Carcinoma oral de células escamosas y su posible asociación con la higiene bucal / Oral squamous cell carcinoma and possible association with oral hygiene

El cáncer se caracteriza por la falta de diferenciación citológica, autonomía de la homeostasis local y general; el cáncer bucal ocupa el sexto sitio de frecuencia de todas las áreas del cuerpo. Alrededor de 90% de los tipos histológicos de cáncer en cavidad bucal corresponden a carcinoma bucal de células escamosas (COCE) (AU)

Cancer is characterized by a lack of cytological differentiation, autonomy of local and general homeostasis, and oral cancer ranks sixth frequency site of all areas of the body. About 90% of histologic types of oral cavity cancer are OSCC (AU)

Traumatismo esplénico secundario a colonoscopia: una complicación infrecuente

Introducción: La colonoscopia es un procedimiento frecuente y seguro, no exento sin embargo de complicaciones. El traumatismo esplénico es una complicación infrecuente, pero potencialmente mortal. Caso Clínico: Mujer de 75 años, consultaba por dolor y distensión abdominal tras colonoscopia. A la exploración presentaba dolor a la palpación en epigastrio e hipocondrio izquierdo sin irritación peritoneal. La TC urgente informaba de hematoma esplénico de 10 x 2,6 cm sin signos de sangrado activo. Fue tratada de forma conservadora con evolución favorable. Conclusión: El manejo del traumatismo esplénico depende de la estabilidad hemodinámica, el grado de la lesión y la presencia de sangrado activo. En casos seleccionados, el tratamiento conservador constituye una alternativa para evitar cirugías innecesarias, aunque se debe monitorizar al paciente de forma estricta durante 48-72 h en una Unidad de Cuidados Intensivo. Aunque la lesión esplénica secundaria a la colonoscopia es una complicación infrecuente, puede presentar alta morbimortalidad si pasa inadvertida.

Introduction: Colonoscopy is a frequent and routine procedure, and even though it is considered safe, it can have complications. The splenic traumatism is an infrequent complication, but potentially mortal. Clinical Case: Woman 75 years old, consulted for abdominal pain and distension after a colonoscopy. Physical examination revealed pain in epigastric and left hypochondrium without peritoneal irritation. Urgent TC scan reported a splenic hematoma of 10 x 2,6 cm, without active bleeding. She received non-operative treatment with a favorable evolution. Conclusion: The management depends on the hemodynamic stability, the grade of injury and the presence of and active bleeding. In selected cases, non-operative treatment is an option that avoids unnecessary surgeries, even if the patient must stay 48-72 h hospitalized in an Intensive Care Unit for a strict monitoring of vital signs. Although the splenic injury secondary a colonoscopy is an infrequent complication, it can be potentially mortal if it is not diagnosed.

[Tumores neuroendocrinos pancreáticos. Nuestra experiencia]. / Pancreatic neuroendocrine tumors. Our experience.

Pancreatic neuroendocrine tumors are rare. It is a heterogeneous group of neoplasms with very different behavior and prognosis. They can appear sporadically or associated with genetic syndromes. They are divided into functioning and non-functioning. A descriptive retrospective study of patients diagnosed with pancreatic neuroendocrine tumor was performed. The incidental diagnosis of these tumors is increasingly. The only curative treatment for these tumors is surgical excision, depending on the location and characteristics of the tumor and the patient. In selected cases a conservative attitude is recommended.

Los tumores neuroendocrinos pancreáticos son poco frecuentes. Es un grupo heterogéneo de neoplasias con comportamiento y pronóstico muy diferentes. Pueden aparecer de manera esporádica o asociados a síndromes genéticos. Se dividen en funcionantes y no funcionantes. Se realizó un estudio retrospectivo descriptivo de los pacientes diagnosticados de tumor neuroendocrino pancreático. Como se refleja en nuestra serie, cada vez es más frecuente el diagnostico incidental de estos tumores. El único tratamiento curativo de estos tumores es la exéresis quirúrgica, según la localización y las características del tumor y del paciente. En casos seleccionados se puede optar por una actitud conservadora.

