¿Existen asimetrías condilares en pacientes infantiles con mordida cruzada posterior? / Are condylar asymmetries in infantile patients with posterior cross-bite?

El objetivo de este estudio fue determinar la presencia de asimetría del cóndilo mandibular en pacientes con mordida cruzada posterior unilateral que acudieron para posible tratamiento ortodóncico, comparando la altura y el ancho mandibular de ambos cóndilos. Métodos: Se midieron las anchuras y alturas condilares derechas e izquierdas en 42 ortopantomografías de pacientes infantiles de siete, ocho y nueve años, de ambos sexos, utilizando el método de Habets. Resultados: No se encontraron diferencias estadísticamente significativas, respecto al género y tipo de dentición, tanto en la altura como en la anchura condilar en la muestra compuesta por 42 pacientes. Conclusiones: No observamos la existencia de asimetría del cóndilo en el que se desarrolla la mordida cruzada posterior en relación al contralateral en los grupos de edad estudiados

The aim of this study was to determine the presence of asymmetry of the mandibular condyle in patients with a unilateral posterior crossbite who came for possible orthodontic treatment, comparing the mandibular height and width of both condyles. Methods: Right and left condyle widths and heights were measured in 42 orthopantomographies of seven, eight and nine year old children of both sexes, using the Habets method. Results: No statistically significant differences were found regarding gender and type of dentition, both in the height and in the condylar width in the sample composed of 42 patients. Conclusions: We did not observe the asymmetry of the condyle in which the posterior crossbite was developed in relation to the contralateral bite in the age groups studied

Evaluation of total phenol pollution in water of San Martin Canal from Santiago del Estero, Argentina.

Santiago del Estero is a province located in northwestern Argentina. The Dulce River is used for irrigation through a vast network of channels and ditches, including the San Martin Canal (SMC), which crosses the capital city of Santiago del Estero. This canal's water is used for drinking, as well as recreational use for the general population. However, this river has been seriously polluted for several decades. The present study focuses on the identification and the quantification of the water pollution levels of total phenols in the SMC according to the seasonal periods. Water samples from various areas of the canal in different months of the year, extending from December to September, were collected for analysis. Additionally, the concentration of total dissolved solids (TDS), chlorides, sulphates, nitrites and organic matter, as well as water hardness and alkalinity, were analysed in order to conduct a more complete study of the contamination of this area. The results showed a worrying total phenol concentration that exceeded the limit set by Argentine legislation for drinking water, as well as water for recreational use (5 µg/L). The total phenol (TP) concentration was directly determined by a molecular absorption spectroscopy method based on a new flow injection analysis system (FIA). Under the selected experimental conditions, the detection and quantification limits were 0.0490 and 0.1633 µg/mL, respectively. The developed method provides a number of improvements related to the speed of analysis, the restricted consumption of the reagents and sample volumes and the unnecessary sample treatment that contribute to environmentally friendly analytical chemistry. The results showed that TP make a significant contribution in the SMC pollution, especially during the months of April (400 ±â€¯110 µg/L) and September (240 ±â€¯20 µg/L). A high sulphate concentration that was higher than the limit allowed by the legislation was also found.

Better sexual acceptability of agomelatine (25 and 50 mg) compared with paroxetine (20 mg) in healthy male volunteers. An 8-week, placebo-controlled study using the PRSEXDQ-SALSEX scale.

Sexual dysfunction (SD) is a common and underestimated effect of antidepressants. Healthy volunteers are the most adequate group to study this adverse event avoiding influence of depression itself. Sexual acceptability of agomelatine (a melatonergic agonist and 5HT(2C) antagonist) paroxetine and placebo by using the Psychotropic-Related Sexual Dysfunction Salamanca Sex Questionnaire (PRSEXDQ-SALSEX) was explored. A total of 92 healthy male volunteers were randomised to agomelatine (25 or 50 mg), paroxetine 20 mg or placebo for 8 weeks. SD, defined as at least one sexual impairment in one of the following PRSEXDQ-SALSEX items (decreased libido, delayed orgasm/ejaculation, anorgasmia/no ejaculation and erectile dysfunction), was evaluated at baseline and after 2, 4 and 8 weeks. At the last post-baseline assessment, SD was significantly lower in each agomelatine group (22.7% on 25 mg and 4.8% on 50 mg) than in the paroxetine group (85.7%; p < 0.0001). In the placebo group, 8.7% of volunteers reported a SD. The percentages of volunteers with moderate or severe SD were 4.5% for agomelatine 25 mg, 4.8% for agomelatine 50 mg, 61.9% for paroxetine 20 mg and 0% in the placebo group (p < or = 0.0001 agomelatine versus paroxetine). There is a much lower risk of having SD with agomelatine than paroxetine in healthy male volunteers, which confirms the better sexual acceptability profile of agomelatine compared with the SSRIs.

