Extensive carcinoma cuniculatum of the maxilla: A rare variant of oral carcinoma

Carcinoma cuniculatum (CC), is a rare well-differentiated, low-grade variant of squamous cell carcinoma. However, diagnosis of oral CC has remained very difficult, because many pathologists and clinicians remain un acquainted with oral CC, because there are very few reported cases of this disease in the oral cavity. To our knowledge, no more than 60 head and neck cases have been reported since Flieger and Owinski first described a case involving the mandible in 1977, because there are very few published cases of this disease in the oral cavity, the aim of this report is to provide a detailed clinical and histopathologic description of carcinoma cuniculatum of the maxila, provide a brief review of the literature, and highlight the difficulties in arriving at the correct diagnosis.

Religion and Death in the United States: A Meta-Regression Comparative Assessment of Between-County Mortality Heterogeneity in the United States.

Religion can have a favorable impact on individual-level health. The influence of religion on population health, however, remains less clear. This study investigated the association between religion and mortality at the population-level. Using county data, a meta-regression was performed to examine between-county mortality heterogeneity. The percent heterogeneity associated with religion variables were compared to demographics (i.e., place, race, language, age, and gender) and health factors (i.e., individual behaviors, clinical care, social and economic, and physical environment) as predictors of mortality. Religion was measured in terms of adherence (i.e., prevalence attending/belonging to a congregation), congregation density, and the diversity of adherents and congregation by denominations. Results showed counties with lower mortality were associated with higher proportions of religion adherents and a greater diversity of adherents and congregations. Counties with higher mortality were associated with higher religion congregation density. Religion, as a parsimonious multivariate model with all demographic and health factor predictors, had less added value when controlled for individual variables or constructs. The direction of association between religion and mortality was consistent, even when controlling for demographics and health factors, and thus merits further consideration as a population health determinant, as it may play a critical role in understanding other population health outcomes.

Primary health care challenge for nursing professionals: a narrative review.

OBJECTIVE: Carry out a narrative review of scientific literature on nursing professionals training in primary health care (PHC), which allows us to know the challenges facing the renewal of this strategy. METHODS: Review of the literature found, selection of 55 articles from various scientific sources in the last 10 years in electronic databases (MEDLINE, IME, LILACS, Centro Cochrane Iberoamericano, Embase, CUIDEN, CINAHL, BDIE). The selected articles were submitted to an interpretation, synthesis, and critical analysis process for the purpose of selection. RESULTS: Higher education institutions in Colombia have been working on training of undergraduate students responding to the axes established in the strengthening of human resources in health. This training is used for the application of the integral health care model, focusing on the strengthening of work profiles and the acquisition of competencies that can generate significant contributions to the reality and needs of the individual, family, community, as well as to the different cultures and ethnic groups with humanization, under the general social security health system. An analysis of renewed and comprehensive PHC approaches has been carried out in different countries involving transformations in education with training by competencies, interprofessional work, teamwork, strengthening communication with the community, and health team. CONCLUSIONS: Based on the narrative review, this research highlights the importance of developing studies on interventions carried out by students with acquired competencies in their training process and management to improve health conditions of the community.

Primary health care challenge for nursing professionals: a narrative review / Atención primaria en salud reto de los profesionales de enfermería: una revisión narrativa

ABSTRACT OBJECTIVE Carry out a narrative review of scientific literature on nursing professionals training in primary health care (PHC), which allows us to know the challenges facing the renewal of this strategy. METHODS Review of the literature found, selection of 55 articles from various scientific sources in the last 10 years in electronic databases (MEDLINE, IME, LILACS, Centro Cochrane Iberoamericano, Embase, CUIDEN, CINAHL, BDIE). The selected articles were submitted to an interpretation, synthesis, and critical analysis process for the purpose of selection. RESULTS Higher education institutions in Colombia have been working on training of undergraduate students responding to the axes established in the strengthening of human resources in health. This training is used for the application of the integral health care model, focusing on the strengthening of work profiles and the acquisition of competencies that can generate significant contributions to the reality and needs of the individual, family, community, as well as to the different cultures and ethnic groups with humanization, under the general social security health system. An analysis of renewed and comprehensive PHC approaches has been carried out in different countries involving transformations in education with training by competencies, interprofessional work, teamwork, strengthening communication with the community, and health team. CONCLUSIONS Based on the narrative review, this research highlights the importance of developing studies on interventions carried out by students with acquired competencies in their training process and management to improve health conditions of the community.

