Spontaneous Recovery of Paraplegia in a Polytrauma Patient following Spinal Cord Ischemia due to Type B Traumatic Aortic Dissection.

Aortic dissection is a life-threatening acute condition characterized by the separation of the aortic wall's layers. It is caused by a tear in the internal vascular wall (intimal layer and middle layer), which results in bleeding between the layers and causes abrupt and excruciating pain. The appropriate consideration must be given to the condition's dynamic nature, and variations in clinical presentation, without neglecting the urgency for intervention. In this case study, a 65-year-old male engaged in a car accident is admitted to urgent care with a traumatic aortic dissection diagnosis that included the aortic arch, a segmental exposed fracture of 1/3 distal of the right femur AO 32C3k, and an intertrochanteric fracture AO 31A1.3. The patient developed transient paraplegia as the initial manifestation of acute aortic dissection, which represents a high mortality and morbidity entity without adequate and prompt treatment, and prompt diagnosis and management were critical. A patient with severe thoracic and abdominal trauma caused by high-energy injury should be properly evaluated for the possibility of traumatic aortic dissection. The endovascular aortic repair was performed, resulting in a positive clinical evolution due to the important participation of the multidisciplinary trauma team involved in patient management and prompted decision-making.

Riesgo arrítmico en episodios únicos o recurrentes de síncope inexplicado con bloqueo completo de rama / Arrhythmic risk in single or recurrent episodes of unexplained syncope with complete bundle branch block

Introducción y objetivos: Los pacientes con un episodio sincopal inexplicable único (ESU) y bloqueo completo de rama del haz de His (BcR) con frecuencia se tratan de manera más conservadora que aquellos con episodios recurrentes (ESR). El objetivo fue analizar si existen diferencias entre pacientes con ESU o ESR y BcR en cuanto al riesgo arrítmico, el rendimiento diagnóstico de las pruebas y los resultados clínicos. Métodos: Estudio de cohorte de pacientes consecutivos con seguimiento medio de 3 años. Fueron estudiados mediante un protocolo escalonado basado en un estudio electrofisiológico y seguimiento con un monitor cardiaco implantable (MCI). Resultados: De los 503 pacientes incluidos en el estudio, 238 (47,3%) referían un ESU. El riesgo de síncope arrítmico fue similar en ambos grupos (58,8% ESU frente a 57,0% ESR; p=0,68), también tras ajustar por variables de confusión (HR=1,06; IC95%, 0,81-1,38; p=0,674). No se encontraron diferencias significativas en cuanto a los resultados del estudio electrofisiológico y la rentabilidad diagnóstica del monitor cardiaco implantable. Un total de 141 (59,2%) pacientes con ESU y 154 (58,1%) con ESR requirieron el implante de un dispositivo cardiaco (p=0,797). Tras el tratamiento adecuado, 35 (7%) pacientes presentaron recurrencia del síncope. La tasa de recurrencia y la mortalidad también fueron similares. Conclusiones: Los pacientes con BcR y síncope tienen un alto riesgo de tener una etiología arrítmica, aunque solo hayan presentado un episodio aislado. Los pacientes con ESU y ESR tienen un riesgo arrítmico similar y presentan un pronóstico similar, por lo que no existe una justificación clínica para no tratarlos de la misma manera.(AU)

Introduction and objectives: Patients with a single syncopal episode (SSE) and complete bundle branch block (cBBB) are frequently managed more conservatively than patients with recurrent episodes (RSE). The objective of this study was to analyze if there are differences between patients with single or recurrent unexplained syncope and cBBB in arrhythmic risk, the diagnostic yield of tests, and clinical outcomes. Methods: Cohort study of consecutive patients with unexplained syncope and cBBB with a median follow-up time of 3 years. The patients were evaluated via a stepwise workup protocol based on electrophysiological study (EPS) and long-term follow-up with an implantable cardiac monitor. Results: Of the 503 patients included in the study, 238 (47.3%) had had only 1 syncopal episode. The risk of an arrhythmic syncope was similar in both groups (58.8% in SSE vs 57.0% in RSE; P=.68), also after adjustment for possible confounding variables (HR, 1.06; 95%CI, 0.81-1.38; P=.674). No significant differences between the groups were found in the EPS results and implantable cardiac monitor diagnostic yield. A total of 141 (59.2%) patients with SSE and 154 (58.1%) patients with RSE required cardiac device implantation (P=.797). After appropriate treatment, 35 (7%) patients had recurrence of syncope. The recurrence rate and mortality were also similar in both groups. Conclusions: Patients with cBBB and unexplained syncope are at high risk of an arrhythmic etiology, even after the first syncopal episode. Patients with SSE and RSE have a similar arrhythmic risk and similar outcomes, and therefore there is no clinical justification for not managing them in the same manner.(AU)

Arrhythmic syncope: From diagnosis to management.

