Cambios en la alimentación de pacientes con recurrencia de cáncer / Mudança de hábitos alimentares em pacientes com recidiva de câncer / Changing Diet Habits in Patients with Cancer Recurrence

Introducción: Hasta 30% de las causas del cáncer se atribuyen a la alimentación. Los sobrevivientes de esta enfermedad, como parte del autocuidado, deben adquirir una alimentación saludable. Este estudio pretendió describir los cambios alimentarios realizados entre el primero y segundo diagnóstico de cáncer y conocer algunas de sus causas. Materiales y Métodos: Se utilizó una muestra aleatoria de proporciones con 195 pacientes, a quienes se les aplicó una encuesta en el año 2019, relacionada con el objeto de estudio. Para el análisis de los datos, se usó el método estadístico factorial de correspondencia múltiple, análisis de clúster y distribución de frecuencias. Resultados: La salud fue lo que más motivó al cambio de hábitos alimentarios, seguido por factores asociados al tratamiento. Las personas disminuyeron el consumo de carnes con grasa, fritos, alcohol, snacks, embutidos y lácteos, aumentando la ingesta de frutas y verduras. Discusión: Luego de un segundo diagnóstico de cáncer, los participantes presentaron cambios favorables para la salud, acordes a las recomendaciones de los entes internacionales. El estado de salud y el tratamiento para el cáncer, fueron las condiciones que más influyeron para que las personas sobrevivientes de cáncer realizaran cambios en su alimentación ante un nuevo diagnóstico o una recidiva. Conclusión: Los sobrevivientes de cáncer con recidiva, modifican su alimentación hacia una vida más saludable. Se debe promover una alimentación adecuada en la población en general, y más aún en sobrevivientes de cáncer.

Introduction: Up to 30% of cancer cases are linked to food. As part of their self-care practice, cancer survivors should eat a healthy diet. This study aimed to describe the changes in diet habits made between the first and second cancer diagnosis, as well as to learn more about cancer causes. Materials and Methods: A random sample proportion was used with 195 patients who responded to a survey in 2019 related to the object of study. For data analysis, statistical correspondence factorial analysis, cluster analysis and frequency distribution were carried out. Results: Health was the main reason for changing eating habits, followed by factors associated with cancer treatment. Patients reduced their consumption of fatty meats, fried foods, alcohol, snacks, cold cuts, and dairy products, while increased their fruit and vegetable intake. Discussion: After a second cancer diagnosis, participants reported favorable changes in improving their health based on the recommendations of international organizations. Health status and cancer treatment were conditions that most influenced cancer survivors to change diet habits in the face of a new diagnosis or relapse. Conclusion: Patients with cancer recurrence decide to change their eating habits to have a healthier life. Adequate nutrition should be promoted among the general population and even more in cancer survivors.

Introdução: Até 30% dos casos de câncer são atribuídas à dieta. Como parte de seu autocuidado, os sobreviventes desta doença devem ter uma dieta saudável. Este estudo teve como objetivo descrever as mudanças nos hábitos alimentares feitas entre o primeiro e o segundo diagnóstico de câncer e compreender algumas das causas. Materiais e métodos: Uma amostra aleatória foi utilizada com 195 pacientes que responderam a uma pesquisa em 2019 relacionada ao objeto de estudo. Para análise de dados, foram realizadas análises fatoriais de correspondência estatística, análise de agrupamentos e distribuição de frequências. Resultados: A saúde foi a principal razão para a mudança de hábitos alimentares, seguida por fatores associados ao tratamento do câncer. Os pacientes reduziram seu consumo de carnes gordurosas, alimentos fritos, álcool, lanches, embutidos e produtos lácteos, enquanto aumentavam a ingestão de frutas e vegetais. Discussão: Após um segundo diagnóstico de câncer, os participantes apresentaram mudanças favoráveis para melhorar sua saúde, com base nas recomendações de organizações internacionais. O estado de saúde e o tratamento do câncer foram as condições que mais influenciaram para que os sobreviventes do câncer mudassem sua dieta diante de um novo diagnóstico ou recaída. Conclusão: Os pacientes com recidiva de câncer decidem mudar seus hábitos alimentares para ter uma vida mais saudável. A nutrição adequada deve ser promovida entre a população em geral e ainda mais entre os sobreviventes de câncer.