RESUMEN OBJETIVO Realizar una revisión narrativa de la literatura científica sobre la formación en la atención primaria en salud (APS) en los profesionales de enfermería permitiéndonos conocer los retos ante la renovación de esta estrategia. MÉTODOS Se realizó revisión de la literatura encontrada seleccionando 55 artículos de varias fuentes científicas, entre los últimos 10 años, en bases de datos electrónicas (MEDLINE, IME, LILACS, Centro Cochrane Iberoamericano, Embase, CUIDEN, CINAHL, BDIE); la selección se realizó mediante la interpretación, síntesis y análisis crítico de los artículos seleccionados. RESULTADOS Las instituciones de educación superior en Colombia vienen trabajando en la formación de los estudiantes de pregrado, respondiendo a los ejes establecidos en el fortalecimiento del recurso humano en salud. Esto, para la aplicación del modelo integral de atención en salud, enfocándolo al fortalecimiento de los perfiles laborales y adquisición de competencias que puedan generar aportes significativos a la realidad y necesidades de individuo, familia, comunidad, así como las diferentes culturas y grupos étnicos con humanización, acogiéndose al sistema general de seguridad social en salud. En diferentes países se ha realizado análisis de los enfoques de APS renovada e integral, implicando transformaciones en la educación con la formación por competencias, trabajo interprofesional, trabajo en equipo, fortaleciendo la comunicación con la comunidad y equipo de salud. CONCLUSIONES Basado en la revisión narrativa, se resalta la importancia de desarrollar estudios investigativos de cómo han sido las intervenciones realizadas por los estudiantes con las competencias adquiridas en su proceso formativo y la gestión para mejorar las condiciones de salud de la comunidad.

Building the Evidence Base for the Prevention of Raw Milk-Acquired Brucellosis: A Systematic Review.

Background: The scientific evidence of the health risks associated with the consumption of raw milk has been known for a long time. However, less clear is the impact of acquiring infectious diseases from raw milk consumption in the United States (US) due to incomplete reporting of cases and the complex factors associated with the sale and consumption of raw milk. Investigations of this current study focused on human brucellosis, one of the infectious diseases commonly acquired through the consumption of raw milk and milk products, and which continues to be a public health threat worldwide. Methodology: A qualitative systematic review of the sources of opinions that contribute to the increased trend of raw milk sales and consumption in the US was conducted. Results: Interestingly, opinions about the sale of raw milk and/or the benefits arising from its consumption varied by US region, with the proportion of messages supporting raw milk consumption being highest in the Northeast compared to other US regions. Several evidence gaps and factors that possibly contribute to the increased prevalence of raw milk-acquired brucellosis were identified including inadequate monitoring of the raw milk sales process and lack of approved diagnostic methods for validating the safety of raw milk for human consumption. Conclusions: The unavailability of data specifying brucellosis cases acquired from raw milk consumption have precluded the direct association between raw milk and increased brucellosis prevalence in the United States. Nevertheless, the evidence gaps identified in this study demonstrate the need for intensified surveillance of raw-milk acquired infectious diseases including human brucellosis; establishment of safety and quality control measures for the process of selling raw milk; and design of an effective strategy for the prevention of raw milk-acquired infectious diseases including brucellosis. Overall, for the first time, this study has not only shown the gaps in evidence that require future investigations, but also, variations in the perception of raw milk consumption that may impact disease acquisition in different US regions.

Cultura de seguridad en profesionales del quirófano en una institución de atención materno infantil / Safety Culture in Operating Room Professionals from a Mother and Child Care Institution

Introducción: En los profesionales de la salud existe la necesidad de liderar la seguridad del paciente como política pública, la cual es un criterio de calidad al evaluar la cultura de seguridad en las instituciones de salud y de cada servicio que ofrece. Objetivo: Valorar las dimensiones de la cultura de seguridad del paciente. Métodos: Estudio de tipo analítico y transversal en área de quirófanos de la clínica Materno Infantil San Luis, desde abril a julio del 2018. Se captaron las respuestas de la cultura de seguridad en 45 profesionales de salud a través del cuestionario Hospital Survey on Patient Safety, versión en español. El análisis estadístico presenta proporciones, medidas de tendencia central, dispersión y rango intercuartílico. Para identificar las diferencias entre los grupos se utilizaron las pruebas: Exacta de Fisher, Anova y Kruskal Wallis. Los análisis se realizaron en el programa STATA 12 (StataCorp College Station, TX, EE. UU.). Resultados: Existen diferencias estadísticamente significativas entre los grupos de profesionales en cuanto al sexo (p = 0,002), formación académica (p = 0,042) y trabajar en otra institución (p = 0,022). El 50 por ciento de los profesionales encuestados calificaron la seguridad del paciente en su servicio con una nota entre 8 y 9. Conclusiones: En la valoración de la cultura de seguridad se logró identificar como fortaleza las dimensiones de aprendizaje organizacional/mejora continua, trabajo en equipo dentro de la unidad/servicio y apoyo de la gerencia del hospital en la seguridad del paciente(AU)

