ABSTRACT
La resorción ósea alveolar suele dar lugar a que las inserciones de la mucosa interfieran para la construcción, estabilidad y retención de una prótesis removible, una opción que permite modificar este tejido se obtiene por medio de una vestibuloplastia. Actualmente se puede favorecer la cicatrización de heridas utilizando láser de alta potencia aplicado a procedimientos quirúrgicos orales. Se realiza reporte de caso en paciente femenino a la que se realizó procedimiento de vestibuloplastia con láser de Er,Cr:YSGG, utilizando de forma postoperatoria gel de quitosano en nanotransportador biomolécula EPX. Se observa una cicatrización rápida y favorable al combinar ambas terapéuticas, además al utilizar productos con quitosano se disminuye el riesgo de la necrosis de fibroblastos gingivales humanos como recientemente se reportó en el uso de colutorios de clorhexidina (AU)
Alveolar bone resorption often results in mucosal insertions interfering with the construction, stability and retention of a removable prosthesis, an option to modify this tissue is obtained by means of vestibuloplasty. Currently, wound healing can be promoted by using high power laser applied to oral surgical procedures. A case report of a female patient who underwent a vestibuloplasty procedure with laser Er,Cr:YSGG, using chitosan gel with EPX biomolecule nanocarriers postoperatively. A fast and favorable healing is observed when combining both therapeutics, besides, when using products with chitosan, the risk of necrosis of human gingival fibroblasts is reduced, as recently reported in the use of chlorhexidine mouthwashes (AU)
Subject(s)
Humans , Female , Middle Aged , Wound Healing , Nanotechnology/methods , Laser Therapy/methods , Lasers, Solid-State , ChitosanABSTRACT
La leucemia mieloide aguda es una neoplasia con una elevada letalidad, con resultados inferiores en nuestro país respecto a la experiencia internacional publicada, posicionándola como una prioridad desde el punto de vista de salud pública oncológica. Actualmente, para su diagnóstico y estratificación se dispone de citología, inmunofenotipo, cariograma y escasas traslocaciones/mutaciones por biología molecular. Esta aproximación diagnóstica es insuficiente, ya que nos permite clasificar menos del 50% de los pacientes en un grupo específico y, por lo tanto, la elección de la terapia de consolidación se realiza con escasa información biológica. El rol de la morfología y de la citogenética progresivamente pierden relevancia pronóstica con respecto a la biología molecular, y la secuenciación de siguiente generación se ha posicionado como un elemento clave para el diagnóstico y estratificación de riesgo de estos pacientes. Además, la pesquisa de mutaciones germinales ha ido adquiriendo mayor relevancia, aumentando su frecuencia de detección e influyendo en la toma de decisiones respecto al tratamiento y en la selección de donante emparentado para un trasplante alogénico. En esta revisión se realiza una actualización del diagnóstico integrado de pacientes con leucemia mieloide aguda, a la luz de las nuevas clasificaciones diagnósticas (OMS 2022 e ICC 2022) y pronósticas (ELN 2022) y se propone un algoritmo a considerar para su implementación. Es perentorio como país invertir en nuevas tecnologías diagnósticas para mejorar el pronóstico de nuestros pacientes.
Acute myeloid leukemia is a neoplasm with a high lethality, with alarming results in our country, positioning it as a priority from the point of view of oncological public health. Cytology, immunophenotype, karyogram, and a few translocations/mutations by molecular biology are currently available for diagnosis and stratification. This diagnostic approach is insufficient since it allows classifying less than 50% of patients in a specific group. Therefore, consolidation therapy is selected with little biological information. The role of morphology and cytogenetics is progressively losing prognostic weight with respect to molecular biology, and next-generation sequencing has positioned itself as a key element for diagnosing our patients. In addition, the investigation of germline mutations is acquiring greater relevance, increasing its detection frequency and influencing decision-making regarding treatment and selecting a related donor for an allogeneic transplant. In this review, an update of the integrated diagnosis of patients with acute myeloid leukemia is carried out in light of the new diagnostic (WHO 2022 and ICC 2022), and prognostic classifications (ELN 2022). We propose an algorithm for integrated diagnosis to be considered for its implementation. It is imperative as a country to invest in new diagnostic technologies to improve the prognosis of our patients.
ABSTRACT
Objective: Evaluate the protective effect of artificial saliva formulations associated or not with mucin on dentin. Materials and Methods: Bovine dentin specimens were randomly allocated to 10 groups (n = 20) according to the artificial saliva tested and the presence or absence of mucin: Amaechi et al. (1998); Klimek et al. (1982); Vieira et al. (2005) and Eisenburger et al. (2001) and deionized water (control). Samples were submitted to an erosive cycle consisting of two immersions of 120 min in the saliva, followed by 1 min in hydrochloric acid solution, and new storage in saliva for 120 min. Surface loss (µm) was measured before and after the cycle. Data were analyzed using 2-way ANOVA and Tukey's test (p < 0.05). Results: A significant difference was observed for the saliva formulation but not for the presence of mucin. The deionized water provided the highest surface loss and the Eisenburger's saliva formulation the lowest. The groups testing the Amaechi, Klimek, and Vieira saliva did not present significant differences. Conclusion: Eisenburger's saliva formulation provides a higher protective effect against dentin erosion. The presence of mucin did not increase the erosion-preventive effect of artificial saliva formulations. (AU)
Objetivo: Avaliar o efeito protetor de formulações de saliva artificial associadas ou não à mucina sobre a dentina submetida a erosão. Material e Métodos: Espécimes de dentina bovina foram alocados em 10 grupos (n = 20) de acordo com a saliva testada e a presença ou ausência de mucina: . Amaechi et al. (1998); Klimek et al. (1982); Vieira e cols. (2005), Eisenburger et al (2001) e agua deionizada (controle). As amostras foram submetidas a um ciclo erosivo composto por duas imersões de 120 min na saliva, seguidas de 1 min em solução de ácido clorídrico e novo armazenamento na saliva por 120 min. A perda de superfície (µm) foi medida antes e depois do ciclo. Os dados foram analisados usando ANOVA 2 fatores e teste de Tukey (p <0,05). Resultados: Foi observada diferença significativa para a formulação de saliva, mas não para a presença de mucina. A água deionizada proporcionou a maior perda de superfície e a formulação de saliva de Eisenburger a menor. Os grupos que testaram a saliva Amaechi, Klimek e Vieira não apresentaram diferenças significativas entre si. Conclusão: A formulação de saliva de Eisenburger fornece o maior efeito protetor contra a erosão dentinária e a presença de mucina não aumentou o efeito preventivo de erosão de formulações de saliva artificial (AU).
