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Massive rotator cuff injuries (LMMRs) are those breaks of more than 5 cm either the anteroposterior plane, or lateromedial plane. Some authors consider them to be complete ruptures of at least two rotator cuff tendons. The clinical case of a 63-year-old man with this type of injury that was resolved by the superior capsule reconstruction technique is presented, technical details and some of the literature review to carry out the procedure are shown.

Las lesiones masivas del manguito rotador (LMMR) son aquellas roturas de más de 5 cm ya sea el plano anteroposterior o lateromedial. Algunos autores las consideran como roturas completas de al menos dos tendones del maguito rotador. Se presenta el caso clínico de un varón de 63 años con este tipo de lesión que se resolvió mediante la técnica de reconstrucción de cápsula superior, se muestran detalles técnicos y un poco de la revisión de la literatura para llevar a cabo el procedimiento.

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RESUMEN: El correcto sellado apical es un paso importante durante el tratamiento de conductos, para esto, se utilizan puntas de gutapercha y cemento sellador, de este último existen diversas formulaciones químicas en el mercado, por lo cual es importante tomar en cuenta los efectos que estas pueden tener en el proceso de cicatrización periapical. El propósito de este estudio fue evaluar la biocompatibilidad de cuatro cementos selladores con diferente composición química con osteoblastos humanos. Se prepararon extractos de cementos selladores a con dos concentraciones (10 mg/mL y 40 mg/mL) y dos tiempos de exposición (10 min y 8 h), estos fueron colocados en contacto con osteoblastos humanos para evaluar la proliferación y citotoxicidad a 24, 72 y 96 h con sus respectivos controles y blancos. Se realizó un análisis estadístico con ANOVA de un factor y la prueba de comparaciones múltiple de Bonferroni. Los resultados obtenidos, tanto en el ensayo de citotoxicidad como en el de proliferación, indicaron que el cemento a base de resina no es biocompatible con osteoblastos. El cemento a base de poli-dimetilxilosano fue el único que no mostró citotoxicidad a ningún de tiempo de exposición y concentración examinadas en este estudio.

ABSTRACT: Correct apical sealing is an important step during root canal treatment, hence, gutta-percha points and sealant are used. There are several chemical compositions on the market, so it is important to evaluate the effects of these in the periapical healing process. The aim of this study was to evaluate the biocompatibility of four sealer cements with different chemical composition placed in contact with human osteoblast. Different extracts were prepared at two concentrations (10 mg/mL and 40 mg/mL) and two exposure times (10 min and 8 h) these were placed in contact with human osteoblast to evaluate cytotoxicity and proliferation at 24, 48 and 72 h with their respective controls and blanks. A statistical analysis was performed with ANOVA of one factor and Bonferroni post hoc. Results obtained in cytotoxicity and proliferation assays, indicated that the resinbased cement is not biocompatible with osteoblast. The poly-dimethylxilosanbased cement was the only that did not show cytotoxicity at any time of exposure and concentration examined in this study.

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RESUMEN Los tiempos modernos nos obligan a que la formación de un médico cirujano no se base sólo en conocimientos teóricos, sino que adquiera las mayores habilidades quirúrgicas para así evitar riesgos innecesarios en una sociedad altamente exigente. La disección y el entrenamiento de los procedimientos quirúrgicos juegan un papel primordial para cumplir este objetivo, por lo que recientemente se ha promovido una forma de preservación cadavérica que permite realizar mediante situaciones bastantes realistas dichos adiestramientos. Se realizó una búsqueda bibliográfica electrónica, restringida al idioma inglés en Pubmed, Scopus y WOS donde se pretende describir y analizar las aplicaciones de esta técnica. La revisión ofreció artículos de relevancia que demuestran la aplicación de esta técnica novedosa en la preservación de cadáveres y sus posibles aplicaciones en el campo de otorrinolaringología.

