Estimating the incidence of Venezuelan migration and other socioeconomic factors on urban growth in Colombia.

This study investigates the intricate relationship between Venezuelan migration and urban growth in Colombia from 2018 to 2021. The study employs remote sensing data and social network metrics to uncover migration patterns and their impact on urban expansion. The methodology consists of three stages. Firstly, nighttime satellite imagery is used to analyze year-over-year urban growth in Colombia. Secondly, social network data estimates Venezuelan migration, overcoming challenges of underreporting and informal border crossings. Lastly, an econometric analysis explores the quantitative link between Venezuelan migration and urban growth, integrating socioeconomic variables to address endogeneity. The findings reveal the complex interplay of Venezuelan migration, socioeconomic factors, and urban growth. The study outlines remote sensing analysis, introducing the Anthropogenic Footprint Expansion Index (AFEI) to quantify urban growth. Facebook API data estimates migration trends and explores socioeconomic impacts on urban expansion. The analysis uncovers migration, poverty, aging, and urban population proportion as key factors affecting Colombia's urban landscape. Furthermore, the research underscores how Venezuelan migration affected short-term urban expansion pre- and post-COVID-19. Migration had a notable effect before the pandemic, but this influence waned afterward. The study highlights migration's short-term nature and emphasizes age demographics' role in medium-term dynamics.

Elaboration of Thermally Performing Polyurethane Foams, Based on Biopolyols, with Thermal Insulating Applications.

In this work, biobased rigid polyurethane foams (PUFs) were developed with the aim of achieving thermal and fireproofing properties that can compete with those of the commercially available products. First, the synthesis of a biopolyol from a wood residue by means of a scaled-up process with suitable yield and reaction conditions was carried out. This biopolyol was able to substitute completely the synthetic polyols that are typically employed within a polyurethane formulation. Different formulations were developed to assess the effect of two flame retardants, namely, polyhedral oligomeric silsesquioxane (POSS) and amino polyphosphate (APP), in terms of their thermal properties and degradation and their fireproofing mechanism. The structure and the thermal degradation of the different formulations was evaluated via Fourier Transformed Infrared Spectroscopy (FTIR) and thermogravimetric analysis (TGA). Likewise, the performance of the different PUF formulations was studied and compared to that of an industrial PUF. From these results, it can be highlighted that the addition of the flame retardants into the formulation showed an improvement in the results of the UL-94 vertical burning test and the LOI. Moreover, the fireproofing performance of the biobased formulations was comparable to that of the industrial one. In addition to that, it can be remarked that the biobased formulations displayed an excellent performance as thermal insulators (0.02371-0.02149 W·m-1·K-1), which was even slightly higher than that of the industrial one.

Comprehensive orthodontic treatment using miniscrews and digital rehabilitation in a patient with severe recessive dystrophic epidermolysis bullosa.

INTRODUCTION: Epidermolysis bullosa (EB) is a rare genetic disorder characterized by skin fragility and blister formation. The phenotypic presentation is broad with four major types, being Recessive Dystrophic EB (RDEB) the most severe, including oral anomalies such as severe microstomia, ankyloglossia, vestibule obliteration and occlusal anomalies, turning orthodontic treatment into a challenge. AIM: This case report aims to present the comprehensive treatment of a patient with severe RDEB, including periodontal surgery, orthodontic fixed braces with mini-screws and oral rehabilitation with anterior veneers. CASE REPORT: A 27-year-old female patient with severe RDEB received orthodontic treatment in the upper jaw to improve malalignment and anterior crossbite. After 13 months of treatment with fixed appliances, miniscrews were placed in the anterior segment to intrude and procline the upper incisors. Oral surgery was performed to increase the vestibule depth of the upper lip. Once edge-to-edge occlusion was obtained, anterior veneers were placed to improve aesthetic and stabilize occlusion, especially with the lack of posterior support. DISCUSSION: The multidisciplinary treatment approach, involving orthodontic treatment, periodontal surgery and oral rehabilitation, played a crucial role in achieving favorable results. This case highlights the successful use of miniscrews as a viable orthodontic approach for patients with severe RDEB.

Impression technique modification and oral contracture release surgery for orthodontic treatment in a patient with severe microstomia due to recessive dystrophic epidermolysis bullosa.