Introduction: There is a need for health professionals to lead patient safety as a public policy, which is a quality criterion to evaluate the safety culture in health institutions and in each service they offer. Objective: To assess the dimensions of culture about patient safety. Methods: Analytical and cross-sectional study carried in the operating room area of ​​San Luis Maternal and Child Clinic, from April to July 2018. The responses about safety culture were taken from 45 health professionals through the Hospital Survey on Patient Safety questionnaire, Spanish version. The statistical analysis presents proportions, measures of central tendency, dispersion and interquartile range. To identify the differences between the groups, the following tests were used: exact Fisher's test, Anova test, and Kruskal Wallis test. The analyzes were performed in the STATA 12 program (StataCorp College Station, TX, USA). Results: There are statistically significant differences between the groups of professionals regarding sex (p=0.002), academic training (p=0.042) and work in another institution (p=0.022). 50 percent of the respondents rated patient safety in their service with a score between 8 and 9. Conclusions: In assessing safety culture, some dimensions were identified as strengths, such as organizational learning/continuous improvement, teamwork within the unit/service, and support of the hospital management to patient safety(AU)

Surgical ciliated cyst after maxillary orthognathic surgery: a literature review and case report.

PURPOSE: Surgical ciliated cyst of the maxilla is a rare complication following surgical procedures or trauma involving the maxillary sinus. The surgical ciliated cyst of the maxilla is a rare lesion and appears as a delayed complication after surgery in the maxillary sinus, midface osteotomies, traumatic tooth extraction and maxillary fractures. CASE REPORT AND LITERATURE REVIEW: We report a case that occurred 5 years after a maxillary sinus surgery in a Caucasian Female. A well-defined unilocular radiolucency in the right anterior maxilla was noted in cone beam image associated to osteosynthesis material. The lesion was completely excised, and upon histological examination, findings were consistent with Ciliated cyst. The PubMed database was searched for PMC within the last 15 years. RESULTS: Together with the current case, we found 18 reports including 21 patients describing PMC. It wasdiagnosed at a mean time of 22 years after causal surgery at a mean age of 47 years. The main radiologicalsign was a unilocular radiolucency. DISCUSSION: This lesion may present histologically different epithelial linings, but respiratory epithelium was the most frequent. The most important clinical and pathological features of these conditions are also discussed. CONCLUSION: Although surgical ciliated cysts have only rarely been reported after orthognathic surgery, anincreased awareness of this possibility is necessary to avoid delays in diagnosis.

Responsabilidades éticas en la práctica de enfermería en instituciones de alta complejidad / Ethical responsibilities in nursing practice at tertiary care centers / Responsabilidades éticas na prática de enfermagem em instituições de alta complexidade

Resumen Introducción Los códigos deontológicos, permiten guiar las acciones para un apropiado ejercicio profesional. En Colombia, la Ley 911 del 2004, establece las disposiciones legales sobre ética para el ejercicio de la enfermería y conceptualiza el acto de cuidado. Objetivo Determinar la percepción de las enfermeras sobre las responsabilidades éticas en la práctica profesional y la relación con el servicio e institución donde laboran. Materiales y Métodos Estudio de corte transversal en enfermeras que laboran en instituciones públicas y privadas. Se realizó análisis descriptivo y estratificado. Resultados Las enfermeras perciben en alto porcentaje que siempre cumple lo establecido en el Título III. Hubo relación estadísticamente significativa entre percepción y la institución donde labora para los ítems de conducta respetuosa, objeción de conciencia y registros de enfermería claros y entre percepción versus servicios, para los ítems de conducta respetuosa, ubicación de acuerdo a la experiencia y formación y diligenciamiento de registros claros, secuenciales y sin errores. Discusión Los resultados de este estudio permiten evidenciar elementos fundamentales del actuar ético de enfermería referidos en la literatura científica. Conclusiones La práctica de enfermería implica una serie de responsabilidades éticas con los sujetos de cuidado que pueden variar según el contexto donde esta se desarrolle. En este estudio, se concluyó que los registros de enfermería, la objeción de conciencia, la ubicación de acuerdo a la experiencia y formación académica eran fundamentales para el ejercicio de la práctica y estaban relacionados con la institución y servicio donde se laboraba.

Abstract Introduction The codes of ethics guide actions for an appropriate professional practice. Colombian Law 911 of 2004 establishes the legal provisions on ethics for nursing practice and conceptualizes the performance of nursing care. Objective To determine how nurses see ethical responsibilities in professional practice and identify their relation with the service they provide and the institution they work at. Materials and Methods Cross-sectional study among nurses working in public and private institutions. Descriptive and stratified analyses were performed. Results A high percentage of nurses believe they always comply with the provisions of Section III. There was a statistically-significant relation between perception versus place of work in the items of respectful behavior, conscientious objection and clear nursing records, as well as, between perception versus services in the items of respectful behavior, location based on experience and training and completion of clear, sequential, and error-free records. Discussion The results of this study evidence the fundamental elements of ethical nursing care stated in the scientific literature. Conclusions Nursing practice involves a series of ethical responsibilities with the people in care that can vary depending on the context in which it is performed. This study found that the nursing records, conscientious objection, location based on experience and academic education are key factors of nursing practice related to the institution and service where nurses work.

