Odontogenic keratocysts tumor with iliac crest graft

El tumor odontogénico queratoquístico es un tumor intraóseo benigno uni o multiquístico caracterizado por la presencia de un epitelio escamoso estratificado paraqueratinizado, que tiene un potencial agresivo y un comportamiento infiltrativo. Su importancia se basa en su alta tasa de recurrencia. Se reporta un caso clínico de un paciente masculino de 46 años, asintomático, con aumento de volumen facial del lado derecho. Luego de los exámenes clínico, histopatológico y radiográfico se diagnosticó: Tumor Odontogénico Queratoquístico. Se realizó tratamiento quirúrgico obteniendo resultados satisfactorios.The odontogenic keratocysts tumor is a benign intraosseous uni- or multicystic tumor, characterized by the presence of stratified squamous parakeratinized epithelium, with a aggressive potential and infiltrative behavior. Its importance lies in its high rate of recurrence. We report a case of a male patient of 46 years, asymptomatic, with a volume augmentation of the right side of the face. After the clinical, histopathological and radiographic examination, it was diagnosed as Odontogenic Keratocysts Tumor. Surgical treatment was performed with satisfactory results

Effects Of Confinement on The Emotional Stress of High School Teachers: An Exploratory Approach

El estrés emocional, también conocido como síndrome de Burnout, puede surgir como resultado del confinamiento por desastres o tragedias, especialmente en contextos virtuales. El estudio se enfoca en medir el estrés laboral en docentes de educación media superior, específicamente en el CETis No. 70, que enfrentaron la modalidad en línea debido a la pandemia del COVID-19. Métodos: Se aplicó el cuestionario Maslach Burnout Inventory, evaluando tres dimensiones: agotamiento emocional, despersonalización y realización personal, con 22 ítems. Resultados: Los docentes mostraron altos niveles de realización personal (65%) y agotamiento emocional (56%), pero bajos niveles de despersonalización (5%). Conclusiones: Los altos niveles de agotamiento emocional reflejan la problemática del confinamiento en un entorno virtual, evidenciando la necesidad de preparar los sistemas educativos para enfrentar desafíos similares en el futuro y cuidar la salud de los profesores.Emotional stress, also known as Burnout syndrome, can arise as a result of confinement due to disasters or tragedies, especially in virtual contexts. The study focuses on measuring work stress in high school teachers, specifically in CETis No. 70, who faced the online modality due to the COVID-19 pandemic. Methods: The Maslach Burnout Inventory questionnaire was applied, evaluating three dimensions: emotional exhaustion, depersonalization and personal accomplishment, with 22 items. Results: Teachers showed high levels of personal accomplishment (65%) and emotional exhaustion (56%), but low levels of depersonalization (5%). Conclusions: The high levels of emotional exhaustion reflect the problem of confinement in a virtual environment, evidencing the need to prepare educational systems to face similar challenges in the future and take care of the health of teachers

La percepción del profesorado sobre la enseñanza del deporte en la enseñanza secundaria obligatoria

Physical Education teachers show a constant concern for making their subject a subject with great educational potential in the integralformation of young people. Within this subject, sport occupies a very important place in the programming, while it is also the one thatgenerates most controversy from the pedagogical point of view. These two aspects are the main reasons that lead us to study how theteaching process of this content is approached during Compulsory Secondary Education (C.S.E.). Therefore, the main objectives of thisstudy have been: to analyze the perception of physical education teachers about sport as a content of C.S.E.; and, secondly, to describepossible didactic implications that may help to improve the teaching and learning process of this content during C.S.E. Within the qualitativeresearch paradigm, the design of the study is phenomenological, using the semi-structured interview as a research instrument. Theseinterviews were applied in a focus group. The most outstanding results are that the main teaching objectives set by the teachers wereattitudinal and also motivational. In addition, the orientation of the sport was one of initiation and promotion; the most developed contentswere the technical-tactical and regulatory ones; and an active methodology was advocated in which values such as collaboration or respectwere included. In the evaluation, the attitudinal aspects are highlighted.Los profesores de Educación Física muestran una preocupación constante por hacer de su asignatura una materia con gran potencial educativo en la formación integral de los jóvenes. Dentro de esta asignatura, el deporte ocupa un lugar muy importante en las programaciones, a la vez que es también el que más controversias genera desde el punto de vista pedagógico. Estos dos aspectos son los motivos principales que nos llevan a estudiar cómo se aborda el proceso de enseñanza de este contenido durante la Enseñanza Secundaria Obligatoria (E.S.O.). Por ello, los objetivos principales de este estudio han sido: analizar la percepción del profesorado de educación física sobre el deporte como contenido de la ESO; y, en segundo lugar, describir posibles implicaciones didácticas que puedan ayudar a mejorar el proceso de enseñanza y aprendizaje de este contenido durante la E.S.O. Dentro del paradigma de investigación cualitativo, el diseño del estudio es fenomenológico, utilizando la entrevista semiestructurada como instrumento de investigación. Dicha entrevista fue aplicada en un grupo focal compuesto por 9 profesores: 8 hombres y 1 mujer; todos Graduados en Ciencias del Deporte; con una edad comprendida entre 28 y 32 años; y entre 4 y 6 años de experiencia docente. Como resultados más destacados, se puede indicar que los objetivos didácticos principales planteados por los profesores eran de carácter actitudinal y también de motivación del alumnado. Además, la orientación del deporte era de iniciación y promoción; los contenidos más desarrollados eran los técnico-tácticos y reglamentarios; y se aboga por una metodología activa en la que se incluyan valores como la colaboración o el respeto. En la evaluación destaca lo actitudinal sobre lo procedimental.&nbsp