Subject(s)
Saliva, Artificial , Tooth Erosion , Tooth Wear , MucinsABSTRACT
Objective: to investigate the antimicrobial effects of toothpastes containing bioactive surface pre-reacted glass particles (S-PRG) on S. mutans biofilms adherence, initial colonization and maturation. Material and Methods: a reference UA 159 and a clinical S. mutans (SM6) strain were used. Bovine enamel specimens were randomly allocated into the groups (n=5): toothpastes containing 0%; 1%; 5%; 20%; 30% S-PRG; positive control dentifrice (NaF+triclosan); and negative control (distilled water). For biofilm development, samples were placed in a 24-well plate containing artificial saliva (4h), followed by adding 1mL of artificial saliva, BHI broth and 225µL of S. mutans suspension. Treatments with toothpastes were applied previously or after 4h and 24h of biofilm formation. Samples were incubated for 48h at 37°C in 5%CO2 and biofilm was detached and seeded in Petri dishes for determining the number of viable cells. Data were analyzed by ANOVA and Tukey test (5%). Results: significantly lower microorganisms' adherence (p<0.05) was obtained for all S-PRG toothpastes, with similar results to NaF+triclosan for SM6 and 20 and 30%S-PRG groups exhibiting higher inhibition effect than the NaF+Triclosan for UA159. Antibacterial effect on the early-stage biofilm was also observed for the S-PRG groups, but was not superior to the NaF+Triclosan toothpaste. For the mature biofilm, the effective antimicrobial potential of S-PRG toothpastes was observed only for the SM6 clinical strain, but was not higher than the positive control. Conclusion: experimental S-PRG toothpastes were effective to inhibit S. mutans biofilm growth by exhibiting antimicrobial activity, being promising agents to prevent cariogenic biofilm development (AU)
Objetivo: investigar o efeito de dentifrícios contendo S-PRG sobre a colonização inicial e maturação de biofilmes de S. mutans. Material e Métodos: uma cepa de referência (UA 159) e uma cepa clínica de S. mutans (SM6) foram utilizadas. Espécimes de esmalte bovino foram alocados nos grupos (n=5): dentifrícios contendo 0%; 1%; 5%; 20% e 30%S-PRG; controle positivo (NaF+triclosan); e controle negativo (água destilada). Os espécimes foram inseridos em uma placa de 24 poços contendo saliva artificial (4h), seguido por adição de 1mL de saliva artificial, BHI, 225µL de suspensão de S. mutans e foram tratados com suspensões de dentifrícios antes ou depois de 4 e 24h da formação do biofilme. Os espécimes foram incubados por 48h e o biofilme foi removido dos espécimes e semeado em placas de Petri para contagem de UFC/mL. Os dados foram analisados por ANOVA e teste de Tukey (5%). Resultados: houve diminuição na adesão de microrganismos para os grupos tratados com S-PRG (p<0.05). Para SM6, os dentifrícios contendo S-PRG apresentaram resultados semelhantes ao NaF+triclosan e para a cepa UA159 o dentifrício com 30%S-PRG apresentou efeito superior. Efeito antimicrobiano no biofilme recém-formado (4h) foi observado para os grupos contendo S-PRG, mas não foi observado efeito superior ao NaF+Triclosan. Para o biofilme maduro, efeito antimicrobiano do S-PRG foi observado apenas para a cepa clínica, mas não superior ao efeito do NaF+Triclosan. Conclusão: dentifrícios contendo S-PRG foram eficazes na inibição do desenvolvimento de biofilmes de S. mutans, sendo promissores agentes para prevenir o desenvolvimento de biofilme cariogênico. (AU)
Subject(s)
Animals , Cattle , Streptococcus mutans , Biofilms , Dental Enamel , Dental Plaque , DentifricesABSTRACT
Los supervivientes de cáncer se definen como aquellos individuos que han completado su tratamiento inicial y no tienen evidencia de la enfermedad. Para el caso de las pacientes supervivientes de cáncer de mama, el seguimiento involucra no sólo la vigilancia de la recaída locorregional y a distancia, así como la tamización de segundos primarios mamarios, sino también la evaluación de los efectos relacionados con las terapias recibidas. Hoy en día, existe controversia sobre cuál debe ser el método, la frecuencia, la duración y tipo de personal de la salud que realice el seguimiento de estas pacientes. Las guías de las distintas sociedades científicas muestran una variabilidad importante en las recomendaciones a este respecto. Este documento pretende revisar la mejor evidencia disponible sobre los procedimientos para la detección de la recaída locorregional, de las metástasis a distancia, de un segundo cáncer de mama contralateral y de los eventos adversos relacionados con los tratamientos para el cáncer de mama. Adicionalmente, se examinan los porcentajes y sitios de recidiva tumoral con relación al estadio clínico y a la biología tumoral
Cancer survivors are defined as those individuals who have completed their initial treatment and have no evidence of disease. In the case of breast cancer survivors, follow-up involves not only surveillance of locoregional and distant relapse, as well as screening for second primary breast cancers, but also evaluation of the effects related to the therapies received. Nowadays, there is controversy about what should be the method, the frequency, the duration and the type of health personnel that carry out the follow-up of these patients. The guides of the different scientific societies show a significant variability in the recommendations in this regard. This document aims to review the best available evidence on procedures for the detection of locoregional relapse, distant metastases, contralateral second breast cancer, and adverse events related to breast cancer treatments. Additionally, the percentages and sites of tumor recurrence are examined in relation to clinical stage and tumor biology
Subject(s)
Humans , Female , Therapeutics , Clinical DiagnosisABSTRACT
La adición de la terapia dirigida a la quimioterapia citotóxica en pacientes con cáncer de mama ha mejorado significativamente los desenlaces oncológicos en las pacientes con tumores HER2 positivo. El uso de pertuzumab durante el manejo neoadyuvante incrementa significativamente la respuesta patológica completa y en la actualidad permite emplear regímenes libres de antraciclinas con una eficacia similar y menores efectos cardiovasculares (en especial sobre la fracción de eyección). El beneficio en supervivencia libre de enfermedad invasiva, de adicionar pertuzumab en el escenario adyuvante en las pacientes sin tratamiento anti HER2 previo, está limitado a aquellas con ganglios positivos. La implementación de esquemas con bloqueo dual anti HER2, durante el tratamiento inicial del cáncer de mama HER2 positivo, mejora significativamente el pronóstico oncológico en este grupo de pacientes.
The addition of targeted therapy to cytotoxic chemotherapy in patients with breast cancer has significantly improved oncologic outcomes in patients with HER2-positive tumors. The use of pertuzumab during neoadjuvant management significantly increases the complete pathological response and currently allows the use of anthracycline-free regimens with similar efficacy and fewer cardiovascular effects (especially on ejection fraction). The benefit of pertuzumab in disease-free survival in the adjuvant setting for patients without prior anti-HER2 treatment is limited to those with positive nodes. The implementation of schemes with dual anti-HER2 blockade during the initial treatment of HER2-positive breast cancer significantly improves the oncological outcomes in this group of patients.
