Anthropometric Similarities and Differences in Children of Aymara and Non-Aymara Descent in Northern Chile: Implications for Health and Development / Similitudes y Diferencias Antropométricas en Niños de Etnia Aymara y Ascendencia No-Aymara en el Norte de Chile: Implicaciones para la Salud y el Desarrollo

SUMMARY: This study aims to assess the nutritional status of Aymara and non-Aymara children in Arica, comparing anthropometric measurements of boys and girls aged 4-10 to inform interventions for child health and development. We conducted a non-experimental, quantitative, cross-sectional study in Arica, Chile. The sample included 458 children, with equal representation of Aymara and non-Aymara children from diverse socioeconomic backgrounds. Trained research assistants collected anthropometric data using standardized techniques. IBM SPSS statistical software was used for data analysis, including Student's t-test and the Levene test. Both Aymara and non-Aymara children showed high prevalence of overweight and obesity. Boys had a meso-endomorph somatotype, while girls had an endomorph somatotype. Among 8-year-olds, non-Aymara children had a slightly higher mean body weight (35.87, SD 4.50) compared to Aymara children (32.27, SD 4.31), but the difference was not statistically significant (p>0.05). However, 10-year-old Aymara girls had a significantly higher mean body mass index (22.34, SD 4.21) than non-Aymara girls (20.10, SD 3.58) (p=0.05). Regarding body fat percentage, 10-year- old non-Aymara girls had a slightly higher mean (31.01, SD 5.64) than Aymara girls (26.12, SD 5.63), but the difference was not statistically significant (p>0.05). The study found high levels of overweight and obesity in children from northern Chile, increasing with age for both Aymara and non-Aymara groups. The somatotype patterns were consistent across both groups. Although the differences between Aymara and non-Aymara children were not statistically significant, the Aymara group showed slightly higher levels of overweight and obesity. Further research with a larger sample size is needed to confirm these results and identify potential trends. Efforts should focus on promoting healthy nutrition and physical activity to address the growing problem of overweight and obesity in this region.

Este estudio tiene como objetivo evaluar el estado nutricional de los niños Aymaras y no Aymaras en Arica, comparando las medidas antropométricas de niños y niñas de 4 a 10 años para informar las intervenciones para la salud y el desarrollo infantil. Realizamos un estudio no experimental, cuantitativo, de corte transversal en Arica, Chile. La muestra incluyó a 458 niños, con igual representación de niños Aymaras y no Aymaras de diversos estratos socioeconómicos. Asistentes de investigación capacitados recolectaron datos antropométricos utilizando técnicas estandarizadas. Se utilizó el software estadístico IBM SPSS para el análisis de datos, incluyendo la prueba t de Student y la prueba de Levene. Tanto los niños Aymaras como los no Aymaras presentaron una alta prevalencia de sobrepeso y obesidad. Los niños tenían un somatotipo meso-endomorfo, mientras que las niñas tenían un somatotipo endomorfo. Entre los niños de 8 años, los niños no Aymaras tenían un peso corporal medio ligeramente superior (35,87, DE 4,50) en comparación con los niños Aymaras (32,27, DE 4,31), pero la diferencia no fue estadísticamente significativa (p>0,05). Sin embargo, las niñas Aymaras de 10 años tenían un índice de masa corporal medio significativamente mayor (22,34, SD 4,21) que las niñas no Aymaras (20,10, SD 3,58) (p=0,05). En cuanto al porcentaje de grasa corporal, las niñas no Aymaras de 10 años tuvieron una media ligeramente superior (31,01, DE 5,64) que las niñas Aymaras (26,12, DE 5,63), pero la diferencia no fue estadísticamente significativa (p>0,05). El estudio encontró altos niveles de sobrepeso y obesidad en niños del norte de Chile, aumentando con la edad tanto para los grupos Aymaras como para los no Aymaras. Los patrones de somatotipo fueron consistentes en ambos grupos. Aunque las diferencias entre los niños Aymaras y no Aymaras no fueron estadísticamente significativas, el grupo Aymara mostró niveles ligeramente más altos de sobrepeso y obesidad. Se necesita más investigación con un tamaño de muestra más grande para confirmar estos resultados e identificar tendencias potenciales. Los esfuerzos deben centrarse en promover una nutrición saludable y la actividad física para abordar el creciente problema del sobrepeso y la obesidad en esta región.