Avaliação da variação de área e transporte foraminal após preparo e ampliação apical / Evaluation of area variation and foraminal transport after preparation and apical enlargement

A limpeza durante o preparo endodôntico tem por objetivo a eliminação de todo conteúdo séptico dos canais radiculares ao passo que a modelagem atribui ao mesmo conformação regressivamente cônica desde o orifício de sua entrada até o ápice, mantendo-se ao máximo sua anatomia original. Um dos maiores desafios da Endodontia é promover adequada limpeza e desinfecção de todo sistema de canais principalmente na região apical em equilíbrio com a manutenção da anatomia apical, o que favoreceria a reparação. Diante do exposto, este estudo teve como propósito, avaliar por meio da microscopia eletrônica, a capacidade de ampliação apical e transporte foraminal nos procedimentos de patência e alargamento utilizando instrumentos de glide path após instrumentação mecanizada. Para tal finalidade foram avaliados, por meio de Microscopia Eletrônica de Varredura (MEV), os forames de 60 raízes antes e após a instrumentação com sistema automatizado Easy Pro Logic. Todas as raízes foram preparadas com instrumento 40/05 com comprimento de trabalho 1 mm aquém e posteriormente complementadas com instrumentos de glide path 45/01 e 50/01 no comprimento do dente ou 1 mm além de acordo com os grupos experimentais. Os resultados revelaram que houve aumento do diâmetro apical estatisticamente significante com consequentemente maior remoção de debris nos grupos onde foi realizada a ampliação foraminal. Em todos os grupos experimentais houve regularização no desgaste dos forames após a instrumentação com inexpressivo transporte apical, no entanto, o grupo onde foi realizada a ampliação foraminal com instrumento 40.01 além do comprimento do dente apresentou menor coeficiente de deformação e transporte foraminal. Conclui-se que melhores resultados, tanto na variação da área do forame quanto no transporte foraminal foram obtidos nos grupos onde foi realizada a ampliação apical(AU)

Cleaning during endodontic preparation aims to eliminate all septic content from the root canals, while modeling attributes to the same conformation that is regressively conical from the entrance orifice to the apex, maintaining its original anatomy as much as possible. One of the greatest challenges in Endodontics is to promote adequate cleaning and disinfection of the entire canal system, mainly in the apical region, in balance with the maintenance of the apical anatomy, which would favor repair. In view of the above, this study aimed to assess, through electron microscopy, the capacity of apical enlargement and foraminal transport in the procedures for patency and enlargement using glide path instruments after mechanized instrumentation. For this purpose, the Scanning Electron Microscopy (SEM) evaluated the foramina of 60 roots before and after instrumentation with an automated Easy Pro Logic system. All roots were prepared with a 40/05 instrument with a working length of 1 mm below and then supplemented with 45/01 and 50/01 glide path instruments in the tooth length or 1 mm in addition to the experimental groups. The results revealed that there was a statistically significant increase in the apical diameter with consequently greater removal of debris in the groups where foraminal enlargement was performed. In all experimental groups there was regularization of foramen wear after instrumentation with inexpressive apical transport, however, the group where foraminal enlargement was performed with instrument 40.01 in addition to the length of the tooth showed a lower coefficient of deformation and foraminal transport. It was concluded that better results, both in the variation of the foramen area and in the foraminal transport, were obtained in the groups where the apical enlargement was performed(AU)

[Metástasis en el lóbulo frontal como primera manifestación clínica de un carcinoma folicular de tiroides]. / Frontal lobe metastases as the initial presentation of follicular thyroid carcinoma.

ANTECEDENTES: El carcinoma folicular de tiroides puede producir metástasis a distancia, siendo las localizaciones más habituales el pulmón y el hueso. Las metástasis cerebrales son inusuales, y es poco habitual que aparezcan como primera manifestación de cáncer. CASO CLÍNICO: Paciente varón de 80 años, que tras una caída al suelo comenzó con alteración del comportamiento, desorientación y pérdida del control de esfínteres. La tomografía computarizada cerebral evidenció una masa en el lóbulo frontal derecho. Se realizó la extirpación de la lesión cerebral, cuyo estudio histológico informó de metástasis de carcinoma folicular de tiroides. CONCLUSIÓN: La manifestación de la enfermedad con metástasis cerebrales es muy infrecuente, y empeora el pronóstico notablemente. BACKGROUND: Follicular thyroid carcinoma can produce distant metastases, generally occur to lung followed by bone. Brain metastases are unusual, and onset manifestation is little frequently. CLINICAL CASE: A 80-years old men presented disturbance behavior, desorientation and loss of sphincters after fallin to the ground. Computed tomography scan showed a lesion in the right frontal lobe. The patient underwent a craniotomy to remove the brain tumor, histopathology confirmed of follicular thyroid carcinoma metastases. CONCLUSION: At initial diagnosis brain metastasis are extremely rare, with adverse prognosis.

