An evolutionary parsimonious approach to estimate daily reference evapotranspiration.

The reference evapotranspiration (ETo) is an essential component in hydrological and ecological processes. The objective of this research is to develop an explicit model to estimate ETo only using commonly measurable meteorological parameters such as relative humidity, air temperature, and wind speed, where the measurements corresponding to solar radiation are omitted. The model was generated using Genetic Programming (GP), evaluated, and validated with reference data ETo using FAO56-PM. This reference data was obtained from different climates (warm-temperate and arid-warm) and latitudes, acquired from CIMIS stations in the state of California, United States, and the El Porvenir station in the state of Coahuila, located in north-central Mexico. After applying the proposed methodology, a total of 3754 results were generated, demonstrating a significant improvement in the estimation of ETo compared to the Hargreaves-Samani model. A particularly noteworthy result revealed that our approach outperformed the Hargreaves-Samani model in the training phase by 27%, and in the testing phase by 16%, on average. In order to achieve a generalized model, a dataset encompassing meteorological stations in two different climates (warm-temperate and arid-warm) and various latitudes was utilized. The obtained outcome unveiled a highly effective model for estimating ETo in diverse climatic contexts, eliminating the need for local adjustments. This model significantly surpassed the Hargreaves-Samani model, exhibiting superior performance by 17% during the training phase and 18% during the testing phase. These results conclusively underscore the capability of our approach to provide more accurate and reliable ETo estimates. These results conclusively underscore the capability of our approach to provide more accurate and reliable ETo estimates. Finally, to validate the model, four different datasets with climates similar to those used for model creation (warm-temperate, warm-arid) and different latitudes were employed. The validation stage results clearly indicate the superiority of our reference evapotranspiration ETo11 model over the Hargreaves-Samani model by 51% in warm-temperate climates. For the dataset with arid-warm climate, our model continued to show satisfactory results, surpassing the Hargreaves-Samani model by 8%. GP emerges as an innovative and effective alternative for simplified model development. This approach introduces a novel paradigm that facilitates the efficient development of models, standing out for its simplicity and effectiveness in generating solutions.

Resistance Exercise Program in Cognitively Normal Older Adults: CERT-Based Exercise Protocol of the AGUEDA Randomized Controlled Trial.

OBJECTIVES: To provide a comprehensive CERT (Consensus on Exercise Reporting Template)-based description of the resistance exercise program implemented in the AGUEDA (Active Gains in brain Using Exercise During Aging) study, a randomized controlled trial investigating the effects of a 24-week supervised resistance exercise program on executive function and related brain structure and function in cognitively normal older adults. DESIGN AND PARTICIPANTS: 90 cognitively normal older adults aged 65 to 80 were randomized (1:1) to a: 1) resistance exercise group; or a 2) wait-list control group. Participants in the exercise group (n = 46) performed 180 min/week of resistance exercise (3 supervised sessions per week, 60 min/session) for 24 weeks. INTERVENTION: The exercise program consisted of a combination of upper and lower limb exercises using elastic bands and the participant's own body weight as the main resistance. The load and intensity were based on the resistance of the elastic bands (7 resistances), number of repetitions (individualized), motor complexity of exercises (3 levels), sets and rest (3 sets/60 sec rest), execution time (40-60 sec) and velocity (as fast as possible). SETTINGS: The maximum prescribed-target intensity was 70-80% of the participants' maximum rate of perceived exertion (7-8 RPE). Heart rate, sleep quality and feeling scale were recorded during all exercise sessions. Those in the wait-list control group (n = 44) were asked to maintain their usual lifestyle. The feasibility of AGUEDA project was evaluated by retention, adherence, adverse events and cost estimation on the exercise program. RESULTS AND CONCLUSIONS: This study details the exercise program of the AGUEDA trial, including well-described multi-language manuals and videos, which can be used by public health professionals, or general public who wish to implement a feasible and low-cost resistance exercise program. The AGUEDA exercise program seems to be feasible by the high retention (95.6%) and attendance rate (85.7%), very low serious adverse event (1%) and low economic cost (144.23 € /participant/24 weeks). We predict that a 24-week resistance exercise program will have positive effects on brain health in cognitively normal older adults.

