Traumatic dental injuries sustained during Chile's civil unrest: A case series study.

BACKGROUND/AIM: During Chile's period of social unrest, numerous people suffered physical trauma due to the use of police force. However, there have been no reports regarding traumatic dental injuries (TDIs) suffered in this context. This study aims to describe the dental trauma of patients injured by police during the social unrest period in Chile from 2019 to 2021. MATERIAL AND METHODS: A case series methodology was employed. Following informed consent, clinical records of patients admitted to the Ocular and Dentomaxillofacial Prosthetic Care and Rehabilitation Program, who were affected by the violence of state agents during social mobilizations, were reviewed from October 2019 to December 2021. Information on the sociodemographic characteristics of the patients and the TDI diagnoses with their treatment needs were collected. A descriptive analysis was performed. RESULTS: Forty-six patients were identified, nine of whom agreed to the informed consent. Most were male, with a mean age of 28 years, public health insurance, and a high educational level. The most common causes of injury were kinetic impact projectiles (KIPs) and the use of physical force (punches, kicks, or pushes). Of the nine cases described, 26 teeth were affected by TDI. The most affected teeth were the central upper incisors and, in most cases, they presented lesions in both injury categories: NA0D.0 (the tooth and pulp) and NA0D.1 (periodontal tissues). Treatment needs varied and included some complex procedures, such as implant-retained crowns and removable dental prostheses. CONCLUSIONS: The use of force by police during the period of social unrest in Chile caused TDIs among demonstrators, which were mainly due to physical force from less-than-lethal weapons. Most cases presented injuries affecting the incisors with multiple teeth requiring complex treatments.

Relative roles of climatic suitability and anthropogenic influence in determining the pattern of spread in a global invader.

Because invasive species threaten the integrity of natural ecosystems, a major goal in ecology is to develop predictive models to determine which species may become widespread and where they may invade. Indeed, considerable progress has been made in understanding the factors that influence the local pattern of spread for specific invaders and the factors that are correlated with the number of introduced species that have become established in a given region. However, few studies have examined the relative importance of multiple drivers of invasion success for widespread species at global scales. Here, we use a dataset of >5,000 presence/absence records to examine the interplay between climatic suitability, biotic resistance by native taxa, human-aided dispersal, and human modification of habitats, in shaping the distribution of one of the world's most notorious invasive species, the Argentine ant (Linepithema humile). Climatic suitability and the extent of human modification of habitats are primarily responsible for the distribution of this global invader. However, we also found some evidence for biotic resistance by native communities. Somewhat surprisingly, and despite the often cited importance of propagule pressure as a crucial driver of invasions, metrics of the magnitude of international traded commodities among countries were not related to global distribution patterns. Together, our analyses on the global-scale distribution of this invasive species provide strong evidence for the interplay of biotic and abiotic determinants of spread and also highlight the challenges of limiting the spread and subsequent impact of highly invasive species.

Rational application of the ESPGHAN 2022 recommendations for the follow-up of the paediatric coeliac patient: consensus document of scientific societies (SEGHNP, AEPAP, SEPEAP, SEEC, AEG, SEPD, SEMFYC, SEMG and SEMERGEN).

Coeliac disease is a common condition for which the only current treatment is a gluten-free diet. Adherence to this diet is not always easy and is associated with a reduction in quality of life for the patient and their family. Non-adherence is associated with complications of varying severity. The lack of control at the outpatient care level in a high percentage of these patients evinces the need to improve follow-up protocols and the approach to care delivery with coordination of paediatric gastroenterology units (PGU) and primary care paediatricians. With this aim in mind, the present document was developed by consensus to offer a set of recommendations adapted to our region, based on the recent recommendations published by the European Society of Paediatric Gastroenterology, Hepatology and Nutrition (ESPGHAN), and with participation of the pertinent scientific societies, including those concerning the adult population, for the management and follow-up of adolescents and the transition to adult care.

Mechanisms shaping the gypsum stromatolite-like structures in the Salar de Llamara (Atacama Desert, Chile).