Intervención quirúrgica de catarata por técnica de Blumenthal modificada

The development of ophthalmology in Cuba in recent years has prompted the introduction of new surgical techniques for the treatment of cataracts, some of them are modified from others seeking to improve their results and introduce concepts to optimize them. This work was intended to determine the results of extracapsular lens extraction by the modified Blumenthal technique. An observational, descriptive, prospective cross-sectional study was conducted. The universe consisted of all patients (eyes) diagnosed with presenile and senile cataract who were surgically treated with this surgical technique in the Eye Center of the State of Lara, Venezuela, in the period from March 2006 to June 2010. The sample was formed by a simple random sample of 3280 patients. Most of them were over 60 years of age and there was a similar behavior in both sexes. The white skin patients predominated, most were retired ones, and a preoperative visual acuity of counting fingers. There were few complications: the most common were posterior capsule rupture, vitreous loss and hyphema.El desarrollo de la Especialidad de Oftalmología en Cuba en los últimos años ha motivado que se introduzcan nuevas técnicas quirúrgicas para el tratamiento de la catarata, algunas de ellas modificadas a partir de otras que buscan perfeccionar sus resultados e introducir conceptos que las optimizan. Con la realización de este trabajo se pretendió determinar los resultados de la extracción extracapsular del cristalino por la técnica de Blumenthal modificada. Se realizó un estudio observacional, descriptivo, prospectivo de corte transversal; el universo estuvo constituido por todos los pacientes (ojos) con diagnóstico de catarata presenil y senil que recibieron tratamiento quirúrgico con esta técnica quirúrgica en el Centro Oftalmológico del Estado de Lara, Venezuela, en el período de  marzo de 2006 hasta junio de 2010; se seleccionó una muestra mediante un muestreo simple aleatorio de 3 280 pacientes; la mayoría tenía más de 60 años de edad y hubo un comportamiento similar en ambos sexos; el color de la piel blanca predominó, la mayoría eran jubilados y con una agudeza visual preoperatoria de cuenta dedos. Se presentaron pocas complicaciones: las más frecuentes fueron la ruptura de la cápsula posterior, la pérdida de vítreo y el hifema

Sinus elevation by in situ utilization of bone scrapers : technique and results

Objectives: The objective was to present a novel technique for antrostomy performed before sinus elevation in atrophic maxilla for subsequent implant placement. Material and methods: The study included 10 sinus elevations performed by the proposed technique in nine consecutive patients presenting with inadequate posterior maxillary height. The technique is described, calculating the antrostomy surface area, volume of bone tissue obtained and final height attained in each case. A total of 16 implants were placed. Results: All ten elevations were accomplished. Mean antrostomy surface area was 0.55 mm2 , mean bone volume obtained was 0.56 cm3 and mean height attained was 11.7 mm from a baseline mean height of 5.6 mm. Out of the 16 implants, 14 were inserted immediately after the elevation and 2 were inserted in a second step, after ossification; 93.7% of the implants were osseointegrated at 6 months after prosthesis placement. Conclusion: The use of bone scrapers to create antrostomy for sinus elevation is a simple and very safe procedure. It provides a variable amount of particulate bone graft that is easily handled and highly useful for packing the cavity that will elevate the sinus membrane

