Clinical Aspects and Etiopathogenesis of Recurrent Aphthous Ulcer: Narrative Literature Review / Aspectos Clínicos e Etiopatogenia da Úlcera Aftosa Recorrente: Revisão Narrativa da Literatura

Recurrent aphthous ulcer (RAU) is a common oral mucosal lesion with varied and etiopathogenesis. It presents with pain and clinically manifests as an oval-shaped lesion with regular borders surrounded by an erythematous halo and covered by pseudo membrane. Due to the uncertainty about the possible causative factors, there is a need for studies that seek a better understanding of its pathophysiology. In this context, this study aimed to discuss the etiopathogenesis and clinical aspects of RAU. It was a descriptive study characterized as a narrative literature review. The inclusion criteria were studies relevant to the topic, written in Portuguese and English, without a time limit. The search was conducted between December 2022 and July 2023, through active searching in the Pubmed, LILACS, and SciELO platforms, as well as grey literature from Google Scholar and secondary free search. The Health Sciences Descriptors (DeCS/MeSH) were crossed using a Boolean operator, namely "aphthous ulcers" AND "predisposing factors." RAU has a multifactorial etiopathogenesis and may be associated with immunological, hereditary, nutritional, dietary, psycho-emotional, hormonal, and local trauma factors, although its relationship with microorganisms is controversial. Clinically, it is classified based on its morphology and clinical course. Morphologically, it is classified into minor, major, and herpetiform types, with the minor form being the most common. Therefore, RAU is a frequent oral mucosal lesion, with the minor form being the most prevalent, and despite its uncertain etiopathogenesis, studies indicate that immunological, traumatic, hereditary, hormonal, nutritional, and psycho-social factors are directly related to its development. (AU)

A úlcera aftosa recorrente (UAR) é uma lesão frequente da mucosa oral com etiopategia variada. Apresenta dor e clinicamente se manifesta com formato oval, bordas regulares circundada por halo eritematoso e coberta por pseudomembrana. Devido a incerteza sobre os possíveis fatores causais, há uma necessidade de estudos que busquem maior compreensão sobre sua patofisiologia. Diante desse contexto, o presente estudo teve como objetivo discorrer sobre a etiopatogenia e os aspectos clínicos da UAR. Tratou-se de um estudo descritivo, caracterizado como revisão narrativa da literatura. Os critérios de inclusão estabelecidos foram: estudos pertinentes à temática, redigidos em português e inglês, sem corte temporal. O levantamento ocorreu entre dezembro/2022 a julho/2023, através da busca ativa nas plataformas Pubmed, LILACS e SciELO, além da literatura cinzenta do Google Acadêmico e busca livre secundária. Os Descritores em Ciências da Saúde (DeCS/ MeSH) foram cruzados com operador booleano, a saber: "aphthous ulcers" AND "predisposing factors". A UAR apresenta etiopatogenia multifatorial, em que pode estar associada com fatores imunológicos, hereditários, nutricionais, alimentares, psico-emocionais, hormonais e traumas locais, todavia sua relação com microrganismos é controversa. Clinicamente, é classificada de acordo com sua morfologia e com sua evolução clínica. Morfologicamente, se classifica em menor, maior e herpetiformes, e a forma menor apresenta maior ocorrência. Portanto, a UAR trata-se de uma lesão frequente em mucosa oral, em que a forma menor tem maior frequência, e apesar de sua etiopatogenia incerta, estudos indicam que fatores imunológicos, traumáticos, hereditários, hormonais, nutricionais e psico-sociais apresentam relação direta com seu desenvolvimento. (AU)

Factores predisponentes asociados a la fractura de cadera en la región noroeste de la provincia de Villa Clara / Predisposing Factors Associated With Hip Fracture in the Northwest Region of Villa Clara Province

Introducción: La fractura de cadera es la causa más común de hospitalización en los servicios de urgencias de ortopedia. Objetivo: Describir los factores predisponentes asociados a la fractura de cadera en la región noroeste de la provincia de Villa Clara. Métodos: Se realizó un estudio descriptivo transversal en el período de noviembre de 2017 a diciembre de 2019, en la la región noroeste de la provincia de Villa Clara. La población en estudio estuvo integrada por 227 pacientes atendidos en el Hospital General Universitario Mártires del 9 de abril, del municipio Sagua la Grande, los cuales fueron ingresados en el servicio de Ortopedia y Traumatología por fractura de cadera. La muestra fue seleccionada mediante un muestreo no probabilístico y se tuvieron en cuenta los criterios de la investigación. Resultados: Según grupos de edad, predominaron las edades comprendidas entre 80-89 años en ambos sexos (42,7 por ciento), con mayor frecuencia entre las mujeres (45,3 por ciento) con respecto a los hombres (36,4 por ciento). Conclusiones: La caída de sus pies resultó ser el factor predominante asociado a la fractura de cadera en la región noroeste de la provincia de Villa Clara, con predominio en el sexo femenino. Esto sugiere la necesidad de desarrollar campañas de comunicación social para la población, dirigidas a la prevenciónde la fractura de cadera con un enfoque de género(AU)

Introduction: Hip fracture is the most common cause of hospitalization in orthopedic emergency services. Objective: To describe the predisposing factors associated with hip fracture in the northwestern region of the province of Villa Clara. Methods: A cross-sectional descriptive study was carried out from November 2017 to December 2019, in the northwestern region of Villa Clara province. A total of 227 patients participated; they were admitted to Mártires del 9 de abril General University Hospital, in Sagua la Grande municipality, and were treated in the Orthopedics and Traumatology service for hip fracture. Non-probabilistic sampling and the research criteria were taken into account for the selection. Results: According to age groups, the ages between 80-89 years prevailed in both sexes (42.7 percent), with higher frequency among women (45.3 percent) compared to men (36.4 percent). Conclusions: The fall from their feet"turned out to be the predominant factor associated with hip fracture in the northwest region of Villa Clara province, where the female sex predominated. This suggests the need to develop social communication campaigns for the population, aimed at the prevention of hip fracture with a gender approach(AU)

Evaluation of Predisposing Factors of Necrotic Enteritis in Experimentally Challenged Broiler Chickens.

