Effective Wavelength Range in Photobiomodulation for Tooth Movement Acceleration in Orthodontics: A Systematic Review.

Objective: The present systematic review aims to establish an effective range of low-level laser therapy wavelengths to accelerate tooth movement in orthodontic treatments. Materials and methods: The electronic literature search was carried out in the following databases: PubMed, ISI Web of Science, Scopus, and Cochrane randomized controlled trials (RCTs). The protocol (CRD42019117648) was registered in PROSPERO. Results: According to PRISMA guidelines and after applying the inclusion criteria, nine RCTs were included. Three blind reviewers independently assessed the methodological quality and evidence level of selected articles. Evidence level classification was established according to the recommendations of SIGN 50 (Scottish Intercollegiate Guidelines Network 2012) and was high quality being ++, acceptable +, low quality -, unacceptable -, reject 0. Conclusions: The majority of RCTs related to accelerating the tooth movement in orthodontic treatments are ideally between 780 and 830 nm wavelengths. The average increase in speed movement calculated as a percentage of the control group in nine studies is 24%. Further studies are necessary to establish the exact dosimeter in photobiomodulation during orthodontic movement.

Asociación entre desenlaces clínicos y cumplimiento del protocolo de recuperación mejorada después de la cirugía (ERAS) en procedimientos colorrectales: estudio multicéntrico / Association between clinical outcomes and compliance with the Enhanced Recovery After Surgery (ERAS) protocol in colorectal procedures: A multicenter study

Introducción. Los protocolos de recuperación mejorada después de cirugía se han diseñado como una innovación en salud tras demostrarse que la mejora en los dispositivos médicos y la depuración de técnicas alcanzaron la meseta en disminución de complicaciones. Con estas estrategias de la medicina perioperatoria, en cirugía colorrectal se reducen la morbilidad y estancia hospitalaria. El objetivo del estudio fue evaluar si la tasa de adherencia al programa de recuperación mejorada después de la cirugía (ERAS) está asociada con los resultados quirúrgicos. Métodos. Estudio multicéntrico, observacional, retrospectivo de cohorte (2015-2019), en cinco hospitales latinoamericanos certificados por la sociedad ERAS. Se calculó la incidencia de complicaciones quirúrgicas durante el posquirúrgico inmediato (30 días) y la duración de la estancia hospitalaria. Se utilizaron análisis bivariado y regresión logística multivariada para evaluar los factores asociados con la tasa de complicaciones. Resultados. Fueron incluidos en el estudio 648 pacientes en cinco hospitales ERAS, con edad promedio de 61 años y mayor porcentaje de hombres (51 %). El cumplimiento global al protocolo ERAS fue de 75 % y la estancia promedio de 6,2 días (mediana: 4 días). Se tuvo un cumplimiento óptimo del protocolo ERAS (igual o mayor al 80 %) en 23,6 % de los pacientes. Se documentó fuga de la anastomosis en 4 %, complicaciones infecciosas en 8,4 %, íleo en 5,7 %, reingreso en 10,2 % y mortalidad de 1,1 %. El análisis multivariado mostró que los niveles de adherencia óptima al protocolo ERAS reducen significativamente la aparición de complicaciones como fuga de la anastomosis (OR 0,08; IC95% 0,01-0,48; p=0,005) y complicaciones infecciosas (OR 0,17; IC95%0,03-0,76; p=0,046).Discusión. Los resultados sugieren que un cumplimiento del programa ERAS mayor al 80 % se asocia a menor frecuencia de complicaciones en pacientes con cirugía electiva colorrectal

