Marginalization and tooth loss in older Mexican adults.

OBJECTIVE: To examine the association between the level of marginalization and tooth loss in adults aged ≥50 years in Mexico. METHODS: A retrospective cross­sectional study was conducted on 2098 adults selected from communities presenting both high and medium levels of marginalization, with data obtained from the annual reports of the Epidemiological Surveillance System of Oral Pathologies 2019-2022. Analysis considered sociodemographic characteristics such as sex, age, and years of education. The prevalence of tooth loss was determined using the Decayed, Missing and Filled teeth (DMFT) index. Negative binomial regression was used to estimate rate ratio (RR) and 95% confidence intervals (CIs), using the presence of lost teeth as an outcome. RESULTS: Most (62.4%) participants had lost at least one tooth, of whom 60.3% had a medium level of marginalization, 28.8% a high level, and 10.9% a very high level. More adults who lived in high or very high marginalization communities had lost teeth [RR=1.19 (95% CI 1.08 - 1.30)] than those living in communities with a medium level of marginalization. More males [RR=1.19 (95% CI 1.09 - 1.31)], adults ≥70 years [RR=1.77 (95% CI 1.57 - 1.99)], people who were illiterate [RR=1.60 (95% CI 1.35 - 1.88)] or who had poor oral hygiene [RR=1.26 (95% CI 1.15 - 1.38)] had also lost teeth. CONCLUSION: High and very high marginalization was associated with tooth loss in adults ≥50 years in Mexico. Effective oral health strategies are required to prevent tooth loss, as are interventions to improve access to and quality of dental services for marginalized communities.

[Glomus tumor of subungual presentation in the thumb and use of ultrasound in its diagnosis. Case report and literature review]. / Tumor glómico de presentación subungueal en pulgar y uso de ecografía en su diagnóstico. Reporte de caso y revisión de bibliografía.

INTRODUCTION: the glomus tumor is a benign neoplasm originated in the smooth muscle cells of the vascular glomus. Approximately 80% of lesions are located on the upper extremity and, of these, the majority are in the subungual area. The diagnosis must include imaging tests, among which ultrasound stands out, being a good alternative due to its low cost and accessibility. OBJECTIVE: we present a case of late diagnosis of surgically managed glomus tumor, as well as a review of the existing literature for diagnosis, treatment, and prognosis of this uncommon pathology. CLINICAL CASE: the case of a 52-year-old female patient who reported chronic, burning pain, radiating to the distal phalanx of the thumb with no history of trauma, of 2 years of evolution and which limited her daily life activities, is presented. The exploration with interphalangeal Doppler ultrasound is complemented, being an excellent alternative due to its easy accessibility. A glomus tumor was diagnosed in the interphalangeal thumb. An "H" approach was performed on the interphalangeal fold with subungual dissection with resection of the tumor piece and follow-up by an outpatient clinic where a surgical wound with adequate healing was found. Physical examination with capacity for the mobilization of the distal interphalangeal joint (IFJ) and visual analogue scale (VAS) 1 point. The updated pathological evaluation of the existence of a glomus tumor. CONCLUSIONS: ultrasound is an excellent aid in the diagnosis, as well as in the surgical planning for the treatment of the glomus tumor; for being accessible, low cost and highly effective. The anatomopathological study is the gold standard.

