Inequalities by sex on remaining teeth in adults: A decomposition analysis.

OBJECTIVE: To identify which social determinants of health explain the gap in the remaining teeth between men and women. METHODS: A secondary analysis of data from the Chilean National Health Survey (CNHS) 2016-2017 was performed on the number of remaining teeth in adults. The explanatory variables were organized into structural and intermediate social determinants of health according to the WHO framework. The contribution of both groups and the contribution of each individual explanatory variable to the remaining teeth gap was estimated using the Blinder-Oaxaca decomposition analysis. RESULTS: The predicted average number of remaining teeth for men was 23.4 and 21.0 for women, thus a mean difference of 2.4 teeth. 49.8% of the inequality between men and women was due to the different distribution (endowments) of the predictors in the model. Among them, structural determinants of health, namely education level (15.8%) and employment status (17.8%), contributed the most. Intermediate determinants had no relevant contribution to explain the gap. CONCLUSIONS: Results revealed that the difference in the mean number of remaining teeth between men and women was mainly explained by two structural determinants: education level and employment status. The lack of explanatory power of intermediate determinants and the large explanatory power of structural determinants means that tackling oral health inequity in Chile requires strong political commitment. The role of intersectoral and intersectional public policies to address gender inequalities in oral health in Chile is discussed.

Clinical relevance of the use of Dentoxol® for oral mucositis induced by radiotherapy: A phase II clinical trial.

BACKGROUND: Severe oral mucositis associated with cancer therapy is a frequent complication that may affect a patient's systemic condition, resulting in interruption and/or prolongation of cancer therapy. Dentoxol® is a medical solution in the form of a mouthwash that has been shown to result in statistically significant improvement in the prevention of severe oral mucositis. However, knowing the measures of the clinical significance of this therapy is important for accurate decision-making. AIM: To describe the clinical impact of Dentoxol® use in severe oral mucositis. METHODS: Clinical significance was measured using the results obtained in a randomized controlled clinical trial previously conducted by the same group of researchers. The measures of clinical significance evaluated were the absolute risk or incidence, relative risk, absolute risk reduction, relative risk reduction, number needed to treat, and odds ratio. RESULTS: The data obtained show that the impact of Dentoxol® on reducing the severity of oral mucositis has important clinical relevance. CONCLUSION: The results of this study justify the incorporation of Dentoxol® mouth rinse into clinical protocols as a complement to cancer therapy to prevent and/or treat oral mucositis secondary to radiotherapy.

Depresión, desregulación emocional y estrategias de afrontamiento en adolescentes con conductas de autolesión / Depression, emotional dysregulation and coping strategies in adolescents with self-injurious behaviors

Resumen En México, el estudio de la autolesión cuenta con pocas investigaciones, y menos si se trata de estudios que conformen posibles modelos explicativos. Teniendo esto en cuenta, en el presente trabajo se planteó como objetivo conocer la relación de la autolesión con la depresión, la desregulación emocional y los estilos de afrontamiento, con el fin de generar un modelo explicativo de la problemática. El estudio se realizó a partir de un diseño cuantitativo, transversal y con alcance explicativo, y se contó con una muestra de 5835 adolescentes (M edad = 11-15 años) inscritos en 62 secundarias públicas del estado de Sonora. Se realizaron regresiones logísticas para el análisis de los datos, y como resultado se encontró que, para los estudiantes con autolesión severa (3.54 %), el modelo explica el 61 % de la varianza en los datos (R1 de Nagelkerke = .61) y clasifica correctamente al 84.1 % de los participantes; mientras que, en la autolesión leve (5.29 %), el modelo explica el 72 % de la varianza en los datos (R2 de Nagelkerke = .72) y clasifica correctamente al 88.2 % de los estudiantes. Asimismo, las dimensiones de depresión mostraron el mayor nivel explicativo (cognitiva-afectiva, somática) y correlaciones positivas con la desregulación emocional y el estilo de afrontamiento de evitación, así como correlaciones negativas con el estilo de afrontamiento de aproximación. Al final se discute respecto a la importancia de las variables independientes para futuras investigaciones, y sobre los resultados anómalos y otros datos de interés.

Abstract In Mexico, there is little research on the study of self-injury and even less on possible explanatory models. With this in mind, this study aimed to determine the relationship between self-injury and depression, emotional dysregulation, and coping styles, to generate an explanatory model of the problem. The study was carried out using a quantitative, cross-sectional, explanatory scope, design and a sample of 5835 adolescents (Mage = 11-15 years) enrolled in 62 public high schools in the state of Sonora. Logistic regressions were performed for data analysis, and as a result it was found that, for students with severe self-injury (3.54 %), the model explains 61 % of the variance in the data (Nagelkerke's R2 = .61) and correctly classifies 84.1 % of the participants; whereas, in mild self-injury (5.29 %), the model explains 72 % of the variance in the data (Nagelkerke's R2 = .72) and correctly classifies 88.2 % of the students. Likewise, the depression dimensions showed the highest explanatory level (cognitive-affective, somatic) and positive correlations with emotional dysregulation and avoidance coping style, as well as negative correlations with approach coping style. At the end, the importance of the independent variables for future research is discussed, as well as anomalous results and other data of interest.

Usefulness of P0.1 in the Follow-Up of Individuals With Air Trapping and Home Noninvasive Ventilation and CPAP.

