Estudio in vitro del ajuste de supraestructuras pasivadas sobre implantes múltiples / In vitro study of the adjustment of passivated suprastructures on multiple implants

Resumen Objetivo Comparar dos procedimientos de soldadura convencionales empleando una aleación de Cr-Co, para conectar barras coladas seccionadas a ser fijadas sobre implantes. Materiales y métodos A partir de un modelo maestro que representa un maxilar desdentado con cuatro implantes, se confeccionaron veinte (n=20) probetas seccionadas en tres partes. Se conformaron dos grupos, cada uno con diez (n=10) ejemplares. Una vez acondicionadas, fueron atornilladas al modelo maestro. Su desajuste inicial se analizó utilizando una lupa estereoscópica, con una cámara incorporada y un software. Las partes fueron soldadas empleando un procedimiento diferente para cada grupo. Las correspondientes al Grupo I se invistieron en un block refractario a base de sílico-fosfato. Las del Grupo II se montaron en una estructura metálica Clever Spider. El desajuste fue mensurado y los resultados procesados estadísticamente. El nivel de significación fue establecido en p<0,05. Resultados El Grupo I tuvo un desajuste inicial de 97,30±13,81μm y el Grupo II de 98,53±11,24μm. Luego de la soldadura, el Grupo I registró 98,53±17,17μm, 1,23μm mayor respecto al inicial. En el Grupo II se observó 103,13±17,61μm, 4,60μm por encima del original. Se analizaron mediante prueba t de Student; en ambos casos el resultado fue de p>0,05. Al comparar entre sí los grupos I y II, por medio de la prueba t y de comprobación no paramétrica de Mann-Whitney, se observaron diferencias no significativas, p=0,41 y p=0,38 respectivamente. Conclusiones Bajo las condiciones de este estudio, se observó que los dos métodos de soldadura analizados fueron confiables para unir supraestructurasos metálicas sin que se afecte su ajuste final.

Abstract Aim Compare two conventional welding procedures using a Cr-Co alloy, to connect sectioned cast bars to be fixed on implants. Materials and methods From a master model representing a toothless jaw with four implants, twenty (n=20) specimens sectioned into three parts were made. Two groups were formed, each with ten (n=10) specimens. Once conditioned, they were screwed to the master model. Its initial mismatch was analyzed using a stereoscopic magnifier, with a built-in camera and a software. The parts were welded using a different procedure for each group. Those corresponding to Group I were invested in a refractory block based on silyl-phosphate. Those of Group II were mounted on a Clever Spider metal structure. The mismatch was measured, and the results processed statistically. The level of significance was established at p<0.05. Results Group I had an initial mismatch of 97.30 ±13.81μm, and Group II of 98.53±11.24μm. After welding, Group I registered 98.53±17.17μm, 1.23μm higher than the initial one. In Group II, 103.13±17.61μm was observed, 4.60μm above the original. They were analyzed using Student's t test; in both cases the result was p>0.05. When comparing groups I and II, using the t-test and the Mann-Whitney nonparametric verification, non-significant differences were observed, p=0.41 and p=0.38 respectively. Conclusions Under the conditions of this study, it was observed that the two welding methods analyzed were reliable for joining metallic superstructures without affecting their final fit.

Estudio in vitro del ajuste de supraestructuras pasivadas sobre implantes múltiples / In vitro study of the adjustment of passivated suprastructures on multiple implants

Objetivo: Comparar dos procedimientos de soldadura convencionales empleando una aleación de Cr-Co, para co- nectar barras coladas seccionadas a ser fijadas sobre implantes. Materiales y métodos: A partir de un modelo maes- tro que representa un maxilar desdentado con cuatro implan- tes, se confeccionaron veinte (n=20) probetas seccionadas en tres partes. Se conformaron dos grupos, cada uno con diez (n=10) ejemplares. Una vez acondicionadas, fueron atornilla- das al modelo maestro. Su desajuste inicial se analizó utili- zando una lupa estereoscópica, con una cámara incorporada y un software. Las partes fueron soldadas empleando un pro- cedimiento diferente para cada grupo. Las correspondientes al Grupo I se invistieron en un block refractario a base de sílico-fosfato. Las del Grupo II se montaron en una estructu- ra metálica Clever Spider. El desajuste fue mensurado y los resultados procesados estadísticamente. El nivel de significa- ción fue establecido en p<0,05. Resultados: El Grupo I tuvo un desajuste inicial de 97,30±13,81µm y el Grupo II de 98,53±11,24µm. Luego de la soldadura, el Grupo I registró 98,53±17,17µm, 1,23µm mayor respecto al inicial. En el Grupo II se observó 103,13±17,61µm, 4,60µm por encima del original. Se analizaron mediante prue- ba t de Student; en ambos casos el resultado fue de p>0,05. Al comparar entre sí los grupos I y II, por medio de la prueba t y de comprobación no paramétrica de Mann-Whitney, se ob- servaron diferencias no significativas, p=0,41 y p=0,38 res- pectivamente (AU)

