Night-time blood pressure dipping, but not 24-h blood pressure level, is linked to increased 24-h ocular volume slope

ABSTRACT Purpose: This study investigated the relationship between blood pressure and intraocular pressure in treatmentnaive, non-glaucoma patients with different blood pressure statuses, focusing on the 24-h ocular volume and nocturnal blood pressure decline. Methods: Treatment-naive, non-glaucoma patients undergoing hypertension evaluation were enrolled as study participants. Simultaneous 24-h ambulatory blood pressure measurement and 24-h ocular volume recording with a contact lens sensor. We also compared ocular volume curve parameters between normotensive and hypertensive patients, as well as between those with and without nocturnal blood pressure decline. Results: A total of 21 patients, including 7 normotensive and 14 treatment-naive hypertensive individuals, were included in the study. of them, 11 were dippers and 10 were non-dippers. No significant difference in the 24-h ocular volume slope was observed between the hypertensive and normotensive patients (p=0.284). However, dippers had a significantly higher 24-h ocular volume slope (p=0.004) and nocturnal contact lens sensor output (p=0.041) than non-dippers. Conclusion: Nocturnal blood pressure decline, rather than the blood pressure level, is associated with the increased 24-h ocular volume slope and nocturnal ocular volume. Further studies are required to determine whether the acceleration of glaucoma progression in dippers is primarily due to low blood pressure, high intraocular pressure, or a combination of both.

Actividad repelente e insecticida de cuatro aceites esenciales de plantas recolectadas en Chocó-Colombia contra Tribolium castaneum / Repellent and insecticidal activity of four essential oils from plants recolleted in Chocó-Colombia against Tribolium castaneum

This study aimed to determine the repellent and insecticidal activity of four essential oils (EOs) from plants collected in the Chocó rain forest, Colombia, against T. castaneum . Conventional hydrodistillation was used to obtain the EOs. The repellent and insecticidal activities were evaluated by the preference area and gas dispersion methods, espectively. Statistical differences (p<0.05) were determined by applying a student's t-test. EOs of Siparuna guianensis, S. conica, Piper marginatum, and Nectandra acutifolia showed excellent repellent properties as the main findings, highlighting S. conicaEO with 84% repellency (1-hµL/cm2), while P. marginatum showed to be bioactive to the dose of 500 µL/mL (72 h), inducing mortality of 100% of the exposed population. In conclusion, the results evidenced the repellent properties of the EOs evaluated against T. castaneum , which allows us to conclude that these plant species are potential natural sources producing bio-repellents that contribute to the integrated control of T. castaneum.

Se evaluaron cuatro aceites esenciales (AEs) de plantas recolectadas en la selva pluvial del Chocó, Colombia, para determinar su actividad repelente e insecticida contra T. castaneum. Los AEs fueron obtenidos por hidrodestilación convencional. Las actividades repelentes e insecticidas se evaluaron por los métodos de área de preferencia y dispersión de gas, respectivamente. Las diferencias significativas (p<0,05) fueron determinadas aplicando una prueba t de student. Los AEs de Siparuna guianensis, S. conica, Piper marginatum y Nectandra acutifolia mostraron excelentes propiedades repelentes, destacando el AE de S. conicacon un 84% de repelencia (1µL/cm2), mientras que el AE de P. marginatummostró ser bioactivo a la dosis de 500 µL/mL (72 h) al inducir la mortalidad del 100% de la población expuesta. Se concluye que estas especies de plantas son fuentes naturales potencialmente viables para la producción de biorepelentes que contribuyan en el control integrado de T. castaneum.

Incremento del riesgo hemorrágico en pacientes con fibrilación auricular y enfermedad renal crónica en hemodiálisis tratados con anticoagulantes. Serie de cuatro centros / Increased risk of bleeding in patients with atrial fibrillation and chronic kidney disease on hemodialysis treated with anticoagulants. A four center series

