Theoretical Studies for the Discovery of Potential Sucrase-Isomaltase Inhibitors from Maize Silk Phytochemicals: An Approach to Treatment of Type 2 Diabetes.

A theoretical analysis of the potential inhibition of human sucrase-isomaltase (SI) by flavonoids was carried out with the aim of identifying potential candidates for an alternative treatment of type 2 diabetes. Two compounds from maize silks, maysin and luteolin, were selected to be studied with the structure-based density functional theory (DFT), molecular docking (MDock), and molecular dynamics (MD) approaches. The docking score and MD simulations suggested that the compounds maysin and luteolin presented higher binding affinities in N-terminal sucrase-isomaltase (NtSI) than in C-terminal sucrase-isomaltase (CtSI). The reactivity parameters, such as chemical hardness (η) and chemical potential (µ), of the ligands, as well as of the active site amino acids of the NtSI, were calculated by the meta-GGA M06 functional in combination with the 6-31G(d) basis set. The lower value of chemical hardness calculated for the maysin molecule indicated that this might interact more easily with the active site of NtSI, in comparison with the values of the acarbose and luteolin structures. Additionally, a possible oxidative process was proposed through the quantum chemical calculations of the electronic charge transfer values (∆N) between the active site amino acids of the NtSI and the ligands. In addition, maysin displayed a higher ability to generate more oxidative damage in the NtSI active site. Our results suggest that maysin and luteolin can be used to develop novel α-glucosidase inhibitors via NtSI inhibition.

El Sancocho, la Bandera y la Familia: La vida social de los alimentos y sus implicaciones para la salud y el bienestar de los inmigrantes dominicanos.

Para comprender mejor los factores que influyen en la salud y el bienestar de los inmigrantes dominicanos, exploramos las formas en que la inmigración influye en las prácticas culturales, el comportamiento de salud y la salud. Los inmigrantes dominicanos (n = 42) participaron en cinco discusiones grupales reflexivas y no estructuradas y (n = 5) participaron en un grupo de fotovoz intergeneracional. La pérdida del contexto familiar y social en el que tradicionalmente se llevan a cabo las prácticas dietéticas dominicanas fue un tema destacado. Para los participantes, comer se convirtió en una actividad apresurada y superficial que involucraba a menos personas y menos socialización. Las prácticas dietéticas en la República Dominicana se establecen en el contexto de las normas familiares y los procesos sociales, que brindan apoyo, así como oportunidades para la socialización y la transmisión de prácticas culturales a través de las generaciones. En los Estados Unidos, las fuerzas sociopolíticas más amplias se enfocan en el individualismo y no apoyan el desarrollo o mantenimiento de patrones culturales para los dominicanos. Las políticas que promueven el equilibrio entre el trabajo y la vida personal pueden tener implicaciones importantes para las prácticas dietéticas en las nuevas comunidades de inmigrantes.

Hernia obturatriz: Aspectos clínicos, imagenológicos y tratamiento / Obturator hernia: Clinical, imaging and treatment aspects

Introducción. Debido a la rareza de la hernia obturatriz y la imposibilidad para desarrollar estudios controlados de alto grado de evidencia, la mayoría de la literatura al respecto proviene de reportes de casos. Lo anterior, aunado al poco conocimiento del área anatómica de presentación y el cuadro clínico, la convierte en la hernia con mayor mortalidad. Métodos. Se realizó una búsqueda de la literatura en las principales bases de datos, ilustrado con pacientes manejados en el Servicio de Cirugía general de la Clínica Santa María de Sincelejo, Colombia. Discusión. La hernia obturatriz se puede descubrir en mujeres ancianas con antecedentes de cirugía abdominal o multiparidad. El signo de Howship­Romberg, que se presenta en la mitad de los pacientes, puede acompañarse de dolor abdominal en hipogastrio, vómitos y distensión progresiva. La radiografía de abdomen simple muestra tardíamente niveles hidroaéreos con ausencia de gas en ampolla rectal, pero como es poco específica para demostrar el sitio de obstrucción, es preferible la Tomografía computarizada. Conclusión. La hernia obturatriz requiere alto índice de sospecha, que ayude a la detección temprana e intervención quirúrgica inmediata, para evitar las complicaciones.