Syncope is a concerning symptom that affects a large proportion of patients. It can be related to a heterogeneous group of pathologies ranging from trivial causes to diseases with a high risk of sudden death. However, benign causes are the most frequent, and identifying high-risk patients with potentially severe etiologies is crucial to establish an accurate diagnosis, initiate effective therapy, and alter the prognosis. The term cardiac syncope refers to those episodes where the cause of the cerebral hypoperfusion is directly related to a cardiac disorder, while arrhythmic syncope is cardiac syncope specifically due to rhythm disorders. Indeed, arrhythmias are the most common cause of cardiac syncope. Both bradyarrhythmia and tachyarrhythmia can cause a sudden decrease in cardiac output and produce syncope. In this review, we summarized the main guidelines in the management of patients with syncope of presumed arrhythmic origin. Therefore, we presented a thorough approach to syncope work-up through different tests depending on the clinical characteristics of the patients, risk stratification, and the management of syncope in different scenarios such as structural heart disease and channelopathies.

Oral and maxillo-facial injuries in victims of political repression during the Chilean dictatorship.

INTRODUCTION: Chile was under a civil-military dictatorship from 1973 to 1990. During that time, systematic violations to human rights were perpetrated. Oral and maxillo-facial trauma was not an exception, and such trauma was carried out through different methods of torture or ill treatment by agents of the State. Currently, Chile has laws and programs in the public healthcare system to carry out the re-habilitation and reparation process in victims, and the registration of the suffered injuries is considered an important part of these med-ico-legal procedures. The aim of this study is to describe and classify the type of torture or ill-treatment in the orofacial area of victims of political repression during the Chilean military dictatorship and relate them to the injuries registered in written reports. METHODS: 14 reports of oral and maxillo-fa-cial injuries of tortured victims from 2016 to 2020 were analyzed, considering the alleged history of the patient, the visible effects on the oral examination, and the type of torture that was inflicted. Historical clinical records and X ray exams were analyzed when available. RESULTS: 6 variations of torture and ill-treat-ment that involve the maxillo-facial area were caused by agents of the State during the dic-tatorship period. DISCUSSION: According to the patient ́s account and the clinical examination, all of the torture techniques applied caused, directly or indirectly, the loss of teeth. This resulted in not only physical problems, but psychological problems for the victims.

Arrhythmic risk in single or recurrent episodes of unexplained syncope with complete bundle branch block.

INTRODUCTION AND OBJECTIVES: Patients with a single syncopal episode (SSE) and complete bundle branch block (cBBB) are frequently managed more conservatively than patients with recurrent episodes (RSE). The objective of this study was to analyze if there are differences between patients with single or recurrent unexplained syncope and cBBB in arrhythmic risk, the diagnostic yield of tests, and clinical outcomes. METHODS: Cohort study of consecutive patients with unexplained syncope and cBBB with a median follow-up time of 3 years. The patients were evaluated via a stepwise workup protocol based on electrophysiological study (EPS) and long-term follow-up with an implantable cardiac monitor. RESULTS: Of the 503 patients included in the study, 238 (47.3%) had had only 1 syncopal episode. The risk of an arrhythmic syncope was similar in both groups (58.8% in SSE vs 57.0% in RSE; P=.68), also after adjustment for possible confounding variables (HR, 1.06; 95%CI, 0.81-1.38; P=.674). No significant differences between the groups were found in the EPS results and implantable cardiac monitor diagnostic yield. A total of 141 (59.2%) patients with SSE and 154 (58.1%) patients with RSE required cardiac device implantation (P=.797). After appropriate treatment, 35 (7%) patients had recurrence of syncope. The recurrence rate and mortality were also similar in both groups. CONCLUSIONS: Patients with cBBB and unexplained syncope are at high risk of an arrhythmic etiology, even after the first syncopal episode. Patients with SSE and RSE have a similar arrhythmic risk and similar outcomes, and therefore there is no clinical justification for not managing them in the same manner.

Sex-Related Differences in Patients With Unexplained Syncope and Bundle Branch Block: Lower Risk of AV Block and Lesser Need for Cardiac Pacing in Women.

Objective: To analyze if there are sex-related differences in patients with unexplained syncope and bundle branch block (BBB). Background: Despite increasing awareness that sex is a major determinant of the incidence, etiology, and the outcomes of different arrhythmias, no studies have examined differences in presentation and outcomes between men and women with syncope and BBB. Methods: Cohort study of consecutive patients with unexplained syncope and BBB was included from January 2010 to January 2021 with a median follow-up time of 3.4 years [interquartile range (IQR) 1.7-6.0 years]. They were evaluated by a stepwise workup protocol based on electrophysiological study (EPS) and long-term follow-up with an implantable cardiac monitor (ICM). Results: Of the 443 patients included in the study, 165 (37.2%) were women. Compared with men, women had less diabetes (25.5 vs. 39.9%, p = 0.002) and less history of ischemic heart disease (IHD; 13.3 vs. 25.9%, p = 0.002). Left bundle branch block (LBBB) was more frequent in women (55.2 vs. 27.7%, p < 0.001) while right bundle branch block (RBBB) was more frequent in men (41.5 vs. 67.7%, p < 0.001). His to ventricle (HV) interval in the EPS was shorter in women (58 ms [IQR 52-71] vs. 60 ms [IQR 52-73], p = 0.035) and less women had an HV interval longer than 70 ms (28.5 vs. 38.1%, p = 0.039), however, EPS and ICM offered a similar diagnostic yield in both sexes (40.6 vs. 48.9% and 48.4% vs. 51.1%, respectively). Women had a lower risk of developing atrioventricular block (AVB) (adjusted odds ratio [OR] 0.44-95% CI 0.26-0.74, p = 0.002) and of requiring permanent pacemaker implantation (adjusted hazard ratio [HR] 0.72-95% CI: 0.52-0.99, p = 0.046). The mortality rate was lower in women (4.5 per 100 person-years [95% CI 3.1-6.4 per 100 person-years] vs. 7.3 per 100 person-years [95% CI 5.9-9.1 per 100 person-years]). Conclusions: Compared to men, women with unexplained syncope and BBB have a lower risk of AVB and of requiring cardiac pacing. A stepwise diagnostic approach has a similar diagnostic yield in both sexes, and it seems appropriate to guide the treatment and avoid unnecessary pacemaker implantation, especially in women.

