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Nowadays, high-performance audio communication devices demand superior audio quality. To improve the audio quality, several authors have developed acoustic echo cancellers based on particle swarm optimization algorithms (PSO). However, its performance is reduced significantly since the PSO algorithm suffers from premature convergence. To overcome this issue, we propose a new variant of the PSO algorithm based on the Markovian switching technique. Furthermore, the proposed algorithm has a mechanism to dynamically adjust the population size over the filtering process. In this way, the proposed algorithm exhibits great performance by reducing its computational cost significantly. To adequately implement the proposed algorithm in a Stratix IV GX EP4SGX530 FPGA, we present for the first time, the development of a parallel metaheuristic processor, in which each processing core simulates the different number of particles by using the time-multiplexing technique. In this way, the variation of the size of the population can be effective. Therefore, the properties of the proposed algorithm along with the proposed parallel hardware architecture potentially allow the development of high-performance acoustic echo canceller (AEC) systems.

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Objetivo: Determinar el efecto del anestésico local di-bucaína sobre las principales isoformas de la SERCA (calcio ATPasa de retículo sarco-endoplásmico) pre-sentes en músculo pterigoideo interno. Métodos: Se aislaron por centrifugación diferencial membranas de retículo sarcoplásmico de pterigoideo interno de conejo neozelandés macho (n=5). Se separaron las isoformas SERCA1a, 2a y 2b por cromatografía de afinidad. Se determinó in vitro la actividad enzimá-tica en presencia de diferentes concentraciones de dibucaína (0-90 mM) por el método de Fiske y Subba-row, realizando 5 experimentos por duplicado y en paralelo para cada isoforma. Se calculó la media y ES de la CI50 (mM) del anestésico para cada isofor-ma y éstas se compararon por ANOVA de una vía (p<0,05), y prueba Student-Newman-Keuls de com-paraciones múltiples. Resultados: Dibucaína inhibió la actividad enzimática en función de su concentra-ción en las tres isoformas en estudio. Las CI50 fueron: SERCA1a 20,02 ± 0,64 mM, SERCA2a 15,03 ± 0,52 mM y SERCA2b 16,00 ± 0,51 mM y resultaron signi-ficativamente diferentes (F2,27 = 11,08, p<0,001). La prueba post hoc identificó diferencias significativas entre SERCA1a y 2a, 1a y 2b. El efecto inhibitorio re-sultó significativamente mayor sobre las isoformas 2a y 2b, cuya presencia es sustancialmente mayor en músculos masticadores. Conclusión: La dibucaína inhibe a la SERCA de pterigoideo interno a concen-traciones menores que las usadas en clínica médica (29 mM). Es un anestésico local con potencial efecto miotóxico derivado de la inhibición de la SERCA (AU)

Aim: To test the effect of the local anesthetic dibu-caine on the main isoforms of the SERCA (sarco-endosplasmic reticulum calcium-ATPase) in medial pterygoid muscle. Methods: Sarcoplasmic reticulum membranes from male New Zealand rabbits (n=5) were isolated from medial pterygoid muscle by ul-tracentrifugation. The isoforms SERCA1a, 2a and 2b were separated using high affinity chromatography. In vitro enzymatic activity determinations were per-formed in the presence of different dibucaine con-centrations (0-90 mM) using the colorimetric method described by Fiske & Subbarow. Five assays in dupli-cate and run in parallel were performed for each of the isoforms. Mean and SEM of the IC50 (mM) for the effect of the anesthetic on each isoform were calcu-lated and compared by one-way ANOVA (p<0.05), and Student-Newman-Keuls multiple comparisons test. Results: Dibucaine inhibited the enzymatic activity in a concentration-dependent manner for the three studied isoforms. The IC50 values were: SERCA1a 20.02 ± 0.64 mM, SERCA2a 15.03 ± 0.52 mM and SER-CA2b 16.00 ± 0.51 mM. The values were significantly different (F2.27 = 11.08, p<0.001). The post hoc test revealed significant differences between SERCA1a and 2a, 1a and 2b. The inhibitory effect was signifi-cantly higher on 2a and 2b isoforms, whose presence is substantially higher in masticatory muscles. Con-clusion: Dibucaine inhibits SERCA in medial pterygoid muscle at concentrations lower than those used in clinical medicine (29 mM). It is a potentially myotoxic local anesthetic whose toxic effect may derive from SERCA inhibition (AU)

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Introducción. La incidencia del carcinoma de tiroides ha aumentado a nivel mundial, probablemente relacionado con el sobre diagnóstico de nódulos tiroideos asintomáticos. La alta sobrevida del carcinoma diferenciado de tiroides ha permitido posibilidades de manejo quirúrgico menos radicales, o inclusive, la vigilancia activa de tumores seleccionados. Existen reportes de características clínico-patológicas del carcinoma de tiroides de nuestro país distintas a las reportadas en la literatura internacional. Métodos. Estudio observacional descriptivo de una cohorte retrospectiva de pacientes con carcinoma de tiroides atendidos en un hospital universitario entre 2015 y 2020. Resultados. Se identificaron 634 pacientes, el 83,4 % de sexo femenino. La tiroidectomía total con vaciamiento central fue el procedimiento más realizado (86,7 %). De 613 carcinomas diferenciados de tiroides, el 94,2 % corresponden al tipo papilar, seguido por el carcinoma de células de Hürtle (1,6 %); el 26,2 % presentaron subtipos histológicos agresivos y el 28,4 % compromiso tumoral bilateral. En los vaciamientos centrales se encontró 58,7 % de enfermedad metastásica; que fue de 49 % en los pacientes con microcarcinomas papilares (19 %). De las 68 lesiones del nervio laríngeo recurrente, 47 % fueron por secciones oncológicas. Discusión. En nuestra serie, la proporción de pacientes con carcinoma papilar de tiroides y de sus variantes histológicas agresivas, así como el compromiso tumoral bilateral es mayor a lo reportado en la literatura científica. Conclusión. El comportamiento biológico del carcinoma de tiroides es variable y puede tener características diferentes entre regiones; el manejo en nuestro medio debería considerar las características propias de nuestra población.