Introduction. Due to the rarity of the obturator hernia and the impossibility to develop controlled studies with a high degree of evidence, most of the reference in the literature comes from case reports. This, coupled with little knowledge of the anatomical area of presentation and clinical picture, makes it the hernia with the highest mortality. Methods. A literature search was carried out in the main databases, illustrated with patients managed in the General Surgery Service of the Clínica Santa María de Sincelejo. Discussion. Obturator hernia can be discovered in elderly women with a history of abdominal surgery or multiparity. The Howship ­ Romberg sign occurs in half of the patients, it can be associated with lower abdominal pain, vomiting, and progressive distension. Plain abdominal X-ray shows delayed air-fluid levels with absence of gas in the rectal ampulla, but since it is not very specific to demonstrate the site of obstruction, computed axial tomography is preferable. Conclusion. Obturator hernia requires a high index of suspicion, which helps early detection and immediate surgical intervention, to avoid complications.

El Sancocho, la Bandera y la Familia: The Social Life of Food and its Implications for Dominican Immigrant Health and Well-Being.

In order to better understand factors that influence the health and well-being of Dominican immigrants, we explored the ways in which immigration influences cultural practices, health behavior, and health. Dominican immigrants (n = 42) took part in five reflective and unstructured group discussions and (n = 5) participated in an intergenerational photovoice group. The loss of the familial and social context in which Dominican dietary practices traditionally take place was a salient theme. For participants, eating became a rushed, perfunctory activity involving fewer people and less socializing. Dietary practices in the Dominican Republic are set in the context of familial norms and social processes, which provide support as well as opportunities for socializing and the transmission of cultural practices across generations. In the United States, broader sociopolitical forces are guided by individualism and do not support the development or maintenance of these factors for Dominicans. Policies that promote work-life balance may have important implications for dietary practices in new immigrant communities.

Antimicrobial Resistance and Inorganic Nanoparticles.

Antibiotics are being less effective, which leads to high mortality in patients with infections and a high cost for the recovery of health, and the projections that are had for the future are not very encouraging which has led to consider antimicrobial resistance as a global health problem and to be the object of study by researchers. Although resistance to antibiotics occurs naturally, its appearance and spread have been increasing rapidly due to the inappropriate use of antibiotics in recent decades. A bacterium becomes resistant due to the transfer of genes encoding antibiotic resistance. Bacteria constantly mutate; therefore, their defense mechanisms mutate, as well. Nanotechnology plays a key role in antimicrobial resistance due to materials modified at the nanometer scale, allowing large numbers of molecules to assemble to have a dynamic interface. These nanomaterials act as carriers, and their design is mainly focused on introducing the temporal and spatial release of the payload of antibiotics. In addition, they generate new antimicrobial modalities for the bacteria, which are not capable of protecting themselves. So, nanoparticles are an adjunct mechanism to improve drug potency by reducing overall antibiotic exposure. These nanostructures can overcome cell barriers and deliver antibiotics to the cytoplasm to inhibit bacteria. This work aims to give a general vision between the antibiotics, the nanoparticles used as carriers, bacteria resistance, and the possible mechanisms that occur between them.

Ginecomastia: Consideraciones médicas y quirúrgicas en cirugía general / Gynecomastia: Medical and surgical considerations in general surgery

