Deslizamiento en céntrica y la prevalencia de ruido y/o sintomatología mioarticular de las ATM. Estudio descriptivo

Introducción. El deslizamiento en céntrica (DC) y su incidencia en la sintomatología mioarticular ha sido un tema ampliamente estudiado, sin embargo, aún no está clara la relación entre ambos fenómenos. Objetivo. Evaluar la relación entre el DC y la prevalencia de ruido y/o sintomatología mioarticular de las articulaciones temporomandibulares en una muestra de pacientes. Material y Método. Se analizó una muestra de 183 modelos de estudio con dentición permanente completa excluyendo terceros molares. Se midió el DC en sentido sagital, vertical y transversal. Se recopilaron los datos del examen funcional de cada paciente para registrar las variables ruido y sintomatología mioarticular. Resultados. La magnitud del DC en los sentidos sagital, vertical y transversal está relacionada significativamente (p<0,05) con la presencia de ruido articular. El DC como variable dicotómica está relacionado significativamente, en sentido vertical, con la presencia de sintomatología mioarticular de las articulaciones temporomandibulares. El DC como magnitud y como variable dicotómica, en los sentidos sagital y transversal, están relacionados significativamente con la presencia de ruido y sintomatología mioarticular. Conclusión. Los pacientes que presentan DC con valores superiores a los normales presentan algún tipo de ruido y/o sintomatología mioarticular.

Introduction. Centric slide (CS) and its incidence in myoarticular symptoms have been widely studied: However, the relationship between both phenomena is still unclear. Objective. To evaluate the relationship between CS and the prevalence of noise and/or myoarticular symptoms of the temporomandibular joints in a sample of patients. Material and method. A sample of 183 study models with complete permanent dentition, excluding third molars, was analyzed. CS was measured in the sagittal, vertical, and transverse directions. Data from the functional examination of each patient were collected to record the "noise" and "myoarticular symptoms" variables. Results. The magnitude of CS in the sagittal, vertical, and transverse directions is significantly (p<0.05) related to the presence of joint noise. CS as a dichotomous variable is significantly related, vertically, to the presence of myoarticular symptoms of the temporomandibular joints. As a magnitude and as a dichotomous variable in the sagittal and transverse directions, CS is significantly related to the presence of noise and myoarticular symptoms. Conclusion. Patients with CS values ​​higher than normal present some type of noise and/or myoarticular symptoms.

Health, dependency and caregiving: barriers to economic activity among individuals aged 50 to 69 years in Mexico.

In Mexico, the economically active population aged over 50 years has been increasing in recent years. Due to their age, these workers may experience health deterioration and require some form of care. However, only formal employment is associated with better access to health services and pensions. At the same time, these workers may also need to care for children, sick partners or dependent older adults, which limits their time available for employment. This study examined the association between disability, receiving and providing care and access to health services, and economic activity among adults aged 50 to 69 in Mexico in 2015 and 2018. Multilevel modeling was conducted using data from the Mexican Health and Aging Study (MHAS). The MHAS is a longitudinal panel study of adults aged 50 years and older. The study sample included data from 8,831 observations from 2015 and 10,445 observations from 2018. Those living with some degree of disability and receiving care were found to be less likely to be economically active than those living with disability and not receiving care. Similarly, individuals who care for someone were also found to be less likely to be employed. Furthermore, the data suggested that individuals without access to health services were more likely to be economically active. For individuals aged 50 to 69 years, health and care issues were factors that limited economic activity status. In family-oriented societies with weak welfare states, the right to health is partial for the population and care is traditionally the responsibility of women, which exacerbates gender inequalities and has a differential impact on paid work for men and women.

Antiparasitic Evaluation of Aquiluscidin, a Cathelicidin Obtained from Crotalus aquilus, and the Vcn-23 Derivative Peptide against Babesia bovis, B. bigemina and B. ovata.

Babesiosis is a growing concern due to the increased prevalence of this infectious disease caused by Babesia protozoan parasites, affecting various animals and humans. With rising worries over medication side effects and emerging drug resistance, there is a notable shift towards researching babesiacidal agents. Antimicrobial peptides, specifically cathelicidins known for their broad-spectrum activity and immunomodulatory functions, have emerged as potential candidates. Aquiluscidin, a cathelicidin from Crotalus aquilus, and its derivative Vcn-23, have been of interest due to their previously observed antibacterial effects and non-hemolytic activity. This work aimed to characterize the effect of these peptides against three Babesia species. Results showed Aquiluscidin's significant antimicrobial effects on Babesia species, reducing the B. bigemina growth rate and exhibiting IC50 values of 14.48 and 20.70 µM against B. ovata and B. bovis, respectively. However, its efficacy was impacted by serum presence in culture, and it showed no inhibition against a B. bovis strain grown in serum-supplemented medium. Conversely, Vcn-23 did not demonstrate babesiacidal activity. In conclusion, Aquiluscidin shows antibabesia activity in vitro and its efficacy is affected by the presence of serum in the culture medium. Nevertheless, this peptide represents a candidate for further investigation of its antiparasitic properties and provides insights into potential alternatives for the treatment of babesiosis.

