Ciencias de la Salud

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Biomarcadores Salivales en Pacientes Diagnosticados con Fibrosis Quística, Concepción, 2016
(01/05/2018) Gaete O., Fernanda; Astudillo R., Edgardo; Rojas E., Bastián; Narváez Carrasco, Carmen
El odontólogo como profesional integral del área de la salud, debe tener conocimiento acerca de distintas manifestaciones bioquímicas que pueden tener repercusión en la cavidad oral. El objetivo del trabajo fue determinar las manifestaciones bioquímicas y alteraciones en biomarcadores salivales en la cavidad oral producto de la fibrosis quística o del consumo crónico de medicamentos para el tratamiento de la FQ. Se seleccionó un total de cinco personas con fibrosis quística y cuatro personas sanas, pertenecientes a la ciudad de Concepción en la Octava Región de Chile. Se midió pH salival, capacidad buffer, concentración de proteínas totales, tasa de flujo salival estimulado y se determinó presencia de ciertas enzimas salivales en pacientes que padecen la enfermedad. Se pudo evidenciar que el pH salival en sujetos con fibrosis quística tiende a ser mayor a los valores de referencia, la tasa de flujo salival es mucho menor al igual que la capacidad buffer, la concentración de proteínas totales en saliva se encuentra igual a los valores de referencia y se determinó la presencia biomarcadores salivales a través de la técnica de electroforesis. La fibrosis quística afecta de muchas formas a las personas que la padecen, genera cambios a nivel de los biomarcadores salivales como también en la cavidad oral, por lo que el odontólogo debe estar capacitado para identificar estos cambios y poder tratar de la mejor manera a todo tipo de paciente.
How distributed processing produces false negatives in voxel-based lesion deficit analyses
(01/06/2018) Gajardo-Vidal, Andrea; Lorca-Puls, Diego L.; Crinion, Jennifer; White, Jitrachote; Seghier, Mohamed L.; Leff, Alex P.; Hope, Thomas M.H.; Ludersdorfer, Philipp; Green, David W.; Bowman, Howard; Price, Cathy J.
In this study, we hypothesized that if the same deficit can be caused by damage to one or another part of a distributed neural system, then voxel-based analyses might miss critical lesion sites because preservation of each site will not be consistently associated with preserved function. The first part of our investigation used voxelbased multiple regression analyses of data from 359 right-handed stroke survivors to identify brain regions where lesion load is associated with picture naming abilities after factoring out variance related to object recognition, semantics and speech articulation so as to focus on deficits arising at the word retrieval level. A highly significant lesion-deficit relationship was identified in left temporal and frontal/premotor regions. Post-hoc analyses showed that damage to either of these sites caused the deficit of interest in less than half the affected patients (76/162=47%). After excluding all patients with damage to one or both of the identified regions, our second analysis revealed a new region, in the anterior part of the left putamen, which had not been previously detected because many patients had the deficit of interest after temporal or frontal damage that preserved the left putamen. The results illustrate how (i) false negative results arise when the same deficit can be caused by different lesion sites; (ii) some of the missed effects can be unveiled by adopting an iterative approach that systematically excludes patients with lesions to the areas identified in previous analyses, (iii) statistically significant voxel-based lesion-deficit mappings can be driven by a subset of patients; (iv) focal lesions to the identified regions are needed to determine whether the deficit of interest is the consequence of focal damage or much more extensive damage that includes the identified region; and, finally, (v) univariate voxel-based lesiondeficit mappings cannot, in isolation, be used to predict outcome in other patients.