INTRODUCCIÓN: el tumor glómico es una neoplasia benigna originada en las células musculares lisas del glomus vascular. Aproximadamente 80% de las lesiones se localiza en la extremidad superior y, de éstas, la mayoría se sitúa en la zona subungueal. El diagnóstico debe incluir exámenes de imágenes, entre los que destaca la ecografía, siendo una buena alternativa por su bajo costo y accesibilidad. OBJETIVO: presentamos un caso de diagnóstico tardío de tumor glómico manejado quirúrgicamente, así como revisión de la literatura existente para diagnóstico, tratamiento y pronóstico de esta patología poco común. CASO CLÍNICO: paciente femenino de 52 años que refería un dolor crónico, ardoroso, irradiado hacia falange distal del pulgar sin antecedente traumático, de dos años de evolución y que limitaba actividades de su vida diaria. Se complementa exploración con ultrasonido Doppler interfalángico siendo una excelente alternativa por su fácil accesibilidad. Se diagnostica tumor glómico en interfalángica pulgar. Se realiza abordaje en "H" sobre pliegue interfalángico con disección subungueal con resección de pieza tumoral y seguimiento por consulta externa donde se encuentra herida quirúrgica con adecuada cicatrización. Exploración física con capacidad para la movilización de movilización de la articulación interfalángica distal (IFD) y escala visual análoga (EVA) de 1 punto. La evaluación anatomopatológica informó la existencia de tumor glómico. CONCLUSIONES: la ecografía es una excelente ayuda en el diagnóstico, así como en la planificación operatoria para el tratamiento del tumor glómico, por ser accesible, de bajo costo y de alta efectividad. El estudio anatomopatológico es el estándar de oro que da la certeza diagnóstica.

Pacientes con afectación ganglionar inicial por cáncer de mama que han recibido quimioterapia neoadyuvante: técnica combinada ganglio centinela-cirugía radioguiada del ganglio patológico / Patients with initial nodal involvement due to breast cancer who have received neoadjuvant chemotherapy: Combined sentinel node-radioguided surgery of the pathological node

Objetivo Estudiar la viabilidad y utilidad de la técnica combinada biopsia selectiva de ganglio centinela (BSGC)-biopsia radioguiada del ganglio patológico en pacientes con cáncer de mama y afectación axilar sometidas a quimioterapia neoadyuvante (QTNA). aterial y métodos Estudio prospectivo en el que se incluyeron 30 pacientes con cáncer de mama y estadificación axilar cN1, con indicación de QTNA. El ganglio biopsiado se marcó (GBM) mediante un clip, antes del tratamiento QTNA. Tras completar este se valoró la respuesta axilar con ecografía. En caso de buena respuesta ecográfica se procedió a realizar BSGC (99mTc-nanocoloides) y disección axilar dirigida mediante biopsia radioguiada del GBM (99mTc-macroagregados albúmina). Se procedía a realizar una linfadenectomía axilar si el ganglio centinela (GC) y/o el GBM contenían células tumorales. Se evaluaron las tasas de localización-exéresis del GC y del GBM. También se evaluaron la tasa de falsos negativos y el valor predictivo positivo de la BSGC sola. Resultados Se extirpó el GC en todas las pacientes, mientras que el GBM se extirpó exitosamente en 27 (90%). El GC coincidió con el GBM en 15 pacientes (50%). En 12 pacientes el GC fue negativo pero el GBM fue positivo para metástasis, lo que comportó una tasa de falsos negativos del 44,4% y un valor predictivo positivo del 37% para la BSGC sola. Tanto el GC como el GBM resultaron negativos en 5 pacientes (18,5%), lo que permitió evitar realizarles la linfadenectomía axilar. Conclusiones La técnica combinada descrita BSGC-biopsia radioguiada del ganglio patológico es un procedimiento útil y accesible para la reestadificación precisa de la axila tras QTNA, evitando la alta tasa de falsos negativos de la BSGC sola en este grupo de pacientes y evitando un número mayor de linfadenectomías axilares (AU)

Objective To study the feasibility and usefulness of the combined technique selective sentinel lymph node biopsy (SLNB)-radioguided biopsy of the pathological lymph node in patients with breast cancer and axillary involvement undergoing neoadjuvant chemotherapy (NAC). Material and methods Prospective diagnostic study of 30 patients with breast cancer and cN1 axillary staging with NACT indication. Before NACT, the biopsied node was marked with a clip (MBN). After NACT an ultrasound was performed and in case of good response a SLNB (99mTc-nanocolloids) plus targeted axillary dissection MBN pathologic node radioguided biopsy (99mTc-albumin macroaggregates) was performed. Axillary lymph node dissection was performed if SLNB and/or MBN were positive for tumor cells. The localization-removal rate of the sentinel lymph node (SLN) and MBN were evaluated. False-negative rate and positive predictive value of SLNB alone were also evaluated. Results Thirty patients were included in the study. SLN could be detected in all patients while MBN was successfully removed in 27 (90%). The SLN coincided with MBN in 15 patients (50%). In 12 patients SLNB was negative while MBN positive, leading to a FNR of 44,4% for SLNB alone. We found a positive predictive value of 37% for the SLNB. In 5 patients (18,5%) both SLNB and MBN were negative, avoiding axillary lymph node dissection. Conclusions SLNB-MBN radioguided biopsy combined technique is a useful and accessible procedure for accurate axillary restaging after NACT, avoiding the high rate of false-negative rate of SLNB alone in this group of patients and avoiding a great number of axillary lymph node dissection (AU)