Sports motivation, anxiety and diet in education students / Motivación deportiva, ansiedad y dieta en estudiantes de educación

Motivational development with regards to sport plays a fundamental role in sport performance, however, anxiety and dietary patterns also play a key role. In consideration of the above, the present research aimed to develop an explanatory model of the motivational climate towards sport and its relationship with the Mediterranean diet and anxiety. This structural model was then examined according to gender using multi-group analysis. To this end, a cross-sectional, descriptive and comparative study was carried out with 556 university students. The instruments used were a sociodemographic questionnaire, the Perceived Motivational Climate in Sport Questionnaire (PMCSQ-2), the Beck Anxiety Inventory (BAI) and the Predimed questionnaire. Finally, outcomes revealed that the female gender had a negative relationship with adherence to a healthy dietary pattern, whilst males showed better adherence to the Mediterranean diet and higher levels of anxiety (AU)

La motivación juega un papel fundamental en la práctica del ejercicio físico, sin embargo, la ansiedad y el patrón dietético también juegan un rol clave, por tanto,la presente investigación refleja los objetivos de desarrollar un modelo explicativo del clima motivacional hacia el deporte y su relación con la dieta mediterránea y la ansiedad y contrastar el modelo estructural mediante un análisis multigrupo en función del sexo. Se ha realizado un estudio descriptivo comparativo de corte transversal con 556 estudiantes universitarios. Los instrumentos utilizados han sido un cuestionario sociodemográfico, el Cuestionario de Clima Motivacional Percibido en el Deporte (PMCSQ-2), el Inventario de Ansiedad de Beck (BAI) y el cuestionario Predimed. Finalmente, los resultados revelan que el sexo femenino tiene una relación negativa con la adherencia positiva a un patrón dietético saludable, mientras que el masculino muestra una mejor adherencia hacia la dieta mediterránea y mayores niveles de ansiedad (AU)

COVID-19 personal protective equipment (PPE) contamination in coastal areas of Granada, Spain.

The use of disposable personal protective equipment (PPE) as a control measure to avoid transmission against COVID-19 has generated a challenge to the waste management and enhances plastic pollution in the environment. The research aims to monitor the presence of PPE waste and other plastic debris, in a time interval where the use of face mask at specific places was still mandatory, on the coastal areas of Granada (Spain) which belongs to the Mediterranean Sea. Four beaches called La Rijana, La Charca, La Rábita and Calahonda were examined during different periods. The total amount of sampled waste was 17,558 plastic units. The abundance, characteristics and distribution of PPE and other plastic debris were determined. Results showed that the observed amount of total plastic debris were between 2.531·10-2 and 24.487·10-2 units per square meter, and up to 0.136·10-2 for PPE debris, where face masks represented the 92.22 % of the total PPE debris, being these results comparable to previous studies in other coastal areas in the world. On the other hand, total plastic debris densities were in the range from 2.457·10-2 to 92.219·10-2 g/m2 and densities were up to 0.732·10-2 for PPE debris. PPE debris supposed 0.79 % of the weight of total waste and the 0.51 % of total items. Concerning non-PPE plastic waste: cigarettes filters, food containers and styrofoam were the most abundant items (42.95, 10.19 and 16.37 % of total items, respectively). During vacation periods, total plastic debris amount increased 92.19 % compared to non-vacation periods. Regarding type of beaches, the presence of plastic debris was significantly higher on touristic/recreational than in fishing beaches. Data showed no significant differences between accessible and no-accessible beaches, but between periods with restrictive policy about mask face use and periods with non-restrictive policy data suggest significant differences between densities (g/m2) for PPE litter. The amount of PPEs debris is also correlated with the number of cigarettes filters (Person's r = 0.650), food containers (r = 0.782) and other debris (r = 0.63). Finally, although interesting results were provided in this study, further research is required to better understand the consequences of this type of pollution and to provide viable solutions to this problem.