BACKGROUND: The ventilatory mechanics of patients with COPD and obesity-hypoventilation syndrome (OHS) are changed when there is air trapping and auto-PEEP, which increase respiratory effort. P0.1 measures the ventilatory drive and, indirectly, respiratory effort. The aim of the study was to measure P0.1 in subjects with COPD or OHS on treatment with positive pressure and to analyze their changes in P0.1 after treatment. METHODS: With a prospective design, subjects with COPD and OHS were studied in whom positive airway pressure was applied in their treatment. P0.1 was determined at study inclusion and after 6 months of treatment. RESULTS: A total of 88 subjects were analyzed: 56% were males, and the mean age of 65 ± 9 y old. Fifty-four (61%) had OHS, and 34 (39%) had COPD. Fifty (56%) had air trapping, with an initial P0.1 value of 3.0 ± 1.3 cm H2O compared with 2.1 ± 0.7 cm H2O for subjects who did not have air trapping (P = .001). After 6 months of treatment, subjects who had air trapping had similar P0.1 as those who did not: 2.3 ± 1.1 and 2.1 ± 1 cm H2O, respectively (P = .53). In subjects with COPD, initial P0.1 was 2.9 ± 1.4 cm H2O and at 6 months 2.2 ± 1.1 cm H2O (P = .02). In subjects with OHS, initial P0.1 was 2.4 ± 1.1 cm H2O and at 6 months 2.2 ± 1.0 cm H2O (P = .28). CONCLUSIONS: COPD and air trapping were associated with greater P0.1 as a marker of respiratory effort. A decrease in P0.1 indicates less respiratory effort after treatment.

Tendencia de niños y niñas de 6 años libres de caries en Chile entrelos años 2012 y 2019

RESUMEN: Objetivo: La caries dental es la patología más prevalente en niños*. En Chile se desconoce si el estado de salud bucal ha mejorado al implementar estrategias y programas preventivos dirigidos a la población infantil en la última década. El objetivo fue determinar la prevalencia de niños de 6 años sin experiencia de caries (ceod=0) del país, su distribución territorial y tendencia en el período 2012 a 2019. Materiales y método: Se realizó un estudio ecológico utilizando los registros de atención odontológica de 1.020.920 niños de 6 años en los Servicios de Salud (SS) de Chile. Se analizó la tendencia en el tiempo utilizando un test de tendencia lineal para proporciones. Resultados: La prevalencia de niños de 6 años sin experiencia de caries aumentó 1,2 puntos por año entre 2012 y 2019. La prevalencia en los SS Arica e Iquique y los tres de la Región de Valparaíso supera el 40% y en los cuatro SS de la Región del Biobío y el SS Chiloé es menor al 25%. Conclusiones: La prevalencia de niños de 6 años sin experiencia de caries ha mejorado en la última década y su distribución territorial presenta gran variabilidad, sin embargo, aún sigue siendo baja. *Se usará la palabra "niño" para referirse a "niños y niñas".

ABSTRACT: Objective: Dental caries is the most prevalent disease in children. In Chile, it is unknown whether the oral health status in children population has improved after the implementation of preventive strategies and programs in the last decade. The objective was to determine the prevalence of 6-year-old children with no caries experience (ceod=0) in the country, its territorial distribution and trend in the period 2012 to 2019. Methodology: An ecological study was carried out using the dental care records of 1,020,920 6-year-old children in the Chilean Health Services. The trend over time was analyzed using a linear trend test for proportions. Results: The prevalence of 6-year-old children without caries experience increased 1.2 points per year between 2012 and 2019. The prevalence in the Arica and Iquique Health Services and in the three Health Services in the Valparaíso Region exceeds 40%. In the four Health Services in the Biobío Region and in the Chiloé Health Service it is less than 25%. Conclusions: The prevalence of 6-year-old children without caries experience has improved in the last decade and its territorial distribution presents great variability; however, it still remains low.

Radiotherapy for cervical cancer: Chilean consensus of the Society of Radiation Oncology.

BACKGROUND: Cervical cancer is a public health problem in Latin America. Radiotherapy plays a fundamental role both as definitive or adjuvant treatment. There are important intra and inter-country differences regarding access and availability of radiotherapy facilities in this region. The aim of a study was to standardize the basic clinical and technical criteria for the radiation treatment of patients with CC in Chile and provide a guide for Latin American Radiation Oncologists. MATERIALS AND METHODS: Forty-one expert radiation oncologists from the Chilean Radiation Oncology Society made a consensus using the Delphi methodology. RESULTS: There was a high degree of agreement for each of the recommendations. Those with the lowest percentage were related to the definition of the conformal 3D technique as the standard for definitive external radiotherapy (81%) and the criteria for extended nodal irradiation (85%). CONCLUSIONS: These recommendations present an updated guide for radiotherapy treatment of patients with cervical cancer for Latin America. Those should be implemented according to local resources of each institution.

Efficacy and safety of Dentoxol® in the prevention of radiation-induced oral mucositis in head and neck cancer patients (ESDOM): a randomized, multicenter, double-blind, placebo-controlled, phase II trial.