The explanation of the origin of microbialites and specifically stromatolitic structures is a problem of high relevance for decoding past sedimentary environments and deciphering the biogenicity of the oldest plausible remnants of life. We have investigated the morphogenesis of gypsum stromatolite-like structures currently growing in shallow ponds (puquíos) in the Salar de Llamara (Atacama Desert, Northern Chile). The crystal size, aspect ratio, and orientation distributions of gypsum crystals within the structures have been quantified and show indications for episodic nucleation and competitive growth of millimetric to centimetric selenite crystals into a radial, branched, and loosely cemented aggregate. The morphogenetical process is explained by the existence of a stable vertical salinity gradient in the ponds. Due to the non-linear dependency of gypsum solubility as a function of sodium chloride concentration, the salinity gradient produces undersaturated solutions, which dissolve gypsum crystals. This dissolution happens at a certain depth, narrowing the lower part of the structures, and producing their stromatolite-like morphology. We have tested this novel mechanism experimentally, simulating the effective dissolution of gypsum crystals in stratified ponds, thus providing a purely abiotic mechanism for these stromatolite-like structures.

Rapid Anti-tTG-IgA Screening Test for Early Diagnosis of Celiac Disease in Pediatric Populations.

A large number of patients with celiac disease (CD) remain undiagnosed because they do not fulfill the criteria for entry into the conventional diagnostic workflow. This study evaluated the clinical utility of anti-tissue transglutaminase IgA antibody lateral flow immunoassays (anti-tTG-IgA LFIA) in the undiagnosed-CD-based pediatric population and the impact of a gluten-free diet (GFD) on screening-detected CD. A total of 576 volunteers were tested for anti-tTG-IgA. Gluten consumption habits, CD related symptoms, and risk factors for CD development were evaluated. Volunteers testing positive for anti-tTG-IgA were referred to the conventional CD diagnostic workflow, and the impact of the GFD on health-related quality of life (HR-QoL) was measured. Among them, 13 had a positive anti-tTG-IgA LFIA test result: 11 had confirmed CD (1.91%), one refused confirmatory tests, and another is undergoing diagnosis. Regarding the CD prevalence, no significant differences were observed among risk (1.89%) and symptomatic (2.65%) groups and the entire tested population (1.55%). Rapid anti-tTG-IgA LFIAs could be of clinical utility in primary care for the early identification of children with CD unidentified by the conventional diagnostic workflow. It could potentially reduce the costs of undiagnosed CD, avoiding unnecessary referrals to gastroenterologists, reducing diagnosis delays and long-term problems, and improving patients' HR-QoL.

101 contact twins in gypsum experimentally obtained from calcium carbonate enriched solutions: mineralogical implications for natural gypsum deposits.

Gypsum twins are frequently observed in nature, triggered by a wide array of impurities that are present in their depositional environments and that may exert a critical role in the selection of different twin laws. Identifying the impurities able to promote the selection of specific twin laws has relevance for geological studies aimed at interpreting the gypsum depositional environments in ancient and modern deposits. Here, the effect of calcium carbonate (CaCO3) on gypsum (CaSO4·2H2O) growth morphology has been investigated by performing temperature-controlled laboratory experiments with and without the addition of carbonate ions. The precipitation of twinned gypsum crystals has been achieved experimentally (101 contact twin law) by adding carbonate to the solution, and the involvement of rapidcreekite (Ca2SO4CO3·4H2O) in selecting the 101 gypsum contact twin law was supported, suggesting an epitaxial mechanism. Moreover, the occurrence of 101 gypsum contact twins in nature has been suggested by comparing the natural gypsum twin morphologies observed in evaporitic environments with those obtained in experiments. Finally, both orientations of the primary fluid inclusions (of the negative crystal shape) with respect to the twin plane and the main elongation of sub-crystals that form the twin are proposed as a fast and useful method (especially in geological samples) to distinguish between the 100 and 101 twin laws. The results of this study provide new insights into the mineralogical implications of twinned gypsum crystals and their potential as a tool to better understand natural gypsum deposits.