Study of the relationship between motivation towards physical activityand its relationship with anxiety and self-concept in the educational setting.A systematic review / Estudio de la relación entre la motivación hacia la práctica deactividad física y su relación con la ansiedad y el autoconcepto. Unarevisión sistemática

Motivation is one of the most studied elements in sport psychology due to its great potential to explain the attitude towards sport practice. Therefore, the present systematic review aims to analyse the effects of sport-oriented motivation on physical activity, anxiety and self-concept. The Web of Science and SCOPUS databases were used to select articles published between 2012 and 2022. The criteria established by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement were followed for the elaboration of the systematic review, with the final analysis sample comprising a total of 19 articles. Finally, the analysis of the data reveals that developing sport motivation from extrinsic or intrinsic values can help to decrease or increase anxiety levels. In addition, it is also observed that motivation developed through extrinsic values plays a key role in the abandonment of physical activity, due to the frustration and worsening of the mental image generated at a professional level when the proposed objectives are not achieved.(AU)

Actualmente, la motivación es uno de los elementos más estudiados en la psicología del deporte debido a su gran potencial para explicar la actitud hacia la práctica deportiva. Es por ello que la presente revisión sistemática presenta el objetivo de analizar los efectos de la motivación orientada hacia el deporte sobre la práctica de actividad física, la ansiedad y el autoconcepto. Para ello se han utilizado las bases de datos de Web of Science y SCOPUS eligiéndose los artículos publicados entre los años 2012 y 2022. Para la elaboración de la revisión sistemática se han seguido los criterios establecidos por la declaración de los Elementos de Información Preferidos para Revisiones Sistemáticas y Meta-Análisis (PRISMA), quedando la muestra final de análisis compuesta por un total de 19 artículos. Finalmente, el análisis de los datos revela que desarrollar una motivación deportiva desde valores extrínsecos o intrínsecos puede ayudar a disminuir o a aumentar los niveles de ansiedad. Además, también se observa como la motivación desarrollada a través de valores extrínsecos supone jugar un papel clave en el abandono de la práctica de actividad físico deportiva, debido a la frustración y empeoramiento de la imagen mental generada a nivel profesional cuando no se consiguen los objetivos propuestos.(AU)

Tumor de Pott y absceso cerebral secundario a sinusitis aguda de foco dentario en paciente pediátrico

El tumor de Pott es una entidad rara, definida como un absceso subperióstico asociado a osteomielitis del hueso frontal. Suele presentarse como complicación de sinusitis aguda o crónica del seno frontal, y se describe con mayor incidencia en población pediátrica, siendo una complicación grave por su alta morbimortalidad. Se presenta a un paciente pediátrico con tumor de Pott y absceso cerebral posterior a una sinusitis aguda de foco odontogénico, en la que los pilares de tratamiento son drenaje quirúrgico precoz y antibioticoterapia prolongada. Se describe la clínica, manejo médico-quirúrgico y seguimiento posterior, ya que, en ausencia de antecedentes, se debe buscar dirigida- mente enfermedad periodontal y realizar un estudio de inmunodeficiencia primaria.

Pott's tumor is a rare entity, defined as a subperiosteal abscess associated with osteomyelitis of the frontal bone. It usually presents as a complication of acute or chronic sinusitis of the frontal sinus and it is described with a higher incidence in the pediatric population, being a serious complication due to its high morbidity and mortality. We present a pediatric patient with Pott's tumor and brain abscess after acute sinusitis of odontogenic focus, in which the pillars of treatment are an early surgical drainage and prolonged antibiotic therapy. The clinic, medical-surgical management and subsequent follow-up are described, since in the absence of antecedents, periodontal disease should be sought directly and a study of primary immunodeficiency performed.

Hemostasia en cirugía funcional endoscópica (CEF): Revisión de las recomendaciones de la literatura internacional

El manejo del sangrado en CEF es fundamental, ya que aumenta la tasa de complicaciones. El principal objetivo del manejo perioperatorio es lograr una buena hemostasia, es por esto que se realizó una revisión de las principales recomendaciones de la literatura internacional, que incluye medidas preoperatorias, intraoperatorias y postoperatorias.

Bleeding is an important factor in FESS since it increases the rate of complications. The main objective of perioperative management is to achieve good hemostasis. This is a review of the main recommendations of the international literature, that includes preoperative, intraoperative and postoperative measures.

Fractalkine/CX3CR1-Dependent Modulation of Synaptic and Network Plasticity in Health and Disease.