Clostridium perfringens is the etiological agent of NE, a disease that greatly affects the poultry industry. Experiments on the induction of NE are difficult to carry out, as it is a multifactorial disease, and thus different predisposing factors have been used. This study evaluated the effect of the Gumboro disease vaccine virus vaccine (IBDV-vac) associated or not with infection by Eimeria spp. in broilers, as a predisposing factor for NE. Broilers (n = 99) were divided into groups (11) challenged with IBDV-vac, Eimeria spp. CP type G (CP13, CP14 and CP03) or both. The macroscopic evaluation revealed that the highest average (3.45) of injury occurred for the CP13 + IBDV-vac group. The microscopic analysis showed that Eimeria spp. increased the population of intraepithelial lymphocytes and reduced the villus/crypt ratio in duodenum and jejunum when associated with CP13 or CP14. There was a synergistic effect between the CP strain used and the predisposing factors; nevertheless, it was not clear which was the most effective predisposing factor to potentiate the lesions, suggesting that the association of the strain with the factors should first be evaluated for each experimental protocol.

Causas de muerte en pacientes adultos con insuficiencia cardíaca internados Hospital Nacional en el periodo 2017 - 2021

RESUMEN Introducción: la insuficiencia cardíaca presenta una elevada mortalidad intrahospitalaria y tras el alta, siendo una causa frecuente de reingreso hospitalario por descompensación cardíaca. Objetivos: determinar las causas de muerte en pacientes adultos con insuficiencia cardíaca internados Hospital Nacional, Itauguá, Paraguay, en el periodo 2017 - 2021 Metodología: estudio observacional descriptivo retrospectivo de corte trasverso, que incluyó a 103 adultos, de ambos sexos, con insuficiencia cardíaca. Resultados: la edad media fue 60 ± 14 años (27 - 92 años), la mayoría de los pacientes eran varones (54,37%), de procedencia urbana (57,28 %), con estudios primarios (65,05%), secundarios (31,07%) y con comorbilidades (99,03%). La principal comorbilidad fue la hipertensión arterial (28,16%). Las principales patologías intercurrentes fueron las patologías de causa infecciosa (56,25%). La media de la fracción de eyección fue 43 ± 11% (17 - 68%). La patología cardiaca más frecuente fue la cardiopatía hipertensiva (53,40%) seguida de la isquémica (35,92%). La media del BNP fue 1823 pg/dL. La mayoría de los pacientes tenían una fracción de eyección disminuida (70,87%) seguida de la conservada (29,13%). La mortalidad fue 41,7%. La principal causa de muerte fue la causa extracardiaca (62,79%) con las patologías infecciosas como la más común (44,44%). Al analizar los factores relacionados con la mortalidad se constató que la edad ≥ 60 años y el presentar patología intercurrente estuvo relacionado con la mortalidad (p< 0,05). Conclusiones: la mortalidad fue 42% y la principal causa de muerte fue de causa extra cardiaca (62,7%), siendo las patologías intercurrentes de causa infecciona las más frecuentes. Los predictores de mortalidad fueron la edad igual o mayor a 60 años y la presencia de patologías intercurrentes (p <0.05).

ABSTRACT Introduction: Heart failure presents a high in-hospital and after discharge mortality, being a frequent cause of hospital readmission due to cardiac decompensation. Objectives: To determine the causes of death in adult patients with heart failure admitted to the National Hospital, Itauguá, Paraguay, in the period 2017 - 2021. Methodology: Retrospective descriptive observational cross-sectional study, which included 103 adult men and women with heart failure. Results: The mean age was 60±14 years (27-92 years), most of the patients were men (54.37%), of urban origin (57.28%), with primary studies (65.05%), secondary (31.07%) and with comorbidities (99.03%). The main comorbidity was arterial hypertension (28.16%). The main intercurrent pathologies were pathologies of infectious cause (56.25%). The mean ejection fraction was 43±11% (17-68%). The most frequent cardiac pathology was hypertensive heart disease (53.40%) followed by ischemic heart disease (35.92%). The mean BNP was 1823 pg/dL. Most of the patients had a decreased ejection fraction (70.87%) followed by a preserved one (29.13%). Mortality was 41.7% and the main cause of death was extracardiac (62.79%) with infectious pathologies as the most common (44.44%). When analyzing the factors related to mortality, it was found that age ≥ 60 years and presenting intercurrent pathology was related to mortality (p<0.05). Conclusions: Mortality was 42% and the main cause of death was non-cardiac (62.7%), with intercurrent pathologies caused by infection being the most frequent. The predictors of mortality were age equal to or greater than 60 years and the presence of intercurrent pathologies (p <0.05).