Introduction. The incidence of thyroid carcinoma has increased worldwide, probably related to the overdiagnosis of asymptomatic thyroid nodules. The high survival of differentiated thyroid carcinoma has allowed less radical surgical resection or even active surveillance for selected tumors. There are reports of clinicopathological features of thyroid carcinoma in our country that are different from those reported in the international literature. Methods. Retrospective observational study of a cohort of patients with thyroid carcinoma treated at a university hospital between 2015 and 2020. Results. 634 patients were identified; 83.4% were female. Total thyroidectomy with central dissection was the most performed procedure (86.7%). Of the 613 differentiated thyroid carcinomas, 94.2% were papillary type, followed by Hürtle cell carcinoma with 1.6%; 26.2% presented aggressive histological subtypes and 28.4% had bilateral tumor involvement. Metastatic disease was found in 58.7% of the central dissections performed, which was 49% in patients with papillary microcarcinomas (19%). Of the 68 recurrent laryngeal nerve injuries, 47% were due to oncological involvement. Discussion. In our series, the rate of patients with papillary thyroid carcinoma and its aggressive histological subtypes as well as bilateral tumor involvement is higher than that reported in the scientific literature. Conclusion: The biological behavior of thyroid carcinoma is variable and may have different characteristics between regions; the management in our country should consider our population's characteristics.

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BACKGROUND: The awake prone positioning strategy for patients with acute respiratory distress syndrome is a safe, simple and cost-effective technique used to improve hypoxaemia. We aimed to evaluate intubation and mortality risk in patients with coronavirus disease 2019 (COVID-19) who underwent awake prone positioning during hospitalisation. METHODS: In this retrospective, multicentre observational study conducted between 1 May 2020 and 12 June 2020 in 27 hospitals in Mexico and Ecuador, nonintubated patients with COVID-19 managed with awake prone or awake supine positioning were included to evaluate intubation and mortality risk through logistic regression models; multivariable and centre adjustment, propensity score analyses, and E-values were calculated to limit confounding. RESULTS: 827 nonintubated patients with COVID-19 in the awake prone (n=505) and awake supine (n=322) groups were included for analysis. Fewer patients in the awake prone group required endotracheal intubation (23.6% versus 40.4%) or died (19.8% versus 37.3%). Awake prone positioning was a protective factor for intubation even after multivariable adjustment (OR 0.35, 95% CI 0.24-0.52; p<0.0001, E=2.12), which prevailed after propensity score analysis (OR 0.41, 95% CI 0.27-0.62; p<0.0001, E=1.86) and mortality (adjusted OR 0.38, 95% CI 0.26-0.55; p<0.0001, E=2.03). The main variables associated with intubation among awake prone patients were increasing age, lower baseline peripheral arterial oxygen saturation/inspiratory oxygen fraction ratio (P aO2 /F IO2 ) and management with a nonrebreather mask. CONCLUSIONS: Awake prone positioning in hospitalised nonintubated patients with COVID-19 is associated with a lower risk of intubation and mortality.

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Objetivo: Determinar los momentos de fuerza del haz superficial del masetero (SMH) obtenidos por modelos lineal y vectorial. Métodos: Investigación comparati-va in silico. Se obtuvo la fuerza del SMH con dinamó-metro en 12 pacientes varones adultos jóvenes para calcular el momento de la fuerza y trabajo mecánico a través de simulaciones en JAVA+ con NetBeans8.2. La descomposición de la fuerza fue F.cos α(x,y) y F.cos α(x,y,z) en el modelo lineal y vectorial respectivamen-te. Los momentos de fuerza fueron comparados por ANOVA (p<0,05). Resultados: La fuerza del SMH unila-teral obtenida con dinamómetro (2,5±0,1N) no difirió significativamente del modelo lineal (2,6±0,05N), pero difirió (p<0,001) del vectorial: 1,7, 2,2, 4,2N en x,y,z (general 2,7±0,02N). El momento medio de la fuerza en el modelo vectorial fue -17,9, -15,5, +14,3N.m-2, apuntando a la inclinación mandibular en el eje lateral en dirección caudal anterior, movimiento de inclina-ción en el eje lateral en la dirección cráneo-medial, e inclinación en el eje craneal en la dirección lateral-an-terior. El modelo lineal mostró momento de fuerza de 13,5N.m-2 apuntando un movimiento traslacional en dirección caudal-craneal en el eje anterior-posterior y menor trabajo mecánico del SMH (p=0,012). Con-clusión: Los modelos vectoriales son más eficientes proporcionando datos detallados para estimar los momentos de fuerza y el trabajo mecánico del SMH, y deben incluirse en los algoritmos de cálculo utilizados por dinamómetros (AU)