Proteínas Totales, Fosfatasa Alcalina, Prostaglandinas E2 y Lisozima como biomarcadores Salivales en Pacientes Adultos con Periodontitis Crónica
(01/12/2017) Romero R., Camila; Suarez M., Mara; Narváez Carrasco, Carmen Gloria
La periodontitis cr nica es una inflamaci n de los tejidos que rodean y dan soporte a los dientes. Diversos biomarcadores qu micos y pro inflamatorios est n aumentados durante el transcurso de la enfermedad. El objetivo del estudio fue determinar los distintos niveles salivales de prote nas totales, fosfatasa alcalina, prostaglandina E2 (PGE2) y lisozima en pacientes con periodontitis cr nica. Se obtuvieron muestras de saliva de 31 pacientes con periodontitis cr nica y se realiz un estudio de serie de casos para la determinaci n cuantitativa de los biomarcadores. La concentraci n de prote nas totales se encontr por sobre los rangos de referencia en 22 pacientes, la actividad de la fosfatasa alcalina se vio aumentada en 9 pacientes y la concentraci n de PGE2 se vio por sobre los rangos de referencia en 30 pacientes. Las prote nas totales y PGE2 son biomarcadores salivales en estos pacientes con periodontitis, no as la fosfatasa alcalina y la lisozima.
Problemas de adherencia a dietoterapia en pacientes hipertensos Pehuenches
(2011) Oliva, Patricio; Buhring, Kristian
Background: Hypertension is a disease with a high national prevalence which increases in sectors where there are indigenous populations. The complexity of the disease lies in the behavior that must be maintained to effectively adhere to medication and diet therapy. Objective: To understand the cultural factors that are associated with problems of adherence to diet therapy in hypertensive pehuenches. Methods: Qualitative study in hypertensive patients who do not adhere to diet therapy. We interviewed 42 individuals in the municipality of Alto Bio Bio for 6 months, analyzing them using semantic structural analysis completed with the saturation point of speech. Results: Discourse analysis showed the following results: a) ethnic foods have a symbolic value, b) ethnic foods are described as “natural” in opposition to any food that does not occur in their environment, although they are based in a high consumption of fats, proteins and carbohydrates, c) nonexistent biochemical properties ascribed to ethnic foods justify their use. Conclusion: there are cultural differences between the prescription of the nutritionist and the eating behavior of pehuenches, which affect non-compliance with diet and disease complications.
Evaluación de una intervención en actividad física en niños con síndrome de Down
(2011) Mosso C., Constanza; Santander V., Patricia; Pettinelli R., Paulina; Valdés G., Marcela; Celis B., Magdalena; Espejo S., Fabián; Navarro M., Lecter; Sepúlveda V., Francisco
Introducción: En Chile no existen estudios acerca del efecto de la actividad física sobre el estado nutricional en niños con síndrome de Down. Objetivo: Conocer el estado nutricional en niños con síndrome de Down y la capacidad aeróbica y resistencia al esfuerzo muscular antes y después de una intervención en actividad física. Material y Método: Entre agosto y noviembre del año 2006, en un grupo de 18 niños (10 hombres y 8 mujeres) con síndrome de Down, con edades comprendidas entre 5 - 9 años, se desarrolló un estudio de intervención en actividad física de 12 semanas, realizándose una evaluación diagnóstica y una evaluación final de resistencia muscular (dorsal, abdominal y cuádriceps) y capacidad aeróbica. Se evaluó el estado nutricional a través de P/E y T/E (Fundación Catalana), IMC, IP/T y porcentaje de masa grasa. Resultados: Se observaron diferencias significativas en resistencia muscular, capacidad aeróbica, IP/T y circunferencia de cintura entre el pre-test y post-test (p < 0,05). Al inicio de la intervención un 53% presentaba exceso de peso según IMC, un 26% según P/E y un 68% según IP/T; con un porcentaje masa grasa fue de 22,6%. Conclusión: Aunque el tiempo de intervención fue breve, se observó una mejora significativa en la resistencia muscular, capacidad aeróbica, IP/T y circunferencia de cintura. De acuerdo a nuestros resultados, existe una alta prevalencia de malnutrición por exceso en esta población de niños con SD en la que se hace vital intervenir con una actividad física adecuada
Tutorías virtuales como herramienta complementaria y su efecto sobre las evaluaciones globales en estudiantes universitarios
(2011) Guzmán Castro, Andrea Elizabeth