The role of borosilicate glass in Miller-Urey experiment.

We have designed a set of experiments to test the role of borosilicate reactor on the yielding of the Miller-Urey type of experiment. Two experiments were performed in borosilicate flasks, two in a Teflon flask and the third couple in a Teflon flask with pieces of borosilicate submerged in the water. The experiments were performed in CH4, N2, and NH3 atmosphere either buffered at pH 8.7 with NH4Cl or unbuffered solutions at pH ca. 11, at room temperature. The Gas Chromatography-Mass Spectroscopy results show important differences in the yields, the number of products, and molecular weight. In particular, a dipeptide, multi-carbon dicarboxylic acids, PAHs, and a complete panel of biological nucleobases form more efficiently or exclusively in the borosilicate vessel. Our results offer a better explanation of the famous Miller's experiment showing the efficiency of borosilicate in a triphasic system including water and the reduced Miller-Urey atmosphere.

Experiencia cotidiana de personas con trauma ocular y maxilo facial producto de violencia por agentes del Estado en el contexto del estallido social chileno: aproximaciones desde una perspectiva de derechos humanos / Experiência cotidiana de pessoas com trauma ocular e maxilofacial resultante de violência por agentes do Estado no contexto da crise social chilena: aproximações a partir de uma perspectiva de direitos humanos / Daily experience of people with ocular and maxillofacial trauma as a result of violence by State agents in the context of the Chilean social outbreak: approaches from a human rights perspective

Resumen Introducción La violenta represión ocurrida en Chile durante el estallido social (2019-2020) dejó un número sin precedentes de personas lesionadas con resultado de trauma ocular y maxilofacial producto de la acción de agentes del Estado, desatando una crisis socio-sanitaria que requirió del abordaje las problemáticas de salud con énfasis en el daño estructural y funcional. Objetivo Analizar la experiencia cotidiana de personas afectadas por trauma ocular y/o maxilofacial desde una perspectiva de derechos humanos, con énfasis en aportar antecedentes que contribuyan a los procesos de apoyo funcional y psicosocial. Método Estudio de enfoque cualitativo, considerando el análisis de 3 entrevistas en profundidad centradas en la experiencia cotidiana producida a raíz de la violencia policial. Éstas se analizaron en base a la técnica de análisis de contenido, con una posterior triangulación. Resultados Se apreciaron una serie de interferencias y repercusiones cotidianas producto del trauma, generando el fenómeno de una cotidianidad interferida, además del extrañamiento de sí misma/o. Se discutió sobre el contraste entre las experiencias y expectativas de la atención en salud y procesos de reparación, que resultan aún insuficientes y tienden hacia la revictimización. Conclusión El acceso a rehabilitación funcional y psicosocial es parte fundamental de los procesos de reparación integral de las personas que vivieron estas experiencias traumáticas durante el estallido social. Es fundamental que los dispositivos sanitarios y judiciales profundicen abordajes desde una perspectiva de derechos humanos incorporando el enfoque de género para cumplir los principios de verdad, justicia, reparación y garantías de no repetición.

Resumo Introdução A violenta repressão ocorrida no Chile durante a crise social (2019-2020) deixou um número sem precedentes de pessoas feridas por traumas oculares e maxilofaciais, produto da ação de agentes do Estado, desencadeando uma crise sociossanitária que exigiu a abordagem dos problemas de saúde com ênfase nos danos estruturais e funcionais. Objetivo Analisar a experiência cotidiana de pessoas acometidas por traumas oculares e/ou maxilofaciais sob a ótica dos direitos humanos, com ênfase no fornecimento de informações básicas que contribuam para os processos de apoio funcional e psicossocial. Método Estudo com abordagem qualitativa, considerando a análise de três entrevistas em profundidade, focadas na experiência cotidiana produzida em decorrência da violência policial. Estas foram analisadas ​​com base na técnica de análise de conteúdo, com posterior triangulação de dados. Resultados Observou-se uma série de interferências e repercussões cotidianas em decorrência do trauma, gerando o fenômeno de uma cotidianidade interferida, além do estranhamento de si mesma/o. Discutiu-se o contraste entre as experiências e expectativas da atenção em saúde e processos de reparação, que ainda são insuficientes e tendem à revitimização. Conclusão O acesso à reabilitação funcional e psicossocial é parte fundamental dos processos de reparação integral e psicossocial das pessoas que vivenciaram essas experiências traumáticas durante a crise social. É fundamental que os dispositivos sanitários e judiciais aprofundem as abordagens desde uma perspectiva dos direitos humanos, incorporando o enfoque de gênero para cumprir os princípios de verdade, justiça, reparação e garantias de não repetição.

