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La clase II esqueletal puede deberse a una mandíbula retruida, un maxilar protruido o una combinación de ambas, dando como resultado un perfil convexo en el paciente. Actualmente existen diferentes alternativas de tratamiento siendo una de ellas la extracción de primeros premolares para mejorar el perfil. El uso de microimplantes es una mecánica de anclaje absoluto que permite la retracción y cierre de espacios de los dientes. Se presenta un caso clínico de una paciente femenina de 19 años, clase II esqueletal por postero-rotación mandibular con biotipo dolicofacial, perfil convexo, sonrisa gingival, clase I molar y canina, overbite de 2 mm y overjet de 2 mm, apiñamiento moderado con incisivos superiores e inferiores protruidos y proinclinados. Como objetivo del tratamiento se planteó mantener la clase I molar y canina, mejorar el perfil facial y liberar el apiñamiento. Mediante el anclaje absoluto con los microimplantes interradiculares, se logró retraer el segmento antero-superior, conservando la clase I molar, clase I canina y reduciendo la proyección labial mejorando el perfil facial. Concluyendo que el uso de microimplantes resulta ser una mecánica de anclaje esqueletal cómoda, práctica y estable para lograr los objetivos del tratamiento sin la necesidad de la cooperación del paciente.

Class II can be due to a retrognathous mandible, a prognathous maxilla, or a combination of both, resulting in a convex profile in the patient. Currently there are different treatment alternatives, one of which is the extraction of first premolars to improve the profile. The use of microimplants is an absolute anchorage mechanics that allows the retraction and closing spaces of the teeth. A clinical case of a 19-year-old female patient, skeletal class II due to mandibular postero-rotation with dolichofacial biotype, convex profile, gummy smile, molar and canine class I, 2 mm overbite and 2 mm overjet, moderate crowding with upper and lower incisors protruding and proclining, as treatment objectives we must maintain molar and canine class I, improve facial profile and releive the crowding. Through absolute anchorage with interradicular microimplants, it was possible to retract the upper anterior segment, preserving molar class I, canine class I and reducing labial projection, improving facial profile. Concluding that the use of microim-plants turns out to be a comfortable, practical and stable skeletal anchorage mechanism to achieve the treatment objectives without the need for the patient's cooperation.

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Evidence points to a direct relationship between nutritional quality and food expenditure. However, food expenditure is highly susceptible to changes, and nutritional quality of household food presents limited evidence. The aim of this study was to assess the relationship between nutritional quality available and total food expenditure in Peruvian households, and whether there were differences by area (urban and rural) and between years of the COVID-19 pandemic. For this, we used Peru's National Household Survey (ENAHO) from 2019 and 2020. We assessed total food expenditure in US dollars per day, whereas household nutritional quality available was assessed based on dietary diversity and compliance with the household calorie requirements, percentage of food expenditure, and potential confounders. We used the Student's t-test, analysis of variance (ANOVA), linear regression, and the Wald test to assess the interaction effect. Households with adequate total/partial nutritional quality available by area were found to spend, on average, USD 2.00 more in urban than in rural areas and, by year, they presented 7.1% more percentage of food expenditure in 2020 than in 2019. Despite associations existing between nutritional quality available and total food expenditure by year and study area, the effect modification was only present by study area. In multivariable model, households with adequate total/partial nutritional quality available consistently presented a lower total food expenditure by year, with a lower total food expenditure in urban areas. An inverse relationship was found between nutritional quality available and total food expenditure, in contrast to the direct relationship of studies assessing dietary cost and nutritional quality. Our results reflect the nutritional deficit in the food purchases of Peruvian households.

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Abstract: Evidence points to a direct relationship between nutritional quality and food expenditure. However, food expenditure is highly susceptible to changes, and nutritional quality of household food presents limited evidence. The aim of this study was to assess the relationship between nutritional quality available and total food expenditure in Peruvian households, and whether there were differences by area (urban and rural) and between years of the COVID-19 pandemic. For this, we used Peru's National Household Survey (ENAHO) from 2019 and 2020. We assessed total food expenditure in US dollars per day, whereas household nutritional quality available was assessed based on dietary diversity and compliance with the household calorie requirements, percentage of food expenditure, and potential confounders. We used the Student's t-test, analysis of variance (ANOVA), linear regression, and the Wald test to assess the interaction effect. Households with adequate total/partial nutritional quality available by area were found to spend, on average, USD 2.00 more in urban than in rural areas and, by year, they presented 7.1% more percentage of food expenditure in 2020 than in 2019. Despite associations existing between nutritional quality available and total food expenditure by year and study area, the effect modification was only present by study area. In multivariable model, households with adequate total/partial nutritional quality available consistently presented a lower total food expenditure by year, with a lower total food expenditure in urban areas. An inverse relationship was found between nutritional quality available and total food expenditure, in contrast to the direct relationship of studies assessing dietary cost and nutritional quality. Our results reflect the nutritional deficit in the food purchases of Peruvian households.