Análisis de factores predictivos en la aparición de fístulas faringocutáneas poslaringectomía total / Analysis or predictive factors associated with pharingocutaneous fistulas after total laryngectomy

RESUMEN Antecedentes: la fístula faringocutánea es la complicación más común luego de una laringectomía total. Los factores implicados en su aparición son estudiados por numerosos autores sin obtener resultados concluyentes. Objetivo: Evaluar las causas de aparición de fístula faringocutánea y describir los factores de riesgo implicados en la aparición de fístulas faringocutáneas en la población estudiada. Material y métodos: estudio retrospectivo, observacional, con análisis estadístico de variables. Se consideraron 55 pacientes a quienes se les realizó una laringectomía total inicialmente o como rescate, desde enero de 2000 hasta diciembre de 2019, con una proporción hombre/mujer de 48/7. La edad media fue de 61,3 años. El 96,36% con diagnóstico anatomopatológico de carcinoma epidermoide. Análisis estadístico (prueba de chi cuadrado-prueba de Mann-Whitney) de variables relacionadas con la aparición de fístula faringocutánea. Resultados: la incidencia de fístulas alcanzó el 20% de los pacientes laringectomizados. Cerraron espontáneamente el 72,73% de las fístulas y requirieron el uso de colgajos, 3 (27,27%) pacientes. De los pacientes fistulizados, el 63,64% tenían radioterapia previa. El uso de sonda nasogástrica para alimentación se prolongó en dichos pacientes por más de 15 días. El tiempo de internación promedio de los pacientes fistulizados fue de 23 días. Conclusión: en nuestro medio, el factor más asociado a la aparición de fístulas tras laringectomía fue el uso de radioterapia previa. La fístula en estos pacientes tardó más tiempo en cerrarse y requirió en algunos casos reconstrucciones más complejas.

ABSTRACT Background: Pharyngocutaneous fistula is the most common complication after total laryngectomy. The factors associated with its development have been studied by several authors without conclusive results. Objective: To evaluate the causes for the development of PCF and to describe the risk factors associated with PCF in the population studied. Material and methods: We conducted a retrospective and observational study with statistical analysis of the variables. A total of 55 patients undergoing initial or salvage total laryngectomy from January 2000 to December 2019 were included. Male-to-female ratio was 48/7. Mean age was 61.3 years. The pathological diagnosis was epidermoid carcinoma in 96.36% of the cases. Statistical analysis: (chi square test and Mann-Whitney test) of the variables related with the development of pharyngocutaneous fistula. Results: The incidence of fistula in patients with laryngectomy was 20%. Spontaneous closure occurred in 72.73% and 3 patients (27.27%) required the use of flaps. In patients with fistula, 63.64% had previous radiotherapy. In these patients, the use of nasogastric tube feeding lasted > 15 days. Mean length of hospital stay in patients with fistula with 23 days. Conclusion: In our environment, previous radiotherapy was the most significant factor associated with the development of fistula. In these patients, fistula took longer to close and required more complex reconstructions in some cases.

Predisposição a formas graves de COVID-19 e adesão às medidas de prevenção: o papel do apoio social / Predisposition to severe forms of COVID-19 and adherence to preventive measures: the role of social support

Resumo Objetivou-se verificar a adesão às medidas de prevenção em idosos com maior predisposição a formas graves de COVID-19 e sua associação e interação com o apoio social. Trata-se de um estudo transversal realizado em amostra de 3.477 participantes do inquérito telefônico do Estudo Longitudinal da Saúde dos Idosos Brasileiros (iniciativa ELSI-COVID-19), que informaram ter saído de casa na semana anterior à realização do inquérito. A adesão foi aferida pela frequência com que saiu de casa, necessidade de sair de casa, uso de máscara e higienização das mãos. As análises basearam-se no modelo Poisson com variância robusta. Idade ≥ 65 anos, hipertensão, diabetes e obesidade foram considerados fatores predisponentes para formas graves de COVID-19. O apoio social incluiu o arranjo domiciliar e a conexão social na pandemia. Aproximadamente 46% apresentaram melhor adesão, que foi associada positivamente ao número de fatores predisponentes para formas graves. O apoio social não foi associado à adesão e não modificou essa associação, após ajustamentos. Conclui-se que a adesão às medidas de prevenção, que deveria ser estendida a todos, está concentrada nos idosos com maior predisposição a formas graves de COVID-19, independentemente do apoio social.

Abstract This study sought to assess the adherence to preventive measures among the elderly more prone to severe forms of COVID-19, and the association and interaction with social support. It is a cross-sectional study conducted with a sample of 3,477 participants of the telephone survey of the Brazilian Longitudinal Study of Aging (ELSI-COVID-19 initiative), who reported going out of the home in the past week. The adherence was based on the frequency of leaving the house, the need to venture outside the home, use of masks, and sanitization of hands. Statistical analysis was based on the Poisson model with robust variance. Predisposing factors for severe forms of COVID-19 included age ≥65 years, hypertension, diabetes, and obesity. Social support included living arrangements and social distancing during the pandemic. Approximately 46% of the participants showed higher adherence, which was positively associated with the number of predisposing factors for severe forms of COVID-19. Social support was not associated with adherence, nor was this association modified after adjustments. The conclusion drawn is that higher adherence is concentrated among the elderly with greater predisposition to severe forms of COVID-19, irrespective of social support, albeit preventive measures should be adopted by all.

Caracterización de los factores predisponentes de la conducta sexual en parejas infértiles. Guisa. Enero - Diciembre. 2018 / Characterization of predisposing factors of sexual behavior in infertile couples. Guise. January December. 2018 / Caracterização dos fatores predisponentes do comportamento sexual em casais inférteis. Guise. Janeiro dezembro. 2018

RESUMEN Introducción: la infertilidad ha aumentado al nivel mundial como consecuencia del incremento de las infecciones de transmisión sexual y la enfermedad inflamatoria pélvica, que dejan como secuelas la obstrucción de las trompas uterinas, además de otros factores asociados como las infecciones vaginales, el aborto provocado y sus complicaciones infecciosas. Objetivo: caracterizar factores predisponentes de la conducta sexual en las parejas infértiles en Guisa. Métodos: se realizó un estudio observacional, retrospectivo. Las variables utilizadas en el estudio fueron edad de las mujeres, número de abortos, antecedentes de infección vaginal (por tricomonas, cándidas, clamidias y vaginosis bacteriana). Para la realización de la investigación se revisaron las historias clínicas de todas las pacientes que acudieron a consulta de infertilidad durante el periodo de estudio y se confeccionó una planilla de recogida de datos. El universo estuvo constituido por las 105 pacientes atendidas en consulta de infertilidad y la muestra se conformó con 92 pacientes que cumplieron los criterios de inclusión. Resultados: predominaron las pacientes con edad promedio entre 25-29 años, los factores predisponentes como los abortos provocados, la infección vaginal por clamidia y la salpingitis como causa más frecuente de infertilidad. Conclusiones: la prevalencia de la infertilidad en Guisa es alta, puede ser prevenible si se manejan de forma integral los factores que la originan. Su abordaje integral y precoz puede disminuir su incidencia.