INTRODUCTION: Epidermolysis bullosa (EB) is a group of genetic disorders characterized by fragility of the skin and mucosal membranes. Dystrophic EB (DEB) is caused by mutations in the gene coding for type VII collagen. Among the most frequent oral manifestations in Recessive DEB (RDEB) are oral ulcers and blisters, absence of tongue papillae and palatal rugae, ankyloglossia, oral vestibule obliteration, and microstomia. The following report describes a modified impression technique used in a patient with severe RDEB and severe microstomia to obtain models for orthodontic treatment with aligners. CASE REPORT: A 25-year-old female patient with severe RDEB was referred for orthodontic treatment. Severe microstomia (8 mm), hindered the use of conventional trays or intraoral scanners to design the aligners. Therefore, a contracture release surgery in combination with a modified impression technique was performed to obtain an optimal impression and subsequent aligners for orthodontic treatment. DISCUSSION: This case presents an alternative strategy to provide orthodontic treatment with aligners in patients with severe microstomia due to severe RDEB. Reports of orthodontic treatment in people living with EB, especially in RDEB, are still rare, with few publications about fixed braces, early teeth extraction and removable devices, and none using aligners. Most of the impression techniques reported are aimed at oral rehabilitation. The multidisciplinary approach and impression technique reported should broaden the alternatives of orthodontic techniques provided to patients with EB and severe microstomia. CONCLUSIONS: This article describes an oral contracture release surgery and modified impression technique for obtaining good quality impression for the design of orthodontic aligners in patients with severe microstomia due to severe RDEB.

Prioritization of carceral spending in U.S. cities: Development of the Carceral Resource Index (CRI) and the role of race and income inequality.

BACKGROUND: Policing, corrections, and other carceral institutions are under scrutiny for driving health harms, while receiving disproportionate resources at the expense of prevention and other services. Amidst renewed interest in structural determinants of health, roles of race and class in shaping government investment priorities are poorly understood. METHODS: Based on the Social Conflict Model, we assessed relationships between city racial/ economic profiles measured by the Index of Concentration at the Extremes (ICE) and budgetary priorities measured by the novel Carceral Resource Index (CRI), contrasting investments in carceral systems with funding for health and social support across the 50 most populous cities in the United States (U.S.). Bivariate correlations, and unadjusted and adjusted polynomial regression models were used to assess the relationship between budgetary investments and population concentration at extremes in terms of income, racial/ethnic composition, and education, controlling for other demographic characteristics. RESULTS: In our sample, median CRI was -0.59 (IQR -0.64, -0.45), with only seven cities exhibiting positive CRI values. This indicates that most large U.S. cities spend more on carceral systems than on health and supportive services, combined. Adjusted polynomial models showed a convex relationship between the CRI and ICE-Education, and ICE-Race(White vs. Black)+Income, with quadratic terms that were positive and significant at p<0.05. After controlling for age, the strongest prioritization of carceral systems was observed in cities where the proportion of low-income Black residents approached or exceeded that of high-income white residents. CONCLUSIONS: Municipal prioritization of carceral investments over health and social support is pervasive in the U.S and exacerbated by racial and economic disparities. The CRI offers new opportunities to understand the role of government investments as a structural determinant of health and safety. Longitudinal research is warranted to examine the relationship between budget priorities, structural racism, and health outcomes.

Desafíos en el tratamiento de ortodoncia en paciente con síndrome de down, reporte de caso

RESUMEN: El Síndrome de Down es una condición genética que se identifica por la presencia de un grado variable de discapacidad cognitiva, rasgos y características físicas singulares, que también repercuten a nivel estomatognático. El objetivo de este reporte de caso es reflejar los desafíos terapéuticos que podemos enfrentar para lograr un tratamiento integral en estos pacientes. Madre de paciente consulta por apiñamiento dentario. Presenta enfermedades sistémicas asociadas al Síndrome de Down, alteraciones sensoriales, gingivitis generalizada, lesiones de caries, anomalías dentomaxilares y fibroma traumático en flanco lingual. El tratamiento incluyó adaptación a la atención odontológica, odontología preventiva y restauradora, periodoncia y ortodoncia. Luego de 25 meses de tratamiento, se logró el alta integral, debiendo modificar los objetivos del tratamiento y el manejo terapéutico ortodóncico en diversas ocasiones. Es posible realizar tratamientos integrales en pacientes con Síndrome de Down, considerando una buena adaptación, objetivos alcanzables y trabajo en equipo multidisciplinario.

