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OBJECTIVES: This study aimed to comprehensively evaluate Mexico's health system performance from 1990 to 2019 utilising the Health Access and Quality Index (HAQI) as a primary indicator. STUDY DESIGN: A retrospective ecological analysis was performed using data from the Global Burden of Diseases, Injuries and Risk Factors Study (GBD) study and the National Population Council (CONAPO). METHODS: HAQI values for 1990, 2000, 2010, 2015, and 2019 were examined for each state in Mexico and three age groups (young, working, and post-working). Additionally, the marginalisation index was employed to assess inequalities in the HAQI distribution across states. The concentration index of the HAQI for each year was estimated, and the efficiency of states in producing the HAQI was evaluated using a data envelopment approach. RESULTS: Through the analysis of national and subnational data, results indicated an overall improvement in healthcare access and quality during the study period. Although differences in the HAQI value related to state marginalisation decreased from 1990 to 2015, by 2019, the inequality had returned to a level comparable to 2000. Efficiency in producing health (HAQI values) exhibited substantial heterogeneity and fluctuations in the ranking order over time. States such as Nuevo León consistently performed well, while others, such as Guerrero, Chihuahua, Mexico City, and Puebla, consistently underperformed. CONCLUSIONS: The findings from this study emphasise the necessity for nuanced strategies to address healthcare disparities and enhance the overall system performance. The study provides valuable insights for ongoing discussions about the future of Mexico's healthcare system, aiming to inform evidence-based policy decisions and improve the nationwide delivery of healthcare services.
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OBJECTIVES: This study aimed to synthesize and compare the prioritization strategies outlined in the national vaccination plans (NVPs) against Coronavirus Disease 2019 (COVID-19) developed by countries in the Latin America and Caribbean (LAC) region. STUDY DESIGN: We conducted a comparative policy analysis based on COVID-19 NVPs. METHODS: We conducted a search strategy in three stages to identify NVPs for COVID-19 across 41 countries/territories in the LAC region. Sources included official governmental repositories, complementary Google searches, and less formal documentation. We extracted key variables and conducted a comparative policy analysis based on the prioritization criteria and specific prioritization groups. RESULTS: The study identified 52 NVPs for COVID-19, corresponding to 27 (65.8 %) out of 41 countries/territories in the LAC region. Official national websites yielded documents for 12 countries. All NVPs included frontline healthcare personnel in the first prioritization phase/stage, whilst some included residents of long-term healthcare facilities, adults aged 60 years or more, and people with disabilities. The decision criteria for prioritization were declared in 14 countries/territories. Ethical considerations declared in five NVPs included human welfare, equality, solidarity, equity, and social justice as values. CONCLUSION: The early stages of vaccination rollout in LAC countries prioritized protection of the healthcare system and epidemiological risk for severe disease. Few countries included ethical considerations in their NVPs, and global inequities in vaccine access and distribution led to varied protections for vulnerable populations across LAC. This analysis highlights the need for improved emergency-response capacity, planning, and enhanced multilateral cooperation in the LAC region for future public health emergencies.
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Vacunas contra la COVID-19 , COVID-19 , Adulto , Humanos , América Latina/epidemiología , Vacunas contra la COVID-19/uso terapéutico , COVID-19/epidemiología , COVID-19/prevención & control , Región del Caribe/epidemiología , Salud PúblicaRESUMEN
OBJECTIVES: To describe the burden and causes of disease in Mexican women in 1990 and 2019, based on the data disaggregation by age groups and states. Also, to evaluate the relationship of years of healthy life lost with the Socio-demographic Index (SDI) and with the Healthcare Access and Quality (HAQ) Index. STUDY DESIGN: This was an ecological descriptive study. METHODS: Based on the Global Burden of Disease, Injuries, and Risk Factors Study study, the age-standardized and age-specific rates for mortality, years of life lost (YLLs), years lived with disability (YLDs), and disability-adjusted life years (DALYs) were reported. RESULTS: At the national level, the all-cause age-standardized rates for Mexican women decreased in mortality -28.8%; YLLs -39.8%; YLDs -1.3%; and DALYs -26.2%. For 2019, the indicators analyzed had the worst performances in Chiapas and Chihuahua, while women in Sinaloa had the lowest age-standardized rates. In 1990, it is worth noting that there was a remarkable presence of CDs, mainly in YLLs. In all age groups, diabetes mellitus was the leading cause of DALYs in Mexico's 32 states, followed by CKD (in 24 states), and ischemic heart disease (in 18 states). In both 1990 and 2019, a negative and statistically significant correlation between DALYs and the HAQ Index was evident. The correlation between DALYs and the SDI was only significant in 1990. CONCLUSION: In the last 30 years, the burden of disease on Mexican women has undergone substantial changes that reflect progress in the improvement of their health conditions. However, the current scenario is complex because the convergence of communicable diseases, non-communicable diseases, and injuries is evident, which implies important challenges that must be addressed as soon as possible.