CX3CR1 is a G protein-coupled receptor that is expressed exclusively by microglia within the brain parenchyma. The only known physiological CX3CR1 ligand is the chemokine fractalkine (FKN), which is constitutively expressed in neuronal cell membranes and tonically released by them. Through its key role in microglia-neuron communication, the FKN/CX3CR1 axis regulates microglial state, neuronal survival, synaptic plasticity, and a variety of synaptic functions, as well as neuronal excitability via cytokine release modulation, chemotaxis, and phagocytosis. Thus, the absence of CX3CR1 or any failure in the FKN/CX3CR1 axis has been linked to alterations in different brain functions, including changes in synaptic and network plasticity in structures such as the hippocampus, cortex, brainstem, and spinal cord. Since synaptic plasticity is a basic phenomenon in neural circuit integration and adjustment, here, we will review its modulation by the FKN/CX3CR1 axis in diverse brain circuits and its impact on brain function and adaptation in health and disease.

Usos de cámara hiperbárica en otorrinolaringología / Uses for hyperbaric chambers in otolaryngology

Resumen En la terapia con oxígeno hiperbárico (HBO) se utiliza oxígeno al 100% de concentración en una cámara presurizada con presiones supraatmosféricas, que corresponden de 2 a 3 atmósferas. Los mecanismos por los cuales funciona esta terapia se relacionan con propiedades físicas de los gases y su comportamiento fisiológico en el organismo, lo que lleva finalmente a la hiperoxia, evento fisiológico que permite la obtención de diversos efectos beneficiosos. La evidencia en medicina ha demostrado su utilidad mayormente en la enfermedad por descompresión, infecciones cutáneas graves e intoxicación por monóxido de carbono. En el ámbito de la otorrinolaringología ha probado ser útil en algunas enfermedades como la hipoacusia súbita idiopática, tanto como terapia única como asociada al uso de corticosteroides, como en la osteomielitis refractaria del oído externo, la que en conjunto con antibioticoterapia y manejo quirúrgico presenta un evidente aumento en la tasa de mejoría. Cabe mencionar que la terapia con HBO ha demostrado también beneficios en los tratamientos y complicaciones posteriores a la radiación en pacientes con cáncer de cabeza y cuello. Es importante mencionar que la terapia con HBO no está exenta de riesgos y requiere que los pacientes cumplan con características específicas para su utilización, por lo que su indicación debe ser juiciosa y en casos seleccionados.

Abstract In hyperbaric oxygen therapy, 100% pure oxygen is used in a pressurized chamber with super atmospheric pressures which correspond to 2-3 atmospheres. The mechanism by which this treatment works is related to the physical properties of gases and their physiological behavior in the body, which leads to hyperoxia, the physiological event which allows for diverse beneficial health effects. The evidence in medicine has proven its utility mainly in decompression sickness, severe skin infections and carbon monoxide poisoning. In the otolaryngology field it has been proven useful in diseases like idiopathic sudden sensorineural hearing loss, both as the only treatment and as a concurrent treatment along with corticosteroids, in malignant otitis externa which in conjunction with antibiotic treatment and a surgical approach presents a clear increase in improvement rates. It must be mentioned that hyperbaric chamber treatment has also shown benefits in radiation treatment and post radiation complications in head and neck cancer patients. It is important to note that hyperbaric oxygen therapy is not without risks and patients must meet specific criteria for it to be applied, therefore it must be indicated using careful judgement and only in necessary cases.

Más allá de la infección aguda por SARS-CoV-2: un nuevo desafío para la Medicina Interna / Beyond acute SARS-CoV-2 infection: A new challenge for Internal Medicine

La infección por el nuevo coronavirus SARS-CoV-2 ha alcanzado proporciones de pandemia, con un número de muertes muy elevado en todo el mundo. A pesar del esfuerzo ímprobo desarrollado por la comunidad científica para abordar esta enfermedad en su fase aguda, así como en la prevención mediante la creación de vacunas en tiempo récord, aún queda otro caballo de batalla importante: comprender y tratar la persistencia de síntomas más allá de la fase aguda, el llamado «síndrome COVID-19 prolongado» o «COVID persistente». Estas manifestaciones persistentes afectan a varios órganos y sistemas y podrían depender tanto de los mecanismos patogénicos del virus como de la respuesta fisiopatológica del paciente. Un año después del inicio de esta pandemia es una necesidad urgente abordar esta situación desde un enfoque integral (AU)

