Adverse Reactions Associated with Dermal Fillers in the Oral and Maxillofacial Region: A Venezuelan Experience.

BACKGROUND: Dermal facial fillers are increasingly popular. Published reports on the clinical and histopathologic characteristics related to adverse reactions to dermal fillers in the facial region have been relatively well documented. This study adds to the literature on adverse reactions to injected filler in the oral and maxillofacial region in a South American population. METHODS: A retrospective, descriptive cross-sectional study (2019-2020) was performed. The study population was a dermatology service in Venezuela. Clinical and histopathologic features of patients with adverse effects were documented. RESULTS: A total of 35 cases of adverse reactions associated with cosmetic filler procedures were diagnosed during the analyzed period; of these, six cases (17.1%) involved the oral and maxillofacial region. All cases occurred in women. The mean age at diagnosis was 59.3 years (58-73). In three cases, dermal fillers were used in different locations on the face, while three involved the lips. Five patients exhibited adverse reactions to lip filler. All six cases were histopathologically diagnosed as foreign body reactions to injected material. Four and two cases revealed microscopic features compatible with hyaluronic acid and polymethylmethacrylate, respectively. CONCLUSION: Reflecting the dramatic increase in cosmetic procedures with soft tissue fillers, this study contributed by reporting six cases of foreign body reaction involving the oral and maxillofacial region, confirmed with biopsy and histopathology.

Simulation of soil water balance and partitioning of evapotranspiration of maize grown in two growing seasons in Southern Brazil / Simulação do balanço hídrico do solo e particionamento da evapotranspiração do milho cultivado em duas épocas de semeadura no Sul do Brasil

ABSTRACT: The objective of this study was to simulate the variation of the available soil water during maize crop growth, in two different sowing times (first and second growing season), using a drip irrigation system. The treatments consisted of different irrigation strategies (full to deficit). The SIMDualKc simulation model was used to determine the daily soil water balance and crop evapotranspiration using the dual crop coefficient approach. Soil, climate, crop and irrigation parameters were used as input data. Two experiments were carried out in a rainout shelter composed of two metallic structures (16x10m) in the city of Santa Maria, Rio Grande do Sul, Brazil, during 2010/11 (second crop, season 1) and 2011/12 (first crop, season 2) growing seasons, under no-tillage system. The simulations showed that all the irrigation management strategies used in season 2 resulted in soil water deficit, while only two strategies showed deficit in season 1. Results showed good agreement between observed and simulated soil water data, with an R2 ranging from 0.86 to 0.99 and the root mean square error ranging from 2.7 to 5.6% of the total available water for seasons 1 and 2, respectively. The observed results of water balance showed that maize grown in season 2 presented higher water consumption compared to season 1, due to the higher atmospheric demand of season 2. The SIMDualKc model allowed the partitioning of crop evapotranspiration into soil evaporation and crop transpiration, demonstrating that the vegetative growth subperiod presented the greatest differences between the two seasons compared to the others growth phases.

RESUMO: O objetivo deste estudo foi simular a variação da água disponível no solo durante o desenvolvimento da cultura do milho, em duas épocas de semeadura diferentes (primeira e segunda safra), utilizando sistema de irrigação por gotejamento. Os tratamentos consistiram em diferentes estratégias de irrigação (plena e deficitária). O modelo de simulação SIMDualKc foi utilizado para determinar o balanço hídrico diário do solo e a evapotranspiração da cultura usando a abordagem do coeficiente cultura dual. Os parâmetros de solo, clima, cultura e irrigação foram utilizados como dados de entrada. Dois experimentos foram realizados em uma cobertura móvel composta por duas estruturas metálicas (16x10m) na cidade de Santa Maria, Rio Grande do Sul, Brasil, nas safras 2010/11 (segunda safra, época 1) e 2011/12 (primeira safra, época 2), sob sistema de plantio direto. As simulações mostraram que todas as estratégias de manejo de irrigação usadas na época 2 resultaram em déficit hídrico, enquanto que apenas duas estratégias apresentaram déficit na época 1. Os resultados mostraram boa concordância entre os dados de água no solo observados e simulados, com um R2 variando de 0.86 a 0.99 e raiz quadrada do erro médio variando de 2,7 a 5,6% da água total disponível para as épocas 1 e 2, respectivamente. Os resultados observados do balanço hídrico mostraram que o milho cultivado na época 2 apresentou maior consumo de água em comparação com a época 1, devido à maior demanda atmosférica da época 2. O modelo SIMDualKc permitiu a partição da evapotranspiração da cultura em evaporação do solo e transpiração da cultura, demonstrando que o subperíodo de crescimento vegetativo apresentou as maiores diferenças entre as duas épocas em relação às demais fases de crescimento.