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Carga Global de Enfermedades , Esperanza de Vida , Humanos , Femenino , Años de Vida Ajustados por Calidad de Vida , México/epidemiología , Salud Global , Factores de RiesgoRESUMEN
INTRODUCTION: Dementias, including Alzheimer´s disease (AD), are one of the leading causes of disability and mortality in older people. It is a growing health problem in low- and middle-income countries, where epidemiological information is scarce and deficient. The aim of this study was to analyze the burden of AD and other dementias in Mexico from 1990 to 2019 by sex, subnational level, and age groups. METHODS: A secondary analysis was conducted using data from the 2019 Global Burden of Disease, Injury, and Risk Factors Study (GBD). Data on prevalence, incidence, mortality, years of life lost (YLL), years lived with disability (YLD), and disability-adjusted life years (DALY) due to AD and other dementias were obtained. A joinpoint regression analysis was performed to describe the changes in the trend of age-standardized DALY rates by AD and other dementias during the analysis period. RESULTS: AD and other dementias ranked second among neurological disorders producing the most DALY in Mexico. Between 1990 and 2019, prevalence and incidence increased by almost 203%. In 2019, the age-standardized rate per 100,000 inhabitants was: 512 for prevalence, 79.3 for incidence, 73.3 for YLD, 256.9 for YLL and 272.2 for DALY. Likewise, five states concentrated 39% of AD and other dementias cases: Ciudad de México, Estado de México, Veracruz, Jalisco and Puebla. Differences were also observed by sex and age groups. DISCUSSION: Given that the number of older adults in Mexico will significantly rise over the next few decades, AD and other dementias represent one of the most important health challenges. The fact that epidemiological and demographic transformations take place in Mexico in a very diverse way makes it difficult for the country to adequately plan for the growing demands of both people with AD and other dementias and their families.
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Enfermedad de Alzheimer , Humanos , Anciano , Enfermedad de Alzheimer/epidemiología , Años de Vida Ajustados por Calidad de Vida , México/epidemiología , Carga Global de Enfermedades , PrevalenciaRESUMEN
INTRODUCTION: The COVID-19 pandemic triggered transformations in the population's lifestyles, including electronic nicotine delivery system (ENDS) consumption. The aim of the study was to determine associations between ENDS consumption habits and lifestyles among higher education students in Bogotá, Colombia. METHODS: This study employed a cross-sectional analytical design, based on a self-administered online survey, conducted in 2021, among students aged 18-59 years. The sample size was 3985 students. Statistical analysis was done through frequency studies, hypothesis testing and a multivariate-penalized logistic regression model (firthlogit), based on the Akaike information criterion (AIC). RESULTS: A total of 3573 students completed the survey, 61.5% were female, 55.3% were young (aged 18-26 years), and 44.6% were adults (aged 27-59 years). The prevalence of ENDS use during the pandemic was 7.3%. Age was negatively associated with ENDS use, as young people had a higher likelihood of using these devices. The likelihood of ENDS use was negative among females (OR=0.38; 95% CI: 0.2-0.5). In contrast, it was positive in students with a history of psychoactive substance abuse and/or dependence (OR=3.59; 95% CI: 1.0-12.0), students who had tried conventional cigarettes (OR=5.12; 95% CI: 3.0-8.5), participants who smoked tobacco during the pandemic (OR=3.15; 95% CI: 2.3-4.2), those who studied virtually (OR=1.52; 95% CI: 1.0-2.3), participants who lived with other ENDS users (OR=3.86; 95% CI: 2.8-5.2) and students with negative perception of impacts on their mental health (OR=1.48; 95% CI: 1.1-1.9). CONCLUSIONS: Being male, aged <26 years, having a history of substance use, having tried conventional cigarettes, pandemic tobacco use, and having lived with other ENDS users, were the main factors associated with pandemic ENDS use. Studying the consumption habits of students in response to lifestyle changes, is fundamental for the formulation of strategies to reduce the development of addictive behaviors, especially in young students during the pandemic.