ABSTRACT Nowadays, it is not possible to train a healthcare professional only based on theoretical knowledge, but acquiring the highest surgical skills to avoid unnecessary risks in a highly demanding society, therefore dissection and training of surgical procedures play a key role in fulfilling this objective, which is why a form of cadaveric preservation has recently been promoted, which allows realizing such training through realistic situations. An electronic literature search was carried out, restricted to the English language in MEDLINE, where it is intended to describe and analyze the applications of this technique. The review offered articles of relevance that demonstrate the application of this novel technique in the preservation of corpses and their possible applications in the field of otorhinolaryngology.

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INTRODUCCIÓN: El pH es una propiedad básica del agua potable y cuyos valores extremos pueden originar reacciones secundarias dañinas, entendiéndose por agua potable aquel que puede ser consumido sin restricción para el consumo humano, OBJETIVO: Determinar el valor del pH de agua potable que consumen los estudiantes de segundo año de la carrera de medicina de la Universidad Mayor de San Andrés (UMSA). MATERIAL Y MÉTODOS: Se analizaron 388 muestras de agua potable del domicilio de estudiantes regulares de segundo año cátedra de bioquímica entre los meses de julio y agosto del 2017, realizándose un estudio de tipo descriptivo con un enfoque transeccional. RESULTADOS: Se obtuvieron los siguientes resultados, 1) la media del pH total fue de 7,24; con x=7,22 en la ciudad de la Paz y x=7,28 en la ciudad de el Alto. 2) en cuanto al sistema de potabilización se obtuvo: x=7,34 en la planta el Alto, x=7,21 en la planta de Tilata, x=7,15 en la planta de Achachicala y de x=7,20 en la planta de Pampahasi. CONCLUSIONES: El pH del agua potable consumida se encontró dentro de parámetros establecidos con un valor medio de 7,24.

INTRODUCTION: The pH is a basic property of potable water and whose extreme values may cause harmful secondary reactions. It is understood that potable water can be consumed without any restriction by human beings. OBJECTIVE: To determine the pH value of potable water consumed by medicine students of second year at UMSA university. MATERIAL AND METHODS: 388 samples of potable water were analyzed which were taken from the homes of the second year students of the biochemistry department between July and August 2017, developing a descriptive study with a cross-sectional approach. RESULTS: The following results were obtained: 1) the average of the pH was 7.24; with x = 7.22 in La Paz city and x = 7.29 in El Alto city. 2) in relation to the drinking water was obtained: x=7.34 in El Alto plant, x=7.21 in Tilata plant, x=7.16 in Achachicala plant and x=7.21 in Pampahasi plant. CONCLUSION: The pH of the drinking water drunk is established within parameters with an average value of 7.24.

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This study aim to determine the proportion of traffic rule infractions in Cali, Colombia, in places where a road traffic injury (RTI) occurred. Description of videotaping of sites where a person was injured in an RTI in 2009. Counts of road users and infractions were established for each road user group and were compared using a Z-test. They were found 13,491 users, distributed as follow: 8.9% were pedestrians, 4.6% cyclists, 24.6% motorcyclists, and 61.8% were automobile drivers. The most frequent traffic violation among motorcyclists was transiting on lines designated for other vehicles (55.2%). Among cyclists, the most frequent violations were transiting without a helmet (99.2%) and not wearing the designated vest (100%). Among pedestrians, crossing streets at prohibited places (77.3%), even at sites where a pedestrian bridge was present (72.7%), represented two common violations. Vulnerable road users committed more traffic infractions than automobile drivers (p < 0.001). High rates of traffic rule infractions among vulnerable road users were observed. Studies to better understand the occurrence of these behaviours and the promotion of effective interventions are warranted.

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Measurements of ultraviolet erythemal radiation (UVER) made during two years at three sites located at altitudes over 1000ma.s.l. in Northwestern Argentina (Salta, San Carlos, and El Rosal) have been used to estimate and analyze the UV Index (UVI) and the cumulative doses at these locations. For the UVER irradiance, data of January (maximum values) and June (minimum values) have been analyzed as representative of the year for all locations. The UVI reaches extreme (>11) values in >20% of the analyzed days in Salta (1190ma.s.l.), while these are reached in San Carlos (1611ma.s.l.) and El Rosal (3355ma.s.l.) in >40% of the analyzed days. Finally, the cumulative doses over an average year have also been studied for each location. The doses received during austral summer and autumn are of the same order, and represent one third of the annual dose, while the doses received during austral winter and spring represent one sixth of the annual dose approximately.