Resumen Objetivo: El objetivo de este estudio fue estimar si el uso de anticoagulantes se asociaba con una diferencia en la frecuencia de trombosis de cualquier sitio, hemorragia mayor y mortalidad en adultos con coexistencia de ambas patologías. Método: Se realizó un estudio de cohorte retrospectivo en cuatro centros de alta complejidad. Se incluyeron mayores de 18 años con ERC en hemodiálisis y FA no valvular, con indicación de anticoagulación (CHA2DS2VASc ≥ 2). El desenlace primario fue la ocurrencia de sangrado mayor, evento trombótico (accidente vascular cerebral, infarto agudo al miocardio o enfermedad tromboembólica venosa) o muerte. Se realizó ajuste por variables de confusión por regresión logística. Resultados: De los 158 pacientes incluidos, el 61% (n = 97) recibieron anticoagulante. El desenlace principal se encontró en el 84% de quienes recibieron anticoagulación y en el 70% de quienes no la recibieron (OR: 2.12, IC95%: 0.98-4.57; luego del ajuste OR: 2.13, IC95%: 1.04-4.36). De los desenlaces mayores se presentaron sangrado en el 52% vs. el 34% (OR: 2.03; IC95%: 1.05-3.93), trombosis en el 35% vs. el 34% (OR: 1.03; IC95%: 0.52-2.01) y muerte en el 46% vs. el 41% (OR: 1.25; IC95%: 0.65-2.38). Conclusiones: Los resultados de este estudio sugieren un incremento en el riesgo de sangrado en los pacientes con FA y ERC en hemodiálisis que reciben anticoagulación, sin disminución del riesgo de eventos trombóticos ni de muerte.

Abstract Objective: The aim of this study was to estimate whether the consumption of anticoagulants was associated with a difference in the frequency of thrombosis of any site, major bleeding and mortality, in adults with both diseases. Method: A retrospective cohort study was carried out in four high complexity centers. Patients older than 18 years with CKD on hemodialysis and non-valvular AF, with an indication for anticoagulation (CHA2DS2VASc ≥ 2), were included. The primary outcome was the occurrence of: major bleeding, thrombotic event (cerebrovascular accident, acute myocardial infarction or venous thromboembolic disease) or death. Adjustment for confounding variables was performed using logistic regression. Results: From 158 patients included, 61% (n = 97) received an anticoagulant. The main outcome was found in 84% of those who received anticoagulation and 70% of those who did not (OR: 2.12, 95%CI: 0.98-4.57; after the adjusted analysis OR: 2.13, 95%CI: 1.04-4.36). Separate outcomes were bleeding in 52% vs. 34% (OR: 2.03; 95%CI: 1.05-3.93), thrombosis in 35% vs. 34% (OR: 1.03; 95%CI: 0.52-2-01) and death in 46% vs. 41% (OR: 1.25; 95%CI: 0.65-2.38). Conclusions: The results of this study suggest an increased risk of bleeding in patients with AF and CKD on hemodialysis receiving anticoagulation, without a decrease in the risk of thrombotic events or all-cause mortality.

Documento de posición para la mejora en la reperfusión del infarto agudo de miocardio con elevación del ST en Latinoamérica / Position statement for improvement in reperfusion of ST-elevation myocardial infarction in Latin America

Resumen El tratamiento del infarto agudo de miocardio con elevación del segmento ST tiene barreras dependiendo de la región geográfica. La angioplastia coronaria primaria es el tratamiento de elección, siempre y cuando sea realizada dentro de tiempo y por operadores experimentados. Sin embargo, cuando no está disponible, la administración de fibrinólisis y el envío para angioplastia de rescate, en caso de reperfusión negativa, es la mejor estrategia. De la misma manera, la angioplastia coronaria, como parte de una estrategia farmacoinvasiva, es la mejor alternativa cuando hay reperfusión positiva. El desarrollo de redes de tratamiento del infarto aumenta el número de pacientes reperfundidos dentro de los tiempos recomendados y mejora los desenlaces. En América Latina, los programas nacionales para el tratamiento del infarto deben centrarse en mejorar los resultados y el éxito a largo plazo depende de trabajar hacia objetivos definidos y obtener métricas de rendimiento, por lo tanto, estos deben desarrollar métricas para cuantificar su desempeño. El siguiente documento discute todas estas alternativas y sugiere oportunidades de mejora.