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OBJECTIVES: This study aimed at evaluating territorial inequalities in avoidable mortality in children under 5 years of age in Colombia between 2000 and 2019. STUDY DESIGN: This was an ecological study. METHODS: An ecological, longitudinal, multigroup study was conducted using secondary sources. Because of the hierarchical structure of the data, the effect of territorial characteristics on the count of avoidable under-five deaths was estimated using a three-level negative binomial regression model with random intercepts for municipality and fixed intercepts for time and departments. RESULTS: Between 2000 and 2019, there were 216,809 avoidable under-five deaths in Colombia (91.3% of all registered deaths of children under 5 years of age). A total of 1117 municipalities located in 33 departments were analyzed over five 4-year periods. Ecological relationships were found between avoidable under-five mortality and the percentage of adolescent births, female illiteracy, and multidimensional poverty at the municipal level (standardized mortality ratio: 1.43 95% confidence interval: 1.33-1.54 for the group with the highest level vs the group with the lowest level of poverty). Furthermore, multidimensional poverty was a confounding factor for the association between the percentage of the population living in rural areas and avoidable child mortality. CONCLUSIONS: Systematic and avoidable gaps were observed in mortality in children aged under 5 years in Colombia, where the territory constitutes an axis of inequality. Implementing strategies and programs that contribute to improving the conditions of women and socio-economic conditions in the territories should be a priority.
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Pobreza , Niño , Femenino , Humanos , Preescolar , Adolescente , Colombia/epidemiologíaRESUMEN
The high cost of protein feeds and growing concern for the environment have motivated dairy producers and nutritionists to focus their attention on reducing nitrogen (N) losses on dairy farms. It is well recognized that reducing the N content of cattle diets is the single most important factor to increase the efficiency of N use. However, effectively lowering the N content of diets requires the nutritionist to know the availability of N in feeds so as to not negatively affect milk production or overfeed N. To provide reliable data for nutritionists, a new assay to estimate unavailable N in the intestine (uN) was developed. To determine whether uN could be used as a replacement for acid detergent insoluble nitrogen (ADIN) in diet formulation, we conducted a replicated pen study to evaluate the effect of total-tract uN on the performance of high-producing dairy cattle. One hundred twenty-eight cattle that were 97 to 147 d in milk at the beginning of the experiment were allocated into 8 pens of 16 cows, and pens were randomly allocated to 2 dietary treatments. Cattle were fed 1 of 2 isonitrogenous and isocaloric diets that were also equal in neutral detergent fiber, deviating only in the inclusion of 2 different blood meals (BM) used in each diet. The uN contents of the 2 BM were 9% (low uN) and 34% (high uN) total N content as predicted by the assay, whereas when measured as ADIN, no difference in indigestibility was observed. The inclusion of BM was on an isonitrogenous basis, and the predicted difference in uN was 39 g/d or 5.8% of N intake, representing the formulated difference in available N between the 2 treatments. There was no effect of uN on dry matter or N intake, which averaged 27.3 kg/d and 668 g/d for both treatments, respectively. Milk yield and energy-corrected milk were 1.6 and 1.9 kg/d greater for cows fed the low uN diet compared with those fed the high uN diet. The lower uN diet was also associated with greater milk protein yield, greater milk fat yield, and greater milk urea N. The Cornell Net Carbohydrate and Protein System (version 6.5) was used to evaluate the application of the uN measurement by replacing ADIN in BM with the uN value in the inputs for the BM. All other cow and feed chemistry data were inputted as measured in the experiment. The predictions of metabolizable protein-allowable milk demonstrated that using the uN values in place of ADIN increased the accuracy of the prediction and enabled the model to predict the first-limiting nutrient provided all other feed, cattle, and management characteristics were also defined.