PURPOSE: The aim of this study was to assess the efficacy and safety of Dentoxol mouthrinse in reducing the severity of oral mucositis (OM) secondary to radiation therapy (RT) for head and neck cancer. METHODS: A randomized, double-blind, placebo-controlled, multicenter phase II clinical trial was conducted. Subjects were asked to use Dentoxol (n = 55) or control (n = 53) mouthrinse 5 times/day during RT. Twice a week, OM was assessed clinically using the WHO scale and the Oral Mucositis Daily Questionnaire (OMDQ) was completed. RESULTS: The incidence of severe OM was 40.7% in the Dentoxol group and 51% in the control group (p = 0.265). Comparing all recorded clinical assessments, severe OM was seen in 13.3% of all assessments in the Dentoxol group vs. 21.8% in the control group (p = 0.000). There was a statistically significant lower proportion of assessments showing severe OM in the Dentoxol group at weeks 4, 5, and 6 of RT. The mean duration of severe OM was 11.95 days in the Dentoxol group vs. 14.59 days in the control group (p = 0.502). There was no difference between groups in mouth pain and its impact on function. The use of Dentoxol was safe and was not linked to any serious adverse events. CONCLUSION: The use of Dentoxol 5 times/day is safe and resulted in significantly fewer time-points with severe OM and a delay in the onset of severe OM, compared with a control rinse. A phase III clinical trial is warranted to confirm efficacy and address the limitations of this study.

Lens changes in cardiovascular catheterization laboratories staff / Cambios en el cristalino en personal de laboratorio de cateterismo cardiovascular

Abstract Objective: To determine the association between occupational ionizing radiation exposure in the cardiovascular catheterization laboratories staff and development of lens changes. Methods: A cross-sectional study was made. Participants were recruited at the XIII Colombian Conference of Interventional Cardiology and SOLACI conferences in Bogotá - Colombia 2017. Informed consent was obtained from all study participants. Demographics and clinical data were collected. Associated lens changes were determined according to the ionizing radiation exposure status. Results: A total of 89 subjects (178 eyes) participated in the study. In general, the mean age was 40 years old, ranging from 19 to 78 years old. Distribution according gender was 55.3% male and 44.7% female. 31 subjects (62 eyes) were deemed to have not occupational exposure to radiation and 58 subjects (116 eyes) with a history of occupational radiation exposure. Exposed eyes had twice risk for present subcapsular posterior lens opacity compared to non-exposed eyes. The subjects with older age and physician role were associated to the presence of lens opacity, with a p value 0.001 in both cases. Likewise, exposed subjects with any lens opacity had a high mean occupational lifetime, with a p 0.001. Conclusions: This study confirms a statistically significant increase in radiation-associated subcapsular lens changes in the eyes of interventional cardiology staff compared to unexposed controls.

Resumen Objetivo: Determinar la asociación entre la exposición a radiación ionizante en el personal de las salas de cateterismo cardiovascular y el desarrollo de cambios en el cristalino. Métodos: Se hizo un estudio transversal. Los participantes fueron reclutados en el XIII Congreso Colombiano de Cardiología Intervencionista y las Conferencias SOLACI en Bogotá - Colombia 2017. Se obtuvo el consentimiento informado de todos los participantes. Se recolectaron datos demográficos y clínicos. Se determinó la asociación entre los cambios en el cristalino y la exposición a la radiación ionizante. Resultados: Un total de 89 sujetos (178 ojos) participaron en el estudio. En general, la edad promedio fue de 40 años, con edades comprendidas entre los 19 años y 78 años. La distribución según el género fue del 55,3% en hombres y el 44,7% en mujeres. Se consideró que 31 sujetos (62 ojos) no tenían exposición ocupacional a la radiación y 58 sujetos (116 ojos) presentaban exposición ocupacional a esta. Los ojos expuestos tenían dos veces el riesgo de presentar opacidad subcapsular posterior del cristalino en comparación con los ojos no expuestos. Los sujetos de mayor edad y con rol de médico se asociaron a la presencia de opacidad del cristalino, con un valor p de 0.001 en ambos casos. Del mismo modo, los sujetos expuestos con cualquier opacidad del cristalino tenían una vida laboral más larga, con una p 0.001. Conclusiones: Este estudio confirma un aumento estadísticamente significativo en la presencia de cambios en el cristalino en el personal de las salas de cateterismo cardiovascular en comparación con los controles no expuestos.

Recovery of environmental Cryptococcus neoformans and Cryptococcus gattii in Cúcuta and association with clinical isolates / Recuperación de Cryptococcus neoformans y C. gattii ambientales y su asociación con aislados clínicos en Cúcuta, Colombia

ABSTRACT Objective. Isolate, identify and molecularly characterize pathogenic Cryptococcus isolates for humans from environmental and clinical samples from the city of Cúcuta. Materials and methods. A total of 1300 samples were collected from 446 trees of 10 different species in 10 public areas of Cúcuta. Concomitantly, clinical isolates of Cryptococcus neoformans were obtained (June 2016-June 2017). The samples were cultivated in Guizottia abysinica seed medium and were then biochemically identified and characterized by PCR fingerpinting and RFLP of the URA5 gene. Results. C. neoformans displayed an environmental prevalence of 4.3% (19 positive individuals), and that of C. gattii was 0.2% (1 positive individual); this yielded a total of 20 Cryptococcus-positive trees and 21 isolates (two from the same individual). Santander Park registered 47.6% of the global prevalence (10/21 isolates), followed by La Victoria Park with 23.8% (5/21 isolates), corresponding to C. neoformans. One C. gattii isolate was collected from a Ficus benjamina tree located in Mercedes Ábrego Park. Genotypic analysis revealed the presence of C. neoformans var. grubii VNI in 85.7% of environmental isolates as well as 100% of clinical isolates. VNII and VGII molecular types represented 9.5% and 4.8% of the environmental isolates, respectively. Conclusions. The longitudinal sampling of previously reported environmental niches of the fungus reveals its presence and suggests that permanent monitoring is required both in the environment and in patients, especially in endemic areas of the city.

