Dental Anomalies in Permanent Teeth Associated With Nonsyndromic Cleft Lip and Palate in a Group of Colombian Children.

OBJECTIVES: To assess the risk of dental anomaly presentation in permanent teeth in a group of Colombian children with nonsyndromic cleft lip and palate (NSCLP) and to determine the frequency of the anomalies according to the cleft type. METHODS: An analytical matched case-control study was conducted with 210 controls and 210 patients with NSCLP. The patients were classified into 3 groups: complete right unilateral cleft lip and palate (RCLP), complete left unilateral cleft lip and palate (LCLP), and complete bilateral cleft lip and palate (BCLP). Univariate and multivariate Poisson regression models were used to analyze paired samples (Bonferroni adjustment, P ≤ .002). RESULTS: A high risk of finding agenesis of the maxillary lateral incisors, supernumerary teeth, microdontia of the maxillary lateral incisors, and rotation of the maxillary central incisors adjacent to the cleft (P < .0001) was observed in the patients with NSCLP. One or more dental anomalies were found in 98% of patients with BCLP, in 96% of those with LCLP, and in 87% of those with RCLP. Most of the anomalies were located on the cleft area. The incidence relative risk (IRR) of anomalies was highest in patients with BCLP (IRR: 10.5; 95% confidence interval [CI]: 6.76-16.3), followed by in those with LCLP (IRR: 8.51; 95% CI: 5.64-12.8). CONCLUSIONS: Most dental anomalies were found in the cleft area; this was expected because the cleft area was the most affected in the patients included in this study.

Image-guided brachytherapy in cervical cancer: Experience in the Complejo Hospitalario de Navarra.

PURPOSE: To evaluate dosimetric and clinical findings of MRI-guided HDR brachytherapy (HDR-B) for cervical carcinoma. MATERIAL AND METHODS: All patients had a CT, MRI and pelvic-paraaortic lymphadenectomy. Treatment: pelvic (+/-)para-aortic3D/IMRT radiotherapy (45 Gy), weekly cisplatin and HDR-B and pelvic node/parametrial boost 60 Gy until interstitial brachytherapy was done. Two implants: 2008-2011: 5 fractions of 6 Gy, 2011: 2016, 4 fractions of 7 Gy. MRI/TAC were done in each implant. The following were defined: GTV, CTH-HR, CTV-IR; OAR: rectum, bladder and sigmoid. RESULTS: From 2007 to 2016: 57 patients. Patients: T1b2-T2a: 4p, T2b 41p, T3a: 2p; T3B 8p T4a: 2p; N0: 32p, N1 21p, no lymphadenectomy: 4p. Median follow up: 74.6 m (16-122 m), recurrence: 5p local, 6p node, 9p metastasis and 37p without recurrence.Local control 5 years: 90.1%; Ib2-IIB: 94.8%, III-IVa: 72.2%. (p:0.01). RDFS 5y was 92.5%; IB2-IIB: 93%, III: 85% (p:0.024); for pN0: 100%; pN+ iliac-paraaortic: 71.4% (p: 0.007). MFS 5y was 84.1%. Overall survival (OS) at 5y: 66.6% and the cancer specific survival (CEOS) was 74%. Univariate analysis survival: stage Ib2-II 83% vs. III-IVa 41% (p = 0.001); histology: squamous 78%, adenocarcinoma 59.7% (p: ns); lymph node: N0 85% vs. PA+P- 72%, and PA+P+ 35% (p = 0.010). In relation with: HR-CTV dose > 85 Gy, CEOS: 82.5% vs. 77%, and volume CTV-HR < 30 cc: 81.8% and >30 cc: 67%; p: ns. Acute grade 2-3 toxicity: rectal 15.7%, intestinal 15.7% and vesical 15.5%. CONCLUSION: Use of interstitial HDR-BQ guided by RM increased CTV-HR dose and local control, like EMBRACE results. Nodal boost improves RDFS and perhaps OS.

Para-aortic plus pelvic lymphadenectomy in locally advanced cervical cancer: A single institutional experience.