Introduction. Enhanced Recovery After Surgery (ERAS) protocol has been designed as an innovation in health after demonstrating that the improvement in medical devices and the refinement of techniques reached the plateau in reducing complications. With these strategies of perioperative medicine, in colorectal surgery morbidity and hospital stay are reduced. The aim of the study was to evaluate whether the rate of adherence to the ERAS protocol is associated with surgical outcomes.Methods. Multicenter, observational, retrospective cohort study (2015-2019), in five Latin American hospitals certified by the ERAS Society. The incidence of surgical complications during the immediate postoperative period (30 days) and length of hospital stay were calculated. Bivariate analyzes and multivariate logistic regression were used to assess factors associated with complication rates.Results. 648 patients were included in the study in five ERAS hospitals, with an average age of 61 years and a higher percentage of men (51%). Overall compliance with the ERAS protocol was 75% and the average stay was 6.2 days (median: 4 days). There was optimal compliance with the ERAS protocol (equal to or greater than 80%) in 23.6% of the patients. Anastomotic leak was documented in 4%, infectious complications in 8.4%, ileus in 5.7%, readmission in 10.2%, and mortality in 1.1%. Multivariate analysis showed that optimal adherence levels to the ERAS protocol significantly reduce the appearance of complications such as anastomotic leakage (OR 0.08; 95%CI 0.01-0.48; p=0.005) and infectious complications (OR 0.17; 95%CI 0.03-0.76; p=0.046).Discussion. The results suggest that compliance with the ERAS program greater than 80% is associated with a lower frequency of complications in patients with elective colorectal surgery

Quiste broncogénico gástrico: una localización singular / Gastric bronchogenic cyst: a singular presentation

Los quistes broncogénicos son formaciones quísticas originadas por una anomalía de desarrollo del eje traqueobronquial durante la embriogénesis a partir de la pared ventral del intestino anterior. Se define al quiste broncogénico como una yema pulmonar ectópica cuya localización más frecuente es en la carina, intraparenquimatoso y en el mediastino; presenta otras localizaciones atípicas y menos comunes, como las regiones cervical, supraclavicular, esofágica, retroperitoneal y cutánea. Se presenta el caso de una mujer joven que consultó al servicio de urgencias con síntomas de dolor abdominal, a quien se le practicaron múltiples pruebas y se le diagnosticó un quiste broncogénico gástrico.

Bronchogenic cysts are cystic formations originated by a tracheobronchial axis developmental anomaly during embryogenesis from the ventral wall of the anterior intestine. A bronchogenic cyst is defined as an ectopic pulmonary bud with most frequent location in the carina, intraparenchymal and mediastinal, presenting atypical and less common locations such as the cervical, supraclavicular, esophageal, retroperitoneal, and cutaneous regions. We present the case of a young woman, who consults the emergency department with abdominal pain, who is subjected to multiple tests being diagnosed as gastric bronchogenic cyst

Reevaluation of the Strain Pressure Theory: Toward a Better Understanding the Biology of Tooth Movement / Reevaluación de la Teoría Presión - Tensión: Hacia una Mejor Comprensión de la Biología del Movimiento Dental

The aim of this report was to analyze the majority of publications referred to orthodontic movement Biological basis, principally strain- pressure theory taking account contemporaneous methodological study designs. The literature published in Pubmed from 1967 to 2014 was reviewed, in addition to well-known scientific reports that were not classified under this database like classical manuscripts since 1839. The comment items are: Limitations of animal models, Histological slices, what to watch for, Rats as an experimental model in orthodontics, Strain­pressure, the force used in these studies that fundament this theory, Reevaluation studies about strain-pressure theory in biology movement using contemporaneous models, Up to date concepts, Theory reevaluation the first step to understanding new acceleration concepts and Movement biology research, present and future. After analyzing those items we concluded: A 3D perspective is essential for a complete understanding of events in tooth movement involves two interrelated processes: the bending of alveolar bone and remodeling of the periodontal tissues. It's important to start, and acknowledge that the PDL cannot be divided into two different areas that react independently to an applied force. It´s a continuous periodontal compartment in OTM, rather than a pressure side and a tension side. When an orthodontic force is applied there are two simultaneous effects that correlate. Alveolar bone flexion and remodeling of the periodontal tissues. Alveolar Bone deformation compromising the main structures (PDL, bone and cement), compression and tension can coexist in different directions. The magnitudes of compression and tension are typically different in different directions. As the majority of research and studies indicate that fundamental movement biology are made on animal models, it is important to know that their results and conclusions, under the actual evidenced based practice guidelines do not allow to make clinical decisions even if they are included on systematic reviews.