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Background: Bleeding in pregnancy, childbirth or postpartum period is an emergency. Selective internal iliac (hypogastric) arteries ligation is a surgical therapy in selected cases of obstetric massive hemorrhage. It had proven to be safe. Objetive: To evaluate the risk for re-intervention for post-operatory bleeding in patients with obstetric hysterectomy and selective hypogastric arteries ligation. Material and method: Cross-sectional study including women diagnosed with obstetric hysterectomy with and without selective arterial ligation as a factor to assess the risk of re-intervention, from December 2013 to December 2014, at High Specialty Medical Unit 23 of Gynaecology and Obstetrics, in Monterrey, which is a tertiary care medical center. Those patients with 28 weeks of gestation or more were selected. The postoperative blood loss was quantified by open drainage system (Penrose). Results: We performed 88 hysterectomies in the study period. We included 45 women according to selection criteria. The average was 31.9 ± 5.48 years old. Performing a selective hypogastric arteries ligation may be a protective factor (p<0.05) for re-intervention as a consequence of postoperative bleeding. Conclusion: Selective arterial ligation is a factor that could help to prevent a re-intervention. A continuous training of physicians and residents of Gynecology and Obstetrics is essential to ensure the reduction in morbidity and maternal mortality.

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BACKGROUND/OBJECTIVE: The aim of this study was to assess the validity of body fatness estimations based on skinfolds and bioelectrical iImpedance analyses (BIA) measurements compared to a three-component model (3C model) in prepubertal Chilean children, considering potential differences by sex and nutritional status. SUBJECTS/METHODS: Four hundred and twenty four Chilean children (198 females and 226 males) were assessed for body composition. Body fat percentage (BF%) was evaluated by Skinfold equations (Slaughter, Ramirez and Huang) and Bioelectrical impedance (BIA: Tanita BC-418MA) using both the equipment and the Ramirez equation. Measurements based on a 3C model constructed from total body water estimates by isotope dilution and from body volume estimates by air displacement plethysmography were used as gold standard. RESULTS: Coefficient of determination (R2) values were higher in overweight and in the whole group of both gender. All slopes were differed significantly from 1, and most intercepts were significantly different from 0. Skinfold Equations: an underestimation of BF% was found for all equations, being higher with the Slaughter equation. BIA: Tanita underestimated BF% in all groups, whereas Ramirez equation shows an overestimation. CONCLUSIONS: Skinfolds and bio-impedance equations serve well to rank children according to their BF%. However, these methods are not accurate for describing body composition in prepubertal Chilean children.

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Objetivo: Evaluar la composición química, la toxicidad aguda y los efectos antiulceroso y antitumoral de tres extractos de Capsicum pubescens (ROCOTO) en estudios preclínicos. Materiales y métodos: Estudio experimental preclínico, analítico. Utilizamos 50 ratas albinas machos para evaluar el efecto antiulceroso y 86 ratones albinos para evaluar el efecto antitumoral y la toxicidad aguda. El tamizado fitoquímico se realizó con el método de Ciulei. Para producir las úlceras gástricas usamos Indometacina como agente ulcerígeno. El efecto antitumoral de Capsicum pubescens, fue evaluado frente al sarcoma-180. La toxicidad aguda (DL-50) fue evaluada con dosis de 500, 1000, 2000, 10000 y 12000 mg/kg de peso de rocoto. Resultados: En el estudio fitoquímico, detectamos grasas, aceites, alcaloides, lactonas, coumarinas, triterpenos, esteroides, catequinas, resinas, azúcares reductores, fenoles y taninos, entre otros. Apreciamos reducción de las lesiones gástricas macroscópicas producidas por indometacina con los extractos acuoso y etanólico de rocoto, superiores a los de la ranitidina. No observamos mortalidad en los ratones hasta la dosis de 12,000 mg/kg de peso, del extracto metanólico de rocoto. El extracto metanólico de rocoto, mejoró la sobrevida de los ratones inoculados con sarcoma, cuando se administró preventivamente, siendo mayor el efecto a la dosis de 750 mg/kg. Conclusiones: Los extractos acuoso y etanólico de rocoto, presentaron propiedades gastroprotectoras, dosis dependiente, superiores a Ranitidina, y el extracto metanólico presentó efecto antitumoral frente al sarcoma-180, administrado preventivamente y es, prácticamente, atóxico según los criterios de Williams.

