Forma y tamaño del arco dental en poblaciones de tres ascendencias étnicas colombianas / Form and size of the dental arch in populations of three Colombian ethnic ancestries

Introducción: En la actualidad existe poca referencia sobre la configuración de los arcos dentales en poblaciones latinoamericanas y se han descrito múltiples formas y variaciones para dichos arcos que se derivan especialmente de pacientes caucásicos. Objetivo: Describir la forma y tamaño de los arcos dentales de tres poblaciones Colombianas (Mestiza, Indígena, Afrodescendiente) en Condiciones de Normo Oclusión. Materiales y métodos: Estudio descriptivo transversal en 184 modelos distribuidos por la ascendencia étnica identificada a través de sus características morfológicas en 66 indígenas, 70 afrodescendientes y 48 mestizos con edades entre los 11 y 41 años de edad. Las variables estudiadas fueron distancia intercanina, distancia intermolar, longitud anterior del arco, perímetro de arco superior e inferior. Los modelos se fotocopiaron y luego se digitalizaron para posteriormente determinar la forma del arco mediante tres observadores. Resultados: La forma predominante en las 3 etnias es la ovalada. Existe baja concordancia entre la forma de arco maxilar y mandibular en un mismo individuo. Hubo una relación significativa entre la forma de arco superior cuadrada y el grupo étnico indígena. Se encontró diferencia significativa en la distancia intercanina superior en las tres formas de arcos. Conclusión: La forma de arco ovoide es la de mayor prevalencia en todos los grupos étnicos, se encontró una diferencia significativa en el ancho intercanino entre las formas del arco para el arco superior. Hubo una relación significativa entre la etnia indígena y la forma de arco superior cuadrada.

Introduction: At present there is little reference to the configuration of dental arches in Latin American populations and have been described many forms and variations for these arcs are derived especially from Caucasian patients. Objective: Describe the shape and size of the dental arches three Colombian populations (mestizo, indigenous, Afro-descendant) under occlusion Normo. Materials and methods: A cross over 184 models of study according to their racial characteristics and population were divided into 3 groups, 66 Indians, 70 and 48 mestizos African descent aged between 11 and 41 years old. The variables studied were intercanine width, intermolar distance, above the arc length, circumference of upper and lower arch. The photocopies of study models were scanned and subsequently determine the shape of the arc by three observers. Results: The predominant form in the three races is the oval. There is low correlation between maxillary and mandibular arch in the same individual. There was a significant relationship between the arc-shaped square top and Indian ethnicity. There was significant difference in the upper intercanine width between arch forms. Conclusion: The ovoid shaped arched is the most prevalent in all ethnic groups, a significant difference was found in the intercanine width between the arch shapes for the upper arch. There was a significant relationship between indigenous ethnicity and the shape of a square upper arch.

Situación actual de la cirugía video-toracoscópica / Current status of video-assisted thoracoscopic surgery

La práctica de la cirugía torácica ha evolucionado a lo largo del tiempo. Inicialmente se utilizaba la toracotomía como único abordaje para tratar las enfermedades torácicas de indicación quirúrgica. En el último siglo, el avance tecnológico y las nuevas técnicas de video han permitido el progreso de la video-toracoscopia, convirtiéndola en la actualidad en el método estándar para el diagnóstico y tratamiento de un importante número de enfermedades torácicas. Este método permite una recuperación rápida de los pacientes, con disminución del trauma quirúrgico, el estrés metabólico, los analgésicos, el tiempo de hospitalización, y las tasas de morbilidad y mortalidad. Aunque se considera un procedimiento seguro, no está exento de presentar complicaciones que pueden requerir, en un muy bajo porcentaje, la toracotomía, razón por la cual los cirujanos entrenados en video-toracoscopia nunca deben desconocer la técnica de abordaje a cielo abierto.

The practice of thoracic surgery has evolved over time. Initially thoracotomy was performed as the only approach in the management of thoracic pathologies amenable to surgical treatment. The technological progress and the advent of video assisted techniques have allowed the advancement of video-assisted thoracic thoracoscopy, positioning it as the gold standard in the diagnosis and treatment of an important number chest diseases. This method permits a rapid recovery, diminution in the surgical trauma and metabolic stress, lesser analgesic requirements, shorter hospital stay, and lower morbidity and mortality rates. Although considered a safe approach, it is not void complications that may require, in a very low percentage, thoracotomy, for which reason surgeons trained in video-assisted thoracic surgery should never ignore the open approach technique.

A qualitative enquiry of caregivers of adolescents with severe disabilities in Guatemala City.

PURPOSE: This study explores the experiences of lower middle class Ladino and Indígena parents and caregivers of adolescents with severe physical disabilities as they negotiate Guatemala's urban health care and education systems. METHOD: Interviews with parents and guardians regarding the diagnostic period, current functioning in several domains and resources were analysed using Constructivist Grounded Theory with 15 families in Guatemala City. RESULTS: Juxtaposing economic resources with preparation for adult roles along two dimensions in an axial grid, individual differences were identified. When families experience financial urgency, finding it difficult to meet even basic needs, securing employment immediately is most salient in the transition to adulthood (Low Resources, High Preparation); when families have greater resources, they are less pressed for economic input and, instead, describe a longer-term concern for the educational and professional development of their child (High Resources, High Preparation) or worry about the care of their offspring after their demise (High Resources, Low Preparation). CONCLUSIONS: Practitioners, therapists, parents and policy-makers can be more effectual in providing targeted services by understanding individual differences in the perception of disability, economic resources, and the need for other resources that ensure viable adult roles for young people with disabilities in Guatemala and elsewhere.