Aneurisma del septo interventricular membranoso ¿Qué hacer con él? / How to deal with aneurysms of the membranous interventricular septum

Resumen Se expone el caso de un paciente con diagnóstico incidental de aneurisma del septo membranoso interventricular, una entidad extremadamente rara en ausencia de defecto septal interventricular asociado. Los pacientes asintomáticos con aneurisma del septo membranoso interventricular deben recibir control periódico debido a las potenciales complicaciones cardiovasculares que acarrea esta entidad.

Abstract We report the case of a patient incidentally diagnosed of aneurysm of the membranous interventricular septum, an extremely rare condition, in the absence of associated ventricular septal defect. Patients with membranous interventricular septal aneurysm who are asymptomatic should be monitored on a regular basis due to potential cardiovascular complications of this entity.

[Psoas abscess as a differential diagnosis in emergency department]. / Absceso de psoas como diagnóstico diferencial en la patología abdominal de urgencias.

BACKGROUND: A psoas (or iliopsoas) abscess is a rare clinical entity with a wide etiological range. It is defined as a collection of pus that begins and extends through the iliopsoas muscle and can reach up to the inguinal region. METHODS: We performed a retrospective descriptive study by reviewing medical records from the General Surgery department of Reina Sofía's General University Hospital. Information was collected from patients diagnosed with psoas abscess who were admitted to the General Surgery department from 2006 to 2011. RESULTS: Five cases were reported for 6 years: four males (80%) and one female (20%). Average age was 51.6 years (range: 35--75). All were admitted to the hospital through the Emergency Department. Lumbar pain, fever and rash were clinical features in three patients. Two patients initiated with septic shock. Each patient had computed tomography performed, which confirmed the diagnosis. Causes of the abscess were as follows: one perforated colon neoplasm, two left hip osteomyelitis, one Crohn's disease and one primary abscess. Surgery was the treatment in three cases and placement of pigtail drainage was the treatment in two patients. Two patients were admitted to the Intensive Care Unit and ultimately died. CONCLUSION: In our case series report, it is seen that treatment delay developed to septic shock and death. We should consider this entity in emergency practice in order to carry out timely treatment.

Antecedentes: el absceso del psoas es una colección de pus que se localiza en el músculo psoas iliaco. Se produce por continuidad desde estructuras adyacentes o por diseminación hematógena; su etiología es diversa. Objetivo: describir la atención ofrecida a los pacientes con absceso de psoas ingresados en un servicio de cirugía general. Material y métodos: estudio retrospectivo y descriptivo de pacientes ingresados al servicio de Cirugía General y del Aparato Digestivo del Hospital General Reina Sofía, Murcia, España, entre enero de 2006 y febrero de 2012 con diagnóstico compatible con absceso de psoas. Resultados: se reunieron 5 casos: 4 varones (80%) y 1 mujer (20%) con una media de edad de 51.6 años (límites: 35 y 75). Todos ingresaron al servicio de Cirugía General desde Urgencias. La clínica fue: dolor lumbar, fiebre y enrojecimiento de partes blandas en 3 pacientes. Dos iniciaron con choque séptico. A todos los pacientes se les realizó tomografía computada abdominal que confirmó el diagnóstico. Las causas del absceso fueron: 1 neoplasia de sigma perforada; 2 osteomielitis de cadera izquierda; 1 enfermedad de Crohn, y 1 absceso primario. El tratamiento fue el drenaje quirúrgico en 3 casos, y colocación de pig tail bajo control radiológico en 2 pacientes. Dos necesitaron atención en la unidad de cuidados intensivos, donde fallecieron. Conclusión: el retraso en el tratamiento suele desembocar en choque séptico con resultado de muerte en todos los casos. Es importante tener en mente esta posibilidad diagnóstica para poder establecer el diagnóstico diferencial en urgencias y tratarla lo más temprano posible.