El objetivo de esta revisión es analizar la mayoría de las publicaciones relacionadas a la fundamentación sobre el movimiento de ortodoncia, principalmente la teoría presión-tensión, teniendo en cuenta los diseños de estudios metodológicos contemporáneos. Se revisó la literatura publicada en la base de datos de MEDLINE, 1967-2013 , además de los informes conocidos que no fueron clasificados en esta base de datos como manuscritos clásicos desde 1839. Los temas principales en los que se divide el artículo son: Limitaciones de los modelos animales, cortes histológicos, las ratas como modelo experimental en ortodoncia, la fuerza utilizada en los estudios que fundamentan esta teoría, reevaluación sobre los estudios de la teoría presión ­tensión en modelos contemporáneos, conceptos actuales en biología del movimiento, reevaluación de la teoría: el primer paso para entender los nuevos métodos en aceleración del movimiento, conceptos e investigaciones en biología del movimiento: presente y futuro. Una perspectiva 3D es esencial para una comprensión completa de los acontecimientos. El movimiento dental implica dos procesos interrelacionados: la curvatura del hueso alveolar y la remodelación de los tejidos periodontales. Es importante empezar, y reconocer que el PDL no puede ser dividido en dos áreas diferentes que reaccionan de forma independiente a una fuerza aplicada. Está en un compartimiento continuo periodontal , en lugar de un lado de presión y un lado de tensión. Al aplicar una fuerza de ortodoncia hay dos efectos simultáneos: la flexión del hueso Alveolar y la remodelación de los tejidos periodontales. La deformación del hueso compromete las estructuras principales (PDL, hueso y cemento) y la compresión y la tensión pueden coexistir en diferentes direcciones.

Definición de nanomateriales para Colombia / Definition of Nanomateriais for Colombia / Definição de nanomateriais para a Colômbia

Debido a la creciente producción y uso de nanomateriales para actividades de investigación y desarrollo en Colombia, es necesario establecer una definición del término nanomaterial que facilite la toma de decisiones en torno a iniciativas de carácter regulatorio y de normatividad. Se presenta la definición de nanomateriales para Colombia que ha adoptado el Consejo Nacional Asesor de Nanociencia y Nanotecnología adscrito a la Red Colombiana de Nanociencia y Nanotecnología.

Due to the increasing production and use of nanomaterials in research and development activities in Colombia, it is necessary to define the nanomaterial term in order to facilitate decision-making process regarding initiatives with a regulatory or normative character. This article presents the nanomaterials definition that has been adopted by the National Advisory Council for Nanoscience and Nanotechnology, a Colombian Network of Nanoscience and Nanotechnology.

Dada a crescente produção e utilização de nanomateriais para a pesquisa e desenvolvimiento na Colombia, é urgente estabelecer uma definição do termo de nanomaterial para facilitar a tomada de decisão sobre iniciativas na regulamentação e as leis. É apresentada uma definição de nanomateriais para a Colombia que aprovou o Conselho Consultivo Nacional de Nanociência e Nanotecnologia ligado à Rede Colombiana de Nanociência e Nanotecnologia.

Efficient control of coulomb enhanced second harmonic generation from excitonic transitions in quantum dot ensembles.

In this work, the second harmonic generation from excitonic transitions in semiconductor quantum dots is computationally studied. By integrating a density matrix treatment with a partial configuration interaction approach, we obtain the second order susceptibility as a function of externally applied electric and magnetic fields for highly confined neutral and charged excitons. Our results show an enhancement in the nonlinear response with respect to analogous optical processes based on intraband transitions, and predict their efficient tunability by taking advantage of the interplay between Coulomb effects and field-driven wave function manipulation.