Clinical and laboratory features of rickettsioses in Yucatan, Mexico.

Rickettsia species are obligate intracellular bacteria that can cause mild to severe human disease. Based on phylogeny, clinical symptoms, and antigenic properties, rickettsiae are classified into four groups. Infections by these agents are characterized by clinical symptoms ranging from self-limited to severe and even fatal febrile illnesses, depending on the Rickettsia spp. involved, the patient's predisposition, and timely medical care. The present study aimed to characterize rickettsial diseases in Yucatan according to clinical and laboratory features appearing in medical records corresponding to 427 samples taken between 2015 and 2018. A study was conducted over the period 2015-2018 on 427 samples. Clinical and laboratory features were documented from the patients' medical records. For molecular diagnosis, blood was collected in 3.8 % sodium citrate as anticoagulant, and DNA was extracted. Single-step and nested PCR amplification was performed using genus-specific primers for the rickettsial 17kDa and ompB genes. The amplicons obtained were purified and sequenced. A total of 22.7 % (97/427) positive cases of Rickettsia spp. were identified by PCR from 14.15 % (15/106) of the municipalities in Yucatan. 75.2 % (73/97) of the cases were from the city of Merida during the autumn (September-December). The age groups with the highest frequency of confirmed cases were pediatric (5-14 years) (57.7 %) and adults (25-49 years) (42.2 %). There were six fatal cases in children, one associated with R. typhi and five with R. rickettsii. In non-fatal cases, 32.9 % (32/97) corresponded to the spotted fever group (SFG), and 60.8 % (59/97) to the typhus group (TG). Significant differences in signs, and laboratory data, were observed between the pediatric and adult populations. For the treatment of patients, oral and intravenous doxycycline was used in severe hospitalized cases. Typhus group and spotted fever group Rickettsiae are endemic pathological agents found in urban and rural areas of our region. Molecular identification allows for greater diagnostic accuracy and timely treatment and consequently a better prognosis. It is necessary to implement or reinforce measures focused on the dissemination of knowledge regarding rickettsial diseases and their prevention.

Health, dependency and caregiving: barriers to economic activity among individuals aged 50 to 69 years in Mexico / Salud, adicción y atención: restricciones a la actividad económica en personas de entre 50 y 69 años en México / Saúde, dependência e cuidado: restrições à atividade econômica em indivíduos de 50 a 69 anos no México

Abstract: In Mexico, the economically active population aged over 50 years has been increasing in recent years. Due to their age, these workers may experience health deterioration and require some form of care. However, only formal employment is associated with better access to health services and pensions. At the same time, these workers may also need to care for children, sick partners or dependent older adults, which limits their time available for employment. This study examined the association between disability, receiving and providing care and access to health services, and economic activity among adults aged 50 to 69 in Mexico in 2015 and 2018. Multilevel modeling was conducted using data from the Mexican Health and Aging Study (MHAS). The MHAS is a longitudinal panel study of adults aged 50 years and older. The study sample included data from 8,831 observations from 2015 and 10,445 observations from 2018. Those living with some degree of disability and receiving care were found to be less likely to be economically active than those living with disability and not receiving care. Similarly, individuals who care for someone were also found to be less likely to be employed. Furthermore, the data suggested that individuals without access to health services were more likely to be economically active. For individuals aged 50 to 69 years, health and care issues were factors that limited economic activity status. In family-oriented societies with weak welfare states, the right to health is partial for the population and care is traditionally the responsibility of women, which exacerbates gender inequalities and has a differential impact on paid work for men and women.

Resumen: La población de México económicamente activa mayor de 50 años de edad se ha incrementado en los últimos años. Estos trabajadores en esta edad pueden sentir empeorar su salud y requerir algún tipo de atención. Sin embargo, solamente el empleo formal dio un mejor acceso a los servicios sanitarios y las pensiones. Al mismo tiempo, esta población también puede necesitar cuidar a niños, a la pareja enferma o a una persona mayor dependiente, lo que limita su tiempo disponible para trabajar. Este estudio evaluó la asociación entre la discapacidad, recibir y brindar asistencia y acceso a los servicios sanitarios, y la actividad económica de adultos de entre 50 y 69 años en México en el período de 2015 y 2018. Se trata de un enfoque de modelado multinivel que utiliza datos del Estudio Nacional de Salud y Envejecimiento en México (ENASEM). ENASEM es un estudio longitudinal con adultos de 50 años o más. La muestra del estudio estuvo conformada por 8.831 observaciones en 2015 y 10.445 en 2018. Las personas que viven con algún grado de discapacidad y reciben atención tienen menos probabilidades de ser económicamente activas en comparación con las que viven con discapacidades y no reciben atención. Del mismo modo, las personas que brindan atención también tienen menos probabilidades de tener un trabajo. Además, los datos destacan que las personas sin acceso a los servicios sanitarios tienen más probabilidades de ser económicamente activas. En las personas de entre 50 y 69 años, los problemas de salud y la atención son factores que restringen la condición de la actividad económica. En las sociedades orientadas a la familia con estados de bienestar débiles, el derecho a la salud es parcial a la población y el cuidado es tradicionalmente realizado por las mujeres, lo que empeora las desigualdades de género y tiene un impacto diferencial en el trabajo remunerado para hombres y mujeres.