The influence of topic and systemic administration of copaiba oil on the alveolar wound healing after tooth extraction in rats.

The Copaiba oil has been used as an auxiliary treatment of inflammations, skin disorders and stomach ulcers, however, in dentistry, this "alternative" medicine has not been investigated yet. The purpose of this study was to evaluate the influence of topic and systemic administration of copaiba oil on the alveolar wound healing after tooth extraction. Twenty-eight wistar male rats had their lower first molar teeth extracted. Subsequently, they were divided in four groups, according to the treatment performed: (a) alveolar socket irrigation with copaiba oil; (b) alveolar socket irrigation with physiological serum; (c) daily gavage with copaiba oil or (d) daily gavage with physiological serum. After the sacrifice, the mandibles were removed and processed in order to obtain decalcified histological sections. The results demonstrated high level of epithelial migration, small number of inflammatory cells and vascular enhancement in the animals which received systemic administration of copaiba oil. The rats treated with topic administration of copaiba oil presented ulcerations and large number of inflammatory cells. An increased bone neoformation was observed in both groups treated with copaiba oil when compared with placebo group. It could be concluded that topic or systemic administration of copaiba oil leads to a better alveolar bone healing, however the topic application on connective tissue should be carefully considered, regarding the whole socket wound healing. Key words:Alveolar wound healing, oil-resin, copaiba.

Evaluation of tooth bleaching effectiveness through an experimental biological model at Gallus spp eggshell / Avaliação da eficácia do clareamento dentário num modelo biológico experimental em casca de ovo de Gallus spp

Tooth darkening compromised oral aesthetics and bleaching is a conservative and efficient method to reestablish it. The aim of this study was to assess the action of 35% hydrogen peroxide in specimens pigmented with different substances. Twenty fragments obtained from chicken eggshell measuring 0.5 x 0.5 cm were randomly divided into 5 groups (G1, G2, G3, G4 and G5) with 4 specimens each. These were previously photographed and pigmented respectively with coffee, cola-based soft drink, wine, beetroot and tobacco for a 48-hour period. In groups 1, 2 and 3, the specimens were directly immersed respectively into the first three substances. In group 4, beetroot was mixed with water to obtain a solution. In group 5, the specimens were submitted to tobacco smoke by the same period. The groups were again photographed and then submitted to bleaching with 35% hydrogen peroxide and photo-activated by laser for 20 min. After the final photographs, the images were analyzed thorugh Adobe Photoshop CS5 software. It was observed that wine most pigmented the specimens (33.34%), followed by coffee (10.35%), beetroot (9.56%), cola-based soft drink (8.85%) and tobacco (0.61%). The bleaching action was more effective on the specimens of G1 (93.9%) and G2 (91.55%), followed by G3 (71.09%), G4 (62.74%) and G5 (57.38%). It was concluded that the methodology was efficient in comparing the effectiveness of the bleaching agent on the pigments tested. The specimens pigmented with tobacco were those which exhibited the greater resistance to bleaching. Taking into consideration the use of this biological material, further studies are necessary to simulate the effects of many other substances onto tooth enamel

O escurecimento dos dentes compromete a estética bucal. O clareamento é um método conservador e eficaz para restabelecê-la. Neste trabalho foi avaliada a ação do peróxido de hidrogênio 35% em espécimes pigmentados com diferentes substâncias. Vinte fragmentos obtidos da casca do ovo, medindo 0,5 x 0,5 cm, foram divididos aleatoriamente em 5 grupos (G1, G2, G3, G4 e G5) com 4 espécimes em cada. Estes foram previamente fotografados e pigmentados respectivamente com café, refrigerante a base de cola, vinho, beterraba e cigarro, por um período de 48 horas. Nos grupos 1, 2 e 3 os espécimes foram imersos diretamente nas respectivas substâncias. No grupo 4, a beterraba foi batida com água para obtenção da solução. No grupo 5 os espécimes ficaram acondicionados na fumaça do cigarro pelo mesmo período. Os grupos foram novamente fotografados e posteriormente submetidos ao clareamento com peróxido de hidrogênio 35%, ativado com laser, por 20 min. Após as fotografias finais, as imagens foram analisadas no programa Adobe Photoshop CS5. Observou-se que o vinho foi o que mais pigmentou os espécimes (33,34%), seguido pelo café (10,35%), beterraba (9,56%), refrigerante a base de cola (8,85%) e cigarro (0,61%). A ação clareadora foi mais efetiva nos espécimes dos grupos G1 (93,9%) e G2 (91,55%), seguidos pelos grupos G3 (71,09%), G4 (62,74%) e por último o grupo G5 (57,38%). Concluiu-se que o método foi eficaz para comparar a efetividade do agente clareador nos pigmentos testados, sendo os espécimes impregnados com fumaça de cigarro os que apresentaram maior resistência ao clareamento>