RESUMEN Objetivo. Aislar, identificar y caracterizar molecularmente aislamientos de Cryptococcus patógenos para humanos a partir de muestras ambientales y clínicas de la ciudad de Cúcuta. Materiales y métodos. Se recolectaron 1300 muestras de 446 árboles de 10 especies diferentes, en 10 zonas públicas de Cúcuta. Concomitantemente, se obtuvieron aislados clínicos de Cryptococcus neoformans (junio de 2016-junio de 2017). Se realizó cultivo en agar semillas de Guizottia abysinica, posterior identificación bioquímica y caracterización genética mediante PCR-huella Digital y RFLP-URA5. Resultados. Se determinó prevalencia ambiental para C. neoformans de 4.3% (19 individuos positivos) y C. gattii de 0.2% (1 individuo positivo), para un total de 21 aislados y 20 árboles positivos. El parque Santander registró el 47.6% de la prevalencia global (10/21 aislados), seguido del parque La Victoria con 23.8% (5/21 aislados), correspondientes a C. neoformans. Se obtuvo un aislado de C. gattii en un individuo Ficus benjamina del parque Mercedes Ábrego. El análisis genotípico reveló presencia de C. neoformans var. grubii VNI en el 85.7% de los aislados ambientales, así como en el 100% de los clínicos, seguido de VNII y VGII en 9.5% y 4.8% de los aislados ambientales, respectivamente. Conclusiones. El muestreo longitudinal de los nichos ambientales previamente reportados del hongo revela su presencia y sugiere que se requiere una vigilancia permanente tanto en el medio ambiente como en los pacientes, especialmente en las zonas endémicas de la ciudad.

Recursos de ajuste psicosocial y su relación con la satisfacción con la vida en jóvenes de México / Psychosocial Adjustment Resources and their Relationship with Life Satisfaction in Young People / Recursos de ajuste psicossocial e sua relação com a satisfação com a vida em jovens do México

Resumen Objetivo. Determinar el valor explicativo de los recursos de ajuste psicosocial sobre la satisfacción con la vida, en un grupo de estudiantes egresados de bachillerato. Método. La muestra se seleccionó de un total de 117271 jóvenes que egresaron en 2016 de la educación media superior en los municipios de Navojoa, Hermosillo y Ciudad Obregón, en México. La muestra final estuvo conformada por 2237 participantes, quienes respondieron a cuatro medidas de ajuste psicosocial (autoconcepto, locus de control, afrontamiento y orientación al éxito) y un cuestionario de satisfacción con la vida. Para el análisis de los datos se realizó un modelo de regresión lineal. Resultados. Se encontró que el modelo de regresión final sugiere que el autoconcepto positivo (P = 0.62) y el afrontamiento positivo (P = 0.14) predicen la satisfacción con la vida en los jóvenes egresados de la educación media (R 2 = 0.63). Conclusión. Se observó que el autoconcepto es la variable de mayor determinación sobre la satisfacción con la vida de estos jóvenes, de ahí que su ajuste se relacione fundamentalmente con el autoconcepto, el locus de control y las formas de enfrentar los problemas, variables que deberían considerarse al momento de promover una transición adecuada del bachiller a la educación superior.

Abstract Objective. The present study objective is to determine the explanatory value of psychosocial adjustment resources on life satisfaction in a group of high school graduates. Method. The sample was selected from a total of 117271 young people, who in 2016, graduated from upper secondary education in the municipalities of Navojoa, Hermosillo and Ciudad Obregón, in Mexico. The final sample consisted of 2237 participants, who responded to four measures of psychosocial adjustment (self-concept, locus of control, coping and orientation to success) and a questionnaire of life satisfaction. For the data analysis, a linear regression model was performed. Results. The final regression model suggests that the positive self-concept (P = 0.62) and positive coping (P = 0.14) predict life satisfaction in the high school graduates (R2 = 0.63). Conclusion. The self-concept is the variable with the greatest determination about life satisfaction in the sample. On the other hand, the adjustment profile of adolescents fundamentally depends on their self-concept, their locus of control and their ways of facing the problems, which should be considered in order to promote an adequate transition from high school to higher education.

Resumo Escopo. O presente trabalho tem como escopo determinar o valor explicativo dos recursos de ajuste psicossocial sobre a satisfação com a vida, em um grupo de estudantes graduados do bacharelado. Metodologia. A amostra foi selecionada de um total de 117271 jovens, que graduaram-se no 2016 da educação média-superior nos municípios de Navojoa, Hermosillo e Ciudad Obregón, no México. A amostra final esteve conformada por 2237 participantes, os quais responderam a quatro medidas de ajuste psicossocial (autoconceito, locus de controle, afrontamento e orientação ao sucesso) e um questionário de satisfação com a vida. Para a análise dos dados foi feito um modelo de regressão lineal. Resultados. O modelo de regressão final sugere que o autoconceito positivo (P = 0.62) e o afrontamento positivo (P = 0.14) predizem a satisfação com a vida nos jovens graduados da educação média (R2 = 0.63). Conclusão. O autoconceito é a variável de maior determinação sobre a satisfação com a vida de estes jovens, enquanto, seu ajuste está relacionado fundamentalmente com o autoconceito, o locus de controle e as formas de enfrentar problemas, variáveis que deveriam ser consideradas ao momento de promover uma transição adequada do bacharel à educação superior.