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Lactancia , Rumen , Alimentación Animal/análisis , Animales , Bovinos , Detergentes/metabolismo , Dieta/veterinaria , Digestión , Femenino , Intestinos , Comidas , Nitrógeno/metabolismo , Rumen/metabolismo , Zea mays/metabolismoRESUMEN
OBJECTIVES: Conducting contact tracing (CT) programs in low- and middle-income countries is challenging, and there is no evidence of their effectiveness in Latin America. We evaluated the effectiveness of CT on reducing fatality from COVID-19 in Colombia. STUDY DESIGN: The study design is a retrospective cohort study with nation-wide data of suspected and confirmed cases of severe acute respiratory syndrome (SARS-CoV-2) infection and their registered contacts. METHODS: We analyzed confirmed and suspected COVID-19 cases and their chains of contact using a nation-wide registry from March 28, 2020 to January 13, 2021. To estimate the effect of CT on fatality, we adjusted a multilevel negative binomial model using the number of deaths and the number of people within a chain of contacts as the outcome variable and offset variable, respectively. Sensitivity analysis was conducted using different cutoff values of contacts traced and a logistic model for the effect of CT on death at an individual level. RESULTS: We analyzed 1.4 million cases, 542,936 chains of contact, and 46,087 deaths. Only, 5.8% of total cases and contacts were included in a chain of a case and five or more contacts. We found that tracing of at least five contacts per case reduces fatality by 48% (95% confidence interval: 45-51), and, at the current levels of tracing in Colombia, it prevents 1.8% of deaths. Results obtained from the sensitivity analysis were consistent with the reduction of fatality at an individual level and higher protective effect with the higher number of contacts traced. CONCLUSIONS: In Colombia, tracing of at least five contacts per case reduces fatality from COVID-19. The coverage and intensity of tracing needs to be increased as a strategy to mitigate fatality in Colombia.
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COVID-19 , Trazado de Contacto , Colombia/epidemiología , Humanos , Estudios Retrospectivos , SARS-CoV-2RESUMEN
There is growing evidence that leptin is able to ameliorate Alzheimer's disease (AD)-like pathologies, including brain amyloid-ß (Aß) burden. In order to improve the therapeutic potential for AD, we generated a lentivirus vector expressing leptin protein in a self-inactivating HIV-1 vector (HIV-leptin), and delivered this by intra-cerebroventricular administration to APP/PS1 transgenic model of AD. Three months after intra-cerebroventricular administration of HIV-leptin, brain Aß accumulation was reduced. By electron microscopy, we found that APP/PS1 mice exhibited deficits in synaptic density, which were partially rescued by HIV-leptin treatment. Synaptic deficits in APP/PS1 mice correlated with an enhancement of caspase-3 expression, and a reduction in synaptophysin levels in synaptosome preparations. Notably, HIV-leptin therapy reverted these dysfunctions. Moreover, leptin modulated neurite outgrowth in primary neuronal cultures, and rescued them from Aß42-induced toxicity. All the above changes suggest that leptin may affect multiple aspects of the synaptic status, and correlate with behavioral improvements. Our data suggest that leptin gene delivery has a therapeutic potential for Aß-targeted treatment of mouse model of AD.
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Enfermedad de Alzheimer/terapia , Terapia Genética , VIH-1/genética , Leptina/genética , Trastornos de la Memoria/terapia , Neuronas/metabolismo , Enfermedad de Alzheimer/genética , Precursor de Proteína beta-Amiloide/genética , Animales , Caspasa 3/genética , Caspasa 3/metabolismo , Vectores Genéticos/administración & dosificación , VIH-1/metabolismo , Inyecciones Intraventriculares , Leptina/metabolismo , Trastornos de la Memoria/genética , Ratones , Neuronas/patología , Presenilina-1/genética , Sinapsis/patología , Sinaptofisina/genética , Sinaptofisina/metabolismoRESUMEN
Existe un grupo de desórdenes hereditarios de la cornificación, caracterizado por una excesiva acumulación de escamas en la piel, que varía desde leve y asintomático hasta amenazar la vida. El término ictiosis es derivado de la raíz griega "icti" que significa pescado. La Hiperqueratosis Epidermolítica (HE), también conocida como eritrodermia ictiosiforme congénita, es un desorden autosómico dominante de la cornificación, con una prevalencia de 1:100.000-300.000. Esta patología se evidencia al nacer o al poco tiempo por la presencia de ampollas y de eritrodermia. Existe un gran número de tipos de ictiosis, de los cuales, la mayoría son extremadamente raros. Entre los cuatro más comunes se encuentran: Ictiosis vulgar, Ictiosis ligada al gen X, Ictiosis lamelar, hiperqueratosis epidermolítica. Se presenta el caso de un paciente de 13 años, con diagnóstico clínico de hiperqueratosis epidermolítica que es llevado a consulta médica por compromiso severo de la piel.