Abstract The treatment of ST-segment elevation myocardial infarction has barriers depending on the geographic region. Primary coronary angioplasty is the treatment of choice, if it is performed on time and by experienced operators. However, when it is not available, the administration of fibrinolysis and referral for rescue angioplasty, in case of negative reperfusion, is the best strategy. In the same way, coronary angioplasty, as part of a pharmacoinvasive strategy, is the best alternative when there is positive reperfusion. The development of infarct treatment networks increases the number of patients reperfused within the recommended times and improves outcomes. In Latin America, national myocardial infarction treatment programs should focus on improving outcomes, and long-term success depends on working toward defined goals and enhancing functionality, therefore programs should develop capacity to measure their performance. The following document discusses all of these alternatives and suggests opportunities for improvement.

Resumen: Consenso internacional para la nomenclatura y clasificación de la válvula aórtica bicúspide congénita y su aortopatía, con fines clínicos, quirúrgicos, intervencionistas y de investigación / Summary: International consensus statement on nomenclature and classification of the congenital bicuspid aortic valve and its aortopathy, for clinical, surgical, interventional and research purposes

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Abstract This consensus of nomenclature and classification for congenital bicuspid aortic valve and its aortopathy is evidence-based and intended for universal use by physicians (both pediatricians and adults), echocardiographers, advanced cardiovascular imaging specialists, interventional cardiologists, cardiovascular surgeons, pathologists, geneticists, and researchers spanning these areas of clinical and basic research. In addition, as long as new key and reference research is available, this international consensus may be subject to change based on evidence-based data1.

Fasting glucose: a cardiometabolic indicator for subclinical atherosclerosis on excess weight adolescents

Abstract Objective: To build a model based on cardiometabolic indicators that allow the identification of overweight adolescents at higher risk of subclinical atherosclerotic disease (SAD). Methods: Cross-sectional study involving 161 adolescents with a body mass index ≥ + 1 z-Score, aged 10 to 19 years. Carotid intima-media complex thickness (IMT) was evaluated using ultrasound to assess subclinical atherosclerotic disease. Cardiometabolic indicators evaluated included nutritional status, central adiposity, blood pressure, lipidic profile, glycemic profile, as well as age and sex. Data was presented using measures of central tendency and dispersion, as well as absolute and relative frequency. The relationship between IMT measurement (outcome variable) and other variables (independent variables) was assessed using Pearson or Spearman correlation, followed by multiple regression modeling with Gamma distribution to analyze predictors of IMT. Statistical analysis was performed using SPSS and R software, considering a significance level of 5 %. Results: It was observed that 23.7 % had Carotid thickening, and the prevalence of abnormal fasting glucose was the lowest. Age and fasting glucose were identified as predictors of IMT increase, with IMT decreasing with age by approximately 1 % per year and increasing with glucose by around 0.24 % per mg/dL. Conclusion: The adolescent at higher risk is younger with higher fasting glycemia levels.

Relationships between internet addiction, quality of life and sleep problems: a structural equation modeling analysis

Abstract Objective: To assess the relationship between internet addiction, quality of life, and sleep problems among adolescents. Method: This research was conducted with a representative sample of 875 adolescents. This cross-sectional study used the Internet Addiction Test, Pediatric Quality of Life Inventory™ version 4.0, Pediatric Daytime Sleepiness Scale, and sleep duration. Sociodemographic factors were also analyzed. Structural equation modeling was used to investigate relationships between variables. Results: After adjusting the model for covariances between the latent variables of daytime sleepiness and correlations between the physical and emotional domains of quality of life, the authors obtained satisfactory fit indices (RMSEA = 0.031, CFI = 0.926, TLI = 0.909, SRMR = 0.058). Internet addiction was positively associated with daytime sleepiness (rho = 0.549, p < 0.001) and negatively associated with quality of life (rho = -0.173, p < 0.001). By contrast, sleep duration was negatively associated with daytime sleepiness (rho = -0.089, p = 0.007), positively associated with quality of life (rho = 0.105, p = 0.014), and dependent on school shift (rho = 0.453, p < 0.001). Conclusions: Adolescents with higher levels of internet addiction had lower perceptions of quality of life and higher daytime sleepiness. Moreover, sleep duration had a positive correlation with quality of life. Given its detrimental effects on quality of life and daytime sleepiness, parents should better supervise internet use in adolescents.