Aim: Compare two conventional welding procedures us- ing a Cr-Co alloy, to connect sectioned cast bars to be fixed on implants. Materials and methods: From a master model representing a toothless jaw with four implants, twenty (n=20) specimens sectioned into three parts were made. Two groups were formed, each with ten (n=10) specimens. Once conditioned, they were screwed to the master mod- el. Its initial mismatch was analyzed using a stereoscop- ic magnifier, with a built-in camera and a software. The parts were welded using a different procedure for each group. Those corresponding to Group I were invested in a refractory block based on silyl-phosphate. Those of Group II were mounted on a Clever Spider metal structure. The mismatch was measured, and the results processed statisti- cally. The level of significance was established at p<0.05. Results: Group I had an initial mismatch of 97.30 ±13.81µm, and Group II of 98.53±11.24µm. After welding, Group I registered 98.53±17.17µm, 1.23µm higher than the initial one. In Group II, 103.13±17.61µm was observed, 4.60µm above the original. They were analyzed using Stu- dent's t test; in both cases the result was p>0.05. When com- paring groups I and II, using the t-test and the Mann-Whitney nonparametric verification, non-significant differences were observed, p=0.41 and p=0.38 respectively. Conclusions: Under the conditions of this study, it was ob- served that the two welding methods analyzed were reliable for joining metallic superstructures without affecting their final fit (AU)

White coat wearing and laundering frequency among internal medicine department physicians.

Self-reported awareness of recommendations by the Society of Healthcare Epidemiology of America on white coat laundering remains low (21%) among physicians from the internal medicine department. Factors such as modifying the laundry schedule of the hospital and personalization of white coats can be considered by hospitals to increase adherence to such recommendations to decrease the risk of health care-associated infection and may also improve professional appearance.

Suplementación de vacas en lactación con Crescentia alata Kunth más urea / Supplementation of cows in lactation with Crescentia alata Kunth plus urea

La escasez de recursos alimenticios en época seca afecta negativamente la producción lechera del hato bovino. El fruto de morro (Crescentia alata Kunth) es una opción en la zona oriental de Guatemala para la suplementación de vacas en lactación. Se evalúo el efecto del morro fresco más urea sobre el consumo total de materia seca (MS) del suplemento y la producción de leche total vaca/día, aplicándose el diseño cuadrado latino en sobre cambio con cuatro tratamientos y tres repeticiones, utilizándose 12 vacas encastadas de doble propósito, en el cuarto parto y el segundo mes de lactación con promedio de 8 kg leche/día. Los tratamientos fueron: TI = napier morado picado (3.12 kg MS), alimento balanceado comercial (1.21 kg MS) y melaza; TII = TI más morro (1.0 kg MS), TIII = TII más urea (0.1 kg) y TIV = TI más morro (2.0 kg MS) más urea (0.1 kg). Después de 60 días, se observó un efecto sustitutivo parcial y un efecto descendiente sobre el consumo de MS de napier morado, respectivamente. Así mismo, se observó un incremento en el consumo total de MS del suplemento cuando se aumentaron los nive-les de morro, no así al adicionar urea en la misma. La producción de leche aumentó significativamente cuando se incrementaron los niveles de morro. Sin embargo, a un mismo nivel de morro, la inclusión de urea causó una reducción baja (3%) pero significativa (p < .001) sobre el consumo de MS total del suplemento.

The shortage of food resources in the dry season negatively affects the milk production of the herd. The fruit of morro (Crescentia alata Kunth) is an option in the eastern region of Guatemala for the supplementation of cows in lactation. The effect of the use of fresh morro plus urea on the total Dry Matter consumption (DM) of the supplement and the production of total milk of cows/day. A Latin Square statistical design was used with four treatments and three replications, using 12 crossbreed cows in the fourth childbirth and the second month of lactation with an average production of 8 kg milk/day. The treatments were: TI = minced purple napier (3.12 kg DM), commercial balanced feed (1.21 kg DM) and molasses; TII = TI plus nose (1 kg DM), TIII = TII plus urea (0.1 kg) and TIV = TI plus morro (2 kg MS) plus urea (0.1 kg). After 60 days, a partial replacement effect and a decreasing effect on the consumption of purple napier DM were observed, respectively. Likewise, an increase in the total consumption of DM of the supplement was observed when the morro levels were increased, but not when urea was added to it. Milk production increased significantly when morro levels increased. However, at the same morro level, the inclusion of urea caused a low (3%) but significant (p < .001) reduction on the total DM consumption of the supplement.