Creación de un Currículo de Competencias en Cariología para Estudiantes de Pregrado de Odontología en Chile / Development of a Competency-based Curriculum in Cariology for Undergraduate Dental Students in Chile

RESUMEN: Objetivo: Creación de un currículo de competencias mínimas en Cariología, para la formación de los Cirujano-Dentistas egresados de las escuelas de Odontología de Chile. Metodologías: A partir de una reunión de académicos de las Universidades de Talca y de Chile (año 2011), se elaboró una propuesta de currículo inicial, basado en los dominios propuestos por la Unión Europea (Schulte AG y cols). Durante el año 2016, dicha propuesta fue analizada mediante diálogos digitales y grupos de trabajo, con la participación del 96% de las Escuelas de Odontología existentes en el país, que concluyeron en un documento intermedio. Este documento fue analizado, discutido y perfeccionado durante el Taller para el Desarrollo de un Currículo de Competencias Mínimas en Cariología para las Escuelas de Odontología Chilenas (22/Mayo/2017, Talca, organizado por la Universidad de Talca y la Universidad de Chile) con la asistencia de representantes del 96% de las escuelas dentales chilenas, Ministerio de Salud de Chile, Colegio de Cirujano-Dentistas de Chile y con la asesoría de los profesores de Cariología Dres. Margherita Fontana y Carlos González-Cabezas (Universidad de Michigan, Ann Arbor, EEUU). Cada grupo de trabajo revisó el documento y envió nuevos comentarios, los que fueron incorporados en el documento final por una comisión asesora. Resultados: El documento del Currículo en Cariología se organizó en 5 Dominios: 1. Conocimientos base; 2. Determinación de Riesgo, diagnóstico de caries y detección de lesiones de caries; 3. Toma de decisiones y manejo preventivo no operatorio; 4. Toma de decisiones y manejo operatorio y 5. Cariología basada en la evidencia, en la práctica clínica y de salud pública. Se consensuaron las definiciones operacionales, las competencias principales y las sub-competencias para cada uno de los dominios. Las sub-competencias fueron clasificadas en tres niveles: A: Ser competente en; B: Tener conocimientos sobre y C: Estar familiarizado con. El documento final fue enviado a todos los participantes del taller para su aprobación y difusión en cada una de las instituciones involucradas. Conclusiones: Se logró, por medio de consenso, la construcción del Currículo de Competencias mínimas en Cariología para estudiantes de pregrado de Odontología en las universidades chilenas.

ABSTRACT: Objective: Development of a minimum set of competencies in Cariology that every dentist graduated from a Dental School in Chile must have. Methodology: Starting from a meeting of scholars from the Universities of Talca and Chile (year 2011), an initial proposal for a curriculum was developed, based on the domains proposed by the European Cariology Curriculum (Schulte, et al, 2011). During 2016, this proposal was discussed through online dialogues and working groups, with the participation of 95.2% of the Chilean dental schools, which resulted in an intermediate document. This document was analyzed, discussed and refined during the Workshop for the Development of a Curriculum of Minimum Competencies in Cariology for Chilean Dental Schools (May 22, 2017, Talca, organized by the Universities of Talca and Chile) with the attendance of representatives from 95.2% of the Chilean dental schools, the Chilean Ministry of Health, Chilean College od Dentists and with the assistance of the professors of Cariology Margherita Fontana and Carlos González-Cabezas (University of Michigan, Ann Arbor, USA). Each working group revised the document and provided feedback, which was incorporated in the final document by an advisory committee, elected on the day of the workshop, including the authors of the present article. Results: The Cariology Curriculum was organized in 5 Domains: 1. Basic knowledge; 2. Risk assessment, caries diagnosis and caries lesion detection; 3. Decision-making and non-operative preventive treatment; 4. Decision making and operative treatment; and 5. Evidence-based, clinical and public health practice. Operational definitions, main competencies and sub-competencies for each domain were agreed. Sub-competencies were classified into three levels: A: Be competent in; B: Have knowledge about, and C: Be familiar with. The final document was sent to all the participants of the workshop for dissemination in each of the institutions involved. Conclusions: The development of the Competency-based Curriculum in Cariology for undergraduate dental students at Chilean universities was achieved through consensus.

Anthropometric Assessment for Bariatric Procedures in the Private Practice of a Registered Dietitian in Colombia.

BACKGROUND: Obesity and its consequences have now reached worldwide pandemic proportions. Among treatments, bariatric interventions are the most effective for weight reduction. Here, we describe the change in anthropometric measurements (AMs) of 615 adult bariatric procedure patients seen in the private practice of a registered dietitian (RD) in Bogotá, Colombia. METHODS: Observational retrospective study of AMs recorded between 1996 and 2013 for patients who had laparoscopic sleeve gastrectomy (LSG, n = 290), laparoscopic adjustable gastric banding (LAGB, n = 207), and laparoscopic Roux-EN-Y gastric bypass (LRYGB, n = 36) or the non-surgical gastric balloon (GB, n = 82) procedure. Patients had three bimonthly follow-up visits. Paired t tests compared baseline (first) and 6-month (fourth) follow-up visit values. RESULTS: Differences in AMs between the baseline and fourth visits were statistically significant for the surgical interventions. A mean weight loss of 22 kg, equivalent to a 22% total body weight loss, together with significant reduction of the waist-to-height-ratio (WHtR)(p < 0.001) and body mass index (BMI)(p < 0.001), was observed across all procedures. CONCLUSIONS: The use of multiple AMs enables a comprehensive assessment of body composition in patients who undergo bariatric procedures. Our study is a useful resource for international future reference and highlights the impact that the RD can have on understanding and influencing the effectiveness of bariatric procedures.

