Growth patterns and outcomes of growth hormone therapy in patients with acrodysostosis.

INTRODUCTION: Severe short stature is a feature of acrodysostosis, but data on growth are sparse. Treatment with recombinant human growth hormone (rhGH) is used in some centers to increase final height, but no studies have been published so far. Our objective was to conduct a multicenter, retrospective, cohort study to investigate growth in individuals with both types of acrodysostosis, treated with rhGH or not; we used the new nomenclature to describe acrodysostosis, as this disease belongs to the large group of inactivating PTH/PTHrP signaling disorders (iPPSD); acrodysostosis refers to iPPSD4 (acrodysostosis type 1 due to PRKAR1A mutations) and iPPSD5 (acrodysostosis type 2, due to PDE4D mutations). METHODS: We present auxological data from individuals with genetically characterized iPPSD4, and participants with clinical features of iPPSD5. RESULTS: We included 20 and 17 individuals with iPPSD4 and iPPSD5, respectively. The rhGH-treated iPPSD4 patients (n = 9) were smaller at birth than those who did not receive rhGH (median - 2.2 SDS vs. - 1.7 SDS); they showed a trend to catch-up growth during rhGH therapy (median 0.5 SDS in the first year). The rhGH-treated patients (n = 5) reached a better final height compared to those who did not receive rhGH (n = 4) (median - 2.8 SDS vs. - 3.9 SDS), suggesting that rhGH is efficient to increase height in those patients. The difference in target height to final height ranged between 1.6 and 3.0 SDS for iPPSD4 not treated with rhGH (n = 4), 2.1-2.8 SDS for rhGH-treated iPPSD4 (n = 5), 0.6-5.5 SDS for iPPSD5 not treated with rhGH (n = 5) and 2.5-3.1 for rhGH-treated iPPSD5 (n = 2). CONCLUSION: Final height may be positively influenced by rhGH in patients with acrodysostosis/iPPSD. Our rhGH-treated cohort started therapy relatively late, which might explain, at least in part, the limited effect of rhGH on height.

Magnetically confined hydrophobic nanoparticles for the microextraction of endocrine-disrupting phenols from environmental waters.

In this article, a solid-phase extraction approach, which takes advantage of the good extraction capabilities of hydrophobic magnetic nanoparticles (MNPs), is presented. The new approach involves the deposition of a thin layer of MNPs in a dedicated stirring unit based on the dual function of a mini-magnet. The system allows the extraction of the analytes in a simple and efficient way. The approach, which reduces the negative effect of the aggregation tendency of hydrophobic MNPs, is characterized for the resolution of a model analytical problem: the determination of some endocrine-disrupting phenols in water by liquid chromatography-photometric detection. All the variables involved in the extraction process have been clearly identified and optimized. The new extraction mode allows the determination of these compounds with limits of detection in the range from 0.15 µg/L (for 4-tert-octylphenol) to 2.7 µg/L (for 4-tert-butylphenol) with a relative standard deviation lower than 5.3 % (for 4-tert-butylphenol).

Determination of non-steroidal anti-inflammatory drugs in urine by the combination of stir membrane liquid-liquid-liquid microextraction and liquid chromatography.

A stir membrane liquid phase microextraction procedure working under the three-phase mode is proposed for the first time for the determination of six anti-inflammatory drugs in human urine. The target compounds are isolated and preconcentrated using a special device that integrates the extractant and the stirring element. An alkaline aqueous solution is used as extractant phase while 1-octanol is selected as supported liquid membrane solvent. After the extraction, all the analytes are determined by liquid chromatography (LC) with ultraviolet detection (UV). The analytical method is optimized considering the main involved variables (e.g., pH of donor and acceptor phases, extraction time, stirring rate) and the results indicate that the determination of anti-inflammatory drugs at therapeutic and toxic levels is completely feasible. The limits of detection are in the range from 12.6 (indomethacin) to 30.7 µg/L (naproxen). The repeatability of the method, expressed as relative standard deviation (RSD, n = 5) varies between 3.4% (flurbiprofen) and 5.7% (ketoprofen), while the enrichment factors are in the range from 35.0 (naproxen) to 72.5 (indomethacin).