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BACKGROUND/OBJECTIVES: Obesity and undernutrition co-exist in many regions of Mexico. However, accurate assessments are difficult because epidemiological data on body composition are not available. The aim of this study was to facilitate assessments of body composition in Mexican school children of different geographical regions and ethnicity by developing equations for bioelectrical impedance and anthropometry based on deuterium oxide dilution. SUBJECTS/METHODS: We evaluated 336 subjects (143 belonged to six major indigenous groups) from Northern, Central and Southern Mexico. We measured height (Ht), weight (Wt), tricipital skinfold (Tricp-SKF) and resistance (R) based on a bioimpedance analysis (BIA). Fat-free mass (FFM) and fat mass (FM) were estimated from measurements of total body water with the deuterium dilution technique. RESULTS: The final BIA equation was FFM (kg)=0.661 × Ht²/R+0.200 × Wt-0.320. The R² was 0.96; the square root of the mean square error (SRMSE) was 1.39 kg. The final anthropometric equation was FM (kg)=-1.067 × sex+0.458 × Tricp-SKF+0.263 × Wt-5.407. The R² was 0.91; SRMSE was 1.60 kg. The BIA equation had a bias of 0.095 kg and precision of 1.43 kg. The anthropometric equation had a bias of 0.047 kg and precision of 1.58 kg. CONCLUSIONS: We validated two equations for evaluating body composition in Mexican indigenous and non-indigenous children and youth from three main regions of the country. These equations provided reliable estimates and will promote a better understanding of both obesity and undernutrition.

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Mexico City children are chronically exposed to significant concentrations of air pollutants and exhibit chronic respiratory-tract inflammation. Epidemiological, controlled human exposures, laboratory-based animal models, and in vitro/in vivo studies have shown that inflammatory, endothelial dysfunction, and endothelial damage mediators are upregulated upon exposure to particulate matter (PM). Endothelial dysfunction is a critical event in cardiovascular disease. The focus of this work was to investigate whether exposure to ambient air pollution including PM(2.5) produces systemic inflammation and endothelial injury in healthy children. We measured markers of endothelial activation, and inflammatory mediators in 52 children age 8.6+/-0.1 yr, residents of Mexico City (n: 28) or of Polotitlán (n: 24), a city with low levels of pollutants. Mexico City children had significant increases in inflammatory mediators and vasoconstrictors, including tumor necrosis factor (TNF)alpha, prostaglandin (PG) E2, C-reactive protein, interleukin-1beta, and endothelin-1. There was a significant anti-inflammatory response, and a downregulation of vascular adhesion molecule-1, intercellular adhesion molecule-1 and -2, and selectins sE and sL. Results from linear regression found TNF a positively associated with 24- and 48-h cumulative levels of PM(2.5), while the 7-d PM(2.5) value was negatively associated with the numbers of white blood cells in peripheral blood in highly exposed children. Systemic subclinical inflammation, increased endothelin- 1, and significant downregulation of soluble adhesion molecules are seen in Mexico City children. Children chronically exposed to fine PM above the standard could be at risk of developing cardiovascular diseases, atherosclerosis, stroke, and other systemic effects later in life.