Estimation of dental age using the kvaal method with digital panoramic radiographs in peruvian adults / Estimación de la edad dental según el método de Kvaal con radiografías panorámicas digitales en adultos peruanos

To determine the accuracy of the Kvaal method in the estimation of dental age through the analysis of digital panoramic radiographs of patients between 20 and 47 years of age who attended the stomatological clinic of the Universidad Científica del Sur, (2018 to 2019), Lima-Perú. 289 digital panoramic radiographs belonging to individuals of both sexes, aged 20 to 47 years were analyzed. Length and width measurements were obtained in the dental and pulp chamber in the upper central incisors. These data were subsequently evaluated by calculating the proportions between the pulp and root length of the upper central incisor by applying the formula of the method of Kvaal et al. to obtain the accuracy of the method in estimating dental age. Applying the formula of Kvaal et al. indicates that the relationship between the width of the pulp and the length of the root has a higher level of significance in relation to others proportions: M mean value of all ratios except T (-0.659) and W-L difference between W and L (-0.643). The coefficient of determination (r²) and standard error of estimation (SEE) using the original Kvaal formula is r²: 0.70, SEE: 4.90 years, then a modified Kvaal formula was proposed for the Peruvian population. The Method of Kvaal et al. has an accuracy of 1.24 in estimating the dental age of individuals, using the upper central incisor in digital panoramic radiographs.

Determinar la precisión del método de Kvaal en la estimación de la edad dental mediante el análisis de radiografías panorámicas digitales de pacientes entre 20 a 47 años atendidos en la clínica estomatológica de la Universidad Científica del Sur, (2018 a 2019), Lima-Perú. Se analizaron 289 radiografías panorámicas digitales pertenecientes a individuos de ambos sexos, de 20 a 47 años. Se obtuvo medidas de longitud y anchura en la cámara dental y pulpar en los incisivos centrales superiores. Estos datos se valoraron posteriormente al calcular las proporciones entre la pulpa y longitud de la raíz del incisivo central superior aplicando la fórmula del método de Kvaal et al. para obtener la precisión del método en la estimación de la edad dental. Al aplicar la fórmula de Kvaal et al. indica que la relación entre la anchura de pulpa y la longitud de la raíz presentan un nivel de significancia mayor en relación a otras proporciones: M valor medio de todas las proporciones excepto T (-0.659) y W-L: diferencia entre los valores de W y L (-0.643). El coeficiente de determinación (r²) y el error estándar de la estimación (SEE) utilizando la fórmula original de Kvaal es de r²: 0.70, SEE: 4.90 años, después se propuso una fórmula modificada de Kvaal para la población peruana. El Método de Kvaal et al. tiene una precisión del 1.24 en la estimación de la edad dental de los individuos, utilizando el incisivo central superior en radiografías panorámicas digitales.

Teachers' experiences of teaching online during COVID-19: implications for postpandemic professional development.

As a result of the Great Online Transition (GOT) that occurred during COVID-19, it is increasingly necessary to understand the digital competencies that are required for online and blended learning in the postpandemic era. Postquarantine, higher education institutions must return to on-campus face-to-face learning, a situation which raises questions concerning how to retain the lessons learned from this period of the forced acquisition and innovation of online teaching competencies. In this article, we present the results of an interview-based study of teachers' experiences of online teaching during the pandemic. One hundred fifty-one teachers were interviewed over a period of 2 years during the pandemic. We conducted a hybrid thematic analysis to systematize teachers' experiences. Our results show that despite the problems faced due to the disruption caused by the pandemic, several lessons were learned: teachers employed an array of digital tools to maintain content delivery and promote interaction, deepened their understanding of course design and assessment, and developed an empathic disposition to understand students' situations. We build upon these experiences to generate recommendations for developing digital competencies following the GOT.