Transcultural validation and adaptation of the Pedi-IKDC scale for the functional assessment of children that undergo knee surgery. / Validación y adaptación transcultural de la escala Pedi-IKDC para la evaluación funcional de niños llevados a cirugía de rodilla.

INTRODUCTION: In the last decades sports practice in children has increased, thus increasing the number of musculoskeletal injuries. There are no validated scales in Spanish for the functional evaluation of knee aspects in children. The validation and cross-cultural adaptation of the Pedi-IKDC scale to Spanish, used for this purpose, was carried out. METHODOLOGY: The scale was applied to 50 patients that suffered traumatic knee injuries between 2016 and 2021 and underwent surgical interventions. The validation process of the scale was carried out after a pilot test, cross-cultural adaptation of words into Spanish, translation-retranslation, statistical, determination of internal consistency of the instrument, intraclass correlation, test-retest and evaluation of data dispersion. RESULTS: The internal consistency of the evaluated instrument is good according to the Gregory scale with a Cronbach's alpha of 0.82 The intraclass correlation was considered substantial (0.624) and the test-retest correlation, showed a coefficient of 0.91. The Bland-Altman graph showed a low dispersion among the data. CONCLUSION: The Pedi-IKDC scale can be a useful tool to assess functionality in children who have undergone knee surgery, it is considered valid, with adequate reliability and with the advantage of easy application.

[Translated article] Transcultural validation and adaptation of the Pedi-IKDC scale for the functional assessment of children that undergo knee surgery.

INTRODUCTION: In the last decades sports practice in children has increased, thus increasing the number of musculoskeletal injuries. There are no validated scales in Spanish for the functional evaluation of knee aspects in children. The validation and cross-cultural adaptation of the Pedi-IKDC scale to Spanish, used for this purpose, was carried out. METHODOLOGY: The scale was applied to 50 patients that suffered traumatic knee injuries between 2016 and 2021 and underwent surgical interventions. The validation process of the scale was carried out after a pilot test, cross-cultural adaptation of words into Spanish, translation-retranslation, statistical, determination of internal consistency of the instrument, intraclass correlation, test-retest and evaluation of data dispersion. RESULTS: The internal consistency of the evaluated instrument is good according to the Gregory scale with a Cronbach's alpha of 0.82 The intraclass correlation was considered substantial (0.624) and the test-retest correlation, showed a coefficient of 0.91. The Bland-Altman graph showed a low dispersion among the data. CONCLUSION: The Pedi-IKDC scale can be a useful tool to assess functionality in children who have undergone knee surgery, it is considered valid, with adequate reliability and with the advantage of easy application.

Sensitive in-surface infrared monitoring coupled to stir membrane extraction for the selective determination of total hydrocarbon index in waters.

In this paper, the direct coupling between stir membrane extraction and infrared spectroscopy working under transmission mode is presented for the sensitive and selective determination of the total hydrocarbon index in waters. For this purpose, a new extraction unit was built using stainless steel in order to maximize the adsorption of the target analytes in the 40-microm-thick polytetrafluoroethylene membrane. The method allows the determination of hydrocarbons in the presence of grease, using hexadecane and stearic acid as model compounds, respectively. The proposal is optimized in depth, taking into account the main experimental variables such as membrane thickness, extraction time, and stirring and sample volume. Later on, the method was characterized on the basis of its linearity, precision, and limits of detection. The combination allows the determination of the hydrocarbon index with a limit of detection of 18 microg L(-1), the precision being (expressed as relative standard deviation) better than 4.3%. The analytical method provides a high sample throughput since some extractions can be performed in parallel, the relative standard deviation between devices being better than 8%. The proposed analytical method is finally compared in terms of analytical figures with counterpart ASTM method, recently presented.

