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El crimen organizado se ha convertido en un flagelo a nivel internacional conformado por grupos al margen de la ley que realizan todo tipo de actividades que involucran desde tráfico de personas, secuestros, extorsiones, narcotráfico y muchos otros delitos. Producto de este fenómeno, la desaparición y ejecución de personas es cada día más frecuente, en muchos casos los cuerpos son quemados o desmembrados para impedir o hacer más difícil la identificación. La odontología forense se ha convertido en una disciplina transcendental en la identificación de cadáveres y restos óseos, además de contar con múltiples métodos para estimar la edad aproximada de una persona. Se presenta el caso de un descuartizamiento múltiple de tres individuos masculinos donde era indispensable identificar si alguno correspondía a una persona menor de 18 años.

Organized crime has become an international scourge made up of outlaw groups that carry out all kinds of activities ranging from human trafficking, kidnapping, extortion, drug trafficking and many more. As a result of this phenomenon, the disappearance and execution of people is becoming more frequent every day, in many cases the bodies are burned or dismembered to prevent or make identification more difficult. Forensic odontology has become a transcendental discipline in the identification of corpses and skeletal remains, in addition to having multiple methods to estimate the approximate age of a person. The case of a multiple dismemberment of three male individuals is presented, where it was essential to identify a person under 18 years of age.

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Las armas de aire comprimido son utilizadas desde hace muchos años con distintos usos que van desde el tiro recreativo hasta el control de plagas. Las más comunes son aquellas que disparan ''balines" o esferas metálicas que pueden llegar a tener capacidad de penetrar tejidos dependiendo del tipo de carga y de la longitud del cañón. Se presenta un caso clínico de un masculino que fue agredido con un arma tipo pistola con carga de CO2 que recibió un impacto a nivel facial y sufrió laceración en piel de labio y fractura dental complicada.

Air guns have been used for many years for a variety of purposes ranging from recreational shooting to pest control. The most common are those that shoot "pellets" or metallic spheres that can penetrate tissues depending on the type of load and the length of the barrel. A clinical case is presented of a male who was assaulted with a CO2-loaded pistol-type weapon, hit at facial level, and suffered laceration of the lip's skin and complicated dental fracture.

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Introducción: Aquellas personas que brindan atención en situaciones de emergencias están expuestas a un alto riesgo de sufrir lesiones o fallecer durante labores de rescate, sea en accidentes de tránsito, desastres naturales, atentados terroristas o crisis humanitarias generadas por conflictos armados. Esta investigación fue realizada en las personas trabajadoras de la Cruz Roja Costarricense (CRC) para establecer la percepción de la utilidad de los registros dentales como método de identificación y elaborar un formato único de información odontológica antemortem. Materiales y métodos: Un cuestionario piloto fue diseñado y aplicado a 10 personas para ser calibrado y validado. Posteriormente se generó un cuestionario electrónico final en la plataforma Google Forms que fue enviado vía correo electrónico institucional a las personas trabajadoras constituida por 175 individuos, de los cuales 92 respondieron en el período del 20 de noviembre de 2022 al 20 de enero de 2023. Los resultados fueron analizados mediante las distribuciones de frecuencia, cruce de variables, comparación de medias con base en el análisis de variancia. El nivel mínimo de confianza para las comparaciones fue del 95%. Resultados: El cuestionario fue realizado por 92 personas, 75% hombres y 25% mujeres. El rango de edad entre los 36 y 40 años fue el más frecuente (23.9%). El 60,9% labora en la provincia de San José, 58% indica que visitaron al odontólogo hace un año o menos y el 38,6% refiere que nunca les han tomado una radiografía panorámica, un 81,8% dice tener tratamientos dentales como coronas, puentes o implantes; y el 75% considera de gran utilidad los registros dentales como método de identificación, y lo ubican en segundo lugar de conocimiento (89,8%) al compararlo con ADN (97,7%) y dactiloscopia (86,4%). Conclusiones: Las personas trabajadoras de la Cruz Roja Costarricense consideran que los registros odontológicos son útiles en la identificación de seres humanos y cuentan con información antemortem útil para dicho efecto.

Introduction: Those who provide care in emergency situations are exposed to a high risk of injury or death during rescue work, whether in traffic accidents, natural disasters, terrorist attacks, or humanitarian crises generated by armed conflicts. This research was carried out among Costa Rican Red Cross (CRC) workers to establish the perception of the usefulness of dental records as a method of identification and to develop a single format for antemortem dental information. Materials and methods: A pilot questionnaire was designed and applied to 10 persons to be calibrated and validated. Subsequently, a final electronic questionnaire was generated in the Google Forms platform and sent via institutional e-mail to 175 workers, of whom 92 responded during the period from November 20, 2022, to January 20, 2023. The results were analyzed by means of frequency distributions, crossing of variables, and comparison of means based on the analysis of variance. The minimum confidence level for comparisons was 95%. Results: The questionnaire was completed by 92 people, 75% men and 25% women. The age range between 36 and 40 years was the most frequent (23.9%). A total of 60.9% worked in the province of San José, 58% indicated that they had visited the dentist a year ago or less and 38.6% said that they had never had a panoramic X-ray taken, 81.8% said they had dental treatments such as crowns, bridges or implants; and 75% considered dental records to be very useful as a method of identification, and placed it in second place in terms of knowledge (89.8%) when compared with DNA (97.7%) and dactyloscopy (86.4%). Conclusions: Costa Rican Red Cross workers consider dental records to be useful in the identification of human beings and have useful antemortem information for this purpose.