Dimorfismo sexual del agujero magno en tomografías de una población peruana / Sexual dimorphism of the foramen magnum in CT scans of a Peruvian population

Introducción: La base del cráneo es una estructura compacta, muy resistente a los daños físicos, la robustez del hueso occipital y la posición anatómica protegida del agujero magno bajo una profundidad de tejido blando pueden hacerlo menos vulnerable a la fragmentación y a los efectos de los procesos tafonómicos en comparación con otras estructuras óseas, lo que permite utilizarlo para estimar el dimorfismo sexual. Objetivo: Establecer la relación entre el dimorfismo sexual y la morfometría del agujero magno en tomografías de pacientes mayores o iguales a los 18 años que asistieron a consultorios privados en Lima metropolitana, durante los años 2015 al 2020. Materiales y métodos: El estudio se desarrolló con 239 tomografías (88 masculinos y 151 femeninos). Se realizaron mediciones del agujero magno de los diámetros anteroposterior máximo (DAPM), transversal máximo (DTM) y el área se estableció mediante la fórmula de Teixeira (1982). Resultados: El DAPM presentó una media en el sexo masculino de 37,182 +/- 2,4012 mm y en el femenino de 34,795 +/- 2,1086 mm, mientras que para el DTM se estableció una media en el sexo masculino de 32,517 +/- 2,3463 mm y para el femenino de 30,514 +/- 2,2084 mm, en el área según Teixeira (1982) en el sexo masculino se observó una media de 957,21390 +/- 115,162403mm2 y en el femenino de 840,11055 +/- 93,775088mm2. Se establece una relación estadística (p<0.05) entre los parámetros DAPM, DTM, A Teixeira (1982) entre ambos sexos. Conclusión: Existe relación entre el dimorfismo sexual y la morfometría del agujero magno, con una predicción de 71.96%

Introduction: The base of the skull is a compact structure, very resistant to physical damage, the robustness of the occipital bone and the protected anatomical position of the foramen magnum under a depth of soft tissue may make it less vulnerable to fragmentation and to the effects of taphonomic processes compared to other bone structures, allowing it to be used to estimate sexual dimorphism. Objective: To establish the relationship between sexual dimorphism and the morphometry of the foramen magnum in CT scans of patients older or equal to 18 years of age who attended private clinics in metropolitan Lima, during the years 2015 to 2020. Materials and methods: The study was developed with 239 tomographies (88 male and 151 female). Foramen magnum measurements of the maximum anteroposterior diameters (DAPM), maximum transverse (DTM) were performed and the area was established using Teixeira's (1982) formula. Results: The DAPM presented a mean in the male sex of 37.182 +/- 2.4012 mm and in the female sex of 34.795 +/- 2.1086 mm, while for the DTM a mean was established in the male sex of 32.517 +/- 2, 3463 mm and for the female of 30.514 +/- 2.2084 mm, in the area according to Teixeira (A Teixeira) in the male sex a mean of 957.21390 +/- 115.162403mm2 and in the female sex of 840.11055 +/- 93.775088mm2 was observed. A statistical relationship (p<0.05) was established between the parameters DAPM, DTM, A TEIXEIRA between both sexes. Conclusion: There is a relationship between sexual dimorphism and foramen magnum morphometry, with a prediction of 71.96%

Rapid Antigingivitis Efficacy of a Novel Stannous Fluoride Dentrifice: Results from a 12-Week Randomized Controlled Clinical Trial.

OBJECTIVE: To assess the anti-gingivitis and anti-plaque efficacy of a novel bioavailable stannous fluoride (SnF2) dentifrice to a negative control. METHODS: This was a 12-week randomized, controlled, double-blind, two-treatment, parallel group clinical study. One hundred generally healthy adults with evidence of plaque and gingivitis were enrolled into the study. Subjects were randomly assigned to one of two dentifrice treatments: (1) novel SnF2 dentifrice containing the amino acid glycine as a stabilizing chelant (Procter and Gamble) or (2) a negative control sodium monofluorophosphate dentifrice. Gingivitis was assessed using the Löe-Silness Gingivitis Index (LSGI) at baseline, Week 1, and Week 12 while plaque was evaluated according to the Turesky Modification of the Quigley-Hein Plaque Index at baseline and Week 12. RESULTS: One hundred subjects completed the trial. Subjects using the novel SnF2 dentifrice demonstrated statistically significantly fewer bleeding sites and a lower LSGI score versus those using the negative control as early as Week 1 (P less than .001). The benefit increased throughout the study, with the SnF2 dentifrice showing 33.4% fewer bleeding sites and a 16.5% lower LSGI score versus the negative control at Week 12 (P less than .001). Subjects with localized or generalized gingivitis (≥10% bleeding sites) had 6 times better odds of transitioning to generally healthy (less than 10% bleeding sites) after using the SnF2 dentifrice for 12 weeks versus the negative control. Plaque scores for the SnF2 dentifrice were also statistically significantly lower (P less than .001) than those for the negative control at Week 12. CONCLUSION: The novel SnF2 dentifrice with the amino acid glycine produced statistically significant improvements in gingival health that were seen as early as 1 week and numerically increased throughout the study.