Resumo: No México, a população economicamente ativa com mais de 50 anos tem crescido nos últimos anos. Devido à idade, estes trabalhadores podem apresentar piora da saúde e necessitar de algum tipo de cuidado. No entanto, apenas o emprego formal está atrelado a um melhor acesso aos serviços de saúde e aposentadorias. Ao mesmo tempo, indivíduos dessa população também podem precisar cuidar de crianças, um companheiro doente ou idoso dependente, o que limita seu tempo disponível para o trabalho. Este estudo examinou a associação entre deficiência, receber e fornecer cuidados e acesso a serviços de saúde e a atividade econômica entre adultos de 50 a 69 anos no México em 2015 e 2018. Trata-se de uma abordagem com modelagem multinível utilizando dados do Estudo Nacional sobre Saúde e Envelhecimento no México (ENASEM). O ENASEM é um estudo longitudinal painel com adultos com 50 anos ou mais. A amostra do estudo incluiu dados de 8.831 observações em 2015 e 10.445 em 2018. Aqueles que vivem com algum grau de incapacidade e recebem cuidados têm menor probabilidade de serem economicamente ativos em comparação com aqueles que vivem com incapacidades e não recebem cuidados. Da mesma forma, os indivíduos que prestam cuidados também são menos propensos a terem um emprego. Além disso, os dados sugerem que indivíduos sem acesso a serviços de saúde têm maior probabilidade de serem economicamente ativos. Em indivíduos na faixa etária de 50 a 69 anos, problemas de saúde e cuidados são fatores que restringem a condição de atividade econômica. Em sociedades orientadas para a família com estados de bem-estar social fracos, o direito à saúde é parcial para a população e o cuidado é tradicionalmente assumido pelas mulheres, o que agrava as desigualdades de gênero e tem um impacto diferencial no trabalho remunerado para homens e mulheres.

Further extension of the Madrid-2019 force field: Parametrization of nitrate (NO3-) and ammonium (NH4+) ions.

The importance of nitrate and ammonium salts both in the environment and in biological processes cannot be questioned. In this work, using the TIP4P/2005 water model, aqueous solutions of nitrate and ammonium electrolytes are parametrized using scaled charges while keeping a rigid structure and nonpolarizable charge distributions. The models are optimized by systematically testing a set of properties for twelve electrolytes-eight nitrate and four ammonium salts-thus, enlarging the number of potential chemical species encompassed within the Madrid-2019 force field for ions. The capacity of the force field for predicting densities, ion-ion and ion-solvent structures, and transport properties of the solutions comprised by the trial batch of salts was tested and discussed. Both the dependence of the densities with the salt concentration and the solution structure were nicely reproduced by the models in the whole concentration range without any trace of precipitating events and with improved accuracy in comparison with recently reported models, while the agreement of the simulated transport properties with experimental data ranges from good to reasonable, depending on the ion/counterion pair. These scaled charge models might be considered as force fields embodying a reasonable compromise between exactness and general applicability and also as an important step in the development of accurate models for polyatomic ions.

Aspectos inmunológicos en preeclampsia / Immunologic Aspects in Preeclampsia

Resumen La preeclampsia es una patología con alta morbimortalidad a nivel mundial. En esta enfermedad la placenta es un órgano de choque donde la inflamación y la respuesta inmunológica generan el daño que se traduce en el cuadro clínico característico. La tríada clásica en preeclampsia está integrada por hipertensión, edema y proteinuria, por lo que se piensa que el endotelio debe estar afectado por la actividad inflamatoria-inmunológica. El sistema inmunológico actúa en el desarrollo del embarazo y lo hace a diferentes tiempos y regulando de manera fisiológica. Tanto componentes celulares como humorales de la respuesta innata y adquirida han sido estudiados en pacientes con preeclampsia y se ha determinado que su participación es decisiva en la fisiopatología de esta enfermedad. La participación del sistema inmunológico en la fisiopatología de la preeclampsia alcanza un alto nivel de complejidad pues interacciona con otros sistemas (coagulación, renal, cardiovascular y endocrinológico entre otros) favoreciendo así la enfermedad. Es por esto que el tratamiento debe ser integral, con una visión holística del padecimiento y que requiere de un equipo multidisciplinario, que actué armónicamente para así alcanzar el mayor éxito terapéutico con la menor frecuencia de secuelas para el binomio madre-feto o madre-recién nacido. En la gestación se desarrolla la denominada "tolerancia inmunológica del embarazo", en ese estado de tolerancia inmunológica las células B y T pueden reconocer antígenos específicos (por ejemplo, los paternos) y posteriormente activarse y generar la respuesta inmunológica, por lo que la preeclampsia podría ser considerada como una patología autoinmune, donde la perdida de la tolerancia inmunológica sería la piedra angular en la fisiopatología, conocer como limitar o regular esta activación celular anómala podría servir para proponer nuevos acercamientos terapéuticos y controlar así esta enfermedad.