Entamoeba histolytica: expression and localization of Gal/GalNAc lectin in virulent and non-virulent variants from HM1:IMSS strain.

We have purified Gal/GalNAc lectin from Entamoeba histolytica by electroelution. The purified protein was used to immunize rabbits and obtain polyclonal IgG's anti-lectin. These antibodies were used as tools to analyze the expression and localization of the amoebic lectin in both virulent (vEh) and non-virulent (nvEh) variants of axenically cultured HM1:IMSS strain. vEh is able to induce liver abscesses in hamsters, whereas nvEh has lost this ability. In vitro, amoebic trophozoites from both variants equally express this protein as shown by densitometric analysis of the corresponding band in Western blots from lysates. In both types of trophozoites, the pattern of distribution of the lectin was mainly on the surface. We have also compared by immunohistochemistry the presence and distribution of lectin in the in vivo liver lesions produced in hamsters. In order to prolong the survival of nvEh to analyze both variants in an in vivo model, hamsters inoculated with nvEh were treated with methyl prednisolone. Our results suggest that the Gal/GalNAc lectin is equally expressed in both nvEh and vEh.

Dispersive solid phase extraction for in-sorbent surface attenuated total reflection infrared detection.

The combination of dispersive solid phase extraction (DSPE) and attenuated total reflection (ATR) infrared spectroscopy is presented using the joint determination of sorbic and benzoic acids in juice samples as a model analytical problem. The dispersive extraction process allows the selective extraction of the target analytes from the sample matrix allowing their preconcentration prior to their infrared detection. The extraction efficiency is improved compared to the conventional procedures since the interaction between sorbent and analytes is favored with the stirring process. Moreover, the extracted analytes are directly determined in the sorbent. As no elution step is required, analyte dilutions and consumption of organic solvents are avoided. The proposed approach has been qualitative and quantitative studied. The hierarchical cluster analysis permits the sample classification according to the relative concentration of the analytes. The precision of the quantitative analysis was better than 6% with analyte recoveries in the range 87-90%. The proposed method was applied to the analysis of different commercial fruit juice samples. Finally, the main advantages and limitations of the new proposal are presented and compared with existing alternatives.

Stir membrane extraction: a useful approach for liquid sample pretreatment.

In this paper, a novel extraction approach based on the use of a polymeric membrane as the extraction medium is described. For this aim, an original unit which allows the magnetic stirring of the membrane during the extraction process has been designed, optimized, and practically evaluated. On one hand, the main variables affecting the extraction process such as the unit design, the stirring rate, the extraction time, the sample volume, and the elution conditions were deeply studied. Once optimized, a model analytical problem, the determination of polycyclic aromatic hydrocarbons in water samples, was selected for practical evaluation of the stir membrane extraction procedure. The method was characterized on the basis of its linearity, precision, and limits of detection. The novel approach was sensitive and precise enough for the detection of the target analytes in the low nanogram per liter range using 25 mL of sample. In fact, limits of detection ranged from 0.8 ng/L (fluoranthene) to 7.6 ng/L (benzo-anthracene) with relative standard deviations lower than 8%.

A pilot study of the clinical and statistical significance of a program to reduce eating disorder risk factors in children.

The current study used clinical and statistical significance tests to investigate the effects of two forms (didactic or interactive) of a universal prevention program on attitudes about shape and weight, eating behaviors, the influence of body aesthetic models, and self-esteem. Three schools were randomly assigned to one, interactive, didactic, or a control condition. Children (61 girls and 59 boys, age 9-11 years) were evaluated at pre-intervention, post-intervention, and at 6-month follow-up. Programs comprised eight, 90-min sessions. Statistical and clinical significance tests showed more changes in boys and girls with the interactive program versus the didactic intervention and control groups. The findings support the use of interactive programs that highlight identified risk factors and construction of identity based on positive traits distinct to physical appearance.