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O presente texto tem como objetivo geral versar sobre a relação atemporal existente entre a neuroplasticidade, a memória e a aprendizagem humanas. Além disso, pretende-se tratar de maneira específica sobre os principais aspectos que influenciam a memória, como as emoções, os estados de ânimo e o nível de atenção. Essa temática é de crucial importância para os estudantes brasileiros, eis que na medida em que se conhece o que influencia positiva e negativamente na memória é possível obter melhores resultados no que toca à aprendizagem. Como modalidade de pesquisa, adota-se a bibliográfica; como método, utiliza-se o indutivo.

The present text has as its general objective to deal with the timeless relationship between neuroplasticity, human memory and learning. In addition, it is intended to deal specifically with the main aspects that influence memory, such as emotions, moods and the level of attention. This theme is of crucial importance for Brazilian students, since, as it is known what positive and negative influence on memory, it is possible to obtain better results in terms of learning. As a research modality, bibliography is adopted; as a method, the inductive is used.

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Introducción: El consentimiento informado es el resultado de la evolución de la relación entre las personas profesionales de la salud y sus pacientes o usuarios donde el principio de autonomía está por encima de cualquier otra cosa. Existen muchos artículos sobre el consentimiento informado pero ninguno de los estudios encontrados evaluó si los pacientes realmente lo comprenden. El objetivo de esta investigación fue determinar el nivel de comprensión del consentimiento informado por parte de los pacientes de la Clínica de Exodoncia y Cirugía de la Facultad de Odontología de la Universidad de Costa Rica, en el período agosto a septiembre del 2022, mediante un cuestionario que permitiera correlacionar la comprensión con el nivel de escolaridad. Materiales y métodos: Se realizó un cuestionario a 100 personas dividido en dos partes, una sobre datos sociodemográficos y la otra para establecer la comprensión del consentimiento informado y determinar si el grado de escolaridad tenía relación con la comprensión de este. Resultados: El grupo entre 20 y 30 años fue el mayor, de estos el 51% tuvo estudios universitarios, y aunque la mayoría (98%) refirió conocer el concepto de consentimiento informado, únicamente el 33 % obtuvo las respuestas correctas a las preguntas clínicas realizadas. Conclusiones: A pesar de que los pacientes refieren conocer qué es el consentimiento informado los resultados sugieren una comprensión poco clara de conceptos importantes como complicaciones o reacciones adversas inmediatas o tardías producidas por el efecto de los tratamientos odontológicos o procedimientos quirúrgicos.

Introduction: Informed consent is the result of the evolution of the relationship between health professionals and their patients or users where the principle of autonomy is above anything else. There are many articles on informed consent but none of the studies found assessed whether patients really understand it. The objective of this research was to determine the level of understanding of informed consent by the patients of the Clinic of Oral Surgery of the Faculty of Dentistry of the University of Costa Rica, in the period August to September 2022, by means of a questionnaire that would allow correlating the understanding with the level of schooling. Materials and methods: A questionnaire was administered to 100 people divided into two parts, one on sociodemographic data and the other to establish the understanding of informed consent and to determine whether the level of schooling was related to the understanding of the same. Results: The group between 20 and 30 years of age was the largest, of these 51% had university studies, and although the majority (98%) referred to knowing the concept of informed consent, only 33% obtained the correct answers to the clinical questions asked. Conclusions: Even though patients refer to knowing what informed consent is the results suggest an unclear understanding of important concepts such as complications or immediate or late adverse reactions produced by the effect of dental treatments or surgical procedures.

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El aumento a nivel mundial de las denuncias por responsabilidad profesional en Ciencias de la Salud hace imprescindible que quienes ejerzan esta profesión deban conocer las implicaciones de su labor, así como cumplir con los principios bioéticos y jurídicos para garantizar una sana relación odontólogo-paciente. Es importante comprender que el ejercicio de la odontología en Costa Rica está regulado por normas, códigos y leyes como cualquier otra actividad humana en un Estado de Derecho.

The number of complaints related to professional liability in health sciences has increased worldwide, it is essential for dental professionals to be aware of the implications of their labor, as well as to comply with bioethical and legal principles to ensure a healthy dentist-patient relationship. It is important to understand that the practice of dentistry in Costa Rica is regulated by norms, codes, and laws like any other human activity in a State governed by the rule of law.

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Resumen Introducción: En Costa Rica la elaboración del expediente odontológico o ficha clínica no se realiza de manera habitual en todos los pacientes como ocurre en muchos países donde es exigido por ley. La realización del expediente únicamente está normada en el Código de Ética del Colegio de Cirujanos Dentistas de Costa Rica, es decir que no realizarlo se considera una falta ético-disciplinaria con pocas repercusiones para la persona profesional; sin embargo, tiene consecuencias graves en los esfuerzos para identificar a un ser humano. Este estudio tiene como propósito describir el impacto de la ausencia o la mala calidad de datos odontológicos antemortem en los casos de identificación realizados por la Unidad de Odontología Forense del Departamento de Medicina Legal en un período de casi ocho años (2015-2022). Materiales y métodos: Se realizó una revisión detallada en la base de datos del Sistema de Medicina Legal (SIMEL) del Departamento de Medicina Legal del Organismo de Investigación Judicial de la totalidad de solicitudes de interconsulta de la Sección de Patología Forense desde enero de 2015 hasta agosto de 2022. La información recopilada fue tabulada en Excel e incluyó tanto los resultados del análisis pericial como las características de la información antemortem disponible. Resultados: El análisis de los datos permitió determinar que en un período de casi 8 años se realizaron 165 valoraciones con fines de identificación, de las cuales se identificaron positivamente 51 individuos, 9 casos presentaron información insuficiente y 105 no contaban con expediente odontológico. Conclusiones: el expediente odontológico completo es indispensable para lograr una identificación positiva, un expediente incompleto o inexistente anula la posibilidad de identificar a un ser humano. La necesidad de contar con legislación que convierta la realización y preservación de los expedientes odontológicos de forma obligatoria con fines de identificación es necesaria en Costa Rica.