Permanently oriented antibody immobilization for digoxin determination with a flow-through fluoroimmunosensor.

This paper reports a new flow-through fluoroimmunosensor, the function of which is based on antibodies immobilized on an inmunoreactor of controlled-pore glass (CPG), for determination of digoxin, used in the treatment of congestive heart failure and artery disease. The immunosensor has a detection limit of 1.20 microg L(-1) and provides high reproducibility (RSD=4.5% for a concentration of 0.0025 mg L(-1), and RSD=6.7% for 0.01 mg L(-1)). The optimum working concentration range was found to be 1.2 x 10(-3)-4.0 x 10(-2) mg L(-1). The lifetime of the immunosensor was about 50 immunoassays; if stored unused its lifetime can be extended to three months. A sample speed of about 10-12 samples per hour can be attained. Possible interference from substances with structures similar to digoxin (morphine, heroin, tebaine, codeine, pentazocine and narcotine) was investigated. No cross-reactivity was seen at the highest digoxin: interferent ratio studied (1:100). The proposed fluoroimmunosensor was successfully used to determine digoxin concentrations in human serum samples.

Sindrome poiquilodermia congenita / Sindrome poiquilodermia congenita

El síndrome de poiquilodermia congénita, denominado también síndrome de Tothmund Thomson o poiquilodermia atrófica, es una genodermatosís rara que presenta una gama variada de manifestaciones clínicas, siendo las características más comunes: Estatura baja, eritema irregular que progresa a poiquilodermia, altraciones esqueléticas, cabellos escasos y catarata juvenil. Describimos el caso de un adolescente masculino de 13 años de edad que fue atendido en el Servicio de Pediatría del "Hospital Obrero N§ 3" - CNS, por presentar el mencionado síndrome.

Sexual behaviour of Zebu bulls in the humid tropics of Costa Rica: single versus multiple-sire groups.

This study compares the courtship and mounting behaviour of Bos indicus bulls in single- and multiple-sire groups in Costa Rica (latitude 10 degrees 25'N, longitude 84 degrees 32'W, annual precipitation of 3096mm, temperature of 24 degrees C and humidity of 85.3%). Four, 3-4 year-old Brahman bulls with previous sexual experience were used to sire a group of 120 multiparous cows (average of 128 days post-partum and a body condition score of 2.5) allocated to two groups of 60 each: (1) single-sire mating group (SSM) and (2) multiple-sire mating group of three bulls (MSM). Bulls were rotated among groups every 7 days for 28 days. The frequency, type and duration of sexual activities (mounting and mounting attempts) and courtship activities (smelling and licking genital area, butting, supporting the head over a female and the sign of Flehmen) were calculated for each mating group. Descriptive and non-parametric statistics (Wilcoxon, Mann-Withney tests) were used to calculate differences between mating programmes. Sexual activities tended to be more frequent in the SSM group than the MSM group (267 versus 124, P>0.05). Differences in the ratios of sexual to courtship activities between both groups were significant (1:3 in SSM and 1:6 in MSM, P>0.05). Pregnancy rate averages were 28 and 37%, respectively, (P>0.05). It is concluded that under these conditions multiple-sire mating and single-sire mating achieved similar pregnancy rates.

Effect of beta-lactamase inhibitors on minimum inhibitory concentration of ampicillin and amoxicillin for Staphylococcus aureus strains.