Resumo Introdução Os códigos de ética permitem orientar as ações para um exercício profissional adequado. Na Colômbia, a Lei 911 de 2004 estabelece as disposições legais sobre ética para a prática de enfermagem e conceitua o ato de cuidar. Objetivo: Determinar a percepção das enfermeiras no referente às responsabilidades éticas na prática profissional e a relação com o serviço e a instituição onde as enfermeiras trabalham. Materiais e Métodos Estudo transversal em enfermeiras que trabalham em instituições públicas e privadas. Foi realizada uma análise descritiva e estratificada. Resultados As enfermeiras percebem, em um alto percentual, que sempre cumprem o estabelecido no Título III. Houve uma relação estatisticamente significativa entre a percepção e a instituição onde elas trabalham para os itens de comportamento respeitoso, objeção de consciência e registros claros de enfermagem e entre a percepção versus os serviços para os itens de comportamento respeitoso, localização de acordo com a experiência e a formação e o preenchimento de registros claros, sequenciais e sem erros. Discussão Os resultados deste estudo permitem evidenciar elementos fundamentais das ações éticas de enfermagem referidas na literatura científica. Conclusões A prática de enfermagem implica uma série de responsabilidades éticas com os sujeitos que são cuidados, que podem variar de acordo com o contexto em que seja feito esse cuidado. Neste estudo, concluiu-se que os registros de enfermagem, a objeção de consciência, a localização de acordo com a experiência e a formação acadêmica foram fundamentais para a prática e estavam relacionados com a instituição e com o serviço em que as enfermeiras atuavam.

Ameloblastoma uniquístico intramural en maxilar superior. Reporte de un caso / Intramural unicystic ameloblastoma in upper jaw. A case report

El ameloblastoma uniquístico (AU) representa aproximadamente el 6% de todos los ameloblastomas y es frecuentemente encontrado durante la segunda década de la vida, sin predilección por sexo, se localiza en la mandíbula en relación a un diente no erupcionado, demuestra características clínicas y radiográficas similares a los quistes maxilares, pero evidencia histológicamente epitelio ameloblástico. Aunque el AU tiene un comportamiento menos agresivo que el ameloblastoma sólido, se recomienda un tratamiento radical para la variante intramural debido a su naturaleza infiltrativa, lo que tiende a potenciarse cuando se localiza en el maxilar superior. El objetivo del presente trabajo fue describir un caso de ameloblastoma uniquístico intramural localizado en el maxilar superior de un paciente masculino de 26 años de edad, quien presentaba un aumento de volumen indoloro en hemicara derecha de cinco meses de evolución. De acuerdo al resultado de la biopsia incisional se decidió realizar una hemimaxilectomía utilizando un abordaje intrabucal y colocación de una malla de titanio en piso de la órbita. La localización y el tipo histológico del AU son factores a considerar en la elección de la terapéutica, es importante el seguimiento a largo plazo del paciente para valorar la posibilidad de recidivas y un abordaje interdisciplinario del caso. Palabras clave: Ameloblastoma; Maxila; Neoplasias orales; Tumores odontogénicos

Unicystic Ameloblastoma (UA) accounts for approximately 6% of all ameloblastomas. They are often observed during the second decade of life, without a predilection for gender, with 90% of the lesions occurring in the jaw and related to an unerupted tooth. Unicystic ameloblastoma shows clinical and radiographic features similar to maxillary cysts but histologically evidences ameloblastic epithelium. The lesion has a less aggressive biological behavior than solid ameloblastoma, with a lower recurrence rate compared with conservative treatment, however, a radical therapeutic is recommended for the intramural variant. The aim of the present work was to describe a case of UA located in the maxilla of a 26-year-old male patient, who showed an increase in volume in the right hemiface of five months of evolution. The histopathological examination of the specimen obtained by the incisional biopsy was UA Intramural; In a second surgical tempo, a hemimaxilectomy was performed on the affected side using an intra-oral approach. Long-term follow-up of these lesions is recommended to assess the possibility of relapse and an interdisciplinary therapeutic-rehabilitation approach. Keywords: Ameloblastoma; Maxilla; Odontogenic tumor; Oral neoplasms

Should they play outside? Cardiorespiratory fitness and air pollution among schoolchildren in Bogotá / ¿Deberían los niños jugar al aire libre? Acondicionamiento cardiorespiratorio y contaminación del aire en Bogotá

Objective: This study was aimed at comparing cardiorespiratory fitness (CF), measured as VO2 max, amongst school children exposed to varying levels of particulate matter (PM10), and air pollution in Bogotá, Colombia. Methods: This was a cross-sectional study; it involved 1,045 children aged 7-12 attending four public schools served by different public transit routes and systems. Three schools were classified as being highly polluted (HP) and one slightly polluted (SP). The children and their parents were surveyed to collect data regarding their socio-demographic characteristics, physical activity habits and respiratory disease background. Objective measurements of weight and height were used to calculate the body mass index. VO2max was estimated using the 20-meter shuttle-run test, previously validated for Bogotá. Spirometry was performed on 435 children. Results: After adjustment for covariates, no difference was found in VO2max between children attending SP or HP schools (girls SP 45.8 ml/kg/min vs HP 44.6 ml/kg/min, p=0.11; boys SP 47.2 ml/kg/min cf HP 48.2 ml/kg/min, p=0.41). Conclusions: VO2max levels did not differ amongst children attending schools exposed to high compared to low levels of air pollution and PM. A longitudinal study assessing children’s VO2max levels in relation to exposure to highly-polluted areas is warranted.