Abstract Preeclampsia is a pathology with high morbidity and mortality worldwide. In this disease, the placenta is an organ of shock where inflammation and the immune response generate the damage that results in the characteristic clinical scenario. The classic triad in preeclampsia is made up of hypertension, edema, and proteinuria, so it is thought that the endothelium must be affected by inflammatory-immunological activity. The immune system acts in the development of pregnancy and does so at different times and regulating physiologically. Both, cellular and humoral components of the innate and acquired response have been studied in patients with preeclampsia and it has been determined that their participation is decisive in the pathophysiology of this disease. The involvement of the immune system in the pathophysiology of preeclampsia reaches a high level of complexity since it interacts with other systems (coagulation, renal, cardiovascular and endocrinological among others) thus favoring the disease. For this reason, treatment must be comprehensive, with a holistic vision of the condition and requires a multidisciplinary team that acts harmoniously to achieve the greatest therapeutic success with the least frequency of sequelae for the mother-fetus or mother-newborn dyads. During pregnancy, the so-called "immunological tolerance of pregnancy" develops, in this state of immunological tolerance the B and T cells can recognize specific antigens (for example, the paternal ones) and later activate and generate the immune response, which is why preeclampsia could being considered an autoimmune pathology, where the loss of immunological tolerance would be the cornerstone of pathophysiology, knowing how to limit or regulate this abnormal cell activation could help to propose new therapeutic approaches and thus control this disease.

A Portable Triboelectric Nanogenerator Based on Dehydrated Nopal Powder for Powering Electronic Devices.

Triboelectric nanogenerators (TENGs) based on organic materials can harvest green energy to convert it into electrical energy. These nanogenerators could be used for Internet-of-Things (IoT) devices, substituting solid-state chemical batteries that have toxic materials and limited-service time. Herein, we develop a portable triboelectric nanogenerator based on dehydrated nopal powder (NOP-TENG) as novel triboelectric material. In addition, this nanogenerator uses a polyimide film tape adhered to two copper-coated Bakelite plates. The NOP-TENG generates a power density of 2309.98 µW·m-2 with a load resistance of 76.89 MΩ by applying a hand force on its outer surface. Furthermore, the nanogenerator shows a power density of 556.72 µW·m-2 with a load resistance of 76.89 MΩ and under 4g acceleration at 15 Hz. The output voltage of the NOP-TENG depicts a stable output performance even after 27,000 operation cycles. This nanogenerator can light eighteen green commercial LEDs and power a digital calculator. The proposed NOP-TENG has a simple structure, easy manufacturing process, stable electric behavior, and cost-effective output performance. This portable nanogenerator may power electronic devices using different vibration energy sources.

Machine Learning Models to Forecast Outcomes of Pituitary Surgery: A Systematic Review in Quality of Reporting and Current Evidence.

BACKGROUND: The complex nature and heterogeneity involving pituitary surgery results have increased interest in machine learning (ML) applications for prediction of outcomes over the last decade. This study aims to systematically review the characteristics of ML models involving pituitary surgery outcome prediction and assess their reporting quality. METHODS: We searched the PubMed, Scopus, and Web of Knowledge databases for publications on the use of ML to predict pituitary surgery outcomes. We used the Transparent Reporting of a multivariable prediction model for Individual Prognosis Or Diagnosis (TRIPOD) to assess report quality. Our search strategy was based on the terms "artificial intelligence", "machine learning", and "pituitary". RESULTS: 20 studies were included in this review. The principal models reported in each article were post-surgical endocrine outcomes (n = 10), tumor management (n = 3), and intra- and postoperative complications (n = 7). Overall, the included studies adhered to a median of 65% (IQR = 60-72%) of TRIPOD criteria, ranging from 43% to 83%. The median reported AUC was 0.84 (IQR = 0.80-0.91). The most popular algorithms were support vector machine (n = 5) and random forest (n = 5). Only two studies reported external validation and adherence to any reporting guideline. Calibration methods were not reported in 15 studies. No model achieved the phase of actual clinical applicability. CONCLUSION: Applications of ML in the prediction of pituitary outcomes are still nascent, as evidenced by the lack of any model validated for clinical practice. Although studies have demonstrated promising results, greater transparency in model development and reporting is needed to enable their use in clinical practice. Further adherence to reporting guidelines can help increase AI's real-world utility and improve clinical practice.

A generalized framework for estimating snakebite underreporting using statistical models: A study in Colombia.