Frequency of perfume in 398 children's cosmetics

Abstract Objective: Perfume (Parfum) or fragrance is a natural or synthetic cosmetic ingredient added to emit a pleasant aroma or to improve the odor of a cosmetic formula. It is a mixture of substances, not revealed by the manufacturer, which may contain ingredients with allergenic potential, endocrine disruptors, and other possible harmful effects on human health. This study aims to analyze children's cosmetics labels to assess the presence of Perfume. Methods: The researchers randomly visited points of sale in Curitiba, the capital of a southern Brazilian state; in order to catalog the largest possible number of children's cosmetics items. Results: 398 children's cosmetics were analyzed and found Parfum on 295 (74.1 %) of the labels, including 90.4 and 79,1 % of the shampoos and wet wipes, respectively. Conclusion: Exposure of children's skin to fragrances can lead to local side effects such as allergies, but also to systemic effects, and the lack of knowledge of the general population and health professionals about its possible deleterious effects emphasizes the importance of changes in the regulation of cosmetics aiming to reduce the use of this ingredient.

Saúde bucal e sua relação com a doença falciforme / Oral health and its relationship with sickle cell disease

Um material educativo sobre Saúde Bucal e Doença Falciforme em celebração ao dia 19 de Junho, Dia Mundial da Conscientização da Doença Falciforme.

Encuesta nacional para pediatras de Argentina: vacunación en la práctica diaria, percepción de conocimientos y barreras / National survey for pediatricians in Argentina: Vaccination in daily practice, perception of knowledge and barriers

Introducción. El descenso de las coberturas de vacunación fue muy significativo en la última década. Los pediatras son una pieza fundamental para recuperar coberturas y aumentar la confianza en la vacunación. Objetivos. Describir la percepción de los pediatras acerca del conocimiento y prácticas sobre vacunas, e identificar barreras en el acceso. Métodos. Estudio analítico observacional, mediante encuesta en línea. Se incluyeron variables del perfil del profesional, capacitación y barreras en inmunizaciones. Resultados. Participaron 1696 pediatras (tasa de respuesta: 10,7 %), media de 50,4 años. El 78,7 % fueron mujeres. El 78,2 % contaba con ≥10 años de ejercicio profesional. El 78,4 % realizaba atención ambulatoria y el 56,0 % en el subsector privado. El 72,5 % realizó una capacitación en los últimos 2 años. Se manifestaron "capacitados" para transmitir a sus pacientes los beneficios de las vacunas: 97,2 %; objetivos de campañas: 87,7 %; contraindicaciones: 82,4 %; efectos adversos: 78,9 %; recupero de esquemas: 71,2 %; notificación de ESAVI: 59,5 %. La proporción fue estadísticamente superior, en todos los aspectos, en pediatras con ≥10 años de ejercicio y en aquellos con capacitación reciente (p ≤ 0,01). Barreras identificadas en el acceso a la vacunación: falsas contraindicaciones (62,3 %); falta temporaria de vacunas (46,4 %); motivos culturales (41,4 %); horario restringido del vacunatorio (40,6 %). Conclusiones. La percepción del grado de capacitación fue variable según el aspecto de la vacunación. Aquellos con mayor tiempo de ejercicio profesional y con actualización reciente se manifestaron con mayor grado de capacidad. Se identificaron múltiples barreras frecuentes asociadas al acceso en la vacunación.

Introduction. The decline in vaccination coverage has been very significant in the past decade. Pediatriciansplay a key role in catching-up coverage and increasing confidence in vaccination. Objectives. To describe pediatricians' perceptions of vaccine knowledge and practices and to identify barriers to access. Methods. Observational, analytical study using an online survey. Variables related to professional profile, training and barriers to vaccination were included. Results. A total of 1696 pediatricians participated (response rate: 10.7%). Their mean age was 50.4 years; 78.7% were women; 78.2% had ≥ 10 years of experience; 78.4% provided outpatient care and 56.0%, in the private subsector; and 72.5% received training in the past 2 years. Respondents described themselves as "trained" in convey the following aspects to their patients: benefits of vaccines: 97.2%; campaign objectives: 87.7%; contraindications: 82.4%; adverse effects: 78.9%; catchup vaccination: 71.2%; reporting of events supposedly attributable to vaccination or immunization: 59.5%. The proportion was statistically higher in all aspects, among pediatricians with ≥ 10 years of experience and those who received training recently (p ≤ 0.01). The barriers identified in access to vaccination were false contraindications (62.3%), temporary vaccine shortage (46.4%), cultural reasons (41.4%), and restricted vaccination center hours (40.6%). Conclusions. The perception of the level of training varied depending on the vaccination-related aspect. Pediatricians with more years of professional experience and those who received recent updates perceivedthemselves as more trained. Multiple barriers associated with access to vaccination were identified.