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We examined the influence of the reproductive cycle and environmental factors on variations of the condition index (CI), tissue dry mass, shell size, total lipid content, and relative percent of fatty acids in the mussel, Perna perna. Spat or juveniles were reared to commercial size (70 mm) in suspension culture in the Golfo de Cariaco, Venezuela between May and October 2004. The dry mass of soft tissues and shell, a visual assessment of gonadal status and the organism lipid profile were established every fortnight. In parallel, we measured the environmental conditions, following chlorophyll a, salinity, temperature and seston levels. After an initial decrease, the CI rose and remained high until August after which it decreased continuously until October. Total lipid values also decreased initially, after which they showed two periods of rapid recuperation and depletion, the first between May and August and the second between August and October. Similar tendencies were noted in the fatty acids, C18:3n-3, C18:4n-3 and C22:6n-3. Correlation analysis found no significant relationships between environmental parameters and the variations in total lipids. However, significant correlations were noted between fatty acids and specific environmental parameters. In particular, temperature was inversely correlated with C14:0, C16:1n-7, C18:0, C18:1n-9 and 20:5n-3. Chlorophyll a was positively correlated with C14:0, C16:1n-7, C18:1n-7, C18:4n-3 and 20:4n-6. On the other hand, gametogenesis had an effect on C14:0, C16:1n-7, C18:1n-9 and C18:1n-7, while spawned and gonadal regression states had an effect on fatty acid 20:4n-6. Temperature and chlorophyll a levels strongly influenced the proportion of mussels spawning, suggesting that their influence upon lipid composition may be secondary to their impact upon reproduction. Despite the thermal stability of this tropical system, the lipid composition of mussels changed markedly during the study, reflecting the central role of diet and reproductive investment upon lipid composition.

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Zinc (Zn) deficiency and obesity can be observed together in some developing countries. Zn deficiency may enhance fat deposition and decrease lean mass accrual, which in turn, appears to influence physical activity (PA), although this has not yet been evaluated in obese children. The objective of the study was to find out the association between measurements of plasma Zn and serum leptin, body composition, and PA in Chilean obese preschool children. Seventy-two 18- to 36-month-old obese children [weight-for-length/height z score (WHZ) > 2.0 SD], belonging to low socioeconomic communities, participated in the study. Plasma Zn, serum leptin, weight, waist circumference, height, total body water (TBW) assessed by deuterium isotopic dilution technique and daily activity, measured by registering 48 h with an accelerometer, were evaluated. We found 82% of children with WHZ > 3 SD. The geometric mean Zn intake was 6.2 +/- 2.5 mg/day. The mean plasma Zn was 91.8 +/- 11.4 microg/dL, with 10% of the children having levels <80 microg/dL. No correlation was found between plasma Zn concentrations and either weight, WHZ, or waist circumference. Serum leptin was lower in males than in females (2.9 +/- 2.8 vs 6.8 +/- 5.0 ng/mL, respectively; p < 0.001). TBW was different between males and females (56.2 +/- 5.4 vs 52.8 +/- 4.3% body weight, respectively; p = 0.004), but no significant association was found between TBW and plasma Zn. Moderate + intense PA, (as percentage of wake time), was greater in males than in females (6.3 +/- 3.1% vs 3.4 +/- 2.3%, respectively; p < 0.001), but it was not significantly correlated to plasma Zn. In conclusion, plasma Zn was not associated with body composition as assessed by TBW, serum leptin, or with the magnitude of physical activity in Chilean overweight preschool children.

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Several psychosocial and behavioral problems have been reported in liver transplanted children. Most publications have focused on them, without considering their family environment. The aim of this study was to evaluate the interaction between liver transplanted children and their families, compared with a healthy control group. We selected liver transplanted children, between 8 and 12 years of age, with at least 6 months follow-up posttransplantation and in good clinical condition. Family structure also included 1 to 3 other children. Evaluable patients must have been living with their parents throughout the whole posttransplantation period. They were compared with a similar group of children without any chronic disease. A written informed consent was signed by both parents. All families were evaluated using a standard test consisting of different situations. The information was evaluated by 3 independent experts. Factors evaluated were limits (rules and limits of behavior), alliance-opposition (interaction between members to act), and hierarchy. Scoring was given to all observed acts. Statistical analysis was performed using chi-square tests with P < .05 considered significant. No statistical differences were found between groups in limits, alliance, and hierarchy. Our results showed that there were no differences in family structure and behavior between families of liver-transplanted and healthy children belonging to a similar socioeconomic level.