Tensiones y contradicciones en la intervención gubernamental para la promoción de la lactancia materna / Tensions and contradictions in government interventions for the promotion of breastfeeding

RESUMEN Con el propósito de esclarecer el abandono de la lactancia materna en zonas rurales de México, se aborda el modelo biomédico vigente y las políticas y acciones para la promoción de la lactancia materna que se derivan de su enfoque teórico, y se discuten las estrategias operativas del programa gubernamental de beneficio social Oportunidades. Para ello se retoman los testimonios de 39 madres jóvenes lactantes, 11 mujeres madres abuelas y 12 miembros del personal sanitario de la población náhuatl de Cuentepec, Morelos, México, recabados en un trabajo de investigación previo, realizado entre 2008 y 2009. Se constató que el modelo biomédico, que permea todas las acciones de promoción de lactancia materna, cosifica a las personas, limita la comunicación, devalúa los saberes tradicionales de las mujeres e impone un discurso que paulatinamente desalienta dicha práctica. Se propone adoptar un cambio epistémico del pensamiento biomédico que transite del paradigma de la simplicidad al de la complejidad, para lograr un acercamiento mayor a la comprensión de los procesos bio-psico-socio-culturales propios del ser humano.

ABSTRACT With the purpose of shedding light on the decrease in the practice of breastfeeding in rural areas of Mexico, this article looks at the current biomedical model and the policies and actions to promote breastfeeding derived from the model's theoretical approach. The article also discusses operational strategies of the governmental social welfare program Oportunidades. For this purpose, the study utilizes the testimonies of 39 young breastfeeding mothers, 11 mothers and grandmothers and 12 members of the health staff in the Nahuatl population of Cuentepec, Morelos, Mexico, which were collected during a previous study in 2008 and 2009. It was found that the biomedical model, which permeates all actions to promote breastfeeding, reifies people, limits communication, devaluates women's traditional knowledge and imposes a discourse that gradually discourages the practice of breastfeeding. The article's proposal is to adopt an epistemic change in biomedical thought that shifts from a paradigm of simplicity to one of complexity, with the purpose of achieving a greater understanding of the bio-psycho-socio-cultural processes of human beings.

[Tensions and contradictions in government interventions for the promotion of breastfeeding]. / Tensiones y contradicciones en la intervención gubernamental para la promoción de la lactancia materna.

With the purpose of shedding light on the decrease in the practice of breastfeeding in rural areas of Mexico, this article looks at the current biomedical model and the policies and actions to promote breastfeeding derived from the model's theoretical approach. The article also discusses operational strategies of the governmental social welfare program Oportunidades. For this purpose, the study utilizes the testimonies of 39 young breastfeeding mothers, 11 mothers and grandmothers and 12 members of the health staff in the Nahuatl population of Cuentepec, Morelos, Mexico, which were collected during a previous study in 2008 and 2009. It was found that the biomedical model, which permeates all actions to promote breastfeeding, reifies people, limits communication, devaluates women's traditional knowledge and imposes a discourse that gradually discourages the practice of breastfeeding. The article's proposal is to adopt an epistemic change in biomedical thought that shifts from a paradigm of simplicity to one of complexity, with the purpose of achieving a greater understanding of the bio-psycho-socio-cultural processes of human beings.