Infection with the new SARS-CoV-2 coronavirus has reached pandemic proportions, with a very high death toll worldwide. Despite the scientific community's strenuous efforts to address this disease in its acute phase, as well as in prevention through the development of vaccines in record time, there remains another important workhorse: understanding and treating the persistence of symptoms beyond the acute phase, the so-called protracted COVID-19 syndrome or persistent COVID. These persistent manifestations affect several organs and systems and may depend on both the pathogenic mechanisms of the virus and the pathophysiological response of the patient. One year after the onset of this pandemic, there is an urgent need to address this situation from a comprehensive approach (AU)

Rotating Micro-Spheres for adsorption monitoring at a fluid interface.

HYPOTHESIS: A broad range of phenomena, such as emulsification and emulsion stability, foam formation or liquid evaporation, are closely related to the dynamics of adsorbing colloidal particles. Elucidation of the mechanisms implied is key to a correct design of many different types of materials. EXPERIMENTS: Microspheres forced to rotate near a fluid interface exhibit a roto-translational hydrodynamic mechanism that is hindered by capillary torques as soon as the particles protrude the interface. Under these conditions, the time evolution in the ratio of moving spheres provides a direct description of the adsorption kinetics, while microscopy monitoring of particle acceleration\deceleration informs about the adsorption\desorption dynamics. In this work, the proposed strategy is applied at an air/water interface loaded with spherical magnetic particles negatively charged, forced to rotate by the action of a rotating magnetic field. FINDINGS: The proposed method enables the adsorption/desorption dynamics to be followed during the earliest phase of the process, when desorption of a small fraction of particles is detected, as well as to estimate approximated values of the adsorption/desorption constants. The results obtained show that the addition of a monovalent salt or a cationic (anionic) surfactant promotes (inhibits) both adsorption and formation of permanent bonds between particles.

Sensorimotor effects of plasticity-inducing percutaneous peripheral nerve stimulation protocols: a blinded, randomized clinical trial.

BACKGROUND: Electrical stimulation of skin afferents can induce somatosensory plasticity in humans. Nevertheless, it is unknown if this is possible to do through percutaneous stimulation of a peripheral nerve, which will allow for regional anaesthesia interventions. Furthermore, potentiation protocols applied over mainly non-nociceptive fibres inhibit nociception in rodents, but this has not been tested in humans. OBJECTIVE: To determine whether a protocol aiming to depress the nociceptive circuit and another aiming to potentiate non-nociceptive circuits produce regional hypoalgesia and changes in motor function, applied through percutaneous peripheral nerve stimulation (pPNS), and to assess which of them is more promising for pain relief, immediately and 24 h after the intervention. METHODS: PT-cLF protocol aims to depress the nociceptive pathway through Pain Threshold, continuous Low Frequency stimulation and ST-bHF aims to produce potentiation of the non-nociceptive pathway, through Sensory Threshold burst stimulation at High Frequency. All subjects (n = 29) went through both protocols and a control condition in a randomized and blinded crossover design. RESULTS: Compared to control, ST-bHF induced distal hypoalgesia, towards electrical (p = 0.04) and mechanical stimuli (p = 0.02) and produced mechanical hypoesthesia (p = 0.02). Contrarily, hypoalgesia was not observed after PT-cLF (p > 0.05) but increased electrical motor threshold (p = 0.04), reduced motor recruitment (p = 0.03), and the subjects reported feeling reduced strength (p < 0.01). CONCLUSION: This works provides evidence that is possible to induce antinociceptive plasticity in a wide territory using pPNS. Moreover, it demonstrates for the first time in humans that a protocol aiming to produce long-term potentiation applied predominantly over non-nociceptive afferents induces hypoesthesia and hypoalgesia.

Beyond acute SARS-CoV-2 infection: A new challenge for Internal Medicine.