Postoperative radiotherapy in the management of keloids.

BACKGROUND: The high recurrence rate following keloid resection has generated interest in adjuvant treatments for this disease. OBJECTIVE: This study assesses keloid recurrence when treated with surgery and adjuvant radiotherapy. METHODS: Retrospective analysis of resected keloids in patients referred to a Chilean radiation oncology centre between 2006 and 2013. Local recurrence was defined as new tissue growth on the surgical scar margin. RESULTS: Around103 keloids were analysed in 63 patients treated with 15 Gy in three fraction radiotherapy which was initiated on the same day as the surgery (75% of cases). The median keloid diameter was 6 cm; the most common site was thoracic (22%); the most common cause was prior surgery (35%); 37% caused symptoms, and several (47%) had received prior treatment with corticosteroids (32%), or surgery (30%). The median follow-up was three years, and 94% of recurrences occurred during the first year following treatment. Uni and multivariate analyses showed that an absence of symptoms was a protective factor for recurrence (OR: 0.24), while the time interval from onset to treatment with surgery plus radiotherapy >4.2 years was a risk factor (OR: 2.23). The first year recurrence rate was 32% and stabilised at 32% by the second year with no recurrences after 15 months. CONCLUSIONS: The combination of surgery and radiotherapy proved to be a good therapeutic alternative in the management of keloids. Our results are similar to those described in the literature for a dose of 15 Gy. Given these results, our centre will implement a new dose escalation protocol to improve future outcomes.

Incidence of pain flare following palliative radiotherapy for symptomatic bone metastases: multicenter prospective observational study.

BACKGROUND: Palliative radiotherapy (RT) is an effective treatment for symptomatic bone metastases. Pain flare, a transient worsening of the bone pain after RT, has been described in previous reports with different incidence rates. The aim of the study was to prospectively evaluate the incidence of pain flare following RT for painful bone metastases and evaluate its effects on pain control and functionality of the patients. METHODS: Between June 2010 and June 2014, 204 patients were enrolled in this study and 135 patients with complete data were evaluable. Pain flare was defined as a 2- point increase in worst pain score as compared with baseline with no decrease in analgesic intake or a 25% increase in analgesic intake as compared with baseline with no decrease in worst pain score. All pain medications and worst pain scores were collected before, daily during, and for 10 days after RT. The Brief Pain Inventory (BPI) was filled out on the pretreatment and at the 4 weeks follow-up visit. RESULTS: There were 90 men (66.7%) and 45 women (33.3%). Mean age was 66 years (SD 9.8). The most common primary cancer site was lung in 42 patients (31.1%), followed by prostate in 27 patients (20.0%). Forty-two patients (31.1%) patients received a single fraction of 8 Gy and 83 (61.5%) received 20 Gy in five fractions. The overall pain flare incidence across all centers was 51/135 (37.7%). The majority of pain flares occurred on days 1-5 (88.2%). The mean duration of the pain flare was 3 days (SD: 3). There were no significant relationships between the occurrence of pain flare and collected variables. All BPI items measured four weeks after end of RT showed significant improvement as compared with pretreatment scores (p < 0.001). No significant differences in BPI time trends were found between patients with and without flare pain. CONCLUSION: Pain flare is a common event, occurring in nearly 40% of the patients that receive palliative RT for symptomatic bone metastases. This phenomenon is not a predictor for pain response.

Propagación in vitro de materiales seleccionados de Rubus glaucus Benth (mora de Castilla) en la provincia de Pamplona, región nororiental de Colombia / Propagation in vitro of selected materials of Rubus glaucus Benth (mora de Castilla) in the province of Pamplona, northeastern Colombia

En este estudio los materiales fueron seleccionados en 53 fincas pertenecientes a cuatro asociaciones de cultivadores de mora en los municipios de Pamplona y Chitagá (Norte de Santander, Colombia). Se emplearon como explantes segmentos nodales, los cuales permitieron obtener en poco tiempo brotes adventicios adecuados para la multiplicación masiva. Para la etapa de establecimiento se empleó el medio de cultivo Murashige y Skoog, (MS 1962), suplementado con ácido giberélico (GA3) (0.0-0.1 mg/L) y 6-benzil aminopurina (BAP) (0,0-2,0 mg/L), en la etapa de multiplicación MS ,suplementado con GA3 (0,0-0,03 mg/L-1) y BAP (0,0-2,5 mg/L) y para la etapa de enraizamiento MS, suplementados con ácido indolbutírico (AIB) (0,0-1,0 mg/L). A los datos generados en las tres etapas, se les aplicó un diseño experimental de bloques completos al azar y se analizaron estadísticamente los promedios de los tratamientos mediante una prueba de Tukey. Los resultados alcanzados indicaron tasas promedio de contaminación (16,5-49,7 %) multiplicación (3,8-4,3 brotes/explante) y enraizamiento (3,3-4,3 raíces/planta) in vitro para los diferentes materiales seleccionados y evaluados. Estos resultados, logrados por primera vez en la región Nororiental de Colombia, son importantes por cuanto se contara con materiales seleccionados disponibles para los cultivadores de mora de la región.