There is a group of hereditary disorders of cornification characterized by an excessive accumulation of scales in the skin, which can range anywhere from mild and non-symptomatic to life threatening. The term ichthyosis derives from the Greek root "icti", which means fish. Epidermolytic hyperkeratosis (EHK), also known as bullous congenital ichthyosiform erythroderma, is an autosomal dominant disorder of cornification with a prevalence of 1:100,000 300,000. EHK is evident at birth or soon thereafter, characterized by blistering and erythroderma. There are numerous types of ichthyosis, of which the majority are extremely rare. Vulgar ichthyosis, X-linked ichthyosis, lamellar ichthyosis, and epidermolytic ichthyosis are amongst the 4 most common types. The case report presented involves a 13-year-old patient with a clinical diagnosis of Epidermolytic hyperkeratosis who was taken to medical consultation presenting severely compromised skin.
Existe um grupo de desordens hereditárias da cornificação, caracterizados por uma excessiva acumulação de escamas na pele; a qual varia desde leve e assintomático até ameaçar a vida. O termo ictiosis é derivado da raiz grega "icti" o qual significa peixe. A Hiperqueratose epidermolítica (HE) também conhecida como eritrodermia ictiosiforme congênita, é uma desordem autossômico dominante da cornificación, com uma prevalência de 1:100.000 300.000. Esta patologia se evidência ao nascer ou ao pouco tempo deste; pela presença de ampolas e de eritrodermia. Existe um grande número de tipos de ictiosis, dos quais a maioria são extremamente raros. Entre os 4 mas comuns se encontram: Ictiosis vulgar, Ictiosis unida ao gene X, Ictiosis lamelar, hiperqueratose epidermolítica. Apresentasse-se o caso de um paciente de 13 anos, com diagnóstico clínico de hiperqueratose epidermolítica que é levado a consulta médica por compromisso severo da pele.
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Humanos , Hiperqueratosis Epidermolítica , Piel , Dermatitis Exfoliativa , IctiosisAsunto(s)
Antibacterianos/uso terapéutico , Gastritis/tratamiento farmacológico , Infecciones por Helicobacter/tratamiento farmacológico , Helicobacter pylori/efectos de los fármacos , Úlcera Péptica/tratamiento farmacológico , Inhibidores de la Bomba de Protones/uso terapéutico , Femenino , Humanos , MasculinoRESUMEN
BACKGROUND: Success in H. pylori eradication with conventional therapies has decreased to unacceptable levels (≤80%). New schemes of combined treatment are currently needed. AIM: To test a miscellaneous therapy for H. pylori eradication. METHODS/PATIENTS: Open-label, pilot, single-centre and prospective study. Patients received a 15-day treatment scheme that consisted of 5 initial days of lansoprazole 30 mg b.d., amoxicillin 1 g b.d., and metronidazole 500 mg t.d.s.; days 6 to 10: lansoprazole 30 mg q.d.s. and metronidazole 500 mg t.d.s.; days 11 to 15: lansoprazole 30 mg b.d., clarithromycin 500 mg b.d. and metronidazole 500 mg t.d.s. Each patient underwent an upper endoscopy before treatment and a second follow-up endoscopy at least 4 weeks after therapy. Success was defined on the basis of an eradication rate following a per-protocol analysis ≥95%. Biopsies before and after therapy were obtained for histological evaluation and rapid urease test. RESULTS: One hundred and twenty-two patients were enrolled and 118 patients completed the study. The eradication rate for H. pylori with miscellaneous therapy was 94% (confidence Interval (CI) 95%, 90-98.3%) in the per-protocol analysis (PP) and 91% (95% CI, 86-96%) in the intention-to-treat (ITT) analysis. Adherence to treatment was 96% (113 patients). Among patients who completed treatment, 55% presented adverse events, mainly nausea and abdominal pain. CONCLUSION: A miscellaneous therapy, based on the combination of multiple medications in high doses for 2 weeks, and with gastric pH elevation, is a highly effective treatment as a first-line therapy for the eradication of H. pylori.