La ginecomastia, definida como el crecimiento del tejido glandular mamario en los hombres, aparece desde la etapa neonatal hasta la senil, puede ser unilateral o bilateral, y es de causa multifactorial, incluyendo aquellos pacientes asociados al uso de medicamentos, donde predomina un desbalance en la relación testosterona­estrógeno. Relativamente, la idiopática es la más frecuente. La mayoría involucionan espontáneamente, las neonatales por perdida del influjo transplacentario en las primeras semanas, y las puberales entre 12 a 24 meses. Se presenta como un aumento del tamaño mamario, asintomático o con hipersensibilidad por inflamación durante el crecimiento del tejido fibroglandular mamario, con una repercusión psicológica enorme, sobre todo en la etapa de la adolescencia. El estudio y manejo es interdisciplinario y se ofrece de acuerdo con las condiciones y la etiología. Aquellos pacientes púberes en quienes no involuciona reciben tratamientos médicos, o tratamientos quirúrgicos cuando falla la terapéutica o hay presión social, e incluso radioterapia en casos donde desarrollan ginecomastia con hipersensibilidad al tratamiento hormonal del cáncer de próstata

Gynecomastia, defined as the growth of breast glandular tissue in men, appears from the neonatal to senile stage, can be unilateral or bilateral, and is of multifactorial cause, including those patients associated with the use of medications, where an imbalance in the testosterone ­ estrogen ratio. Relatively, idiopathic is the most common. Most regress spontaneously, neonatals due to loss of transplacental influx in the first weeks, and pubertal ones between 12 to 24 months. It presents as an increase in breast size, asymptomatic or with hypersensitivity due to inflammation during the growth of the mammary fibroglandular tissue, with an enormous psychological repercussion, especially in adolescence. The study and management is interdisciplinary and offered according to conditions and etiology. Those pubertal patients in whom it does not regress receive medical treatments, or surgical treatments when therapy fails or there is social pressure, and even radiotherapy in cases where they develop gynecomastia with hypersensitivity to hormonal treatment of prostate cancer

'There You Enjoy Life, Here You Work': Brazilian and Dominican Immigrants' Views on Work and Health in the U.S.

Structural inequalities in the U.S. work environment place most immigrants in low paying, high-risk jobs. Understanding how work experiences and influence the health of different immigrant populations is essential to address disparities. This article explores how Brazilian and Dominican immigrants feel about their experiences working in the U.S. and how the relationship between work and culture might impact their health. In partnership with the Dominican Development Center and the Brazilian Worker Center, we held five cultural conversations (CCs) with Brazilians (n = 48) and five with Dominicans (n = 40). CCs are participatory, unstructured groups facilitated by representatives from or embedded in the community. Brazilian immigrants focused on physical health and the American Dream while Dominicans immigrants emphasized concerns about the influence of work on mental health. Dominicans' longer tenure in the U.S. and differences in how Brazilians and Dominicans are racialized in the region might account for the variation in perspectives between groups. Future studies should further investigate the relationship between health and how immigrants' work lives are shaped by culture, race and immigrant status.

Inhibitory effect of saccharides and phenolic compounds from maize silks on intestinal α-glucosidases.

Maize silks have been used in Mexico for centuries as a natural-based treatment for various illnesses, including obesity and diabetes. It has been shown in mice that intake of maize silk extracts reduces the levels of blood glucose. However, it is not clear how or what maize silk compounds are involved in such an effect. A hypothesized mechanism is that some maize silk compounds can inhibit carbohydrate hydrolyzing enzymes like α-glucosidases. This work aimed to assess the capability of both saccharides and phenolic compounds from maize silks to inhibit intestinal α-glucosidases. Results showed that saccharides from maize silks did not produce inhibition on intestinal α-glucosidases, but phenolics did. Maize silk phenolics increased the value of Km significantly and decreased the Vmax slightly, indicating a mixed inhibition of α-glucosidases. According to the molecular docking analysis, the phenolics maysin, methoxymaysin, and apimaysin, which had the highest predicted binding energies, could be responsible for the inhibition of α-glucosidases. PRACTICAL APPLICATIONS: The International Diabetes Federation (IDF) reported in 2017 that diabetes affects over 424 million people worldwide, and caused 4 million deaths. Non-insulin-dependent diabetes or type 2 diabetes mellitus (T2DM) accounts for ∼90% of cases. T2DM is characterized by insulin resistance and pancreatic ß-cell failure. Therapy for T2DM includes the use of sulfonylureas, thiazolidinediones, biguanides, and α-glucosidase inhibitors. Regarding the α-glucosidase inhibitors, only few are commercially available, and these have been associated with severe gastrointestinal side effects. This work aimed to assess the capability of both saccharides and phenolic compounds from maize silks to inhibit intestinal α-glucosidases. Results from this work evidenced that maize silk polyphenols acted as effective inhibitors of intestinal rat α-glucosidases. Computational analysis of maize silk polyphenols indicated that maysin, a particular flavonoid from maize silks, could be responsible for the inhibition of α-glucosidases.