OBJECTIVE: The aim of the study is to assess the safety and efficacy of transperitoneal laparoscopic para-aortic and pelvic lymphadenectomy in the setting of surgical staging of patients with locally advanced cervical cancer (LACC), and to analyse the prognostic value and impact of this staging on the survival prognosis of this condition. STUDY DESIGN: Data from 67 patients with LACC who underwent transperitoneal laparoscopic para-aortic and pelvic lymphadenectomy and who received chemo-radiation therapy were retrospectively analysed. RESULTS: Metastatic lymph nodes (LN) were identified in 32 patients (47.7%), 20 (29.8%) had metastatic LN in the pelvic area and 12 (17.9%) had metastatic LN in the pelvic and para-aortic area. There were no skip metastases in the para-aortic area. After a median follow-up of 54.6 months (5-122.2 months), the 5-year local control and disease-free survival (DFS) rates for the whole group were 91.1% and 60.5% respectively. The five-year DFS for patients without LN metastasis was 86.4%, while for patients with pelvic LN metastases or pelvic and para-aortic metastases was 34.2% and 24.2% respectively (p < 0.001). The five-year overall survival (OS) for the whole group was 67.3%. The mortality rate in patients with para-aortic nodal metastases was increased compared to patients with negative nodes (5-year OS 21.3% vs 81.6% respectively, p = 0.005), but the OS rate was similar in patients with negative nodes and those with only pelvic nodes affected (5-year OS 81.6% vs 70.8% respectively, p = 0.380). This approach allowed the modification of the initial treatment plan in the para-aortic area in 13.4% of patients and in the pelvic area in 28.3%. The overall intraoperative morbidity rate was 5.9%, while the postoperative morbidity rate was 10.4%, with only 3 patients presenting grade 3 morbidity. CONCLUSIONS: Transperitoneal para-aortic and pelvic lymphadenectomy provides precise information about nodal state and allows personalized treatment planning in patients with LACC, avoiding false negative (FN) and false positive (FP) imaging results. In 17.9% of patients, the external beam radiotherapy (EBRT) field had to include the aortic area, whilst 47.7% received pelvic boost to the involved nodes.

INFECCIÓN NATURAL POR Trypanosoma cruzi (TRYPANOSOMATIDAE) EN TRIATOMINOS INTRADOMÉSTICOS DEL DEPARTAMENTO DE GUAINÍA / Natural infection with Trypanosoma cruzi (TRYPANOSOMATIDAE) in intradomestic triatomine bugs from Guainía department

RESUMEN La búsqueda continua de triatominos forma parte de los programas de vigilancia de la enfermedad de Chagas en zonas con características ecológicas apropiadas para la presencia del vector, permitiendo priorizar y definir las acciones de intervención. El objetivo del presente trabajo fue determinar la presencia y estado de infección de triatominos en viviendas del municipio de Inírida (Guainía). El estudio se realizó entre 2018 y 2019 mediante vigilancia comunitaria y búsqueda activa. Los vectores se identificaron y evaluaron por PCR. Se recolectaron cinco triatominos (un Panstrongylus lignarius y cuatro P. geniculatus). Se evidenció la infección natural en ambas especies. La genotipificación mostró la presencia de TcI Dom. Se actualiza así la presencia e infección P. lignarius, así como la infección de P. geniculatus para Inírida.

ABSTRACT The continuous search and characterization of triatomine bugs is essential for Chagas disease surveillance programs in areas with ideal ecological conditions for the distribution of these vectors. These activities are necessary to define and optimize intervention strategies. The objective of this work was to determine the presence of triatomine and its infection status in households located in the municipality of Inírida (Guainía). Between 2018 and 2019, we developed a community participation strategy where an active search was essential for the capturing of triatomine bugs. The collected bugs were evaluated by PCR allowing to identify one as Panstrongylus lignarius and four as P. geniculatus. Genotyping showed the presence of TcI Dom confirming infection in both species. Thus, this study presents an update of the infection status of P. geniculatus and the presence of infected P. lignarius in the Guainía region in Colombia.

Resultado de Tratamientos Ortodóncicos y su Relación con la Complejidad de la Maloclusión / Outcome of Orthodontic Treatments and its Relationship to Malocclusion Complexity

Este estudio descriptivo evalúa los resultados clínicos estáticos de los tratamientos finalizados en el Posgrado de Ortodoncia de la Universidad de Antioquia durante el periodo 2010-2011 y su relación con la complejidad inicial y otros factores administrativos. A los pacientes terminados se les realizó un seguimiento documental de la historia clínica para determinar el grado de compromiso inicial y se evaluaron, con los parámetros del Objective Grading System (OGS) del American Board of Orthodontic (ABO), los modelos y las radiografías panorámicas finales. De 99 pacientes que terminaron el tratamiento, 40 cumplieron los criterios de inclusión. El 80% de los pacientes que terminaron el tratamiento tenían maloclusión comprometida o altamente comprometida al iniciar. El puntaje OGS del ABO encontrado fue en promedio de 31,7(±8,5) puntos y el 50% de los casos pasaban los criterios del OGS. El tiempo de duración del tratamiento (55±22,25 meses) y el número de citas promedio para terminar el tratamiento (37,3±11,4) aumentan según la complejidad de la maloclusión inicial. El grado de maloclusión inicial tuvo relación estadísticamente significativa con los puntajes de OGS (p=0,018), mientras que otras variables administrativas y clínicas no afectaron los resultados. Los valores finales del OGS encontrados no son los ideales y son afectados por el compromiso de la maloclusión.