Seventy strains of Staphylococcus aureus isolated from the nasopharynx (80%), urinary tract (16%), skin (1 strain) and eyes (2 strains) of patients at the clinical laboratory "El eritrocito" were analyzed. Susceptibility to 12 antibiotics was tested by the method of Kirby-Bauer. Minimal inhibitory concentration (MIC) of ampicillin, ampicillin + sulbactam, amoxicillin and amoxicillin + clavulanic acid were determined by plate dilution. Percentages of resistance were: Penicillin and ampicillin (100%), ceftazidime (81.4%), erythromycin (68.6%), tetracycline (31.4%) trimethoprim-sulphametoxasol (25.7%), dicloxacillin and pefloxacin (12.8%), cefuroxime and cefotaxime (4.3%), gentamicin (2.8%), cephalothin (0%). All strains were resistant to three or more antibiotics, with higher percentages of resistance to four (31.4%), three (27.1%), five (21.4%) and six (12.9%) drugs. One strain was resistant to nine antibiotics and 5.9% were resistant to seven. 97.5% of the strains were beta-lactamase-positive. The MIC50 of ampicillin and amoxicillin was 500 micrograms/ml and the MIC90 were 1727 micrograms/ml and 2000 micrograms/ml, respectively. beta-lactamase inhibitors sulbactam and clavulanic acid reduced these values eightfold, except for the MIC50 of ampicillin + sulbactam whose reduction was sixteen fold. These results show that the combination of beta-lactamic + beta-lactamase inhibitor was more efficient than cephalosporins for killing these beta-lactamase-positive strains.

Chronic recurrent multifocal osteomyelitis: report of a case with epiphyseal and metaphyseal involvement.

Chronic recurrent osteomyelitis is a recognized clinicopathological entity with typical radiographic findings in the metaphyses of the long bones. Epiphyseal lesions usually are small and may easily be overlooked. Bone scintigraphy is helpful in identifying multiple lesions whether symptomatic or not. The diagnosis is one of exclusion without pathognomonic findings. Recognition of the condition is important to avoid treatment with antibiotics and repeated operations.

[Physiopathology, diagnosis and treatment of acute renal insufficiency]. / Fisiopatología, diagnóstico y tratamiento de la insuficiencia renal aguda.

Fifty-two clinical charts of children who had been discharged from this hospital, after being treated for acute renal failure, were analyzed to determine the incidence, presentation and results of the treatment used. We found that 0.7% of the total number of children admitted developed this complication and that 4/5 of them were under two years old. The initial illnesses were gastroenteritis, bronchial pneumonia, cyanogenic cardiopathies and sepsis. Some of the patients had hypoxic episodes or went into hypovolemic shock or a combination of both. In half of the patients diagnosis was reached from anamnesis, from of oliguria, acidosis and nitrogen retention. In the rest from whom a urine sample was obtained, the diagnosis was confirmed when the FeNa was higher than 2 and because the U/P osmolarity and urea were under 1.3 and 5 respectively. The oliguric type of acute renal failure was seen in 65% of the cases; the non-oliguric type in 35%. In the first group the mortality rate reached 6.5% even though a third of them were placed under dialysis. Yet, in another 7 cases, dialysis could not be used because the child was in shock. Of the 18 cases of non-oliguric acute renal failure, 12 recovered; only 3 required dialysis. We conclude that the high mortality rate in cases of acute renal failure depends on the severity of the underlying illness, the age of the patient and the delay in the diagnosis of the disease. The use of dopamine and furosemide, as well as the application of hemoperfusion instead place of peritoneal dialysis in neonates with sepsis, could improve results.

[DMF index in patients with end-stage kidney disease]. / Indice CPO en pacientes con enfermedad renal terminal.

In order to demonstrate the role of saliva with high concentration of urea and alkalinity, preventing dental caries in the uremic patients, 4 groups of children were studied: I healthy controls, II children with successful renal transplantation, III uremic children in dialysis and IV uremic children with conservative treatment. The results show a direct correlation between increase of saliva urea concentrations and decrease in saliva hydrogen ion concentration. Higher values of urea and more alkaline pH were found in children with uremia, with or without dialysis. Despite that there was not a statistically significant difference in the caries-lost-obturation index: 0.252 was found in the group of healthy controls and the lowest was 0.119, in the patients with uremia and dialysis. The results suggest that a protector role of saliva in uremic children is possible.

[Advances in the management of severe arterial hypertension]. / Avances en el manejo de la hipertensión arterial grave.