Infection with the new SARS-CoV-2 coronavirus has reached pandemic proportions, with a very high death toll worldwide. Despite the scientific community's strenuous efforts to address this disease in its acute phase, as well as in prevention through the development of vaccines in record time, there remains another important workhorse: understanding and treating the persistence of symptoms beyond the acute phase, the so-called protracted COVID-19 syndrome or persistent COVID. These persistent manifestations affect several organs and systems and may depend on both the pathogenic mechanisms of the virus and the pathophysiological response of the patient. One year after the onset of this pandemic, there is an urgent need to address this situation from a comprehensive approach.

[Beyond acute SARS-CoV-2 infection: A new challenge for Internal Medicine]. / Más allá de la infección aguda por SARS-CoV-2: un nuevo desafío para la Medicina Interna.

Infection with the new SARS-CoV-2 coronavirus has reached pandemic proportions, with a very high death toll worldwide. Despite the scientific community's strenuous efforts to address this disease in its acute phase, as well as in prevention through the development of vaccines in record time, there remains another important workhorse: understanding and treating the persistence of symptoms beyond the acute phase, the so-called protracted COVID-19 syndrome or persistent COVID. These persistent manifestations affect several organs and systems and may depend on both the pathogenic mechanisms of the virus and the pathophysiological response of the patient. One year after the onset of this pandemic, there is an urgent need to address this situation from a comprehensive approach.

Inteligencia emocional y adherencia a la dieta mediterránea. Un modelo de ecuaciones estructurales en adolescentes de educación primaria de la provincia de granada / Emotional intelligence and adherence to the Mediterranean diet. A model of structural equations in adolescents of primary education in the province of Granada

La adolescencia es una etapa de desarrollo, la cual juega un papel clave en lo que se refiere a la adquisición de una adherencia positiva a un patrón dietético saludable y en el control de las distintas emociones vivenciadas en el día a día. Teniendo en cuenta lo anterior, la presente investigación refleja los objetivos de desarrollar un modelo explicativo de la incidencia de la atención, claridad y reparación emocional sobre la adherencia hacia la dieta mediterránea en estudiantes del tercer ciclo de educación primaria y contrastar el modelo estructural mediante un análisis multigrupo en función del sexo. Para ello, se ha realizado un estudio descriptivo comparativo de corte transversal con 293 estudiantes del tercer ciclo de educación primaria. Los instrumentos utilizados han sido un cuestionario sociodemográfico, el test KIDMED y el Trait Meta-Mood Scale (TMMS-24). Finalmente, los resultados revelan una relación negativa entre la adherencia a la dieta mediterránea y la claridad y atención emocional en el sexo femenino.(AU)

Adolescence is a stage of development, which plays a key role in terms of acquiring positive adherence to a healthy dietary pattern and in controlling the different emotions experienced on a daily basis. Taking into account the above, the present investigation reflects the objectives of developing an explanatory model of the incidence of attention, clarity and emotional repair on adherence to the Mediterranean diet in students of the third cycle of primary education and contrasting the structural model through a multigroup analysis according to sex. For this, a cross-sectional comparative descriptive study has been carried out with 293 students of the third cycle of primary education. The instruments used have been a sociodemographic questionnaire, the KIDMED test and the Trait Meta-Mood Scale (TMMS-24). Finally, the results reveal a negative relationship between adherence to the Mediterranean diet and clarity and emotional attention in the female sex.(AU)

Timpanoplastías en el Hospital San Vicente de Arauco: Revisión de 3 años / Tympanoplasties in San Vicente de Arauco Hospital: 3 years review

Resumen Introducción: La timpanoplastía es el tratamiento de elección en la otitis media crónica simple. En Chile se han realizado diversos estudios para evaluar el éxito de la timpanoplastía. En nuestro centro evaluamos el resultado anatómico y funcional, correlacionando los resultados con la demografía de nuestra población. Objetivo: Realizar una descripción epidemiológica de los pacientes con diagnóstico de otitis media crónica simple, sometidos a timpanoplastía en el Hospital San Vicente de Arauco entre los años 2017 y 2019. Material y Método: Estudio retrospectivo y descriptivo. Se revisaron las fichas clínicas de pacientes con cirugía realizada entre enero de 2017 y noviembre de 2019. Este estudio cuenta con la aprobación del comité de ética del servicio de salud Arauco. Resultados: Se realizaron 77 timpanoplastías. 56 oídos cumplieron los criterios de inclusión. 71,43% fueron de sexo femenino. El rango de edad es de 8 a 64 años. 92,86% corresponde a timpanoplastía tipo I. Se utilizó un abordaje endoauricular en el 58,93%. El injerto utilizado fue predominantemente compuesto (cartílago-pericondrio) en un 75%. Se usó una técnica medial en un 94,94%. Se obtuvo un éxito anatómico 85,71% de los pacientes. Se obtuvo una ganancia sobre 10 dB en un 60,71% de los pacientes. Conclusión: No se encontraron diferencias significativas importantes que relacionan las elecciones quirúrgicas con los resultados anatómicos y auditivos del procedimiento a mediano plazo.