Objective: to determine the moments of force exerted by the superficial masseter head (SMH) obtained through linear models and vector ones. Methods: comparative in silico research. Data of SMH force obtained with dynamometer in 12 young adult male patients was used to calculate the moment of the force and mechanical work through simulations in JAVA+ performed with NetBeans8.2. Force decomposition was F.cos α(x,y) and F.cos α(x,y,z) in the linear and vector model respectively. The moments of force were compared by ANOVA (p<0.05). Results: Dynamometrical unilateral SMH force (2.5±0.1N) did not differ significantly from the linear model (2.6±0.05N), but differed (p<0.001) from the vector model: 1.7, 2.2, 4.2N on x,y,z (overall 2.7±0.02N). The mean moment of the force in the vector model was -17.9, -15.5, +14.3N.m-2, pointing to mandible's inclination on the lateral axis in anterior-caudal direction, inclination movement on the lateral axis in the cranio-medial direction and inclination on the cranial axis in the lateral-anterior direction. The linear model showed a moment of force of 13.5N.m-2 pointing to translational motion on caudal-cranial direction on the anterior-posterior axis and lower SMH mechanical work (p=0,012). Conclusion: Vector models are more efficient to provide detailed data to estimate the moments of force and mechanical work of SMH and should be included in the calculation algorithms used by dynamometers (AU)

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Intravascular leiomyoma is an uncommon disease and depending of vascular involvement and anesthetic challenge. We review a case of a 53-year-old woman who underwent vena cava leiomyoma resection under cardiopulmonary bypass using deep hypothermic circulatory arrest (DHCA). Invasive hemodynamic and neurologic monitoring, transesophageal echocardiography, and viscoelastic coagulation test were used during the procedure. Total surgical resection was accomplished with no complications and the patient was extubated 2 days after surgery without cardiac or neurologic deficit. Although uncommon, level IV intravascular leiomyoma surgery is a challenge because the total resection needs DHCA, prolonged cardiopulmonary bypass and aortic cross-clamp times. These conditions expose the patient to the risk of coagulopathy, low cardiac output syndrome, and neurologic deficit.

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In spiking neural P (SN P) systems, neurons are interconnected by means of synapses, and they use spikes to communicate with each other. However, in biology, the complex structure of dendritic tree is also an important part in the communication scheme between neurons since these structures are linked to advanced neural process such as learning and memory formation. In this work, we present a new variant of the SN P systems inspired by diverse dendrite and axon phenomena such as dendritic feedback, dendritic trunk, dendritic delays and axonal delays, respectively. This new variant is referred to as a spiking neural P system with dendritic and axonal computation (DACSN P system). Specifically, we include experimentally proven biological features in the current SN P systems to reduce the computational complexity of the soma by providing it with stable firing patterns through dendritic delays, dendritic feedback and axonal delays. As a consequence, the proposed DACSN P systems use the minimum number of synapses and neurons with simple and homogeneous standard spiking rules. Here, we study the computational capabilities of a DACSN P system. In particular, we prove that DACSN P systems with dendritic and axonal behavior are universal as both number-accepting/generating devices. In addition, we constructed a small universal SN P system using 39 neurons with standard spiking rules to compute any Turing computable function.

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Candida dubliniensis (Cd) and Candida albicans (Ca) are the most frequently isolated yeasts in HIV+ patients. Some of the enzymes produced by these yeasts are considered virulence factors since they contribute to pathogenicity of Candida spp. The aim of the present study was to compare production of enzymes such as phospholipase (Ph), proteinase (P), and hemolysin (H) by Cd and Ca strains isolated from periodontal HIV-positive patients receiving and not receiving highly active antiretroviral therapy (HAART). Subgingival biofilm samples were obtained using paper points, and a sample of oral mucosa was taken using a swab. Phenotypic and molecular methods were used to isolate 39 strains of Candida, including 25 strains of Cd and 14 strains of Ca, obtained from 33 periodontal pocket samples and 6 oral mucosa samples collected from 15 HIV+ patients (8 receiving and 7 not receiving HAART). Malt egg-yolk agar, albumin agar and blood agar were used to evaluate pH, P and H production respectively. The strains were inoculated in duplicate and incubated at 37 ºC. Colony and halo diameters were measured. A greater proportion of Ca was observed in patients not receiving HAART, and a higher proportion of Cd was observed in those under HAART, Chi2 p< 0.001. Phospholipase production was observed in 92.9% percent of isolated Ca strains but in none of the isolated Cd strains. Proteinase production was high in Ca and Cd strains isolated from patients not receiving HAART. Hemolysin production was observed in all the studied strains, though it was significantly higher (p=0.04) in Ca and Cd strains isolated from patients not receiving HAART. To sum up, the proportion of Candida dubliniensis strains was highest in the subgingival biofilm of patients receiving HAART, and Cd strains were found to express fewer virulence factors than Ca strains.

Las levaduras más aisladas en pacientes VIH+ son Candida dubliniensis (Cd) y Candida albicans (Ca). Algunas de sus enzimas constituyen factores de virulencia ya que favorecen la diseminación tisular. El objetivo fue comparar la producción de enzimas como fosfolipasa (F), proteinasa (P) y hemolisina (H) en cepas de Cd y Ca aisladas de pacientes VIH+ tratados y no tratados con antirretrovirales (TARGA). Se realizó la toma del biofilm de placa subgingival con conos de papel y la muestra de la mucosa bucal con hisopo. Se aislaron y tipificaron por métodos fenotípicos y moleculares 39 cepas: 25 de Cd y 14 Ca, obtenidas 33 de bolsas periodontales y 6 de mucosa bucal de 15 pacientes VIH+ (8 con y 7 sin tratamiento). Se utilizó agar malta con yema de huevo, agar albúmina y agar sangre para demostrar la producción de F, P y H, respectivamente. Se inocularon por duplicado e incubaron a 37°C. Se midieron los diámetros de las colonias y los de hidrólisis alrededor de las mismas. Se observó mayor proporción de Ca en los pacientes sin tratamiento y mayor proporción de Cd en los con tratamiento; Chi2 p< 0.001. El 92,9% de las Ca estudiadas, fueron productoras de fosfolipasa. En tanto que ninguna Cd produjo la enzima. En cuanto a la producción de proteinasa se observa una alta producción tanto en las cepas de Ca, como en las Cd aisladas en los pacientes no tratados. Todas las cepas estudiadas produjeron hemolisina, observándose una diferencia estadísticamente significativa (p=0,04) en ambas especies a favor de la alta producción de la enzima en las cepas obtenidas de pacientes no tratados. Podemos concluir que en el biofilm subgingival, en los pacientes bajo TARGA, se aíslan mayor proporción de Candida dubliniensis las cuales expresan menos factores de virulencia.