ABSTRACT: Down Syndrome is a genetic condition identified by the presence of a variable degree of cognitive disability and unique physical characteristics and traits, which also have an impact on the stomatognathic system. The aim of this case report is to report the therapeutic challenges that we can face to achieve a comprehensive treatment. Patient's mothers consult for dental crowding. The patient presents systemic diseases associated with Down Syndrome, sensory anomalies, generalized gingivitis, dental caries lesions, maxillary dental anomalies, and traumatic fibroma in the tongue. The treatment included adaptation to dental care, preventive and restorative dentistry, periodontics and orthodontics. After 25 months of treatment, comprehensive discharge was achieved, with modifications in the treatment objectives and orthodontic therapeutic management in several occasions. Comprehensive treatment in patients with Down Syndrome is possible, considering a good adaptation to the treatment, achievable objectives and multidisciplinary teamwork.

Barriers and facilitators in the orthodontic treatment of teenagers with neurodevelopmental disabilities.

INTRODUCTION: Patients with neurodevelopmental disabilities often experience barriers to dental care. Despite greater access to orthodontic treatment, information about the perceptions of patients with neurodevelopmental disabilities regarding orthodontic care remains scarce. The objective of this research was to investigate perceptions of patients, caretakers, and orthodontic residents regarding the barriers to and facilitators of orthodontic care for patients with neurodevelopmental disabilities. METHODS: A qualitative study was conducted through semistructured interviews of 26 subjects: 10 patients with neurodevelopmental disabilities (4 with cognitive disabilities, 4 with autism spectrum disorder, and 2 with communication disorder), 8 caretakers, and 8 orthodontic residents. The responses were analyzed qualitatively by content analysis. RESULTS: Four dimensions of analysis were identified: previous experience, barriers to care, facilitators of care, and perception of care. There are different orthodontic care barriers and facilitators perceived by patients, caretakers, and residents treating patients with neurodevelopmental disabilities. Factors such as the reason for consultation, previous experience or exposure to orthodontic care or attention, and personal motivation of those involved were used to model the care of these patients. CONCLUSIONS: There are barriers and facilitators in orthodontic care for patients with neurodevelopmental disabilities, caretakers, and orthodontic residents. Educational programs in orthodontics must work to improve access and care for patients and educational training programs for students and clinical faculty.

Epidemiological Indicators of SARS-CoV-2 (COVID-19) and Vaccination Effectiveness on the Report of Positive Cases in the Colombian Army.

The description of the epidemiological indicators of SARS-CoV-2 (COVID-19), such as the mortality rate (MR), the case fatality rate (CFR), and the attack rate (AR), as well as the geographical distribution and daily case reports, are used to evaluate the impact that this virus has had within the Colombian Army and its health system. As military forces around the world represent the force that defends sovereignty, independence, the integrity of the national territory, and the constitutional order, while maintaining migration controls in blocked border areas during this critical pandemic times, they must carry out strict epidemiological surveillance to control the situation among the servicemen. Up to date, the Colombian Army has faced a very high attack rate (AR = 8.55%) due, among others, to living conditions where active military personnel share bedrooms, bathrooms, and dining facilities, which facilitate the spread of the virus. However, being a mainly young and healthy population, the MR was 1.82 deaths/1,000 ha, while the CFR = 2.13% indexes consistently low if compared with those values reported for the national population. In addition, the effectiveness of vaccination is shown in daily cases of COVID-19, where, for the third peak, the active military population presented a decrease of positive patients compared to the dynamics of national transmission and the total population of the military forces (active, retired, and beneficiaries).

Consideraciones en el tratamiento ortodóncico de pacientes con necesidades especiales. Revisión de la literatura / Considerations in the orthodontic treatment of patients with special needs. Review of the literature

Las necesidades especiales en salud han sido definidas por la Asociación Americana de Odontopediatría como "toda condición o limitación física, del desarrollo, mental, sen- sorial, conductual, cognitiva o deterioro emocional que requiere tratamiento médico, intervención de atención de la salud, y/o el uso de servicios o programas especializados". Actualmente, los pacientes con necesidades especiales en salud presentan una mayor tasa de supervivencia y expectativas de vida mayores. Además, presentan una mayor preva- lencia y severidad de anomalías dento-maxilares que impactan negativamente su salud general y calidad de vida. La creciente preocupación de los padres y profesionales por el aspecto estético y funcional, ha llevado a un aumento en la demanda por tratamiento de ortodoncia, sin embargo, el acceso a él sigue siendo limitado. El objetivo de la presente revisión es describir según la literatura disponible, las consideraciones para el tratamiento ortodóncico en pacientes con necesidades especiales en salud. Se concluye que el tra- tamiento no debe ser denegado solo por presentar una discapacidad; no obstante, el compromiso de los padres y/o cuidadores con el tratamiento es crucial para el éxito. El tratamiento debe ser planificado en etapas, siendo la fase de adaptación a la atención de gran importancia. La longitud de tratamiento en estos pacientes, es similiar a la de individuos sanos, pero se requiere un mayor tiempo-sillón y los resultados obtenidos suelen ser inferiores. El tratamiento de ortodoncia puede mejorar la estética y función en pacientes con situación de discapacidad, facilitando su integración social e impactando positivamente en su calidad de vida