BACKGROUND: Snakebite envenoming is a neglected tropical disease affecting deprived populations, and its burden is underestimated in some regions where patients prefer using traditional medicine, case reporting systems are deficient, or health systems are inaccessible to at-risk populations. Thus, the development of strategies to optimize disease management is a major challenge. We propose a framework that can be used to estimate total snakebite incidence at a fine political scale. METHODOLOGY/PRINCIPAL FINDINGS: First, we generated fine-scale snakebite risk maps based on the distribution of venomous snakes in Colombia. We then used a generalized mixed-effect model that estimates total snakebite incidence based on risk maps, poverty, and travel time to the nearest medical center. Finally, we calibrated our model with snakebite data in Colombia from 2010 to 2019 using the Markov-chain-Monte-Carlo algorithm. Our results suggest that 10.19% of total snakebite cases (532.26 yearly envenomings) are not reported and these snakebite victims do not seek medical attention, and that populations in the Orinoco and Amazonian regions are the most at-risk and show the highest percentage of underreporting. We also found that variables such as precipitation of the driest month and mean temperature of the warmest quarter influences the suitability of environments for venomous snakes rather than absolute temperature or rainfall. CONCLUSIONS/SIGNIFICANCE: Our framework permits snakebite underreporting to be estimated using data on snakebite incidence and surveillance, presence locations for the most medically significant venomous snake species, and openly available information on population size, poverty, climate, land cover, roads, and the locations of medical centers. Thus, our algorithm could be used in other countries to estimate total snakebite incidence and improve disease management strategies; however, this framework does not serve as a replacement for a surveillance system, which should be made a priority in countries facing similar public health challenges.

Chromatin Dispersion Test to Asses DNA Damage in Cervical Epithelial Cells.

The chromatin dispersion test (CDT) is based on the removal of nuclear proteins under the assumption that cells with fragmented DNA produce a typical halo of circular DNA loops, which is absent in cells with non-fragmented DNA. This method represents a simple, rapid, accurate, highly reproducible, and inexpensive technique to assess nuclear DNA damage in somatic cells. The visualization of DNA damage and the capacity of the test to provide a threshold value to discriminate between high and low levels of cervical lesions would aid in determining the malignant transformation. All of these advantages associated with the CDT protocol could promote this technique as a tool for the quick and reliable diagnosis of cervical epithelial disorders, even at primary-care centers.

Tratamiento de defectos acetabulares tipo IIIA-B de Paprosky y discontinuidad pélvica con implantes 3D a medida: resultados a mediano plazo / Treatment of Paprosky type IIIA-B acetabular defects and pelvic discontinuity with custom 3D implants. Medium-term results

Introducción: La revisión acetabular es una cirugía particularmente desafiante cuando hay pérdida de stock óseo y defectos acetabulares extensos. Los implantes 3D pueden suplir estos defectos y adaptarse a cada circunstancia. El objetivo de este estudio fue evaluar los resultados clínicos y radiográficos en pacientes con defectos acetabulares severos tratados con implantes impresos en 3D y determinar la constricción adecuada del cotilo para cada paciente. Materiales y métodos: Se realizó un estudio retrospectivo de 10 pacientes con defectos acetabulares severos clasificados como tipo IIIA-B de Paprosky y discontinuidad pélvica que se sometieron a una cirugía con prótesis acetabular a medida impresa en 3D, a cargo del mismo equipo quirúrgico, entre 2016 y 2022. Resultados: El seguimiento medio fue de 40.5 meses. El puntaje de cadera de Harris mejoró significativamente de un promedio de 24,2 a 63,5 en el último control. No se observaron signos de aflojamiento ni migración del cotilo 3D en cuanto a la inclinación y anteversión en ningún caso, en el último control. Conclusión: Los implantes acetabulares a medida representan una solución válida para tratar defectos óseos acetabulares severos y la discontinuidad pélvica. Nivel de Evidencia: IV

Introduction: Acetabular revision is a particularly challenging surgery when there is loss of bone stock and extensive acetabular defects. 3D implants can make up for these defects and adapt to each circumstance. The objective of this study was to evaluate clinical and radiographic outcomes in patients with severe acetabular defects treated with 3D-printed implants and determine the appropriate cup constraint for each patient. Materials and methods: A retrospective study was carried out on 10 patients with severe acetabular defects classified as Paprosky type IIIA-B and pelvic discontinuity who underwent surgery with a custom 3D-printed acetabular prosthesis, carried out by the same surgery team between 2016 and 2022. Results: The average follow-up was 40.5 months. The Harris hip score improved significantly from an average of 24.2 to 63.5 at the last follow-up. No signs of loosening or migration of the 3D cup in terms of inclination and anteversion were observed in any case, at the last control. Conclusion: Custom-made acetabular implants represent a valid solution to treat severe acetabular bone defects and pelvic discontinuity. Level of Evidence: IV

ID please: Evaluating the utility of Facebook as a source of data for snake research and conservation.