Fractura craneal deprimida congénita ("fractura ping-pong") en neonatos como diagnóstico diferencial de maltrato físico / Congenital depressed skull fracture ("ping-pong" fracture) in newborn infants as a differential diagnosis of physical abuse

Las fracturas con hundimiento de cráneo sin una explicación clara sobre su origen orientan al traumatismo con un objeto romo y a la sospecha de maltrato infantil. En el caso de los bebés recién nacidos, su corta edad es un factor de vulnerabilidad y obliga a una exhaustiva evaluación. Ante la sospecha de maltrato infantil, resulta importante evaluar los diagnósticos diferenciales para realizar la intervención más adecuada posible. Es necesario evitar tanto intervenciones excesivas como omitir la intervención que sea necesaria. Las fracturas craneales deprimidas congénitas, descritas como "fracturas pingpong", son raras (0,3 a 2/10 000 partos). Pueden aparecer sin antecedentes traumáticos o en partos instrumentalizados. Se describe en este artículo el caso de un recién nacido con una fractura ping-pong como ejemplo de una fractura no intencional.

Depressed skull fractures without a clear explanation as to their origin point to trauma with a blunt object and suspected child abuse. In the case of newborn infants, their young age is a vulnerability factor and requires an exhaustive assessment. When child abuse is suspected, an assessment of the differential diagnoses is required to make the most appropriate intervention possible. Both an excessive intervention and an omission of a necessary intervention should be avoided. Congenital depressed skull fractures, described as "ping-pong fractures", are rare (0.3 to 2/10 000 births). They may appear without any trauma history or in instrumentalized childbirth. Here we describe the case of a newborn infant with a ping-pong fracture as an example of an accidental fracture.

Antibody persistence 7 years after hepatitis-A vaccine in children with human immunodeficiency virus infection / Persistencia de anticuerpos siete años después de la vacuna de la hepatitis A en niños con infección por el virus de la inmunodeficiencia humana

Abstract Background: HIV-infected children have a higher risk of presenting infections, including the hepatitis A virus (HAV). The inactivated HAV vaccine is immunogenic in immunocompetent hosts; however, there are insufficient studies on the duration of seroprotection in HIV-infected children. Methods: An analytical cohort study was conducted. HIV-1-infected children who received the inactivated HAV vaccine (2 doses) were included. Blood samples were taken for antibody measurement, the first one 28 days after the second dose and another 7 years after the vaccination schedule. Information on viral load, immunological category, weight, height, and response to antiretroviral treatment from diagnosis to the last assessment was obtained. Results: 19 patients were included, with a mean age of 12.6 years (SD ± 2.29). 58% were male. 80% of the patients presented protective immunoglobulin G antibodies against HAV 7-year post-vaccination. The antibody concentration was found to be between 13 and 80 mIU/mL (median of 80 mIU/mL). 52% showed some degree of immunosuppression. There was no statistically significant relationship between the presence of seroprotection and viral load, treatment failure, immunological category, and malnutrition. Twelve patients presented with antiretroviral treatment failure, and in 33% of them, the antibodies did not offer satisfactory seroprotection. Conclusion: 7-year post-vaccination, 80% of HIV-infected children maintain seroprotection titers against HAV.