The American Academy of Pediatric Dentistry defines Special Health Care Needs as "any physical, developmental, mental, sensory, behavioral, cognitive, or emotional impair- ment condition or limitation that requires medical management, health care interven- tion, and/or the use of specialized services or programs". Currently, patients with special health needs present a higher survival rate and higher life expectancies. In addition, they present a higher prevalence and severity of malocclusion that negatively impact their general health and quality of life. The growing concern of parents and professionals for the aesthetic and functional aspect, has led to an increase in the demand for orthodontic treatment, however, the health care access still remains limited. A review of the availa- ble literature was performed aiming at describing the considerations in the orthodontic treatment of special health care needs patients. It is concluded that the treatment should not be denied just for presenting a disability. Notwithstanding, it is crucial for the treat- ment success parents and/or caregivers commitment. The treatment should be planned in stages, being of great importance the care adaptation phase. The overall treatment time is similar to those patients without special needs, but still requires longer armchair time and the results obtained are usually lower. Orthodontic treatment can improve aesthetics and function in patients with disabilities, facilitating their social integration and positively impact in their quality of life.

Rehabilitación protésica en pacientes fisurados con fístula buconasal / Prosthetic rehabilitation in patients with cleft lip and buconasal fistula

La fisura labiopalatina consiste en la falta de fusión de los procesos palatinos y labial durante el desarrollo embrionario. Estos pacientes presentan una comunicación buconasal, alteraciones dentarias de forma, tamaño y posición, y un deficiente desarrollo del maxilar. Su tratamiento requiere un trabajo de equipo multidisciplinar, ya que afecta funciones básicas que comprometen su calidad de vida, como comer, hablar o relacionarse socialmente. Aunque la cirugía primaria soluciona mayormente esta anomalía, algunas veces persiste la comunicación entre las cavidades bucal y nasal, lo que se conoce como comunicación o fístula buconasal. Esto supone una mayor dificultad en el cierre quirúrgico, siendo a veces imposible de cerrar a través de la cirugía. En tales casos, la obturación de dicha fístula a través de una prótesis otorga una solución de bajo costo para el paciente y con resultados óptimos a corto y mediano plazo. El objetivo de este artículo es exponer casos de rehabilitación protésica en pacientes con fisura labiopalatina y fístula buconasal posterior al tratamiento quirúrgico.

Cleft lip and palate is the lack of fusion of the palatal and labial processes during embryonic development. Patients are characterised by the presence of buconasal communication, dental alterations, and poor development of the maxilla. Treatment requires multidisciplinary team work, due to the impact on basic functions such as eating, talking or interacting with other people, and even compromising their quality of life. Although primary surgery mostly solves this anomaly, sometimes communication between the oral and nasal cavity persists (called communication or buconasal fistula). This leads to greater difficulty to surgically close it, being impossible in some cases. In these cases, the closure using a prosthesis provides a low-cost solution for the patient, with an optimal result in the short and medium term. The aim of this article is to present cases of prosthetic rehabilitation in patients with cleft lip and buconasal fistula after surgical treatment.

Hemifacial microsomia: a literature review / Microsomía hemifacial: revisión de la literatura

ABSTRACT Hemifacial microsomia is the second congenital malformation in prevalence, after cleft lip and palate, and is described as a congenital alteration of the first and second branchial arches. As a condition of wide spectrum, its characteristics are expressed in many different ways and therefore treatments are usually individualized. This topic review discusses its etiology, classification, characteristics, and treatment with mandibular surgery.

RESUMEN La microsomía hemifacial corresponde a la segunda malformación congénita en prevalencia, luego de la fisura labiopalatina, y se describe como una alteración congénita del primer y el segundo arcos branquiales. Al ser una entidad en espectro, presenta características de expresión variable y por tanto los tratamientos son acordes a su individualidad. En esta revisión de tema se analizan su etiología, clasificaciones, características y tratamiento quirúrgico mandibular.