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Malaria is one of the most important parasitic diseases in the world and a major public health problem because of emerging drug-resistant strains of Plasmodium. A number of synthetic and natural compounds are now being analysed to develop more effective antimalarial drugs. We investigated the effect of homeopathic preparations of Eupatorium perfoliatum and Arsenicum album on parasitemia using a rodent malaria model. We found significant inhibitory effect on parasite multiplication with both medications with a level of 60% for Eupatorium perfoliatum at a 30 CH potency. Arsenicum album 0/6 gave 70% inhibition but this was less stable than Eupatorium perfoliatum. The number of schizonts was higher in animals treated with homeopathic medications. Although the mechanism of action is unknown, these agents would be good candidates as alternative or complementary medications in the treatment of malaria.

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OBJECTIVE: To evaluate energy balance and physical activity in obese preschool children attending day-care centres. DESIGN: Cross-sectional study. SUBJECTS: Twenty-four 3-5 years old obese children selected at random from four different day-care centres in Santiago City, Chile. Total energy expenditure (TEE) was measured by doubly labelled water and physical activity as recorded by TRITRAC R3D motion sensor. Energy intake was assessed by measuring food intake while at the centre, along with the recording of additional food intake in the home. RESULTS: Obese children had a 5.4% higher weighed energy intake than their energy requirements 2001. Energy intake during the week was 7716+/-1092 kJ/day and 7401+/-1023 kJ/day in boys and girls, respectively. Minimal activity was higher in the day-care centres (62%) compared to 52% during the weekend at home. Light activity was higher during the weekend at home than during the week (25 versus 20%), but moderate-intense activity was similar (3-5%). CONCLUSIONS: Reduction in dietary energy provided at the day-care centres helps to balance energy requirements during the week. Obese children had marked sedentary characteristics with regards to physical activity, although children are more active at home in weekends. This situation suggests that educators and parents need to improve children's physical activity levels and nutrition habits.

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OBJECTIVE: The objective of this study was to assess total energy expenditure (TEE), resting metabolic rate (RMR) and physical activity level (PAL), and to estimate energy requirements (ERs) in free-living elderly subjects from Cuba, Chile and Mexico. DESIGN: Cross-sectional study designed to estimate ERs. SETTING: Rural regions of Cuba, Chile and Mexico. SUBJECTS: Forty subjects >60 years old were selected to participate in this study. INTERVENTIONS: A dose of doubly labeled water (DLW) was administered and urine samples were collected in the following 12-14 days. From the isotopic analysis, TEE was derived. RMR was measured by indirect calorimetry. RESULTS: TEE in Chilean (8.8+/-1.6 MJ/day) and Cuban (8.3+/-1.3 MJ/day) elderly was not different, and was higher for the Mexican group (9.5+/-1.5 MJ/day) (P < 0.0001). RMR was not different between countries. PAL and activity energy expenditure (AEE) were only different between Chile and Mexico (P < 0.002). For the three regions, overall PALs were 1.70+/-0.16 for male and 1.62+/-0.13 for female subjects (P < 0.02), and AEE was 3.05+/-0.66 and 2.27+/-0.66 MJ/day for male and female subjects, respectively (P < 0.001). Predictive equations (MJ/day) were RMR = 1.6447 + 0.05714 x weight (kg) + 0.449 sex (male = 1; female = 0) (R2 = 0.75; SEE = 0.479) and TEE = 3.414 + 0.0795 x weight (kg) + 1.227 x sex (male = 1; female = 0) (R2 = 0.75; SEE = 0.668). CONCLUSIONS: There were differences in TEE and PAL owing to sex and region. The average PAL in men was higher than the PAL reported either with factorial approach or with the DLW method in elderly. Predictive ER equations based on RMR and TEE gave very similar results to calculations from the 2004 FAO/WHO/UNU report.

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