Resumen Introducción: Los niños infectados por el virus de la inmunodeficiencia humana (VIH) tienen mayor riesgo de presentar infecciones, incluyendo hepatitis por virus A (VHA). La vacuna inactivada contra el VHA es inmunógena en el huésped inmunocompetente. No hay estudios suficientes sobre el tiempo de seroprotección en niños infectados por el VIH. Método: Estudio de cohorte, analítico. Se incluyeron niños con infección por VIH-1 que recibieron la vacuna inactivada contra el VHA (dos dosis). Se les tomaron muestras sanguíneas para medición de anticuerpos, una 28 días después de la segunda dosis y otra 7 años después del esquema de vacunación. Se obtuvo información de carga viral, categoría inmunológica, peso y talla, y respuesta al tratamiento antirretroviral desde el diagnóstico hasta la última valoración. Resultados: Se incluyeron 19 pacientes con una edad media de 12.6 años (± 2.29). El 58% fueron del sexo masculino. El 80% de los pacientes presentaron anticuerpos immunoglobulin G (IgG) contra el VHA protectores a los 7 años de la vacunación. La concentración de anticuerpos se encontró entre 13 y 80 mUI/ml (mediana: 80 mUI/ml). El 52% mostraron algún grado de inmunosupresión. No existe relación estadísticamente significativa entre la presencia de seroprotección y la carga viral, la falla al tratamiento, la categoría inmunológica ni la desnutrición. Doce pacientes presentaron falla al tratamiento antirretroviral; en el 33% de ellos los anticuerpos no ofrecían seroprotección satisfactoria. Conclusiones: A 7 años posvacunación, el 80% de los niños con VIH mantienen títulos de seroprotección frente al VHA.

COVID-19 associated transverse myelitis: case report / Mielitis transversa asociada a COVID-19: reporte de un caso

Abstract Background: Transverse myelitis (TM) is a demyelinating inflammatory disease that presents with motor, sensory, and autonomic dysfunction, which may be acute or subacute. COVID-19-associated TM has been described in a scarce number of patients. Clinical case: A 15-year-old previously healthy male patient with respiratory disease before his neurological deterioration presented to the emergency room after developing a complete medullary syndrome located at the cervical-dorsal level, with ascending and symmetric paraparesis that rapidly progressed to paraplegia, with sensory dysfunction from the T3 level, sphincter dysfunction and sudden ventilatory deterioration that required mechanical ventilation. Magnetic resonance imaging was compatible with acute TM. Inflammatory and non-inflammatory etiologies were discarded. In addition, a positive severe acute respiratory syndrome coronavirus 2 test was obtained. Treatment included steroid pulses and plasmapheresis, with an insidious evolution. Conclusion: COVID-19 is an infrequent cause of TM and should be suspected when other etiologies have been ruled out.

Resumen Introducción: La mielitis transversa (MT) es una enfermedad inflamatoria desmielinizante que se presenta con disfunción motora, sensitiva y autonómica, de forma aguda o subaguda. La MT asociada al COVID-19 se ha escrito en un escaso número de pacientes. Caso clínico: Se presenta el caso de un masculino de 15 años previamente sano, quien cursaba con un cuadro respiratorio y que desarrollo un deterioro neurológico súbito que involucro un síndrome medular completo localizado en el nivel cérvico dorsal, con paraparesia simétrica que progreso a la paraplejia, con disfunción sensitiva desde el nivel medular de T3, disfunción de esfínteres y deterioro ventilatorio que requirió manejo avanzado de la vía aérea. Su resonancia magnética fue compatible con mielitis transversa aguda. Se descartaron causas inflamatorias y no inflamatorias de la patología. Además, se obtuvo un resultado positivo de SARS-COV-2. Se inició tratamiento con pulsos de metilprednisolona y plasmaféresis, con una evolución insidiosa. Conclusión: El COVID-19 es una causa infrecuente de MT y debe sospecharse cuando otras causas han sido descartadas.

Comparison of the Functional Outcomes of Arthroscopic Anterior Cruciate Ligament Reconstruction through the All-inside and Outside-in Techniques: A Double-Blinded Randomized Controlled Trial / Comparação dos resultados funcionais da reconstrução artroscópica do ligamento cruzado anterior pelas técnicas all-inside e outside-in: Um ensaio clínico controlado, randomizado e duplo-cego