Abstract Introduction: Tympanoplasty is the treatment of choice for chronic otitis media. In Chile, several studies have been carried out to evaluate the success of tympanoplasty. Here, we assesed the anatomical and functional outcomes, correlating the results with the demographics of our population. Aim: To carry out an epidemiological description of patients with a diagnosis of chronic otitis media who underwent tympanoplasty at our hospital between 2017 and 2019. Material and Method: Retrospective, descriptive study. We reviewed clinical records of patients who underwent surgery between January 2017 and November 2019. This study has been approved by the ethics committee of Arauco health service. Results: 77 tympanoplasties were performed, of which 56 ears met the inclusion criteria. 71.43% were female. The age range is 8 to 64 years. 41% had chronic pathologies. 51.79% were left ear surgeries. 92.86% were type I tympanoplasty. An endoauricular approach was performed in 58.93%. A cartilage - perichondrium composite graft was used in 75% of the surgeries. A medial technique was performed in 94.94%. Anatomical success was achieved in 85.71% of patients. An average gain over 10 dB was obtained in 60.71% of the patients. Conclusion: There were no significant differences regarding the surgical choices with the anatomical and auditory results.

Effect of Materials For Interim Restoration on Estimation of Working Length Using Electronic Apex Locator: in vitro Study

ABSTRACT: The aim of this in vitro study was to evaluate measurement accordance using an electronic apex locator for estimation of working length in endodontics when different restorative materials for interim crown restoration are utilized. For this study, 13 single-rooted premolars with endodontic occlusal access cavity were prepared. To establish the working length of each tooth, these were mounted in alginate and with the help of an electronic foramen locator and endodontic file K-file # 15, the working length was established. This length was later compared to the estimated working lengths using different intermediate restoration materials. These materials were: Superior Chemfil, Ketac ™ Molar Easymix and Filtek z350 resin. In the electronic measurements, an acceptable tolerance range of variation up to ± 0.5 mm was considered. Highest discrepancies were considered erroneous. For these measurements, central tendency and dispersion were analyzed. The Bland-Altman method was used, and the ANOVA test with a significance level of p <0,05 for statistic difference. Regarding measurements' acceptability and the type of interim restoration material utilized, 7 were acceptable, and 6 were unacceptable for ChemFil Superior, 12 were acceptable and 1 unacceptable for Ketac™ Molar Easymix, and 11 were acceptable and 2 were unacceptable for Filtek Z350 composite resin. The average difference between all electronic measurements was 0.29 (± 0.44). Chemfill Superior showed the most prominent variation between measurements 0.58 (± 0.45). When using an electronic apex locator, measurements showed statistically significant differences depending on the interim restoration material of choice (p<0.05). In conclusion, the measurement accordance using electronic apex locator to estimation the working length is higher, however the electronic estimation of working length can be significatively affected by the material chosen for interim temporary restoration.