A Power-Efficient Sensing Approach for Pulse Wave Palpation-Based Heart Rate Measurement.

Heart rate (HR) is an essential indicator of health in the human body. It measures the number of times per minute that the heart contracts or beats. An irregular heartbeat can signify a severe health condition, so monitoring heart rate periodically can help prevent heart complications. This paper presents a novel wearable sensing approach for remote HR measurement by a compact resistance-to-microcontroller interface circuit. A heartbeat's signal can be detected by a Force Sensing Resistor (FSR) attached to the body near large arteries (such as the carotid or radial), which expand their area each time the heart expels blood to the body. Depending on how the sensor interfaces with the subject, the FSR changes its electrical resistance every time a pulse is detected. By placing the FSR in a direct interface circuit, those resistance variations can be measured directly by a microcontroller without using either analog processing stages or an analog-to-digital converter. In this kind of interface, the self-heating of the sensor is avoided, since the FSR does not require any voltage or bias current. The proposed system has a sampling rate of 50 Sa/s, and an effective resolution of 10 bits (200 mΩ), enough for obtaining well-shaped cardiac signals and heart rate estimations in real time by the microcontroller. With this approach, the implementation of wearable systems in health monitoring applications is more feasible.

Optimal waist circumference cutoff values to predict cardiometabolic alterations in a Venezuela national representative sample. The EVESCAM study / Valores óptimos de punto de corte de circunferencia abdominal para predecir alteraciones cardiometabólicas en una muestra representativa nacional de Venezuela. El estudio EVESCAM

Abstract Objective: Waist circumference (WC) value reflects abdominal adiposity, but the amount abdominal fat that is associated to cardiometabolic risk factors varies among ethnicities. Determination of metabolic abnormalities has not undergone a WC adaptation process in Venezuela. The aim of the study was (1) to determine the optimal WC cutoff value associated with ≥2 cardiometabolic alterations and (2) incorporating this new WC cutoff, to determine the prevalence of abdominal obesity and cardiometabolic risk factors related in Venezuela. Methods: The study was national population-based, cross-sectional, and randomized sample, from 2014 to 2017. To assess performance of WC for identifying cardiometabolic alterations, receiver operating characteristics curves, area under the curve (AUC), sensitivity, specificity, and positive likelihood ratios were calculated. Results: Three thousand three hundred eighty-seven adults were evaluated with mean age of 41.2 ± 15.8 years. Using the best tradeoff between sensitivity and specificity, WC cutoffs of 90 cm in men (sensitivity = 72.4% and specificity = 66.1%) and 86 cm in women (sensitivity = 76.2% and specificity = 61.4%) were optimal for aggregation of ≥2 cardiometabolic alterations. AUC was 0.75 in men and 0.73 in women using these new cutoffs. Prevalence of abdominal obesity and metabolic syndrome was 59.6% (95 CI; 57.5-61.7) and 47.6% (95 CI; 45.2-50.0), respectively. Cardiometabolic risk factors were associated with being men, higher age, adiposity, and living in northern or western regions. Conclusion: The optimal WC values associated with cardiometabolic alterations were 90 cm in men and 86 cm in women. More than half of the Venezuelan population had abdominal obesity incorporating this new WC cutoff.