Social media has the potential to provide large amounts of biological data, especially for notoriously difficult groups of organisms to study in nature such as snakes. Here, we explored the utility of various Facebook communities to provide data for research on Colombian snakes. Specifically, we determined the richness, distribution, rarity, and popularity of snake species and compiled information on natural history observations and human-snake interactions. We also explored the spatial structure of posts using a geographically weighted regression model. Queries relating to species identifications made up 86.1% of Facebook posts. The portion of the snake community "sampled" by snake-related Facebook posts was not representative of the total richness of snake species in Colombia; however, these posts permitted a greater proportion of snake species to be sampled more rapidly compared with traditional snake sampling approaches. Facebook posts provided new distributional records for 9-21% of Colombian snake species. Rainfall, rural population, and internet availability were the strongest predictors of snake-related Facebook posts. Although the use of Facebook for compiling information on snakes is not free of bias, our findings demonstrate that Facebook communities provide a potentially powerful source of data that could aid studies of snake biology.

Genomic diversity and genetic variation of Leishmania panamensis within its endemic range.

Species belonging to the Leishmania (Viannia) subgenus are important causative agents of cutaneous and mucocutaneous leishmaniasis in Central and South America. These parasites possess several distinctive biological features that are influenced by their genetics, population structure, and genome instability. To date, several studies have revealed varying degrees of genetic diversity within Leishmania species. Particularly, in species of the L. (Viannia) subgenus, a generalized high intraspecific genetic diversity has been reported, although, conflicting conclusions have been drawn using different molecular techniques. Despite being the most common Leishmania species circulating in Panama and Colombia, few studies have analyzed clinical samples of Leishmania panamensis using whole-genome sequencing, and their restricted number of samples has limited the information they can provide to understand the population structure of L. panamensis. Here, we used next generation sequencing (NGS) to explore the genetic diversity of L. panamensis within its endemic range, analyzing data from 43 isolates of Colombian and Panamanian origin. Our results show the occurrence of three well-defined geographically correlated groups, and suggests the possible occurrence of additional phylogeographic groups. Furthermore, these results support the existence of a mixed mode of reproduction in L. panamensis, with varying frequencies of events of genetic recombination occurring primarily within subpopulations of closely related strains. This study offers important insights into the population genetics and reproduction mode of L. panamensis, paving the way to better understand their population structure and the emergence and maintenance of key eco-epidemiological traits.

Disentangling snakebite dynamics in Colombia: How does rainfall and temperature drive snakebite temporal patterns?

The role of climate driving zoonotic diseases' population dynamics has typically been addressed via retrospective analyses of national aggregated incidence records. A central question in epidemiology has been whether seasonal and interannual cycles are driven by climate variation or generated by socioeconomic factors. Here, we use compartmental models to quantify the role of rainfall and temperature in the dynamics of snakebite, which is one of the primary neglected tropical diseases. We took advantage of space-time datasets of snakebite incidence, rainfall, and temperature for Colombia and combined it with stochastic compartmental models and iterated filtering methods to show the role of rainfall-driven seasonality modulating the encounter frequency with venomous snakes. Then we identified six zones with different rainfall patterns to demonstrate that the relationship between rainfall and snakebite incidence was heterogeneous in space. We show that rainfall only drives snakebite incidence in regions with marked dry seasons, where rainfall becomes the limiting resource, while temperature does not modulate snakebite incidence. In addition, the encounter frequency differs between regions, and it is higher in regions where Bothrops atrox can be found. Our results show how the heterogeneous spatial distribution of snakebite risk seasonality in the country may be related to important traits of venomous snakes' natural history.

Morphology and seasonality of the sexual segment of the kidney in genus Bothrops snakes.

In Squamata, the sexual segment of the male kidney (SSK) produces secretory granules that are transmitted to the female tract during copulation. Here, we investigate the morphology of SSK in various species of the pitviper-genus Bothrops, a medically relevant clade of Neotropical snakes, using histology, histochemistry, as well as scanning and transmission electron microscopy. We also evaluated the relationship of SSK hypertrophy with spermatogenesis and storage of sperm. The SSK in Bothrops consists of tall columnar epithelial cells filled with electron-dense secretory granules. These granules are apparently released into the lumen by an apocrine secretory process. In general, the ultrastructural morphology of SSK in Bothrops is similar to those described for other pitvipers in the genus Agkistrodon. In most Bothrops males, the SSK produces carbohydrates and proteins, and occurs in all lobes of the kidney, occupying most of the kidney mass. In contrast, intersexual females (with male copulatory organs) of Bothrops insularis had a smaller SSK diameter than males and did not show hypertrophy. The seasonal development of SSK in Bothrops species seems to be driven by environmental factors rather than phylogeny, since sister species exhibited periods of hypertrophy at different months. In most Bothrops males, hypertrophy occurs at various seasons of the year (spring, summer, autumn), even in winter, and seasonal changes in SSK do not necessarily accompany spermatogenesis.