Adenomiomatosis de la vía biliar, incidencia de 10 años y revisión de la bibliografía actual / Adenomyomatosis of the biliary tree, ten-year incidence and review of current literature

Introducción. La adenomiomatosis es una entidad anatomo-clínica de difícil diagnóstico. Se puede clasificar en generalizada, segmentaria y localizada. Suele presentarse con síntomas de colelitiasis, aunque puede variar desde ser completamente asintomática hasta sugerir una lesión maligna. El objetivo de este estudio fue revisar la afectación adenomiomatosa de la vesícula biliar y los conductos biliares intrahepáticos y extrahepáticos, así como su diagnóstico y tratamiento. Materiales y métodos. Se llevó a cabo un estudio retrospectivo de 10 años de duración en los servicios de Cirugía Digestiva y Anatomía Patológica del Hospital Universitario San Cecilio en Granada, España. Se incluyeron todos los pacientes que presentaban afectación adenomiomatosa de la vesícula biliar y del sistema biliar intrahepático y extrahepático. Resultados, Entre los años 2000 y 2010, se identificaron 24 pacientes, 19 mujeres y 5 hombres, con adenomiomatosis de un total de 5.141 piezas quirúrgicas. Las manifestaciones clínicas fueron de colelitiasis en 20 (83,3 %) pacientes, de colecistitis en 2 (8,35 %) y de obstrucción (ictericia) en 2 (8,35 %), y correspondieron con los hallazgos histopatológicos: se encontraron 20 lesiones localizadas en el fondo de la vesícula, dos en el conducto cístico y dos en el colédoco distal. En la mayoría de los casos se practicó colecistectomía laparoscópica simple; los últimos dos se sometieron a duodenopancreatectomía cefálica u operación de Whipple, por sospecharse afectación maligna. Conclusión. Esta enfermedad puede presentarse con ausencia completa de síntomas, o con manifestaciones de colelitiasis, colecistitis o de síndrome colestásico. En los casos en que se sospeche una afectación maligna, lo adecuado es hacer un examen histopatológico intraoperatorio, antes de practicar cirugías complejas.

Introduction: Adenomyomatosis of the gallbladder and biliary ducts is an anatomic and medical entity of difficult diagnosis. It can be classified as generalized, segmentary or localized. Typical clinical presentation includes symptoms of cholelithiasis, but it can range from completely asymptomatic to suspicion of malignancy. The aim of this study was to review the gallbladder and intra and extrahepatic biliary ducts affectation by adenomyomatosis, its diagnosis and treatment. Patients and Method: Ten-year retrospective study, held at San Cecilio University Hospital's Digestive Surgery and Pathology Services in Granada, Spain. All patients with gallbladder and intra and extrahepatic biliary ducts adenomyomatosis were included. Results: 24 patients with adenomyomatosis were identified out of 5,141 surgical specimen in the ten-year period 2000-2010; 19 were female and five male. Twenty (83.3%) patients presented with symptoms of cholelithiasis, two (8.35%) with symptoms of cholecystitis, and two (8.35%) with obstructive signs (jaundice),all of which were consistent with the pathology findings: 20 lesions were located in the gallbladder fundus, two in the cystic duct, and two in the distal common bile duct. Laparoscopic cholecystectomy was performed in all but the last two cases, in which a cephalic pancreatico-duodenectomy, or Whipple procedure, was perfomed for suspected malignancy. Conclusion: This entity's clinical condition can present as totally asymptomatic, or with symptoms of cholelithiasis, cholecystitis, or cholestatic syndrome. When malignancy is suspected, intra-operative pathological confirmation is recommended before undertaking a complex surgical procedure.

Dental movement acceleration: Literature review by an alternative scientific evidence method.