Las competencias del neurólogo en Colombia: una propuesta / The competencies of the neurologist in Colombia: a proposal

RESUMEN INTRODUCCIÓN: Tener claras las competencias profesionales permite dirigir adecuadamente los esfuerzos académicos, económicos y sociales para cumplir la vocación como neurólogos; hasta ahora, la bibliografía al respecto es escasa. OBJETIVO: Describir las competencias profesionales que debe tener un neurólogo clínico en Colombia. MÉTODOS Y MATERIALES: Es un estudio cualitativo exploratorio descriptivo, realizado según la teoría fundamentada, mediante una entrevista semiestructurada a 23 líderes de la especialidad en Colombia. RESULTADOS Y DISCUSIÓN: A partir de las entrevistas, se redactan según el modelo del Ministerio de Salud, competencias transversales y específicas que complementan las 8 planteadas previamente por ASCOFAME, para un total de 34 competencias divididas en cinco dominios. CONCLUSIONES: luego de conocer las competencias profesionales, deben diseñarse criterios de desempeño para medir el logro de esas habilidades. Dado que las competencias dependen de las condiciones de la sociedad, las cuales son cambiantes, su reevaluación debe ser continua.

SUMMARY INTRODUCTION: Having a clear idea of professional competencies allows to direct properly the academic economic and social efforts to accomplish the neurologist's vocation; neverthless, the literature is scarce. OBJECTIVE: Describe the professional competencies of clinical neurologists in Colombia. METHODS AND MATERIALS: It is a descriptive exploratory qualitative study, carried out according to grounded theory, through a semi-structured interview with 23 leaders of the specialty in Colombia. RESULTS AND DISCUSSION: From the interviews, transversal and specific competences are drawn up according to the model of the Ministry of Health, complementing the 8 previously proposed by ASCOFAME, for a total of 34 competencies divided into five domains. CONCLUSIONS: After knowing the neurologist's competencies, it's mandatory to design perfomance criteria to measure the achievement of those abilities. Since competencies depend on the conditions of society which are in constant change, their reassessment must be continuous.

Caracterización de los cambios en estilos de vida de sobrevivientes de cáncer con recurrencia / Characterization of lifestyle changes of cancer survivors with recidivism

Introducción: Según la Organización Panamericana de Salud, la incidencia de cáncer va en aumento. Entre los cánceres más prevalentes en Antioquia (Colombia), se destacan el de pulmón, colorrectal, mama, próstata y estómago. Objetivo: Describir los cambios en el estilo de vida, de las personas que presentan recurrencia o un segundo diagnóstico de cáncer. Métodos: Se estudiaron datos sociodemográficos, tipo de cáncer, tanto primario como secundario, antecedentes personales y familiares, cambios en actividad física, horas de sueño, consumo de cigarrillo y licor. Resultados: El primer diagnóstico de "otros tipos de cáncer" fue el más común. El antecedente más frecuente fue la hipertensión arterial, en casi 50 por ciento de los sujetos. Tras un primer diagnóstico de cáncer, tanto la práctica de actividad física, como el hábito de fumar y el consumo de alcohol, se redujeron de manera notoria en ambos sexos. En relación a la presencia de cáncer y los hábitos poco saludables, 28,1 por ciento de los hombres que reportaron ser fumadores, presentaron cáncer de próstata, donde el 25,8 por ciento tomaba licor. Conclusiones: Se observaron cambios destacados en los estilos de vida, en lo relacionado con el hábito de fumar, el cual disminuyó, al igual que el consumo de licor. Como aspecto negativo se observa la reducción en la práctica de actividad física y las horas dedicadas al sueño(AU)

Introduction: According to the Pan American Health Organization, the incidence of cancer is increasing. Among the most prevalent cancers in Antioquia (Colombia), there are lung, colorectal, breast, prostate and stomach. Objective: Describe the changes in lifestyle of people who have recurrence or a second diagnosis of cancer. Methods: Sociodemographic data, type of cancer, both primary and secondary, personal and family history, changes in physical activity, sleep hours, cigarette consumption and liquor were studied. Results: The first diagnosis of "other types of cancer" was the most common. Arterial hypertension was reported in almost 50 percent of the subjects. After a first diagnosis of cancer, both the practice of physical activity, smoking and alcohol consumption, were significantly reduced in both sexes. In relation to the presence of cancer and unhealthy habits, 28.1 percent of the men who reported being smokers had prostate cancer, where 25.8 percent consumed liquor. Conclusions: Notable changes in lifestyle were observed, in relation to the decrease in smoking, as well as the consumption of liquor. The negative aspect is the reduction in the practice of physical activity and the hours dedicated to sleep(AU)

Quantifying Vascular Changes Surrounding Bone Regeneration in a Porcine Mandibular Defect Using Computed Tomography.