Resumen Objetivo: El valor de la circunferencia abdominal (CA) refleja la adiposidad abdominal, pero la cantidad de grasa abdominal asociada a factores de riesgo cardiometabólicos varía según la etnia. La determinación de anomalías metabólicas no se ha adaptado a la CA en Venezuela. 1) Detrerminar el valor de corte óptimo de CA asociados a ≥ 2 alteraciones cardiometabólicas. 2) Incorporando este nuevo límite de CA, determinar la prevalencia de obesidad abdominal y factores de riesgo cardiometabólicos relacionados en Venezuela. Métodos: Fue un estudio poblacional, transversal, de muestreo aleatorio de 2014 a 2017. Para evaluar el valor de CA para identificar alteraciones cardiometabólicas, se realizaron curvas características operativa del receptor y se calculó área bajo la curva (ABC), sensibilidad, especificidad y razón de similitud. Resultados: se evaluaron 3387 adultos con una edad promedio de 41.2 ± 15.8 años. Utilizando la mejor relación entre sensibilidad y especificidad, se determinó que los valores de corte de 90 cm en hombres (sensibilidad = 72.4% y especificidad = 66.1%) y 86 cm en mujeres (sensibilidad = 76.2% y especificidad = 61.4%) fueron óptimos para la agregación de ≥ 2 alteraciones cardiometabólicas. El ABC fue de 0,75 en hombres y de 0,73 en mujeres usando estos nuevos puntos de corte. La prevalencia de obesidad abdominal y síndrome metabólico fue 59.6% (95IC; 57.5 - 61.7) y 47.6% (95CI; 45.2 - 50.0), respectivamente. La presencia de factores de riesgo cardiometabólicos se asoció con ser hombre, mayor edad, adiposidad y vivir en regiones del norte o del oeste. Conclusión: Los valores óptimos de CA asociados con alteraciones cardiometabólicas fueron 90 cm en hombres y 86 cm en mujeres. Más de la mitad de la población venezolana tenía obesidad abdominal al incorporar este nuevo corte de CA.

Laparoscopic inguinal hernia repair: cost-effectiveness analysis of trend modifications of the technique.

The aim of this study is to evaluate the cost-effectiveness of different modifications of the trans-abdominal pre-peritoneal (TAPP) repair of groin hernia. Data were collected prospectively for all consecutive patients who underwent TAPP unilateral inguinal hernia repair between November 2017 and March 2019, and who completed a minimum of 1 year of follow-up. Costs and quality adjusted life year (QALY) gained were collected. Three TAPP variations were assessed: mesh fixation and peritoneal closure with staples (group 1); mesh fixation with fibrin glue and peritoneal closure with sutures (group 2); and mesh fixation and peritoneal closure with fibrin glue (group 3). A matched group of open repairs was established. The incremental cost-effectiveness ratio (ICER) and main intra-operative and post-operative outcomes were assessed. Overall 120 patients were included (group 1 n = 31; group 2 n = 27; group 3 n = 33; open group: 29). Operative time was shorter for groups 2 and 3, and the main post-operative outcomes were similar. The overall mean total cost of the open group (1185.95€) was lower compared with the laparoscopic group (group 1: 1682.39; group 2: 1538.54€; group 3: 1510.1€) (p = 0.026). However, the mean ICERs of groups 2 and 3 were significantly higher compared with group 1 (p = 0.021) and the open group (p = 0.032). At simulations analysis, the probability of cost-effectiveness was 33.32%, 36.26%, and 36.7% in TAPP groups 1, 2, and 3. In the long term, laparoscopic repair of groin hernia is cost-effective compared with open surgery. The use of fibrin glue for mesh fixation and/or for closing the peritoneum is the most cost-effective option and shortens operative times.

Phytochemical analysis and evaluation of antioxidant and antimycobacterial activity of Colletia paradoxa from Brazil.

Colletia paradoxa (Spreng.) Esc. (Rhamnaceae, Colletieae) is a medicinal plant, threatened with extinction in Brazil, presenting great morphological variability. Our objective is to investigate the phytochemical components, antioxidant capacity and antimycobacterial activity of different morphotypes of C. paradoxa in different environments. For this, the crude extract of the leaves and branches of the individuals sampled was used. The elimination capacity of the free radicals was determined by the DPPH method, the antimycobacterial activity by the broth microdilution method and the phenolic content by the spectrophotometric method using the Folin-Ciocalteu reagent and by HPLC. The extracts of C. paradoxa and its morphotypes showed significant amounts of phenolic compounds, including quercetin, quercitrin and rutin, besides considerable antioxidant and antimycobacterial activity No connection was detected between the phytochemical composition and different morphotypes of C. paradoxa.

Optimal waist circumference cutoff values to predict cardiometabolic alterations in a Venezuela national representative sample. The EVESCAM study. / Valores óptimos de punto de corte de circunferencia abdominal para predecir alteraciones cardiometabólicas en una muestra representativa nacional de Venezuela. El estudio EVESCAM

BACKGROUND: Waist circumference (WC) value reflects abdominal adiposity, but the amount abdominal fat that is associated to cardiometabolic risk factors varies among ethnicities. Determination of metabolic abnormalities has not undergone a WC adaptation process in Venezuela. AIMS: The aim of the study was (1) to determine the optimal WC cutoff value associated with ≥2 cardiometabolic alterations and (2) incorporating this new WC cutoff, to determine the prevalence of abdominal obesity and cardiometabolic risk factors related in Venezuela. METHODS: The study was national population-based, cross-sectional, and randomized sample, from 2014 to 2017. To assess performance of WC for identifying cardiometabolic alterations, receiver operating characteristics curves, area under the curve (AUC), sensitivity, specificity, and positive likelihood ratios were calculated. RESULTS: Three thousand three hundred eighty-seven adults were evaluated with mean age of 41.2 ± 15.8 years. Using the best tradeoff between sensitivity and specificity, WC cutoffs of 90 cm in men (sensitivity = 72.4% and specificity = 66.1%) and 86 cm in women (sensitivity = 76.2% and specificity = 61.4%) were optimal for aggregation of ≥2 cardiometabolic alterations. AUC was 0.75 in men and 0.73 in women using these new cutoffs. Prevalence of abdominal obesity and metabolic syndrome was 59.6% (95 CI; 57.5-61.7) and 47.6% (95 CI; 45.2-50.0), respectively. Cardiometabolic risk factors were associated with being men, higher age, adiposity, and living in northern or western regions. CONCLUSION: The optimal WC values associated with cardiometabolic alterations were 90 cm in men and 86 cm in women. More than half of the Venezuelan population had abdominal obesity incorporating this new WC cutoff.