ABSTRACT Introduction: infertility has increased worldwide as a consequence of the increase in sexually transmitted infections and pelvic inflammatory disease, which leave as sequelae the obstruction of the uterine tubes, in addition to other associated factors such as vaginal infections, induced abortion and its infectious complications. Objective: to characterize predisposing factors of sexual behavior in infertile couples in Guisa. Methods: an observational, retrospective study was carried out. The variables used in the study were age of the women, number of abortions, history of vaginal infection (due to trichomonas, candida, chlamydia and bacterial vaginosis). To carry out the research, the medical records of all the patients who attended the infertility consultation during the study period were reviewed and a data collection sheet was prepared. The universe consisted of 105 patients seen in infertility consultation and the sample was made up of 92 patients who met the inclusion criteria. Results: patients with an average age between 25-29 years prevailed, predisposing factors such as induced abortions, vaginal chlamydial infection and salpingitis as the most frequent cause of infertility. Conclusions: the prevalence of infertility in Guisa is high, it can be preventable if the factors that originate it are managed in an integral way. Its comprehensive and early approach can reduce its incidence.

RESUMO Introdução: a infertilidade tem aumentado mundialmente como consequência do aumento das infecções sexualmente transmissíveis e doenças inflamatórias pélvicas, que deixam como sequelas a obstrução das tubas uterinas, além de outros fatores associados como infecções vaginais, aborto induzido e suas complicações infecciosas. Objetivo: caracterizar os fatores predisponentes do comportamento sexual em casais inférteis da Guisa. Métodos: foi realizado um estudo observacional retrospectivo. As variáveis ​​utilizadas no estudo foram idade das mulheres, número de abortos, história de infecção vaginal (por tricomonas, candida, clamídia e vaginose bacteriana). Para a realização da pesquisa, foram revisados ​​os prontuários de todas as pacientes que compareceram à consulta de infertilidade no período do estudo e elaborada uma ficha de coleta de dados. O universo foi constituído por 105 pacientes atendidos em consulta de infertilidade e a amostra foi composta por 92 pacientes que atenderam aos critérios de inclusão. Resultados: prevaleceram pacientes com idade média entre 25-29 anos, fatores predisponentes como aborto induzido, infecção vaginal por clamídia e salpingite como a causa mais frequente de infertilidade. Conclusões: a prevalência de infertilidade na Guisa é elevada, podendo ser evitada se os fatores que a originam forem geridos de forma integral. Sua abordagem abrangente e precoce pode reduzir sua incidência.

Factores asociados a mortalidad en pacientes Covid-19 en un Hospital del norte de Perú / Factors associated with mortality in Covid-19 patients in a Hospital in northern Peru

Objetivo. Determinar los factores de riesgo sociodemográficos y clínicos relacionados con la mortalidad en pacientes COVID-19 en un Hospital del norte de Perú. Material y Métodos: la investigación se llevó a cabo en un Hospital del norte de Perú. La población la constituyeron 208 Historias Clínicas de pacientes COVID-19 atendidos entre Marzo a Julio del 2020. La variable independiente fueron los factores sociodemográficos tales como la edad, sexo y el estado civil y los factores clínicos como antecedentes epidemiológicos, los factores de riesgo (co-morbilidades) y el estado de salud y la variable dependiente fue la mortalidad Covid-19. Resultados: La mortalidad COVID-19 alcanzó al 46,20 % en pacientes mayores 65 años (51,90 %), de sexo masculino (60,40 %) y casados (65,40 %), con antecedentes epidemiológicos (37,5%), y factores de riesgo (comorbilidad) un 74,50 %, principalmente asociados con hipertensión arterial (8,2%), obesidad (3,4%) y diabetes mellitus II (1,9%), y comorbilidades indeterminadas (Otras) un 6,7%. No se presentó mortalidad en los pacientes cuyo estado de salud era Estable, mientras que los pacientes con estado de salud reservado y fallecieron representaron un 46,2%. Conclusión: La mortalidad por COVID-19 alcanzó un 46,20%; mayores de 65 años (51,90 %), de sexo masculino (60,40 %) y casados (65,40 %). Se encontró relación significativa entre factores sociodemográficos como la edad, factores clínicos (comorbilidad), en su mayoría hipertensión arterial, obesidad y diabetes mellitus II, y pacientes con estado de salud reservado con la mortalidad del COVID-19.

Objetive. To determine the sociodemographic and clinical risk factors related to mortality in COVID-19 patients in a Hospital in northern Peru. Material and Methods: the research was carried out in a Hospital in the north of Peru. The population was made up of 208 Clinical Histories of COVID-19 patients seen between March and July 2020. The independent variable was sociodemographic factors such as age, sex and marital status, and clinical factors such as epidemiological history, risk factors (co-morbidities) and health status and the dependent variable was Covid-19 mortality. Results: COVID-19 mortality reached 46.20% in patients older than 65 years (51.90%), male (60.40%) and married (65.40%), with an epidemiological history (37.5%) , and risk factors (comorbidity) 74.50%, mainly associated with arterial hypertension (8.2%), obesity (3.4%) and diabetes mellitus II (1.9%), and indeterminate comorbidities (Others) 6.7%. There was no mortality in patients whose health status was Stable, while patients with reserved health status and who died represented 46.2%. Conclusion: mortality from COVID-19 reached 46.20%; older than 65 years (51.90%),male(60.40%) and married (65.40%). A significant relationship was found between sociodemographic factors such as age, clinical factors (comorbidity), mostly arterial hypertension, obesity and diabetes mellitus II, and patients with a reserved health status with the mortality of COVID-19.