Síndrome Gorlin-Goltz asociado a fisura labiopalatina bilateral / Gorlin-Goltz syndrome associated with bilateral cleft lip and palate

El síndrome de Gorlin-Goltz corresponde a un trastorno de herencia autosómica dominante. Uno de los criterios menores de este síndrome es la fisura labiopalatina. Si bien esta corresponde a la anomalía congénita maxilofacial más prevalente, un porcentaje variable está asociado a síndromes. Presentar un caso de un paciente con síndrome de Gorlin-Goltz y fisura labiopalatina bilateral asociada constituye el propósito de esta presentación. Se trata de un paciente de 12 años de edad, con diagnóstico de síndrome de Gorlin-Goltz remitido por genetista. Clínicamente presenta anomalías cutáneas, óseas, dentarias, neurológicas, tumores, hoyuelos palmoplantares, prognatismo mandibular y fisura labiopalatina bilateral operada. Es importante reconocer las características asociadas no solo al área craneofacial, sino también a otras partes del cuerpo. Se requiere de la atención de un equipo multidisciplinario en el que el odontólogo también debe participar. La mayoría de las publicaciones se enfocan solo en el manejo quirúrgico de los quistes y no en el de otras secuelas asociadas, como lo es la fisura labiopalatina(AU)

Gorlin-Goltz syndrome is an autosomal dominant inheritance disorder. Cleft lip and palate is one of the minor criteria for this syndrome. Cleft lip and palate is the most prevalent congenital maxillofacial anomaly, and a varying percentage is associated with syndromes. Present the case of a patient with Gorlin-Goltz syndrome and associated bilateral cleft lip and palate. A 12-year-old male patient was referred by the geneticist with a diagnosis of Gorlin-Goltz syndrome. Clinical examination revealed skin, bone, dental and neurological anomalies, as well as tumors, palmoplantar pits, mandibular prognathism and operated bilateral cleft lip and palate. It is important to examine not only features associated with the craniofacial region, but also with other parts of the body. An interdisciplinary team is required of which the odontologist should be a member. Most publications only refer to the surgical management of cysts and not to associated sequels, such as cleft lip and palate(AU)

Manifestaciones clínicas del espectro óculo aurículo vertebral / Clinical manifestations of oculo auriculo vertebral spectrum

El Espectro óculo Aurículo Vertebral corresponde a un desorden heterogéneo y complejo que afecta el desarrollo de estructuras derivadas del primer y segundo arco branquial. Presenta un compromiso variable del macizo maxilofacial, condicionando el tratamiento de cada paciente a su expresión fenotípica. El objetivo de esta revisión de tema es describir las diversas características de este espectro. Para ello se realizó un análisis de la literatura científica con el fin de entregar una referencia actualizada sobre las principales manifestaciones clínicas, su diagnóstico, exámenes complementarios utilizados y posibles diagnósticos diferenciales. Dada su gran variabilidad, es de vital importancia que sea conocido no solo por el odontólogo, sino también por los equipos de salud, posibilitando la entrega de un diagnóstico oportuno a temprana edad y un manejo adecuado de las diferentes alteraciones que pueden presentar.

The Oculo Auriculo Vertebral spectrum corresponds to a heterogeneous and complex disorder that affects the development of structures derived from the first and second branchial arch. It has a variable commitment of maxillofacial structures , conditioning treatment for each patient to their phenotypic expression. The objective of this review article it's to describe various features of this spectrum . A scientific literature analysis was done with the aim of delivering an up to date reference regarding the main clinical manifestations, diagnosis, complementary exams used and possible differential diagnosis. Given its variable expression is that it becomes important to be known not only by the dentist, but also by health teams , allowing the delivery of timely early diagnosis and proper management of the different alterations that may present.

Análisis de la Simetría Transversal del Maxilar Anterior en Niños con Fisura Labiopalatina Operada / Transverse Symmetry Analysis of Anterior Maxilla in Children with Operated Unilateral Cleft Lip and Palate

El objetivo de este trabajo fue comparar la simetría transversal del maxilar desde los caninos hacia anterior, contrastando el lado fisurado con el lado no fisurado respecto a la línea mediana. Se diseño un estudio retrospectivo, comparativo de tipo cuantitativo, con doble enmascaramiento. Se analizaron 60 modelos de estudio dental de niños en dentición mixta con labio leporino unilateral y fisura velopalatina, operados, pertenecientes al IRMADEMA y al Hospital Luis Calvo Mackenna. Se determinó la longitud transversal anterior del maxilar a nivel de caninos. Luego se determino la longitud anterior del maxilar a nivel de la línea media, la cual se dividió en tercios. Se determinó la longitud transversal de cada lado, desde estos puntos hasta el punto medio del reborde alveolar. Existe una diferencia significativa entre la longitud transversal del lado fisurado y el lado no fisurado en relación a la línea mediana, siendo este último mayor en los tres niveles de medición. No se observó diferencia por sexo (p>0,05) La zona anterior del maxilar se presenta en forma asimétrica en el sentido transversal, en pacientes con labio leporino unilateral y fisura velopalatina operada. La diferencia es mayor a nivel de caninos y tiende a un aplanamiento del lado fisurado. Se sugiere un estudio longitudinal que muestre la evolución en el tiempo de dicha asimetría.