Abstract Objective To compare the functional outcomes of anterior cruciate ligament (ACL) reconstruction with hamstring autograft (HA) through the all-inside (AI) technique with adjustable-loop cortical Endobutton (Smith & Nephew, Watford, Hertfordshire, England) on the sides of the femur and tibia and through the outside-in (OI) technique using an interference screw on the tibial side and a cortical Endobutton on the femoral side. Materials and Methods The present is a double-blinded randomized controlled trial (RCT) of 44 patients undergoing arthroscopic ACL reconstruction from February 2019 to February 2022 in a tertiary care hospital. As per computer-based randomization, the patients were distributed into two groups: the AI and OI groups. Both groups were evaluated for 12 months using the Visual Analog Scale (VAS), the Lysholm Knee Scoring Scale, and part I (pain score) and part II (function score) of the Knee Society Score (KSS). Results On postoperative day 2,the VAS score was significantly higher in the OI group (p = 0.0001), but insignificant (p = 0.807) at 6 weeks. At 3, 6, and 12 months of follow-up, the score on the Lysholm Knee Scoring Scale was significantly higher (p = 0.001) in the AI group. At 6 months, both parts of the KSS showed a significant difference, with the AI group presenting a better outcome (p = 0.04). However, at 12 months, the AI group presented a better score on part I of the KSS, but no differences were observed regarding part II. Conclusion In a follow-up of 12 months, the patients submitted to the AI technique presented better outcome scores and pain relief than those submitted to the OI technique.

Resumo Objetivo Comparar os resultados funcionais da reconstrução do ligamento cruzado anterior (LCA) com autoenxerto de isquiotibiais pela técnica all-inside (AI) com Endobutton (Smith & Nephew, Watford, Hertfordshire, Inglaterra) cortical de alça ajustável nos lados do fêmur e da tíbia e pela técnica outside-in (OI) com parafuso de interferência no lado tibial e Endobutton cortical no lado femoral. Métodos Trata-se de um ensaio clínico controlado, randomizado e duplo-cego com 44 pacientes submetidos à reconstrução artroscópica do LCA de fevereiro de 2019 a fevereiro de 2022 em um hospital de cuidados terciários. De acordo com a randomização por computador, os pacientes foram distribuídos em dois grupos: AI e OI. Ambos os grupos foram avaliados durante 12 meses pela Escala Visual Analógica (EVA), a Escala de Pontuação do Joelho de Lysholm e pela parte I (pontuação de dor) e a parte II (pontuação de função) da escala Knee Society Score (KSS). Resultados No segundo dia de pós-operatório, a pontuação média na EVA foi significativamente maior no grupo OI (p = 0,0001), mas insignificante (p 0,807) às 6 semanas. Aos 3, 6 e 12 meses de acompanhamento, a pontuação na Escala de Lysholm (p = 0,001) foi significativamente maior no grupo AI. Aos 6 meses, ambas as partes da KSS apresentam uma diferença significativa, com o grupo AI apresentando um desfecho melhor (p = 0,04). No entanto, aos 12 meses, o grupo AI apresentou uma pontuação melhor na parte I da KSS, mas não foram observadas diferenças na parte II. Conclusão Em um acompanhamento de 12 meses, os pacientes submetidos à técnica AI apresentaram melhores pontuações de desfecho e alívio da dor do que aqueles submetidos à técnica OI.

Músculos Isquiotibiales. Análisis de su Uso y Propuesta de Inclusión en Terminologia Anatomica / Hamstring Muscles. Analysis of its Use and Proposal for Inclusion in Terminologia Anatomica

Terminologia Anatomica Internacional publicada el año 2019 en inglés y el 2001 en español contiene los nombres oficiales de las estructuras anatómicas. Sin embargo, existen términos que no están incluidos en esta terminología, y son ampliamente utilizados, es el caso del término músculos isquiotibiales. El objetivo de este trabajo fue analizar la utilización del término músculos isquiotibiales, músculos del compartimento femoral posterior y músculos del compartimento femoral flexor. Se realizó una revisión narrativa que incluyó 37 libros de anatomía, 3 diccionarios de terminología médica y biológica, 10 bases de datos y 15 recursos digitales. En los libros publicados después del año 2001 el 55,6 % utilizaba el término músculos isquiotibiales y el 18,5 % utilizó músculos del compartimento femoral posterior. En ningún diccionario se encontró el uso de los términos músculos isquiotibiales, músculos del compartimento femoral posterior ni músculos del compartimento femoral flexor. En las bases de datos se encontraron 12.104 artículos con el término músculos isquiotibiales, cinco con el término músculos del compartimento femoral posterior y uno con el término músculos del compartimento femoral flexor. En los recursos digitales de anatomía el 50 % utilizaba el término músculos isquiotibiales, el 37,5 % el término músculos del compartimento femoral posterior y el 12,5 % músculos del compartimento femoral flexor. En conclusión, el uso del término músculos isquiotibiales supera ampliamente al uso de los términos indicados por Terminologia Anatomica Internacional. Adicionalmente, este término es anatómicamente descriptivo y unívoco. Al respecto, parece apropiado valorar la incorporación del término músculos isquiotibiales en Terminologia Anatomica Internacional.