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ABSTRACT Candida dubliniensis (Cd) and Candida albicans (Ca) are the most frequently isolated yeasts in HIV+ patients. Some of the enzymes produced by these yeasts are considered virulence factors since they contribute to pathogenicity of Candida spp. The aim of the present study was to compare production of enzymes such as phospholipase (Ph), proteinase (P), and hemolysin (H) by Cd and Ca strains isolated from periodontal HIV-positive patients receiving and not receiving highly active antiretroviral therapy (HAART). Subgingival biofilm samples were obtained using paper points, and a sample of oral mucosa was taken using a swab. Phenotypic and molecular methods were used to isolate 39 strains of Candida, including 25 strains of Cd and 14 strains of Ca, obtained from 33 periodontal pocket samples and 6 oral mucosa samples collected from 15 HIV+ patients (8 receiving and 7 not receiving HAART). Malt egg-yolk agar, albumin agar and blood agar were used to evaluate pH, P and H production respectively. The strains were inoculated in duplicate and incubated at 37 ºC. Colony and halo diameters were measured. A greater proportion of Ca was observed in patients not receiving HAART, and a higher proportion of Cd was observed in those under HAART, Chi2 p< 0.001. Phospholipase production was observed in 92.9% percent of isolated Ca strains but in none of the isolated Cd strains. Proteinase production was high in Ca and Cd strains isolated from patients not receiving HAART. Hemolysin production was observed in all the studied strains, though it was significantly higher (p=0.04) in Ca and Cd strains isolated from patients not receiving HAART. To sum up, the proportion of Candida dubliniensis strains was highest in the subgingival biofilm of patients receiving HAART, and Cd strains were found to express fewer virulence factors than Ca strains.

RESUMEN Las levaduras más aisladas en pacientes VIH+ son Candida dubliniensis (Cd) y Candida albicans (Ca). Algunas de sus enzimas constituyen factores de virulencia ya que favorecen la diseminación tisular. El objetivo fue comparar la producción de enzimas como fosfolipasa (F), proteinasa (P) y hemolisina (H) en cepas de Cd y Ca aisladas de pacientes VIH+ tratados y no tratados con antirretrovirales (TARGA). Se realizó la toma del biofilm de placa subgingival con conos de papel y la muestra de la mucosa bucal con hisopo. Se aislaron y tipificaron por métodos fenotípicos y moleculares 39 cepas: 25 de Cd y 14 Ca, obtenidas 33 de bolsas periodontales y 6 de mucosa bucal de 15 pacientes VIH+ (8 con y 7 sin tratamiento). Se utilizó agar malta con yema de huevo, agar albúmina y agar sangre para demostrar la producción de F, P y H, respectivamente. Se inocularon por duplicado e incubaron a 37°C. Se midieron los diámetros de las colonias y los de hidrólisis alrededor de las mismas. Se observó mayor proporción de Ca en los pacientes sin tratamiento y mayor proporción de Cd en los con tratamiento; Chi2 p< 0.001. El 92,9% de las Ca estudiadas, fueron productoras de fosfolipasa. En tanto que ninguna Cd produjo la enzima. En cuanto a la producción de proteinasa se observa una alta producción tanto en las cepas de Ca, como en las Cd aisladas en los pacientes no tratados. Todas las cepas estudiadas produjeron hemolisina, observándose una diferencia estadísticamente significativa (p=0,04) en ambas especies a favor de la alta producción de la enzima en las cepas obtenidas de pacientes no tratados. Podemos concluir que en el biofilm subgingival, en los pacientes bajo TARGA, se aíslan mayor proporción de Candida dubliniensis las cuales expresan menos factores de virulencia.

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Introducción. Es frecuente (46 %) que la lesión esplénica se acompañe de otra lesión visceral concomitante, con una alta tasa de morbimortalidad. La evolución de las técnicas para el abordaje de estas lesiones incluye procedimientos quirúrgicos, intervencionistas y de manejo expectante. Métodos. Se trata de un estudio con cohorte única retrospectiva y observacional. Se incluyeron pacientes mayores de 13 años de edad con trauma esplénico, atendidos entre enero de 2000 y diciembre de 2017. Se describieron las características relacionadas con el proceso de atención.Resultados. Se identificaron 116 pacientes con trauma esplénico, el 85,2 % de ellos hombres, con una edad promedio de 26 años. El 75,9 % de los pacientes presentaba lesiones concomitantes; las más frecuentes fueron de diafragma (31,0 %), de hígado (17,2 %) y de riñón (11,2 %). Los mecanismos de lesión más frecuentes fueron por arma corto-punzante (29,3 %), por arma de fuego (22,4 %) y por accidentes de tránsito (22,4 %). La gravedad fue clasificada como de grado V en el 24,1 % de los pacientes y de grado I en el 23,3 %. Se practicó esplenectomía total en el 39,7 % de los pacientes y el 15,2 % fue manejado de forma conservadora. La mortalidad fue del 4,3 %, tres casos en el posoperatorio inmediato (menos de 24 horas) y dos en la primera semana postoperatoria. Discusión. El manejo conservador de las lesiones esplénicas de poca gravedad es una estrategia segura y efectiva, con una tasa de fracaso de menos del 5 %. El abordaje quirúrgico se reserva para lesiones de mayor gravedad y su relación con otros órganos lesionados, con una mayor morbimortalidad (63 %)