Subject(s)
Humans , Female , Receptor, ErbB-2 , Neoplasm, Residual , Neoadjuvant Therapy , TrastuzumabABSTRACT
La estadificación del cáncer de mama tiene como objetivo determinar la extensión de la enfermedad, definir el tratamiento y el pronóstico de la misma. La American Joint Committee on Cancer(AJCC) ha asignado el estadio utilizando el tamaño del tumor (T), la presencia de compromiso ganglionar (N), y la presencia o ausencia de metástasis a distancia (M). Con el advenimiento de la biología molecular, se integra a la estadificación anatómica la información pronóstica con el grado histológico, el estado de los receptores hormonales y el resultado del receptor de HER2. En el Instituto Nacional de Cancerología (INC), la incorporación del TNM pronóstico trajo consigo un aumento de estadio en el 14,47% de los casos y una disminución en el 40,3%; este resultado se atribuyó en parte al mayor porcentaje de tumores localmente avanzados dentro de la institución. Por subtipo biológico, los tumores luminales presentan mayor riesgo de metástasis óseas, los tumores triple negativo a pulmón y sistema nervioso central; y los tumores HER2 a SNC, hígado y pulmón. Teniendo en cuenta este compromiso a distancia, los métodos de estadificación comúnmente utilizados son gammagrafía ósea (GO), radiografía de tórax (RxT), ecografía hepática (UH) y/o tomografía computarizada (TC). En el caso de identificar hallazgos sospechosos en estos exámenes o si el cuadro clínico del paciente lo sugiere, se realizan estudios adicionales como TC o resonancia magnética nuclear (RMN). Los cambios en la estadificación clínica y la biología del cáncer de mama motivaron a las Unidades de Seno y Tejidos Blandos y Oncología Clínica del Instituto Nacional de Cancerología a revisar la evidencia científica disponible para recomendar la pertinencia de los estudios de extensión.
The staging of breast cancer has the objective to determine the extent of the disease, define treatment and prognosis. The American Joint Committee on Cancer (AJCC) has assigned the stage using the size of the tumor (T), the presence of lymph node involvement (N), and the presence or absence of distant metastases (M). With the advent of molecular biology, prognostic information with histological grade, hormone receptor status, and HER2 receptor is integrated with anatomic staging. In the National Institute of Cancerology (INC) the incorporation of TNM brought with it an increase in stage in 14.47% of cases and a decrease in 40.3%; this result was attributed in part to the higher percentage of locally advanced tumors within the institution. By biological subtype, luminal tumors have a higher risk of bone metastases, triple negative tumors to the lung and central nervous system; and HER2 tumors to CNS, liver and lung. Taking this distant involvement into account, the commonly used staging methods are bone scan (BS), chest radiography (CXR), liver ultrasound (UH) and/or computed tomography (CT) scans. In the case of identifying suspicious findings in these tests or if the patient's clinical condition suggests it, additional studies such as CT or magnetic resonance imaging (MRI) are performed. Changes in the clinical staging and biology of breast cancer motivated the Breast and Clinical Oncology Functional Unit of the National Cancer Institute to review the available scientific evidence to recommend the relevance of extension studies.
Subject(s)
HumansABSTRACT
Introducción: En la búsqueda de nuevas y mejores alternativas quirúrgicas que permitan disminuir el trauma a la pared abdominal, ha surgido la cirugía por puerto único (PU), un procedimiento que consiste en la realización de la cirugía laparoscópica a través de una incisión única, generalmente en la cicatriz umbilical. Los resultados han sido alentadores y nuevas investigaciones al respecto son necesarias. Objetivo: Comparar la técnica quirúrgica de la apendicectomía laparoscópica por puerto único (PU) versus técnica estándar de 03 puertos (AL3P) en el tratamiento de pacientes con apendicitis aguda. Metodología: Estudio prospectivo, aleatorizado, incluyó 158 pacientes distribuidos en 2 grupos (71 PU, 89 AL3P), desde junio de 2013 a junio de 2016, comparándose variables demográficas, tiempo quirúrgico, complicaciones trans y postoperatorias, conversión, dolor postoperatorio, beneficios estéticos y satisfacción. Resultados: La edad, sexo, IMC, evolución, medicación previa, recuento leucocitario y fase de la enfermedad fue similar en ambos grupos. El tiempo operatorio promedio en PU fue de 48 min, menor que en AL3P (pË0,001), y se evidenció disminución del mismo posterior a la curva de aprendizaje de 30 casos. No hubo conversión en PU a cirugía abierta. La tasa de complicaciones intra Y postoperatorias fue similar en ambos grupos (p=0,486 y p=0,887). La estancia hospitalaria fue menor en los pacientes de PU (pË0,001) con mejor resultado estético (p=0,036) y mayor grado de satisfacción (p=0,047). Conclusión: La apendicectomía por PU demostró ser una técnica factible, segura y reproducible en nuestro medio(AU)
Introduction: In the search for new and better surgical alternatives to reduce the trauma to the abdominal wall, it has emerged single port surgery (SP), a procedure that involves performing laparoscopic surgery through a single incision, usually in the umbilicus. The results have been encouraging and further investigations are needed in this regard. Objective: To compare laparoscopic single port appendectomy (SP) versus standard 03 ports laparoscopic technique (AL3P) in the treatment of patients with acute appendicitis. Materials and Methods: Prospective, randomized study, included 158 patients divided into 2 groups (71 SP, 89 AL3P), from June 2013 to June 2016, comparing demographic variables, surgical time, trans and postoperative complications, conversion, postoperative pain, aesthetic benefits and satisfaction. Results: Age, sex, BMI, evolution, premedication, white blood cell count and stage of the disease was similar in both groups. Mean operative time was 48 min on the SP, lower than in AL3P (pË0,001), and decreased following the learning curve of 30 cases. There was no conversion of SP to open surgery. The rate of intraoperative and postoperative complications was similar in both groups (p = 0.486 and p = 0.887). The hospital stay was lower in patients SP (pË0,001), with better cosmetic outcome (p = 0.036) and greater satisfaction (p=0.047). Conclusion: SP appendectomy proved to be a feasible, safe and reproducible technique in our environment(AU)
Subject(s)
Humans , Male , Female , Adult , Middle Aged , Appendectomy , Laparoscopy , Minimally Invasive Surgical Procedures , Appendicitis , General Surgery , Surgical Procedures, Operative , Abdominal WallABSTRACT
Objective: The present study compared the effect of whitening mouthrinses (WM) on the color change of stained resin composites (RC). Material and Methods: Cylindrical specimens (6mm-diameter and 1mm-thickness) were prepared with the following RC (n=60/group): Filtek Z350XT (Z350- methacrylate-based), Admira Fusion (AD- ormocer-based), TPH3 (TPH- methacrylate-based), and Beautifil II (BII- giomer/methacrylate-based). The initial color was assessed with reflectance spectrophotometer using CIE L*a*b* system. The specimens were immersed in staining broth during 14 days, submitted to color evaluation (ΔE1) and randomly allocated in 4 subgroups (n=15), according to WM adopted: Listerine Whitening (LW-2% hydrogen peroxide), Plax Whitening (PW-1.5% hydrogen peroxide), Bromelain/papain (BP-experimental solution), and Deionized water (DW-negative control). The whitening cycle consisted of RC immersion in WM for 1 min and in artificial saliva for 30 min, simulating 12 weeks, and final color assessment was performed (ΔE2). Color change data were analysed by ANOVA and Tukey's tests (α=5%). Results: After staining, TPH showed the lowest ΔE1 values and Z350 showed the highest color change (p=0.001). The whitening effect promoted by LW was significantly higher than color alteration obtained with PW (ΔE2), and BII showed the highest color change values (ΔE2) after whitening cycle. Conclusion: LW exhibited the greatest whitening potential on stained RC, mainly with the Giomer (Beautifill II) and the Ormocer-based (Admira Fusion) materials. Bromelain/papain solution showed no whitening effect on stained RC. (AU)