Con el propósito de esclarecer el abandono de la lactancia materna en zonas rurales de México, se aborda el modelo biomédico vigente y las políticas y acciones para la promoción de la lactancia materna que se derivan de su enfoque teórico, y se discuten las estrategias operativas del programa gubernamental de beneficio social Oportunidades. Para ello se retoman los testimonios de 39 madres jóvenes lactantes, 11 mujeres madres abuelas y 12 miembros del personal sanitario de la población náhuatl de Cuentepec, Morelos, México, recabados en un trabajo de investigación previo, realizado entre 2008 y 2009. Se constató que el modelo biomédico, que permea todas las acciones de promoción de lactancia materna, cosifica a las personas, limita la comunicación, devalúa los saberes tradicionales de las mujeres e impone un discurso que paulatinamente desalienta dicha práctica. Se propone adoptar un cambio epistémico del pensamiento biomédico que transite del paradigma de la simplicidad al de la complejidad, para lograr un acercamiento mayor a la comprensión de los procesos bio-psico-socio-culturales propios del ser humano.

Hair follicle characteristics as early marker of Type 2 Diabetes.

Type 2 Diabetes mellitus (DM2) includes a continuum of metabolic disorders characterized by hyperglycemia that causes several chronic long-term complications such as coronary artery disease, peripheral arterial disease, nephropathy, and neuropathy. The hair follicle could reveal signs of early vascular impairment, yet its relationship to early metabolic injuries has been largely ignored. We propose that in earlier stages of the continuum of DM2-related metabolic disorders, a group of susceptible patients who do not yet meet the diagnostic criteria to be considered as persons with DM2 may present chronic vascular impairment and end organ damage, including hair follicle damage, which can be evaluated to identify an early risk marker. This hypothesis is based in the association found between insulin resistance and alopecia in non-diabetic persons, and the hair loss on the lower limbs as a manifestation of long-term peripheral arterial disease among subjects with DM2. In order to test this hypothesis, studies are required to evaluate if hair follicle characteristics are related to and can predict hyperglycemic complications, and if they do so, which feature of the hair follicle, such as hair growth, best characterizes such DM2-related conditions. If this hypothesis were proven to be true, significant advances towards a personalized approach for early prevention strategies and management of DM2 would be made. By focusing on the hair follicles, early stages of metabolic-related organ damage could be identified using non-invasive low-cost techniques. In so doing, this approach could provide early identification of DM2-susceptible individuals and lead to the early initiation of adequate primary prevention strategies to reduce or avoid the onset of large internal organ damage.

Incidencia de infecciones vaginales diagnósticadas por citolog¡a cervicovaginal: en mujeres mayores de 40 años: Hospital Miliar Dr. Carlos Arvelo / Incidence of vaginal infections diagnosed by cervicovaginal cytology in women older than 40 years: Hospital Militar Dr. Carlos Arvelo

Las infecciones son probablemente, la patología más frecuente de consulta en ginecología. La abundante y molesta sintomatología que suele acompañar a estos procesos lleva a la mujer a consultar con su médico. Las infecciones vaginales o vaginitis se puede ocasionar por virus, bacterias, hongos o parásitos, estos gérmenes pueden estar en la vagina solos o asociados. Clínicamente pueden distinguirse según los síntomas y signos, pero el diagnóstico definitivo se establece por citología y/o microbiología. Los cambios hormonales durante la pubertad, en la adolescencia, el ambarazo y la menopausia, predisponen a la mujer a contraer vaginitis, al igual que la falta de higiene adecuada, sensibilidad a ciertos jabones, utilización de anticonceptivos, entre otros. En este tarbajo se presenta la casuística de esta patología en las pacientes examinadas entre enero y diciembre de 2004 en el Departamento de Ginecología y Obstetricia de nuestro hospital.