrés Bello, con el código PROPRGFO 54- 2019. El tamaño muestral fue de 31 pacientes, dividido en 2 grupos, Grupo A Dexametasona (15) y Grupo B PRF (16). Ambos grupos fueron medicados de manera IV con Cefazolina 1 gr y Ketoprofeno 100 mg. Excepcionalmente al grupo A se le administró Dexametasona 4 mg. Una vez realizada la extracción del tercer molar, se aplicó L-PRF en el alvéolo de los pacientes del grupo B. Se indicaron los mismos cuidados y medicación postquirúrgica para ambos grupos. Cada paciente se controló en 4 ocasiones: Antes de la cirugía, inmediatamente después, a las 72 horas y a los 7 días de realizada la intervención, donde se consignaron las medidas faciales según el método de Neupert. Además, se registró la intensidad de dolor según escala EVA y longitud de apertura bucal. No existen diferencias estadísticamente significativas en cuanto a inflamación entre ambos grupos analizados, ni en cuanto al control de la inflamación entre cada instante de tiempo, cuando se analizó cada método por separado. Se puede considerar al L-PRF como una alternativa a la medicación preoperatoria clásica para disminuir la inflamación y complicaciones postoperatorias en pacientes en los cuales está contraindicado el uso de corticoides.

ABSTRACT: Third molar extraction is one of the most frequent outpatient procedures in oral surgery, usually requiring osteotomies and odontosection. For this reason, the management of post operative inflammation has been varying in order to obtain better results with the lowest posible risk. The aim was to compare the efficacy of Dexamethasone versus L-PRF in the control of inflammation, pain and trismus in patients without basal pathologies who underwent exodontia of included and semi-included lower third molars. A randomised controlled clinical experimental study was carried out, authorised by the ethics committee of the Universidad Andrés Bello, with code PROPRGFO 54- 2019. The simple size was 31 patients, divided into 2 groups, Group A Dexamethasone (15) and Group B PRF (16). Both groups were medicated IV with Cefazolin 1 g and Ketoprofen 100 mg. Exceptionally, group A was given Dexamethasone 4 mg. After the extraction of the third molar, L-PRF was applied to the alveolus of group B patients. The same post- surgical care and medication was indicated for both groups. Each patient was monitored on 4 occasions: Before surgery, immediately after, 72 hours and 7 days after surgery, where facial measurements were recorded according to Neupert's method. In addition, pain intensity was recorded according to the VAS scale and buccal opening length. There are no statistically significant differences in terms of inflammation between the two groups analysed, nor in L-PRF can be considered as an alternative to classic preoperative medication to reduce inflammation and post operative complications in patients in who use of corticosteroids is contraindicated.

Sialolitiasis submandibular gigante, extracción quirúrgica y reparación ductal: reporte de caso / Giant submandibular sialolithiasis, surgical removal and ductal repair: case report

Introducción: la patología litiásica de las glándulas salivales forma parte de un grupo de afecciones que perjudica el sistema de drenaje normal de la saliva hacia la cavidad oral, ocasionando lesiones múltiples sobre la glándula afectada. Se realizó el reporte de un caso clínico con esta patología que, por el tamaño del lito, se considera extremadamente rara en nuestro medio. Método: se realizó el reporte de caso y revisión de la literatura (estudios radiológicos, historia clínica y hallazgos clínicos); además, el paciente firmó el consentimiento para esta publicación. Resultados: un paciente masculino de 38 años remitido de consulta externa con un cuadro clínico de 1 semana de dolor, edema y tumefacción en la región submandibular izquierda asociado con una secreción sialopurulenta por la cavidad oral. En la radiografía (Rx) oclusal estricta y en la tomografía axial computarizada (TAC) de cuello contrastado se evidenció una lesión litiásica de más o menos 4,5 x 1,8 cm de diámetro, de característica radiolúcida, a nivel del conducto de wharton. Se dio un manejo quirúrgico por otorrinolaringología maxilofacial, consistente en sialolitotomía y antibioticote- rapia por 10 días, con las cuales se obtuvieron buenos resultados. Conclusiones: la litiasis gigante a nivel del sistema salival (glándula, conductos) es una patología poco común en nuestro medio y está involucrada en el desarrollo de múltiples patología de tipo inflamatorio recurrente de la glándula involucrada, lo cual afecta la calidad de vida de los pacientes. Por esta razón, el diagnóstico y manejo debe ser oportuno para evitar complicaciones, como una infección profunda del cuello; en nuestro caso, el manejo fue oportuno con una extracción quirúrgica por la vía oral del cálculo y la reparación del conducto de wharton del lado izquierdo.

Introduction: the lithiasic pathology of the salivary glands is part of a group of conditions that harms the normal drainage system of the saliva towards the oral cavity, causing multiple lesions on the affected gland, a report of a clinical case with this pathology was made. Due to the size of the stone it is considered extremely rare in our environment. Method: case report and review of the literature (radiological studies, clinical history, clinical findings) patient consent was signed for this publication. Results: a 38-year-old male patient referred from the outpatient clinic with a 1-week clinical picture of pain, swelling and edema in the left submandibular region associated with sialopurulent secretion from the oral cavity in the strict occlusal Rx and a contrast-enhanced neck CT revealed a lithiasic lesion with more or less 4.5 x 1.8 cm in diameter of radiolucent features at the level of the wharton duct, surgical management was given by maxillofacial ENT, consisting of sialolitotomy and antibiotic therapy for 10 days with good results. Conclusions: the giant lithiasis at the level of the salivary system (gland, ducts) is a rare pathology in our environment, is involved in the development of multiple pathologies of recurrent inflammatory type of the affected gland, affecting the quality of life of patients, so the diagnosis and management should be timely and avoid complications, such as deep neck infection; in our case, the management was timely with oral surgical removal of the calculus and repair of the wharton duct on the left side.