Este estudio persiguió determinar el efecto de las tutorías virtuales (TV) como herramienta complementaria sobre las calificaciones globales en estudiantes universitarios. A partir del universo, se extrajo una muestra no probabilística de 44 estudiantes; el control fue el mismo grupo previo a la intervención pedagógica. Las TV comenzaron posterior a la primera evaluación global y hasta finalizar el curso, utilizando la herramienta "Grupos Google©". Se recolectaron calificaciones global 1 (sin tutoría virtual) y global 2 (con tutoría virtual), datos analizados descriptivamente y mediante t-test para muestras dependientes. Los resultados muestran que las TV como herramienta complementaria, mejoran significativamente las calificaciones de las evaluaciones globales de los estudiantes que la utilizan (p < 0,01). Adicionalmente, se evidenció un patrón en la frecuencia de participación de los estudiantes, que se relacionaría con la cercanía a fechas evaluativas. Es necesario que las instituciones de educación superior promuevan prácticas educativas innovadoras que favorezcan el aprendizaje
MALNUTRICIÓN POR EXCESO Y RIESGO CARDIOMETABÓLICO EN ESCOLARES DE SEGUNDO Y TERCERO MEDIO DE LA COMUNA DE LOTA DE CHILE
(2011) Buhring B., Kristian; Oliva M., Patricio; Villablanca A., Claudia; Rifo M., Valeria
La malnutrición por exceso en el adolescente es un problema prevalente y aumenta el riesgo de desarrollar enfermedades metabólicas. El objetivo de este estudio fue asociar el síndrome metabólico y el riesgo cardiovascular en escolares de la comuna de Lota de Chile. Estudio de corte transversal, muestreo probabilístico aleatorio simple, se tomó una muestra de 286 niños, de 14 y 18 años de edad. Se estableció la prevalencia de malnutrición, y se realizó una correlación de Pearson. Las correlaciones fueron: peso y talla de 0.55; peso y circunferencia de cintura 0,87; el peso y el índice de masa corporal de 0,86; la talla y la circunferencia de cintura de 0,39; la talla e índice de masa corporal de 0,047; índice de masa corporal y circunferencia de cintura 0,80. El índice de masa corporal, la circunferencia de cintura y el peso, se agrupan en un diagnóstico efectivo. El síndrome metabólico posee una relación que condiciona la presencia de patologías nutricionales, significa que los indicadores antropométricos pueden ser adecuados para identificar la presencia de riesgo cardiometabólico en adolescentes.
Electromyographic activity of the sphenomandibularis and lateral pterygoid human muscles during mandibular lateral movements
(2012) Fuentes, Edgardo; Frugone, Raúl; Paolinelli, C; Hack, G D; Bittner, V
Aim. Understanding of the functional anatomy of the Sphenomandibularis muscle (SM) is limited. In order to begin to elucidate its function, the present authors determined, using electromyographic evaluations, that the (SM) displays signifcantly more electromyographic (EMG) activity (during jaw movement excursions from edge to edge to maximal intercuspation with occlusive force), than does the lateral pterygoid muscle. Methods. A descriptive, non-experimental study was conducted. Electromyographic recordings were performed with depth electrodes during movements of the mandible, both with and without occlusal contact. Five male subjects between 18 and 27 years of age underwent electromyographic study of the SM and lateral pterygoid muscles. EM activity was observed to occur only in the lateral pterygoid muscle (and not the SM), during lateral movements, with and without tooth contact, on a working side movement. Results. During both contralateral movements, without tooth contact, and also during ipsilateral movements with forced occlusal contact, we observed an increase in the SM only. During mandibular movements, from lateral to medial with forced occlusal contact, we observed strong EM activity in both muscles, with the EM activity being greater in the SM. Conclusion. The authors conclude that the SM is a lateral pterygoid agonist; coming into play during the last phase of mastication, and may play an important role in eccentric bruxism
Percepción de rendimiento académico en estudiantes de Odontología
(2013) Oliva Mella, Patricio; Narváez, Carmen Gloria
La investigación se centra en la percepción del rendimiento académico de estudiantes de pregrado de Odontología de la Universidad del Desarrollo, Concepción, Chile, contrastándola con distintas variables vinculadas a este concepto, con el objetivo de establecer una visión completa por medio de las asociaciones estadísticas existentes entre ellas. La investigación es de tipo cuantitativo, comparativo, transversal, se utilizó una encuesta validada por expertos y mediante un pilotaje, de la cual derivó una base de datos analizada mediante el programa SPSS®. Los datos tienen una distribución paramétrica, utilizando el test de Kolmogorov-Smirnov, posteriormente se aplica la prueba de t-Student. Los resultados demuestran que la percepción del redimiendo académico se vincula con variables que se asocian al propio estudiante y a variables que son consideradas exógenas por ellos. Se concluye que la percepción del rendimiento es una construcción socio-educacional constituida por múltiples variables que interaccionan y redundan en un resultado de calificación formal.