Abstract Introduction: In Costa Rica the elaboration of dental records or clinical files is not performed routinely in all patients as it is required by law in many countries. The completion of the dental record is only regulated by the Code of Ethics of the Colegio de Cirujanos Dentistas de Costa Rica (Board of Dental Surgeons of Costa Rica), which means that failure to do so is considered an ethical-disciplinary offense with few consequences for the professional; however, it has serious consequences in the efforts to identify a person. This study aims to describe the impact of the absence or poor quality of antemortem data in identification cases performed by the Forensic Odontology Unit of the Department of Legal Medicine over a period of almost eight years (2015-2022). Materials and Methods: A detailed review was performed in the database of the Forensic Medicine System (SIMEL) of the Legal Medicine Department of the Judicial Investigation Organism of the totality of interconsultation requests of the Forensic Pathology Section from January 2015 to August 2022. The information collected was tabulated in Excel and included both the results of the expert analysis and the characteristics of the available antemortem information. Results: The analysis of the data made it possible to determine that in a period of almost 8 years 165 assessments were carried out for identification purposes, of which 51 individuals were identified, 9 cases presented insufficient information and 105 had no dental files. Conclusions: A complete dental record is indispensable for a positive identification; an incomplete or non-existent record nullifies the possibility of identifying a human being.

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The study was conducted at the Amazon Research Center CIMAZ -MACAGUAL of the University of Amazonia, Colombia, with a tropical rain forest climate (Af). The behavior of Bos taurus, Bos indicus, and Caqueteño Creole cattle, the animals were observed in paddocks with three levels of scattered tree cover density. The pasture was composed of Braquiaria decumbenswith 35 days of regrowth. Direct observations were made from 9:00 a.m. to 5:00 p.m. with 10-minute intervals between the recording of the activities. The activity performed most often during the day by all of the animals was grazing under the sun, and those who pasture the most arethe Caqueteño Creole, followed by the Bos indicusand, finally, the Bos taurus. Ruminating was the second most important activity performed by the cattle, having presented the same tendency. In the paddocks with a low level of tree cover, the animals pasture more in the shade; this trend is more relevant among B. taurus cattle.Caqueteño Creole cattle dedicate less time to water consumption and rest, spending more time grazing, in the high and medium cover levels, they interrupt the grazing at noon for a shorter time compared to B. indicusand B. taurus; after 2 p.m., the creoles vertiginously increase grazing. At the high cover level, the peak of grazing of the Caqueteño Creoles is at 9 a.m. and from 1-1:30 p.m., while at the medium tree cover level, the peak of pasturing was at noon, 1:30 p.m., and 4:30 p.m., at the high tree level of cover, the peak for the three breeds was at 11 a.m. Only at the average tree level of cover did the Caquetaño creoles and B. indicuspresent a similar peak. In 9-9:30 a.m. and 4-5 p.m., the breeds substantially reduce rumination.(AU)

O estudo foi realizado no Centro de Pesquisa Amazônica CIMAZ -MACAGUAL da Universidade da Amazônia, Colômbia, com um clima de floresta tropical úmida (Af). O comportamento do gado Bos taurus, Bos indicuse Caqueteño crioulo, os animais foram observados em cercados com três níveis de densidade de cobertura arbórea dispersa. A pastagem era composta de Braquiaria decumbenscom 35 dias de recrescimento. Observações diretas foram feitas das 9h às 17h com intervalos de 10 minutos entre o registro das atividades.A atividade mais executada durante o dia por todos os animais era o pasto sob o sol, e aqueles que mais pastam são os Caqueteñocrioulo, seguido pelo Bos indicuse, finalmente, o Bos taurus. A ruminação foi a segunda atividade mais importante desempenhada pelo gado, tendo apresentado a mesma tendência. Nos cercados com um baixo nível de cobertura arbórea, os animais pastam mais à sombra; esta tendência é mais relevante entre o gado B. taurus.O gado crioulo Caqueteñodedica menos tempo ao consumo de água e descanso, passando mais tempo pastando, nos níveis de cobertura alta e média, interrompem o pastoreio ao meio-dia por um tempo mais curto em comparação com o B. indicuse B. taurus; depois das 14 horas, os crioulos aumentam vertiginosamente o pastoreio. No nível de cobertura alta, o pico de pastagem dos Caqueteñocrioulosé às 9h e das 13h30, enquanto no nível médio de cobertura de árvores, o pico de pastagem era ao meio-dia, 13h30 e 16h30, no nível alto de cobertura de árvores, o pico para as três raças era às 11h. Nas 9-9h30 e16-17h, as raças reduzem substancialmente a ruminação.(AU)