Factores del estilo de vida predisponentes a displasia cervical en mujeres atendidas en el hospital María Auxiliadora, 2013-2017 / Lifestyle factors predisposing to cervical dysplasia in women attended in the hospital María Auxiliadora, 2013-2017

Introduccion: La displasia cervical es la lesión precursora del cáncer de cuello uterino, en el que se observan alteraciones de las células cervicales sin llegar a adoptar características de malignidad. Objetivo: Identificar los factores predisponentes para displasia cervical en las pacientes atendidas en el hospital María Auxiliadora durante el 2013 al 2017. Métodos: Estudio de diseño casos y controles, analítico y observacional. Se analizaron 216 historias clínicas de pacientes, dividiéndose en 72 casos y 144 controles. Resultados: En el análisis bivariado, resultaron significativos la menarquia temprana (OR=2,071;p=0.024), el inicio temprano de relaciones sexuales (OR=2,213;p=0.017), el tener múltiples parejas sexuales (OR=3,036;p=0.001) y la multiparidad (OR=2,316;p=0.005). En el análisis multivariado las variables independientes fueron el tener múltiples parejas sexuales (OR=2,626; p=0.003) y la multiparidad (OR=2,759;p=0.045) las cuales resultaron significativas. Conclusión: Se concluye que los factores del estilo de vida predisponentes a displasia cervical fueron tener múltiples parejas sexuales y la multiparidad.

Introduction: The cervical clearance is the precursor lesion of cancer of the cervix, in which alterations of the cervical cells are observed. Objective: To identify the predisposing factors for the cervical dispute in the patients treated at the María Auxiliadora Hospital during 2013 to 2017. Methods: Design study, cases, controls, analytical and observational. 216 clinical records of patients will be analyzed, divided into 72 cases and 144 controls. Results: In the bivariate analysis, significant results in early menarche (OR = 2.071, p = 0.024), early onset of sexual relations (OR = 2.213, p = 0.017), having multiple sexual partners (OR = 3.036; = 0.001) and multiparity (OR = 2.316, p = 0.005). In the multivariate analysis, the independent variables were multiple sexual partners (OR = 2.626, p = 0.003) and multiparity (OR = 2.759, p = 0.045). Conclusion: It is concluded that lifestyle factors predispose a cervical dispute.

Factores predisponentes de trauma dental en escolares del municipio Rafael Freyre / Predisposing Factors for Dental Trauma in Students from Rafael Freyre Municipality

Introducción: los traumatismos dentales representan uno de los más serios problemas de salud pública de los niños y adolescentes. Objetivo: identificar los factores predisponentes de trauma dentario en escolares de la escuela primaria. Método: se realizó un estudio descriptivo transversal, en escolares de 5 a 12 años de la escuela primaria "28 de septiembre" del Municipio Rafael Freyre, en el período de enero a junio de 2016. El universo de estudio y la muestra estuvo constituido por 236 niños. Se estudiaron algunas variables como edad, sexo, hábitos bucales deformantes, competencia labial y resalte. Resultados: las edades de 9 y 10 años fueron las más afectadas representadas por 47 escolares para el 19,9%. Predominó el sexo masculino (68,1%) en escolares con lesión traumática. El hábito bucal deformante más frecuente fue la succión digital en el 82,9%. El 65,9% de los pacientes que sufrieron lesiones traumáticas tenían una relación labial incompetente. El 80,9% de los escolares con trauma dental presentaban resalte aumentado. Conclusiones: los factores predisponentes más frecuentes fueron el resalte aumentado, el perfil convexo y la presencia de hábitos bucales deformantes entre los cuales la succión digital y la respiración bucal fueron los más representativos.

Introduction: dental trauma is one of the one of the most serious problems of public health in children and adolescents. Objective: identify the predisposing factors of dental trauma in children of the elementary school. Method: a descriptive cross-sectional study was conducted with students aged 5-12 from "28 de September" elementary school in the municipality of Rafael Freyre from January to June 2016.The universe and the sample of study was constituted for 236 children. The variables studied were age, sex, type of deforming oral habit, labial competence and overbite. Results: the ages between 9-10 were the most affected ones represented with 47 children (19.9%). There was a predominance of the male sex (68.1%) among students with traumatic injuries. Thumb sucking was the most common deforming oral habit (82.9%). Bilabial incompetence was found in 65.9% of the children with history of traumatic injuries. Increased overbite was found in 80.9% of the children with dental trauma. Conclusions: the most common predisposing factors were increased overjet, bilabial incompetence, and deforming oral habits. Thumb sucking and the buccal respiration were the prevailing ones.

Salmonella enterica: una revisión de la trilogía agente, hospedero y ambiente, y su trascendencia en Chile / Salmonella enterica: a review or the trilogy agent, host and environment and its importance in Chile

Salmonella enterica is a major foodborne pathogen worldwide, being the main cause of outbreaks by food consumption in Chile. Despite all efforts deployed for control and prevention, the high incidence in people still persists, with several factors that could be influencing the epidemiological behavior of this infection. The objective of this review is to identify these factors belonging to the biological agent, the human host and the environment, which probably have a greater importance in Chile. Thus, priority areas for research of S. enterica are inferred, which hopefully will help to understand its spread in nature and its success as a wide host range pathogen. In the future, increased understanding of these determinants will facilitate the implementation of biosecurity and surveillance strategies for the prevention of disease in people and animals.