Introduction. Splenic injuries are usually accompanied by another concomitant visceral lesion (46 %), with a high rate of morbidity and mortality. The evolution of techniques for approaching these injuries includes surgical, interventional and expectant management procedures.Methods. Retrospective, observational single cohort study. Patients older than 13 years of age with splenic trauma who were treated between January 2010 and December 2017 were included. The characteristics related to the care process were described.Results. 116 patients with splenic trauma were identified, 85,2 % were men and the average age was 26 years. Concomitant lesions were identified in 75,9% of patients, the most common were diaphragm (31 %), liver (17,2 %), and kidney (11,2 %). The most common mechanisms of injury were stab wounds (29,3 %), gunshot wounds (22,4 %), and motor vehicle collisions (22,4 %). Severity was classified as grade V in 24,1 % of patients and grade I in 23,3 %. Total splenectomy was performed in 39,7 % of patients and 15,2 % was conservatively managed. Mortality was 4,3 %, three cases in the immediate postoperative period (within 24 hours) and two in the first week postoperative week. Discussion. Conservative management of low-grade splenic injuries is a safe and effective strategy, with a failure rate of less than 5 %. Surgical approach is reserved for injuries with greater severity and their relationship with other injured organs, with greater morbidity and mortality (63 %)

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RESUMEN Objetivo Comparar la frecuencia de los principales factores clínicos, bioquímicos y antropométricos de riesgo cardiovascular entre una comunidad rural y una urbana de Tinaquillo, Venezuela. Métodos Se evaluaron 118 individuos mayores de 18 años (52 pertenecientes a la comunidad urbana y 66 a la comunidad rural) a los cuales se les determinó peso, talla, circunferencia abdominal, presión arterial, glicemia y perfil lipídico. Se aplicó una encuesta para medir antecedentes personales de enfermedad cardiovascular y estilo de vida. Resultados Se evidenció que alrededor del 60 % de los individuos de la comunidad rural presentaron entre obesidad y sobrepeso. Cifras similares fueron obtenidas en la comunidad urbana, no encontrándose diferencias estadísticamente significativas entre ambas. Casi la mitad de los participantes mostró obesidad abdominal, así como una frecuencia importante de individuos con HDLc bajo (mayor al 70 %). Cabe destacar que si bien, se obtuvieron bajos porcentajes de hipertrigliceridemia, los mismos fueron significativamente superiores en la comunidad rural (Chi-cuadrado=4,82; p=0,0281). Caso contrario ocurre con la frecuencia del hábito tabáquico, el cual es estadísticamente superior en la comunidad urbana (Chi-cuadrado=4,48; p=0,0342). Conclusión Los resultados muestran una elevada frecuencia de factores de riesgo cardiovascular en ambas comunidades. En consecuencia, los programas de promoción en salud emergentes deben tener alcance hasta las comunidades rurales, pues el riesgo a padecer una enfermedad cardiovascular es similar al de la comunidad urbana, además de estar igualmente propensas a la adquisición de hábitos no saludables.(AU)

ABSTRACT Objective To compare the frequency of major clinical, biochemical and anthropometric cardiovascular risk factors between a rural community and an urban community from Tinaquillo, Venezuela. Method 118 individuals older than 18 years (52 of the urban community and 66 of the rural community) were included; their weight, height, waist circumference, blood pressure, blood glucose and lipid profile were assessed. A survey to measure personal history of cardiovascular disease and lifestyle was applied. Results About 60 % of the individuals of the rural community were either obese or overweight; similar figures were obtained in the urban community with no statistically significant differences. Almost half of the participants had abdominal obesity, and also a significant frequency of individuals with low HDLc (greater than 70 %) was observed. It should be noted that although low percentages of hypertriglyceridemia were obtained, they were significantly higher in the rural community (chi-square=4.82, p=0.0281). The opposite occurs with the frequency of smoking, which is statistically higher in the urban community (chi-square=4.48, p=0.0342). Conclusions The results show a high prevalence of cardiovascular risk factors in both communities. Consequently, health promotion programs should reach out to rural communities, as the risk of cardiovascular disease is similar to that of the urban community, who are equally prone to acquire unhealthy habits.(AU)

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OBJECTIVES: Free radicals play an important role in the onset and progression of many diseases. The aim of this study was to investigate the contribution of oxidative stress in the pathology of aggressive (AgP) and chronic (CP) periodontitis and its relation with the clinical periodontal status. METHODS: Eighty subjects were divided into two groups: 20 patients with AgP and 20 patients with CP with their 20 corresponding matched controls, based on clinical attachment loss (CAL), probing pocket depth (PPD), and bleeding on probing (BOP). Saliva reactive oxygen species (ROS), lipid peroxidation, and non-enzymatic antioxidant defences were measured by luminol-dependent chemiluminescence assay, as thiobarbituric acid-reactive substances (TBARs) and total radical-trapping antioxidant potential (TRAP), respectively. Pearson's correlation and multivariate analysis were used to determine the relationship between ROS and TBARs and the clinical parameters. RESULTS: ROS and TBARs were increased in AgP while TRAP was decreased, comparing with CP. In AgP, a strong and positive correlation was observed between ROS and TBARs and they were closely associated with CAL and PPD. DISCUSSION: In AgP, but not in CP, oxidative stress is a high contributor to periodontal pathology and it is closely associated with the clinical periodontal status.