This descriptive study assessed the clinical static results of the treatment finished in the orthodontic graduate clinics of the University of Antioquia during the years 2010-2011, and its relationships with initial malocclusion complexity and some administrative factors. The records and complete medical histories of the patients were reviewed to determine the degree of initial malocclusion commitment and the final panoramic radiography and plasters were evaluated applying the Objective Grading System (OGS) proposed by the American Board of Orthodontic (ABO). Of 99 patients who completed treatment, 40 met the inclusion criteria. 80% of patients, who completed treatment, started with committed or highly committed malocclusion. The ABO OGS score found an average of 31.7 (±8.5) and 50% of the cases approved OGS criteria. The duration of treatment (55±22.25 months) and the average number of appointments to complete treatment (37.3±11.4) increased with the complexity of the initial malocclusion. The degree of initial malocclusion had statistically significant relationship with OGS scores (p=0.018), while other administrative and clinical variables did not affect the results. The final values of OGS found are not ideal and are affected by the complexity of the initial malocclusion.

Opinión del familiar sobre la calidad de atención que brindan las enfermeras, a los pacientes adultos mayores en el servicio de hospitalización en el Hospital Geriátrico San Isidro Labrador 2010 / Opinion of the relative on the quality of attention that offers to the nurse in the service of hospitalization of the Geriatrical Hospital San Farm Isidro, 2010

El objetivo fue determinar la opinión del familiar sobre la calidad de atención que brinda la enfermera en el servicio de hospitalización del Hospital Geriátrico "San Isidro Labrador" e identificar la opinión según la dimensión técnica, interpersonal y confort. Material y Método: El estudio fue de nivel aplicativo, tipo cuantitativo, método descriptivo de corte transversal, la técnica fue la entrevista y el instrumento una escala modificada tipo Lickert, aplicado previo consentimiento informado. Resultados: Del 100 por ciento (70), 60 por ciento (42) es favorable, 21 por ciento (15) medianamente favorable y 19 por ciento (13) desfavorable. En la dimensión técnica 16 por ciento (11) es favorable, 71 por ciento (50) medianamente favorable, y 13 por ciento (9) desfavorable. Acerca de la dimensión interpersonal 51 por ciento (35) tienen favorable, 36 por ciento (25) medianamente favorable, y 13 por ciento (10) desfavorable; y en la dimensión entorno 43 por ciento (30) favorable, 44 por ciento (31) medianamente favorable, y 13 por ciento (9) desfavorable. Conclusiones: Un porcentaje considerable de los familiares tienen una opinión medianamente favorable, a desfavorable; asi como en la dimensión técnica, interpersonal y confort; referido a que la enfermera no siempre brinda educación sobre los cuidados que debe tener frente a la enfermedad del paciente, es afectuosa al interactuar con el paciente, se preocupa por la dieta, le proporciona privacidad ante un procedimiento, no se identifica, no muestra preocupación ante la limpieza del ambiente. y un porcentaje considerable tienen una opinión favorable que está dado por que la enfermera escucha los problemas y necesidades de los pacientes y familiares, atiende cordialmente, y se preocupa por proporcionarle cama con barandas y aditamentos necesarios para evitar escaras.

The objective was to determine the opinion of the relative on the quality of attention that offers to the nurse in the service of hospitalization of the Geriatrical Hospital "San Farm Isidro" and to identify the opinion according to the technical dimension, interpersonal and comfort. Material and Method: The study was of aplicative level, quantitative type, descriptive method of cross section, the technique was the interview and the instrument a modified scale Lickert type, applied previous informed consent. Results: Of 100 por ciento (70), 60 por ciento (42) are favorable, 21 por ciento (15) moderately favorable and 19 por ciento (13) unfavorable. In technical dimension 16 por ciento (11) he is favorable, 71 por ciento (50) moderately favorable, and unfavorable 13 por ciento (9). About interpersonal dimension 51 por ciento (35) they have favorable, 36 por ciento (25) moderately favorable, and 13 por ciento (10) unfavorable; and in the dimension surroundings 43 por ciento (30) favorable, 44 por ciento (31) moderately favorable, and unfavorable 13 por ciento (9). Conclusions: A considerable percentage of the relatives has a favorable opinion moderately, to unfavorable; as well as in the technical, interpersonal dimension and comfort; referred to that the nurse not always offers education on the cares that must have as opposed to the disease of the patient, she is affectionate when interacting with the patient, one worries about the diet, he provides privacy to him before a procedure, does not identify, he does not show preoccupation before the cleaning of the atmosphere. and a considerable percentage has a favorable opinion that is given so that the nurse listens to the problems and necessities of the patients and relatives, takes care of sincerely, and it worries to provide bed with railings and additions to him necessary to avoid escaras.