Effectiveness of the mixture of nopal and cassava starch as clarifying substances in water purification: A case study in Colombia.

Aluminum sulfate is one of the most used chemical coagulants in the world, but research has shown that high concentrations of aluminum in the body are associated with neuropathological conditions. Because of this, different alternatives have been evaluated such as natural coagulants, which are considered safe for human health and contain fewer contaminants than chemicals due to their biodegradation properties. The main objective of this study was to evaluate the efficiency of mixing nopal mucilage and cassava starch for turbidity removal in water purification. In this paper, test jars and the treatment equipment (TA-scale FQ-005/PE manufactured by Generatoris SA de CV of Mexico) was applied in order to measure turbidity and pH parameters before and after the process of coagulation-flocculation, which was applied to water from the Magdalena River in Colombia. Samples from two sampling periods were assessed. One was evaluated during the rainy season and the other was evaluated without precipitation (drought) with initial turbidities of 316 NTU and 80 NTU, respectively. It was found that aluminum sulfate as a coagulant reference obtained better turbidity removal results (up to 99%) as compared to nopal (up to 60.4%), and nopal-starch combination of cassava (up to 67%), indicating that this mixture increases the effectiveness of natural coagulants used individually. Our results indicate that this should be considered as an alternative in the water purification process.

Laparoscopic Transabdominal Preperitoneal (TAPP) Inguinal Hernia Repair Using Fibrin Glue for Fixation of the Mesh and Peritoneum Closure.

PURPOSE: The aim of this case series is to describe our ongoing experience of laparoscopic transabdominal preperitoneal (TAPP) inguinal hernia repair using Tisseel fibrin glue for the fixation of the mesh and peritoneum closure. MATERIALS AND METHODS: From October 2018, patients who underwent laparoscopic TAPP for unilateral inguinal hernia repair using Tisseel fibrin glue to secure the mesh and the peritoneum, with a minimum of 1 year of follow-up, have been included. Patient demographics, main operative findings, and main postoperative outcomes were analyzed prospectively using a visual analgesic scale (VAS) and a modified short-form 36 (SF-36) questionnaire. RESULTS: A total of 26 patients have been included and none have been lost during the follow-up. The mean operative time was 92.1 minutes and there was no conversion. The median hospital stay was 1.03 day (range, 1 to 2). The mean follow-up duration was 19.3 months (range, 12 to 26 mo) and none had a recurrence. The postoperative VAS score at 1, 7, 30 days, and 6 months from surgery was 3.18, 1.52, 0, and 0, respectively. The mean SF-36 score at 1, 6, and 12 months from surgery was 90.09, 94.8, and 05.1, respectively. CONCLUSIONS: The use of fibrin glue for TAPP inguinal hernia repair is a safe and feasible technique with favorable results. Larger comparative randomized studies are needed to confirm these early results.

Effects of long-term aerobic training and detraining on functional capacity and quality of life in hemodialysis patients: A pilot study.

Although previous studies have shown the benefits of exercise training in hemodialysis patients, little is known about the effects of long-term of exercise program on these patients. We investigated the effects and the safety of long-term aerobic training and the effects of detraining on functional capacity and quality of life in hemodialysis patients. Ten patients were allocated to two groups: training and detraining. The training group completed at least 30 months of aerobic training, and the detraining group completed at least 20 months and then discontinued the training for at least 10 months. The outcomes were analyzed at baseline, after 3 months of aerobic training and at the 30-month follow-up. The training and detraining groups performed 37 (5.5) and 24 (3.0) months of aerobic training, respectively. The detraining group discontinued the training for 11.0 (2.0) months. After 3 months of aerobic training, six-minute walking test distance increased significantly in both groups (training group = 569 (287.8) vs 635.5 (277.0) m, p = 0.04; detraining group = 454.5 (72.3) vs 515.0 (91.8) m, p = 0.04). There was no significant difference in the six-minute walking test distance in the training group (576.5 (182.5), p > 0.05) and a significant decrease (436.2 (89.6) m, p = 0.04) in the detraining group at the follow-up compared to the third month of aerobic training. No significant difference was observed in quality of life during the study. No complications were found during the protocol of the exercise. These results suggest that long-term aerobic training is safe and can maintain functional capacity in hemodialysis patients. In contrast, detraining can result in loss of functional capacity in these patients.