Computer-guided implant surgery and immediate loading with a modifiable radiographic template in a patient with partial edentulism: A clinical report
(2015) Lanis, Alejandro; Padial-Molina, Miguel; Gamil, Rami; Alvarez del Canto, Orlando
Computer-guided implant surgery in fresh extraction sites is an underdeveloped procedure. The presence of teeth that will be extracted makes the creation of an appropriate radiographic template for virtual simulation of the rehabilitation impossible. A modified radiographic template is presented to define a digital restorative simulation for the maxillary rehabilitation of a patient with partial edentulism. This modification enables 3-dimensional prosthetic virtual information in regions where teeth will be extracted.
Maternal supraphysiological hypercolesterolemia leads to endothelial dysfunction of the human fetoplacental macro and microvasculature
(2015) Leiva, Andrea; Salsoso, Rocío; Sáez, Tamara; Silva, Luis; Sanhueza, Carlos; Pardo, Fabian; Sobrevía, Luis
Maternal physiological hypercholesterolemia (MPH) occurs in pregnancy assuring fetal growth and development. However, maternal supraphysiological hypercholesterolemia (MSPH) leads to increased atherosclerosis in the fetal vasculature. In this study the maternal and neonatal total cholesterol (TCh) and lipoprotein levels were determined in a group of pregnant women and her newborns. A cut-off value for MSPH was established as maternal TCh levels at term of pregnancy >280 mg/dl. Pregnancies with values over this cut-off point were associated with fetoplacental endothelial dysfunction evaluated as reduced endothelial-dependent vascular dilation in the macro- (umbilical vein; 41 ± 7% and 10± 2% for MPH and MSPH, respectively) and microvasculature (veins in placental stem villi; 52 ± 6% and 1± 0.2% for MPH and MSPH, respectively). The mechanisms involved in this phenomenon include reduced nitric oxide synthase (NOS) activity and therefore reduced nitric oxide (NO) availability in human umbilical vein endothelial cells (HUVEC; reduction of 51 ± 2% compared with MPH) and human placental microvascular endothelial cells (HPMEC; reduction of 83 ± 4% compared with MPH). MSPH was also associated with reduced synthesis of the eNOS cofactor tetrahydrobiopterin (BH4; reduction of 87.5 ± 5% compared with MPH) as well as increased activity of arginases, a group of enzymes that compete with NOS for the substrate L-arginine (1.5 times compared with MPH). Interestingly, the restoration of the BH4 levels and the inhibition of arginases improved the endothelial function impaired by the MSPH condition. Therefore MSPH is a maternal condition likely involved in the endothelial dysfunction and the later development of atherosclerosis described for MSPH offspring. However, the mechanism(s) leading to the development MSPH as well as whether this maternal condition modifies the placental transport of cholesterol and therefore the fetal lipid function are actually unknown.