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OBJECTIVE: To compare the frequency of major clinical, biochemical and anthropometric cardiovascular risk factors between a rural community and an urban community from Tinaquillo, Venezuela. METHOD: 118 individuals older than 18 years (52 of the urban community and 66 of the rural community) were included; their weight, height, waist circumference, blood pressure, blood glucose and lipid profile were assessed. A survey to measure personal history of cardiovascular disease and lifestyle was applied. RESULTS: About 60 % of the individuals of the rural community were either obese or overweight; similar figures were obtained in the urban community with no statistically significant differences. Almost half of the participants had abdominal obesity, and also a significant frequency of individuals with low HDLc (greater than 70 %) was observed. It should be noted that although low percentages of hypertriglyceridemia were obtained, they were significantly higher in the rural community (chi-square=4.82, p=0.0281). The opposite occurs with the frequency of smoking, which is statistically higher in the urban community (chi-square=4.48, p=0.0342). CONCLUSIONS: The results show a high prevalence of cardiovascular risk factors in both communities. Consequently, health promotion programs should reach out to rural communities, as the risk of cardiovascular disease is similar to that of the urban community, who are equally prone to acquire unhealthy habits.

OBJETIVO: Comparar la frecuencia de los principales factores clínicos, bioquímicos y antropométricos de riesgo cardiovascular entre una comunidad rural y una urbana de Tinaquillo, Venezuela. MÉTODOS: Se evaluaron 118 individuos mayores de 18 años (52 pertenecientes a la comunidad urbana y 66 a la comunidad rural) a los cuales se les determinó peso, talla, circunferencia abdominal, presión arterial, glicemia y perfil lipídico. Se aplicó una encuesta para medir antecedentes personales de enfermedad cardiovascular y estilo de vida. RESULTADOS: Se evidenció que alrededor del 60 % de los individuos de la comunidad rural presentaron entre obesidad y sobrepeso. Cifras similares fueron obtenidas en la comunidad urbana, no encontrándose diferencias estadísticamente significativas entre ambas. Casi la mitad de los participantes mostró obesidad abdominal, así como una frecuencia importante de individuos con HDLc bajo (mayor al 70 %). Cabe destacar que si bien, se obtuvieron bajos porcentajes de hipertrigliceridemia, los mismos fueron significativamente superiores en la comunidad rural (Chi-cuadrado=4,82; p=0,0281). Caso contrario ocurre con la frecuencia del hábito tabáquico, el cual es estadísticamente superior en la comunidad urbana (Chi-cuadrado=4,48; p=0,0342). CONCLUSIÓN: Los resultados muestran una elevada frecuencia de factores de riesgo cardiovascular en ambas comunidades. En consecuencia, los programas de promoción en salud emergentes deben tener alcance hasta las comunidades rurales, pues el riesgo a padecer una enfermedad cardiovascular es similar al de la comunidad urbana, además de estar igualmente propensas a la adquisición de hábitos no saludables.

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Discrimination based on one's racial or ethnic background is one of the oldest and most perverse practices in the United States. While much of this research has relied on self-reported racial categories, a growing body of research is attempting to measure race through socially-assigned race. Socially-assigned or ascribed race measures how individuals feel they are classified by other people. This paper draws on the socially assigned race literature and explores the impact of socially assigned race on experiences with discrimination using a 2011 nationally representative sample of Latina/os (n=1,200). While much of the current research on Latina/os has been focused on the aggregation across national origin group members, this paper marks a deviation by using socially-assigned race and national origin to understand how being ascribed as Mexican is associated with experiences of discrimination. We find evidence that being ascribed as Mexican increases the likelihood of experiencing discrimination relative to being ascribed as White or Latina/o. Furthermore, we find that being miss-classified as Mexican (ascribed as Mexican, but not of Mexican origin) is associated with a higher likelihood of experiencing discrimination compared to being ascribed as white, ascribed as Latina/o, and correctly ascribed as Mexican. We provide evidence that socially assigned race is a valuable complement to self-identified race/ethnicity for scholars interested in assessing the impact of race/ethnicity on a wide range of outcomes.

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The third molar is a tooth of anatomical, surgical, prosthetic and forensic dental interest. However, there is currently a lack of updated data regarding its morphology. The aim of this study was to determine the morphometric features of third molars and their predictive capability as regards dental arch and side. Two calibrated operators (ƙ = 0.83) determined the cervicalocclusalvestibular (COV), cervicalocclusalpalatal (COP) and occlusalapical (OA) distances, mesiodistal (MD), and vestibularpalatal (VP) diameters, number of roots (R) and number of cusps (C) of 961 cadaveric third molars, both upper (n = 462) and lower (n = 499), using a CONCOR 050 thin mandible caliper (resolution 0.01 mm). Median and range for each variable were calculated and compared using Mann Whitney nonparametric test (p < 0.05). Multivariate cluster analysis was used to determine the predictive capability of each variable for dental arch and side. For upper molars (UM), 50.6% were from the right side (RS) and 49.4% from the left side (LS), while for lower molars (LM), 60.9% were from the RS and 39.1% from the LS. No significant difference was found in the study variables in LM according to side. For UM, MD diameter (10.90 mm), COP(7.42 mm) distance and number of R (3) were significantly higher (p < 0.05) forRS, and number of C (3) was higher (p < 0.0001) for LS. They were also significant predictive grouping factors for side. For dental arch, OA (17.84 mm) and COV (7.60 mm) distances, MD (11.26 mm) diameter and the number of C (5) were significantly higher (p < 0.0001) for LM, while VP (10.84 mm) and COP (7.34 mm) distances, and the number of R (3) were significantly higher (p < 0.0001) for UM. These variables were significant predictive factors for dental arch. Despite the morphometric heterogeneity of third molars, there are intrinsic parameters with predictive capability for dental arch and side, but it would be advisable to supplement this study with data from topographic occlusal variables in order to validate their predictive capability.