Medio siglo de vida y progresos en la Escuela de Odontología de la Universidad del Valle, Cali - Colombia: hechos relevantes de la última década / Half Century of creation and progress at the Dental School - Universidad del Valle, Cali - Colombia: relevant achievements in the last decade

Hace cincuenta años el 4 de junio de 1970, fue creado el Departamento de Estomatología adscrito a la División de Salud, el cual dio origen en 1990 a la Escuela de Odontología, que estará celebrando medio siglo de creación y desarrollo, en el 2020 (1). Inicialmente, el 27 de Febrero de 1957 se había nombrado un comité para estudiar la creación de la Facultad de Odontología en la Universidad del Valle. Dicho comité incluyó, entre otros, a los médicos Luis María Borrero y Pablo Barreto Reyes, y a los odontólogos Itamar Alcalay, Gustavo Ulloa Iragorry y Jaime Ángel. Sin embargo, aunque la propuesta presentada en el Primer Plan Quinquenal de Desarrollo de la Facultad de Medicina ­auspiciada por las Fundaciones Rockefeller y Kellogg­ permitió el fortalecimiento y expansión de los Departamentos de Ciencias Básicas Médicas de la Facultad, este no contó con la aprobación para crear un programa de odontología, debido al alto costo de la propuesta, asociado a la dotación de infraestructura y equipos para los laboratorios, preclínicas y clínicas (2). Este articulo pretende recopilar los mas relevantes hitos de un largo camino que se inicio oficialmente con la creación en 1965 del Comité Universitario Pro Facultad de Odontología CUPFO, integrado por los odontólogos José Fernando Barreto y Jaime Álvarez entre otros. Dicho comité impulsó la creación del Departamento de Estomatología, el de Junio de1970. Para entonces un selecto grupo de profesionales de la Odontología de Cali liderados por el doctor José Fernando Barreto le propusieron a la Organización Panamericana de la Salud-OPS y a los Ministerios de Salud y de Educación la creación de dos programas revolucionarios para la época, un pregrado en Odontología de cuatro años de duración, el cual al ser finalizado daba la posibilidad de continuar con estudios de Magister en Estomatología con dos años adicionales de estudio; el servicio social obligatorio contaría como uno de los años de la Maestría. Ambos programas de estudios estaban apoyados por trabajos previos en donde, se destacan los programas de auxiliares de Odontología, cuyo espectro contemplaba desde los niveles mas básicos del personal de apoyo a los servicios de odontología representadas en las auxiliares de consultorio, niveles intermedios de complejidad como el programa de auxiliares de higiene oral o higienista, y un programa novedoso para Colombia y América Latina como eran los auxiliares de Odontología social que tenia funciones de operatorista y que trabajarían con la supervisión del odontólogo y/o estomatólogo, y cuya función era incrementar el acceso al cuidado de la salud bucal, una necesidad real de los Colombianos para esa época. La auxiliar de Odontología Social, se derivaba del programa o enfermera dental en Nueva Zelanda (1). Los principales principios del nuevo profesional de la Odontología eran: 1. Tener un fuerte conocimiento y uso de las ciencias básicas biomédicas para fortalecer su trabajo clínico; 2. Poseer la capacidad de implementar y supervisar programas de estomatología social y/o comunitaria en los puestos, centros de salud y hospitales de la red publica, a nivel departamental, con enfoque de atención primaria de la salud y en donde lo primordial es intervenir los riesgos en salud del grupo familiar, con el apoyo de las auxiliares de Odontología, 3. Fortalecer la promoción de la salud, el uso de los equipos de odontología simplificado y el trabajo a cuatro manos con auxiliares de consultorio, auxiliares de higiene oral, y auxiliares de odontología social para masificar la promoción de la salud y la atención en salud entre la población, 4. Consolidar al estomatólogo (médico de la boca), como el líder de la pirámide del equipo de salud bucal con fortalezas en el diagnostico, prevención y tratamiento de las principales patologías bucales y su relación son la salud general, con capacidad resolutiva y las competencias para la dirección y coordinación de los equipos de salud para trabajar en el ámbito gubernamental, en los puestos de salud y centros hospitales del Departamento del Valle y en el área de influencia del sur-occidente Colombiano (1,2).

Alternative of timely treatment of unilateral posterior cross-bite in primary and mixed early dentition. Case series / Tratamiento de la mordida cruzada posterior unilateral en dentición primaria y mixta temprana: Serie de casos

Introduction Unilateral posterior cross bites (UPCB) are one of the most frequent types of malocclusions found in both primary and early mixed dentitions. Due to its multifactorial origin, its treatment is focused not only on the correction of malocclusion, but also on long-term functional and occlusal stability that reduces alterations in the growth and development of the stomatognathic system at an early age. The objective of this series of cases is to present two alternatives of timely treatment for this malocclusion. Description of the cases The first case is an 8-year-old patient with left UPCB who receives controlled palatal expansion treatment with a Hyrax screw with acrylic splint, in which favorable results are obtained in a short time and with long-term stability. The second case, a 4-year-old patient with a right UPCB is presented with Planas' direct tracks, achieving a desired mandibular postural change. Discussion The treatment alternatives presented, several authors have reported a series of benefits obtained from the type of intervention that not only achieve the correction of malocclusion, but also achieve the improvement of structures that make up the craniofacial complex, within which highlights the desired long-term stability. These benefits are obtained through the selected treatment alternative, according to the diagnosis and clinical characteristics presented in each patient and justifies the decision to perform an early intervention especially in this type of malocclusion. Conclusion The early treatment of the unilateral posterior crossbite should be selected according to the type of dentition and the patient's need, which favors the proper growth and development of the stomatognathic system.