The objective of this study was to compare the transversal symmetry of the upper maxilla starting from the canine towards the anterior contrasting the cleft side and the non-cleft side with respect to the centerline. A retrospective and comparative study of the quantitative type. Sixty study models of children were analyzed with mixed dentition with unilateral cleft lip and operated velum cleft, these patients were from the Craniofacial Malformation Unit and the Luis Calvo Mackenna Hospital. The anterior transversal length of the maxilla wasdetermined at the canine level, then the anterior length of the maxilla at the level of the center line was determined, which was split into thirds. The transversal length of each side was determined from these points to the center point of the alveolar ridge. There is a significant stastistical difference between the transversal length of the cleft and non cleft side with regards to the center line, with the latter being greater on all three measuring levels. No difference was shown regarding sex (P>0.05). On patients with unilateral cleft lip and operated cleft palate, the anterior zone of the upper maxilla shows an asymmetry in the transversal direction. The difference is greater at the canine level and tends to flatten out on the cleft side. A longitudinal study is suggested that this would show an evolution of such asymmetry in a time period.

Comprehensive orthodontic treatment of adult patient with cleft lip and palate.

The aim of the paper is to present full orthodontic treatment of an operated cleft lip adult patient. Case Report. An 18-year-old patient consulted for severe crowded teeth. He comes from a poor family. At that time he already had four operations (velum, palate, lip, and myringotomy). Treatment included maxillary expansion, tooth extraction, and fixed orthodontic, as well as kinesiology and speech therapy treatment. A multidisciplinary approach allowed us to achieve successfully an excellent result for this patient and gave him a harmonic smile and an optimal function without orthognathic surgery. Two years after treatment, occlusion remains stable.

[Evaluation of methods for studying susceptibility to oxacillin and penicillin in 60 Staphylococcus lugdunensis isolates]. / Evaluación de métodos para el estudio de la sensibilidad a oxacilina y penicilina en 60 aislamientos de Staphylococcus lugdunensis.

INTRODUCTION: Staphylococcus lugdunensis is a coagulase-negative staphylococcus associated with a variety of clinical infections. In this paper we present the results of a comparative study using 4 methods to determine antimicrobial susceptibility to oxacillin and penicillin in 60 S. lugdunensis isolates. MATERIAL AND METHODS: We studied 60 S. lugdunensis isolates obtained from clinical specimens sent to our laboratory over an 8-year period. All isolates were free coagulase-negative and DNase-negative, and biochemically identified by API ID 32 STAPH (bioMérieux). Presence of mecA and ss-lactamase production were studied in all cases. Antimicrobial susceptibility was determined by the Vitek 2 System (bioMérieux) and broth microdilution (Wider) (Soria Melguizo) for penicillin and oxacillin, and the E-test (AB Biodisk) and cefoxitin disk diffusion test (BD BBLTM) for oxacillin. RESULTS: All isolates lacked the mecA gene and were susceptible to oxacillin by broth microdilution, E-test, and cefoxitin disk diffusion test. Only two isolates were oxacillin-resistant by the Vitek 2 System. Twenty-four isolates (40%) were ss-lactamase-positive, 4 after induction. Susceptibility testing to penicillin determined that 48 isolates showed concordance between the results obtained by broth microdilution and Vitek 2, but 12 isolates (20%), showed divergent results. CONCLUSIONS: We detected no resistance to oxacillin in S. lugdunensis. All the methods evaluated were adequate for determining oxacillin resistance. The Vitek 2 System is useful for detecting penicillin resistance, but the ss-lactamase test should be applied to isolates with a MIC=0.25microg/ml to avoid the interpretation of false resistance to this antibiotic.