Madelung's Disease Leading to Presenile Dementia in a Non-alcoholic Patient.

INTRODUCTION: Madelung's disease (MD) is a rare disorder of unknown etiology defined as the presence of multiple and symmetrical fatty accumulations most commonly involving the upper trunk, neck, and head. Excessive alcohol ingestion has been linked traditionally to the pathogenesis of the disease. The central and peripheral nervous system could both be affected. Presenile dementia, without alcohol abuse, has been rarely reported in the literature as a complication. AIM: The aim of this case report is to highlight that multiple symmetric lipomatosis can be complicated by presenile dementia even if the patient is non-alcoholic. CASE REPORT: This case report describes a middle age non-alcoholic woman who presented for increased forgetfulness. Brain CT scan showed cerebral and cerebellar atrophy inappropriate for her age. Despite being started on anticholinergic drug, her MMSE decreased 3 points in 1 year. CONCLUSION: Clinicians should consider early onset dementia as a potential complication of Madelung's disease even in patients with no preceding history of alcoholism. A brain MRI and MMSE can aid with identifying such a complication.

Pulse oximeter ingestion in a psychotic patient.

Psychotic conditions such as schizophrenia, bipolar disorder, major depressive disorder, and polysusbstance abuse are risk factors for foreign body ingestion. A foreign body can include sharp objects that lead to serious complications. In this case report, we present a patient with a history of psychosis who ingested a pulse oximeter in a suicidal attempt. The pulse oximeter passed uneventfully with no interventions needed, and was followed by a serial of abdominal imaging.

Cardiac arrest identified by a chest CT scan in a patient with normal telemetry findings.

Early recognition of cardiac arrest has been linked traditionally to clinical signs and telemetry findings. Few case reports have presented normal telemetry findings in patients with cardiac arrest where a contrast enhanced CT scan of the chest was able to identify the diagnosis. The early recognition of a cardiac arrest whether by telemetry monitoring or CT scan is important to improve the clinical outcomes. This case report presents a patient who was hypertensive and unresponsive upon arrival to the emergency department. A chest CT scan to rule out aortic dissection showed no contrast in the pulmonary arteries, aorta, and the rest of the heart chambers although normal telemetry findings were present. Resuscitation was initiated, and patient survived with poor neurological recovery.

Orthogonal NGS for High Throughput Clinical Diagnostics.

Next generation sequencing is a transformative technology for discovering and diagnosing genetic disorders. However, high-throughput sequencing remains error-prone, necessitating variant confirmation in order to meet the exacting demands of clinical diagnostic sequencing. To address this, we devised an orthogonal, dual platform approach employing complementary target capture and sequencing chemistries to improve speed and accuracy of variant calls at a genomic scale. We combined DNA selection by bait-based hybridization followed by Illumina NextSeq reversible terminator sequencing with DNA selection by amplification followed by Ion Proton semiconductor sequencing. This approach yields genomic scale orthogonal confirmation of ~95% of exome variants. Overall variant sensitivity improves as each method covers thousands of coding exons missed by the other. We conclude that orthogonal NGS offers improvements in variant calling sensitivity when two platforms are used, better specificity for variants identified on both platforms, and greatly reduces the time and expense of Sanger follow-up, thus enabling physicians to act on genomic results more quickly.

Fracturas distales de radio / Distal fractures of the radium

La presente comunicación tiene como objetivo presentar un informe preliminar sobre 20 pacientes tratados en los últimos 2 años con un tutor externo de fabricación regional, a bajo costo, como tratamiento de fracturas articulares distales del radio, en especial, aquellas conminutas y complejas (tipo C según clasificación de la AO International); observando discreta mejoría en relación al anterior tutor de los autores, presentado el año anterior. En especial se logró disminuir las complicaciones presentadas en la muestra anterior

Fracturas del tercio distal de radio: análisis comparativo entre un tutor externo nuevo y placas atornilladas / Distal fractures of radius: comparative analysis between a new external tutor and screws plate

La presente comunicación tiene como finalidad mostrar las utilidades de un nuevo tutor externo, sencillo, versátil y de fácil adquisición y confección en el interior de nuestro país,para utilizar en el tratamiento las fracturas del tercio distal del radio y en comparación con uno de los mejores métodos de tratamiento actual como son las placas atornilladas de pequeños fragmentos. Para este análisis se estudiaron solamente fracturas tipo B y C según la clasificación AO, pues otras eran suceptibles de tratamiento ortopédico. El tutor propuesto ofrece resultados muy similares a las placas atornilladas, pero tiene la ventaja de su fácil confección y se evita el problema de suministros internacionales que en algunas oportunidades no son seguros, además de favorecer las industrias regionales