Objetivo: Comparar el acondicionamiento cardiorespiratorio medido como VO2 máximo en niños escolarizados expuestos a diferentes niveles de PM10 en Bogotá. Métodos: Estudio de corte transversal. Se incluyeron 1045 niños de 7-12 años de 4 colegios públicos con diferentes corredores viales y sistemas de transporte público. Tres colegios tenían alta contaminación (AC) y uno baja contaminación (BC). Se aplicó una encuesta a niños y padres sobre características sociodemográficas, actividad física, antecedentes de enfermedades respiratorias y salud. Se midió objetivamente peso y talla para calcular el índice masa corporal. El VO2 máximo se estimó con la prueba de Leger validada para Bogotá. Se realizaron espirometrias en 435 niños. Resultados: Después de ajustar por covariables, no se encontraron diferencias significativas en el VO2 máximo de los niños en colegios con BC ò AC. (Niñas BC: 45,8ml/kg/min vs. AC: 44,6ml/kg/min; p=0,11, niños BC: 47,2ml/kg/min vs. AC: 48,2ml/kg/min; p=0,41). Conclusión: No se encontraron diferencias en el VO2 máximo de los niños que asistían a los colegios de AC ó BC. Se recomienda un estudio longitudinal que evalúe los niveles de VO2 máximo en los niños expuestos a áreas altamente contaminadas.

Should they play outside? Cardiorespiratory fitness and air pollution among schoolchildren in Bogotá.

OBJECTIVE: This study was aimed at comparing cardiorespiratory fitness (CF), measured as VO2 max, amongst school children exposed to varying levels of particulate matter (PM10), and air pollution in Bogotá, Colombia. METHODS: This was a cross-sectional study; it involved 1,045 children aged 7-12 attending four public schools served by different public transit routes and systems. Three schools were classified as being highly polluted (HP) and one slightly polluted (SP). The children and their parents were surveyed to collect data regarding their socio-demographic characteristics, physical activity habits and respiratory disease background. Objective measurements of weight and height were used to calculate the body mass index. VO2max was estimated using the 20-meter shuttle-run test, previously validated for Bogotá. Spirometry was performed on 435 children. RESULTS: After adjustment for covariates, no difference was found in VO2max between children attending SP or HP schools (girls SP 45.8 ml/kg/min vs HP 44.6 ml/kg/min, p=0.11; boys SP 47.2 ml/kg/min cf HP 48.2 ml/kg/min, p=0.41). CONCLUSIONS: VO2max levels did not differ amongst children attending schools exposed to high compared to low levels of air pollution and PM. A longitudinal study assessing children's VO2max levels in relation to exposure to highly-polluted areas is warranted.

Vasculitis gingival como complicación de sepsis de punto de partida enteral / Vasculitis gingival sepsis complicating enteral starting point

Vasculitis es la inflamación de vasos sanguíneos, con isquemia, necrosis y compromiso sistémico. se describe el manejo multidisciplinario de niña de 4 meses quien ingresó al hospital universitario de Maracaibo con fiebre, diarrea, deshidratación, consciente, con períodos de somnolencia, abdomen distendido, ausencia de ruidos hidroaéreos. Posteriormente presenta convulsión, deterioro del estado general, lesiones eritematosas múltiples y en rodetes gingivales, de color blanco parduzco, necróticas, manifestaciones de shock séptico. Antecedente de ingestión de n-butilbromuro de hioscina. laboratorio: anemia, leucocitosis, proteína c reactiva elevada, cultivos negativos. Biopsia del rodete gingival: vasos sanguíneos con paredes infiltradas por células inflamatoriasmononucleares y polimorfonucleares dispersas y necróticas, destrucción y oclusión del endotelio, confirmando la vasculitis gingival. Recibió antibioticoterapia, soporte hemodinámico, cirugía de zonas necrosadas. egresó a los 15 días con diagnóstico de vasculitis gingival por sepsis de origen enteral. el manejo interdisciplinario médico-odontológico facilita la resolución de situaciones generales con compromiso bucodental