Evaluación de métodos para el estudio de la sensibilidad a oxacilina y penicilina en 60 aislamientos de Staphylococcus lugdunensis / Evaluation of methods for studying susceptibility to oxacillin and penicillin in 60 Staphylococcus lugdunensis isolates

Introducción: Staphylococcus lugdunensis es un estafilococo coagulasa negativo relacionado con diversos tipos de infección. En este trabajo se presentan los resultados de un estudio comparativo mediante cuatro métodos para determinar la sensibilidad a oxacilina y penicilina. Material y métodos: se estudiaron 60 aislamientos de S. lugdunensis procedentes de muestras clínicas enviadas a nuestro laboratorio durante 8 años. Todos los aislados fueron coagulasa y DNasa negativos. La identificación se realizó bioquímicamente mediante API ID 32 STAPH (bioMérieux). En todos los casos se analizó la presencia de betalactamasa y la detección del gen mecA. La susceptibilidad antimicrobiana se determinó mediante: Vitek 2 System (bioMérieux) y microdilución en caldo (Wider) (Soria Melguizo) para oxacilina y penicilina; E-test (AB Biodisk) y método de difusión con disco de cefoxitina (BD BBLTM), para ensayar la sensibilidad a oxacilina. Resultados: todos los aislamientos fueron mecA negativos y sensibles a oxacilina en microdilución en caldo, E-test y en el método de difusión con cefoxitina, mientras que en Vitek 2 solamente dos aislamientos fueron resistentes a oxacilina; 24 (40%) fueron betalactamasa positivos, 4 tras inducción. Los resultados de susceptibilidad a penicilina mostraron que 48 aislamientos presentaban concordancia entre los obtenidos por microdilución en caldo y Vitek 2, pero 12 (20%) mostraron resultados discrepantes Conclusiones: en nuestro estudio no hemos hallado ningún aislamiento de S. lugdunensis resistente a oxacilina; los métodos de microdilución en caldo (Wider), E-test de oxacilina y difusión con disco de cefoxitina son adecuados para el estudio de sensibilidad a este antibiótico. El empleo del sistema Vitek 2 es útil para el estudio de la sensibilidad a penicilina si se aplica la prueba de betalactamasa a los aislamientos con concentración mínima inhibitoria (CMI) de 0,25μg/ml para evitar la interpretación de una falsa resistencia a dicho antibiótico (AU)

Introduction: Staphylococcus lugdunensis is a coagulase-negative staphylococcus associated with a variety of clinical infections. In this paper we present the results of a comparative study using 4 methods to determine antimicrobial susceptibility to oxacillin and penicillin in 60 S. lugdunensis isolates. Material and methods: We studied 60 S. lugdunensis isolates obtained from clinical specimens sent to our laboratory over an 8-year period. All isolates were free coagulase-negative and DNase-negative, and biochemically identified by API ID 32 STAPH (bioMérieux). Presence of mecA and ß-lactamase production were studied in all cases. Antimicrobial susceptibility was determined by the Vitek 2 System (bioMérieux) and broth microdilution (Wider) (Soria Melguizo) for penicillin and oxacillin, and the E-test (AB Biodisk) and cefoxitin disk diffusion test (BD BBLTM) for oxacillin. Results: All isolates lacked the mecA gene and were susceptible to oxacillin by broth microdilution, E-test, and cefoxitin disk diffusion test. Only two isolates were oxacillin-resistant by the Vitek 2 System. Twenty-four isolates (40%) were ß-lactamase-positive, 4 after induction. Susceptibility testing to penicillin determined that 48 isolates showed concordance between the results obtained by broth microdilution and Vitek 2, but 12 isolates (20%), showed divergent results. Conclusions: We detected no resistance to oxacillin in S. lugdunensis. All the methods evaluated were adequate for determining oxacillin resistance. The Vitek 2 System is useful for detecting penicillin resistance, but the ß-lactamase test should be applied to isolates with a MIC=0.25μg/ml to avoid the interpretation of false resistance to this antibiotic (AU)

Análisis fotoelástico comparativo de un sistema de construcción de barras articuladas para sobredentaduras mandibulares soportadas por cuatro implantes / A comparative photoelastic analysis of a system of articulated bars construction for overdentures supported by four implants

El ajuste pasivo de las barras para sobredentaduras implantosoportadas ha sido sugerido como un pre-requisito para el éxito a largo plazo de la oseointegración. Sin embargo, no hay lineamientos científicos de cómo lograrlo ni medirlo clínicamente con precisión. El propósito de este estudio fotoelástico fue determinar los patrones de estrés generados por la falta de pasividad en un diseño de construcción de barras tipo Hader para sobredentaduras, alrededor de cuatro implantes ubicados en la región intermentoniana, con una articulación horizontal ubicada en el tramo central. Se fabricó un modelo fotoelástico que simuló una mandíbula humana edéntula, en la que se incorporaron cuatro implantes roscados con hexágono externo (3.75 de diámetro x 13 mm de longitud, con base de 4 mm). Fueron construidas cuatro barras que ferulizaron los cuatro implantes y a las que se les colocó una articulación horizontal en el tramo central. Las barras fueron asentadas y torqueadas sobre el modelo fotoelástico y se registraron fotográficamente los patrones de estrés generados en cada implante. Las barras articuladas mostraron mayor pasividad en el tramo central donde se ubicó la unión articulada. Además, se determinó que el área crítica para la mayor concentración de tensiones fueron los cuellos de los implantes y no así los ápices, que mostraron valores muy inferiores. Cada ejemplar de férula mostró un comportamiento diferente a las demás, a pesar de que fueron procesadas todas sobre el mismo modelo y con idéntico procedimiento de construcción. Las uniones articuladas mostraron pasivisar más el tramo donde se ubican pero no es un recurso suficiente para otorgar un asentamiento pasivo cuando son colocados y torqueados los tornillos que fijan las barras a los implantes