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Resumen Introducción: Las personas que laboran en investigación criminal se exponen a un alto riesgo de sufrir lesiones o fallecer durante operaciones contra el crimen organizado que pueden provocar condiciones que dificulten su identificación por métodos convencionales. La presente investigación fue realizada en las personas investigadoras del Organismo de Investigación Judicial para establecer la percepción de la utilidad de los registros dentales como método de identificación y elaborar un formato único de información odontológica antemortem. Materiales y métodos: Un cuestionario piloto fue diseñado y aplicado a 10 personas para ser calibrado y validado. Posteriormente se generó un cuestionario electrónico final en la plataforma Google Forms que fue enviado vía correo electrónico institucional a la totalidad de personas investigadoras constituida por 1200 individuos, de los cuales 807 respondieron en el período del 21 de junio al 20 de julio de 2021. Los resultados fueron analizados mediante las distribuciones de frecuencia, cruce de variables, comparación de medias con base en el análisis de variancia. El nivel mínimo de confianza para las comparaciones fue del 95%. Resultados: El cuestionario fue realizado por 807 personas, 79% hombres y 21% mujeres. La edad promedio fue de 37,8 años (IC95%: 37,3 - 38,48) sin que se encontrara diferencia estadísticamente significativa (p=0,419). El 80% labora en la Región Central del país, 78% indica que visitaron al odontólogo hace un año o menos y el 69% refiere que en algún momento les han tomado una radiografía panorámica, un 89% dice tener tratamientos dentales como coronas, puentes o implantes; y el 88% considera de gran utilidad los registros dentales como método de identificación, y lo ubican en tercer lugar de conocimiento (95,5%) al compararlo con ADN (99,6%) y dactiloscopia (98,7%). Conclusiones: Las personas investigadoras del Organismo de Investigación Judicial consideran que los registros odontológicos son útiles en la identificación de seres humanos y cuentan con información antemortem útil para dicho efecto.

Abstract Introduction: People who work in criminal investigations are exposed to a high risk of suffering injuries or dying during operations against organized crime that can cause conditions that make identification difficult by conventional methods. This research was carried out in the investigators of the Organismo de Investigación Judicial (Judicial Investigation Agency) to establish the perception of the usefulness of dental records as a method of identification and to elaborate a unique format of dental information antemortem. Materials and methods: A pilot questionnaire was designed and applied to 10 people to be calibrated and validated. Subsequently, a final electronic questionnaire was generated on the Google Forms platform that was sent via institutional email to all the investigators consisting of 1200 individuals, of which 807 responded in the period of the June 21 to July 20, 2021. The results were analyzed by frequency distributions, crossing of variables, comparison of means based on the analysis of variance. The minimum confidence level for comparisons was 95%. Results: The questionnaire was conducted by 807 people, 79% men and 21% women. The mean age was 37.8 years (95% CI: 37.3 - 38.48) with no statistically significant difference (p=0.419), 80% work in the Central Region of the country, 78% indicate that they visited the dentist a year or less ago and 69% report that at some point they have taken a panoramic X-ray, 89% say they have dental treatments such as crowns, bridges or implants; and 88% consider dental records as a method of identification very useful, and place it in third place in knowledge (95.5%) when compared with DNA (99.6%) and dactyloscopy (98.7%). Conclusions: The investigators of the Judicial Investigation Agency consider that dental records are useful in the identification of human beings and have useful antemortem information for this purpose.

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The study was conducted at the Amazon Research Center CIMAZ - MACAGUAL of the University of Amazonia, Colombia, with a tropical rain forest climate (Af). The behavior of Bos taurus, Bos indicus, and Caqueteño Creole cattle, the animals were observed in paddocks with three levels of scattered tree cover density. The pasture was composed of Braquiaria decumbens with 35 days of regrowth. Direct observations were made from 9:00 a.m. to 5:00 p.m. with 10-minute intervals between the recording of the activities. The activity performed most often during the day by all of the animals was grazing under the sun, and those who pasture the most are the Caqueteño Creole, followed by the Bos indicus and, finally, the Bos taurus. Ruminating was the second most important activity performed by the cattle, having presented the same tendency. In the paddocks with a low level of tree cover, the animals pasture more in the shade; this trend is more relevant among B. taurus cattle. Caqueteño Creole cattle dedicate less time to water consumption and rest, spending more time grazing, in the high and medium cover levels, they interrupt the grazing at noon for a shorter time compared to B. indicus and B. taurus; after 2 p.m., the creoles vertiginously increase grazing. At the high cover level, the peak of grazing of the Caqueteño Creoles is at 9 a.m. and from 1-1:30 p.m., while at the medium tree cover

O estudo foi realizado no Centro de Pesquisa Amazônica CIMAZ - MACAGUAL da Universidade da Amazônia, Colômbia, com um clima de floresta tropical úmida (Af). O comportamento do gado Bos taurus, Bos indicus e Caqueteño crioulo, os animais foram observados em cercados com três níveis de densidade de cobertura arbórea dispersa. A pastagem era composta de Braquiaria decumbens com 35 dias de recrescimento. Observações diretas foram feitas das 9h às 17h com intervalos de 10 minutos entre o registro das atividades. A atividade mais executada durante o dia por todos os animais era o pasto sob o sol, e aqueles que mais pastam são os Caqueteño crioulo, seguido pelo Bos indicus e, finalmente, o Bos taurus. A ruminação foi a segunda atividade mais importante desempenhada pelo gado, tendo apresentado a mesma tendência. Nos cercados com um baixo nível de cobertura arbórea, os animais pastam mais à sombra; esta tendência é mais relevante entre o gado B. taurus. O gado crioulo Caqueteño dedica menos tempo ao consumo de água e descanso, passando mais tempo pastando, nos níveis de cobertura alta e média, interrompem o pastoreio ao meio-dia por um tempo mais curto em comparação com o B. indicus e B. taurus; depois das 14 horas, os crioulos aumentam vertiginosamente o pastoreio. No nível de cobertura alta, o pico de pastagem dos Caqueteño crioulos é às 9h e das 13h30, enquanto no nível médio de cob

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Abstract The ingestion or aspiration of dental material or instruments is one of the most feared complications in clinical dental practice, it can occur in both children and adults. The mouth is a moist, dark, small area; where the involuntary movements of the patient during the procedures and the small dimensions of the materials and instruments turn dental care into a challenge. A swallowed or aspirated foreign body during dental treatment can result in serious complications and even death, these depend largely on the shape, size and anatomical pathway through which it passes. This article describes an uncommon complication of which there is only one report in the literature worldwide, the ingestion of the tip of a triple syringe during a routine dental procedure that was recovered by esophagogastroduodenoscopy. It also highlights the importance of knowing the protocols for handling aspirated or swallowed foreign bodies where a fast and adequate approach during the first minutes can make the difference between life and death.