Angiogenesis is a critical process essential for optimal bone healing. Several in vitro and in vivo systems have been previously used to elucidate some of the mechanisms involved in the process of angiogenesis, and at the same time, to test potential therapeutic agents and bioactive factors that play important roles in neovascularization. Computed tomography (CT) is a noninvasive imaging technique that has recently allowed investigators to obtain a diverse range of high-resolution, three-dimensional characterization of structures, such as bone formation within bony defects. Unfortunately, to date, angiogenesis evaluation relies primarily on histology, or ex vivo imaging and few studies have utilized CT to qualitatively and quantitatively study the vascular response during bone repair. In the current study a clinical CT-based technique was used to evaluate the effects of rhBMP-2 eluting graft treatment on soft tissue vascular architecture surrounding a large segmental bone defect model in the minipig mandible. The objective of this study was to demonstrate the efficacy of contrast-enhanced, clinical 64-slice CT technology in extracting quantitative metrics of vascular architecture over a 12-week period. The results of this study show that the presence of rhBMP-2 had a positive effect on vessel volume from 4 to 12 weeks, which was explained by a concurrent increase in vessel number, which was also significantly higher at 4 weeks for the rhBMP-2 treatment. More importantly, analysis of vessel architecture showed no changes throughout the duration of the study, indicating therapeutic safety. This study validates CT analysis as a relevant imaging method for quantitative and qualitative analysis of morphological characteristics of vascular tissue around a bone healing site. Also important, the study shows that CT technology can be used in large animal models and potentially be translated into clinical models for the development of improved methods to evaluate tissue healing and vascular adaptation processes over the course of therapy. This methodology has demonstrated sensitivity to tracking spatial and temporal changes in vascularization and has the potential to be applied to studying changes in other high-contrast tissues as well. Impact Statement Tissue engineering solutions depend on the surrounding tissue response to support regeneration. The inflammatory environment and surrounding vascular supply are critical to determining if therapies will survive, engraftment occurs, and native physiology is restored. This study for the first time evaluates the blood vessel network changes in surrounding soft tissue to a bone defect site in a large animal model, using clinically available computed tomography tools and model changes in vessel number, size, and architecture. While this study focuses on rhBMP2 delivery impacting surrounding vasculature, this validated method can be extended to studying the vascular network changes in other tissues as well.

Reactions: Antibacterial and bioactive dental restorative materials: Do they really work?

PURPOSE: The study and development of antibacterial materials for use in dental applications is growing with the development of novel materials and procedures. Examination of the effects of such antibacterial materials on oral pathogens as well as on stability and longevity of dental restorations is of paramount importance to the field. RESULTS: This review addressed the range of topics covered by the manuscripts presented at the Seoul symposium on antibacterial dental materials. CLINICAL SIGNIFICANCE: Based on the presented works, it seems that the emerging antibacterial and bioactive mate-rials can potentially benefit restorative dentistry; however, like many other subjects in clinical dentistry, good quality evidence on their effectiveness under clinical situations is yet to be accumulated.

Spontaneous pneumomediastinum. case report

ABSTRACT Introduction: Spontaneous pneumomediastinum (SPM) is defined as the presence of air in the mediastinum. It is a rare entity considered benign and self-limiting, which mostly affects young adults. Its diagnosis is confirmed through clinical and radiological studies. Case description: 21-year-old male patient with cough and greenish expectoration for four days, associated with dyspnea, chest pain, fever and bilateral supraclavicular subcutaneous emphysema. Chest X-ray suggested pneumomediastinum, which was confirmed by tomography. The patient was hospitalized for observation and treatment. After a positive evolution, he was discharged on the sixth day. Discussion: SPM is a differential diagnosis in patients with chest pain and dyspnea. Its prevalence is lower than 0.01% and its mortality rate is low. It should be suspected in patients with chest pain and subcutaneous emphysema on physical examination. Between 70 and 90% of the cases can be identified by chest X-ray, while confirmation can be obtained through chest tomography. In most cases it does not require additional studies. Conclusion: SPM is a little known cause of acute chest pain, and rarely considered as a differential diagnosis; it is self-limited and has a good prognosis.

Three-dimensional printing for craniomaxillofacial regeneration.

Craniomaxillofacial injuries produce complex wound environments involving various tissue types and treatment strategies. In a clinical setting, care is taken to properly irrigate and stabilize the injury, while grafts are molded in an attempt to maintain physiological functionality and cosmesis. This often requires multiple surgeries and grafts leading to added discomfort, pain and financial burden. Many of these injuries can lead to disfigurement and resultant loss of system function including mastication, respiration, and articulation, and these can lead to acute and long-term psychological impact on the patient. A main causality of these issues is the lack of an ability to spatially control pre-injury morphology while maintaining shape and function. With the advent of additive manufacturing (three-dimensional printing) and its use in conjunction with biomaterial regenerative strategies and stem cell research, there is an increased potential capacity to alleviate such limitations. This review focuses on the current capabilities of additive manufacturing platforms, completed research and potential for future uses in the treatment of craniomaxillofacial injuries, with an in-depth discussion of regeneration of the periodontal complex and teeth.