Objetivo: O presente estudo comparou o efeito de enxaguatórios clareadores (EC) na alteração de cor de resinas compostas (RC) previamente manchadas. Material e Métodos: Espécimes cilíndricos (6mm de diâmetro e 1mm de espessura) foram preparados com as seguintes RC (n=60/grupo): Filtek Z350XT (Z350- metacrilato), Admira Fusion (AD- ormocer), TPH3 (TPH- metacrilato), e Beautifil II (BII- giomer/metacrilato). A cor inicial foi mensurada com espectrofotômetro de reflectância utilizando o sistema CIE L*a*b*. Os espécimes foram imersos em um caldo de manchamento durante 14 dias, submetidos a avaliação de cor (ΔE1) e alocados aleatoriamente em 4 subgrupos (n=15), de acordo com EC adotado: Listerine Whitening (LW-peróxido de hidrogênio a 2%), Plax Whitening (PW- peróxido de hidrogênio a 1,5%), Bromelina/papaína (BP-solução experimental), e Água deionizada (AD- controle negativo). O ciclo clareador consistiu na imersão da RC no EC por 1 min e na saliva artificial por 30 min, simulando 12 semanas, e a cor final foi mensurada (ΔE2). Os dados de alteração de cor foram analisados pelos testes ANOVA e Tukey (α=5%). Resultados: Após o manchamento, TPH apresentou o menor valor de ΔE1 e Z350 apresentou a maior alteração de cor (p=0,001). O efeito clareador promovido pelo LW foi significativamente maior que o obtido com o PW (ΔE2) e BII teve a maior alteração de cor (ΔE2) após o ciclo clareador. Conclusão: LW exibiu maior potencial clareador nas RC manchadas. BII apresentou maior alteração de cor em resposta à ação clareadora de ambos enxaguatórios à base de peróxido de hidrogênio testados.(AU)
Subject(s)
Composite Resins , Tooth Bleaching Agents , Organically Modified Ceramics , Hydrogen PeroxideABSTRACT
Objetivo La biopsia de próstata es una ayuda esencial en el diagnóstico de cáncer, siendo el método más utilizado la biopsia transrectal guiada por ultrasonido (TRUS), con una tasa diagnóstica entre el 37% y el 45%, aunque no exenta de complicaciones como infecciones, dolor o sangrado. El enfoque alternativo y seguro a las biopsias TRUS se encuentra en la biopsia transperineal (BTP), realizada comúnmente bajo anestesia regional o general. El objetivo de este estudio fue determinar la efectividad de la BTP bajo anestesia local y guía ultrasonográfica transrectal, con el impacto sobre la sensibilidad del estudio y la tasa de readmisión hospitalaria por infección. Métodos Estudio de cohorte retrospectiva en el que se evaluaron 83 pacientes sometidos a BTP con anestesia local y guía ultrasonográfica transrectal de enero de 2017 a agosto de 2018 en una ciudad intermedia de Colombia. La muestea incluyó todos los hombres mayores de 18 años con datos de historia clínica disponibles para su análisis, así como los reportes histopatológicos de las biopsias. Se excluyeron casos de rebiopsia o con datos insuficientes. El análisis de datos nominales se realizó mediante la prueba de chi cuadrado, y el de los datos numéricos, con las prubas t de Student o de Mann-Whitney. Resultados Un total de 83 pacientes, con media de edad de 65 ± 7.9 años fueron sometidos al análisis del estudio histopatológico. Se excluyeron nueve pacientes que no tenían información disponible en el registro clínico sistematizado, ni en historia clínica de formato físico. Se encontró una proporción de positividad y diagnóstico de cáncer de prostata en el 39.7% (33) de los pacientes, distribuidos así: grado de grupo 1 (69.7%; 23); grado de grupo 2 )15.2%; 5); grados de grupos 3 y 4 (3% cada uno de ellos; 2); y grado de grupo 5 (9%; 3). En total, 60% (50) fueron negativos para malignidad y, de estos el 54% (27) tuvo hiperplasia. El antibiótico profiláctico indicado en el 96.7% (80) de los casos fue una cefalosporina de primera generación, administrada en el 15% (12) por vía parenteral preoperatoria. En esta serie de casos, no se documentaron ingresos hospitalarios asociados a infección después del procedimiento. Conclusiones La biopsia de próstata por vía transperineal es una técnica con rendimiento diagnostico similar al del abordaje transrectal: es segura, rápida, de fácil acceso, con bajo costo y, sobre todo, con un riesgo insignificante de infección y sepsis. Sus beneficios son altamente representativos en un sistema de salud como el de nuestro país, y la BTP facilita el acceso de la población vulnerable del área rural y de ciudades intermedias, en las que no se dispone de un urólogo experto.
Objective Prostate biopsy is an essencial aid in cancer diagnosis, and the the most widely-used method is known as transrectal ultrasound-guided (TRUS) biopsy, with a diagnostic rate ranging from 37% to 45%; however, it is not free of complications such as infections, pain, or bleeding. The alternative and safe approach lies in the transpineal biopsy (TPB), commonly performed under regional or general anesthesia. The objetive of the present study was to determine the effectiveness of TPBunder local anesthesia and transrectal ultrasound guidance, with the impact of the sensitiviy of the study and the rate of hospital readmission due to infection. Methods Retrospective cohort study in which 83 patients underwent TPB with local anesthesia and transrectal ultrasound guidance from january 2017 and august 2018 in an intermediate city in Colombia. The sample included all male subjects older than 18 years of age with medical history data available for analysis, as well as the histopathological reports of the biopsies. Cases of rebiopsy or with insufficient data were excluded. The analysis of the nominal data was performed using the chi-squared test, and that of the numerical data, with the Student t or the Mann-Whitney test. Results A total of 83 patientswith an average age was of 65 ± + 7.9 years, had their histopathological studies analyzed. We excluded nine patients who did not have information available in the systematized clinical registry nor in the medical history in physical format. Positivity and a diagnosis of prostate cancer was found in 39.7% (33) of the patients, who were distributed like this: grade group 1 (69.7%; 23); grade group 2 (15.2%; 5); grade groups 3 and 4 (each with 3%; 2); and grade group 5 (9%; 3). In total, 60% (50) were negative for malignancy, and, of these, 54% (27) had glandulostromal hyperplasia. The indicated prophylactic antibiotic in 96.7% (80) of the cases was a first generation cephalosporin and, in 15% (12) of the cases it was administered through a preoperative parenteral route. Hospital admissions after the procedure associated with infection were not documented in the present series of cases. Conclusions Transperineal prostate biopsy is a technique with diagnostic performance similar to that of the transrectal approach: it is safe, fast, easy to access, has a low cost and, above all, presents a minimum risk of infection and sepsis. Its benefits are highly representative in a health system like that of our country, and TPB facilitates the access of the vulnerable population of the rural area and of intermediate cities in which there is no availability of an expert urologist.