Forensic Evaluation of Highmore Antrum Sexual Dimorphism by Cone Beam Computed Tomography: A Retrospective Study of a Peruvian Population.

OBJECTIVE: The aim of this study was to evaluate Highmore antrum sexual dimorphism by cone-beam computed tomography (CBCT) in a Peruvian population. MATERIALS AND METHODS: This was a retrospective analytical study. The sample consisted of 190 CBCT scans. Inter-observer concordance was performed previously obtaining an intraclass correlation coefficient (ICC) of 0.99 for the width, length, and height of the right and left maxillary sinus. Then the dimensions of the maxillary sinus (left and right) were measured. All statistical analyses were performed using the Student's t test and Lambda de Wilks, establishing a level of significance of P < 0.05. RESULTS: It was observed that on the right side of the maxillary sinus there were only statistically significant differences between the width, height, area, perimeter, and volume of the Highmore's antrum and sex with a P < 0.05. Statistically significant differences were observed between sex and the width, height, area, perimeter, and volume of the Highmore's antrum in the right side of the maxillary sinus (P < 0.05), whereas the left side only showed statistically significant differences between the height and volume of the Highmore's antrum and sex (P < 0.05). CONCLUSION: The maxillary sinuses have significant sexual dimorphism, with the parameter of height showing the greatest dimorphism according to the discriminant analysis.

Dimorfismo sexual a través del análisis morfométrico de bóvedas palatinas en una población peruana / Sexual Dimorphism Via Palatal Vault Morphometric Analysis on A Sample Peruvian Population

Resumen: Objetivo: Determinar la precisión del dimorfismo sexual a través del análisis morfométrico de bóvedas palatinas en cráneos procedentes del Laboratorio de Investigación Forense del Equipo Forense Especializado (EFE) de Ayacucho del Ministerio Público - Perú. Materiales y métodos: Diseño transversal, constituido con una muestra de 43 cráneos con sexo biológico preestablecido, (24=masculino y 19=femenino). La estimación del dimorfismo sexual se estableció a través del método propuesto por Meera Jacob y cols., basado en las mediciones de la longitud y ancho palatino, posteriormente se calculó el índice palatino, estableciéndose la precisión y exactitud del método. El análisis inferencial se realizó con un nivel de significancia del 5% a través de la prueba T student, Shapiro Wilk y el coeficiente de Pearson. Resultados: Se estableció que el ancho palatino presenta una media de 3,43 (+0,31) cm. para el sexo masculino y 3,62 (+0,25) cm. para el femenino, en la longitud palatina la media fue de 5,07 (+0,44) cm. para masculino y 4,79 (+0,41) cm. en el femenino; en el índice palatino, el 100% de los cráneos de sexo masculino corresponden al paladar duro estrecho y en el femenino un 73,7% al estrecho, un 21% al intermedio y un 5,3% al ancho. Además, se determinó que existió diferencias estadísticamente significativas entre los parámetros del ancho y longitud de la bóveda palatina entre ambos sexos y se planteó una fórmula de análisis discriminante. Conclusión: El análisis morfométrico de bóvedas palatinas establece una precisión de 83.72% en la estimación del dimorfismo sexual.

Abstracts: Objective: Determine sexual dimorphism precision via palatal vault morphometric analysis in craniums sourced from the Laboratorio de Investigación Forense del Equipo Forense Especializado (EFE) de Ayacucho del Ministerio Público- Perú. Materials and Methods: Cross-sectional design consisting of a sample of 43 skulls with pre-established biological gender, (24 males and 19 females). Sexual dimorphism was established by means of the method proposed by Meera Jacob and co., based on palatal width and length measurements, after which the palatal index was calculated, establishing the method's precision and accuracy. The inferential analysis was made with a level of significance of 5% through the T student test, Shapiro Wilk and Pearson's coefficient. Results: Palatal width had a mean of 3.43 (+0.31cm) for males and 3.62 (+0.25) for females and in palatal length a mean of 5.07 (+0.44) cm. for males and 4.79 (+0.41) cm. for females is established; on palatal index, 100% of the male skulls correspond to hard narrow palate and on females 73.7% to narrow, 21% to intermediate and 5.3% to wide. Furthermore, it was determined that there were statistically significant differences between width and length of palatal vault for both genders, and a discriminating analysis formula was proposed. Conclusion: Morphometric analyses of palatal vaults establish an 83.72% precision on the estimation of sexual dimorphism.