Cementado de una copa de doble movilidad dentro de un cotilo no cementado fijo para el tratamiento de una luxación recurrente. Resultados a corto plazo / Cementation of a dual mobility cup in a fixed uncemented cup for the treatment of recurrent dislocation. Short-term results

Introducción: El reemplazo total de cadera (RTC) es la artroplastia más exitosa hasta el momento, no exenta de complicaciones, como la inestabilidad protésica. Las copas de doble movilidad (DM) constituyen una opción de tratamiento en la resolución del RTC con luxaciones recidivantes por inestabilidad. Se presenta el caso de una paciente a la que se le había practicado un RTC no cementado de fijación distal, después de una osteosíntesis fallida. Debido a que la paciente presentó episodios de luxaciones recurrentes, se decidió tratarla mediante revisión con implante de DM cementado dentro de un cotilo primario no cementado fijo y el uso de un módulo femoral proximal con offset extendido, preservando la tensión, la longitud y la reductibilidad de la prótesis. Se logró la resolución de la inestabilidad protésica y la paciente no presentó más episodios de luxación, con buenos resultados a corto plazo. El score de Harris pasó de 4/80 en el prequirúrgico a 61/80, 73/80 y 76/80 a los 3, 6 y 9 meses del posoperatorio, respectivamente. Conclusión: La cementación de un cotilo DM en una copa previamente bien fijada parece una opción viable para tratar y prevenir la inestabilidad después del RTC de revisión. Nivel de Evidencia: IV

Introduction: Total hip replacement (THR) is the most successful arthroplasty to date, not exempt from complications, such as prosthetic instability. Double mobility (DM) cups are a treatment option in the resolution of THR with recurrent dislocations due to instability. The objective of the study was to evaluate the results of cementing a DM component in a previous, stable uncemented cup, in a patient with recurrent dislocation, undergoing revision THR. A patient with uncemented THR with distal fixation after failed osteosynthesis, who presented episodes of recurrent dislocations, was treated by revision with a cemented DM implant inside a fixed uncemented primary cup and a proximal femoral module with extended offset, preserving tension, length and reducibility of the prosthesis. Resolution of the prosthetic instability was achieved and the patient did not present any episodes of dislocation, ob-taining good outcomes in the short term. The hip Harris score went from 4/80 preoperatively to 61/80, 73/80, and 76/80 evaluated at 3, 6, and 9 months postoperatively, respectively. Conclusion: Cementation of a DM cup in a previously well-fixed cup appears to be a viable option to treat and prevent instability after revision THR. Level of Evidence: IV

Análisis clínico y radiográfico del vástago de cadera no cementado "CEMENTFREE"® de fabricación nacional. Resultados a corto plazo / Clinical and radiographic analysis of the CemenTFRee® uncemented hip stem of national manufacture. Short-term results

Introducción: La estabilidad del componente femoral y su resistencia al hundimiento son factores críticos para lograr una correcta osteointegración y el éxito clínico de la artroplastia total de cadera no cementada. Hay pocos estudios que evalúen los resultados con vástagos de fabricación nacional, aun los de corto y mediano plazo. El objetivo de este estudio fue realizar un análisis clínico y radiográfico de pacientes sometidos a un reemplazo total de cadera con implante de un componente femoral de fabricación nacional (CEMENTFREE®). Materiales y métodos: Se llevó a cabo un estudio retrospectivo con pacientes sometidos a un reemplazo total de cadera con vástago CEMENTFREE®, entre enero de 2015 y agosto de 2020, a cargo del mismo cirujano y en la misma institución. Resultados: Se implantaron 46 vástagos sin cementación en 42 pacientes (rango etario: 60-81 años). El seguimiento promedio fue de 3 años (mín. 1 año, máx. 5 años). Aplicando el Harris Hip Score se observó una franca mejoría (promedio 47 en el preoperatorio y 93 después de la cirugía). La tasa de supervivencia fue del 100% a los 5 años. Conclusión: La artroplastia de cadera con el vástago CEMENTFREE® de fabricación nacional ha demostrado ser una opción comparable con otros vástagos importados, en cuanto a los resultados clínicos y radiográficos a corto plazo. Resta evaluar los resultados a mediano y largo plazo. Nivel de Evidencia: IV

Introduction: The stability of the femoral component and its resistance to subsidence are critical factors to achieve correct osseointegration and subsequent clinical success in cementless total hip arthroplasty. Few studies have evaluated the results of nationally manufactured stems, even in the short and medium term. Our objective is to clinically and radiologically analyze patients undergoing a total hip replacement with a nationally manufactured femoral component (Cementfree® stem).materials and methods: We carried out a retrospective study on patients who had undergone a total hip replacement with the Cementfree® stem between January 2015 and August 2020 by the same surgeon and at the same institution.Results: 46 uncemented stems were implanted in 42 patients with an age range between 60 and 81 years. The average follow-up was 3 years, with a minimum of 1 year and a maximum of 5 years. There was an evident improvement in the Harris Hip Score (an average of 47 preoperatively vs. 93 after surgery). The revision of the stem for aseptic loosening, in the Kaplan Meier analysis, demonstrated a 100% survival rate at 5 years. Conclusion: According to the results obtained in this research, hip arthroplasty with the nationally manufactured Cementfree® stem has proven to be an option comparable to other imported stems in terms of short-term clinical and radiographic outcomes. An evaluation of the outcomes in the medium and long term is pending. Level of Evidence: IV