In this study plant materials were selected in 53 farms belonging to four growers associations of blackberry in the municipalities of Pamplona and Chitagá (North of de Santander, Colombia). Nodal segments were used as initial explants of R. glaucus. For the establishment stage Murashige and Skoog, 1962 (MS) media was used and, supplemented with of gibberellic acid (GA3) (0.0 -0.1 mg/L) and 6-aminopurine (BAP) (0.0 -2.0 mg/L); for the multiplication stage MS was supplemented with GA3 (0.0 -0.03 mg/L) and BAP, (0.0 -2.5 mg/L) and for the rooting stage MS was supplemented with acid indolbutirico (0.0 -1.0 mg/L). From the data generated during the three stages, an experimental design of incomplete blocks was randomly applied and the treatments averages were statistically analyzed using the Tukey Test. The results indicated average rates of contamination (16.5-49.7 %), multiplication (3.8-4.3 shoots/explant) and in vitro rooting (3.3-4.3 roots/plant) for the different evaluated materials. These results, achieved first in the Northeastern region of Colombia, are important in that they will feature selected materials available for blackberry growers in the region.

Analgesia, sedación y anestesia para cateterismo diagnóstico y/o terapéutico en pacientes pediátricos con cardiopatías congénitas en el Hospital Clínico de la Pontificia Universidad Católica de Chile: algunas recomendaciones / Analgesia, sedation and anesthesia in diagnostic or therapeutic catheterization in pediatric patients with congenital heart disease

Las presentes recomendaciones han sido elaboradas en base a nuestra experiencia, con el propósito de entregar algunas pautas sobre analgesia, sedación y anestesia para cateterismos diagnósticos y/o terapéuticos en pacientes pediátricos con cardiopatías congénitas, de acuerdo a la clasificación de riesgo de los mismos. El propósito de ésta es contribuir a disminuir la incidencia de eventos adversos asociados a morbilidad y mortalidad.

Recommendations based con clinical experience with analgesia, sedation and anesthesia in diagnostic or therapeutic cardiac catheterization in pediatric patients with congenital heart disease are outlined. These recommendations, based on clinical experience at a single institution (Catholic University Hospital in Santiago, Chile) are intended to help reduce de incidence of adverse effects, morbidity and mortality in this patient population.

Stereotactic body radiotherapy for colorectal lung oligometastases: preliminary single-institution results.

PURPOSE: To present the preliminary results of stereotactic body radiotherapy (SBRT) for lung oligometastases originated from colorectal cancer (CRC). METHODS: Thirteen patients (9 male, 4 female) with lung oligometastases from CRC were prospectively selected for SBRT between July 2009 and July 2013. We used a dose risk-adapted schedule of radiation. RESULTS: The median follow-up was 9.16 months (range 2-45.6). The median age was 69 years (range 40-84). Three cases (23.1%) were treated with 12.5 Gy in 4 fractions (112.5 biological effective dose/BED). Four cases (30.8%) received 18Gy (151.2 BED), 2 (15.4%) 7.5 Gy in 8 fractions (BED 105) and 4 (30.8%) a monofraction of 34 Gy (149.6 BED). There were 5 (38.5%) complete responses, 5 (38.5%) partial responses and 3 (23%) patients remained with stable disease. During follow-up 6 patients (46.2%) showed distant metastases: liver (N=3, 50%), bone (N=1, 16.6%) and contralateral lung (N=2, 33.3%). Median time to systemic progression was 9 months. One- and two-year distant progression-free survival (DPFS) was 45.8% and 22.9%, respectively. Local control (LC), overall survival (OS), and cause-specific survival (CSS) at one- and two-years were all 92.3%. A tendency for a better local response and DFPS in patients aged ≤70 years and BED > 120 Gy was observed. No grade 3-4 toxicity was noticed. CONCLUSIONS: Excellent LC and longer DFS could be achieved with SBRT in oligometastatic lung disease from CRC, delaying thus disease progression and the need for further treatment.

Evaluación del bienestar subjetivo en estudiantes de universidad privada mexicana / Avaliação do bem-estar subjetivo de estudantes de uma universidade privada mexicana / Evaluation of subjective well-being in mexico private college students

Se llevó a cabo un estudio sobre bienestar subjetivo en estudiantes de una universidad privada en Hermosillo, Sonora, México. Se estudió la relación de los constructos "satisfacción con la vida" y "afectos positivos", en una muestra de 371 alumnos mediante la Encuesta Internacional para Alumnos Universitarios (Diener, 2001). Los resultados muestran que en el grupo de los más satisfechos la dimensión "satisfacción con la vida" se correlaciona significativamente con la percepción de la felicidad, mientras la dimensión "afectos positivos" se correlaciona con socialización de las emociones. La edad contrasta significativamente con los niveles de satisfacción con la vida: a menor edad, mayor es la satisfacción. Además, los que estudian una ingeniería o una carrera del área administrativa resultan con los puntajes más elevados, dato contrario con jóvenes de universidades públicas, donde estudiantes que pertenecen a las ciencias sociales y humanidades son las áreas que resultan más satisfechos con la vida.