Functional Connectivity Changes in Behavioral, Semantic, and Nonfluent Variants of Frontotemporal Dementia.

Frontotemporal dementia (FTD) affects behavior, language, and personality. This study aims to explore functional connectivity changes in three FTD variants: behavioral (bvFTD), semantic (svPPA), and nonfluent variant (nfvPPA). Seventy-six patients diagnosed with FTD by international criteria and thirty-two controls were investigated. Functional connectivity from resting functional magnetic resonance imaging (fMRI) was estimated for the whole brain. Two types of analysis were done: network basic statistic and topological measures by graph theory. Several hubs in the limbic system and basal ganglia were compromised in the behavioral variant apart from frontal networks. Nonfluent variants showed a major disconnection with respect to the behavioral variant in operculum and parietal inferior. The global efficiency had lower coefficients in nonfluent variants than behavioral variants and controls. Our results support an extensive disconnection among frontal, limbic, basal ganglia, and parietal hubs.

Design of a monitoring network and assessment of the pollution on the Lerma river and its tributaries by wastewaters disposal.

While the 2005 progress report of the United Nations Millennium Development Goals stresses out the need of a dramatic increase in investment to meet the sanitation target in the third world, it is important to anticipate about some parallel negative impacts that may have this optimistic programme (extension of sewer networks without sufficient treatment works). Research was initiated on Lerma River (Mexico), subjected to many rejects disposal, to design a monitoring network and evaluate the impact of wastewaters on its water quality. The discharges was inventorized, geo-positioned with a GPS and mapped, while the physico-chemical characteristics of the river water, its tributaries and main rejects were evaluated. Microtox system was used as an additional screening tool. Along the 60 km of the High Course of Lerma River (HCLR), 51 discharges, with a diameter or width larger than 0.3 m (including 7 small tributaries) were identified. Based on the inventory, a monitoring network of 21 sampling stations in the river and 13 in the important discharges (>2 m) was proposed. A great similitude was found between the average characteristics of the discharges and the river itself, in both the wet and dry seasons. Oxygen was found exhausted (<0.5 mg/L) almost all along the high course of the river, with COD and TDS average levels of 390 and 1980 mg/L in the dry season, against 150 and 400 mg/L in the wet season. In the dry season, almost all the sites along the river revealed some toxicity to the bacteria test species (2.9 to 150 TU, with an average of 27 TU). Same septic conditions and toxicity levels were observed in many of the discharges. Four of the six evaluated tributaries, as well as the lagoon (origin of the river), were relatively in better conditions (2 to 8 mg/L D.O., TU<1) than for the Lerma, acting as diluents and renewal of the HCLR flow rate. The river was shown to be quite a main sewer collector. The high surface water contamination by untreated wastewaters that is depicted in this research should be taken into account in the Millennium Goals strategies, by promoting treatment plan works simultaneously, when sewer networks in the third world would extend.

Validación y adaptación transcultural de la escala Pedi-IKDC para la evaluación funcional de niños llevados a cirugía de rodilla / Transcultural validation and adaptation of the Pedi-IKDC scale for the functional assessment of children that undergo knee surgery

Introducción: En las últimas décadas la práctica deportiva en los niños ha incrementado, presentándose así mayores lesiones osteomusculares. No existen escalas validadas al español para la evaluación funcional de la rodilla en niños. Se realizó la validación y adaptación transcultural de la escala Pedi-IKDC al español, usada para este fin. Metodología: Se aplicó la escala a 50 pacientes operados por lesiones traumáticas de la rodilla entre el 2016 y el 2021, se realizó el proceso de validación, previa prueba piloto, adaptación transcultural de palabras al español, traducción-retraducción, y análisis estadístico, determinación de consistencia interna del instrumento, correlación intraclase, test-retest y evaluación de dispersión de los datos. Resultados: La consistencia interna del instrumento evaluado es buena según la escala de Gregory, con un alfa de Cronbach de 0,82; la correlación intraclase se consideró sustancial (0,624) y al momento de realizar la correlación test-retest se encontró un coeficiente de 0,91. En el gráfico de Bland-Altman se evidenció una baja dispersión entre los datos. Conclusión: La escala Pedi-IKDC puede ser una herramienta útil para evaluar la funcionalidad en niños que han sido llevados a cirugía de rodilla; se considera válida, con una adecuada confiabilidad y con la ventaja adicional de ser de fácil aplicación.(AU)