Cumplimiento del esquema de vacunación contra el Virus de Papiloma Humano en niñas de 11 años, Municipio de Danlí, Departamento El Paraíso, Honduras, 2018 / Compliance with the vaccination scheme against Human Papillomavirus in 11-year-old girls, Danlí Municipality, El Paraíso Department, Honduras, 2018

OBJETIVO: Determinar el cumplimiento del esquema de vacunación contra el Virus de Papiloma Humano en niñas de 11 años, Municipio de Danlí, Departamento El Paraíso, Honduras, 2018. DISEÑO: Estudio Descriptivo de corte Transversal, universo de estudio fue la totalidad de 2,216 dosis aplicadas de los registros vacunales de VPH del PAI, de niñas de 11 años. RESULTADOS: En el municipio de Danlí, departamento de El Paraíso, se encontraron bajas coberturas para las segundas dosis de VPH en las de niñas de 11 años, predominando en un 69% de los establecimientos de salud. En el mes de diciembre se captaron mayor número de este grupo de población para completar su esquema de dos dosis (114%), hubo una brecha menor o igual al 5% de cumplimiento en un 35% de los establecimientos y un período de cumplimiento entre las dosis de 6 meses en un 72%. CONCLUSIONES: El nivel de riesgo fue alto, tanto para primeras como para segundas dosis aplicadas de VPH y el nivel de riesgo alto predominó en la mayoría de establecimientos de salud para ambas dosis pero habiendo aumentado en la aplicación de la segunda dosis, el índice de cobertura de inmunización alcanzado fue en aumento a medida que se avanzaba en los meses habiendo alcanzado el mayor porcentaje superando el cumplimiento en el mes de diciembre, en relación a los meses anteriores. La brecha de cobertura de inmunización por establecimiento estuvo concentrada por debajo de la mitad. El período de cumplimiento entre primeras y segundad dosis se dio su mayoría en 6 meses seguido por 7 meses y solo un menor porcentaje en mas de 7 meses

Studying the chemical reactivity properties of the target tumor-environment tripeptides NGR (asparagine-glycine-arginine) and RGD (arginine-glycine-aspartic acid) in their interactions with tamoxifen through conceptual density functional theory.

Here, we report theoretical research into the interaction of the drug tamoxifen drug with tripeptides found in the tumor environment-specifically, asparagine-glycine-arginine (NGR) and arginine-glycine-aspartic acid (RGD). Reactivity parameters of these tripeptides were calculated and their intrinsic reactivities and cross-reactivities were analyzed. The interactions of the tripeptides with the nanodiamond-tamoxifen (ND-TAM) complex where the nanodiamond acts as a nanocarrier were also examined theoretically. In addition, their intestinal absorption was predicted based on the polar surface area. The results showed that tamoxifen interacts with RGD, and this interaction remained after the addition of the nanodiamond. An analysis of the chemical hardnesses of the tripeptides was carried out to explore their possible use as synthetic vectors when joined to the nanodiamond. Results indicated that NGR is the most stable of the tripeptides and could be used for active targeting. All calculations were implemented using the conceptual framework of density functional theory.

Interaction of Tamoxifen Analogs With the Pocket Site of Some Hormone Receptors. A Molecular Docking and Density Functional Theory Study.