Patients with initial nodal involvement due to breast cancer who have received neoadjuvant chemotherapy: Combined sentinel node-radioguided surgery of the pathological node.

OBJECTIVE: To study the feasibility and usefulness of ultrasound-guided pre-chemotherapy marking of pathologic lymph node followed by sentinel lymph node biopsy (SLNB)-pathologic node radioguided biopsy (ROLL) combined technique, in axillary involvement breast cancer patients undergoing neoadjuvant chemotherapy (NACT). MATERIAL AND METHODS: Prospective diagnostic study of 30 patients with breast cancer and cN1 axillary staging with NACT indication. Before NACT, the biopsied node was marked with a clip (MBN). After NACT an ultrasound was performed and in case of good response a SLNB (99mTc-nanocolloids) plus targeted axillary dissection MBN ROLL biopsy (99mTc-albumin macroaggregates) was performed. Axillary lymph node dissection (ALND) was performed if SLNB and/or MBN were positive for tumor cells. The localization-removal rate of the sentinel lymph node (SLN) and MBN were evaluated. False-negative rate (FNR) and positive predictive value (PPV) of SLNB alone were also evaluated. RESULTS: Thirty patients were included in the study. SLN could be detected in all patients while MBN was successfully removed in 27 (90%). The SLN coincided with MBN in 15 patients (50%). In 12 patients SLNB was negative while MBN positive, leading to a FNR of 44.4% for SLNB alone. We found a PPV of 37% for the SLNB. In 5 patients (18.5%) both SLNB and MBN were negative, avoiding ALND. CONCLUSIONS: SLNB-MBN radioguided biopsy ROLL combined technique is a useful and accessible procedure for accurate axillary restaging after NACT, avoiding the high rate of FNR of SLNB alone in this group of patients and avoiding a great number of ALND.

Análisis y mejora de la adherencia terapéutica en una farmacia comunitaria de Ourense / Analysis and improvement of therapeutic adherence in a community pharmacy in Ourense

Objetivos: evaluar la adherencia terapéutica de pacientes con patologías prevalentes, identificandofactores relacionados. Cuantificar la mejora en la adherencia conseguida mediante servicios profesionalesfarmacéuticos (SPF). Comprobar la satisfacción con el servicio.Métodos: diseño: 1ª fase: estudio monocéntrico, descriptivo, longitudinal, realizado entre 18/3y 10/4/2019. 2ª fase: estudio cuasiexperimental sin grupo control, con intervención educativa y SPF,revisión del uso de la medicación (RUM) y sistemas personalizados de dosificación (SPD), octubre-noviembre/2019.Sujetos: pacientes mayores de edad con dislipemia, hipertensión o diabetes, que acudieron a lafarmacia y aceptaron participar. Para la 2ª fase se seleccionaron pacientes que resultaron no adherentesen la 1ª.Variables: adherencia (medida con el test Morisky-Green), satisfacción con el servicio. Variables demográficas.Resultados: 1ª fase: 101 pacientes, media de edad de 69 años. 50,5% hombres. La proporción deno adherentes fue del 55,4%. 40 (71,4%) olvidan alguna vez tomar sus medicamentos. La adherenciano resultó relacionada con sexo, edad, acompañamiento, número de patologías o nivel de estudios(p>0,05).2ª fase: RUM: el porcentaje de no adherentes disminuyó al 67%. SPD: 9 de los 10 pacientes resultaron adherentes al final del estudio. 1 paciente resultó no adherente por olvidar esporádicamente algunatoma.El 100% de las encuestas de satisfacción dio como resultado “muy satisfechos”, continuarían visitando la farmacia y la recomendarían.Conclusiones: la adherencia terapéutica resulto baja, menor del 50%. No se encontró relación con losfactores analizados. (AU)

Diversity, Co-Occurrence, and Nestedness Patterns of Sand Fly Species (Diptera: Psychodidae) in Two Rural Areas of Western Panamá.