Infected pulmonary infarction case report / Infarto pulmonar infectado. reporte de caso

ABSTRACT Introduction: Pulmonary infarction occurs in 29% to 32% of patients with pulmonary thromboembolism (PTE). The infection of a pulmonary infarction is a complication in approximately 2 to 7% of the cases, which makes it a rare entity. Case Presentation: 49-year-old woman with pleuritic pain in the left hemithorax that irradiated to the dorsal region, associated with dyspnea and painful edema in the left lower limb of two days of evolution. Two weeks prior to admission, the patient suffered from a left knee trauma that required surgical intervention; however, due to unknown reasons, she did not receive antithrombotic prophylaxis. Physical examination showed tachycardia, tachypnea and painful edema with erythema in the left leg. After suspecting a pulmonary thromboembolism, anticoagulation medication was administered and a chest angiotomography was requested to confirm the diagnosis. The patient experienced signs of systemic inflammatory response, and respiratory deterioration. A control tomography was performed, suggesting infected pulmonary infarction. Antibiotic treatment was initiated, obtaining progressive improvement; the patient was subsequently discharged, and continued with anticoagulation medication and follow-up on an outpatient basis. Conclusions: Pulmonary infarction is a frequent complication in patients with PTE. Therefore, infected pulmonary infarction should be suspected in patients with clinical deterioration and systemic inflammatory response. The radiological difference between pulmonary infarction and pneumonia is not easily identified, thus the diagnostic approach is clinical, and anticoagulant and antimicrobial treatment should be initiated in a timely manner.

RESUMEN Introducción El infarto pulmonar ocurre entre un 29 y un 32% de pacientes con tromboembolismo pulmonar (TEP). Por su parte, la infección de un infarto pulmonar complica aproximadamente del 2 al 7% de los casos, lo que hace que el infarto pulmonar infectado sea una entidad poco frecuente. Descripción del caso Mujer de 49 años con dolor pleurítico en hemitórax izquierdo, irradiado a región dorsal, asociado a disnea y edema doloroso de miembro inferior izquierdo de dos días de evolución. Dos semanas antes de su ingreso la paciente sufrió trauma de rodilla izquierda, el cual que requirió intervención quirúrgica; sin embargo, por motivos desconocidos, no recibió profilaxis anti trombótica. En el examen físico se encontró taquicardia, taquipnea y edema doloroso con eritema en pierna izquierda. Al existir alta sospecha de tromboembolia pulmonar se inició anticoagulación y se solicitó angiotomografía de tórax, con la cual fue posible confirmar el diagnóstico. Durante su evolución, la paciente experimentó signos de respuesta inflamatoria sistémica, deterioro respiratorio. Se realizó tomografía de control sugestiva de infarto pulmonar infectado. Se inició antibiótico y la paciente mejoró de forma progresiva; después de esta mejora, fue dada de alta para continuar anticoagulación y seguimiento ambulatorios. Conclusiones El infarto pulmonar es una complicación frecuente en pacientes con TEP. Por lo tanto, debe sospecharse infarto pulmonar infectado en pacientes con deterioro clínico y respuesta inflamatoria sistémica. La diferencia radiológica entre infarto pulmonar y neumonía no es fácil de identificar, su enfoque diagnóstico es clínico y el tratamiento anticoagulante y antimicrobiano debe iniciarse de manera oportuna.

Current trends in dental implants.

Tooth loss is very a very common problem; therefore, the use of dental implants is also a common practice. Although research on dental implant designs, materials and techniques has increased in the past few years and is expected to expand in the future, there is still a lot of work involved in the use of better biomaterials, implant design, surface modification and functionalization of surfaces to improve the long-term outcomes of the treatment. This paper provides a brief history and evolution of dental implants. It also describes the types of implants that have been developed, and the parameters that are presently used in the design of dental implants. Finally, it describes the trends that are employed to improve dental implant surfaces, and current technologies used for the analysis and design of the implants.

Antimicrobial surfaces for craniofacial implants: state of the art.

In an attempt to regain function and aesthetics in the craniofacial region, different biomaterials, including titanium, hydroxyapatite, biodegradable polymers and composites, have been widely used as a result of the loss of craniofacial bone. Although these materials presented favorable success rates, osseointegration and antibacterial properties are often hard to achieve. Although bone-implant interactions are highly dependent on the implant's surface characteristics, infections following traumatic craniofacial injuries are common. As such, poor osseointegration and infections are two of the many causes of implant failure. Further, as increasingly complex dental repairs are attempted, the likelihood of infection in these implants has also been on the rise. For these reasons, the treatment of craniofacial bone defects and dental repairs for long-term success remains a challenge. Various approaches to reduce the rate of infection and improve osseointegration have been investigated. Furthermore, recent and planned tissue engineering developments are aimed at improving the implants' physical and biological properties by improving their surfaces in order to develop craniofacial bone substitutes that will restore, maintain and improve tissue function. In this review, the commonly used biomaterials for craniofacial bone restoration and dental repair, as well as surface modification techniques, antibacterial surfaces and coatings are discussed.