El tercer molar es una pieza dentaria de interés odontológico anatómico, quirúrgico, endodóntico, protético y forense. Sin embargo, no hay disponibles hoy en día datos morfométricos actualizados del molar. El objetivo del trabajo fue determinar las características morfométricas de terceros molares y establecer el carácter predictivo de las mismas en cuanto a arco dental y lado. Dos operadores calibrados (ƙ = 0.83) determinaron la longitud oclusocervical vestibular (OCV) y palatina (OCP), oclusoapical (OA), diámetro mesiodistal (MD), diámetro vestíbulopalatino (VP), número de raíces (R) y número de cúspides (C), de 961 terceros molares cadavéricos, superiores (n = 462) e inferiores (n = 499), mediante el uso de un calibre de mandíbula fina CONCOR 050 (resolución 0.01 mm). Calculamos mediana y rango para cada variable y las comparamos haciendo uso de la prueba de Mann Whitney (p < 0.05). Utilizamos el análisis de cluster para determinar el valor predictivo de cada variable en cuanto a arco y lado. De los molares superiores (MS), 50.6% correspondió al lado derecho (LD) y 49.4% al lado izquierdo (LI). De los inferiores (MI), 60.9% correspondió al LD y 39.1% al LI. No hallamos diferencias significativas para las variables en estudio para los MI según su lado. Para los MS, el MD (10.90 mm), la OCP (7.42 mm) y el R (3) resultaron significativamente mayores (p < 0.05) para el LD, y el C (3), mayor (p < 0.0001) para el LI; y, además evidenciaron significancia como factores predictivos de agrupamiento para la predicción del lado. En relación al arco, la OA (17.84 mm), la OCV (7.60 mm), el MD (11.26 mm) y el C (5), resultaron significativamente mayores (p < 0.0001) en los MI, mientras que el VP (10.84 mm), la OCP (7.34 mm) y el R (3) fueron significativamente mayores (p < 0.0001) en MS. Dichas variables evidenciaron significan cia como factores predictivos para el arco. Pese a la heteroge neidad morfométrica del tercer molar, existen parámetros característicos con valor predictivo para el arco y lado, aunque sería recomendable complementar el estudio con variables topográficas oclusales a fin de validar la capacidad predictiva de los mismos.

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The third molar is a tooth of anatomical, surgical, prosthetic and forensic dental interest. However, there is currently a lack of updated data regarding its morphology. The aim of this study was to determine the morphometric features of third molars and their predictive capability as regards dental arch and side. Two calibrated operators (ƙ = 0.83) determined the cervicalocclusalvestibular (COV), cervicalocclusalpalatal (COP) and occlusalapical (OA) distances, mesiodistal (MD), and vestibularpalatal (VP) diameters, number of roots (R) and number of cusps (C) of 961 cadaveric third molars, both upper (n = 462) and lower (n = 499), using a CONCOR 050 thin mandible caliper (resolution 0.01 mm)...

El tercer molar es una pieza dentaria de interés odontológico anatómico, quirúrgico, endodóntico, protético y forense. Sin embargo, no hay disponibles hoy en día datos morfométricos actualizados del molar. El objetivo del trabajo fue determinar las características morfométricas de terceros molares y establecer el carácter predictivo de las mismas en cuanto a arco dental y lado. Dos operadores calibrados (ƙ = 0.83) determinaron la longitud oclusocervical vestibular (OCV) y palatina (OCP), oclusoapical (OA), diámetro mesiodistal (MD), diámetro vestíbulopalatino (VP), número de raíces (R) y número de cúspides (C), de 961 terceros molares cadavéricos, superiores (n = 462) e inferiores (n = 499), mediante el uso de un calibre de mandíbula fina CONCOR 050 (resolución 0.01 mm)...

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La infección por el HIV-1 cursa con enfermedades oportunistas asociadas. En referencia a los virus herpes, la asociación más conocida es con el HVS-2. La coinfección HIV-1, HVS-1 y P. jiroveci constituye un cuadro clínico de alta morbilidad y baja frecuencia. Caso clínico: una paciente de 17 años de edad fue derivada a la consulta con sintomatología compatible con gingivoestomatitis herpética recurrente resistente a la terapia con aciclovir p.o. 200 mg cada 5 hs y tratada con amoxicilina-clavulánico p.o. (875 mg-125 mg) cada 12 hs por 20 días. Al ingreso presentaba adenitis cervical, odinofagia, disnea, fiebre (38.2ºC), pulso: 120/min, presión arterial: 120/75 mm Hg, frecuencia respiratoria: 24/min y deterioro generalizado. Se solicitó hacer la serología para el HIV y estudio RX de tórax. La serología para HIV-1 resultó positiva y los valores de CD4+ y carga viral fueron 320/mm3 y 25.000 copias/ml, respetivamente. El estudio RX de tórax reveló neumonía por P. jiroveci que se confirmó posteriormente por fibrobroncoscopía. Se realizó el tratamiento farmacológico de la infección herpética con foscarnet (i.v) 60mg /kg cada 12 hs. durante 3 días, mientras que la neumonía se trató con trimetropima 160 mg y sulfametoxazol p.o. 800 mg cada 6 horas durante 14 días. La remisión de la sintomatología bucal se oservó a los 15 días postratamiento. Conclusión: la población femenina adolescente evidencia una mayor vulnerabilidad biológica y social en relación a la transmisión del HIV. El odontólogo responsable deberá calibrarse en el reconocimiento y diagnóstico precoz de las manifestaciones bucales de dicha infección viral. Ante la presencia de cepas de HVS-1 aresistentes deberá contemplarse la posibilidad de otras infecciones oportunistas simultáneas

