DETERMINACION DE DIENTES IMPACTADOS EN RADIOGRAFIAS 2D Y 3D EN PACIENTES DE 15 A 40 AÑOS EN EL SERVICIO DE RADIOLOGÍA DEL HOSPITAL MILITAR CENTRAL 2018

Objetivo: Determinar el nivel de concordancia que existe entre los dos tipos de exámenes imagenológicos: Radiografía Panorámica y Tomografía, en la clasificación de las terceras molares inferiores impactados en pacientes de 15 a 40 años del Hospital Militar Central en el año 2018. Metodología: investigación nivel descriptivo con diseño observacional analítico transversal. Con una muestra de 80 radiografías panorámicas y tomografías pertenecientes a un mismo paciente. Resultados: Según la contrastación de hipótesis existe buena concordancia entre los dos tipos de exámenes imagenológicos; radiografía panorámica y tomografía en la clasificación de terceros molares inferiores impactados en pacientes de 15 a 40 años del hospital militar central en el año 2018. Conclusiones: Existe una concordancia muy buena para la clasificación de las terceras molares con relación a la rama de la mandíbula y segundo molar en pacientes de 15 a 40 años atendidos en el servicio de radiología del hospital militar central en el año 2018. Existe una Concordancia muy buena para la clasificación de las terceras molares inferiores con relación a la profundidad del hueso en pacientes de 15 a 40 años atendidos en el servicio de radiología del hospital militar central en el año 2018. Existe una Concordancia muy buena o alta para la clasificación de las terceras molares inferior con relación al eje longitudinal del segundo molar inferior en pacientes de 15 a 40 años atendidos en el servicio de radiología del hospital militar central en el año 2018.Tesi

Perspectiva actual de la violencia juvenil*

ResumenEste artículo de linea algunas de las principales de las contribuciones biológicas y psicológicas que buscan explicar el fenómeno de la violencia juvenil. Se analizan los factores genéticos  bajo los diferentes estudios de adopción, gemelos y familiares, así como los genes relacionados con la violencia.[Días JL, de la Peña F, Suárez JA, Palacios L. Perspectiva actual de la violencia juvenil.]Palabras clave: violencia jóvenes, causas biológicas y sociales

Current perspective of youth violence

Este artículo delinea algunas de las principales contribuciones biológicas y psicológicas que buscan explicar el fenómeno de la violencia juvenil. Se analizan los factores genéticos bajo los diferentes estudios de adopción, gemelos y familiares, así como los genes relacionados con la violencia. Se analiza el tópico de los neurotransmisores, especialmente los hallazgos relacionados con la serotonina. Al considerar los factores extrínsecos se subrayan los elementos relacionados con la violencia y el abuso físico y sexual además de la asociación con el consumo de alcohol y drogas. Se analiza de forma resumida lo concerniente a los me-dios de comunicación y la violencia. El artículo finaliza con una descripción de los tratamientos de la violencia desde una perspectiva farmacológica y psicoterapéutica. [Díaz JL, de la Peña F, Suárez JA, Palacios L. Perspectiva actual de la violencia juvenil.This article outlines some of the main biological and psychological contributions that seek to explain the phenomenon of youth violence. Genetic factors are analyzed under the different adoption, twin and family studies, as well as genes related to violence. The topic of neurotransmitters is analyzed, especially the findings related to serotonin. When considering extrinsic factors, elements related to violence and physical and sexual abuse are highlighted, in addition to the association with alcohol and drug consumption. What concerns the media and violence is briefly analyzed. The article ends with a description of violence treatments from a pharmacological and psychotherapeutic perspective. [Díaz JL, de la Peña F, Suárez JA, Palacios L. Current perspective of youth violence

Ten-year course of treated bipolar I disorder: The role of polarity at onset

Introduction: Early-stage predictors of illness course are needed in bipolar disorder (BD). Differences among patients with a first depressive versus maniac/hypomanic episode have been stated, although in most studies, memory bias and time from onset to start of specialized treatment might interfere. The aim was to compare the first 10 years of illness course according to polarity at onset. Methods: 49 type I BD patients admitted for treatment for a first-time affective episode and a following 10-year attendance to the institution were included. A retrospective year by year comparison according to polarity at onset (depressive (DPO) or maniac (MPO)) was performed. Cramer's V and Cohen d were computed to determine effect size. Results: 59.2% (n = 29) started with MPO. Both groups were similar in demographic and social outcome characteristics, clinical features, and treatment variables. Patients with DPO reported more depressive episodes than MPO patients (U = 149.0 p < .001, Cohen's d = 0.87); both groups had a similar number of manic episodes. Only during the first year of follow-up, suicide attempts (SA) were more frequent in patients with DPO while the presence of a psychotic episode and psychiatric hospitalizations were more frequent in the MPO group. Conclusion: According to these findings, it can be concluded that illness onset is only indicative of depressive predominant polarity but is not related to other poor prognostic variables after the first year of illness onset, in treated BD. SA in the first year of an affective disorder could represent a marker of BD