Intervención quirúrgica de catarata por técnica de Blumenthal modificada

The development of ophthalmology in Cuba in recent years has prompted the introduction of new surgical techniques for the treatment of cataracts, some of them are modified from others seeking to improve their results and introduce concepts to optimize them. This work was intended to determine the results of extracapsular lens extraction by the modified Blumenthal technique. An observational, descriptive, prospective cross-sectional study was conducted. The universe consisted of all patients (eyes) diagnosed with presenile and senile cataract who were surgically treated with this surgical technique in the Eye Center of the State of Lara, Venezuela, in the period from March 2006 to June 2010. The sample was formed by a simple random sample of 3 280 patients. Most of them were over 60 years of age and there was a similar behavior in both sexes. The white skin patients predominated, most were retired ones, and a preoperative visual acuity of counting fingers. There were few complications: the most common were posterior capsule rupture, vitreous loss and hyphema.El desarrollo de la Especialidad de Oftalmología en Cuba en los últimos años ha motivado que se introduzcan nuevas técnicas quirúrgicas para el tratamiento de la catarata, algunas de ellas modificadas a partir de otras que buscan perfeccionar sus resultados e introducir conceptos que las optimizan. Con la realización de este trabajo se pretendió determinar los resultados de la extracción extracapsular del cristalino por la técnica de Blumenthal modificada. Se realizó un estudio observacional, descriptivo, prospectivo de corte transversal; el universo estuvo constituido por todos los pacientes (ojos) con diagnóstico de catarata presenil y senil que recibieron tratamiento quirúrgico con esta técnica quirúrgica en el Centro Oftalmológico del Estado de Lara, Venezuela, en el período de  marzo de 2006 hasta junio de 2010; se seleccionó una muestra mediante un muestreo simple aleatorio de 3 280 pacientes; la mayoría tenía más de 60 años de edad y hubo un comportamiento similar en ambos sexos; el color de la piel blanca predominó, la mayoría eran jubilados y con una agudeza visual preoperatoria de cuenta dedos. Se presentaron pocas complicaciones, las más frecuentes fueron la ruptura de la cápsula posterior, la pérdida de vítreo y el hifema

Egg intake and cardiovascular risk factors in adolescents; role of physical activity: the HELENA study

Introducción: Las enfermedades cardiovasculares (ECVs) suponen la principal causa de morbi-mortalidad en los países occidentales. El incremento del colesterol plasmático se ha relacionado con el desarrollo de ECV. El huevo, por su alto contenido en colesterol, ha sido indirectamente relacionado con el riesgo de desarrollar ECVs. Objetivo: Examinar la asociación entre ingesta de huevo y factores de riesgo cardiovascular en adolescentes, estudiando si dicha relación está influenciada por la actividad física. Método: Se estudiaron 380 adolescentes pertenecientes al estudio HELENA (HEalthy Lifestyle in Europe by Nutrition in Adolescence). La ingesta de alimentos se estimó mediante anamnesis nutricional de dos días no consecutivos. Se midieron indicadores de adiposidad, perfil lipídico, glucosa, insulina, resistencia a la insulina, tensión arterial y capacidad aeróbica. Se calculó un índice integrado de riesgo cardiovascular (IRCV) como medida del perfil cardiovascular global. La actividad física se midió mediante acelerometría. Se examinó el desarrollo madurativo. El estatus socioeconómico y consumo de tabaco se obtuvieron mediante cuestionario. La asociación entre ingesta de huevo y factores de riesgo de ECV se examinó mediante un modelo de regresión multinivel ajustado por factores de confusión. Resultados: La ingesta de huevo no se asoció con perfil lipídico, nivel de adiposidad, tensión arterial, resistencia a la insulina, capacidad aeróbica o IRCV (todos P > 0,05). Esta falta de asociación no estuvo influenciada por el nivel de actividad física. Conclusiones: Estos resultados sugieren que no existe asociación entre ingesta de huevo y perfil lipídico, adiposidad, resistencia a la insulina, tensión arterial, capacidad aeróbica o el IRCV en adolescentes. La actividad física no influencia dicha falta de asociación.INTRODUCTION: Cardiovascular diseases (CVDs) represent the main cause of morbi-mortality in western countries. Serum cholesterol levels have been related to cardiovascular disease (CVD). Egg intake has been indirectly related to the risk of developing CVD because of its high cholesterol content. OBJECTIVE: The aim of the present study was to examine the association between egg intake and CVD risk factors in adolescents, assessing the possible influence of physical activity. METHODS: We studied 380 adolescents enrolled in the HELENA (HEalthy Lifestyle in Europe by Nutrition in Adolescence) study. Food intake was estimated by 2 nonconsecutive 24 h recalls. We measured adiposity indicators, lipid profile, blood glucose and insulin levels, insulin resistance, blood pressure and cardiorespiratory fitness. A CVD risk score was computed as a measure of the overall CVD risk profile. Physical activity was objectively measured by accelerometry. Sexual development was examined. Socioeconomic and smoking statuses were obtained by questionnaire. The association between egg intake and CVD risk factors was examined using a multilevel analysis adjusted for potential confounders. RESULTS: Egg intake was not associated with lipid profile, adiposity, insulin resistance, blood pressure, cardiorespiratory fitness or the integrated CVD risk score. This lack of association was not influenced by physical activity. CONCLUSIONS: The findings of the present study suggest that egg intake is not associated with a less favorable lipid or CVD risk profile in adolescents. This lack of association is not influenced by the level of physical activity.El estudio HELENA se llevó a cabo con el apoyo económico del Sexto Programa Marco de la Unión Europea (Contract FOOD-CT: 2005-007034). Este estudio también fue apoyado por becas del Ministerio de Ciencia e Innovación (AP 2008-03806: RYC- 2010-05957)