Introduction: In the last decades sports practice in children has increased, thus increasing the number of musculoskeletal injuries. There are no validated scales in Spanish for the functional evaluation of knee aspects in children. The validation and cross-cultural adaptation of the Pedi-IKDC scale to Spanish, used for this purpose, was carried out. Methodology: The scale was applied to 50 patients that suffered traumatic knee injuries between 2016 and 2021 and underwent surgical interventions. The validation process of the scale was carried out after a pilot test, cross-cultural adaptation of words into Spanish, translation-retranslation, statistical, determination of internal consistency of the instrument, intraclass correlation, test-retest and evaluation of data dispersion. Results: The internal consistency of the evaluated instrument is good according to the Gregory scale with a Cronbach's alpha of 0.82 The intraclass correlation was considered substantial (0.624) and the test-retest correlation, showed a coefficient of 0.91. The Bland-Altman graph showed a low dispersion among the data. Conclusion: The Pedi-IKDC scale can be a useful tool to assess functionality in children who have undergone knee surgery, it is considered valid, with adequate reliability and with the advantage of easy application.(AU)

[Translated article] Transcultural validation and adaptation of the Pedi-IKDC scale for the functional assessment of children that undergo knee surgery / Validación y adaptación transcultural de la escala Pedi-IKDC para la evaluación funcional de niños llevados a cirugía de rodilla

Introducción: En las últimas décadas la práctica deportiva en los niños ha incrementado, presentándose así mayores lesiones osteomusculares. No existen escalas validadas al español para la evaluación funcional de la rodilla en niños. Se realizó la validación y adaptación transcultural de la escala Pedi-IKDC al español, usada para este fin. Metodología: Se aplicó la escala a 50 pacientes operados por lesiones traumáticas de la rodilla entre el 2016 y el 2021, se realizó el proceso de validación, previa prueba piloto, adaptación transcultural de palabras al español, traducción-retraducción, y análisis estadístico, determinación de consistencia interna del instrumento, correlación intraclase, test-retest y evaluación de dispersión de los datos. Resultados: La consistencia interna del instrumento evaluado es buena según la escala de Gregory, con un alfa de Cronbach de 0,82; la correlación intraclase se consideró sustancial (0,624) y al momento de realizar la correlación test-retest se encontró un coeficiente de 0,91. En el gráfico de Bland-Altman se evidenció una baja dispersión entre los datos. Conclusión: La escala Pedi-IKDC puede ser una herramienta útil para evaluar la funcionalidad en niños que han sido llevados a cirugía de rodilla; se considera válida, con una adecuada confiabilidad y con la ventaja adicional de ser de fácil aplicación.(AU)

Introduction: In the last decades sports practice in children has increased, thus increasing the number of musculoskeletal injuries. There are no validated scales in Spanish for the functional evaluation of knee aspects in children. The validation and cross-cultural adaptation of the Pedi-IKDC scale to Spanish, used for this purpose, was carried out. Methodology: The scale was applied to 50 patients that suffered traumatic knee injuries between 2016 and 2021 and underwent surgical interventions. The validation process of the scale was carried out after a pilot test, cross-cultural adaptation of words into Spanish, translation-retranslation, statistical, determination of internal consistency of the instrument, intraclass correlation, test-retest and evaluation of data dispersion. Results: The internal consistency of the evaluated instrument is good according to the Gregory scale with a Cronbach's alpha of 0.82 The intraclass correlation was considered substantial (0.624) and the test-retest correlation, showed a coefficient of 0.91. The Bland-Altman graph showed a low dispersion among the data. Conclusion: The Pedi-IKDC scale can be a useful tool to assess functionality in children who have undergone knee surgery, it is considered valid, with adequate reliability and with the advantage of easy application.(AU)