Ligamento periodontal y pulpa radicular en la estimación de la edad cronológica en una población peruana / Periodontal ligament and root pulp in the estimation of chronological age in Peruvian population

Objetivo. Determinar la eficacia entre los métodos radiográficos del ligamento periodon-tal y pulpa radicular en el tercer molar inferior para la estimación de la edad cronológica.Métodos. Diseño transversal, se trabajó con una muestra de 347 imágenes radiográficas panorámicas digitales (187 hombres, 160 mujeres) comprendidos entre los 16 a 74 años, La estimación de la edad cronológica se basó en la clasificación de estadios propuestos por Olze, con una correlación intraexaminador de (0,870; 0,902) e inter-examinador (0,907; 0,920) por la Prueba de Kappa de Cohen. La relación entre la edad cronológica, los estadios del ligamento periodontal y pulpa radicular se determinó a través de prue-bas de correlación de Spearman y Pearson, la prueba de Wilcoxon estimó la diferencia entre las piezas dentarias 38 y 48 con un nivel de significancia p<0,05. Resultados. La correlación de Spearman fue positiva mediana y alta y la correlación de Pearson positiva moderada y alta. La diferencia fue significativa entre las terceras molares inferiores en ambos métodos. Además, no hubo diferencia significativa entre la edad cronológica y la estimación de la edad con el estudio de la pulpa radicular y con el estudio del ligamento periodontal. Conclusión. El método radiográfico de la pulpa radicular en el tercer molar inferior derecho es más preciso que del ligamento periodontal, así mismo, el método de estudio radiográfico del ligamento periodontal del tercer molar inferior izquierdo es más eficaz que de la pulpa radicular.

Objective. Determine the effectiveness between radiographic methods of the periodontal ligament and root pulp of the lower third molars, in the estimation of chronological age. Methods. Through a cross-sectional design, using a sample of 347 digital panoramic ra-diographic images (187 males, 160 females) between 16 and 74 years old. The estimation of chronological age was based on the classification of stages proposed by Olze, with a intra-examiner and inter-examiner agreement was determined by Cohen's Kappa Test. The relationship among the chronological age, the stages of the periodontal ligament and the root pulp were assessed using Spearman and Pearson rank-order correlation. The Wilcoxon test estimated the difference between dental pieces 38-48, with a level of significance p<0.05.Results. There was a medium and long positive correlation. There was a significant difference between the lower third molars in both methods. Also, there wasn ́t a significant difference between age chronology and age estimation with the study of root pulp of dental and with the study of periodontal ligament. Conclusions. The radiographic method of the root pulp in the right lower third molar is more precise than the periodontal ligament. Likewise, the radiographic study method of the periodontal ligament of the left lower third molar is more efficient than of the root pulp.

Estimación de la edad cronológica a través de los métodos de Demirjian y Ubelaker en niños peruanos / Estimation of the Chronological Age Through the Methods of Demirjian and Ubelaker in Peruvian Children

RESUMEN Objetivo: Determinar el método de estimación de la edad dental más eficaz, Demirjian y Ubelaker, para estimar la edad cronológica en pacientes de 4 a 13 años del Instituto Nacional de Salud del Niño- Lima Perú. Materiales y métodos: Diseño transversal con una muestra conformada por 465 radiografías panorámicas, 229 de personas de sexo masculino (49.2%) y 236 de femenino (50.8%). La estimación de la edad se realizó mediante el protocolo establecido en cada método. La edad cronológica se estableció a través de la diferencia entre la fecha de toma radiográfica con la fecha de nacimiento. Se estableció la precisión y exactitud de cada método. El análisis inferencial se realizó con un nivel de significancia del 5% a través de las pruebas de correlación de Spearman, test de Wilcoxon. Resultados: Se comprobó que el método Ubelaker tuvo 270 casos errados o no coincidentes y 195 coincidencias mientas que el método Demirjian tuvo 360 casos errados y 105 coincidencias entre la edad cronológica estimada y la edad dental encontrándose diferencias significativas en la estimación en cada uno de los métodos p=0,001 y p<0,001 respectivamente. La exactitud obtenida con Ubelaker fue 0,112 y con Demirjian 1,039. Conclusión: El método Ubelaker es más eficaz con una exactitud mayor en comparación a Demirjian.