Effectiveness of an intervention for improving drug prescription in primary care patients with multimorbidity and polypharmacy:Study protocol of a cluster randomized clinical trial (Multi-PAP project)

This study was funded by the Fondo de Investigaciones Sanitarias ISCIII (Grant Numbers PI15/00276, PI15/00572, PI15/00996), REDISSEC (Project Numbers RD12/0001/0012, RD16/0001/0005), and the European Regional Development Fund ("A way to build Europe").Background: Multimorbidity is associated with negative effects both on people's health and on healthcare systems. A key problem linked to multimorbidity is polypharmacy, which in turn is associated with increased risk of partly preventable adverse effects, including mortality. The Ariadne principles describe a model of care based on a thorough assessment of diseases, treatments (and potential interactions), clinical status, context and preferences of patients with multimorbidity, with the aim of prioritizing and sharing realistic treatment goals that guide an individualized management. The aim of this study is to evaluate the effectiveness of a complex intervention that implements the Ariadne principles in a population of young-old patients with multimorbidity and polypharmacy. The intervention seeks to improve the appropriateness of prescribing in primary care (PC), as measured by the medication appropriateness index (MAI) score at 6 and 12months, as compared with usual care. Methods/Design: Design:pragmatic cluster randomized clinical trial. Unit of randomization: family physician (FP). Unit of analysis: patient. Scope: PC health centres in three autonomous communities: Aragon, Madrid, and Andalusia (Spain). Population: patients aged 65-74years with multimorbidity (≥3 chronic diseases) and polypharmacy (≥5 drugs prescribed in ≥3months). Sample size: n=400 (200 per study arm). Intervention: complex intervention based on the implementation of the Ariadne principles with two components: (1) FP training and (2) FP-patient interview. Outcomes: MAI score, health services use, quality of life (Euroqol 5D-5L), pharmacotherapy and adherence to treatment (Morisky-Green, Haynes-Sackett), and clinical and socio-demographic variables. Statistical analysis: primary outcome is the difference in MAI score between T0 and T1 and corresponding 95% confidence interval. Adjustment for confounding factors will be performed by multilevel analysis. All analyses will be carried out in accordance with the intention-to-treat principle. Discussion: It is essential to provide evidence concerning interventions on PC patients with polypharmacy and multimorbidity, conducted in the context of routine clinical practice, and involving young-old patients with significant potential for preventing negative health outcomes. Trial registration: Clinicaltrials.gov, NCT02866799Publisher PDFPeer reviewe

Treatment with tocilizumab or corticosteroids for COVID-19 patients with hyperinflammatory state: a multicentre cohort study (SAM-COVID-19)

Objectives: The objective of this study was to estimate the association between tocilizumab or corticosteroids and the risk of intubation or death in patients with coronavirus disease 19 (COVID-19) with a hyperinflammatory state according to clinical and laboratory parameters. Methods: A cohort study was performed in 60 Spanish hospitals including 778 patients with COVID-19 and clinical and laboratory data indicative of a hyperinflammatory state. Treatment was mainly with tocilizumab, an intermediate-high dose of corticosteroids (IHDC), a pulse dose of corticosteroids (PDC), combination therapy, or no treatment. Primary outcome was intubation or death; follow-up was 21 days. Propensity score-adjusted estimations using Cox regression (logistic regression if needed) were calculated. Propensity scores were used as confounders, matching variables and for the inverse probability of treatment weights (IPTWs). Results: In all, 88, 117, 78 and 151 patients treated with tocilizumab, IHDC, PDC, and combination therapy, respectively, were compared with 344 untreated patients. The primary endpoint occurred in 10 (11.4%), 27 (23.1%), 12 (15.4%), 40 (25.6%) and 69 (21.1%), respectively. The IPTW-based hazard ratios (odds ratio for combination therapy) for the primary endpoint were 0.32 (95%CI 0.22-0.47; p < 0.001) for tocilizumab, 0.82 (0.71-1.30; p 0.82) for IHDC, 0.61 (0.43-0.86; p 0.006) for PDC, and 1.17 (0.86-1.58; p 0.30) for combination therapy. Other applications of the propensity score provided similar results, but were not significant for PDC. Tocilizumab was also associated with lower hazard of death alone in IPTW analysis (0.07; 0.02-0.17; p < 0.001). Conclusions: Tocilizumab might be useful in COVID-19 patients with a hyperinflammatory state and should be prioritized for randomized trials in this situatio