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Resumen Introducción: En Costa Rica las demandas por mala práctica, mala praxis o responsabilidad profesional se encuentran tipificadas bajo el delito de lesiones culposas según el Código Penal de Costa Rica. Este estudio tiene como propósito describir las características de todas las demandas analizadas por la Unidad de Odontología Forense del Departamento de Medicina Legal en un período de seis años (2015-2020). Materiales y métodos: Se realizó una revisión detallada en la base de datos del Sistema de Medicina Legal (SIMEL) del Departamento de Medicina Legal del Organismo de Investigación Judicial de la totalidad de denuncias de "mal praxis" odontológica presentadas desde el 01 de enero de 2015 hasta el 31 de diciembre de 2020. La información recopilada fue tabulada en Excel e incluyó la clasificación por año, especialidad odontológica relacionada, sexo del denunciante y resultado del análisis pericial. Resultados: El análisis de los datos permitió determinar que de las 124 denuncias las disciplinas con mayores porcentajes fueron la cirugía oral y maxilofacial (39,52%), implantes dentales (16,94%) y ortodoncia (12,9%). Más de dos terceras partes (66,12%) de las denuncias corresponden a mujeres y dentro de los resultados de las pericias un 10% de los casos resultaron positivos, un 32% son negativos y un 58 % resultan no concluyentes. Conclusiones: El expediente odontológico completo es indispensable para lograr determinar un nexo de causalidad entre los hechos investigados y los resultados de un tratamiento; en Costa Rica los procedimientos invasivos generan mayor posibilidad de demandas, las mismas pueden ser evitadas mediante un adecuado manejo de los riesgos y complicaciones, comunicación adecuada paciente-tratante y manejo de las expectativas del tratamiento.

Abstract Introduction: In Costa Rica, dental malpractice lawsuits (professional liability) are classified under the crime of culpable injuries according to the Criminal Code of Costa Rica. The purpose of this study is to describe the characteristics of all the claims analyzed by the Forensic Dentistry Unit of the Department of Legal Medicine in a period of six years (2015-2020). Materials and methods: A detailed review was carried out in the database of the Legal Medicine System (SIMEL) of the Legal Medicine Department of the Organismo de Investigación Judicial (Judicial Investigation Agency) of all the complaints of dental "malpractice" filed since January 1, 2015 to December 31, 2020. The information collected was tabulated in Excel and classified by year, related dental discipline, sex of the complainant and the result of the expert analysis. Results: The data analysis determined a total of 124 complaints, the disciplines with the highest percentages were oral and maxillofacial surgery (39.52%), dental implants (16.94%) and orthodontics (12.9%). More than two thirds (66.12%) of the complaints correspond to women and within the results of the forensic report 10% of the cases were positive, 32% negative and 58% inconclusive. Conclusions: The complete dental record is essential to be able to determine a causal link between the investigated facts and the results of a treatment; in this study more than 50% of the files where incomplete, invasive procedures such as oral surgery generate a greater possibility of lawsuits that could be avoided through proper management of risks and complications, adequate patient-caregiver communication, and management of treatment expectations.

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Resumo O objetivo do estudo é verificar a percepção sobre cuidados paliativos, diretivas antecipadas de vontade e ordem de não reanimar de pacientes oncológicos e seus cuidadores, bem como a relação destes com os profissionais de saúde. Trata-se de pesquisa descritiva quantitativa, realizada entre 2018 e 2019 no Centro de Alta Complexidade em Oncologia de um hospital universitário brasileiro. A amostra contou com 200 participantes (100 pacientes oncológicos e 100 cuidadores informais). Os dados coletados foram armazenados no Microsoft Excel e processados pelo software SPSS. Foi possível observar o desconhecimento dos participantes sobre questões ligadas à terminalidade da vida, bem como o paradoxo entre discordância em relação à distanásia e concordância com a reanimação obstinada. Os resultados também atestam a importância dos profissionais de saúde na percepção dos cuidadores sobre a própria capacidade de exercer essa função.

Abstract The objective of this study is to verify the perception of palliative care, advance directives of will and do-not-resuscitate order of patients and their caregivers, as well as their relationship with health professionals. This is a quantitative descriptive research, carried out between 2018 and 2019 at the Center for High Complexity in Oncology of a Brazilian university hospital. The sample included 200 participants (100 cancer patients and 100 informal caregivers). The collected data were stored in Microsoft Excel and processed in the SPSS software. It was possible to observe the participants' lack of knowledge about issues related to the end of life, as well as the paradox of disagreeing with dysthanasia and agreeing with obstinate resuscitation. The results also attest to the importance of health professionals in the perception of caregivers about their own capacity to exercise this function.