In this paper, the antiestrogenic properties of Tamoxifen analogs have been investigated and a theoretical report of its analogs interaction with the pocket site of some hormone receptors are presented. Analogs were generated by modification of the hydrophilic functional group of Tamoxifen by hydroxyl, amide, carboxyl, and sulfhydryl functional groups, in an attempt to improve their activity and selectivity. The analogs exhibit a negative binding energy in the estrogen and progesterone receptors, which indicates a spontaneous interaction between the analogs and the pocket site in the hormone receptors. The values of the molecular polar surface area indicate that the analogs have good permeability and are strong electrophiles. The couplings showed electrostatic interactions such as hydrogen bond and π-π interactions. According with the Lipinsky Rule of Five, the four analogs presented a good biodistribution, permeability, and pharmacological action on the hormone receptors. The analysis of the charge transfer suggests a limited enhanced oxidative damage in the estrogen receptor that not takes place with the progesterone receptor.

Síndrome de Pallister-Killian en una paciente mestiza mexicana: Reporte de caso / Paüister-KiUian syndrome in a Mexican mestizo patient: Case report

El síndrome de Pallister-Killian es una entidad poco frecuente causada por tetrasomía 12p en mosaico. Presenta facies tosca, alopecia frontotemporal, frente prominente, fisuras palpebrales oblicuas ascendentes, hipertelorismo ocular, ptosis palpebral, estrabismo, epicanto, puente nasal ancho, nariz corta, narinas antevertidas, filtrum largo, labio superior delgado e inferior prominente, pabellones auriculares con lóbulos gruesos y protruidos, cuello corto, pezones supernumerarios, manos anchas, braquidactilia, alteraciones en la pigmentación de la piel, cardiopatía congénita, discapacidad intelectual y crisis convulsivas. Su diagnóstico es complejo, ya que, en sangre periférica, el cariotipo suele ser normal. Se presenta el caso de una paciente mestiza mexicana de 4 años de edad con retraso en el desarrollo psicomotor y características fenotípicas que correspondieron a síndrome de Pallister-Killian. El cariotipo en fibroblastos de la biopsia de piel demostró mos47,XX,i(12)(p10)--#91;85--#93;/46,XX--#91;21--#93;. Un equipo multidisciplinario realiza el seguimiento con controles regulares por los departamentos de Neurología, Pediatría General y Genética Médica.

Pallister-Killian syndrome is caused by a tetrasomy 12p mosaicism and is characterized by facial dysmorphism, pigmentary skin anomalies, congenital heart defects, diaphragmatic hernia, epilepsy and mental retardation. The diagnosis is complex as the cytogenetic analysis in blood is usually normal, requiring karyotyping in other tissues, therefore the clinical suspicion is critical to guide the diagnostic tests and the patient requires an interdisciplinary clinical evaluation regarding the several manifestation of the syndrome. W e present the case of a Mexican mestizo female patient of 4 years of age referred by psychomotor delay and cleft palate; the clinical multidisciplinary evaluation demonstrated characteristics corresponding to the Pallister-Killian syndrome. The GTG banding karyotype analysis was normal, the skin fibroblast was mos47,XX,i(12)(p10)--#91;85--#93;/46,XX--#91;21--#93;. This case is an example of the importance of the clinical evaluation in order to establish a diagnosis that is a challenge for the clinical multidisciplinary team to offer medical management and genetic counseling.

[Pallister-Killian syndrome in a Mexican mestizo patient. Case report]. / Síndrome de Pallister-Killian en una paciente mestiza mexicana. Reporte de caso.

Pallister-Killian syndrome is caused by a tetrasomy 12p mosaicism and is characterized by facial dysmorphism, pigmentary skin anomalies, congenital heart defects, diaphragmatic hernia, epilepsy and mental retardation. The diagnosis is complex as the cytogenetic analysis in blood is usually normal, requiring karyotyping in other tissues, therefore the clinical suspicion is critical to guide the diagnostic tests and the patient requires an interdisciplinary clinical evaluation regarding the several manifestation of the syndrome. W e present the case of a Mexican mestizo female patient of 4 years of age referred by psychomotor delay and cleft palate; the clinical multidisciplinary evaluation demonstrated characteristics corresponding to the Pallister-Killian syndrome. The GTG banding karyotype analysis was normal, the skin fibroblast was mos47,XX,i(12)(p10)[85]/46,XX[21]. This case is an example of the importance of the clinical evaluation in order to establish a diagnosis that is a challenge for the clinical multidisciplinary team to offer medical management and genetic counseling.