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Las hernias internas corresponden de 0,2 a 0,9 % de todos los casos de obstrucción intestinal. De ellas, el 8 % son hernias del hiato de Winslow. Este tipo de hernia se asocia frecuentemente a obstrucción intestinal y a algún grado de isquemia. Su diagnóstico prequirúrgico es difícil y se da en menos del 10 % de los casos. Su manejo es quirúrgico y la mortalidad está alrededor del 50 % cuando existe compromiso vascular. Se han descrito cuatro tipos de hernias del hiato de Winslow, dependiendo del órgano comprometido. Se presenta el caso de una paciente que ingresó al servicio de urgencias con dolor abdominal de inicio súbito, progresivo, asociado a náuseas, emesis y compromiso de su estado general. Fue sometida a laparotomía exploratoria. Se encontró una hernia del hiato de Winslow, con necrosis isquémica del íleon terminal, el ciego y el colon ascendente, por lo cual requirió resección intestinal, con ileostomía y fístula mucosa. Durante el posoperatorio necesitó soporte en la unidad de cuidados intensivos y, posteriormente, en salas de hospitalización, y fue dada de alta una vez su condición clínica se estabilizó.

Internal hernias constitute 0.2% - 0.9% of all cases of intestinal obstruction. Of these, hernias through the foramen of Winslow represent about 8%. This type of hernia is often associated with intestinal obstruction and some degree of ischemia. Preoperative diagnosis is difficult and occurs in less than 10% of cases. Treatment is surgical and mortality rate is about 50% when there is vascular compromise. Four types of hernias through the foramen of Winslow are described depending on the organ involved. We report the case of a 73 year old female who was admitted to the emergency department with sudden progressive abdominal pain associated with nausea, emesis, and systemic compromise evidenced by metabolic acidosis and hyperlactatemia. At exploratory celiotomy a large hernia through the foramen of Winslow with ischemic necrosis of the terminal ileum, cecum and ascending colon was encountered, requiring bowel resection, ileostomy and mucous fistula. The patient required initial support in the ICU and was discharged once the clinical condition was stable.

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OBJECTIVE: Salivary mucin and amylase levels are increased in patients with chronic periodontitis (CP). Due to the fact that aggressive periodontitis (AgP) not only differs from chronic periodontitis in terms of its clinical manifestation, the aim of this study was to compare salivary mucin and amylase levels and their relation to the clinical parameters of patients with aggressive periodontitis with that of patients with chronic periodontitis. MATERIAL AND METHODS: Eighty subjects were divided into two groups: 20 patients with AgP and their 20 matched controls and 20 patients with CP and their 20 matched controls, based on clinical attachment loss (CAL), probing pocket depth (PPD) and bleeding on probing (BOP). Whole unstimulated saliva was obtained and mucin, amylase and protein were determined by colorimetric methods. Pearson's correlation analysis was used to determine the relationship between salivary mucin, amylase and protein levels and the clinical parameters. RESULTS: Salivary mucin, amylase and protein levels were increased in patients with AgP and CP but there were no differences between them or between control groups. Pearson's correlation analysis, determined in the entire subjects studied, showed a positive and significant correlation of mucin, amylase and proteins with CAL and PPD and a negative correlation with the flow rate. When Pearson's correlation analysis was carried out in each group separately, Fisher's z transformation showed no significant difference between both groups. CONCLUSION: Comparison of the salivary levels of mucin, amylase and protein and their relationship with clinical parameters of AgP patients with that of CP patients revealed no differences between both groups.

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Objective Salivary mucin and amylase levels are increased in patients with chronic periodontitis (CP). Due to the fact that aggressive periodontitis (AgP) not only differs from chronic periodontitis in terms of its clinical manifestation, the aim of this study was to compare salivary mucin and amylase levels and their relation to the clinical parameters of patients with aggressive periodontitis with that of patients with chronic periodontitis. Material and Methods Eighty subjects were divided into two groups: 20 patients with AgP and their 20 matched controls and 20 patients with CP and their 20 matched controls, based on clinical attachment loss (CAL), probing pocket depth (PPD) and bleeding on probing (BOP). Whole unstimulated saliva was obtained and mucin, amylase and protein were determined by colorimetric methods. Pearson's correlation analysis was used to determine the relationship between salivary mucin, amylase and protein levels and the clinical parameters. Results Salivary mucin, amylase and protein levels were increased in patients with AgP and CP but there were no differences between them or between control groups. Pearson's correlation analysis, determined in the entire subjects studied, showed a positive and significant correlation of mucin, amylase and proteins with CAL and PPD and a negative correlation with the flow rate. When Pearson's correlation analysis was carried out in each group separately, Fisher's z transformation showed no significant difference between both groups. Conclusion Comparison of the salivary levels of mucin, amylase and protein and their relationship with clinical parameters of AgP patients with that of CP patients revealed no differences between both groups. .

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