The aim of this study was to analyze the majority of publications using effective methods to speed up orthodontic treatment and determine which publications carry high evidence-based value. The literature published in Pubmed from 1984 to 2013 was reviewed, in addition to well-known reports that were not classified under this database. To facilitate evidence-based decision making, guidelines such as the Consolidation Standards of Reporting Trials, Preferred Reporting items for systematic Reviews and Meta-analyses, and Transparent Reporting of Evaluations with Non-randomized Designs check list were used. The studies were initially divided into three groups: local application of cell mediators, physical stimuli, and techniques that took advantage of the regional acceleration phenomena. The articles were classified according to their level of evidence using an alternative method for orthodontic scientific article classification. 1a: Systematic Reviews (SR) of randomized clinical trials (RCTs), 1b: Individual RCT, 2a: SR of cohort studies, 2b: Individual cohort study, controlled clinical trials and low quality RCT, 3a: SR of case-control studies, 3b: Individual case-control study, low quality cohort study and short time following split mouth designs. 4: Case-series, low quality case-control study and non-systematic review, and 5: Expert opinion. The highest level of evidence for each group was: (1) local application of cell mediators: the highest level of evidence corresponds to a 3B level in Prostaglandins and Vitamin D; (2) physical stimuli: vibratory forces and low level laser irradiation have evidence level 2b, Electrical current is classified as 3b evidence-based level, Pulsed Electromagnetic Field is placed on the 4(th) level on the evidence scale; and (3) regional acceleration phenomena related techniques: for corticotomy the majority of the reports belong to level 4. Piezocision, dentoalveolar distraction, alveocentesis, monocortical tooth dislocation and ligament distraction technique, only had case series or single report cases (4(th) level of evidence). Surgery first and periodontal distraction have 1 study at level 2b and corticision one report at level 5. Multiple orthodontic acceleration reports on humans were identified by an alternative evidence level scale, which is a simple and accurate way of determining which techniques are better and have a higher rate of effectiveness. The highest level of evidence for a specific procedure to accelerate orthodontic dental movement up to October 2013 was surgery first followed by low level laser application, corticotomy and periodontal distraction located on level 2, recommendation grade b from this proposed scientific evidence-based scale.

Coupling effects on photoluminescence of exciton states in asymmetric quantum dot molecules.

We present a theoretical study of photoluminescence from exciton states in InAs/GaAs asymmetric dot pairs, where interdot coupling is reached via magnetic field in the Faraday configuration. Electronic structure is obtained by finite element calculations, and Coulomb effects are included using a perturbative approach. According to our simulated spectra, bright excited states may become optically accessible at low temperatures in hybridization regimes where intermixing with the ground state is achieved. Our results show effective magnetic control on the energy, polarization and intensity of emitted light, and suggest these coupled nanostructures as relevant candidates for implementation of quantum optoelectronic devices.

Excitonic effects on the second-order nonlinear optical properties of semi-spherical quantum dots.

We study the excitonic effects on the second-order nonlinear optical properties of semi-spherical quantum dots considering, on the same footing, the confinement potential of the electron-hole pair and the Coulomb interaction between them. The exciton is confined in a semi-spherical geometry by means of a three-dimensional semi-parabolic potential. We calculate the optical rectification and second harmonic generation coefficients for two different values of the confinement frequency based on the numerically computed energies and wavefunctions of the exciton. We present the results as a function of the incident photon energy for GaAs/AlGaAs quantum dots ranging from few nanometers to tens of nanometers. We find that the second-order nonlinear coefficients exhibit not only a blue-shift of the order of meV but also a change of intensity compared with the results obtained ignoring the Coulomb interaction in the so-called strong-confinement limit.

Stress ulcer, gastritis, and gastrointestinal bleeding prophylaxis in critically ill pediatric patients: a systematic review.