RESUMEN: El objetivo de este estudio in vitro, fue evaluar la concordancia de las estimaciones de longitud de trabajo mediante localizador electrónico de foramen, utilizando diferentes materiales de restauración intermedia coronaria. Para tales fines fueron preparados 13 premolares uniradiculares con cavidad de acceso oclusal endodóntico. Para establecer la a longitud de trabajo de cada diente, estos fueron montados en alginato y con la ayuda de un localizador electrónico de foramen y lima de endodoncia K-file #15 fue establecida la longitud de trabajo. Esta longitud fue comparada posteriormente con las longitudes de trabajo estimadas utilizando diferentes materiales de restauración in- termedia. Estos materiales fueron: Chemfil superior, Ketac™ Molar Easymix y resina Filtek z350. En las mediciones electrónicas, se consideró un rango de tolerancia aceptable de variación hasta ± 0,5 mm. Las discrepancias mayores se consideraron erróneas. Se calcularon medidas de tendencia central y la dispersión. Se utilizó el método de Bland- Altman y la prueba ANOVA con un nivel de significancia de p <0,05. Con respecto a la aceptabilidad de las mediciones y el tipo de material de restauración intermedia, 7 fueron aceptables y 6 fueron inaceptables para ChemFil Superior, 12 fueron aceptables y 1 inaceptable para Ketac ™ Molar Easymix, y 11 fueron aceptables y 2 fueron inaceptables para el compuesto Filtek Z350 resina. La diferencia promedio entre todas las mediciones electrónicas fue de 0,29 (± 0,44). Chemfil Superior mostró la mayor variación entre medicio- nes 0,58 (± 0,45). Las mediciones mostraron diferencias estadísticamente significativas dependiendo del material de restauración intermedio elegido (p <0,05). En conclusión, la concordancia en la estimación de la longitud de trabajo usando localizador electrónico de foramen es alta, sin embargo, puede verse afectada significativamente por el material de obturación intermedio.

Úlcera duodenal benigna con penetración en cabeza de páncreas, con obstrucción de la vía biliar / Benign duodenal ulcer penetrating into pancreas, with obstruction of common bile duct

Resumen Objetivo: Reportamos un caso clínico con presentación atípica de una úlcera duodenal benigna que simula el cuadro clínico y radiológico de una neoplasia de páncreas. Materiales y Método: Presentamos el caso de un varón de 83 años que debuta con un cuadro clínico de astenia e ictericia mucocutánea. En estudio de imagen se identifica una masa en cabeza pancreática. En estudio endoscópico se observa úlcera duodenal benigna penetrada a cabeza de páncreas que condiciona obstrucción de vía biliar. Discusión y Conclusiones: El manejo de estos pacientes suele ser quirúrgico porque desarrollan un deterioro asociado a sepsis o perforación. Si la situación clínica lo permite se puede intentar un tratamiento conservador. En nuestro caso el paciente precisó un mes de hospitalización con antibioticoterapia intravenosa de amplio espectro, reposo alimentario, nutrición parenteral y tratamiento con inhibidores de la bomba de protones (IBP) para la resolución del cuadro. La penetración o fistulización a la cabeza del páncreas es una complicación grave e infrecuente de la enfermedad ulcerosa péptica. Su manejo puede ser conservador en casos seleccionados donde no exista perforación de la úlcera a la cavidad peritoneal, ni exista deterioro séptico ni hemodinámico.

Aim: To report an atypical presentation of a benign duodenal ulcer that simulates pancreatic neoplasia. Materials and Method: A case of a 83 years old male patient with astenia and jaundice due to a benign duodenal ulcer penetrating into the pancreas with obstruction of common bile duct. Imagining study identified a pancreatic head mass. The patient required one month admission, receiving broad-spectrum antibiotics, parenteral nutrition and intravenous proton pump inhibitors. Discussion and Conclusion: Due to frequent complications associated to this condition, such as haemodynamic failure, sepsis or free peritoneal perforation, surgery is the main treatment. However, in mild cases, as in our patient, conservative management can be considered. Penetration or fistulization to the head of the pancreas is a rare and serious complication of peptic ulcer disease. Its management can be conservative in selected cases where there is no perforation of the ulcer into the peritoneal cavity, nor septic or hemodynamic deterioration.

Cupriavidus pauculus bacteremia related to parenteral nutrition. Case series report.

Cupriavidus pauculus is a Gram negative rod that is usually isolated in water and has been extraordinarily isolated in patients with vascular access and / or immunosuppression. In this work we present a series of cases of patients with positive blood cultures for cupríavidus pauculus, during a short period of time in our hospital center. The only characteristic related to all cases was the use of parenteral nutrition. It highlights the rareness of the microorganism and the susceptibility identified in the antibiogram, which may be useful for future cases.