Resumen Este estudio pretende comprobar la percepción sobre los cuidados paliativos, las directivas anticipadas de voluntad y el orden de no reanimar de los pacientes oncológicos y de sus cuidadores, así como su relación con los profesionales de la salud. Se trata de una investigación descriptiva cuantitativa, realizada entre el 2018 y el 2019 en el Centro de Alta Complejidad en Oncología de un hospital universitario brasileño. La muestra incluyó a 200 participantes (100 pacientes oncológicos y 100 cuidadores informales). Los datos recopilados se almacenaron en Microsoft Excel y se procesaron con el software SPSS. Se pudo observar la falta de conocimiento de los participantes sobre temas relacionados con la terminalidad de la vida, así como la incoherencia entre la desaprobación de la distanasia y la admisión de la reanimación obstinada. Los resultados también confirman la importancia de los profesionales de la salud en la percepción de los cuidadores sobre su propia capacidad para ejercer esta función.

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RESUMO: INTRODUÇÃO: A histerectomia é o segundo procedimento operatório mais frequente em mulheres na idade re-produtiva, sendo superada apenas pela cesariana. É um tratamento cirúrgico de remoção parcial ou total do útero, indicado para diversas doenças do arcabouço uterino. Trata-se de uma cirurgia irreversível, com alteração da inte-gridade corporal e com implicações na identidade sexual feminina. MATERIAL E MÉTODOS: A presente pesquisa se trata de um estudo descritivo, comparativo e transversal, realizado com base em dados secundários, coletados de laudos histológicos e prontuários médicos de mulheres submetidas à histerectomia total no Hospital Universitário Professor Alberto Antunes (HUPAA), Maceió-AL, na série histórica de 2009 a 2018, com o objetivo de descrever o per-fil clínico-epidemiológico das pacientes que passaram pela histerectomia, a fim de avaliar a tendência de indicações cirúrgicas adotadas. RESULTADOS: A faixa etária de 41-50 anos correspondeu a 43,8% das pacientes que passaram pela histerectomia. A leiomiomatose uterina, em conformidade com o que demonstra a literatura, representou 60,3% das indicações. Os sintomas relacionados a alterações menstruais foram os principais citados. A ultrassonografia pélvica, considerada padrão ouro para diagnóstico desses leiomiomas, foi o exame complementar mais utilizado. CONCLUSÃO: Os dados coletados, de maneira geral, entram em consonância com a literatura disponível. Contudo, ainda existem casos em que é preciso uma melhor investigação para a indicação correta da histerectomia. (AU)

ABSTRACT: INTRODUCTION: Hysterectomy is the second most common surgical procedure in women of reproductive age, surpassed only by cesarean section. It is a surgical treatment of partial or total removal of the uterus, indicated for several uterine framework diseases. It is an irreversible surgery, with changes in body integrity and implications for female sexual identity. MATERIAL AND METHODS: This research is a descriptive, comparative and cross-sectional study, based on secondary data, collected from histological reports and medical records of women undergoing total hysterectomy at the Hospital Universitário Professor Alberto Antunes (HUPAA), Maceió- AL, in the historical series from 2009 to 2018, to describe the clinical-epidemiological profile of patients who underwent a hysterectomy, to assess the trend of surgical indications adopted. RESULTS: The 41-50 year old age group corresponded to 43.8% of patients who underwent a hysterectomy. Uterine leiomyomatosis represented 60.3% of the indications. Symptoms related to menstrual changes were the main ones mentioned. A pelvic ultrasound, considered the gold standard for diagnosing these leiomyomas, was the most widely used complementary exam. CONCLUSION:The data collected, in general, are in line with the available literature. However, there are still cases in which a better investigation is needed for the correct indication of hysterectomy. (AU)

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OBJECTIVE: Yacon flour is rich in bioactive compounds (phenolic compounds and fructooligosaccharides (FOS)), and may therefore reduce the risk of diseases associated with excess body weight. However, its effect on fecal short chain fatty acids (SCFA), intestinal permeability, oxidative stress and inflammation markers has not been studied in adult humans with excess body weight. Thus, we evaluated the effect of the consumption of yacon flour on these variables. METHODS: Twenty-six excess body weight (30.4 ± 2.4 kg/m2) adults (31.3 ± 8.5y) were randomized to one of two groups (yacon flour or control; n = 13) on a double blind clinical trial. Subjects received a breakfast drink containing or not yacon flour (25g) associated with an energy restricted diet, for six weeks. The flour chemical characterization, FOS and total phenolics contents were evaluated. Antioxidant capacity was evaluated in vitro and in vivo (plasma). Intestinal permeability, fecal SCFA, oxidative stress and inflammatory markers also were evaluated in vivo. RESULTS: Yacon flour was well tolerated. It presented an in vitro and in vivo antioxidant capacity, increased plasma total antioxidant capacity (ΔYAC: 49.16 (-4.20; 156.63)) and reduced protein carbonyl concentrations (ΔYAC: -0.98 (-1.54; -0.42)). A reduction in SCFAs was observed in both groups (Δacetic: -3.16 (-5.07; -0.95) vs. -1.05 (-2.65; 1.11); Δpropionic: -1.05 (-2.60;-0.38) vs. -0.41 (-2.08; 0.09); Δbutyric -0.75 (-1.38; -0.04) vs. -0.28 (-0.98; 0.11), for YAC and CON, respectively). Other variables did not change. CONCLUSION: The yacon flour increased the plasma antioxidant capacity, decreased oxidative stress and SCFAs in adults with obesity or overweight.