Salmonella enterica es uno de los principales patógenos transmitidos por los alimentos en el mundo, siendo la primera causa de brotes de intoxicación alimentaria en Chile. A pesar de todos los esfuerzos de control y prevención desplegados, la incidencia en las personas se ha mantenido alta, por lo que diversos factores podrían estar influenciando el comportamiento epidemiológico de esta infección. El objetivo de esta revisión es describir factores referidos tanto al agente biológico, al hospedero humano y al medio ambiente, que podrían tener mayor trascendencia en Chile. De esta forma, se infieren ámbitos prioritarios para la investigación de S. enterica, que permitan entender su dispersión en la naturaleza y su éxito como patógeno de un amplio rango de hospederos. A futuro, el mayor conocimiento de estos determinantes facilitará la implementación de estrategias de bioseguridad y vigilancia para la prevención de la enfermedad en las personas y en los animales.

Pérdida de la longitud del arco dental en niños de 8 a 11 años / Loss of length of the dental arch in children aged 8 to 11

Se realizó un estudio descriptivo, observacional y transversal de 332 niños de 8 a 11 años de edad con pérdida no fisiológica del arco dental, atendidos en la Clínica Estomatológica del Policlínico Docente "José Martí Pérez" de Santiago de Cuba, desde septiembre del 2014 hasta diciembre del 2015, a fin de describir los factores predisponentes a dicha alteración. Los pacientes fueron examinados con ayuda de la luz natural, un pie de rey y un depresor lingual, y los promedios calculados de las longitudes de los arcos dentales superior e inferior resultaron de 31 mm y 29 mm, respectivamente, con una mayor afectación en los niños de 11 años. En la población evaluada predominaron los varones, el factor predisponente mayormente hallado fue la caries interproximal y los valores promedios de longitud más elevados estuvieron en la arcada superior y en las hemiarcadas derechas.

A descriptive, observational and cross-sectional study of 332 children aged 8 to 11 with non physiologic loss of the dental arch, assisted in "José Martí Pérez" Teaching Polyclinic Stomatological Clinic in Santiago de Cuba was carried out from September, 2014 to December, 2015, in order to describe the predisposing factors to this disorder. The patients were examined with the help of the natural light, slide gauge and a lingual depressor, and the calculated averages of the upper and lower dental arches length were 31 mm and 29 mm, respectively, with a higher implication in the 11 years children. In the evaluated population the males prevailed, the mostly found predisposing factor was the interproximal decay and the higher mean length values were in the upper arch and in the right hemiarches.

Keratitis caused by moulds in Santa Lucía Ophthalmology Hospital in Buenos Aires, Argentina.

BACKGROUND: Mycotic keratitis by moulds (MKM) is an important cause for corneal blindness and usually carries an unfavorable prognosis. AIMS: This study describes the risk factors and demographic and microbiological features of all MKM cases in Santa Lucía Ophthalmology Hospital during a period of 6 years. METHODS: A prospective study was performed for all MKM cases diagnosed between October 2007 and September 2013. RESULTS: Among 157 diagnosed cases, direct microscopic examination and culture were positive in 97 and 96% of the cases respectively. MKM represents 17% of all microbiologically confirmed corneal abscesses. No significant differences were detected in annual MKM frequencies across the study period, suggesting that MKM incidence remains constant over time. A male-to-female ratio was observed (2.8:1); the most affected age groups ranged from 31 to 40 years old (males) and 61-70 years old (females). The most frequent predisposing factor was trauma (40%) followed by the use of contact lenses (9%), herpetic abscesses (5%) and diabetes (4%). The predominant genera were Fusarium (66%), Aspergillus (10%), Curvularia (6%) and Alternaria (4%). The most frequent agent was Fusarium solani species complex (52%). More than two-thirds of the cases were produced by only 3 species or complexes. However, at least 29 different species were detected in the remaining cases. This is the first report of Pholiota sp. as causative agent of human MKM. CONCLUSIONS: Argentina lacks extensive epidemiological and clinical data on MKM. This six-year study performed in Argentina is a first step leading to a better understanding of MKM epidemiology in our country.

Factores predisponentes del trauma dental, Escuela Primaria República de Angola (2012-2013) / Predisposing factors for dental trauma, República de Angola elementary school, 2012-2013

Introducción: las lesiones traumáticas dentarias constituyen en la actualidad un problema de salud. La literatura científica señala un grupo de factores predisponentes para los traumas dentarios, sobre los cuales se puede actuar preventivamente. Métodos: se realizó un estudio descriptivo transversal, en niños y niñas de 7 a 12 años de la escuela primaria República de Angola del Municipio Boyeros, en el período del 2012 al 2013. Las variables utilizadas fueron: edad, sexo, presencia de lesión traumática, tipo de hábitos bucales deformantes, perfil, competencia labial, resalte, sobrepase. Las medidas de resumen empleadas fueron las frecuencias absolutas y porcentajes. Objetivo: identificar la frecuencia de factores predisponentes al trauma dentario en los escolares estudiados. Resultados: las edades de 11 y 12 años fueron las más afectadas representadas por 65 educandos para un 67 por ciento. Predominó el sexo masculino (68 por ciento) en escolares con lesión traumática. El hábito bucal deformante más frecuente fue la succión digital para (57,7 por ciento). Tenían perfil convexo 97 (73,2 por ciento) escolares de los que sufrieron un trauma. El 88,7 por ciento de los escolares con trauma dental presentaban resalte aumentado. El 83,5 por ciento de los que sufrieron lesiones traumáticas tenían una relación labial incompetente. Se observa que el 48,5 por ciento de los niños que tuvieron trauma presentaban un sobrepase negativo. Conclusiones: los factores predisponentes más frecuentes fueron el resalte aumentado, el perfil convexo, la incompetencia bilabial, el sobrepase negativo y la presencia de hábitos bucales deformantes entre los cuales la succión digital ocupa el primer lugar(AU)