Abstract Introduction The violent repression that occurred in Chile during the social outbreak (2019-2020) left an unprecedented number of people injured as a result of ocular and maxillofacial trauma as a result of the action by state agents, unleashing a socio-sanitary crisis that required the approach of health problems with an emphasis on structural and functional damage. Objective To analyze the daily experience of people affected by ocular and/or maxillofacial trauma from a human rights perspective, with emphasis on providing background information that contributes to functional and psychosocial support processes. Method Study with a qualitative approach, considering the analysis of three in-depth interviews focused on the daily experience produced as a result of police violence. These were analyzed based on the content analysis technique, with subsequent triangulation. Results A series of interferences and daily repercussions as a result of the trauma were observed, generating the phenomenon of an interfered daily life in addition to self-estrangement. The contrast between the experiences and expectations of health care and reparation processes was discussed, which are still insufficient and tend towards re-victimization. Conclusion Access to functional and psychosocial rehabilitation is a fundamental part of the processes of integral and psychosocial repair for the people who lived through these traumatic experiences during the social outbreak. It is essential that health and judicial mechanisms deepen approaches from a human rights perspective, incorporating the gender approach to comply with the principles of truth, justice, reparation, and guarantees of non-repetition.

[Pneumobilia. A case report]. / Neumobilia. Informe de un caso.

Pneumobilia, gas within the biliary tract, is due to an abnormal connection between the gastrointestinal tract and the biliary tract and is considered a serious pathology usually requiring surgical intervention. Most cases of pneumobilia are related to gallstone disease, and spontaneous biliary-enteric fistula is reported to be the most common cause of pneumobilia. Another well-documented cause of pneumobilia is a surgically created anastomosis between the biliary tract and the bowel, the Whipple procedure, and choledocho-jejunostomy, endoscopic retrograde cholangiopancreatography with papillosphincterotomy or surgical transduodenal sphincteroplasty. Transient incompetence of the sphincter of Oddi, gas-forming infections, and trauma have also been reported to cause pneumobilia. We present the case of a 74-year-old woman with asymptomatic cholelithiasis, pneumobilia and cholecystoduodenal fistula treated with cholecystectomy, fistula closure with Graham patch, Stamm-Kader gastrostomy and needle catheter jejunostomy. On the first postoperative day she developed a biliary duodenal fistula that required nutritional support with parenteral, enteral nutrition and octreotide acetate with fistula closure 2 weeks later. We review the etiology, surgical treatment and economic burden. Laparoscopic cholecysto-fistulectomy by skilled laparoscopic surgeons can be adopted as a first-choice treatment for cholecystoduodenal fistula to reduce morbility risks and costs.

Beneficios del abordaje endoscópico en miringoplastias / Endoscopic approach benefits in myringoplasties / Benefícios da abordagem endoscópica em miringoplastias