Ausencia congénita de incisivos laterales superiores. Enfoques terapéuticos y sus resultados a largo plazo. Revisión descriptiva / Congenital absence of upper lateral incisors. Therapeutic approaches and their long-term results. Descriptive review

RESUMEN: La agenesia de incisivos laterales superiores corresponde a un desafío clínico, en cuanto a planificación de tratamiento, así como también para la obtención de resultados estéticos y funcionales adecuados. Con el fin de conseguirlo, el clínico debería informarse sobre las diferentes opciones terapéuticas disponibles en la actualidad, considerando que la indicación depende de cada caso clínico individual, es decir, del paciente en su contexto integral sumado a su condición intra-oral. Además, es importante evaluar los resultados a largo plazo de las diferentes alternativas, para lograr la resolución clínica más adecuada y estable en el tiempo. El éxito en estos pacientes, requiere de un enfoque multidisciplinario, considerando especialistas en ortodoncia, rehabilitación oral, periodoncia y cirugía oral de ser necesario. El objetivo de esta revisión es describir y comparar las alternativas terapéuticas para la agenesia de incisivos laterales maxilares.

ABSTRACT: The agenesis of upper lateral incisors represents a clinical challenge regarding treatment planning and appropriate aesthetic and functional results. In order to obtain the best results, the clinician should be informed about the different therapeutic options currently available, considering that the indication depends on each individual clinical case, that is, on the patient in his/her comprehensive context in addition to his/her oral condition. It is also important to evaluate long term results from each treatment available, in order to achieve the better outcome and most importantly, a stable clinical resolution over time. The treatment success in this kind of patients requires a multidisciplinary approach, including specialists in orthodontics, oral rehabilitation, periodontics, and oral surgery if necessary. The objective of this review is to describe and compare the therapeutic alternatives for maxillary lateral incisor agenesis.

Estabilidad del tratamiento ortodóncico-quirúrgico de avance mandibular mediante osteotomía sagital bilateral de rama mandibular en pacientes clase II. Revisión narrativa / Stability of the orthodontic-surgical treatment of mandibular advancement through bilateral sagittal split osteotomy in class II patients. Narrative review

RESUMEN: Introducción: La anomalía esqueletal clase II posee un 16 a 22,5% de prevalencia mundial. Cuando estos pacientes se someten al avance mandibular mediante osteotomía sagital de rama mandibular pueden presentar un grado de inestabilidad postoperatoria evidenciándose como recidiva de éste. Objetivo: Describir la estabilidad del avance mandibular mediante osteotomía sagital bilateral de rama mandibular en pacientes clase II esqueletal. Material y método: Se realizó una búsqueda electrónica en las bases de datos PubMed, EBSCO, The Cochrane Library, Tripdatabase y Scopus mediante las palabras clave "mandibular stability", "skeletal stability", "mandibular advancement", "sagittal split osteotomy", "sagittal split ramus osteotomy", "class II", "class III" y "distraction osteogenesis", relacionadas entre sí con los términos booleanos AND, OR y NOT. También se incluyeron los términos MeSH "mandibular advancement" y "Sagittal Split Ramus Osteotomy". Paralelamente se realizó una búsqueda manual en las revistas AJODO, BJOMS, JOMS y EJO. Resultados y discusión: Se seleccionaron 29 artículos: 24 estudios observacionales analíticos, 2 revisiones sistemáticas y 3 ensayos clínicos aleatorizados. El avance mandibular mediante osteotomía sagital de rama mandibular es estable. No obstante, se debe tener en cuenta la existencia de múltiples factores pre e intraquirúrgicos que podrían generar recidiva del tratamiento.

ABSTRACT: Introduction: The class II skeletal anomaly has a 16-22,5% prevalence worldwide. When class II patients undergo mandibular advancement through Bilateral Sagittal Split Osteotomy (BSSO), they can present a postoperative instability, evidenced as a relapse. Objective: To describe the stability of mandibular advancement through BSSO in skeletal class II patients. Materials and method: An electronic search was performed in the databases PubMed, EBSCO, The Cochrane Library, Tripdatabase and Scopus using the keywords "mandibular stability", "skeletal stability", "mandibular advancement", "sagittal split osteotomy", "sagittal split ramus osteotomy", "class II", "class III" and "distraction osteogenesis", related to each other with the Boolean terms AND, OR and NOT. Also "mandibular advancement" and "Sagittal Split Ramus Osteotomy" MeSH terms were included. In parallel, a manual search in the journals AJODO, BJOMS, JOMS and EJO was performed. Results and discussion: 29 articles were selected: 24 analytic observational studies, 2 systematic reviews and 3 randomized clinical trials. Mandibular advancement through BSSO is stable. However, multiple pre and intraoperative factors that could cause a treatment relapse must be taken into account.