Realizou-se uma pesquisa sobre o bem-estar subjetivo de estudantes de uma universidade privada de Hermosillo, Sonora, México. Foi estudada a relação entre os construtos "satisfação com a vida" e "afetos positivos", numa amostra de 371 alunos, por meio da Escala Internacional para Alunos Universitários. Os resultados mostram que, no grupo dos mais satisfeitos, a dimensão "satisfação com a vida" correlaciona-se significativamente com a percepção da felicidade, enquanto a dimensão "afetos positivos" correlaciona-se com socialização das emoções. Entre idade e níveis de satisfação com a vida, há uma relação significativa e inversa: quanto menor a idade, maior a satisfação. Além disso, os estudantes das áreas de engenharia e administração apresentam resultados mais elevados, dado diferente do encontrado entre jovens de universidades públicas, entre os quais as ciências sociais e as humanidades são as áreas de mais satisfação com a vida.

A study about the subjective well-being of students from a private university was carried out in Hermosillo, Sonora, Mexico. The relationship between "life satisfaction" and "positive feelings" was studied in a sample of 371 students by means of the International Survey for University Students (Diener, 2001). The results show that the "life satisfaction" factor is highly related to the perception of happiness in the most satisfied group, whereas the "positive feelings" factor is related to the socialization of emotions. Age is related to the levels of life satisfaction: a reverse relationship between age and satisfaction. In addition, it was established that the areas which the subjects study are related to the level of satisfaction. Those who study engineering or administration came out with the highest scores. In contrast, subjects from public universities who study social sciences and humanities turn out more satisfied with life.

Impact of intraoperative MRI/TRUS fusion on dosimetric parameters in cT3a prostate cancer patients treated with high-dose-rate real-time brachytherapy.

PURPOSE: The purpose of this study was to evaluate the impact of intraoperative MRI/TRUS fusion procedure in cT3a prostate cancer patients treated with high-dose-rate (HDR) real-time brachytherapy. MATERIAL AND METHODS: Prostate gland, dominant intraprostatic lesions (DILs), and extracapsular extension (ECE) were delineated in the pre-brachytherapy magnetic resonance images (MRI) of 9 consecutive patients. The pre-implant P-CTVUS (prostate clinical target volume) was defined as the prostate seen in the transrectal ultrasound (TRUS) images. The CTVMR includedthe prostate with the ECE image (ECE-CTV) as defined on the MRI. Two virtual treatment plans were performed based on the MRI/TRUS fusion images, the first one prescribing 100% of the dose to the P-PTVUS, and the second prescribing to the PTVMR. The implant parameters and dose-volume histogram (DVH) related parameters of the prostate, OARs, and ECE were compared between both plans. RESULTS: Mean radial distance of ECE was 3.6 mm (SD: 1.1). No significant differences were found between prostate V100, V150, V200, and OARs DVH-related parameters between the plans. Mean values of ECE V100, V150, and V200 were 85.9% (SD: 15.1), 18.2% (SD: 17.3), and 5.85% (SD: 7) when the doses were prescribed to the PTVUS, whereas ECE V100, V150, and V200 were 99.3% (SD: 1.2), 45.8% (SD: 22.4), and 19.6% (SD: 12.6) when doses were prescribed to PTVMR (p = 0.028, p = 0.002 and p = 0.004, respectively). CONCLUSIONS: TRUS/MRI fusion provides important information for prostate brachytherapy, allowing for better coverage and higher doses to extracapsular disease in patients with clinical stage T3a.

Is argon plasma coagulation an effective and safe treatment option for patients with chronic radiation proctitis after high doses of radiotherapy? / ¿Es la coagulación con plasma argón una opción terapéutica eficaz y segura en pacientes con proctitis crónica actínica tras dosis altas de radioterapia?

Introduction: In severe cases refractory to medical treatment, APC appears to be the preferred alternative to control persistent rectal bleeding of patients with chronic radiation proctitis. Although successful outcomes have been demonstrated in patients previously treated with moderate doses of radiotherapy, there is reluctance towards its indication due to the concern of severe adverse events in patients treated with high doses of radiation. Objectives: The aim of this study was to assess the efficacy and toxicity of APC in the management of bleeding radiationinduced proctitis in patients treated with high doses of radiation for prostate cancer. Methods and materials: Data from 30 patients were treated with APC due to chronic radiation proctitis, were reviewed retrospectively. All cases had prostate cancer and 9 of them (30 %) underwent previous radical prostatectomy. The median dose of conformal 3D External Beam Radiotherapy (EBRT) delivered was 74 Gy (range 46-76). Median rectal D1cc and D2cc was 72.5 and 72.4 Gy respectively. Median rectal V70, V60 and V40 was 12, 39.5 and 80 %. Cardiovascular and digestive disease, diabetes, smoking behaviour, lowest haemoglobin and transfusion requirements were recorded. Indications for treatment with APC were anemia and persistent bleeding despite medical treatment. Argon gas flow was set at 1.8 l/min with an electrical power setting of 50 W. Results: Median age of all patients was 69.6 years. The median lowest haemoglobin level was 9.6 g/dL. Median time between completion of radiotherapy and first session of APC as 13 months. Ninety-four therapeutic sessions were performed (median 3 sessions). Median time follow-up was 14.5 months (range 2-61). Complete response with resolved rectal bleeding was achieved in 23 patients (77 %), partial response in 5 (16 %) and no control in 2 (6 %). No patients required transfusion following therapy. Two patients developed long-term (> 6 weeks) grade 2 rectal ulceration and grade 2 rectal incontinence, respectively. Conclusions: The argon plasma coagulation is an effective and safe management option in patients with medically refractory rectal bleeding after high doses of radiation for prostate cancer (AU)

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