Comparación de la Muestra Salival y de Nasofaringe en la Detección de SARS-CoV-2 mediante RT-PCR / Comparison Between Saliva and Nasopharyngeal Sample in Detection of SARS-CoV-2 by RT-PCR

RESUMEN: El coronavirus tipo 2, SARS-CoV-2, que causa la enfermedad denominada por la OMS como COVID-19, se ha expandido provocando una pandemia desde 2019, sin cura hasta la fecha. El mecanismo de transmisión del SARS-CoV-2 entre humanos es mediante las secreciones generadas durante la respiración y estornudos, presentándose con un período de incubación desde 1 a 14 días. Se describen fiebre, tos y astenia como los síntomas más habituales. El diagnóstico definitivo se logra a través de la correlación entre la presentación clínica y exámenes complementarios, pero en la actualidad, el método de muestreo de preferencia para el diagnóstico de SARS-CoV-2 es mediante una muestra de nasofaringe, en donde se analiza la presencia de material genético viral por medio de RT-PCR. Debido a las complicaciones en la obtención de la muestra, tanto para el personal sanitario como para el paciente, se ha implementado la muestra de saliva con finalidad diagnóstica, como un método que proporciona una detección rápida, simple y no invasiva de la infección viral. Esta alternativa diagnóstica podría entregar información respecto a la patogenia de la enfermedad, permitiendo el manejo y control de pacientes positivos. El siguiente artículo, tiene por objetivo realizar una comparación entre las tomas de muestra de saliva y de nasofaringe para el diagnóstico de SARS-CoV-2, mediante la prueba de reacción en cadena de la polimerasa con transcriptasa inversa (RT-PCR).

SUMMARY: The type 2 coronavirus, SARS-CoV-2, named by the WHO like COVID-19, has expanded causing a pandemic since 2019, with no cure to date. The mechanism of transmission of SARS-CoV-2 between humans is through secretions generated during breathing and sneezing, presenting with an incubation period range from 1 - 14 days. Fever, cough, and fatigue are described as the most common symptoms. The definitive diagnosis is achieved through the correlation between the clinical presentation and the complementary exams, but at present, the preferred sampling method for the diagnosis of SARS-CoV-2 is through a nasopharyngeal swab specimen, where it is analyzed the presence of viral genetic material by the RT-PCR. Due to the complications in obtaining the sample, both for health personnel and for the patient, the saliva sample has been implemented, as a method that provides rapid, simple and non-invasive detection of viral infection. This diagnostic alternative could provide information on the pathogenesis of the disease, the management and control of positive patients. The following article aims to make a comparison between the saliva and nasopharyngeal samples taken for the diagnosis of SARS-CoV-2, using the reverse transcription polymerase chain reaction test (RT-PCR).

Profilaxis antibiótica del paciente con prótesis corporal sometido a cirugía bucal: Reporte de un caso clínico

Introducción: En Chile, según el último censo 2017 del Instituto Nacional de Estadísticas (INE), la población con 65 años o más, corresponde al 11,4% del total de los chilenos. Esto refleja un claro envejecimiento de sus ciudadanos, al ser comparado con versiones anteriores del censo. Estos cambios demográficos conllevan a un aumento de las patologías osteoarticulares, tendencia que puede apreciarse a nivel global. Objetivo: Junto a una revisión narrativa de la literatura, se presenta el caso de un paciente de sexo femenino. Método: Paciente de 82 años, con prótesis de cadera, que acude a la clínica de Cirugía Bucal de la Universidad Andrés Bello de Santiago de Chile. Fue derivada para realizar exodoncia de caninos inferiores por indicación protésica. Al realizar la anamnesis remota personal, la paciente relata haber sido sometido de artroplastia de reemplazo de cadera total hace 5 meses producto de un traumatismo. En el intraoperatorio, se realizó la exodoncia lo menos traumática posible y se aplicaron medidas de hemostasia locales. Conclusión: Según las últimas guías realizada por diversas sociedades del ámbito médico y odontológico, se sugiere el uso de profilaxis antibiótica únicamente en el caso de pacientes con patología sistémica descompensada, polimedicados, sistema inmunológico debilitado y/o con antecedentes de infección protésica.

Introduction: In Chile, according to the last census 2017, performed by the National Statistics Institute (INE), the population with 65 years or older, accounts for 11,4% of Chileans. This reflects an apparent aging of its citizens, in comparison to previous versions of the census. These demographical changes imply an increase in the numbers of osteoarticular pathologies, tendency that may be observed globally. Objective: Alongside with a narrative review of the literature regarding patients with hip prostheses, a case of a female patient. Method: 82 years old patient, attends the surgery clinic of the Andrés Bello University of Santiago de Chile, to perform extraction of lower canines by prosthetic indication. During the anamnesis, the patient reports a total hip replacement arthroplasty 5 months ago due to trauma. Intrasurgically, the extraction was performed as little traumatic as possible and local hemostasis measures. Conclusion: According to the latest guidelines reported by diverse medical and dental societies, it is suggested that the application of antibiotic prophylaxis only in patients with an uncontrolled systemic pathology, polymedicated, weakened immune system, and/or with a history of prosthetic infection.