Subject(s)
Humans , Male , Prostate , Prostatic Neoplasms , Biopsy , Anesthesia, Local , Patient Readmission , Ultrasonics , Cephalosporins , Sepsis , Vulnerable Populations , Insemination, Artificial, Heterologous , Anesthesia, Conduction , Anti-Bacterial AgentsABSTRACT
Introducción: Se conoce poco de la forma adquirida del déficit del factor VII y son pocos los casos reportados en la literatura. Objetivo: Presentar el caso de una paciente con déficit aislado del factor VII, en el contexto de una hemorragia digestiva baja. Presentación del caso: Mujer peruana de 82 años que acude a emergencia por presentar hemorragia digestiva baja. Durante los exámenes de rutina se le detecta tiempo de protrombina prolongado y déficit aislado de factor VII. No se evidencia mecanismos patológicos de deficiencia de vitamina K o malabsorción, terapia anticoagulante con antagonistas de la vitamina K, hiperfibrinolisis o coagulación intravascular diseminada. Respondió al tratamiento con plasma fresco congelado y los resultados normales de la prueba hematológica realizada a la hermana, alejan la posible etiología hereditaria. Conclusión: Este caso peruano de déficit aislado del factor VII, en el contexto de una hemorragia digestiva baja, permite sumar información a la escasa evidencia Latinoamericana(AU)
Introduction: Little is known about the acquired form of factor VII deficiency and few cases are reported in the literature. Objective: To present a case of a patient with an isolated deficit of factor VII, in the context of low gastrointestinal bleeding. Presentation of the case: 82-year-old Peruvian woman who comes to the emergency room for presenting with lower GI bleeding. Prolonged prothrombin time and isolated factor VII deficiency are detected during routine examinations. There were no evidence of pathological mechanisms of vitamin K deficiency or malabsorption, anticoagulant therapy with vitamin K antagonists, hyperfibrinolysis, or disseminated intravascular coagulation. She responded to the treatment with fresh frozen plasma and the normal results of the hematological test carried out on the sister remove the possible hereditary etiology. Conclusion: This Peruvian case of isolated factor VII deficit, in the context of low gastrointestinal bleeding, allows adding information to the limited Latin American evidence(AU)
Subject(s)
Humans , Female , Aged, 80 and over , Vitamin K Deficiency , Disseminated Intravascular Coagulation , Hematologic Tests , Emergency Service, HospitalABSTRACT
SUMMARY OBJECTIVE The aim was to evaluate the prevalence of oropharyngeal dysphagia (OD) and its association with body composition by bioelectrical impedance analysis (BIA) and functionality among institutionalized older adults. METHODS A cross-sectional study was conducted. The swallowing function and diagnosis of OD were evaluated with a volume-viscosity swallow test. Activities of daily living were evaluated by the Barthel Index. Body composition was evaluated by BIA, and phase angle (PhA) was determined. RESULTS Eighty institutionalized older adults were evaluated. The mean age of the study population was 82±9.5 years, and 65% were females. The OD prevalence was 30%, dependence was 30%, and sarcopenia was 16%. In the multivariate analysis, a low PhA (<3.5°) was independently associated with the presence of OD adjusted by sex and age (OR: 2.60, 95%CI 2.41-2.90, p=0.01). CONCLUSIONS A higher prevalence of OD was found. Significant and independent associations were found between low PhA, dependence, and sarcopenia with the presence of OD among institutionalized older persons.
Subject(s)
Humans , Female , Aged , Aged, 80 and over , Deglutition Disorders/diagnosis , Deglutition Disorders/epidemiology , Sarcopenia/diagnosis , Sarcopenia/epidemiology , Body Composition , Activities of Daily Living , Cross-Sectional Studies , Electric ImpedanceABSTRACT
Abstract Objective To evaluate the effect of a toothpaste containing calcium silicate/sodium phosphate/fluoride associated or not to the boost serum (BS) against erosive tooth wear (ETW) on enamel and dentin. Methodology Bovine enamel and dentin specimens were subjected to an erosion-abrasion cycling model (1% citric acid - pH 3.6 -2 min / artificial saliva - 60 min, 4×/day, 5 days). Toothbrushing was performed for 15 s (2 min exposed to slurry), 2×/day, with the toothpastes (n=10): control without fluoride (Weleda), Arg/Ca/MFP (Colgate Pro-Relief), Si/PO4/MFP (Regenerate-Unilever), and Si/PO4/MFP/BS (Si/PO4/MFP with dual BS - Advanced Enamel Serum-Unilever). The effect of treatments on the eroded tissues was assessed by surface microhardness in the first day, and surface loss (SL) resulting from ETW was evaluated by profilometry (μm) after three and five days. Additional dentin specimens (n=5/group) were subjected to 20,000 brushing cycles to verify the abrasivity of the toothpastes. Data were subjected to ANOVA and correlation tests (5%). Results For enamel, no difference in microhardness was observed among the treated groups, and similar SL was obtained after 5 days. For dentin, Si/PO4/MFP/BS resulted in higher microhardness values, but none of the groups presented significantly lower SL than the control. There was no significant correlation between SL and abrasiveness. Conclusion The calcium silicate/sodium phosphate toothpaste and serum increased microhardness of eroded dentin, but they did not significantly reduce enamel and dentin loss compared to the non-fluoride control toothpaste. The abrasiveness of the toothpastes could not predict their effect on ETW.
Subject(s)
Animals , Cattle , Toothpastes , Fluorides , Phosphates , Silicates , Calcium Compounds , Dental Enamel , DentinABSTRACT
RESUMEN El Ministerio de Salud y Protección Social de Colombia, en colaboración con el Instituto Nacional de Salud y la Organización Panamericana de la Salud, convocaron en 2018 a todos los actores asociados al Programa Nacional de Prevención y Control de la Tuberculosis (PNPCT) y el Sistema Nacional de Ciencia, Tecnología e Innovación a la conformación de una red nacional que coordinara la investigación operativa (IO) relacionada con la tuberculosis (TB) en el país. Se realizaron siete talleres en los que se llegó al consenso de establecer la Red Nacional de Gestión de Conocimiento, Investigación e Innovación en Tuberculosis en Colombia (Red TB Colombia). Con más de 180 participantes, organizados en un nodo central y cinco nodos regionales que agrupan a las 37 entidades territoriales, en 2019 la Red TB Colombia realizó cuatro jornadas de capacitación en IO y definió 65 temas priorizados de investigación, ajustados a las líneas estratégicas establecidas por el PNPCT: prevención y atención integral, con foco en los afectados por la TB (41 temas en tres módulos) y compromiso político, protección social y sistemas de apoyo (24 temas en cuatro módulos). La priorización se realizó por el método de comparación por pares. La Red TB Colombia sigue activa y contribuye a la gestión del conocimiento dirigido a eliminar la TB en el país y ha permitido avanzar en la construcción de planes y la ejecución de proyectos locales de IO que generan resultados científicamente validados para fortalecer el PNPCT y mejorar la atención de los pacientes con TB.