Resumen: Las evidencian existentes indican una relación directa entre la calidad nutricional y el gasto con alimentos. Sin embargo, los gastos son muy susceptibles a los cambios. Por otro lado, hay pruebas limitadas sobre la calidad nutricional de los alimentos domésticos disponibles. El objetivo de este estudio fue evaluar la relación entre la calidad nutricional disponible y el gasto total en alimentos en los hogares peruanos, y si hubo diferencias por área (urbana y rural) y entre los años de la pandemia del COVID-19. Para ello, se utilizó la Encuesta Nacional de Hogares del Perú (ENAHO) de 2019 y 2020. Se evalúo el gasto total en alimentos en dólares estadounidenses por día, la calidad nutricional disponible por hogar basado en la diversidad dietética y el cumplimiento de los requisitos calóricos por hogar, teniendo en cuenta el porcentaje de gasto alimentario y los posibles factores de confusión. La prueba t de Student, el análisis de varianza (ANOVA), la regresión lineal y la prueba de Wald se utilizaron para evaluar el efecto de interacción. Se encontró que los hogares con la calidad nutricional disponible total/parcial adecuada por área gastan en promedio USD 2,00 más en áreas urbanas que en áreas rurales, y que por año tuvieron el porcentaje de gasto alimentario 7,1% más grande en 2020 que en 2019. Si bien hubo una asociación entre calidad nutricional disponible y gasto total en alimentos por año y área de estudio, la modificación del efecto solo estuvo presente por área de estudio. En el modelo multivariable, los hogares con la calidad nutricional disponible total/parcial adecuada tuvieron consistentemente un gasto total en alimentos más bajo por año, de la misma manera que en áreas urbanas. Se encontró una relación inversa entre calidad nutricional disponible y gasto total en alimentos en contraste con la relación directa de los estudios que evaluaron el costo de la dieta y la calidad nutricional. Los resultados apuntan al déficit nutricional en las compras de alimentos de los hogares peruanos.

Resumo: Evidências revelam uma relação direta entre a qualidade nutricional e os gastos com alimentação. No entanto, essas despesas são altamente suscetíveis a mudanças. Por outro lado, há uma limitação de evidências sobre a qualidade nutricional dos alimentos domésticos disponíveis. O objetivo deste estudo foi avaliar a relação entre a qualidade nutricional disponível e o gasto total com alimentos em domicílios peruanos, e se havia diferenças por área (urbana e rural) e entre os anos da pandemia de COVID-19. Para isso, foi utilizada a Pesquisa Nacional de Domicílios do Peru (ENAHO) de 2019 e 2020. Foram avaliados o gasto total com alimentos em dólares americanos por di e a qualidade nutricional disponível domiciliar com base na diversidade dietética e no cumprimento das necessidades calóricas domiciliares, considerando o percentual de gasto com alimentos e potenciais fatores de confusão. Utilizou-se o teste t de Student, a análise de variância (ANOVA), a regressão linear e o teste de Wald para avaliar o efeito de interação. Os domicílios com a qualidade nutricional disponível total/parcial adequada por área gastaram, em média, USD 2,00 a mais nas áreas urbanas do que nas rurais e tiveram um percentual de gasto com alimentos 7,1% maior em 2020 do que em 2019. Embora tenha sido encontrada uma associação entre a qualidade nutricional disponível e o gasto total com alimentos por ano e área de estudo, a modificação do efeito só estava presente por área de estudo. No modelo multivariável, os domicílios com a qualidade nutricional disponível total/parcial adequada apresentaram consistentemente um gasto total com alimentos menor por ano, assim como em áreas urbanas. Foi encontrada uma relação inversa entre a qualidade nutricional disponível e o gasto total com alimentos, em contraste com a relação direta dos estudos que avaliaram o custo da dieta e a qualidade nutricional. Esses resultados refletem o déficit nutricional nas compras de alimentos das famílias peruanas.

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We aimed to estimate the prevalence and factors associated with parents' non-intention to vaccinate their children and adolescents against COVID-19 in Colombia and Peru. We performed a secondary analysis using a database generated by the University of Maryland and Facebook (Facebook, Inc). We Included adult (18 and over) Facebook users residing in LAC who responded to the survey between May 20, and November 5, 2021. We Included sociodemographic characteristics, comorbidities, mental health, economic and food insecurity, compliance with mitigation strategies against COVID-19, and practices related to vaccination against this disease. We estimated crude (cPR) and adjusted (aPR) prevalence ratios with their respective 95 %CI. We analyzed a sample of 44,678 adults from Colombia and 24,302 from Peru. The prevalence of parents' non-intention to vaccinate their children and adolescents against COVID-19 was 7.41 % (n = 3,274) for Colombia and 6.64 % (n = 1,464) for Peru. In Colombia, age above 35 years old, compliance with physical distancing, use of masks, having economic insecurity, anxiety symptoms, having a chronic condition or more comorbidities, and being vaccinated were associated with a higher probability of vaccinating children and adolescents against COVID-19. In Peru, female gender, compliance with physical distancing, use of masks, having economic insecurity, anxiety symptoms, having a chronic condition or more comorbidities, having had COVID-19, and being vaccinated were associated with a higher probability of vaccinating children against COVID-19. Living in a town, a village, or a rural area was associated with a higher prevalence of non-intention to vaccinate children and adolescents against COVID-19. About 9 out of 10 parents in Colombia and Peru intend to vaccinate their children and adolescents against COVID-19. This intention is associated with some factors which are similar between the two countries, as well as other factors and variations among the different regions of each country.