El síndrome de Pallister-Killian es una entidad poco frecuente causada por tetrasomía 12p en mosaico. Presenta facies tosca, alopecia frontotemporal, frente prominente, fisuras palpebrales oblicuas ascendentes, hipertelorismo ocular, ptosis palpebral, estrabismo, epicanto, puente nasal ancho, nariz corta, narinas antevertidas, filtrum largo, labio superior delgado e inferior prominente, pabellones auriculares con lóbulos gruesos y protruidos, cuello corto, pezones supernumerarios, manos anchas, braquidactilia, alteraciones en la pigmentación de la piel, cardiopatía congénita, discapacidad intelectual y crisis convulsivas. Su diagnóstico es complejo, ya que, en sangre periférica, el cariotipo suele ser normal. Se presenta el caso de una paciente mestiza mexicana de 4 años de edad con retraso en el desarrollo psicomotor y características fenotípicas que correspondieron a síndrome de Pallister-Killian. El cariotipo en fibroblastos de la biopsia de piel demostró mos47,XX,i(12)(p10)[85]/46,XX[21]. Un equipo multidisciplinario realiza el seguimiento con controles regulares por los departamentos de Neurología, Pediatría General y Genética Médica.

New Methods of Esterification of Nanodiamonds in Fighting Breast Cancer-A Density Functional Theory Approach.

The use of nanodiamonds as anticancer drug delivery vehicles has received much attention in recent years. In this theoretical paper, we propose using different esterification methods for nanodiamonds. The monomers proposed are 2-hydroxypropanal, polyethylene glycol, and polyglicolic acid. Specifically, the hydrogen bonds, infrared (IR) spectra, molecular polar surface area, and reactivity parameters are analyzed. The monomers proposed for use in esterification follow Lipinski's rule of five, meaning permeability is good, they have good permeation, and their bioactivity is high. The results show that the complex formed between tamoxifen and nanodiamond esterified with polyglicolic acid presents the greatest number of hydrogen bonds and a good amount of molecular polar surface area. Calculations concerning the esterified nanodiamond and reactivity parameters were performed using Density Functional Theory with the M06 functional and the basis set 6-31G (d); for the esterified nanodiamond-Tamoxifen complexes, the semi-empirical method PM6 was used. The solvent effect has been taken into account by using implicit modelling and the conductor-like polarizable continuum model.

Priorities, concerns and unmet needs among Haitians in Boston after the 2010 earthquake.

In January 2010, a massive earthquake struck Haiti. The devastation not only affected those living in Haiti at the time but also those Haitians living in the United States (U.S.). Few studies have assessed the degree of impact of the earthquake in U.S. Haitian communities. The purpose of this study was to elicit information about health priorities, concerns and resources needed to improve the delivery of health and social care for Haitians in Boston, MA. We conducted six focus groups among 78 individuals in the spring of 2011. Participants were recruited through community organisations, including churches, Haitian social service centres, restaurants and by word of mouth. Analysis of qualitative data revealed an enormous psychological, emotional, financial and physical toll experienced by Boston-area Haitians following the earthquake. Participants described increased distress, depressive episodes, headaches and financial hardship. They also noted insufficient resources to meet the increased needs of those living in the U.S., and those who had immigrated after the earthquake. Most participants cited an increased need for mental health services, as well as assistance with finding employment, navigating the immigration system, and balancing the health and financial needs of families in the U.S. and in Haiti. Despite this, many reported that the tragedy created a sense of unity and solidarity within the Haitian community. These findings corroborate the need for culturally and linguistically appropriate mental health services, as well as for employment, immigration and healthcare navigation services. Participants suggested that interventions be offered through Haitian radio and television stations, as well as group events held in churches. Further research should assess the need for and barriers to utilisation of mental health services among the Haitian community. A multi-faceted approach that includes a variety of outreach strategies implemented through multiple channels may offer a means of improving awareness of and access to health and social services.