Introduction: traumatic dental injuries are a current health problem. The scientific literature on the subject refers to a number of predisposing factors for dental trauma which may be acted upon preventively. Methods: a descriptive cross-sectional study was conducted with boys and girls aged 7-12 from República de Angola elementary school in the municipality of Boyeros from 2012 to 2013. The variables studied were age, sex, presence of traumatic injury, type of deforming oral habit, profile, labial competence, overbite, overjet. The summary measurements used were absolute frequencies and percentages. Objective: identify the frequency of predisposing factors for dental trauma among the school age children studied. Results: the 11-12 age group was the best represented with 65 children (67 percent). There was a predominance of the male sex (68 percent) among children with traumatic injuries. The most common deforming oral habit was thumb sucking (57.7 percent). Of the children with antecedents of traumatic injuries, 97 had a convex profile (73.2 percent). Increased overjet was found in 88.7 percent of the children with dental trauma. Bilabial incompetence was found in 83.5 percent of the children with antecedents of traumatic injuries. Of the children with dental trauma, 48.5 percent had a negative overjet. Conclusions: the most common predisposing factors were increased overjet, convex profile, bilabial incompetence, negative overjet and deforming oral habits, among which thumb sucking was predominant(AU)

Factores de riesgo cardiovascular y variables asociadas en personas de 20 a 79 años en Manizales, Colombia / Cardiovascular risk factors and variables associated in people aged 20-79 years in Manizales, Colombia

Objetivo: Relacionar los factores de riesgo cardiovascular en personas de 20 a 79 años con variables sociodemográficas, antropométricas, clínicas y categoría de riesgo coronario duro a 10 años de la ciudad de Manizales. Materiales y métodos: Estudio descriptivo correlacional. Muestreo no probabilístico, muestra 405 personas de la ciudad de Manizales, que firmaron el consentimiento y cumplieron los criterios de inclusión. Se realizaron entrevistas, mediciones antropométricas y en sangre de colesterol total y HDL. Resultados: Existió asociación estadísticamente significativa p<0,05 y fuerza de asociación alta (coeficiente mayor de 0,6) en la edad con el riesgo coronario según tensión arterial y tratamiento antihipertensivo. En las variables antropométricas el peso, el índice de masa corporal con el riesgo coronario según hipertensión arterial, colesterol total, colesterol HDL y obesidad abdominal. En las variables clínicas el tratamiento antihipertensivo con el factor de riesgo de hipertensión arterial. Conclusiones: Existe predominio de factores de riesgo modificables tanto antropométricos como clínicos. La edad y el valor de colesterol total en la población encuestada representan riesgo mayor en más del 50% de los participantes. Dentro de los factores predisponentes el sedentarismo fue el más común. La categoría de riesgo coronario duro a 10 años latente fue la de mayor frecuencia.

Objective: To relate cardiovascular risk factors in people aged 20 to 79 years with sociodemographic, anthropometric and clinical variables and hard coronary risk category to 10 years in the city of Manizales. Materials and methods: A descriptive correlational study. Non-probability sampling. The sample were 405 people in the city of Manizales, who signed the consent and met inclusion criteria. Interviews, anthropometric and blood total cholesterol and HDL measurements were made. Results: There was statistically significant association p <0.05 and strength of high association (higher coefficient of 0.6) in the age with coronary risk according to blood pressure and antihypertensive treatment. The anthropometric variables were weight, body mass index with coronary risk as high blood pressure, total cholesterol, HDL cholesterol and abdominal obesity. The clinical variable was antihypertensive treatment with the risk factor of hypertension. Conclusions: There is predominance of modifiable anthropometric and clinical risk factors. Age and total cholesterol in the population surveyed represent greater risk by more than 50% of participants. Among the predisposing factors sedentary lifestyle was the most common. The category of hard coronary risk at 10 years was the most latent frequency.

Factores asociados al uso de mamografía en mujeres mayores de 50 años: Cartagena / Factors Associated with Use of Mammography in Women over 50 years: Cartagena / Fatores associados ao uso de mamografía em mulheres maiores de 50 anos em Cartagena

Objetivo: Determinar los factores asociados al uso de la mamografía en mujeres mayores de 50 años de la ciudad de Cartagena. Materiales y métodos: Se realizó un estudio analítico de corte transversal, con una población de 49987 mujeres mayores de 50 años de Cartagena. Se estimó un tamaño de muestra de 909 mujeres, obtenidas por conglomerados. Para la recolección de información se utilizó: una encuesta socio-demográfica; el cuestionario Apgar, que mide la funcionalidad familiar; el cuestionario Duke -11, que señala el apoyo social percibido, y una escala que evalúa la satisfacción de servicios. Para el análisis de los datos se aplicó estadística descriptiva; se calcularon razones de Odss (OR), con intervalos de confianza al 95% (IC 95%) para estimar la asociación entre los factores evaluados y el uso de la mamografía, utilizando el programa estadístico SPSSS versión 17®. Resultados: Participaron 909 mujeres, 59,5% (541) manifestaron haberse hecho la mamografía, solo 314 (34,5%), se la realizaron en los dos últimos años, de acuerdo a la norma técnica nacional. Entre los factores que explican el uso de la mamografía, se encuentra: tener pareja [OR = 1,3 (IC 5% 1,04-1,8)], convivir con menos de cuatro personas [OR= 0,4 (IC 95% 0,3-0,6)] y haber cursado bachillerato completo en adelante [OR= 2,2 (IC 95% 1,67-3,04)]. Conclusión: Más de la mitad de las mujeres encuestadas manifestaron haberse realizado una mamografía, sin embargo la frecuencia de uso, no cumple con lo establecido por la norma técnica nacional. Factores personales y familiares se asocian al uso de la prueba.