Introducción: la fisiopatología de las otitis medias crónicas simples está en estrecha relación con las rutas de ventilación del sistema tubo tímpano mastoideo, el cual tiene diversos estrechamientos o istmos que son suceptibles de presentar bloqueos de múltiples causas; por lo tanto es necesario que durante la resolución quirúrgica de esta patología se realice sistemáticamente la revisión de dichas rutas de ventilación. Objetivo: Demostrar los beneficios de la cirugía endoscópica de oído en la realización de miringoplastias. Material y métodos: Estudio descriptivo multicéntrico. Revisión de historias clínicas. Resultados: Se realizaron 54 miringoplastias mediante abordaje endoscópico transcanal con la correspondiente exploración de rutas de ventilación. Se evidenciaron 7,4% de casos con bloqueos en los diferentes diafragmas epitimpánicos. El porcentaje de reperforaciones fue del 9,25%. Conclusiones: Si bien la técnica de posicionamiento del injerto es similar a la utilizada tradicionalmente, en el presente estudio se evidenció un leve incremento del índice de reperforaciones a expensas del uso de pericondrio. El uso de técnica endoscópica en miringoplastia presenta una tasa de reperforación comparable a la de la biblografía actual, por lo tanto el principal beneficio sería la detección de bloqueos en las rutas de ventilación del oído medio.

Introduction: the pathophysiology of chronic otitis media simple is closely related with routes of ventilation of the tube tympanum mastoid system, which has several constrictions or istmus that are susceptible to have obstructions of multiple causes, therefore it is necessary that during the surgical resolution of this pathology the review of ventilation routes are systematically performed. Objective: To demonstrate the benefits of endoscopic ear surgery in the performance of myringoplasty. Material and methods: Multi-centre descriptive study, clinical histories review. Results: 54 cases of myringoplasty were performed using a transcanal endoscopic approach with ventilation routes exploration. 7,4% of cases presented blocks in the different epytimpanic diaphragms and the reperforation cases represented 9,25%. Conclusions: Although the technique of positioning the graft is the same as that traditionally used, in the present study there was a slight increase in the index of reperforation at the expense of perichondrium use. The use of endoscopic technique in myringoplasty has an index of reperforation comparable to the current bibliography. Therefore the main benefit would be the detection of blockages in the routes of ventilation in the middle ear.

Introdução: a fisiopatologia da otite média crônica simple esta estreitamente em relação com o sistema de ventilação mastóide tímpanico , que tem várias constrições ou istmos que são suscetíveis de apresentar fechaduras de múltiplas causas , portanto, é necessário que, durante a resolução cirúrgica desta patología a revisão das vias de ventilação seja realizada de forma sistemática. Objectivo: Demostrar os benefícios da cirurgia endoscópica na realização de miringoplastias. Material e métodos: Estudo descritivo multicenter, revisão de prontuários médicos. Resultados: 58 miringoplastias foram realizadas utilizando a abordagem endoscópica trasncanal com a correspondente exploração de rutas de ventilação. Em 7,4 % dos casos com bloqueios em os diferentes diafragmas epitimpánicos e o percentual de reperforaçoes foi de 9,25%. Conclusões: Enquanto a técnica de posicionamento de enxerto e semelhante aquela usada tradicionalmente, no presente estudo a um ligeiro aumento no índice de reperforaçoes a custa de usar pericondrio. A utilização da técnica endoscópica em miringoplastias tem una taxa de reperforação comparável com a bibliografia corrente, por conseguinte a principal vantagem seria a de detectar bloqueios nas rutas de ventilação do ouvido medio.

Sinusitis fúngica alérgica en paciente pediátrico - reporte de un caso / Allergic fungal sinusitis in children - case report / Sinusite fúngica alergica em paciente pediátrico - relato de um caso

La sinusitis micótica alérgica, desde el punto de vista clínico, se distingue por la coexistencia de poliposis nasal y micosis no invasiva. Se presenta con mayor frecuencia en adolescentes o adultos jóvenes inmunocompetentes con antecedentes de atopia, y no existen diferencias significativas en la relación hombre: mujer. La fisiopatología de la sinusitis alérgica micótica es desconocida. El manejo es la cirugía funcional endoscópica. Su objetivo fundamental es extirpar por completo toda la mucina alérgica y el material micótico residual, con el fin de eliminar o reducir el estímulo antigénico. Reportamos este caso, de un paciente pediátrico que presentó sintomatología obstructiva nasal de años de evolución acompañado de asimetría facial, secundario a rinosinusitis fúngica alérgica, requiriendo tratamiento quirúrgico para su resolución.