[Severe temporal bone fractures in children: clinical presentation, complications and sequelae observed in the last 11 years]. / Fracturas de temporal graves en niños: presentación, complicaciones y secuelas observadas en los últimos 11 años.

OBJECTIVES: To evaluate the clinical presentation, complications and sequelae in patients with temporal bone fracture in the last 11 years. MATERIAL AND METHODS: A total of 27 patient medical records were retrospectively analysed. RESULTS: Of the 27 patients who were admitted for temporal bone fracture from 2001 to 2012, 13 (48%) had no petrous involvement (Group 1), and 14 (52%) with petrous involvement (Group 2). Patients in Group 2 had a longer P-ICU stay: median 4.5 days (RI: 2.75-22.25 d) vs 2 (RI: 1-3 d) (P=.018); more days on mechanical ventilation support: median 3 days (RI: 1.50-17 d) vs 1 (RI: 1-1.25 d). This group also had a higher frequency in sequelae (P=.04 OR=1.4 (95% CI: 1.05-1.95)) and a higher incidence in cerebrospinal fluid (CSF) fistula (P<.02; OR 2.33; 95% CI (1.27-4.27)). Severity scores (PRIMS III and PTI) showed no significant differences. Some degree of hearing loss was observed in 31% of the patients. Traffic accident was the main cause of trauma (33%), followed by falls (27%). There were 2 deaths and 4 (15%) had permanent sequelae. CONCLUSIONS: Isolated temporal bone fractures usually have a good outcome in children, but in some cases they can be fatal or have permanent sequelae. Long term follow up is recommended by authors.

Role of cysteine proteinases of Entamoeba histolytica on the cytopathogenicity of axenic trophozoites on rat and hamster hepatocytes in vitro.

The role of amebic cysteine proteinase(s) on the in vitro cytotoxic and cytolytic effects of axenic trophozoites of a virulent strain (HM-1) of Entamoeba histolytica has been studied using freshly isolated rat and hamster hepatocytes as target cells. The cytotoxic effect was defined as cell killing without loss of cell structure and the cytolytic effect as cell disintegration. Incubation experiments of axenic trophozoites with rat or hamster liver cells in the presence and absence of bovine serum, of several proteinase inhibitors, and of galactose, galactosamine, and cysteine, at various ameba:liver cell ratios, different temperatures, and for several time periods, suggest that amebic cysteine proteinase is not involved in the cytotoxic effect but is essential for the cytolytic effect. This suggestion is supported by additional observations made with Transwell chambers, which effectively prevent contact between amebas and target cells, and by experiments with a fraction of an extract of lysed amebas that contained most of their cysteine proteinase activity.

[Diagnosis in severe myoclonic epilepsy in childhood: study of 13 cases]. / Diagnóstico en la epilepsia mioclónica severa de la infancia: estudio de 13 casos.