Objective: To determine the factors associated with the use of mammography in women over 50 years of Cartagena. Materials and Methods: We performed across-sectional study, with a population of 49987 women over 50 years of Cartagena. We estimated a sample size of 909 women, obtained by conglomerates. To gather information was used: a socio-demographic survey, the Apgar questionnaire to measure perception of family functioning, the Duke-11questionnaireto measure perceived social support and a scale to measure satisfaction with services. For the analysis of the data using descriptive statistics, were calculated to estimate or association between some factors and the use of mammography, using the statistical software version 17 SPSSS. Explanatory variables were considered using mammography to those with a chi2 test less than 5%. Results: A total of 909 women, 59.5% (541) reported having had mammograms, only 314 (34.5%), were made in the past two years, according to the national technical rule. Among the factors that explain the use of mammography, is having partner [OR= 1.3 (95% CI 1.04 to 1.8)], coexisting with less than four [OR = 0.4 (95% CI 0.3 to 0.6)] and have completed comprehensive school and older [OR = 2.2 (95% CI 1.67 to 3.04)]. Conclusion: More than half of women surveyed reported having had a mammogram, but frequency of use, does not comply with the provisions of the national technical rule. Personal and family factors are associated with the use of the test.

Objetivo: determinar os fatores associados ao uso de mamografia em mulheres maiores de 50 anos da cidade de Cartagena. Materiais e métodos: realizou-se um estudo analítico de corte transversal, com uma população de 49.987 mulheres maiores de 50 anos de Cartagena. Estimou-se um tamanho de amostra de 909 mulheres, obtidas por conglomerados. Para a recoleção de informação utilizouse: uma enquete sócio-demográfica, o questionário apgar, par medir a funcionalidade familiar, o questionário Duke -11 para medir apoio social percebido e uma escala para medir satisfação de serviços. Para a análise dos dados aplicou-se estadística descritiva; se calcularam or para estimar associação entre os fatores avaliados e o uso da mamografia, utilizando o programa estadístico SPSSS versão 17®. Resultados: participaram 909 mulheres, 59,5% (541) manifestaram se tiver realizado a mamografia, só 34,5% (314) a realizaram nos dois últimos anos, de acordo com a norma técnica nacional. Entre os fatores que explicam o uso da mamografia, encontra-se: ter casal ou namorado (OR = 1,3 (I.C. 95% 1,04 - 1,8)), conviver com menos de quatro pessoas (OR= 0,4 (IC 95% 0,3 - 0,6)) e ter estudado bacharelato completo e mais (OR= 2,2 (IC 95% 1,67 - 3,04)). Conclusão: mais da metade das mulheres participantes da enquete manifestaram ter-se realizado uma mamografia, no entanto a frequência de uso, não cumpre com o estabelecido pela norma técnica nacional. Fatores pessoais e familiares associam-se ao uso da prova.

Factores predisponentes de fractura intraoperatoria de fémur en artroplastía total de cadera primaria / Predisposing factors for intraoperative femur fracture in primary total hip arthroplasty

Introducción: El objetivo de este reporte fue caracterizar los factores predisponentes de la fractura periprotésica intraoperatoria de fémur durante una artroplastia primaria de cadera. Materiales y Métodos: Entre 1999 y 2010, se analizaron 1943 reemplazos de cadera, en 28 casos, se produjo una fractura de fémur durante una artroplastia total de cadera primaria, lo que arroja una incidencia del 1,4 %. Se utilizó la clasificación de Vancouver y se estudiaron la presencia de factores predisponentes, el tratamiento realizado, la evolución clínica y radiográfica. Resultados: Del total de la muestra, 23 (82,1 %) fracturas eran de tipo A y 5 (17,9 %), de tipo B. El promedio obtenido del ángulo cervicodiafisario del fémur de 140° (rango 120°-160°). El 71,4% de la muestra eran mujeres. El 7,1 % presentaba osteosíntesis previa. La incidencia de fracturas fue del 3,54 % para los implantes no cementados (16/452) y del 0,8 % para los tallos cementados (12/1491). Se realizó lazada de alambre en 18 pacientes (64,3 %), malla metálica más lazada de alambre en un paciente (3,6 %) y en 9 (32,1 %) tratamiento conservador. En 27 (96,4 %) casos, la evolución fue buena y el puntaje promedio posoperatorio del Harris Hip Score fue de 93 puntos (rango 89-95). Conclusiones: El sexo femenino, el aumento del ángulo cervicodiafisario, la presencia de caderas displásicas, implantes no cementados y zonas de debilidad luego de retirar una osteosíntesis son factores predisponentes para sufrir este tipo de complicación, por lo que es recomendable realizar una lazada de alambre profiláctica cuando se conjuguen varios de los factores de riesgo mencionados.

Background: The objective of this study was to characterize the predisposing factors for intraoperative femur fracture during primary total hip arthroplasty. Methods: From 1999 to 2010, 28 fractures occurring during 1943 primary total hip arthroplasties were analyzed, an incidence of 1.4 %. Vancouver classification was used. The presence of predisposing factors, their treatment and clinical and radiological outcomes were evaluated. Results: Twenty three (82.1 %) fractures were type A and 5 (17.9 %) were type B. The average of the cervical-shaft angle was 140° (120°-160°). 71.4 % were women and 7.1 % had previous osteosynthesis. The incidence was 3.54 % (16/452) in cementless femoral stems and 0.8 % in cemented femoral stems (12/1491). Intraoperative treatments were: cerclage wire in 18 cases (64.3 %), metal mesh plus cerclage wire in one patient (3.6 %) and conservative treatment in 9 patients. Twenty seven (96.4 %) patients obtained good results and the average Harris Hip Score was 93 points (89-95). Conclusions: Female patients, high cervical-shaft angle, hip dysplasia, cementless femoral stems and femur weakness after removing the osteosynthesis, are predisposing factors for this type of complication. For this reason, we suggest to perform a prophylactic cerclage wire when two o more of these predisposing factors are present.