Modelo explicativo del efecto de la talla y grasa corporal en el peso de escolares entre 9 y 17 años de edad / Explanatory model of the effect of size and body fat in the weight of school children between 9 to 17 years

La obesidad ha aumentado en niños y jóvenes. La importancia de medir la composición corporal es reconocida. Sin embargo, la talla y la proporción de grasa podrían explicar la variabilidad del peso y dependerían de la edad y sexo de la persona. Objetivo Analizar la relación de la talla y grasa corporal con el peso de los estudiantes. Diseño Estudio observacional, transversal y analítico. Lugar y sujetos Se empleó la base de datos del estudio "Quito municipal schools cohort study: Baseline results", desarrollado en 6964 escolares de 9 a 17 años. Mediciones principales Se consideró las variables edad, sexo, peso, talla y grasa corporal. La condición antropométrica fue definida según criterios de la Organi- zación Mundial de Salud. Para evaluar la correlación entre el peso en función de la talla y proporción de grasa corporal se aplicó un modelo de regresión lineal múltiple. Resultados La correlación entre el peso, talla y grasa corporal fue significativa, tanto en mujeres (r=0.93) como en varones (r=0.92). El coeficiente de determinación disminuyó con la edad y la aportación parcial de la grasa al peso fue mayor hasta los 11 años en mujeres y 14 años en varones. En los varones con exceso de peso la aportación de la grasa para explicar el peso fue menor que la talla y en las mujeres la aporta- ción de la grasa corporal y la talla fue igual en todas las edades. Conclusión La proporción de grasa debería tenerse en cuenta siempre que se de- termine el exceso de peso y se determine y analice el sobrepeso y la obesidad, porque es el único de los dos términos que se puede modificar

Obesity has increased in children and youth. The importance of measuring body composition is known. However, the size and the proportion of fat could explain weight variability and depend on the age and sex of the person. Objective To analyze the relationship between size and amount of body fat and the weight of the students. Design Cross ­ sectional study Subjects and setting The database from the study "Quito municipal schools cohort study: Baseline results" was used. This study was developed in 6964 students aged 9 to 17 years. Main measurements Age, sex, weight, height and body fat were considered in the analysis. Anthropometric status was defined according to criteria of the World Health Organization. To evaluate the correlation between the weight depending on the size and proportion of body fat a multiple linear regression was applied. Results The correlation between weight, height and body fat was significant both in women (r=0.93) and in men (r=0.92). The coefficient of determi- nation decreased with age and the partial contribution of fat to weight was higher until the age of 11 in women and 14 years in men. In males with overweight the contribution of fat to explain the weight was lower than the height and in women the contribution of body fat and the height was the same in all ages. Conclusion The proportion of fat should be taken into account when excess weight is determined and when overweight and obesity are analyzed because it is the only one of the two terms that can be modified. Abstract Explanatory model of the effect of size and body fat in the weight of school children between 9 to 17 years 

Sistema de teleconsulta médica / Medical tele consults system

En Cuba, los profesionales de la salud se comunican a través del intercambio persona-persona, y a través de vías como teléfono, correo electrónico y en ocasiones mediante la clínica virtual cubana. Todo esto hace más compleja la evaluación y diagnóstico temprano de los profesionales médicos. El presente trabajo se centra en el producto Sistema de Teleconsulta, del proyecto Teleconsulta, del Departamento de Sistemas Especializados de la Facultad 7, UCI (Universidad de las Ciencias Informáticas). Este tiene como objetivo intercambiar información online, que servirá para realizar diagnósticos certeros y rápidos de los pacientes. Para darle cumplimiento al objetivo, se realizó un estudio de las herramientas y tecnologías necesarias para su desarrollo, entre ellas, Java como lenguaje de programación, Eclipse como entorno de desarrollo, Base de Datos PostgreSQL y Servidor de Streamin Red5(AU)