Cutaneous Leishmaniasis transmission in the New World is observed in areas with rich sand fly species' faunas. The diversity and composition of sand fly species can change in response to seasonal weather and land use changes. Here, we present results from a two-year-long study where we collected, using Centers for Disease Control (CDC) light traps, sand flies from two rural areas, Las Pavas (LP) and Trinidad de las Minas (T) in western Panamá. Over 710 trap-nights, we collected 16,156 sand flies from 15 genera and 35 species. We identified 34 species in T, and the most abundant species collected was Nyssomyia trapidoi (Fairchild and Hertig, 1952) (n = 2278, 37%), followed by Psychodopygus panamensis (Shannon, 1926) (n = 1112, 18%), and Trichopygomyia triramula (Fairchild and Hertig, 1952) (n = 1063, 17%). In LP, we identified 26 species, and the most abundant species collected were Ty. triramula (n = 4729, 48%), and Ps. panamensis (n = 3444, 35%). We estimated a higher species' richness in T (Chao2 ± S.E.: 36.58 ± 3.84) than in LP (27.49 ± 2.28). In T, species' richness was significantly higher in the rainy season, but no seasonal differences were observed in LP. Species' assemblages were nested in the two areas. Phlebotomine sand fly species' abundance increased at the two sites during the rainy season. Our data suggest that seasonality is more important than land use as a factor driving sand fly species' diversity at the studied sites.

Biological Approaches in Polyhydroxyalkanoates Recovery.

Polyhydroxyalkanoates (PHA) are bio-based polymers with the potential of replace petrochemical plastics. Nevertheless, PHA commercialization is still low, due to the high production cost associated with industrial-scale development. The most cost/efficient PHA recovery strategies use organochlorine compounds or harsh reagents implying a high environmental impact. Therefore, the importance of developing an economical and efficient recovery strategy cannot be overestimated. Thus, new approaches have been reported that look for creating a sustainable production process, such as biological recovery, PHA secretion or predator bacteria. Moreover, if bioplastics would become the plastics of the future, it must be necessary to replace the traditional PHA extraction methods by environmentally friendly options. Hence, the aim of this review is to analyze trends in the development of efficient technologies for the sustainable recovery of polyhydroxyalkanoates (PHA) produced by microorganisms.

Assessing the growth of Arctic charr (Salvelinus alpinus) (Linnaeus, 1758) in four salinities, under experimental conditions / Avaliando o crescimento do Charr Ártico (Salvelinus alpinus) (Linnaeus, 1758) em quatro salinidades, sob condições experimentais

Abstract Studies in Salvelinus alpinus, Arctic charr, indicate that it has a low capacity to hyposmorregulatory or adaption to sea in winter periods in Arctic waters. The investigation finds to determinate the rank optimum of salinity to can cultivate this species at Chile. The weight adequate was determined to join on the sea by analysis of gill Na+, K+-ATPase activity, that it was found between the ranks 80-130 g, with 14.5 U/mg. It underwent evaluation of fish growth of 72 g salinities from 0 (control), 18, 25 and 33 g/L (sea water) for 94 days. The results indicate that the largest increases were obtained in brackish water. T18 g/L and T25 g/L achieved growth of 25% and 19% on day 94 and term sampling respectively. It is important to mention that the 8% that survived in seawater introduced percentages growth 16.6% equivalent to brackish water and control. These results suggest that Salvelinus alpinus can grow in seawater, with levels of Na+, K+-ATPase similar to those submitted by Salmo salar with a weight not less than 80 g.