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RESUMEN Introducción: El eritema pigmentado fijo ampolloso, es una forma de toxicodermia potencialmente grave. Se caracteriza por la aparición de lesiones cutáneas y/o mucosas, únicas o múltiples, pueden aparecer en cualquier zona, tras la administración de un fármaco u otra sustancia. Se presenta un varón de 73 años con diagnóstico de eritema pigmentado fijo ampolloso secundario a la ingesta de ivermectina. Es necesario que el medico sepa reconocer los efectos adversos de la automedicación con ivermectina contra el SARS CoV-2, a fin de realizar un diagnóstico temprano e iniciar un tratamiento oportuno.

ABSTRACT Background: Bullous fixed pigmented erythema is a potentially serious form of toxicoderma. It is characterized by the appearance of cutaneous and / or mucosal lesions, single or multiple, which can appear in any area, after the administration of a drug or other substance. A 73-year-old man is presented with a diagnosis of bullous fixed pigmented erythema secondary to the ingestion of ivermectin. It is necessary for the physician to recognize the adverse effects of self-medication with ivermectin against SARS CoV-2, to make an early diagnosis and initiate timely treatment.

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"Dysmobility Syndrome" (DS) is a term that correlates sarcopenia and osteoporosis together with mobility disturbances, obesity, fractures, and falls. The prevalence of DS is of 74% in this study. Further research with bigger sample sizes is needed to describe if prevalence and DS characteristics are similar in other studies. PURPOSE: "Dysmobility Syndrome" (DS) correlates sarcopenia and osteoporosis together with mobility disturbances, obesity, fractures, and falls, all of which are related to adverse outcomes in the health of the elderly; however, there are no studies of DS in Mexican patients. In this study, we aimed to describe the characteristics of DS in Mexican postmenopausal women from a private practice. METHODS: A case-series study was conducted; women of 60 years and older were invited to participate from August to December of 2019, a total of 50 patients were included. Medical history, physical tests, bone densitometry, and body composition analysis were performed; patients who met 3 or more of the following criteria were diagnosed with DS: osteoporosis: T-score ≤ -2.5, falls in a previous year, lean appendicular mass: ≤ 5.45 kg/m2, walking speed: < 1.0 m/s, grip strength: < 20 kg, and body fat percentage: > 40%. RESULTS: Out of the total 50 patients, 37 were diagnosed with DS, with a prevalence of 74% in our study. Sixteen patients had a history of a non-vertebral fragility fracture, of which 14 had a diagnosis of DS (87%). CONCLUSIONS: DS has a high frequency in our study group, and was found to be closely related to the presence of non-vertebral fragility fractures. More research is needed to describe the prevalence and characteristics of DS with a stronger statistical significance within our population, and among others across the country, to get an extensive understanding of its presentation in Mexican women. KEY POINTS: • The frequency of DS in this study is higher than the one that is described in global literature. • DS diagnosis is closely related to the antecedent of non-vertebral fragility fracture.

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La tuberculosis se encuentra en estrecha relación con enfermedades que provocan estados de inmunodeficiencia como la enfermedad renal crónica terminal. El objetivo principal de la investigación realizada, es describir el perfil epidemiológico de los pacientes con tuberculosis en terapia de sustitución renal, a través de la descripción de variables sociodemográficas, factores de riesgo, tipo de terapia dialítica recibida y el tiempo de la misma y frecuencia de terapia dialítica. La población estudiada fueron los pacientes con enfermedad renal terminal en terapia de sustitución renal con diagnóstico de tuberculosis. La obtención de los datos se realizó por medio de la revisión de expedientes clínicos y libros de registro de resultados de baciloscopías (PCT-1), ADA, Cultivos y GeneXpert del departamento de tuberculosis; libro de resultados de estudios histopatológicos en el departamento de patología. Se llevó a cabo la revisión de 30 expedientes que cumplían los criterios de inclusión, encontrando como principales características de la población estudiada: hipoalbuminemia, uremia evidenciada con niveles de creatinina mayores de 10 mg/dl, incidencia en pacientes jóvenes y principalmente en los que se encuentran en diálisis peritoneal intermitente con catéter rígido. El procesamiento de los datos se realizó en Microsoft Excel y Epi Info, por medio de tablas y gráficos

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