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Antibacterianos/uso terapéutico , Gastritis/tratamiento farmacológico , Infecciones por Helicobacter/tratamiento farmacológico , Helicobacter pylori/efectos de los fármacos , Úlcera Péptica/tratamiento farmacológico , Inhibidores de la Bomba de Protones/uso terapéutico , Adulto , Amoxicilina/uso terapéutico , Claritromicina/uso terapéutico , Quimioterapia Combinada/métodos , Femenino , Determinación de la Acidez Gástrica , Gastritis/microbiología , Gastroscopía , Infecciones por Helicobacter/microbiología , Helicobacter pylori/aislamiento & purificación , Humanos , Concentración de Iones de Hidrógeno , Lansoprazol/uso terapéutico , Masculino , Metronidazol/uso terapéutico , Persona de Mediana Edad , Úlcera Péptica/microbiología , Proyectos Piloto , Estudios Prospectivos , Encuestas y Cuestionarios , Resultado del TratamientoRESUMEN
AIM: (i) To evaluate the incidence of microcracks around root-end preparations completed with ultrasonic tips and their relationship with the root filling technique and thickness of surrounding dentine. (ii) To investigate the effect of rapid exposure to a water-soluble dye of Intermediate Restorative Material (IRM), Super Ethoxybenzoic Acid (sEBA) and Mineral Trioxide Aggregate (MTA), on the marginal adaptation and microleakage of root-end fillings. (iii) To describe the microstructure of the surface of root-end filling materials. METHODOLOGY: Ninety-two single-rooted teeth were divided into two groups (n = 46) according to the root canal instrumentation/filling techniques. Group 1 consisted of specimens in which canal preparation was completed using a crown-down technique and then filled with the Thermafil system (TF group); Group 2 consisted of specimens in which canal preparation was completed using a step-back technique and lateral condensation (LC group). Following root-end resection and ultrasonic cavity preparation, the samples were further divided into three subgroups (n = 24) for root-end filling with IRM, sEBA or MTA. The ultrasonic preparation time was recorded. Eight teeth were kept as positive and 12 as negative controls. Following immersion in Indian ink for 7 days, all resected root surfaces were evaluated for the presence of microcracks and the cross-sectional area of root-end surface and root-end filling were measured to evaluate the thickness of the dentinal walls. Thereafter, the samples were sectioned longitudinally so as to assess the depth of dye penetration and marginal adaptation of root-end fillings. Negative controls longitudinally sectioned were used to describe microstructural characteristics of the root-end filling materials using scanning electron microscopic (SEM) techniques. RESULTS: Although the thickness of dentinal walls between groups 1 and 2 was similar, the ultrasonic preparation time and number of microcracks were significantly higher (P < 0.001) in the TF group. Both groups had a significant correlation between microcracks and ultrasonic preparation time (P < 0.001). sEBA and IRM had better adaptation and less leakage compared with MTA. A SEM analysis displayed microstructural differences between the root-end filling materials. CONCLUSION: Microcracks can occur independently of the thickness of dentinal walls and may be associated with the prolonged ultrasonic preparation time required for the removal of the root filling during root-end cavity preparation. Although sEBA and IRM had better behaviour than MTA regarding microleakage and marginal adaptation, it is possible that exposure of MTA to a water-soluble dye before achieving full set and its porous microstructure contributed to the results.