ABSTRACT In 2018, the Colombian Ministry of Health and Social Protection, in collaboration with the National Health Institute and the Pan American Health Organization, convened all actors associated with the National Tuberculosis Prevention and Control Program (PNPCT) and the National Science, Technology, and Innovation System to form a national network to coordinate operations research on tuberculosis (TB) in the country. Seven workshops were held and a consensus was reached to establish the National Network for Knowledge Management, Research, and Innovation in Tuberculosis in Colombia (TB Colombia Network). With more than 180 participants, a central node, and five regional nodes that bring together the country's 37 territorial entities, the TB Colombia Network conducted four days of training in operations research in 2019, defining 65 priority research topics aligned with the strategic lines in the PNPCT: prevention and comprehensive care, with a focus on people affected by TB (41 topics in three modules); and political commitment, social protection, and support systems (24 topics in four modules). The peer comparison method was used for prioritization. The TB Colombia Network remains active and contributes to knowledge management aimed at eliminating TB in Colombia. It has helped make progress in building plans and implementing local operations research projects that generate scientifically validated results to strengthen the PNPCT and improve the care of TB patients.
RESUMO O Ministério da Saúde e Previdência Social da Colômbia, em cooperação com o Instituto Nacional de Saúde e a Organização Pan-Americana da Saúde (OPAS), convocou em 2018 todas as partes interessadas vinculadas ao Programa Nacional de Prevenção e Controle da Tuberculose (PNPCT) e ao Sistema Nacional de Ciência, Tecnologia e Inovação para formar uma rede nacional com o objetivo de coordenar a pesquisa operacional em tuberculose no país. Foram promovidos sete seminários e, deste processo, se chegou a um consenso para criar a Rede Nacional de Gestão do Conhecimento, Pesquisa e Inovação em Tuberculose na Colômbia (Rede TB Colômbia). A rede conta com mais de 180 participantes, organizados em um núcleo central e cinco núcleos regionais que congregam 37 entidades territoriais. Em 2019, a Rede TB Colômbia realizou quatro jornadas de capacitação em pesquisa operacional e definiu 65 áreas temáticas prioritárias de pesquisa harmonizadas com as linhas estratégicas estabelecidas pelo PNPCT: prevenção e atenção integral com enfoque nas pessoas com TB (41 áreas temáticas divididas em três módulos) e compromisso político, proteção social e sistemas de apoio (24 áreas temáticas divididas em quatro módulos). A priorização foi definida pelo método de comparação pareada. A Rede TB Colômbia continua ativa contribuindo para a gestão do conhecimento voltado à eliminação da tuberculose no país e possibilitando avançar na formulação de planos e execução de projetos locais de pesquisa operacional com a produção de resultados científicos validados para fortalecer o PNPCT e melhorar a atenção das pessoas com TB.
Subject(s)
Humans , Tuberculosis/prevention & control , Health Sciences, Technology, and Innovation Management , Science and Technology Information Networks , National Health Programs , ColombiaABSTRACT
Objective: To evaluate the efficacy of different fluoride varnishes on white spot lesions (WSL) remineralization. Material and Methods: Polished bovine enamel specimens were obtained (n = 60) and had their initial surface Knoop microhardness (SMH) determined. WSL were created and the SMH was measured again. Then, specimens were allocated into six groups: C Control (without varnish); BF Bifluorid 12 (6% NaF + 6% CaF2); DP Duraphat (5% NaF); PF Profluorid (5% NaF); FP - Fluor Protector (0.2% NaF + 0.9% difluorsilane); CW - Clinpro White Varnish (5% NaF + 5% TCP). After varnishes application, specimens were immersed in artificial saliva for 24 h. Then, pH-cycling was performed for 8 days and SMH was measured. Data were analyzed by one-way ANOVA and Tukey's test. Results: Non-significant differences were observed among the groups at baseline (p = 0.187) and after WSL formation (p = 0.999). After treatments, significant differences were observed among the groups (p = 0.001). Mean % of alteration (SD) and results of Tukey test were: C- 92.40 (12.10)a; PF- 88.66 (10.66)a; FP- 85.90 (14.49)ab; BF- 67.85 (17.86)bc; CW- 66.60 (18.48)c; DP- 58.62 (8.69)c. Conclusion: Bifluorid 12, Clinpro White Varnish, and Duraphat showed higher efficacy than artificial saliva in promoting the remineralization of WSL, nevertheless, none of the treatments were able to recover sound enamel baseline microhardness (AU)
Objetivo: Avaliar a eficácia de diferentes vernizes fluoretados na remineralização de lesões de mancha branca (LMB). Material e métodos: Espécimes de esmalte bovino polido (n = 60) foram submetidos à análise de microdureza superficial Knoop (KMH) inicial. Foram então criadas LMB artificialmente e os espécimes foram alocados em seis grupos: C Controle (sem aplicação de verniz); BF Bifluorid 12 (6% NaF + 6% CaF2); DP Duraphat (5% NaF); PF Profluorid (5% NaF); FP - Fluor Protector (0.2% NaF + 0.9% difluorsilano); CW - Clinpro White Varnish (5% NaF + 5% TCP). Após a aplicação dos vernizes, os espécimes ficaram imersos em saliva artificial por 24h e uma ciclagem de pH foi realizada por 8 dias. Após a ciclagem, KMH final foi realizada. Os dados foram analisados por ANOVA e teste de Tukey (5%). Resultados: Não foi observada diferença significante para os grupos após a KHM inicial (p = 0.187) e após a formação de LMB (p = 0.999). Após os tratamentos, diferenças significativas foram observadas entre os grupos (p = 0.001). Valores de média de % de alteração superficial (desvio-padrão) e resultados do teste de Tukey foram: C- 92.40 (12.10)a; PF- 88.66 (10.66)a; FP- 85.90 (14.49)ab; BF- 67.85 (17.86)bc; CW- 66.60 (18.48)c; DP- 58.62 (8.69)c. Conclusão: Os vernizes Bifluorid 12, Clinpro White Varnish e Duraphat apresentaram maior eficácia na remineralização das LMB quando comparados à saliva artificial, entretanto, nenhum dos produtos testados foi capaz de recuperar os valores iniciais de microdureza. (AU)
Subject(s)
Animals , Cattle , Fluorides, Topical , Dental Caries , FluorineABSTRACT
SUMMARY: The posterior superior alveolar artery is responsible for the vascularisation of the mucous which covers the posterior wall of the maxillary sinus, pulp and the periodontal tissues of upper molars. The collateral rami of the infraorbital artery irrigate the mucous of the anterior and lateral walls of the maxillary sinus, as well as the pulp and periodontal tissue of the upper anterior teeth and upper premolars. Both these arteries present intraosseous and extraosseous rami which form an anastomosis in the anterior and lateral walls of the maxillary sinus, called the alveolar antral artery (AAA). The aim of this study was to analyse the presence, location and morphometry of the AAA in a Chilean population, considering sex, side and age, using Cone-Beam computed tomography (CBCT). Forty-two CBCT examinations of Chilean adults were evaluated to analyse the presence, location (extraosseous, intraosseous or subperiosteal) and diameter (<1mm, 1-2 mm, 2-3 mm, >3 mm) of the AAA and the distance from the AAA to the amelocemental limit of the upper second premolar (2PM), permanent upper first molar (1M) and permanent upper second molar (2M) by sex and age range. Pearson's chi-squared test, Student's t-test, ANOVA and Pearson's correlation coefficient were applied, using a significance threshold of 5 %. AAA was found in 75 sides (89.3 %), 38 on the right side (90.5 %) and 37 on the left (88.09 %); extraosseous location was most common. More than 80 % of the arteries presented a diameter between 1 and 2 mm, with no important differences between sexes or age ranges. In younger individuals, the artery was located closer to the vestibular amelocemental limit than in older individuals. Carrying out a proper treatment plan which includes imagenological analysis before surgical procedures is essential to avoid possible haemorrhagic events in the region.