Employing a community based participatory research approach to bear witness: psycho-social impact of the 2010 earthquake on Haitians in Somerville, MA.

We employed a community-based participatory research approach to assess mental health among the Haitian community in the Somerville, MA area. The development of the survey coincided with the 2010 earthquake in Haiti, and so several questions related to the natural disaster were included in the analysis to increase understanding of the impact locally. We surveyed a convenience sample of 64 Haitians recruited with the assistance of the Somerville Haitian Coalition. The survey assessed demographic data, reasons for migrating to the area, response to the 2010 earthquake, and mental health. Mental health measures included the short versions of the Center for Epidemiologic Studies Depression Scale (CES-D) and the Perceived Stress Scale. Participants reported high rates of stress and depression post-earthquake. On the CES-D, men reported higher average depression and stress scores than women (13.8 vs. 11 and 20.6 vs. 17.6). Our results suggest that social and family support resources may be beneficial to Haitians in our sample.

Indicaciones para realizar extracciones seriadas en el tratamiento ortodóntico en dentición mixta. Investigación documental / Indications for serial extractions in orthodontic treatment in mixed dentition. Documentary research

La extracción seriada es un recurso necesario para prevenir anomalías causadas por la discrepancia entre el tamaño de los dientes y longitud del arco, durante la etapa de transición de dentición mixta a permanente. Las extracciones seriadas han sido criticadas a menudo como un mal procedimiento y en realidad sino se aplican correctamente pueden ser más nocivas que beneficiosas por lo cual es necesario iniciar la evaluación para su realización a través de un diagnóstico adecuado utilizando registros diagnósticos que permitan analizar el caso de cada paciente, asimismo es necesario mencionar en este apartado las diferentes indicaciones tanto generales como específicas y las contraindicaciones para realizar extracciones seriadas. Todo unido a una serie de fundamentos básicos para los cuales se indica su realización. Concluyendo que los pacientes en los cuales están indicado la realización de extracción seriada son: macrodoncia y micrognatismo ántero posterior y transversal, mesogresión de premolares y molares, la pérdida temprana o prematura de uno o ambos caninos con la resultante discrepancia de la línea media dentaria, erupción lingual de incisivos laterales, pérdida unilateral de canino deciduo y desplazamiento hacia el mismo lado, caninos que hacen erupción en sentido mesial sobre los incisivos laterales, Maloclusión clase I con protrusión dentoalveolar maxilar ­ mandibular, Maloclusión clase I con apiñamiento anterior severo con patrón facial ortognático y relación favorable overjet y overbite en los dientes incisivos, Maloclusión clase II con protrusión dentoalveolar del maxilar y Angulo gonial alto (hiperdivergente).

Serial extraction is a necessary resource to prevent anomalies caused by the discrepancy between tooth size and arch length, during the transition stage from mixed to permanent dentition. Serial extractions have often been criticized as a bad procedure and in reality, if not applied correctly, they can be more harmful than beneficial, which is why it is necessary to start the evaluation for its realization through an adequate diagnosis using diagnostic records that allow analyzing the case of each patient, it is also necessary to mention in this section the different general and specific indications and the contraindications for performing serial extractions. All together with a series of basic foundations for which its realization is indicated. Concluding that the patients in whom serial extraction is indicated are: anteroposterior and transverse macrodontia and micrognathism, mesogression of premolars and molars, early or premature loss of one or both canines with the resulting discrepancy of the dental midline, lingual eruption of lateral incisors, unilateral loss of deciduous canine and displacement to the same side, canines that erupt mesially over the lateral incisors, Class I malocclusion with maxillary-mandibular dentoalveolar protrusion, Class I malocclusion with severe anterior crowding with facial pattern orthognathic and favorable overjet and overbite relationship in incisor teeth, class II malocclusion with maxillary dentoalveolar protrusion and high gonial angle (hyperdivergent).