Análisis fotoelástico comparativo de un sistema de construcción de barras articuladas para sobredentaduras mandibulares soportadas por cuatro implantes / A comparative photoelastic analysis of a system of articulated bars construction for overdentures supported by four implants

El ajuste pasivo de las barras para sobredentaduras implantosoportadas ha sido sugerido como un pre-requisito para el éxito a largo plazo de la oseointegración. Sin embargo, no hay lineamientos científicos de cómo lograrlo ni medirlo clínicamente con precisión. El propósito de este estudio fotoelástico fue determinar los patrones de estrés generados por la falta de pasividad en un diseño de construcción de barras tipo Hader para sobredentaduras, alrededor de cuatro implantes ubicados en la región intermentoniana, con una articulación horizontal ubicada en el tramo central. Se fabricó un modelo fotoelástico que simuló una mandíbula humana edéntula, en la que se incorporaron cuatro implantes roscados con hexágono externo (3.75 de diámetro x 13 mm de longitud, con base de 4 mm). Fueron construidas cuatro barras que ferulizaron los cuatro implantes y a las que se les colocó una articulación horizontal en el tramo central. Las barras fueron asentadas y torqueadas sobre el modelo fotoelástico y se registraron fotográficamente los patrones de estrés generados en cada implante. Las barras articuladas mostraron mayor pasividad en el tramo central donde se ubicó la unión articulada. Además, se determinó que el área crítica para la mayor concentración de tensiones fueron los cuellos de los implantes y no así los ápices, que mostraron valores muy inferiores. Cada ejemplar de férula mostró un comportamiento diferente a las demás, a pesar de que fueron procesadas todas sobre el mismo modelo y con idéntico procedimiento de construcción. Las uniones articuladas mostraron pasivisar más el tramo donde se ubican pero no es un recurso suficiente para otorgar un asentamiento pasivo cuando son colocados y torqueados los tornillos que fijan las barras a los implantes (AU)

Análisis fotoelástico comparativo de un sistema de construcción de barras articuladas para sobredentaduras mandibulares soportadas por cuatro implantes / A comparative photoelastic analysis of a system of articulated bars construction for overdentures supported by four implants

El ajuste pasivo de las barras para sobredentaduras implantosoportadas ha sido sugerido como un pre-requisito para el éxito a largo plazo de la oseointegración. Sin embargo, no hay lineamientos científicos de cómo lograrlo ni medirlo clínicamente con precisión. El propósito de este estudio fotoelástico fue determinar los patrones de estrés generados por la falta de pasividad en un diseño de construcción de barras tipo Hader para sobredentaduras, alrededor de cuatro implantes ubicados en la región intermentoniana, con una articulación horizontal ubicada en el tramo central. Se fabricó un modelo fotoelástico que simuló una mandíbula humana edéntula, en la que se incorporaron cuatro implantes roscados con hexágono externo (3.75 de diámetro x 13 mm de longitud, con base de 4 mm). Fueron construidas cuatro barras que ferulizaron los cuatro implantes y a las que se les colocó una articulación horizontal en el tramo central. Las barras fueron asentadas y torqueadas sobre el modelo fotoelástico y se registraron fotográficamente los patrones de estrés generados en cada implante. Las barras articuladas mostraron mayor pasividad en el tramo central donde se ubicó la unión articulada. Además, se determinó que el área crítica para la mayor concentración de tensiones fueron los cuellos de los implantes y no así los ápices, que mostraron valores muy inferiores. Cada ejemplar de férula mostró un comportamiento diferente a las demás, a pesar de que fueron procesadas todas sobre el mismo modelo y con idéntico procedimiento de construcción. Las uniones articuladas mostraron pasivisar más el tramo donde se ubican pero no es un recurso suficiente para otorgar un asentamiento pasivo cuando son colocados y torqueados los tornillos que fijan las barras a los implantes (AU)