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Filtración Dental/epidemiología , Adaptación Marginal Dental , Tratamiento del Conducto Radicular/métodos , Ápice del Diente/cirugía , Compuestos de Aluminio/química , Análisis de Varianza , Compuestos de Calcio/química , Distribución de Chi-Cuadrado , Combinación de Medicamentos , Humanos , Óxidos/química , Materiales de Obturación del Conducto Radicular/química , Silicatos/química , Estadísticas no Paramétricas , Terapia por UltrasonidoRESUMEN
AIM: To compare healing responses to periosteal sliding grafts and polyglactin 910 periodontal mesh used as guided tissue regeneration (GTR) materials/techniques when both periapical and periradicular bone loss are present. METHODOLOGY: Thirty patients with suppurative chronic apical periodontitis with apicomarginal communication were selected and allocated randomly into two groups according to the barrier technique to be used during periradicular surgery: periosteal graft group (n = 15) and bioabsorbable membrane group (n = 15). Clinical and radiological evaluations were completed prior to surgery, a week later and every 3 months after surgery up to 12 months to measure the periodontal pocket depth (PD), clinical attachment level (CAL), gingival margin position (GMP), size of periapical lesion, percentage reduction of the periapical rarefaction, and periapical healing. RESULTS: Both groups showed highly significant (P < 0.001) reductions in periodontal PD, CAL and size of periapical lesion at 12 months whilst GMP was unaltered. No significant difference between the experimental groups was evident for these parameters, or for the percentage reduction of size of the periapical lesion and clinical-radiographic healing. CONCLUSION: Guided tissue regeneration applied to apicomarginal defects using sliding periosteal grafts and use of bioabsorbable membranes led to similar enhancements of the clinical outcome of periradicular surgery in terms of periapical healing, gain of periodontal support, PD reduction and minimal recession of the gingival margin.
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Pérdida de Hueso Alveolar/cirugía , Defectos de Furcación/cirugía , Regeneración Tisular Guiada Periodontal/métodos , Implantes Absorbibles , Adulto , Anciano , Pérdida de Hueso Alveolar/clasificación , Método Doble Ciego , Femenino , Estudios de Seguimiento , Defectos de Furcación/clasificación , Encía/patología , Recesión Gingival/clasificación , Humanos , Masculino , Membranas Artificiales , Persona de Mediana Edad , Absceso Periapical/cirugía , Pérdida de la Inserción Periodontal/clasificación , Pérdida de la Inserción Periodontal/cirugía , Bolsa Periodontal/clasificación , Bolsa Periodontal/cirugía , Periostio/trasplante , Poliglactina 910 , Estudios Prospectivos , Mallas Quirúrgicas , Resultado del Tratamiento , Cicatrización de Heridas/fisiologíaRESUMEN
La discrepancia dentóalveolar es actualmente el tipo de maloclusión más común durante la dentición mixta y permanente. Se define como la desarmonía entre el tamaño dental y el de los maxilares. El momento ideal para comenzar a resolver el problema de discrepancia dentoalveolares es en la dentición mixta temprana ya que los cambios que afectan realmente las dimensiones de los arcos se dan normalmente a esta edad, donde es necesario aprovechar el espacio Leeway para mejorar el alineamiento. Existen dos grandes alternativas de tratamiento una es crear espacio con aparatología funcional o fija y la segunda exodoncias como en la guía de erupción y extracción seriada. El sistema de aparatología fija parcial (sistema 4x2) presenta muchas ventajas frente a la Aparatología Fija Completa bebido al sistema de fuerzas que maneja. El propósito de este artículo es revisar las alternativas de tratamiento en los pacientes con discrepancia dentoalveolar y además, presentar un caso de discrepancia dentoalveolar leve en el arco superior y severa en el arco inferior tratado con aparatología de 4x2...
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Arco Dental , Maloclusión , Aparatos OrtodóncicosRESUMEN
Se presenta un reporte de casos que describe la respuesta del tejido frente a la retracción de caninos. Todo movimiento ortodóntico tiene una dimensión periodontal y por tanto antes de iniciar un movimiento deben evaluarse adecuadamente los tejidos circundantes. Se trabajo con 10 pacientes divididos en dos grupos; en uno se utilizó la técnica friccional para retracción de caninos y en otro se utilizó la técnica no friccional. En cada uno de los pacientes se midió el grosor y la amplitud de la encía queratinizada (EQ), la altura de las papilas mesiales y distales, el sondaje y la posición de margen gingival de los siguientes dientes: incisivo central, canino, segundo bicúspide y primeros molares superiores e inferiores derechos. Se encontró que tanto el grosor como la amplitud de la EQ de todos los dientes, aumentó en el periodo de observación. Las papilas adyacentes al sitio de la extracción disminuyeron en altura, mientras que en las demás aumentó. En general se encontró una hiperplasia gingival en los pacientes en los cuales se terminó el cierre de espacios, aun en aquellos con buena higiene oral. La rata de retracción fue mayor para los pacientes tratados con la técnica fricccional y el canino inferior derecho presentó mayor cantidad de distalización que el canino superior derecho. Los pacientes de periodonto delgado mostraron una cantidad de distalización menor que los de periodito grueso. Al analizar los cambios en las características gingivales con la ortodoncia en cada biotipo, se encontró que la amplitud de la encía queratinizada y la profundidad de sondaje aumentaron más para los de biotipo grueso que para los de biotipo delgado (p<0.01)...