OBJECTIVE: The purpose of this report is to describe clinical pattern, EEG, outcome and differential diagnosis in severe myoclonic epilepsy in infancy (SMEI). MATERIAL AND METHODS: We report 13 cases initially diagnosed of SMEI and selected according to the following criteria: first seizure between 1 and 12 months of life, frequent seizures resistant to antiepileptic drugs, no previous personal history of disease, normal psychomotor development before the first seizure and normal EEG, CT scanning and laboratory analyses at the beginning. CT and/or MRI were performed in 13 cases, arteriography in 2 patients, MR spectroscopic imaging in 1 child and SPECT in 3 cases. Quantification of enzymatic activities of the mitochondrial respiratory chain was made in 5 patients. RESULTS: Only 8 cases were finally diagnosed of SMEI according to ILAE definition. In two cases, seizures were finally controlled with antiepileptic treatment and EEG abnormalities disappeared. Three patients showed other findings: mesiotemporal sclerosis, angiitis diffusely involving CNS and mitochondrial cytopathy with deficiency of the complex IV. CONCLUSIONS: Although diagnosis of SMEI, based on clinical manifestations, is suspected in most cases from the first year of life, final diagnosis should not be confirmed until steady state, when polymorphous seizures occur. Even then, differential diagnosis should be made with other disorders. Perhaps, further studies should be performed in order to identify and eliminate another etiology.

[Bilateral primary adrenal lymphoma: an unusual presentation]. / Linfoma suprarrenal primario bilateral: una presentación inusual.

A case of primary adrenal bilateral non-Hodgking lymphoma, with depressed adrenal reserve is presented. This rare neoplasm causes rapid evolution and fatal outcome in most cases. In our patient, lethal outcome was associated with severe hypercalcemia and refractary hypotension. Many other complications are due to tumoral lysis syndrome associated with high steroid doses in adrenal insufficiency. This rare entity must be included in the differencial diagnosis of adrenal masses, uni or bilateral, because early diagnostic is important for preventing complications, potentially lethals and for improving survival. Image thecnics and ultrasound-guided or computed-tomography-guided FNA, are best diagnostic methods, but in many cases, definitive diagnostic is obtained by necropsy.

Enfermedad periodontal autopercibida en escolares de 12 años de edad en Machángara, Cuenca, Ecuador, 2016 / Self-perceived periodontal disease in 12-year-old schoolchildren from Machangara, Cuenca, Ecuador, 2016

Determinar la frecuencia de enfermedad periodontal auto percibida en escolares de 12 años de edad, en Machángara Cuenca 2016. Estudio cuantitativo, de diseño descriptivo, observacional transversal. La muestra se calculó mediante fórmula en base a una población de 231 escolares obteniendo una muestra de 192 pacientes de 12 años de edad que dieron su asentimiento y que contaron con el consentimiento del padre o apoderado, los examinadores fueron capacitados para realizar las preguntas de auto percepción y ayudar con las dudas a los encuestados. Se utilizaron 11 preguntas de auto reporte de la salud periodontal validadas por Miller en el año 2007 y se realizó la adaptación transcultural a Ecuador. El 86% percibió tener enfermedad periodontal; la mayor prevalencia de autopercepción se dio en las mujeres, con 87%, no teniendo diferencia estadística con el sexo opuesto. Se encontró diferencia significativa en la prevalencia entre los diferentes tipos de gestión educativa (fisco misional-público). A la pregunta sobre el estado de salud bucal autopercibida, 38 % respondieron que percibían un estado regular seguido de bueno, con 31% y no sé con un 18%. Así, los porcentajes más bajos fueron de 3% para los estados excelente y malo. Existe una alta frecuencia de personas que autoperciben la presencia de enfermedades periodontales (AU)

[Pediatric orbital emphysema caused by a compressed-air pistol shot: a case report]. / Enfisema orbitario pediátrico secundario a disparo con pistola de aire comprimido: a propósito de un caso.

CASE REPORT: We report the case of a 2 year-old child with orbital emphysema secondary to a compressed-air gun shot in the malar region, with no evidence of orbital wall fracture. Conservative treatment was applied, and no complications were observed. DISCUSSION: Orbital emphysema in the absence of an orbital wall fracture is a rare situation. Orbital emphysema is usually seen in facial trauma associated with damage to the adjacent paranasal sinuses or facial bones. To our knowledge there have been very few reports of orbital emphysema caused by a compressed-air injury.