Evaluación fitoquímica, fisicoquímica y farmacológica de Maguey Morado (Rhoeo discolor)

La planta de “Rhoeo discolor” es una especie de planta herbácea perteneciente a la familia de las comelináceas, presente en Centroamérica y México, la cual se utilizó para hacer la determinación de los componentes fitoquímicos y comprobar las propiedades gastroprotectoras modelo animal. Se obtuvo un extracto de las hojas y fue caracterizado por pruebas fitoquímicas, Cromatografía de capa fina y columna, IR y UV –vis; para el estudio farmacológico se utilizó el modelo de ulcera inducida por Ácido Acetil salicílico, en Ratas Wistar (Rattus norvegicus) divididas en cuatro grupos: I Control normal, II Control de la ulcera III Extracto acuoso de Rhoeo discolor, IV ácido acetil salicílico + extracto acuoso. Al término del estudio se extrae el estómago de cada rata para la observación macroscópica e histológica con el objetivo de comprobar sus propiedades antiácidas y probar el extracto como posible principio activo para el tratamiento de la gastritis.The plant "Rhoeo discolor" is a herbaceous plant belonging to the family of comelináceas, present in Central America and Mexico, which was used to determine its phytochemical components and to evaluate the gastro protective properties in an animal model. An extract from the leaves was characterized by phytochemical tests, thin-layer chromatography and column, IR and UV –Vis. The pharmacological Study included an ulcer model induced by acetylsalicylic acid in Wistar rats (Rattus norvegicus) that were divided in four groups: normal control, ulcer control II III Rhoeo discolor aqueous extract, salicylic acid acetyl IV + aqueous extract. At the end of the study, the stomach of each rat was extracted and analyzed for macroscopic and histological observation to prove the antacid properties of the extract as a possible drug for the treatment of gastritis

Ética y estética de la violencia. Estudios críticos y entrevistas sobre la obra literaria de Mario Roberto Morales.

Ética y estética de la violencia. Estudios críticos y entrevistas sobre la obra literaria de Mario Roberto Morales es un libro indispensable para todo interesado en la lectura guatemalteca, especialmente para quienes buscan ampliar su comprensión sobre la ética y la estética de la violencia en Guatemala a partir de la segunda mitad del siglo veinte.Mario Roberto Morales es uno de los más importantes escritores guatemaltecos contemporáneos. Su obra ha sido objeto de análisis en diferentes países y, sin embargo, aún son escasos los acercamientos a su creación artística. Los trabajos reunidos en el presente libro que incluyen estudios críticos y entrevistas con el autor intentan cubrir la carencia de interpretaciones sobre su obra que, dicho sea de paso, es necesaria para comprender la historia reciente de un país como Guatemala, envuelto en una serie de vicisitudes de orden político, social y religioso.Universidad Autónoma del Estado de México

Post-intervention Status in Patients With Refractory Myasthenia Gravis Treated With Eculizumab During REGAIN and Its Open-Label Extension

OBJECTIVE: To evaluate whether eculizumab helps patients with anti-acetylcholine receptor-positive (AChR+) refractory generalized myasthenia gravis (gMG) achieve the Myasthenia Gravis Foundation of America (MGFA) post-intervention status of minimal manifestations (MM), we assessed patients' status throughout REGAIN (Safety and Efficacy of Eculizumab in AChR+ Refractory Generalized Myasthenia Gravis) and its open-label extension. METHODS: Patients who completed the REGAIN randomized controlled trial and continued into the open-label extension were included in this tertiary endpoint analysis. Patients were assessed for the MGFA post-intervention status of improved, unchanged, worse, MM, and pharmacologic remission at defined time points during REGAIN and through week 130 of the open-label study. RESULTS: A total of 117 patients completed REGAIN and continued into the open-label study (eculizumab/eculizumab: 56; placebo/eculizumab: 61). At week 26 of REGAIN, more eculizumab-treated patients than placebo-treated patients achieved a status of improved (60.7% vs 41.7%) or MM (25.0% vs 13.3%; common OR: 2.3; 95% CI: 1.1-4.5). After 130 weeks of eculizumab treatment, 88.0% of patients achieved improved status and 57.3% of patients achieved MM status. The safety profile of eculizumab was consistent with its known profile and no new safety signals were detected. CONCLUSION: Eculizumab led to rapid and sustained achievement of MM in patients with AChR+ refractory gMG. These findings support the use of eculizumab in this previously difficult-to-treat patient population. CLINICALTRIALSGOV IDENTIFIER: REGAIN, NCT01997229; REGAIN open-label extension, NCT02301624. CLASSIFICATION OF EVIDENCE: This study provides Class II evidence that, after 26 weeks of eculizumab treatment, 25.0% of adults with AChR+ refractory gMG achieved MM, compared with 13.3% who received placebo