Clinical allergic fungal sinusitis is distinguished by the coexistence of nasal polyposis and non-invasive mycosis. It occurs more frequently in immunocompetent adolescents or young adults with a history of atopy, and there are no significant differences in the male: female relationship. The pathophysiology of fungal allergic sinusitis is unknown. Management is endoscopic functional surgery. Its primary goal is to completely remove all of the allergic mucin and residual mycotic material, in order to eliminate or reduce the antigenic stimulus. We report this case of a pediatric patient who presented nasal obstructive symptomatology of years of evolution accompanied by facial asymmetry, secondary to allergic fungal rhinosinusitis, requiring surgical treatment for resolution.

A sinusite fúngica alérgica clínica se distingue pela coexistência de polipose nasal e micoses não invasivas. Ela ocorre mais freqüentemente em adolescentes imunocompetentes ou adultos jovens com história de atopia, e não existem diferenças significativas na relação masculino: feminino. A fisiopatologia da sinusite fúngica alérgica é desconhecida. Manipulação é a cirurgia endoscópica funcional. Seu principal objetivo é remover completamente toda a mucina alérgica residual e materiais micó- tica, a fim de eliminar ou reduzir o estímulo antigênico. Relatamos ou evento uma paciente pediátrico tinha sintomas nasais anos obstrução de evolução, faciais cascas acompanhadas assimetria secundária a rinossinusite fúngica alérgica, necessitando de tratamento de ferramentas cirúrgicas para resolução.

Aftershocks of Chile's earthquake for an ongoing, large-scale experimental evaluation.

Evaluation designs for social programs are developed assuming minimal or no disruption from external shocks, such as natural disasters. This is because extremely rare shocks may not make it worthwhile to account for them in the design. Among extreme shocks is the 2010 Chile earthquake. Un Buen Comienzo (UBC), an ongoing early childhood program in Chile, was directly affected by the earthquake. This article discusses (a) the factors the UBC team considered for deciding whether to put on hold or continue implementation and data collection for this experimental study; and (b) how the team reached consensus on those decisions. A lesson learned is that the use of an experimental design for UBC insured that the evaluation's internal validity was not compromised by the earthquake's consequences, although cohort comparisons were compromised. Other lessons can be transferred to other contexts where external shocks affect an ongoing experimental or quasi-experimental impact evaluation.

Disección cadavérica endoscópica de oído medio / Endoscopic cadaver dissection of middle ear / Dissecção endoscópica de orelha média em cadáveres

El avance tecnológico en los últimos tiempos ha permitido la creación de nuevos abordajes quirúrgicos. En este sentido surge el endoscopio como elemento capaz de ofrecer una gran visualización de los diferentes accidentes anatómicos de la cavidad timpánica sin necesidad de resecar tejido óseo circundante, ofreciendo de alguna manera la posibilidad de resolver patologías otológicas mediante un abordaje mínimamente invasivo. En este trabajo se demuestran los diferentes pasos de la disección cadavérica endoscópica de oído con el fin de facilitar al cirujano en formación el inicio en la materia.

Technological advances during the last time have enabled the creation of new surgical approaches. Endoscopic surgery comes out in this sense as an element capable of offering great visualisation of the different anatomical structures within the tympanic cavity without the need of removing surrounding bone structure bringing the possibility of treating otological pathology with a minimum invasive approach. In this paper the different steps to cadaveric disection are shown in order to initiate the novel surgeon in the subject.

O avanço tecnológico nos últimos tempos tem permitido a criação de novas abordagens cirúrgicas. Neste sentido surge o endoscópio como elemento capaz de oferecer uma visualização de diferentes acidentes anatômicos da cavidade timpânica sem necessidade de ressecar tecido ósseo circundante, oferecendo de alguma maneira a possibilidade de resolver patologias otológicas usando uma abordagem minimamente invasiva. Neste trabalho se mostra as diferentes etapas da dissecção endoscópica de ouvido com o fim de facilitar o cirurgião em formação o início na matéria.