Resumo Estudos em Salvelinus alpinus, Charr Ártico, indicam que tem baixa capacidade de hiposmorregulação ou adaptação ao mar em períodos de inverno nas águas do Ártico. A investigação determina o melhor nível de salinidade para cultivar esta espécie no Chile. Determinou-se o peso adequado para se unir ao mar pela análise da atividade da Na +, K + -ATPase das brânquias, que foi encontrada entre as faixas de 80 a 130 g, com 14,5 U/mg. Foi avaliado o crescimento de 72 g salinidades de 0 (controle), 18, 25 e 33 g/L (água do mar) por 94 dias. Os resultados indicam que os maiores aumentos foram obtidos em água salobra. T18 g/L e T25 g/L alcançaram crescimento de 25% e 19% no dia 94 e amostragem a termo, respectivamente. É importante mencionar que os 8% que sobreviveram na água do mar apresentaram percentuais de crescimento de 16,6% equivalentes a água salobra e controle. Estes resultados sugerem que o Salvelinus alpinus pode crescer em água do mar, com níveis de Na +, K + -ATPase semelhantes aos apresentados por Salmo salar com um peso não inferior a 80 g.

Involvement of the Inflammasome and Th17 Cells in Skin Lesions of Human Cutaneous Leishmaniasis Caused by Leishmania (Viannia) panamensis.

Localized cutaneous leishmaniasis (LCL) caused by Leishmania (Viannia) panamensis is an endemic disease in Panama. This condition causes ulcerated skin lesions characterized by a mixed Th1/Th2 immune response that is responsible for disease pathology. However, the maintenance of the in situ inflammatory process involves other elements, such as Th17 and inflammasome responses. Although these processes are associated with parasite elimination, their role in the increase in disease pathology cannot be discarded. Thus, the role in Leishmania infection is still unclear. In this sense, the present study aimed at characterizing the Th17 and inflammasome responses in the skin lesions of patients with LCL caused by L. (V.) panamensis to help elucidate the pathogenesis of this disease in Panama. Th17 and inflammasome responses were evaluated by immunohistochemistry (IHQ) in 46 skin biopsies from patients with LCL caused by L. (V.) panamensis. The Th17 immune response was assessed using CD3, CD4, RoRγt, IL-17, IL-6, IL-23, and TGF-ß1 antibodies, and the inflammasome response was assessed by IL-1ß, IL-18, and caspase-1 antibodies. The presence of the Th17 and inflammasome responses was evidenced by a positive reaction for all immunological markers in the skin lesions. An inverse correlation between the density of amastigotes and the density of RoRγt+, IL-17+, IL-1ß +, and caspase-1+ cells was observed, but no correlation between Th17 and the inflammasome response with evolutionary disease pathology was reported. These data showed the participation of Th17 cells and the inflammasome in the inflammatory response of the skin lesions of LCL caused by L. (V.) panamensis infection. These results suggest a role in the control of tissue parasitism of IL-17 and the activation of the NLRP3 inflammasome dependent on IL-1ß but cannot exclude their role in the development of disease pathology.

Canine systemic mycosis associated with Chaetomium globosum in a dog.

BACKGROUND: Disseminated mycoses other than aspergillosis are infrequently reported in dogs. CASE REPORT: A 4-year-old female Labrador retriever was evaluated because of hyperthermia, cough and intermittent lameness. Computed tomography showed a soft tissue mass in the cranioventral mediastinum, severe left and central tracheobronchial lymphadenopathy, and moderate bilateral pleural effusion. Magnetic resonance imaging identified an irregular intra-axial well-defined contrast enhancing mass extending from the right frontal lobe to the right thalamus. Fungal culture yielded growth of Chaetomium globosum. CONCLUSION: In this case, the authors report a systemic mycosis in a Labrador retriever caused by C. globosum. To the best of authors' knowledge, this is the first report of systemic disease by this species in veterinary medicine.

Assessing the growth of Arctic charr (Salvelinus alpinus) (Linnaeus, 1758) in four salinities, under experimental conditions.