Minimal Symptom Expression' in Patients With Acetylcholine Receptor Antibody-Positive Refractory Generalized Myasthenia Gravis Treated With Eculizumab

The efficacy and tolerability of eculizumab were assessed in REGAIN, a 26-week, phase 3, randomized, double-blind, placebo-controlled study in anti-acetylcholine receptor antibody-positive (AChR+) refractory generalized myasthenia gravis (gMG), and its open-label extension

Mortality from gastrointestinal congenital anomalies at 264 hospitals in 74 low-income, middle-income, and high-income countries: a multicentre, international, prospective cohort study

Summary Background Congenital anomalies are the fifth leading cause of mortality in children younger than 5 years globally. Many gastrointestinal congenital anomalies are fatal without timely access to neonatal surgical care, but few studies have been done on these conditions in low-income and middle-income countries (LMICs). We compared outcomes of the seven most common gastrointestinal congenital anomalies in low-income, middle-income, and high-income countries globally, and identified factors associated with mortality. Methods We did a multicentre, international prospective cohort study of patients younger than 16 years, presenting to hospital for the first time with oesophageal atresia, congenital diaphragmatic hernia, intestinal atresia, gastroschisis, exomphalos, anorectal malformation, and Hirschsprung’s disease. Recruitment was of consecutive patients for a minimum of 1 month between October, 2018, and April, 2019. We collected data on patient demographics, clinical status, interventions, and outcomes using the REDCap platform. Patients were followed up for 30 days after primary intervention, or 30 days after admission if they did not receive an intervention. The primary outcome was all-cause, in-hospital mortality for all conditions combined and each condition individually, stratified by country income status. We did a complete case analysis. Findings We included 3849 patients with 3975 study conditions (560 with oesophageal atresia, 448 with congenital diaphragmatic hernia, 681 with intestinal atresia, 453 with gastroschisis, 325 with exomphalos, 991 with anorectal malformation, and 517 with Hirschsprung’s disease) from 264 hospitals (89 in high-income countries, 166 in middleincome countries, and nine in low-income countries) in 74 countries. Of the 3849 patients, 2231 (58·0%) were male. Median gestational age at birth was 38 weeks (IQR 36–39) and median bodyweight at presentation was 2·8 kg (2·3–3·3). Mortality among all patients was 37 (39·8%) of 93 in low-income countries, 583 (20·4%) of 2860 in middle-income countries, and 50 (5·6%) of 896 in high-income countries (p<0·0001 between all country income groups). Gastroschisis had the greatest difference in mortality between country income strata (nine [90·0%] of ten in lowincome countries, 97 [31·9%] of 304 in middle-income countries, and two [1·4%] of 139 in high-income countries; p≤0·0001 between all country income groups). Factors significantly associated with higher mortality for all patients combined included country income status (low-income vs high-income countries, risk ratio 2·78 [95% CI 1·88–4·11], p<0·0001; middle-income vs high-income countries, 2·11 [1·59–2·79], p<0·0001), sepsis at presentation (1·20 [1·04–1·40], p=0·016), higher American Society of Anesthesiologists (ASA) score at primary intervention (ASA 4–5 vs ASA 1–2, 1·82 [1·40–2·35], p<0·0001; ASA 3 vs ASA 1–2, 1·58, [1·30–1·92], p<0·0001]), surgical safety checklist not used (1·39 [1·02–1·90], p=0·035), and ventilation or parenteral nutrition unavailable when needed (ventilation 1·96, [1·41–2·71], p=0·0001; parenteral nutrition 1·35, [1·05–1·74], p=0·018). Administration of parenteral nutrition (0·61, [0·47–0·79], p=0·0002) and use of a peripherally inserted central catheter (0·65 [0·50–0·86], p=0·0024) or percutaneous central line (0·69 [0·48–1·00], p=0·049) were associated with lower mortality. Interpretation Unacceptable differences in mortality exist for gastrointestinal congenital anomalies between lowincome, middle-income, and high-income countries. Improving access to quality neonatal surgical care in LMICs will be vital to achieve Sustainable Development Goal 3.2 of ending preventable deaths in neonates and children younger than 5 years by 2030