Growth Factors for Treating Diabetic Foot Ulcers
(2015) Marti-Carvajal, Arturo; Gluud, Christian; Nicola, Susana; Simancas-Racines, Daniel; Reveiz, Ludovic; Oliva Mella, Patricio; Cedeno-Taborda, Jorge
Background Foot ulcers are a major complication of diabetes mellitus, often leading to amputation. Growth factors derived from blood platelets, endothelium, or macrophages could potentially be an important treatment for these wounds but they may also confer risks. Objectives To assess the benefits and harms of growth factors for foot ulcers in patients with type 1 or type 2 diabetes mellitus. Search methods In March 2015 we searched the Cochrane Wounds Group Specialised Register, The Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library), Ovid MEDLINE, Ovid MEDLINE (In-Process & Other Non-Indexed Citations, Ovid EMBASE and EBSCO CINAHL. There were no restrictions with respect to language, date of publication or study setting. Selection criteria Randomised clinical trials in any setting, recruiting people with type 1 or type 2 diabetes mellitus diagnosed with a foot ulcer. Trials were eligible for inclusion if they compared a growth factor plus standard care (e.g., antibiotic therapy, debridement, wound dressings) versus placebo or no growth factor plus standard care, or compared different growth factors against each other. We considered lower limb amputation (minimum of one toe), complete healing of the foot ulcer, and time to complete healing of the diabetic foot ulcer as the primary outcomes. Data collection and analysis Independently, we selected randomised clinical trials, assessed risk of bias, and extracted data in duplicate. We estimated risk ratios (RR) for dichotomous outcomes. We measured statistical heterogeneity using the I2 statistic. We subjected our analyses to both fixedeffect and random- effects model analyses. Main results We identified 28 randomised clinical trials involving 2365 participants. The cause of foot ulcer (neurologic, vascular, or combined) was poorly defined in all trials. The trials were conducted in ten countries. The trials assessed 11 growth factors in 30 comparisons: platelet-derived wound healing formula, autologous growth factor, allogeneic platelet-derived growth factor, transforming growth factor beta 2, arginine-glycine-aspartic acid peptide matrix, recombinant human platelet-derived growth factor (becaplermin), recombinant human epidermal growth factor, recombinant human basic fibroblast growth factor, recombinant human vascular endothelial growth factor, recombinant human lactoferrin, and recombinant human acidic fibroblast growth factor. Topical intervention was the most frequent route of administration. All the trials were underpowered and had a high risk of bias. Pharmaceutical industry sponsored 50% of the trials. Any growth factor compared with placebo or no growth factor increased the number of participants with complete wound healing (345/657 (52.51%) versus 167/482 (34.64%); RR 1.51, 95% CI 1.31 to 1.73; I2 = 51%, 12 trials; low quality evidence). The result is mainly based on platelet-derived wound healing formula (36/56 (64.28%) versus 7/27 (25.92%); RR 2.45, 95% 1.27 to 4.74; I-2 = 0%, two trials), and recombinant human platelet-derived growth factor (becaplermin) (205/428 (47.89%) versus 109/335 (32.53%); RR 1.47, 95% CI 1.23 to 1.76, I-2= 74%, five trials). In terms of lower limb amputation (minimum of one toe), there was no clear evidence of a difference between any growth factor and placebo or no growth factor (19/150 (12.66%) versus 12/69 (17.39%); RR 0.74, 95% CI 0.39 to 1.39; I-2 = 0%, two trials; very low quality evidence). One trial involving 55 participants showed no clear evidence of a difference between recombinant human vascular endothelial growth factor and placebo in terms of ulcer-free days following treatment for diabetic foot ulcers (RR 0.64, 95% CI 0.14 to 2.94; P value 0.56, low quality of evidence) Although 11 trials reported time to complete healing of the foot ulcers in people with diabetes, meta-analysis was not possible for this outcome due to the unique comparisons within each trial, failure to report data, and high number of withdrawals. Data on quality of life were not reported. Growth factors showed an increasing risk of overall adverse event rate compared with compared with placebo or no growth factor (255/498 (51.20%) versus 169/332 (50.90%); RR 0.83; 95% CI 0.72 to 0.96; I-2 = 48%; eight trials; low quality evidence). Overall, safety data were poorly reported and adverse events may have been underestimated. Authors' conclusions This Cochrane systematic review analysed a heterogeneous group of trials that assessed 11 different growth factors for diabetic foot ulcers. We found evidence suggesting that growth factors may increase the likelihood that people will have complete healing of foot ulcers in people with diabetes. However, this conclusion is based on randomised clinical trials with high risk of systematic errors (bias). Assessment of the quality of the available evidence (GRADE) showed that further trials investigating the effect of growth factors are needed before firm conclusions can be drawn. The safety profiles of the growth factors are unclear. Future trials should be conducted according to SPIRIT statement and reported according to the CONSORT statement by independent investigators and using the Foundation of Patient-Centered Outcomes Research recommendations.