Studies in Salvelinus alpinus, Arctic charr, indicate that it has a low capacity to hyposmorregulatory or adaption to sea in winter periods in Arctic waters. The investigation finds to determinate the rank optimum of salinity to can cultivate this species at Chile. The weight adequate was determined to join on the sea by analysis of gill Na+, K+-ATPase activity, that it was found between the ranks 80-130 g, with 14.5 U/mg. It underwent evaluation of fish growth of 72 g salinities from 0 (control), 18, 25 and 33 g/L (sea water) for 94 days. The results indicate that the largest increases were obtained in brackish water. T18 g/L and T25 g/L achieved growth of 25% and 19% on day 94 and term sampling respectively. It is important to mention that the 8% that survived in seawater introduced percentages growth 16.6% equivalent to brackish water and control. These results suggest that Salvelinus alpinus can grow in seawater, with levels of Na+, K+-ATPase similar to those submitted by Salmo salar with a weight not less than 80 g.

Mobbing perception among Intensive Care Unit nurses. / Percepción del mobbing entre el personal de enfermería de la Unidad de Cuidados Intensivos.

AIM: to determine the perception of intensive care unit nursing staff on mobbing. METHOD: qualitative approach study, Grounded Theory was used, 12intensive care unit nurses of 2public hospitals in our country during December 2017. RESULTS: female sex predominated with an average age of 41.33 years old, mostly married, on night shift and trained a nursing technicians; 4categories emerged: general knowledge about mobbing, the origin of mobbing and its main actors, experiences of mobbing as a victim and as a spectator and the implications of mobbing in working life. DISCUSSION: issues of workplace harassment are sensitive for most health workers, since they deal with private situations and lack of support from superiors when they have been victims of harassment. The evidence shows that one of the reasons why mobbing can be perceived in different ways is because little is known about the real concept, it can be associated with multiple forms of violence and there is heterogeneity in the use of the term. CONCLUSION: the majority of intensive care unit nursing staff have been victims and witnesses of mobbing behaviour, with negative repercussions on their job satisfaction and performance; It is also the cause of constant staff turnover.

Performance of immunohistochemistry as a useful tool for the diagnosis of cutaneous leishmaniasis in Panama, Central America.

Cutaneous leishmaniasis (CL) is one of the most frequent parasitic zoonoses in Panama. Currently, conventional, molecular and histopathological tests are performed to diagnose CL. Immunohistochemistry (IHC) has proven to be a valuable tool to facilitate the diagnosis of leishmaniasis and to study the cellular immune response developed during the infection. Therefore, considering the absence of IHC in the diagnostic routine in Panama, the objective of this study is to demonstrate the usefulness of this test as a complementary diagnostic tool for improving the sensitivity of histopathology (HP) and helping to study the cellular immune response of patients. Samples from patients with suspected CL were analysed by intradermal reaction of Montenegro (IDRM), smears, culture, PCR (Viannia, Hsp-70), HP and IHC. According to the diagnostic criteria, 95.8% of patients were positive for Leishmania sp., that was characterized as Leishmania (V.) panamensis by PCR-HSP70/RFLP. From positive samples, Leishmania was detected by the tested diagnostic methods in the following degrees: 100% by IDRM, 60% by smears, 93.3% by culture, 100% by kDNA PCR, 78.3% by PCR Hsp-70, 50% by HP and 73.9% by IHC. Although IHC had a poor correlation (k = 0.191) with the diagnostic criteria, the sensitivities of both HP (76.1%) and smears (89.1%) were improved by combining them with IHC. IHC considerably improved the detection of the Leishmania parasites in the histopathological sections, supporting the need to implement this diagnostic tool in Panama. In addition, immunohistochemistry allows evaluation of the patient's immune response and thus provides new guidelines for the treatment and control of CL in Panama.