Introducción: Las mordidas cruzadas posteriores unilaterales (MCPU) constituyen uno de los tipos de maloclusiones más frecuentes encontrados tanto en dentición primaria como en dentición mixta temprana. Debido a su origen multifactorial su tratamiento se encuentra enfocado no solo en la corrección de la maloclusión, sino en obtener una estabilidad oclusal y funcional a largo plazo que disminuya las alteraciones en el crecimiento y desarrollo del sistema estomatognático en edades tempranas. El objetivo de esta serie de casos es presentar dos alternativas de tratamiento oportuno para esta maloclusión. Descripción de los casos: El primer caso es un paciente de 8 años de edad con MCPU izquierda quien recibe tratamiento de expansión palatina controlada con un tornillo tipo Hyrax con férula acrílica, en el cual se obtienen resultados favorables en corto tiempo y con estabilidad a largo plazo. El segundo caso es una paciente de 4 años de edad con MCPU derecha a la cual se le realizan Pistas Directas Planas logrando un cambio postural mandibular deseado. Discusión: En las alternativas de tratamiento presentadas, varios autores han reportado una serie de beneficios obtenidos a partir del tipo de intervención que no solo logran la corrección de la maloclusión, sino que a su vez alcanzan la mejoría de estructuras que componen el complejo craneofacial, dentro de los cuales se destaca la estabilidad a largo plazo deseada. Estos beneficios se obtienen a través de la alternativa de tratamiento seleccionada, según el diagnóstico y las características clínicas presentadas en cada paciente y justifica la decisión de realizar una intervención temprana especialmente en este tipo de maloclusión. Conclusión: El tratamiento temprano de la mordida cruzada posterior unilateral debe ser seleccionado según el tipo de dentición y necesidad del paciente, lo que favorece el adecuado crecimiento y desarrollo del sistema estomatognático.

Hollow ZnO microspheres functionalized with electrochemical graphene oxide for the photodegradation of salicylic acid.

Hollow ZnO microspheres were successfully synthesized by a hydrothermal method and then functionalized with graphene oxide (GO) flakes, previously obtained through electrochemical oxidation. Their photocatalytic activity toward the photodegradation of salicylic acid under UV light irradiation was evaluated by UV-Vis spectroscopy. Unfunctionalized microspheres and ZnO functionalized with chemically oxidized graphene were also studied as comparative terms. The hybrid materials of ZnO with both electrochemical and chemical GO gave a similar photodegradation yield of ∼28% against 18% of the non-functionalized microspheres. The similar degradation yields and rate constants obtained with the two GO synthetic methods indicate that electrochemical oxidation of GO represents an eco-friendly option over traditional methods for photocatalytic degradation systems.

Correlation between cusp pattern and deflecting wrinkle in six ethnic groups from southwestern colombia / Correlación entre el patrón cuspídeo y el pliegue acodado en seis grupos étnicos del suroccidente colombiano

ABSTRACT. Introduction: the cusp pattern and the deflecting wrinkle are two morphological traits whose expression and variability contribute to the morphological configuration of the occlusal surface of deciduous and permanent lower molar teeth. The objective of the present study was to estimate the correlation between cusp pattern and deflecting wrinkle in six ethnic groups from southwestern Colombia. Methods: analysis of 480 plaster models corresponding to 100 mixed Caucasoid mestizos from Cali (50 men and 50 women), 60 Afro-descendants from Cali (34 women and 26 men), 84 Afro-descendants from Puerto Tejada (42 women and 42 men), 116 Afro-descendants from Villa Rica (57 men and 59 women), 60 misak indigenous (37 women and 23 men) and 60 nasa indigenous (35 women and 25 men). Results: there were high frequencies (over 60%) of cusp pattern (Y expression) and deflecting wrinkle (grades 2 and 3) in deciduous first lower molars, mid frequencies (between 40 and 59%) of cusp pattern (Y and + expressions) and deflecting wrinkle (grades 1 and 2) in permanent first lower molars, and mid frequencies (between 40 and 59%) of cusp pattern (+ and X expressions) and deflecting wrinkle (grades 1 and 2) in permanent lower second molars. Conclusions: these frequencies suggest a trend in cusp pattern, which may vary according to the degree of expression of the deflecting wrinkle. This tendency consists of the Y cusp pattern when the deflecting wrinkle is expressed in grades 2 and 3. Bilaterally was observed and there was no sexual dimorphism.