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Resumen Introducción: Las profesiones de alto riesgo como bomberos, rescatistas, policía, paramédicos yaquellas donde existe alta exposición al peligrodurante rescates o intervenciones constituyen poblaciones que requieren adecuada información antemortem con fines de identificación. La presente investigación estableció la percepción de la utilidad de los registros dentales como método de identificación y la presencia de tratamientos dentales del personal de Bomberos de Costa Rica. Materiales y métodos: Se elaboró un cuestionario piloto y se envió a la Dirección General de Bomberos de Costa Rica donde se realizaron observaciones, posteriormente fue calibrado por la experta en estadística. Mediante la plataforma Google Docsfue enviado víacorreo electrónico institucional al personal operativo de Bomberos de Costa Rica. Los resultados fueron analizados mediante las distribuciones de frecuencia, cruce de variables, comparación de medias con base en el análisis de variancia. El nivel mínimo de confianza para las comparaciones fue del 95%. Resultados: El cuestionario fue enviado a un total de 2006 bomberos (personal permanentey voluntario), de los cuales 757 completaron el cuestionario. El 85%de los participantes considera que su profesión tiene un riesgo alto o muy alto, el método de identificaciónmás conocido es el ADN, seguido de la dactiloscopia y luego la identificación odontológica. El 66.7% de los participantes considera que la odontología es útil como método de identificación en bomberos, 58% indica que visitaron al odontólogo hace un año o menos; y 75% en los últimos dos años; no se encontró diferencia estadísticamente significativa por grupo de edad (p=0,400). Conclusiones: el personal de Bomberos de Costa Rica considera que los registros dentales son útiles en la identificación de seres humanos y acuden regularmente a consulta odontológica.

Abstract Introduction: High-risk professions such as firefighters, rescuers, police, paramedics, and those where there is high exposure to danger during rescues or interventions constitute populations that require adequate antemortem information for identification purposes. The present investigation established the perception of the usefulness of dental records as an identification method and the presence of dental treatments of the Costa Rican Fire Department personnel. Materials and methods: A pilot questionnaire was prepared and sent to the General Directorate of Firefighters of Costa Rica where observations were made, later it was calibrated by the statistical expert. Through the Google Docs platform, it was sent via institutional email to the operational personnel of the Costa Rican Fire Department. The results were analyzed through the frequency distributions, crossing of variables, comparison of means based on the analysis of variance. The minimum level of confidence for the comparisons was 95%. Results: The questionnaire was sent to a total of 2006 firefighters (permanent and voluntary personnel), of which 757 completed the questionnaire. 85% of the participants consider that their profession has a high or very high risk, the best-known identification method is DNA, followed by fingerprints and then dental identification. 66.7% of the participants consider that dentistry is useful as an identification method in firefighters, 58% indicate that they visited the dentist a year ago or less; and 75% in the last two years; no statistically significant difference was found by age group (p = 0.400). Conclusions: The Costa Rican Fire Department personnel consider that dental records are useful in the identification of human beings and they regularly attend dental appointments that include dental x-rays.

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Resumen La odontología forense representa una de las disciplinas más útilesen la identificación de seres humanos, los dientes también puedenbrindar entre otras características la edad aproximada de una persona. A lo largo de la historia se han desarrollado diferentes métodos de estimación de edad dentro de los cuáles el método de Lamendin(translucidez radicular) resulta sencillo y bastante precisosin la necesidad de equipo especializado para su realización. Como cualquier método diagnóstico presenta limitaciones, puede ser utilizado en adultos después de los 20 años en dientes unirradiculares sin caries, presentando mayor fiabilidad y precisión, cuando el rango de edad se mantiene entre 40 y 70 años. Sin embargo, el mismo no toma en consideración el sexo, ni la raza, por lo que esto puede representar una limitación considerable; aunado a lo anterior en Costa Rica hasta hoy no existen estudios que permitan corroborar la efectividad del método Lamendin en la población.

Abstract Forensic dentistry represents one of the most useful disciplines in the identification of human beings, teeth can also provide, among other characteristics, the approximate age of a person. Throughout history, different age estimation methods have been developed, among which the Lamendin method (root translucency) is simple and quite accurate without the need for specialized equipment to perform it.As any diagnostic method has limitations, it can be used in adults after the age of 20 in single-rooted teeth without caries, presenting greater reliability and precision, when the age range remains between 40 and 70 years. However, it does not take gender or race into consideration, so this can represent a considerable limitation; In addition to the above, in Costa Rica, to date, there are no studies that allow corroborating the effectiveness of the Lamendin method in the population.

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Resumen El presente estudio tuvo como objetivo establecer los patrones morfológicos presentes en las rugosidades palatinas de una población costarricense mediante el método de Trobo y efectuar un análisis estadístico con las variables de sexo, edad y afinidad biológica. Se eligiron al azar 70 pacientes a los que se realizaron impresiones y modelos dentales superiores, se documentó el sexo, edad y afinidad biológica de cada uno, junto con el consentimiento informado. Se analizó estadísticamente la distribución de patrones de género, edad y afinidad biológica. Las técnicas para el análisis de la información fueron las distribuciones de frecuencia, cruce de variables, comparación de medias con base en el análisis de variancia, coeficiente de correlación de Spearman; pruebas de Chi cuadrado, para evaluar la independencia entre las características de edad y sexo. Estas pruebas señalan un predominio de tipos de rugas palatinas rectas y de tipo simples tanto en la población masculina como femenina, sin encontrarse variación en el número de rugas asociadas a sexo o afinidad biológica; pero sí se determinó diferencia por grupo de edad, disminuyen en número conforme se incrementa la edad. Por otra parte no se presentó dimorfismo por sexo, lateralidad ni posición.