The Combination of Digital Surface Scanners and Cone Beam Computed Tomography Technology for Guided Implant Surgery Using 3Shape Implant Studio Software: A Case History Report
(2015) Lanis, Alejandro; Alvarez del Canto, Orlando
The incorporation of virtual engineering into dentistry and the digitization of information are providing new perspectives and innovative alternatives for dental treatment modalities. The use of digital surface scanners with surgical planning software allows for the combination of the radiographic, prosthetic, surgical, and laboratory fields under a common virtual scenario, permitting complete digital treatment planning. In this article, the authors present a clinical case in which a guided implant surgery was performed based on a complete digital surgical plan combining the information from a cone beam computed tomography scan and the virtual simulation obtained from the 3Shape TRIOS intraoral surface scanner. The information was imported to and combined in the 3Shape Implant Studio software for guided implant surgery planning. A surgical guide was obtained by a 3D printer, and the surgical procedure was done using the Biohorizons Guided Surgery Kit and its protocol.
Valores éticos y formación curricular en odontología
(2015) Vicentela, Luis A.; Narváez, Carmen Gloria; Velásquez, Manuel
Para identificar los valores éticos de los estudiantes de odontología y relacionarlos con el perfil de egreso, se elaboró una encuesta, aplicada a 1.281 estudiantes de ocho sedes que imparten odontología en Chile. Esta contenía 24 valores y cinco categorías de relevancia, estimando un promedio general por curso y género. En orden de relevancia, valores como felicidad, responsabilidad, sinceridad, respeto y bienestar fueron los más destacados; mientras que innovación, liderazgo, civismo, participación y reconocimiento los menos resaltados. En los primeros, no hay diferencias significativas por curso pero sí por género (p<0,05), excepto en bienestar, mientras que en los menos destacados no hay diferencias significativas por género, pero sí por curso (p<0,05). Del análisis de los perfiles destacan los valores de liderazgo, participación, cooperación y convivencia. Sin embargo, estos se encuentran al final de la escala de preferencia de los alumnos. De los cinco más valorados por los estudiantes, solo responsabilidad y respeto destacan en uno de los perfiles de egreso. En conclusión, los perfiles de egreso profesional deben incorporar valores que fortalezcan el desarrollo ético y tengan en cuenta la impronta valórica de los alumnos, de forma de alinearlos con los definidos por la institución y el propio perfil.
Relación entre el bienestar y el rendimiento académico en alumnos de primer año de medicina
(2015) Gómez, Paula; Torres, Graciela; Meyer, Andrea; Matus, Olga; Ortíz, Liliana; McColl, Peter; Parra, Paula; Pérez, Cristhian
Background: Stress may affect the sense of wellbeing and academic achievement of university students. Aim: To assess the relationship of academic engagement and burnout with academic achievement among first year medical students. Material and Methods: The Utrecht Work Engagement Scale-Student and Maslach Burnout Inventory Student Survey (MBI-SS) were applied to 277 first year medical students of four universities. Their results were correlated with the grades obtained in the different courses. Results: Moderately high engagement and low burnout levels were detected. There was a high level of satisfaction with studies and a moderate exhaustion level. Academic achievement was associated with the degree of engagement with studies but not with burnout. Conglomerate analysis detected a group of students with high levels of wellbeing, characterized by high levels of academic engagement and low burnout. Other group had moderate levels of engagement and lack of personal fulfilment. Other group, identified as extenuated, had high levels of personal exhaustion and depersonalization. Finally the disassociated group had a low academic engagement, low emotional exhaustion, high levels of depersonalization and Jack of personal fulfillment. Conclusions: Academic achievement is associated with the level of engagement with studies but not with burnout.