Vasculitis is the inflammation of blood vessels, with ischemia, necrosis and systemic involvement. this paper describes the multidisciplinary management of a 4 month old female infant that was admitted to the hospital universitario de Maracaibo with fever,diarrhea, dehydration, periods of somnolence, distended abdomen, and absence of bowel sounds. later, the patient presented seizures, deterioration of her general condition, multiple erythematous and brownish white, necrotic lesions of the gingival border mucosa, and septic shock manifestations. the patient had a history of ingestion of n-butylbromid hyoscine. laboratory tests: anemia, leukocytosis,elevated c-reactive protein, negative cultures, biopsy of the gingival border: blood vessel walls infiltrated by scattered and necrotic polymorphonuclear and mononuclear inflammatory cells, destruction and occlusion of the endothelium confirming gingival vasculitis. treatment included antibiotics, surgery of necrotic areas and hemodynamic support. she was discharged after 15 days with the diagnosis of gingival vasculitis secondary to enteral sepsis. Medical and dentistry interdisciplinary management facilitates the resolution of generalsituations with oral involvement

Una lesión periférica poco común: Reporte de un caso / A rare peripheral lesion: a case report

El Fibroma Odontogénico Periférico, pertenece al grupo de tumores Odontogénicos Mixtos y es considerado la contraparte de tejido blando del Fibroma Odontogénico Central. Es una lesión gingival benigna poco común, con una ligera preferencia por pacientes entre la segunda y tercera década de la vida, que se caracteriza por ser una masa exofítica, no encapsulada, usualmente de base sesil, cubierta por una mucosa de color normal, firme a la palpación, de crecimiento lento y asintomática. Se localiza con preferencia en la encía vestibular mandibular y generalmente no crece más de 1,5 cm. El propósito de este trabajo es reportar, previo consentimiento, un caso de un FOP en la encía maxilar de una paciente de 67 años de edad, con características clínicas similares a otras lesiones periféricas. Previa preparación de la paciente se realizó la biopsia escisional, diagnosticándose esta entidad. Se procedió a caracterizarla clínica e histopatológicamente, recalcando su similitud con otras lesiones y resaltando la importancia de su estudio microscópico para poder identificarla, considerando esta patología como un probable diagnóstico diferencial cuando se trate de lesiones periféricas.

The Peripheral Odontogenic Fibroma (POF), belongs to the mixed odontogenic tumors group. It is considered the soft tissue counterpart of the Central Odontogenic Fibroma. It is a rare benign lesion, slightly common between the second and third decade of life. It is described as an exofitic, no encapsulated, sessile mass, covered by a normal appearance mucosa. It is a slow growing, firm and asymptomatic tumor and it is mainly located at the vestibular mandibular gingival. Its size usually is not more than 1,5 cm. The purpose of this paper is to report a POF at the maxillary gingiva of a 67 years old female, with clinical features similar to other peripheral lesions. After routine exams an excisional biopsy was performed and the POF diagnosis was given. Clinical and microscopic features were studied as well as its similarities with other peripheral lesions and the importance of its histopathologic study in order to identify it. This pathology must be considered in the differential diagnosis when peripheral lesions are studies.

Caracterización preliminar de los sitios de cría de Aedes (Stegomyia) albopictus (Skuse, 1894) (Diptera: Culicidae) en el municipio de Leticia, Amazonas, Colombia / Characterization of Aedes albopictus (Skuse, 1894) (Diptera: Culicidae) larval habitats near the Amazon River in Colombia

Introducción. Dada la importancia de Aedes albopictus en la salud pública, es necesario caracterizar los criaderos para establecer medidas de control. Objetivo. Caracterizar en función de los parámetros físico-químicos y grupos de organismos presentes, los criaderos de los estadios inmaduros de Ae. albopictus en Leticia, Amazonas. Materiales y métodos. Se inspeccionaron 154 viviendas en el área urbana en diciembre 2002 y enero 2003, para buscar criaderos de Ae. albopictus y otros dípteros con estadios acuáticos inmaduros. En los criaderos con resultados positivos se tomaron datos físico-químicos cualitativos y cuantitativos: exposición al sol, ubicación, tamaño, material, conductividad, turbidez, oxígeno disuelto, temperatura y presencia de macroinvertebrados y plancton. Los resultados se compararon mediante análisis descriptivos, análisis de componentes principales, dendrogramas de clasificación e índices de diversidad. Resultados. Se encontraron 21 criaderos con larvas de dípteros, 13 con Ae. albopictus; 92% de ellos estaban ubicados en el peridomicilio, en recipientes pequeños o medianos, dispuestos en la sombra, con baja turbidez y conductividad, bajos índices de diversidad para macroinvertebrados y altos para organismos productores de plancton. En el análisis de componentes principales, se encontró correlación significativa con ácaros, oligoquetos y hemípteros (macroinvertebrados), y con bacilarofíceas, clorofíceas y cianofíceas (plancton). En presencia de otros culícidos, las larvas de Ae. albopictus fueron escasas. Conclusión. En este estudio se encontró que las hembras de Ae. albopictus depositan sus huevos en depósitos de agua recién establecidos con disponibilidad suficiente de recurso, baja conductividad y turbidez, y menor competencia intraespecífica e interespecífica.