ABSTRACT Objective: To determine the most effective dental age estimation method, Demirjian y Ubelaker, for estimating the chronological age in patients from 4 to 13 years of the National Institute of Child Health- Lima Peru. Materials and methods: Cross-sectional design with a sample consisting of 465 panoramic radiographs, 229 of male (49.2%) and 236 of female (50.8%). The estimated age was made using the protocol established in each method. The chronological age was established through the difference between the date of radiographic capture and the date of birth. The precision and accuracy of each method was established. The inferential analysis was performed with a level of significance of 5% through the Spearman correlation tests, Wilcoxon test. Results: It was proved that the Ubelaker method had 270 erroneous or mismatched cases and 195 coincidences while the Demirjian method had 360 erroneous cases and 105 coincidences between the estimated chronological age and dental age, finding significant differences in the estimation in each of the methods p=0.001 and p <0.001 respectively. The accuracy obtained with Ubelaker was 0,112 and with Demirjian 1,039.

Utilización de la Escala de Empatía Médica de Jefferson en Residentes que realizan su especialización en un hospital peruano / Use of the Jefferson’s Medical Empathy Scale in Resident physicians in specialization training in a Peruvian hospital

La empatía es definida como la capacidad de comprender los sentimientos y emociones de los demás, basada en el reconocimiento del otro como persona similar o semejante. Aplicada a la relación médico-paciente, puede mejorar los resultados clínicos, por lo que es considerada una habilidad esencial en la capacitación de todo profesional médico. Objetivo: Identificar el nivel de empatía y factores relacionados en médicos residentes de áreas médicas y quirúrgicas realizando entrenamiento especializado en un hospital de Lima, Perú. Material y métodos: Se obtuvieron esenciales datos sociodemográficos y profesionales y se aplicó la Escala de Empatía Médica de Jefferson, conformada por 20 preguntas, con puntuación Likert de 1 a 7, puntaje mínimo de 20 y máximo de 140, y nivel de empatía directamente proporcional al puntaje obtenido. Resultados: Cien médicos residentes, 52% de sexo femenino constituyeron la muestra. La media del puntaje obtenido fue 112,88, con DE 14.51, mediana de 115 y coeficiente alfa de Cronbach de 0,82. Los valores de los cuartiles fueron de 102, 115 y 124. Veintiséis por ciento de los médicos residentes de medicina, 19,2% de cirugía, 10% de Gineco-obstetricia y 35% de pediatría alcanzaron puntajes del cuartil superior. No se hallaron diferencias estadísticamente significativas al comparar el puntaje de los encuestados con cada una de las variables estudiadas. Conclusiones: Los médicos residentes de la especialidad de Pediatría presentaron puntajes más altos que el resto de especialidades, pero no se encontraron variables específicas significativas para explicar las diferencias detectadas en niveles de empatía.

Empathy is defined as the ability to understand the feelings and emotions of others, based on the recognition of the other as similar. Applied to the doctor-patient relationship can improve clinical outcomes, reason for which it is considered an essential ability in the training of every medical professional. Objective: To identify the level of empathy and related factors in resident physicians in medical and surgical specialized training in a hospital in Lima, Peru. Material and methods: Sociodemographic, personal and professional data were obtained and the Jefferson Medical Empathy Scale, consisting of 20 questions and a 1 to 7 Likert scoring type, was applied; with a minimum score of 20 and maximum of 140, the level of empathy is directly related to the obtained score obtained. Results: One hundred resident physicians, 52% of them female, were surveyed. The mean score obtained was 112.88, with DE 14.51, median of 115, and a Cronbach’s alpha coefficient of 0.82. The values of the quartiles were 102, 115 and 124. Twenty-six per cent of medical residents, 19.2% of surgery, 10% of gynecology-obstetrics and 35% of pediatrics reached higher values of the upper quartile. No statistically significant differences were found when comparing the respondents’ scores with each of the identified variables. Conclusions: Residents of the Pediatrics specialty has higher scores than the rest of the specialties, although no specific significant variables were found to explain the differences between the empathy levels.