RESUMEN. Introducción: el patrón cuspídeo y el pliegue acodado son dos rasgos morfológicos cuya expresión y variabilidad contribuyen con la configuración morfológica de la superficie oclusal de los dientes molares inferiores temporales y permanentes. El objetivo del presente estudio consistió en estimar la correlación entre el patrón cuspídeo y el pliegue acodado en seis grupos étnicos del suroccidente colombiano. Métodos: se observaron 480 modelos de yeso correspondientes a 100 mestizos caucasoides de Cali (50 mujeres y 50 hombres), 60 afrodescendientes de Cali (34 mujeres y 26 hombres), 84 afrodescendientes de Puerto Tejada (42 mujeres y 42 hombres), 116 afrodescendientes de Villa Rica (59 mujeres y 57 hombres), 60 indígenas misak (37 mujeres y 23 hombres) y 60 indígenas nasa (35 mujeres y 25 hombres). Resultados: se presentaron frecuencias altas (mayores al 60%) de patrón cuspídeo (expresión Y) y pliegue acodado (grados 2 y 3) de los primeros molares inferiores temporales, frecuencias medias (entre 40 y 59%) de patrón cuspídeo (expresiones Y y +) y pliegue acodado (grados 1 y 2) de los primeros molares inferiores permanentes, y frecuencias medias (entre 40 y 59%) de patrón cuspídeo (expresiones + y X) y pliegue acodado (grados 1 y 2) de los segundos molares inferiores permanentes. Conclusiones: con base en dichas frecuencias, se observó una tendencia en la configuración del patrón cuspídeo, el cual puede variar de acuerdo al grado de expresión del pliegue acodado; dicha tendencia consiste en el patrón cuspídeo Y cuando el pliegue acodado se expresa en los grados 2 y 3. Se observó bilateralidad y no hubo dimorfismo sexual.

National Registry of Cardiac Rehabilitation Programs in Mexico II (RENAPREC II) / Registro Nacional de Programas de Rehabilitación Cardiaca en México II (RENAPREC II)

Abstract: Objective: The aim of this paper is to compare the state of Cardiac Rehabilitation Programs (CRP) in 2009 with 2015. Focus is directed on health care, training of health-providers, research, and the barriers to their implementation. Methods: All authors of RENAPREC-2009, and other cardiac rehabilitation leaders in Mexico were requested to participate. These centres were distributed into two groups: RENAPREC-2009 centres that participated in 2015, and the new CRP units. Results: In 2009 there were 14 centres, two of which disappeared and another two did not respond. CRP-units increased by 71% (n = 24), and their geographic distribution shows a centripetal pattern. The coverage of CRP-units was 0.02 centres per 100,000 inhabitants. Only 4.4% of eligible patients were referred to CRP, with a rate of 10.4 patients/100,000 inhabitants in 2015. The ratio of Clinical Cardiologists to Cardiac Rehabilitation Specialists was 94:1, and the ratio of Intervention Specialists to cardiac rehabilitation experts was 16:1. Cardiac rehabilitation activities and costs varied widely. Patient dropout rate in phase II was 12%. Several barriers were identified: financial crisis (83%), lack of skilled personnel (67%), deficient equipment (46%), inadequate areas (42%), and a reduced number of operating centres (38%). Conclusions: CRPs in Mexico are still in the process of maturing. Mexican CRP-centres have several strengths, like the quality of the education of the professionals and the multidisciplinary programs. However, the lack of referral of patients and the heterogeneity of procedures are still their main weaknesses.

Resumen: Objetivo: El propósito de este trabajo es comparar el estado actual de los programas de rehabilitación cardiaca (PRC) en México con el RENAPREC-2009, dirigido a la asistencia, docencia, investigación y barreras. Métodos: Se convocó a participar a todos los autores de RENAPREC-2009 y a otros líderes en rehabilitación cardiaca de México. Los centros fueron distribuidos en 2 grupos: los que participaron en el 2015 y las nuevas unidades de PRC. Resultados: En 2009 había 14 centros operativos, de los cuales 2 cerraron y 2 no respondieron. En 2015 se registraron 24 centros en total, representando un aumento neto del 71%. La distribución geográfica fue centrípeta. La cobertura fue de 0.02 centros/100,000 habitantes y de solamente un 4.4% de los pacientes elegibles (10.4 pacientes/100,000 habitantes). La relación cardiólogo clínico-rehabilitador cardiaco es de 94:1 y la de intervencionista-rehabilitador cardiaco es de 16:1. Las actividades realizadas y los costos de los PRC varían de forma importante de centro a centro. En promedio, el 12% de los pacientes en fase ii abandonaron el programa. Las principales barreras para el desarrollo de PRC fueron: económicas (83%), falta de personal capacitado (67%), falta de equipo (46%), áreas inadecuadas (42%) y un insuficiente número de centros operativos (38%). Conclusiones: Los PRC en nuestro país continúan en crecimiento. Se observan fortalezas como el nivel de docencia y el enfoque multidisciplinario, así como deficiencias en la homogeneidad de las actividades y la falta de referencia de la población elegible.