Asunto(s)
Extracción Dental , Encía , Hiperplasia Gingival , Ortodoncia , PeriodonciaRESUMEN
Introducción: La región ventral del núcleo reticular oral del puente (vRPO) es la zona del tegmento pontino implicada en la generación y mantenimiento del sueño REM. Experimentos realizados mediante microinyección de opiáceos en el tegmento pontino del gato han demostrado que la activación de receptores opioides en esta zona modula la aparición de sueño REM. Material y métodos: En el presente estudio hemos utilizado técnicas de marcaje inmunocitoquímico del receptor opioide del subtipo delta (DOR) (1) a nivel de microscopía óptica con el fin de determinar su localización en el tegmento pontino del gato, y (2) a nivel de microscopía electrónica, con el fin de determinar su localización subcelular en el vRPO. Resultados: DOR se localizó fundamentalmente en el citoplasma de dendritas (55%) de mediano gran tamaño, que recibían contactos sinápticos asimétricos (64%) y simétricos (36%), y en menor medida tuvo una localización presináptica en terminales axónicos. Discusión y conclusiones: Nuestros resultados sugieren que la activación de DOR en el vRPO regula la aparición de sueño REM esencialmente a través de la modulación de las respuestas postsinápticas a aferencias excitatorias, y en menor medida también inhibitorias; la activación de DOR en el vRPO tendría, sin embargo, un papel menor en la modulación directa de la liberación de neurotransmisores (AU)
Introduction: The ventral division of the oral pontine reticular nucleus (vRPO) is the pontine tegmentum region involved in the generation and maintenance of REM sleep. Previous reports of opiate microinjections in the pontine tegmentum of the cat have shown that opioid recptor activation in this region modulates REM sleep. However, only the localization of the mu subtype opioid receptor has been reported in the pontine tegmentum of the cat. Methods. In the present study, we have used immunocytochemistry of the delta opioid receptor (DOR) at the light microscope and the electron microscope levels to determine: (1) DOR cellular distribution in the cat pontine tegmentum, and (2) subcellular distributions of DOR in the cat vRPO. Results. DOR was seen in the vRPO mainly in medium-large dendrites (55%) at intracytoplasmic localization. Those DOR-labeled dendrites received asymmetric (64%) and symmetric (36%) synapses. Less frequently, DOR was localized in axon terminals modulating postsynaptic responses to excitatory and inhibitory afferents. DOR activation in vRPO could have, however, a minor role in direct modulation of neurotransmitter release from axon terminals (AU)
Asunto(s)
Animales , Gatos , Receptores Opioides/fisiología , Vigilia/fisiología , Sueño/fisiología , Analgésicos Opioides/farmacocinética , Tronco Encefálico , Modelos Animales , Sueño , Trastornos del Sueño del Ritmo Circadiano/fisiopatologíaRESUMEN
El propósito de este estudio fue establecer la relación entre la forma del incisivo central superior y el biotipo periodontal del paciente. En 70 sujetos se midió el grosor de la encía queratinizada (E.Q) del incisivo central, canino, segundo bicúspide y primer molar superior e inferior derecho, utilizando una aguja hipodérmica con tope endodóntico y un calibrador de Venier. El radio de la de la corona del incisivo se determinó por la división entre la longitud y la amplitud de la corona medidas en un modelo para determinar la forma anatómica del diente. Se encontró que una corona corta y ancha (diente grueso) se relaciono con una EQ gruesa en el 95.3 por ciento de los casos, mientras que una corona larga y estrecha (diente delgado) se asociaba a un periodonto delgado 18.1 por ciento de los casos. Un mismo paciente posee diferentes biotipos. En general, los dientes posteriores presentan un periodonto grueso y los anteriores un periodonto delgado (especialmente el incisivo antero-inferior...