OBJECTIVE: To identify and evaluate the quality of evidence supporting prophylactic use of treatments for stress ulcers and upper gastrointestinal bleeding. Stress ulcers, erosions of the stomach and duodenum, and upper gastrointestinal bleeding are well-known complications of critical illness in children admitted to the pediatric intensive care unit. DATA SOURCES: Studies were identified from the Cochrane Central Register of Controlled Trials, PUBMED; LILACS; Scirus. We also scanned bibliographies of relevant studies. STUDY SELECTION: This systematic review of randomized controlled trials assessed the effects of drugs for stress-related ulcers, gastritis, and upper gastrointestinal bleeding in critically ill children admitted to the pediatric intensive care unit. DATA EXTRACTION AND SYNTHESIS: Two reviewers independently extracted the relevant data. Most randomized controlled trials were judged as having unclear risk of bias. When pooling two randomized controlled trials, treatment was significantly more effective in preventing upper gastrointestinal bleeding (macroscopic or important bleeding) compared with no treatment (two studies = 300 participants; relative risk, 0.41; 95% confidence interval, 0.19-0.91; I = 12%). Meta-analysis of two studies found no significant difference in death rates among groups (two randomized controlled trials = 132 participants; relative risk, 1.39; 95% confidence interval, 0.70-2.79; I = 4%). The rate of pneumonia was not significantly different when comparing treatment and no treatment in one study. When comparing ranitidine with no treatment, significant differences were found in the proportion of mechanically ventilated children with normal gastric mucosal endoscopic findings by histologic specimens (one randomized controlled trial = 48 participants; relative risk, 3.53; 95% confidence interval, 1.34-9.29). No significant differences were found when comparing different drugs (omeprazole, ranitidine, sucralfate, famotidine, amalgate), doses, or regimens for main outcomes (deaths, endoscopic findings of erosion or ulcers, upper gastrointestinal bleeding, or pneumonia). CONCLUSIONS: Although pooled data of two studies suggested that critically ill pediatric patients may benefit from receiving prophylactic treatment to prevent upper gastrointestinal bleeding, we found that high-quality evidence to guide clinical practice is still limited.

Valoración de la capacidad de ejercicio en los pacientes con hipertensión arterial pulmonar / Assessment of exercise functional capacity in patients with pulmonary arterial hypertension

La valoración de la capacidad funcional en los pacientes con hipertensión arterial pulmonar forma parte del protocolo diagnóstico inicial y del seguimiento. El grado de intolerancia al ejercicio tiene importantes implicaciones pronósticas y en la elección de tratamiento. Clásicamente, esta valoración se ha realizado mediante la prueba de caminata de 6 minutos. La prueba de esfuerzo cardiopulmonar, ampliamente utilizada en la disfunción ventricular izquierda, se está introduciendo como nueva herramienta en la valoración funcional de los pacientes con hipertensión arterial pulmonar, sobre todo en la de aquellos con menos limitaciones funcionales. Aparte de realizar una valoración no invasiva y objetiva de la capacidad de ejercicio, describe cuáles son los mecanismos fisiopatológicos subyacentes a dicha limitación. Es capaz también de identificar a los pacientes con cortocircuito derecha-izquierda secundario a foramen oval permeable. Tiene implicaciones pronósticas y puede emplearse para analizar la respuesta al tratamiento. Sin embargo, es compleja y requiere una gran experiencia para realizarla e interpretar sus resultados. A continuación, revisaremos el comportamiento de los pacientes con hipertensión arterial pulmonar en la prueba de esfuerzo cardiopulmonar describiendo brevemente la respuesta de nuestros pacientes y comparando los resultados con la prueba de caminata de 6 minutos.

The assessment of functional capacity is part of the diagnosisand management of patients with pulmonaryarterial hypertension. Exercise capacity impairment determines prognosis and establishes which is the besttreatment option. Practicing clinicians use various exercisemodalities in pulmonary arterial hypertension: the 6-minute walk test is the one most frequently used. Cardiopulmonary exercise testing, widely used in leftventricle dysfunction, is starting to be incorporated as anew noninvasive tool for functional assessment inpulmonary hypertensive patients, especially in those withless severe disease. Apart from providing objective information about exercise limitation it can describe the pathophysiological bases of functional impairment and it identifies patients with exercise induced right-to-leftshunt due to patent foramen ovale. Cardiopulmonary exercise testing parameters predict prognosis and assessthe response to drugs. However, it is complex and requiresgreat level of experience for interpreting its results. Thisarticle describes pulmonary hypertensive patient responseto cardiopulmonary exercise testing. Finally, we will brieflyanalyze our results comparing them with 6-minute walktest.