Nutrition assessment and indicators of visceral fat and subcutaneous fat in children with Down syndrome
(2015) Venegas, E; Ortiz, T; Grandfeltd, G; Zapata, D; Fuenzalida, P; Mosso, C
Background There are only few publications related to body composition in Down syndrome (DS). Objective Evaluate the relationship between indicators of nutrition assessment by Catalan references and CDC/NCHS and indicators of body composition, and compare the concordance between weight/height index (WHI), body mass index/age (BMIa) and weight/age (WA) to evaluate nutritional status in children with DS. Materials and methods Analytical cross-sectional study in which 40 children with DS, 20 girls and 20 boys between 3 and 13 years old were studied. Anthropometric measurements were performed to obtain indicators of nutrition assessment as WHI, BMIa and WA and indicators of subcutaneous and visceral fat and muscular compartment. Correlation tests and Kappa index were evaluated to establish relationship and agreement respectively. Results The nutrition assessment in children with DS shows that 60% presents overweight and obesity according to BMIa, and 75% according to WHI. Correlation analysis indicates that waist circumference, fat brachial area, % fat mass by Slaughter and Weststrate and Deurenberg have a high positive correlation with BMIa (P-value<0.05). A logistic regression model showed that no indicator of fat mass is clinically significant in predicting an increase of the indicator WA. It was determined that the BMIa and WHI indicators have a higher concordance (Kappa=0.59; P=0.0000). Conclusions We determined a high correlation between nutritional diagnosis (BMIa and WA) with indicators of visceral fat (waist circumference) and subcutaneous (% fat mass and fat brachial area) in children with DS. A greater agreement was found between indicators of BMIa and WA suggesting that they are optimal for assessing the nutritional status.
Efficacy of combined radiotherapy and chemotherapy versus radiotherapy for oral squamous cell carcinoma
(2015) Irisarri Arévalo, Jaime; Oliva Mella, Patricio
Introduction: in the last decade, with all the advanced medical research in the treatments for cancer, there is a constant debate for the best possible treatment for oral squamous cell carcinomas. Radiotherapy with surgery has they compared with the addition of chemotherapy for control of the disease or survival of the patient. Objective: to compare the effectiveness of radiotherapy with combined chemotherapy and radiotherapy for the control of oral squamous cell carcinomas. Methods: it was a systematic review with metaanalysis. Randomized trials in all phases were search with specific inclusion criteria through electronic database, hand searching and contacting experts in the field. After exclusion, criteria and the use of critical review checklist, three trials they selected for analysis. Three randomized trials representing 508 patients they identified. Some trials they analyzed in Review manager software 5.0®. The fix effect model they chosen for the statistical analysis, assuming that any observed variation in the score was an error of the specific article, with a confidence of 95 % (CI 1.13–2.77). The I2 presents percent of heterogeneity of 0 %, indicating that there is no clinically significant change in the results of the studies included. Result: evidenced the significance of 0.44 (higher than 0.05) in the chi square test indicating that the results are homogeneous or clinically similar. The Forest plot is located in the experimental group (chemotherapy and radiotherapy), establishing the clinical recommendation of use. Conclusion: the usage of chemotherapy treatment in combination of radiotherapy regimen they recommended as for its promising results. Not also, the overall survival has improved, survival and distant metastasis free rates improve.
