Maloclusiones en estudiantes de la carrera de Odontología de la Universidad UTE

La maloclusión se considera uno de los problemas más comunes relacionados con la salud bucal, su diagnóstico temprano y adecuado permite establecer un correcto plan de tratamiento más efectivo. El objetivo fue describir las maloclusiones en estudiantes de último año de la carrera de Odontología de la Universidad UTE en Quito, Ecuador, durante los años 2018 y 2019. Los datos fueron obtenidos a partir de las respectivas historias clínicas archivadas en la clínica universitaria SERODU. Las valoraciones para determinar la maloclusión se hicieron a partir de la caracterización de los planos vertical, horizontal y transversal, utilizando los criterios de Angle. La media de edad entre los pacientes fue de 24,5 años, con una desviación estándar de 1,91. El análisis de la presencia de overjet y overbite permitió establecer que la mayor medida media estuvo enmarcada en la clase molar II, para 4,19 mm (DE=3,07) y 3,59 mm (DE=2,47) respectivamente. La mordida cruzada unilateral en el eje transversal (26,67%). La categoría normal preponderó en el tipo de mordida en los planos horizontal y vertical en las tres clases molares.Malocclusion is considered one of the most common problems related to oral health, its early and adequate diagnosis allows establishing a correct and more effective treatment plan. The objective was to describe the malocclusions of students of the school of dentistry in final academic term at the UTE University in Quito, Ecuador, during the years 2018 and 2019. The data were obtained from the respective medical records on file at the SERODU university clinic. The evaluations to determine the malocclusion were made from the characterization of the vertical, horizontal, and transverse planes, using the Angle criteria. The mean age among the patients was 24.5 years, with a standard deviation of 1.91. The analysis of the presence of overjet and overbite allowed establishing that the highest mean measurement was framed in molar class II, for 4.19 mm (SD = 3.07) and 3.59 mm (SD = 2.47), respectively. The unilateral crossbite on the transverse axis (26.67%). The normal category prevailed in the type of bite in the horizontal and vertical planes in the three molar classes

Clonal chromosomal mosaicism and loss of chromosome Y in elderly men increase vulnerability for SARS-CoV-2

The pandemic caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2, COVID-19) had an estimated overall case fatality ratio of 1.38% (pre-vaccination), being 53% higher in males and increasing exponentially with age. Among 9578 individuals diagnosed with COVID-19 in the SCOURGE study, we found 133 cases (1.42%) with detectable clonal mosaicism for chromosome alterations (mCA) and 226 males (5.08%) with acquired loss of chromosome Y (LOY). Individuals with clonal mosaic events (mCA and/or LOY) showed a 54% increase in the risk of COVID-19 lethality. LOY is associated with transcriptomic biomarkers of immune dysfunction, pro-coagulation activity and cardiovascular risk. Interferon-induced genes involved in the initial immune response to SARS-CoV-2 are also down-regulated in LOY. Thus, mCA and LOY underlie at least part of the sex-biased severity and mortality of COVID-19 in aging patients. Given its potential therapeutic and prognostic relevance, evaluation of clonal mosaicism should be implemented as biomarker of COVID-19 severity in elderly people. Among 9578 individuals diagnosed with COVID-19 in the SCOURGE study, individuals with clonal mosaic events (clonal mosaicism for chromosome alterations and/or loss of chromosome Y) showed an increased risk of COVID-19 lethality

Displasia congénita de tibia: reporte de un caso Resumen

La Displasia Congénita de Tibia (DCT), anteriormente llamada Pseudoartrosis Congénita de Tibia, es una enfermedad infrecuente que se caracteriza por presentar deformidad en varo, antecurvatum y con frecuencia discrepancia de la longitud entre extremidades. Epidemiológicamente se estima que su incidencia a nivel mundial varía entre 1:140.000 y 1:250.000 nacidos vivos, la mayoría de las veces se presenta en los primeros 5 años de vida y en algunas ocasiones entre los 5 y 10 años, pero en la totalidad de los pacientes se presenta en la primera década de la vida. La etiología aún no está dilucidada planteándose teorías como trauma uterino, fractura al nacimiento, desórdenes metabólicos generalizados y malformaciones vasculares, incluso se ha evidenciado un carácter familiar que aún no ha sido precisado desde el punto de vista genético. En el siguiente caso clínico se describe una paciente a quien se le realizó el diagnóstico y manejo terapéutico con fijación externa monolateral en un centro de salud ecuatoriano, obteniendo resultados satisfactorios con una técnica quirúrgica poco utilizada.&nbsp

Evaluation of a quality improvement intervention to reduce anastomotic leak following right colectomy (EAGLE): pragmatic, batched stepped-wedge, cluster-randomized trial in 64 countries

Background Anastomotic leak affects 8 per cent of patients after right colectomy with a 10-fold increased risk of postoperative death. The EAGLE study aimed to develop and test whether an international, standardized quality improvement intervention could reduce anastomotic leaks. Methods The internationally intended protocol, iteratively co-developed by a multistage Delphi process, comprised an online educational module introducing risk stratification, an intraoperative checklist, and harmonized surgical techniques. Clusters (hospital teams) were randomized to one of three arms with varied sequences of intervention/data collection by a derived stepped-wedge batch design (at least 18 hospital teams per batch). Patients were blinded to the study allocation. Low- and middle-income country enrolment was encouraged. The primary outcome (assessed by intention to treat) was anastomotic leak rate, and subgroup analyses by module completion (at least 80 per cent of surgeons, high engagement; less than 50 per cent, low engagement) were preplanned. Results A total 355 hospital teams registered, with 332 from 64 countries (39.2 per cent low and middle income) included in the final analysis. The online modules were completed by half of the surgeons (2143 of 4411). The primary analysis included 3039 of the 3268 patients recruited (206 patients had no anastomosis and 23 were lost to follow-up), with anastomotic leaks arising before and after the intervention in 10.1 and 9.6 per cent respectively (adjusted OR 0.87, 95 per cent c.i. 0.59 to 1.30; P = 0.498). The proportion of surgeons completing the educational modules was an influence: the leak rate decreased from 12.2 per cent (61 of 500) before intervention to 5.1 per cent (24 of 473) after intervention in high-engagement centres (adjusted OR 0.36, 0.20 to 0.64; P < 0.001), but this was not observed in low-engagement hospitals (8.3 per cent (59 of 714) and 13.8 per cent (61 of 443) respectively; adjusted OR 2.09, 1.31 to 3.31). Conclusion Completion of globally available digital training by engaged teams can alter anastomotic leak rates. Registration number: NCT04270721 (http://www.clinicaltrials.gov)