Entrevista al doctor Hugo Caballero Cornejo, maestro de generaciones, investigador, referente a nivel nacional e internacional en la odontología forense "especialidad del milenio" / Interview to doctor Hugo Caballero Cornejo, teacher of generations, researcher, the reference to national and international level in forensic dentistry "specialty of the millennium"

En la entrevista realizada al profesor Hugo Caballero Cornejo conoceremos acerca de sus inicios, logros, su aporte académico, científico y de investigación a la odontología forense, siendo un profesional de reconocido prestigio a nivel nacional e internacional. Se conversó sobre el pasado, presente y futuro de la profesión en la especialidad que se desenvuelve a través de sus diversas áreas temáticas, tales como la responsabilidad profesional y la identificación humana, estableciendo que la especialidad de la "odontología forense es la especialidad del milenio" por ser la rectora de todas las especialidades de la profesión, por las implicancias legales y éticas que el odontólogo debe cumplir en el ejercicio profesional. El connotado docente es autor y editor del libro "Odontología Legal y Forense". Palabras clave: Odontología; Odontología forense; Responsabilidad legal; Profesor universitario.

In the interview with the professor Hugo Caballero Cornejo, we will learn about his beginnings, his achievements, his academic, scientific and research contribution to forensic dentistry, being a professional of recognized prestige at a national and international level. We talked about the past, the present and the future of the profession in the specialty that is developed through its various thematic areas, such as professional responsibility and human identification, establishing that the specialty of "forensic dentistry is the specialty of the millennium" for being the rector of all the specialties of the profession, for legal and ethical implications that the dentist must obey in professional practice. The notorious teacher is the author and editor of the book "Legal and Forensic Dentistry". Keywords: Dentistry; Forensic dentistry; Liability, legal; University professor.

Protocolo territorial de adecuación de la intensidad terapéutica. Área Metropolitana Sur de Barcelona / Regional protocol for adjusting the therapeutic intensity. Southern Metropolitan Area of Barcelona

La identificación de pacientes en situación de enfermedad crónica avanzada y complejidad, y la fragmentación de cuidados hacia el final de la vida aconsejan trazar un plan terapéutico a largo plazo, congruente con los valores y preferencias de los pacientes, a la vez que con un pronóstico vital y funcional razonables. Disponer de una herramienta de ajuste en la adecuación de la intensidad diagnóstica y terapéutica sería de ayuda en la continuidad de cuidados y podría ser facilitadora de la toma de decisiones en las transiciones y en los cambios dinámicos que presentan los pacientes a medida que se acercan al final del proceso vital

The identification of patients with advanced and complex chronic diseases, and the fragmentation of care towards the end of life, requires the drawing up a long-term therapeutic plan. This should take into account the values and preferences of the patients, as well as the vital and functional prognosis. Having an adjustment tool for determining the diagnostic and therapeutic effort is helpful in the continuity of care, as well as in decision-making in the transitions and dynamic changes of patients as they approach the end of life process

[Regional protocol for adjusting the therapeutic intensity. Southern Metropolitan Area of Barcelona]. / Protocolo territorial de adecuación de la intensidad terapéutica. Área Metropolitana Sur de Barcelona.

The identification of patients with advanced and complex chronic diseases, and the fragmentation of care towards the end of life, requires the drawing up a long-term therapeutic plan. This should take into account the values and preferences of the patients, as well as the vital and functional prognosis. Having an adjustment tool for determining the diagnostic and therapeutic effort is helpful in the continuity of care, as well as in decision-making in the transitions and dynamic changes of patients as they approach the end of life process.

Modeling heading in adult soccer players.

Heading soccer balls can generate mild brain injuries and in the long run can lead to difficulty in solving problems, memory deficits, and language difficulties. Researchers evaluated the effects on the head for both correct and incorrect heading techniques. They based the head's geometry on medical images. They determined the injury's magnitude by comparing the neurological tissue's resistance with predictions of the generated stresses. The evaluation examined fast playing conditions in adult soccer, taking into account the ball's speed and the type of impact. Mathematical simulations using the finite element method indicated that correctly heading balls arriving at moderate speed presents a low risk of brain injury. However, damage can happen around the third cervical vertebra. These results coincide with medical studies. Incorrect heading greatly increases the brain injury risk and can alter the parietal area.

