Agreement between cranial and facial classification through clinical observation and anthropometric measurement among Envigado school children.

BACKGROUND: To evaluate the agreement between cranial and facial classification obtained by clinical observation and anthropometric measurements among school children from the municipality of Envigado, Colombia. METHODS: This cross-sectional study was carried out among 8-15-year-old children. Initially, an indirect clinical observation was made to determine the skull pattern (dolichocephalic, mesocephalic or brachycephalic), based on visual equivalence of right eurion- left eurion and glabella-opisthocranion anthropometric points, as well as the facial type (leptoprosopic, mesoprosopic and euryprosopic), according to the left and right zygomatic, nasion and gnation points. Following, a direct measurement was conducted with an anthropometer using the same landmarks for cranial width and length, as well as for facial width and height. Subsequently, both the facial index [euryprosopic (≤80.9%), mesoprosopic (between 81% - 93%) and leptoprosopic (≥93.1%)] and the cranial index [dolichocephalic (index ≤ 75.9%), mesocephalic (between 76% - 81%), and brachycephalic (≥81.1%)] were determined. Concordance between the indices obtained was calculated by direct and indirect measurement using the Kappa statistic. RESULTS: A total of 313 students were enrolled; 172 (55%) were female and 141 (45%) male. The agreement between the direct and indirect facial index measurements was 0.189 (95% CI 0.117-0261), and the cranial index was 0.388 (95% CI 0.304-0.473), indicating poor concordance. CONCLUSIONS: No agreement was observed between direct measurements conducted with an anthropometer and indirect measurements via visual evaluation. Therefore, the indirect visual classification method is not appropriate to calculate the cranial and facial indices.

Fracturas expuestas de húmero: serie de casos entre los años 1998 y 2007 / Humeral open fractures: case series

Introducción: tradicionalmente, las fracturas diafisarias de húmero se han manejado de forma conservadora; sin embargo, las lesiones expuestas tienen un tratamiento diferente desde el punto de vista quirúrgico. Las fracturas expuestas de húmero secundarias a accidentes de tránsito o a traumas de alta energía se asocian a otras lesiones en la extremidad como, por ejemplo, compromiso nervioso o vascular, que pueden comprometer la viabilidad de la misma. El objetivo de este estudio es describir las lesiones, las complicaciones y los resultados funcionales secundarios a fracturas expuestas de la diáfisis del húmero en una serie de pacientes. Materiales y métodos: se realizó un estudio descriptivo retrospectivo tipo serie de casos de los pacientes mayores de 18 años que ingresaron con diagnóstico de fractura diafisaria de húmero expuesta según la clasificación de Gustilo-Anderson al Hospital Universitario del Valle, Cali, entre 1998 y 2007. Resultados: se evaluaron las fracturas diafisarias de húmero en un periodo de 10 años, encontrando 159 fracturas expuestas. La mayoría fueron secundarias a heridas por proyectil de arma de fuego y fueron tratadas principalmente de forma ortopédica. Las fracturas expuestas grado IIIB y IIIC se manejaron con fijación externa. Los pacientes no realizaron un control adecuado por la consulta externa. Discusión: las fracturas expuestas grado III fueron llevadas a manejo quirúrgico con fijación externa como medida de control de daño obteniendo resultados funcionales aceptables en los pacientes evaluados. Para mejorar la calidad de la intervención en los pacientes con fracturas expuestas de húmero, es necesario realizar un protocolo unificado de manejo.

[Alterations in hypothalamus-adipose tissue axis in relation with the risk of coronary atherosclerosis]. / Alteraciones en el eje hipotálamo-tejido adiposo y su relación con el riesgo para la aterosclerosis coronaria.

Recent population studies in Southern Argentina have found a sharp rise in prevalence of overweight and obesity in both sexes and specially after fifty years of age. Hence, the obesity in itself was found associated with the presence of metabolic syndrome (MS) and coronary heart disease, which have been demonstrated by angiography studies. The regulation of energy homeostasis is controlled by interactions between the central nervous system (neurotransmitters and neuropeptides) and the peripheric system (hormones) through very complex mechanisms. Genetics or acquired alterations in these regulation systems can be the origin of obesity and specially of central obesity. The visceral adipose tissue can be considered a secretor organ and its mass increment could generate insulin-resistance (IR) state, which directly or indirectly, could develop into endothelial dysfunction and coronary atherosclerosis. Although some studies estimate that 40% of IR are of genetic origin, a high proportion of these are acquired by inadequate habits in life style (specially excess of food intake and low physical activity). Finally, a better knowledge of the central and peripheric regulations in alimentation habits and energetic balance could help to develop treatments to decrease the incidence of these metabolic alterations and, consequently the morbidity and mortality due to coronary atherosclerosis.

Alteraciones en el eje hipotálamo-tejido adiposo y su relación con el riesgo para la aterosclerosis coronaria. / [Alterations in hypothalamus-adipose tissue axis in relation with the risk of coronary atherosclerosis]

Recent population studies in Southern Argentina have found a sharp rise in prevalence of overweight and obesity in both sexes and specially after fifty years of age. Hence, the obesity in itself was found associated with the presence of metabolic syndrome (MS) and coronary heart disease, which have been demonstrated by angiography studies. The regulation of energy homeostasis is controlled by interactions between the central nervous system (neurotransmitters and neuropeptides) and the peripheric system (hormones) through very complex mechanisms. Genetics or acquired alterations in these regulation systems can be the origin of obesity and specially of central obesity. The visceral adipose tissue can be considered a secretor organ and its mass increment could generate insulin-resistance (IR) state, which directly or indirectly, could develop into endothelial dysfunction and coronary atherosclerosis. Although some studies estimate that 40

of IR are of genetic origin, a high proportion of these are acquired by inadequate habits in life style (specially excess of food intake and low physical activity). Finally, a better knowledge of the central and peripheric regulations in alimentation habits and energetic balance could help to develop treatments to decrease the incidence of these metabolic alterations and, consequently the morbidity and mortality due to coronary atherosclerosis.