Introduction. Because the role of Aedes albopictus as an incriminated vector of several viral pathogens, its control is important to human health. To establish appropriate control methods, characterization of the larval habitats is a necessary first step. Objective. Habitats of the immature stages of Ae. albopictus were characterized with respect to physical-chemical parameters and by floral and faunal arrays present. Materials and methods. Leticia is located at the southern most tip of Colombia on the banks of the Amazon River. In the urban area, 154 houses were inspected in December 2002 and January 2003. Physical-chemical data were collected, including exposure to sunlight, location, container size and material, water conductivity, and dissolved oxygen. Macroinvertebrates and plankton samples were taken at each positive larval site. The results were compared using descriptive analysis, principal component analysis, classification dendrograms, and diversity indexes. Results. Twenty-one habitats were found positive for Diptera, and 13 were positive for Ae. albopictus larvae. Most of the positive habitats (92%) were located near the houses-they were small or medium size receptacles located in the shade. This water generally had low conductivity and low turbidity, although high values of these parameters were also identified. The habitats had low diversity indexes for macroinvertebrates and high diversity indexes for plankton. In the principal component analysis, significant correlation was found with mites, oligochaetes and hemipterans (the macroinvertebrates) and with bacilarophyceaes, clorophyceaes and cianophyceas (the algal forms). Conclusion. In Leticia, females of Ae. albopictus were found in newly established habitats with sufficient availability of resources, low conductivity, and turbidity, lower intra-and interspecific competition.

Fibroma osificante juvenil activo trabecular, deformante: Reporte de un caso / Deformity by a Trabecular Juvenile Active Ossifying Fibroma: A case report

El fibroma osificante juvenil activo trabecular (FJOAT), es una variante histológica del fibroma osificante, que forma parte de la familia de lesiones fibro-óseas benignas, cuya característica común, es la sustitución del hueso medular por tejido fibroso con cantidades variables de hueso o cementoide. Aparece con mayor frecuencia en los huesos cráneo-faciales de individuos entre los 12 y 15 años de edad, comportándose como una lesión agresiva y recidivante. El propósito de este artículo es reportar, un paciente masculino, de 16 años quien acude al servicio de cirugía bucal en esta institución, por una marcada asimetría facial del tercio superior y medio del lado derecho, asintomática, con cinco años de evolución. Imagenologicamente se observa masa ocupante de espacio, en seno maxilar, cavidad nasal, extendiéndose al piso de la orbita del lado afectado y a estas mismas estructuras homologas del lado contrario. La biopsia incisional reveló un fibroma osificante juvenil activo, tipo trabecular. La eliminación total de la lesión y su estudio, corroboró el diagnostico. Se demuestra hasta donde es capaz de causar deformidad esta patología y se recalca la importancia del trabajo en equipo transdisciplinario y del estudio microscópico para llegar a un diagnostico definitivo.

The juvenile active ossifying fibroma, trabecular type, is a histological variant of ossifying fibroma, which belong to the benign fibrous osseous lesions family, being its common feature the replacement of medullar bone by fibrous tissue with variable quantity of bone and/or cementoide. It is found on the cranial facial bones in 12 to 15 years old patients, behaving in an aggressive fashion. The purpose of this paper is to report, a sixteen years old male patient, who went for consultation to the oral surgery service at this institution, due to a marked right facial asymmetry, asymptomatic, for five years. The computerized tomography showed a mass involving right maxillary sinus and nasal cavity, extending to the inferior border of the orbit enclosing the homologous structures on the left side. The incisional biopsy revealed a trabecular juvenile active ossifying Fibroma. The excisional biopsy confirmed this diagnosis. It is shown how this lesion is capable to cause a marked facial asymmetry and how is important the microscopic study of the lesions in order to get a precise diagnosis.

Composition and biting activity of Anopheles (Diptera: Culicidae) in the Amazon region of Colombia.

To provide information for public health policy on mosquito nets in the Amazon region of Colombia, we conducted landing catches to estimate Anopheles species composition and biting activity. Two hundred twenty person-nights of catches were done in seven locations over a period of 14 mo. A total of 1,780 Anopheles mosquitoes were caught (8.1 per person-night). Among the nine species found, An. oswaldoi Peryassú was the most common (776 mosquitoes, 44%), followed by An. darlingi Root s.l. (498, 28%). An. oswaldoi was the most common species collected outdoors, where its biting rate dropped steadily from a peak of >15 bites/person-night at the start of the night (1800-1900 hours) to approximately equal to 2 bites/person-night before dawn. An. darlingi was the most common species collected indoors, with a biting rate of approximately equal to 3-4 bites/person-night until about midnight, when the rate dropped below 1 bite/person-night, before showing a secondary peak before dawn. Sixty-four mosquito nets were analyzed by the technique of high-performance liquid chromatography (HPLC) for levels of deltamethrin (DM). All but two (62) of these were reported by their owners to have been impregnated with insecticide, and 53 were found by HPLC to have deltamethrin. However, one half (32) of the nets had concentrations <4 mg/m2 and therefore were likely to have been inadequately protective. An inverse association was found between the reported time between washes and deltamethrin concentration. These findings show a need for additional protection from mosquitoes when not inside nets, as well as for more effective impregnation, possibly through wash-resistant insecticide formulation.