Surgical Management of a Firearm Injury in the Infraorbital Area / Manejo quirúrgico de una herida por arma de fuego en el área infraorbitaria

Abstract The surgical management of firearm injuries to the zygomaticomaxillary complex is a topic that needs to be addressed with much care. The complications that can arise during treatment, as well as the potential residual problems that can appear, lead to the need of recognizing these injuries as a maxillofacial treatment challenge. The infraorbital zone is the second most common area of injury in the face, accounting for up to 45% of midfacial fractures. The case presented is of a 54 year old man affected by the backward firing of a gun rifle that caused an oblique impaction towards the posterior lateral inferior side of the infraorbital complex. He was rapidly stabilized with an antibiotic and analgesic scheme, yet presented the following: a comminute fracture of the orbit floor with consequent communication towards the maxillary sinus, a non-displacing fracture of the frontomalar suture, a non-displacing fracture of the zygomatic arch and a lesion with loss of osseous tissue in the petrous region of the temporal bone. Rigid fixation followed stabilization, and the area was covered with a titanium mesh. Occasional tinnitus and photopsia were reported by the patient upon return, yet all other evaluated factors were in order. There have been different forms of management described in the literature, and it is recognized that each patient has different needs, therefore each case must be closely evaluated, so it is approached in the most appropriate manner.

Resumen El manejo quirúrgico de las lesiones por armas de fuego al complejo cigomaticomaxilar representa una situación compleja en la práctica maxilofacial que debe ser abordada con extrema cautela, debido a las complicaciones que pueden surgir durante el tratamiento y los potenciales problemas residuales. La zona infraorbitaria es la segunda área más común de lesiones en la cara, representando hasta 45% de las fracturas mediocraneales. El presente caso es de un masculino de 54 años de edad, que sufrió trauma ocasionado por la parte trasera de un rifle de caza que causó un impacto en sentido oblicuo hacia el lado lateral inferior del complejo infraorbitario. El paciente fue estabilizado con esquema antibiótico y analgésico, el diagnóstico fue: fractura cominuta del piso de la órbita, con consecuente comunicación al seno maxilar, fractura no desplazada de la sutura frontomalar, fractura no desplazada del arco cigomático, y lesión con pérdida de tejido óseo en la región petrosa del hueso temporal. El tratamiento quirúrgico consistió en reducción de las fracturas y fijación rígida de las estructuras. Al control post operatorio el paciente refirió acufenos y fotopsia ocasional, no presentando otras alteraciones. Se ha descrito en la literatura diferentes abordajes para el manejo de estos traumatismos, sin embargo cada caso debe ser individualizado y evaluado de forma minuciosa para que éste, sea el adecuado.

Improved outcomes for inborn babies with uncomplicated gastroschisis.

INTRODUCTION: Gastroschisis (GS) is a common abdominal wall defect necessitating neonatal surgery and intensive care. We hypothesized that inborn patients had improved outcomes compared to patients born at an outside hospital (outborn) and transferred for definitive treatment. METHODS: A single center, retrospective chart review at a pediatric tertiary care center was performed from 2010 to 2015. All patients whose primary surgical treatment of GS was performed at this center were included. We compared patients delivered within our center (inborn) to patients delivered outside of our center and transferred for surgical care (outborn). Babies with complicated gastroschisis were excluded. RESULTS: During the study period 79 patients with GS were identified. Of these, 53 were inborn and 26 were outborn. Sixteen patients were excluded for complicated GS. The rate of complicated GS was higher in the outborn group (32%) compared to the inborn population (11%) (p=0.03). Duration of stay, readmission rate and time on TPN were all significantly decreased for inborn patients, while time to definitive closure was similar. Mortality was 0% for both inborn and outborn patients. CONCLUSION: Patients with uncomplicated GS seem to benefit from delivery with immediate pediatric surgical care available eliminating the need for transfer. LEVEL OF EVIDENCE: III.

Assessing the growth of Arctic charr (Salvelinus alpinus) (Linnaeus, 1758) in four salinities, under experimental conditions

Abstract Studies in Salvelinus alpinus, Arctic charr, indicate that it has a low capacity to hyposmorregulatory or adaption to sea in winter periods in Arctic waters. The investigation finds to determinate the rank optimum of salinity to can cultivate this species at Chile. The weight adequate was determined to join on the sea by analysis of gill Na+, K+-ATPase activity, that it was found between the ranks 80-130 g, with 14.5 U/mg. It underwent evaluation of fish growth of 72 g salinities from 0 (control), 18, 25 and 33 g/L (sea water) for 94 days. The results indicate that the largest increases were obtained in brackish water. T18 g/L and T25 g/L achieved growth of 25% and 19% on day 94 and term sampling respectively. It is important to mention that the 8% that survived in seawater introduced percentages growth 16.6% equivalent to brackish water and control. These results suggest that Salvelinus alpinus can grow in seawater, with levels of Na+, K+-ATPase similar to those submitted by Salmo salar with a weight not less than 80 g.