Traumas cerebrales en niños secundarios a cabeceo de balones en fútbol: Modelo de simulación matemática / Mathematical simulation of mild brain injury in children heading soccer balls

Background: Heading professional soccer balls can generate mild traumatic brain injury in children. The long-term consequences could include difficulty in solving problems and deficits in memory and language. Aim: To assess the impact of a professional adult soccer ball on a child´s head, using the finite element method and dynamic effects to predict brain damage. Material and Methods: The minimum conditions of an adult game were considered: the ball speed was 6 m/s and the diffuse blow was 345 and 369 Newtons (N), on the forehead and top of the head, respectively. A head was modeled in order to know the stresses, strains and displacements generated by the impacts. The extent of the alteration was determined by comparing the strength of brain tissue, with predictions of computed stresses. The geometric characteristics of the head were transferred from medical images. The input data of the materials of a child´s head was obtained from the literature. Results: In the case of heading with the forehead, mathematical simulation showed frontal lobe alterations, with brain stresses between 0.064 and 0.059 N/mm2. When the heading was with the upper head zone, the brain alterations were in the parietal lobe, with stresses between 0.089 and 0.067 N/mm². In the cerebral spinal fluid the pressure was 3.61 to 3.24 N/mm2. Conclusions: The mathematical simulations reveal evidence of brain alterations caused by a child heading adult soccer balls. The model presented is an economical and quick tool that can help predict brain damage. It demonstrates the ability of the cerebral spinal fluid (CSF) to absorb shock loads.

[Mathematical simulation of mild brain injury in children heading soccer balls]. / Traumas cerebrales en niños secundarios a cabeceo de balones en fútbol. Modelo de simulación matemática.

BACKGROUND: Heading professional soccer balls can generate mild traumatic brain injury in children. The long-term consequences could include difficulty in solving problems and deficits in memory and language. AIM: To assess the impact of a professional adult soccer ball on a child's head, using the finite element method and dynamic effects to predict brain damage. MATERIAL AND METHODS: The minimum conditions of an adult game were considered: the ball speed was 6 m/s and the diffuse blow was 345 and 369 Newtons (N), on the forehead and top of the head, respectively. A head was modeled in order to know the stresses, strains and displacements generated by the impacts. The extent of the alteration was determined by comparing the strength of brain tissue, with predictions of computed stresses. The geometric characteristics of the head were transferred from medical images. The input data of the materials of a child's head was obtained from the literature. RESULTS: In the case of heading with the forehead, mathematical simulation showed frontal lobe alterations, with brain stresses between 0.064 and 0.059 N/mm(2). When the heading was with the upper head zone, the brain alterations were in the parietal lobe, with stresses between 0.089 and 0.067 N/mm(2). In the cerebral spinal fluid the pressure was 3.61 to 3.24 N/mm(2). CONCLUSIONS: The mathematical simulations reveal evidence of brain alterations caused by a child heading adult soccer balls. The model presented is an economical and quick tool that can help predict brain damage. It demonstrates the ability of the cerebral spinal fluid (CSF) to absorb shock loads.

Effect of subcutaneous lidocaine infiltration on blood loss secondary to corporal lipoaspiration: a prospective, randomized, double-masked clinical trial.

BACKGROUND: Lipoaspiration is one of the most frequently performed aesthetic surgical procedures worldwide. The use of tumescent solution containing lidocaine to infiltrate subcutaneous fat before surgery has been accepted as the standard of care for these procedures. Its objective is to diminish postoperative analgesic necessities and secondary blood loss, but its role in hematocrit reduction is not clear at this time. This study aimed to measure the effect of subcutaneous lidocaine infiltration on blood loss secondary to corporal liposuction. METHODS: A prospective, randomized, double-masked clinical trial was performed. Between November 2005 and July 2007, 70 consecutive female patients submitted to corporal liposuction as a single surgery were included in the study. All the patients were randomly assigned to two groups. The study group received tumescent solution containing lidocaine and epinephrine, whereas the control group received tumescent solution containing only epinephrine. Hematocrit was measured preoperatively, then 2 to 4, 12, and 24 h postoperatively. RESULTS: The comparison between the two groups did not show significant statistical differences with respect to age, body mass index, infiltrated volume, aspirated fat volume, surgical time, hospital stay, preoperative hematocrit, or comparison of the areas lipoaspirated. The mean hematocrit reduction in the study group was 10.8% +/- 2.9% compared with 8.8% +/- 2.6% in the control group (P = 0.004). CONCLUSION: The use of lidocaine in the tumescent solution for subcutaneous fat infiltration significantly increases postoperative anemia compared with the results obtained when epinephrine infiltration alone is used.