Abstract The present study aimed to establish the morphological patterns present in the palatal rugae in a Costa Rican population by means of the Trobo method and to carry out a statistical analysis with the variables of sex, age and biological affinity. Seventy patients were randomly chosen to whom impressions and superior dental models were made, the sex, age and biological affinity of each one was documented, together with the informed consent. The distribution of gender, age and biological affinity patterns was statistically analyzed. The techniques for the analysis of the information were the frequency distributions, crossing of variables, comparison of means based on the analysis of variance, Spearman's correlation coefficient; Chi square tests, to evaluate the independence between the characteristics of age and sex. These tests indicate a predominance of straight and simple types of palatal rugae in both the male and female population, with no variation in the number of rugae associated with sex or biological affinity; but a difference was determined by age group, they decrease in number as age increases. On the other hand, there was no dimorphism due to sex, laterality or position.

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ABSTRACT Objectives Yacon flour is rich in bioactive compounds (phenolic compounds and fructooligosaccharides (FOS)), and may therefore reduce the risk of diseases associated with excess body weight. However, its effect on fecal short chain fatty acids (SCFA), intestinal permeability, oxidative stress and inflammation markers has not been studied in adult humans with excess body weight. Thus, we evaluated the effect of the consumption of yacon flour on these variables. Materials and methods Twenty-six excess body weight (30.4 ± 2.4 kg/m2) adults (31.3 ± 8.5y) were randomized to one of two groups (yacon flour or control; n = 13) on a double blind clinical trial. Subjects received a breakfast drink containing or not yacon flour (25g) associated with an energy restricted diet, for six weeks. The flour chemical characterization, FOS and total phenolics contents were evaluated. Antioxidant capacity was evaluated in vitro and in vivo (plasma). Intestinal permeability, fecal SCFA, oxidative stress and inflammatory markers also were evaluated in vivo. Results Yacon flour was well tolerated. It presented an in vitro and in vivo antioxidant capacity, increased plasma total antioxidant capacity (ΔYAC: 49.16 (-4.20; 156.63)) and reduced protein carbonyl concentrations (ΔYAC: -0.98 (-1.54; -0.42)). A reduction in SCFAs was observed in both groups (Δacetic: -3.16 (-5.07; -0.95) vs. -1.05 (-2.65; 1.11); Δpropionic: -1.05 (-2.60;-0.38) vs. -0.41 (-2.08; 0.09); Δbutyric: -0.75 (-1.38; -0.04) vs. -0.28 (-0.98; 0.11), for YAC and CON, respectively). Other variables did not change. Conclusion The yacon flour increased the plasma antioxidant capacity, decreased oxidative stress and SCFAs in adults with obesity or overweight.

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Resumen Introducción: El objetivo de la investigación fue evaluar la satisfacción de los usuarios con la atención recibida en la Unidad de Odontología Forense del Departamento de Medicina Legal del Organismo de Investigación Judicial en cuanto a infraestructura, trato recibido y tiempo, durante el segundo semestre del 2018, para la formulación de recomendaciones que contribuyeran con la calidad de los servicios. Materiales y métodos: Mediante un cuestionario se evaluaron las variables: tiempo de atención, trato recibido e infraestructura y se solicitaron datos sociodemográficos de forma anónima en una muestra de 57 personas; el análisis de los datos se efectúo mediante coeficientes de variación, promedios y cruces de variables mediante una base de datos en Excel que fue procesada con SPSS 22. Resultados: El promedio de satisfacción general es de un 1,46% muy insatisfecho, un 0,33% insatisfecho, un 4.02% satisfecho y en la categoría muy satisfecho el valor promedio de la satisfacción total es del 94,19%. El 36% de la muestra corresponde a mujeres y 64% a hombres; el promedio de edad es de 37,2 años, la secundaria es el nivel educativo predominante (44%). El motivo de valoración principal en ambos sexos es la violencia común. La mayoría de los evaluados proviene de la región central y tardan menos de una hora en trasladarse a valoración. (50,9%). Conclusiones: En términos generales, la infraestructura es muy satisfactoria, al igual que el trato recibido; la variable tiempo influye en la disminución del promedio de satisfacción principalmente porque el horario y disponibilidad para la asignación de las citas no satisface a todos los usuarios específicamente a los provenientes de Guanacaste, Puntarenas y Limón que tardan tres horas o más en trasladarse hasta la Ciudad Judicial.

Abstract Introduction: The objective of the investigation was to evaluate the user´s satisfaction with the attention received in the Forensic Dentistry Unit of the Department of Legal Medicine of the Judicial Investigation Agency regarding infrastructure, treatment received and time, during the second semester of 2018, for the formulation of recommendations that will contribute to improve the quality of services. Materials and methods: A direct questionnaire was carried out in which the variables were evaluated: attention time, treatment received and infrastructure; sociodemographic data was requested anonymously in a sample of 57 individuals; the data analysis was carried out by means of variation coefficients, averages and crossings of variables; through a Excel database processed with SPSS 22. Results: The average percentage of overall satisfaction is 1.46% very dissatisfied, 0.33% dissatisfied, 4.02% satisfied and in the very satisfied category the average value of total satisfaction is 94.19%. The 36% corresponds to women and 64% to men; average age is 37.2, high school level was the predominant educational level (44%). The reason for the assessment presented by the highest percentage, in both sexes is common violence. The majority of the individuals come from the central region; the predominant period of displacement is less than one hour (50.9% of respondents). Conclusions: In general terms, the infrastructure is very satisfactory, as is the treatment received, the time variable influences the decrease in the average satisfaction mainly because the time and availability for the appointment assignment does not satisfy all users, specifically those from Guanacaste, Puntarenas and Limón that take three hours or more to travel to the Ciudad Judicial.

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