In Cuba, health professionals communicate by person-person exchanging, and through means such as telephone, email and sometimes through the virtual clinic in Cuba. All this complicates the assessment and early diagnosis of medical professionals. This work focuses on the product Teleconsulta System, Teleconsulta project, Specialized Systems Department, Faculty 7, UCI (University of Information Sciences). This aims to exchange information online, that will assist in accurate and rapid diagnosis of patients. To accomplish the objective, this paper includes a study of the tools and technologies needed for development, including Java programming language, Eclipse as a development environment, and PostgreSQL Database Server Streamin Red5(AU)

Sistema automatizado para la gestión del programa de control sanitario internacional de Cuba / Automated system for management of the international health control program in Cuba

El programa de Control Sanitario Internacional propuesto en Cuba permite el control y seguimiento de la importación de productos, enfermedades endémicas de otros países y las transmisibles por vectores. Todo esto es realizado en formato duro, de forma manual, por teléfono, correo y Excel. Existen algunos sistemas desarrollados que no presentan todas las funcionalidades necesarias para el manejo de la información requerida. En la Universidad de las Ciencias Informáticas (UCI), se desarrolló el sistema Control Sanitario Internacional (CSI) y su objetivo fundamental es automatizar todos los procesos relacionados a la vigilancia, seguimiento de la higiene de los productos, control de foco y la detección de enfermedades. Para la implementación se utilizó Apache, base de datos MySQL 5, PHP 5 y el framework CodeIgniter v1.6. Con la implantación del sistema se espera centralizar la gestión de la información, otorgando rapidez, calidad y seguridad en la información(AU)

The International Health Control Program proposed in Cuba allows the control and monitoring of the import of products, endemic and vector borne diseases from other countries. All this is done in hard format, manually, by phone, mail and Excel. There are some systems that doesn't have developed all the necessary features for managing the information required. At the University of Informatics Sciences (UCI), we developed the system International Health Control (CSI). Its main objective is to automate all the processes related to surveillance, monitoring of hygiene, control of focus and the disease detection. For the implementation we used Apache, MySQL 5 database, PHP 5 and CodeIgniter 1.6 framework. With the implementation of the system is expected to centralize information management, providing speed, quality and information security(AU)

[Laparoscopic cholecystectomy in a patient with situs inversus totalis]. / Colecistectomía laparoscópica en una paciente con situs inversus totalis.

OBJECTIVE: To report a case with situs inversus totalis (SIT) and chronic cholelithiasis solved by laparoscopic surgery, outlining the utility of minimal invasive surgery and specific considerations in patients with anatomic variations. CASE REPORT: A case of a 46 year-old female who presented with a six-month history of abdominal colic pain at the left hypochondrium, accompanied with nausea and vomiting, is presented. On examination she had epigastric tenderness. Blood tests, including liver function tests, were normal. Electrocardiogram showed right axis deviation and right ventricular hypertrophy, in keeping with dextrocardia. Chest-X-Ray confirmed the diagnosis of dextrocardia. An ultrasound scan of the upper abdomen identified the gallbladder containing stones in the left upper quadrant. A CT scan visualized the spleen and the gastric camera in the right upper quadrant. Barium gastrointestinal transit, barium enema and abdominal-X-Ray were used as complementary diagnostic studies. A magnetic resonance cholangiography was not performed because the patient suffered from claustrophobia. Cholecystectomy and transcystic cholangiography were performed by laparoscopic route, taking care to set-up the operating theatre in the mirror image of the normal set-up for cholecystectomy. The patient completed a successful procedure without complications and was discharged 48 hours after the procedure. Histological exam diagnosed a chronic lithiasic cholecystitis. CONCLUSIONS: Laparoscopic cholecystectomy is an adequate surgical procedure for patients with total situs inversus and cholelithiasis, having a high security range. Detailed clinical examination is important for the diagnosis of previously unknown anatomic variations. Transcystic cholangiography is mandatory when a magnetic resonance cholangiography can not be performed. Furthermore, perhaps in this situation a left-handed surgeon is better prepared than a right-handed one to comfortably carry out the procedure.