This article deals with current concepts about severe hypertension. This is defined by recorded values of more than 20 mmHg above the 97th percentile for weight and height. Exceptionally it is asymptomatic, abut most of the time presents with signs of hypertensive encephalopathy and/or hypertensive cardiopathy, cardiac failure and/or acute pulmonary edema. The most frequent causes in the Hospital Infantil de México Federico Gómez were: diffuse acute glomerulonephritis, segmental renal hypoplasia, renovascular hypertension and end-stage renal disease. First of all, on admission in the emergency room, the hypertensive child must be treated with rapid-acting drugs such as calcium channel blockers, sodium nitroprusside or diazoxide. Secondly, quick laboratory examinations as urinalysis, serum electrolytes and BUN must be performed to elaborate a presumptive diagnosis, in order to choice a therapy upon the pathophysiology. According to this thought, furosemide administration is mandatory in acute glomerulonephritis and could be supported by nifedipine. In renal hypoplasia and in renovascular hypertension the use of convertase enzyme inhibitors is indicated in the first place and may be supported by propranolol and/or diuretics. Finally, in hypertension due to end-stage renal disease, peritoneal dialysis with hypertonic solutions or ultrafiltration in chronic hemodialysis program are usually needed.

[Bone disorders in children with chronic renal insufficiency exposed to high ingestion of aluminum]. / Alteraciones óseas en niños con insuficiencia renal crónica expuestos a ingestión elevada de aluminio.

Bone disorders in 28 children with chronic renal failure exposed to aluminum intoxication were studied. All of the children were in the dialysis program. Aluminum blood levels were higher than normal in all of the children and without any correlation to the magnitude of hypocalcemia or with the increase of the parathormone, which were found in different amounts in all of the children. All of the children had various degrees of skeletal retardation and only one had pathological fractures. The bone biopsy showed hypocellular marrow, decreased osteoclastic activity in the majority of the cases same as trabecular mineralization, although the amount of osteoid was lacking in the trabeculae in the majority of the cases. The deposit of aluminum was detected in a great number of them. It is concluded that osteodystrophy recognizes a number of factors as may be hypocalcemia due to a decrease in the production of 1,25-cholecalciferol, an increase in the parathyroid hormone and the deposit of aluminum, coming mainly from water, in the trabeculae which interfere with the incorporation of calcium in the formation of new bone.

[Neurologic disorders in children with chronic terminal renal insufficiency]. / Alteraciones neurológicas en niños con insuficiencia renal crónica terminal.

Neurological alterations are very frequent in children with end stage renal disease (ESRD). In order to assess the type of these complications, a neurological study was undertaken in 30 children with ESRD. Three of the patients had convulsions and hyperreflexia was the only clinical sign found in all the patients. Low serum levels of hemoglobin and calcium and high concentrations of phosphates, aluminum and parathyroid hormone were found in all cases, but correlations with any neurological alteration were not made. Abnormal EEG with slow waves in the occipital region were obtained in 23 patients. Sensorial hypoacusia was registered in 6 children who were previously treated with aminoglucosides. The cerebral tomography showed calcifications in three instances, but only in one patient were of clinical significance. In five, out of the 30 patients, cerebral atrophy was detected. In conclusion, assessment of the neurological condition is mandatory in children with ESRD before renal transplantation is performed, since the complication itself or the therapy may interfere with rehabilitation.

[Psychosocial problems of children with chronic disease]. / Problemática psicosocial del niño con enfermedad crónica.

This presentation comprises: a) the study of psychosocial problems in children with chronic disease (1980-83); b) application and results of a "pluridimensional approach" model, designed to solve these conflicts (1982-88). Thirty-five children with end stage renal disease (ESRD) and 34 families were studied, as well as the members of the professional team. The methods of study were: conducted observations, projective tests, recording and analysis of psychotherapy (individual and familiar) and Balint sessions. The data were analized in the framework of psychoanalysis, theory of the systems and groups, etc. The results showed: depression, anguish and regression, interfering with rehabilitation, in the group of children. The problems worsening with greater length of the dialysis periods and with younger age of the patients. Poverty increases losses and guilty feelings decreasing the defensive and adaptive mechanisms. In the families, ESRD provoked migration, fragmentation, dynamic and structural dysfunctions and several inter and intrapersonal conflicts. In the professional team, tension, anxiety, compulsive and indiscriminate conducts were detected, as well as a great difficulty to communicate with the patients and their families. In an attempt to decrease these conflicts a pluridimensional approach was designed and applied in the patients, families and members of the professional team, with the aim of interrupt the pathologic interaction patterns and change them in therapeutic. This model included the practice of several independent and simultaneous psychological interventions, ergotherapy, recreative and occupational activities with the patients; group sessions for information, diagnostic interviews and psychotherapy with the families and Balint sessions with the professional team.(ABSTRACT TRUNCATED AT 250 WORDS)