RESUMEN: Arteria alveolar superior posterior es responsable de la vascularización de la mucosa que recubre la pared posterior del seno maxilar, la pulpa y el tejido peridontal en el que se insertan los molares superiores. Las ramas colaterales de la arteria infraorbitaria irrigan la mucosa de las paredes anterior y lateral del seno maxilar, así como la pulpa y el periodonto de los dientes anteriores superiores y los premolares superiores. Ambas arterias presentan ramas intraóseas y extraóseas que forman una anastomosis en las paredes anterior y lateral del seno maxilar, denominada arteria alvéolo antral (AAA). El objetivo de este estudio fue analizar la presencia, localización y morfometría del AAA en una población chilena, considerando sexo, lado y edad, mediante tomografía computarizada Cone-Beam (CBCT). Se evaluaron 42 exámenes CBCT de adultos chilenos para analizar la presencia, ubicación (extraósea, intraósea o subperióstica) y diámetro (<1 mm, 1-2 mm, 2-3 mm,> 3 mm) del AAA. y la distancia del AAA al límite amelocemental del segundo premolar superior (2PM), primer molar superior permanente (1M) y segundo molar superior permanente (2M) por sexo y rango de edad. Se aplicaron la prueba de chi-cuadrado de Pearson, la prueba t de Student, ANOVA y el coeficiente de correlación de Pearson, utilizando un umbral de significancia del 5 %. Se encontró AAA en 75 lados (89,3 %), 38 del lado derecho (90,5 %) y 37 del lado izquierdo (88,09 %); la localización extraósea fue la más común. Más del 80 % de las arterias presentaban un diámetro entre 1 y 2 mm, sin diferencias importantes entre sexos ni rangos de edad. En individuos más jóvenes, la arteria se ubicó más cerca del límite amelocemental vestibular que en individuos mayores. La realización de un adecuado plan de tratamiento que incluya análisis imagenológico antes de los procedimientos quirúrgicos es fundamental para evitar posibles eventos hemorrágicos en la región.
Subject(s)
Humans , Male , Female , Adolescent , Adult , Middle Aged , Young Adult , Arteries/anatomy & histology , Arteries/diagnostic imaging , Cone-Beam Computed Tomography , Alveolar Process/blood supply , Alveolar Process/diagnostic imaging , Chile , Cross-Sectional Studies , Retrospective Studies , Maxillary SinusABSTRACT
RESUMEN La pandemia de COVID-19 ha traído una nueva afección grave e inusual denominada Síndrome Inflamatorio Multisistémico en niños, de la cual aún hay mucho por conocer. Presentamos una serie de 8 casos atendidos en el Instituto Nacional de Salud del Niño, Lima Perú. La edad media fue 5,1 años. La presentación clínica incluyó fiebre, problemas gastrointestinales agudos, afectación ocular y mucocutánea. Cuatro cumplieron criterios para Enfermedad de Kawasaki clásica. Todos tuvieron serología positiva para SARS-CoV-2, hemograma patológico, marcadores inflamatorios elevados y pruebas de coagulación alteradas. Cinco casos presentaron hipertransaminasemia y tres retención nitrogenada. Cuatro casos cumplieron criterios para Síndrome de Activación Macrófagica. Todos recibieron inmunoglobulina intravenosa, corticoides y ácido acetil salicílico. Ninguno desarrolló aneurismas coronarios. Solo uno presentó miocarditis, shock y requirió ingreso a Unidad de Cuidados Intensivos. La mayoría evolucionaron favorablemente. En todo niño con fiebre, síntomas gastrointestinales y dermatológicos; asociado a exposición al SARS-CoV-2, debe investigarse compromiso multisistémico.
ABSTRACT During the COVID-19 pandemic, a new, severe and unusual condition called Multisystem Inflammatory Syndrome in children emerged, from which there is still much to learn. We report 8 children admitted to Instituto Nacional de Salud del Niño, in Lima, Perú. Their mean age was 5,1 years. Their clinical presentation included fever, acute gastrointestinal symptoms, ocular and mucocutaneous involvement. Four patients met criteria for classic Kawasaki Disease. All the patients had positive serology for SARS-CoV-2, abnormal complete blood counts and coagulation tests, and elevated inflammatory markers. Five had elevated liver enzymes and three had kidney involvement. Four patients met criteria for Macrophage Activation Syndrome. All of them received intravenous immune globulin, corticosteroids and aspirin. No coronary aneurysms were identified. Only one developed miocarditis, shock and was admitted to the Pediatric Intensive Care Unit. Most patients recovered successfully. Every child with fever, gastrointestinal and dermatological symptoms, associated with prior exposure to SARS-CoV-2, should be investigated for multi-systemic compromise.
Subject(s)
Humans , Male , Female , Child Health , SARS-CoV-2 , Hospitals, Pediatric , Mucocutaneous Lymph Node Syndrome , Patients , Intensive Care Units, Pediatric , Immunoglobulins, Intravenous , COVID-19ABSTRACT
Introducción: La vitamina D en la piel tras la exposición solar se constituye en precursor y agente anabólico óseo que esti- mula el transporte activo de calcio a través de la mucosa intestinal. La Sociedad Europea de Aspectos Clínicos y Económicos de la osteoporosis y osteoartritis, recomienda que pacientes postmenopáusicas con niveles de 25 (OH) D menores de 50 nmol/L reciban suplementación entre 800 y 1000 UI diarias de vitamina D. Objetivo: Determinar en mujeres con osteoporosis el cambio porcentual de 25 (OH) D en sangre, con la administración de 100.000 UI. de vitamina D cápsulas una vez al mes, así como seguridad y grado de satisfacción con el tratamiento. Sujetos y métodos: Estudio observacional, descriptivo, longitudinal, en el que se incluyeron 44 mujeres que recibieron 100.000 UI de vitamina D una vez al mes por tres meses. Se realizó control de laboratorio pre y post-tratamiento a una sub- muestra no probabilística de 10 pacientes. Resultados: El 70% de casos refirió no tener comorbilidades. El valor inicial de vitamina D en la sub-muestra fue 23,5±10,1nmol/l; al final el promedio fue 27,2±9,6 nmol/l. Post-tratamiento los niveles de vitamina D aumentaron un 20% en más del 50% de casos. El 93% de casos no refirieron eventos adversos. Los eventos adversos reportados fueron gastro-intestinales, eventos ósteo-articulares y cefalea. La mayoría de casos reportaron encontrarse satisfechos con el tratamiento. Conclusión: El tratamiento fue muy bien tolerado, la mayoría de casos refirieron estar satisfechos con el tratamiento. Se observaron incrementos porcentuales significativos de 25 (OH) D en sangre luego de 12 semanas de tratamiento. Palabras clave: Vitamina D, osteoporosis, caracterización.