The efficacy and safety of two fixed combinations: timolol-dorzolamide-brimonidine versus timolol-dorzolamide. A prospective, randomized, double-masked, multi-center, 6-month clinical trial.

We compared the efficacy and safety of a new fixed combination of timolol 0.5%/odorzolamide 20%/brimonidine 0.2% in ophthalmic solution versus a fixed combination of timolol 0.5%/dorzolamide 2% in patients with open-angle glaucoma or ocular hypertension. The fixed triple combination was significantly more efficient in mean intraocular pressure reduction from baseline throughout the six-month follow-up.

Creencias sobre infecciones respiratorias aguda en niños menores de cinco años: estudio etnográfico en dos comunidades indígenas del estado de Oaxaca / Beliefs on acute respiratory infection in children younger than five years old: ethnographic study in two indigenous communities of the State of Oaxaca

Introducción. En México se ha logrado disminuir la mortalidad por infecciones respiratorias agudas, en un 41.5 por ciento de 1990 a 1997. El descenso no ha sido mayor, porque los grupos indígenas y marginados siguen manteniendo altas tasas de mortalidad. Material y métodos. Estudio etnográfico, realizado en dos comunidades indígenas una mixteca y otra zapoteca de diferentes regiones del estado de Oaxaca. Población de estudio: 24 madres mixtecas y 15 zapotecas entre 15 y 65 años, con uno o más niños menores de cinco años. Se les aplicaron dos cuestionarios: uno, semi-abierto y otro socioeconómico, traducidos oralmente por personas de las comunidades. Objetivo. Conocer ¿cómo las madres de dos comunidades indígenas de diferentes regiones del estado de Oaxaca perciben e identifican a las infecciones respiratorias agudas y a qué prácticas médicas recurren? Resultados. En la comunidad mixteca, ninguna madre reconoció la neumonía, y en la zapoteca sólo un tercio. De las infecciones respiratorias agudas superiores, la mayoría de ambas comunidades, reconoce principalmente al resfriado común. Para la atención de las enfermedades, recurren a tres acciones: tradicional, doméstica y automedicación. Ninguna madre mencionó el uso de antibióticos. Sólo cuando sus hijos tienen una infección respiratoria aguda grave, acuden a la clínica oficial. Conclusión. El desconocimiento de las percepciones maternas del proceso salud-enfermedad-atención de las infecciones respiratorias agudas, puede hacer que las actividades de capacitación, para su prevención y control, planeadas bajo la concepción occidental del modelo biomédico les resulten ajenas, contribuyendo a mantener la morbilidad y mortalidad en sus comunidades

Panorama epidemiológico de las infecciones respiratorias agudas en niños menores de cinco años de los Estados Unidos Mexicanos. Comparación con cinco países del continente americano / Epidemic panorama of acute respiratory infections in children under five years of age in Mexico. Compared to five other countries of the American continent

Introducción. En el contexto de la transición epidemiológica, las infecciones respiratorias agudas han disminuido su importancia como causa de muerte en la población general, aunque todavía representan un problema importante de salud pública debido a la incapacidad, secuela y muerte que producen en los grupos etarios extremos de la vida. Esta característica es compartida con países latinoamericanos en condiciones de desarrollo similares al de México. Objetivo. El propósito de este ensayo es decribir la epidemiología de las infecciones respiratorias agudas en México y en cinco países del continente americano para destacar su magnitud actual y la necesidad de mejorar estrategias para su control y prevención. Conclusión. El análisis de la situación existente en los países de América Latina muestra la heterogenidad epidemiológica que existe entre estas naciones. En nuestro país el perfil epidemiológico de las infecciones respiratorias agudas ha mostrado mejoría con respecto a la mortalidad. Para poder abatir las tasas de morbilidad y mortalidad por infecciones respiratorias agudas es necesario conocer con mayor detalle las características que se encuentran asociadas a la enfermedad en las áreas y grupos de mayor riesgo y así proponer alternativas preventivas adecuadas a los niveles local, regional y nacional