Dietary intake, Body Composition, and Physical Activity among Young Patients with Type 1 Diabetes Mellitus
(2015) Mosso, Constanza; Halabi, Victoria; Ortiz, Tamara; Hodgson, María Isabel
Objective: The aim of this study was to assess dietary intake, nutritional status, body composition, and physical activity level in a group of Chilean children and adolescents with Type 1 diabetes mellitus (T1DM), compare these parameters with the recommendations of the International Society for Pediatric and Adolescent Diabetes (ISPAD), and determine the relationships between dietary intake, body composition, and diabetes control. Methods: A total of 30 patients with T1DM (aged 15.2 +/- 4.0 years) were included. Dietary intake was assessed using a 92-item quantitative food frequency questionnaire. Body composition was determined using dual-energy X-ray densitometry. Physical activity was assessed by means of a survey. Results: The energy intake of these patients was derived from 21.4% protein, 48% carbohydrates, and 31.2% fat. The glycosylated hemoglobin (HbA(1c)) was significantly correlated with fat as grams per day (r: 0.363, p < 0.05) and calories per day (r: 0.364, p < 0.05). The mean body fat percentage in females was 31.2% and 20.2% in males (p < 0.01) and the mean amount of physical activity was 4.5 +/- 2.7 h per week. Conclusions: The study patients had a higher protein intake than recommended by ISPAD. Dietary carbohydrate intake was rather low, and dietary fat intake was the same as the limits recommended by ISPAD. Diabetic control was significantly correlated with protein, carbohydrates, fat, and sodium intake. The girls in the study had a higher percentage of body fat than the standard recommendations for their age. The level of physical activity was adequate.
Manejo de pacientes con terapia anticoagulante sometidos a extracciones dentales: una revisión sistemática
(2016) Ruíz Gutiérrez, María Francisca; Oliva Mella, Patricio
Introducción: existe controversia acerca del manejo de los pacientes que son sometidos a cirugías dentales y que están bajo terapia antitrombótica. El objetivo de este estudio fue establecer el manejo de los pacientes con terapia anticoagulante antes de las extracciones dentales. Métodos: se realizó una revisión sistemática basada en la búsqueda de estudios científicos (ensayos clínicos) aleatorizados controlados. La búsqueda de estos artículos se realizó en bases de datos como Embase, Pubmed, Ebsco, entre otras. Se seleccionaron aquellos artículos que cumplían con los criterios de inclusión y que relacionaban las extracciones dentales con el uso de terapia anticoagulante. Resultados: se hallaron estudios con un total de 548 pacientes, de los cuales a 282 se les modificó la terapia anticoagulante y a los 266 restantes se les mantuvo la terapia antes de las extracciones. En ambos grupos se midió el número de eventos desarrollados (hemorragias), y se observó que la mayor cantidad se presentó en el grupo de pacientes a los que se les modificó la terapia (35 eventos) y solo 18 casos en los pacientes que mantuvieron la terapia. La heterogeneidad del estudio fue nula (I² = 0%, p = 0,99) Conclusión: no hay diferencias significativas en cuanto al nivel de hemorragias en los pacientes que mantienen la terapia anticoagulante, en comparación con aquellos a quienes se les modifica antes de las extracciones dentales. Por lo que se recomienda continuar con el tratamiento. [ABSTRACT FROM AUTHOR]
Hydroxyapatite Effectiveness in the Healing of Bone and Implants Dental Implants: a Systematic Review of the Literature
(2016) Pereira G., Álvaro; Oliva M., Patricio
Hydroxyapatite (HA) is a mineral component of bone. Hydroxyapatite has been marketed as synthetic or alloplastic, porous or nonporous, dense and resorbable or non-resorbable form. It is used as bone graft due to its osteoconductive properties and stimulation of cell proliferation, generating favorable conditions for tissue regeneration. The aim of this study is to evaluate the effectiveness of treatment with HA in dental implant surgeries and bone grafts. We conducted a systematic review. Clinical trials on healing and graft of synthetic hydroxyapatite were reviewed in PubMed, Cochrane Library, Google Scholar, Blackwell and Ebsco. The selection criteria was: patient candidates for treatment of periodontal defects or rehabilitation with dental implants without significant systemic abnormalities. The strategy is summarized in the following: Identification of the problem, identifying search terms, systematic search and selection of articles by using critical analysis guides, Incorporating REVMAN ® information, unbiased analysis, and Meta-analysis. Assessing the meta-analysis shows that the HA is effective for healing bone graft. When omitting low weight studies, the summary measure remains in the HA. Treatment with HA in bone healing and dental implants, is positive with a high rate of success in the long term, although its effective range varies according to the materials to which it is associated.

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