"Introduction: Vitamin D in the skin after sun exposure constitutes precursor and bone anabolic agent that stimulates the active transport of calcium through the intestinal mucosa. The European Society for Clinical and Economic Aspects of Os- teoporosis and Osteoarthritis, recommends that postmenopausal patients with 25 (OH) D levels less than 50 nmol / L receive supplementation between 800 and 1000 IU daily of vitamin D. Objective: Determine in women with osteoporosis the percentage change of 25 (OH) vitamin D in blood, with the adminis-tration of 100,000 IU of vitamin D caps once a month, as well as safety and degree of satisfaction with the treatment. Subjects and methods: Observational, descriptive and longitudinal study, which included 44 women who received 100,000 IU of vitamin D once a month for three months. Pre and Post-treatment laboratory control was performed on a non-proba- bilistic subsample of 10 patients. Results: The 70% of cases reported not having comorbidities. The initial value of vitamin D was 23.5 ± 10.1 nmol/l at the end the average was 27.2 ± 9.6 nmol/l in the subsample. Post-treatment increased Vit D. levels 20.4% in more than 50% of cases, 93% of cases did not report adverse events. The adverse events reported were gastro-intestinal, osteo-articular events and headache. The majority of cases reported being satisfied with the treatment. Conclusion: Treatment was very well tolerated, the majority of cases reported being satisfied with the treatment. Significant percentage increases of 25 (OH) D were observed in blood after 12 weeks of treatment. Key words: Vitamin D, osteoporosis, characterization."
Subject(s)
Humans , Female , Middle Aged , Osteoporosis , Osteoporosis/drug therapy , Vitamin D/administration & dosage , Vitamin D/adverse effects , Vitamin D/bloodABSTRACT
RESUMEN El queratocono es una ectasia corneal bilateral en la cual la córnea asume una forma cónica irregular teniendo en cuenta su afinamiento y protrusión. Su etiología es probablemente multifactorial. Está considerada una enfermedad rara por su baja incidencia; no obstante, se considera que esta incidencia sea mucho más variable y probablemente mayor tras la expansión en el uso de los topógrafos. Se presenta un paciente masculino, blanco, de 68 años de edad, quien acudió a la consulta de catarata en el Centro de Microcirugía Ocular del Instituto Cubano de Oftalmología Ramón Pando Ferrer en mayo del año 2017, por disminución lenta y progresiva de la agudeza visual de ambos ojos, mayor del ojo derecho, con antecedente de uso prolongado de lentes de contacto. Se identificó la presencia de catarata en ambos ojos; se realizaron exámenes preoperatorios y se programó cirugía de facoemulsificación del ojo derecho. Se calculó el lente a implantar para una refracción esperada dentro del rango de la emetropía. Se obtuvo como resultado refractivo final una sorpresa refractiva posoperatoria hipermetrópica y se decidió realizar un piggy back secundario. El resultado refractivo final estuvo cercano a los valores de la emetropía. Como consecuencia de la gran inestabilidad de los valores queratométricos en pacientes con ectasias corneales, constituye un reto para el cirujano de catarata decidir cuál es el lente ideal a implantar para obtener un resultado refractivo adecuado(AU)
ABSTRACT Keratoconus is a bilateral corneal ectasia in which the cornea takes on an irregular conical shape due to its thinning and protrusion. The etiology of keratoconus is probably multifactorial. The disease has been classed as rare because of its low incidence. However, it is considered that such incidence will be much more variable and probably greater after expansion of the use of topographs. A male white 68-year-old patient who had attended cataract consultation at the Ocular Microsurgery Center of Ramón Pando Ferrer Cuban Institute of Ophthalmology in May 2017, presents with slow progressive visual acuity reduction in both eyes, greater in the right eye, and an antecedent of prolonged use of contact lenses. Examination revealed the presence of cataracts in both eyes. Preoperative tests were performed and right eye phacoemulsification surgery was planned. Calculation was made of the lens to be implanted to achieve an expected refraction within the range of emmetropia. The final outcome obtained was a postoperative refractive hyperopic surprise, and it was decided to perform a secondary piggy back. The final refractive outcome was close to emmetropia. Because of the great instability of keratometric values in patients with corneal ectasias, the cataract surgeon is faced with the challenge of deciding which is the ideal lens to be implanted to obtain an adequate refractive outcome(AU)
Subject(s)
Humans , Male , Aged , Cataract/diagnosis , Phacoemulsification/methods , Keratoconus/epidemiology , Lenses, Intraocular/adverse effectsABSTRACT
La fractura mandibular es uno de los tipos más comunes en el trauma maxilofacial pediá-trico. El principal objetivo del manejo de fracturas, es la restauración de forma y función del hueso. Las fracturas incompletas son más comunes, debido a la elasticidad del hueso; por lo que, usualmente el tratamiento de fracturas en niños es conservador.Debido al progreso en materiales de reparación ósea y la mejora tecnológica, actualmente la proporción de niños tratados con reducción abierta y fijación interna (RAFI) ha au-mentado; siendo el uso de miniplacas y minitornillos el tratamiento gold estándar para fijación semirrígida craneomaxilofacial. Una alternativa son los materiales reabsorbibles, lo cuales no requieren retiro y van degradándose gradualmente, ventaja considerable en el manejo de fracturas mandibulares en niños. Presentamos el caso de un paciente de 6 años, quién sufrió una fractura mandibular parasinfisiaria y condilar por caída de escale-ras. Al examen se evidencia limitación de apertura bucal, dolor moderado a la palpación; se solicitaron exámenes imagenológicos donde se evidencia trazo de fractura parasinfisia-ria y trazo a nivel intracapsular de cóndilo izquierdo, estas fracturas fueron manejadas con placas reabsorbibles y tratamiento conservador, respectivamente. El resultado fue óptimo. Palabras clave: Fracturas mandibulares; Reducción de fractura abierta; Fijación de frac-tura interna; Placa reabsorbible; Niños (fuente: DeCS BIREME).
The mandibular fracture is one of the most common types in pediatric maxillofacial trauma. The main objective of fracture management is the restoration of bone shape and function. Incomplete fractures are more common due to bone elasticity; so, usually the treatment of fractures in children is conservative. Due to the progress on materials bone reparation and technological improvement, currently the proportion of children treated with open reduction and internal fixation (RAFI) has increased. The use of mi-niplates and miniscrews are the gold standard treatment for craniomaxillofacial semirigid fixation. One alternative are the resorbable materials, which do not require the removal and are gradually degrade. This is a considerable advantage for the management of mandibular fractures in children. We present the case of a 6-year-old patient who suffered a parasympathetic mandibular and condylar fracture. The clinical examination showed limited oral opening and moderate pain on palpation. The radiological evaluation evi-denced parasymphyseal and intracapsular fracture traces on the left condyle. These frac-tures were managed with resorbable plates and conservative treatment, respectively. The result was optimal. Keywords: Mandibular fractures; Open fracture reduction; Fracture fixation internal; Biore-sorbable plate; Children (source: MeSH NLM).