[Characterization of Aedes albopictus (Skuse, 1894) (Diptera:Culicidae) larval habitats near the Amazon River in Colombia]. / Caracterización preliminar de los sitios de cría de Aedes (Stegomyia) albopictus (Skuse, 1894) (Diptera: Culicidae) en el municipio de Leticia, Amazonas, Colombia.

INTRODUCTION: Because the role of Aedes albopictus as an incriminated vector of several viral pathogens, its control is important to human health. To establish appropriate control methods, characterization of the larval habitats is a necessary first step. OBJECTIVE: Habitats of the immature stages of Ae. albopictus were characterized with respect to physical-chemical parameters and by floral and faunal arrays present. MATERIALS AND METHODS: Leticia is located at the southernmost tip of Colombia on the banks of the Amazon River. In the urban area, 154 houses were inspected in December 2002 and January 2003. Physical-chemical data were collected, including exposure to sunlight, location, container size and material, water conductivity, and dissolved oxygen. Macroinvertebrates and plankton samples were taken at each positive larval site. The results were compared using descriptive analysis, principal component analysis, classification dendrograms, and diversity indexes. RESULTS: Twenty-one habitats were found positive for Diptera, and 13 were positive for Ae. albopictus larvae. Most of the positive habitats (92%) were located near the houses--they were small or medium size receptacles located in the shade. This water generally had low conductivity and low turbidity, although high values of these parameters were also identified. The habitats had low diversity indexes for macroinvertebrates and high diversity indexes for plankton. In the principal component analysis, significant correlation was found with mites, oligochaetes and hemipterans (the macroinvertebrates) and with bacilarophyceaes, clorophyceaes and cianophyceas (the algal forms). CONCLUSION: In Leticia, females of Ae. albopictus were found in newly established habitats with sufficient availability of resources, low conductivity, and turbidity, lower intra-and interspecific competition.

Eight years of hepatitis B vaccination in Colombia with a recombinant vaccine: factors influencing hepatitis B virus infection and effectiveness.

OBJECTIVE: To evaluate the effectiveness of a recombinant hepatitis B vaccine used in endemic areas of Colombia, as well as risk factors associated with hepatitis B virus (HBV) infection and carriage after vaccine introduction. METHODS: A cross-sectional study was carried out in urban and rural areas of the Colombian Amazon, a highly endemic area for hepatitis B infection. Children under 12 years of age and their mothers were selected for the study using one-stage cluster sampling (N=2145) and were examined for HBV serological markers and antibodies against surface antigen (anti-HBs). RESULTS: There has been a reduction of 60-75% in the prevalence of HBV infection and hepatitis B surface antigen (HBsAg) carriage since HBV vaccination was introduced. Receiving the first dose of HBV vaccine at more than two months after birth was one of the factors associated with HBV carrier status. Maternal HBV infection was also associated with infection in the child. CONCLUSIONS: The recombinant Cuban hepatitis B vaccine has contributed to the reduction of the infection in this highly endemic area, though further efforts are required to improve timely vaccination for children at high risk.

[Assessment of the efficacy of antimalarial drugs in Tarapacá, in the Colombian Amazon basin]. / Evaluación de la eficacia de los medicamentos antimaláricos en Tarapacá, Amazonas colombiano.

INTRODUCTION: The current antimalarial drug policy in Colombia has been based on studies conducted in Antioquia and the Pacific Coast. However, the efficacy of antimalarial drugs in other endemic regions is unknown. OBJECTIVE: The therapeutic efficacy of three monotherapies was assessed: amodiaquine and sulfadoxine/pyrimethamine for uncomplicated Plasmodium falciparum malaria, and chloroquine for Plasmodium vivax malaria in the municipality of Tarapacá, located in the Colombian province of Amazonas. MATERIALS AND METHODS: Treatment was supervised and clinical/parasitological follow-up was undertaken through a 28-day period following to World Health Organization standard protocols for subjects with a single P. falciparum or P. vivax infection. RESULTS: Due to a decrease in malaria transmission at the time of the study, the sample size was very small. The treatment failed for two subjects who received amodiaquine, and treatment with sulfadoxine/pyrimethamine was discontinued due to a high frequency of therapeutic failures (7/8). Most subjects (18/20) with P. vivax infections showed an adequate therapeutic response. CONCLUSIONS: The use of sulfadoxine/pyrimethamine in Tarapacá, and possibly in the Amazon region of Colombia, needs to be reviewed. Therapeutic efficacy studies in other endemic areas in the Amazon and Orinoco regions in Colombia are desirable but not feasible. Alternative methods such as in vitro assays or detection of molecular markers for resistance in the parasite can provide a basis for decisions concerning antimalarial drug policy for the Amazon and Orinoco regions in Colombia.