Resumo Estudos em Salvelinus alpinus, Charr Ártico, indicam que tem baixa capacidade de hiposmorregulação ou adaptação ao mar em períodos de inverno nas águas do Ártico. A investigação determina o melhor nível de salinidade para cultivar esta espécie no Chile. Determinou-se o peso adequado para se unir ao mar pela análise da atividade da Na +, K + -ATPase das brânquias, que foi encontrada entre as faixas de 80 a 130 g, com 14,5 U/mg. Foi avaliado o crescimento de 72 g salinidades de 0 (controle), 18, 25 e 33 g/L (água do mar) por 94 dias. Os resultados indicam que os maiores aumentos foram obtidos em água salobra. T18 g/L e T25 g/L alcançaram crescimento de 25% e 19% no dia 94 e amostragem a termo, respectivamente. É importante mencionar que os 8% que sobreviveram na água do mar apresentaram percentuais de crescimento de 16,6% equivalentes a água salobra e controle. Estes resultados sugerem que o Salvelinus alpinus pode crescer em água do mar, com níveis de Na +, K + -ATPase semelhantes aos apresentados por Salmo salar com um peso não inferior a 80 g.

Maleimide-grafted cellulose nanocrystals as cross-linkers for bionanocomposite hydrogels.

This article deals with the preparation of bionanocomposite hydrogels from natural polymers and nanoentities, an emerging class of materials for biotechnological and biomedical applications. Herein, the applicability of the Diels-Alder "click" reaction to the design of bionanocomposite hydrogels from furan modified gelatin using maleimide-functionalized cellulose nanocrystals as multifunctional cocross-linkers is demonstrated. The functionalization of cellulose nanocrystals with maleimide moieties was confirmed by XPS. The swelling and rheological properties of the resulting bionanocomposite confirmed the formation of hydrogel networks with covalently embedded nanoentities. The Diels-Alder reaction resulted in the formation of stiffer networks with lower swelling ratios due to the formation of additional cross-linking points. The designed "click" strategy proved to be a promising candidate for the formation of fully renewable bionanocomposite hydrogels.

Incremental cost of implementing residual insecticide treatment with delthametrine on top of intensive routine Aedes aegypti control

Objectif: Les informations sur le coût de l'implémentation du traitement à insecticide résiduel (TIR) pour la lutte contre lAedes sont rares. Nous avons évalué le coût supplémentaire, en plus de celui des activités intensives conventionnelles de routine du programme de lutte contre Aedes (ACP) dans la ville de Santiago de Cuba, à Cuba. Méthodes: Nous avons mené létude d'analyse des coûts en 2011-2012, dans la perspective de lACP. Les sources des données étaient les registres de comptabilité, les registres d'activité du Centre ACP provincial et les comptes d'une étude d'implémentation du TIR dans 21 regroupements de 4 blocs de maisons en moyenne, comprenant 5.180 prémisses. Résultats: Le coût annuel des activités de routine de lACP était de 19,66 $ US par ménage. Les applications de TIR espacées de 4 mois d'intervalles, avec une couverture de 97,2 percent en moyenne et utilisant 8,5 g de deltaméthrine par an et par ménage, coûtent 3,06 $ US par ménage et par an. Le deltaméthrine constituait 66,5 percent de ce coût; le coût supplémentaire pour le déploiement du TIR constituait 15,6 percent du coût de routine totale de lACP et 27 percent du coût lié à la lutte de routine contre le stade adulte de lAedes. Conclusions: Le coût incrémental de l'implémentation du TIR est élevé. Il devrait être jaugé par rapport à l'effet incrémental sur la charge de morbidité causée par la panoplie d'agents pathogènes transmis par lAedes. Le coût pourrait être réduit si l'insecticide devenait moins cher, en limitant le nombre d'applications annuelles ou en ciblant les foyers importants de transmission(AU)