SUMMARY: The Terminologia Anatomica published in 2019 in English and 2001 in Spanish conTAIns the official names of anatomical structures. However, there are terms that are not included in this terminology, and are widely used, such as the term "hamstring muscles. The objective of this work was to analyze the use of the terms hamstring muscles, muscles of the posterior compartment of thigh and muscles of the flexor compartment of thigh. A narrative review was carried out that included 37 anatomy books, 3 dictionaries of medical and biological terminology, 10 databases and 15 digital resources. Results: In the books published after 2001, 55.6 % used the term hamstring muscles, 18.5 % muscles of the posterior compartment of thigh and 0 % muscles of the flexor compartment of thigh; In no dictionary was the use of the terms hamstring muscles, muscles of the posterior compartment of thigh or muscles of the flexor compartment of thigh found; In the databases, 12,104 articles were found with the term hamstring muscles, 5 with the term muscles of the posterior compartment of thigh and 1 with the term muscles of the flexor compartment of thigh; In the digital anatomy resources, 50 % used the term hamstring muscles, 37.5 % the term muscles of the posterior compartment of thigh and 12.5 % muscles of the flexor compartment of thigh. In conclusion, the use of the term hamstring muscles far exceeds the use of the terms indicated by the International Anatomical Terminology. Additionally, this term is anatomically descriptive and univocal. In this regard, it seems appropriate to assess the incorporation of the term hamstring muscles in Terminologia Anatomica.

Unusually Pronounced and Expansive Mandibular Foramen. A Incidental Radiological Finding / Foramen Mandibular Inusualmente Pronunciado y Expansivo: Un Hallazgo Radiológico Incidental

SUMMARY: The mandibular foramen and its canal are one of the most important structures in the skull, as they solely supply the mandible through their associated nerves and vessels. Many anatomical variations have been reported in the literature until now, and this case report represents a clear-cut appearance of its shape in a panoramic radiograph, which is not mostly seen in normal panoramic radiographs. These factors are of utmost importance when it comes to performing various surgeries and preventing complications due to their varied anatomy, which will allow dentists to create a better treatment plan and provide better treatments without any complications.

El foramen mandibular y su canal son algunas de las estructuras más importantes del cráneo y cara, ya que a través de ellos la mandíbula es inervada por nervios e irrigada por vasos. Hasta ahora, en la literatura consultada, se han informado de numerosas variaciones anatómicas. En este trabajo reportamos la forma y trayecto del foramen y canal mandibular, obtenidos en una radiografía panorámica, que no es observada normalmente en este tipo de radiografía. Los factores anatómicos son de importancia a la hora de realizar las cirugías para prevenir complicaciones debido a su variada anatomía, permitiendo a los odontólogos crear un mejor plan de tratamiento sin ningún tipo de complicaciones.

Biometrics of the Hand's Middle Finger to Determine Stature in Chilean University Students / Biometría del Dedo Medio de la Mano para Determinar Estatura en Estudiantes Universitarios Chilenos

SUMMARY: Biometrics and forensic osteology play a significant role in human identification, as the morphological uniqueness of every individual enables the differentiation and recognition of skeletal remains. Through meticulous analysis of human remains, it is possible to determine key demographic attributes such as stature, a significant parameter in the forensic identification process. This information is of practical relevance for the identification of individuals in contexts such as disasters, vehicular accidents, terrorist attacks, armed conflicts, and forensic investigations. The objective of this study was to determine the correlation between the hand's middle finger length and stature in a group of Chilean students. A total of 211 students of both sexes from La Araucanía region, Chile, participated in the study. After obtaining informed consent to participate voluntarily in the study, each individual underwent a general anthropometric examination, followed by a specific assessment of the length of the middle finger (MFL) of both hands. The results of the multiple linear regression analysis indicated a significant prediction of stature using the length of the right (R-MFL) and left (L-MFL) middle fingers, F (2, 207) = 79.80, p < 0.001. The equations for estimating stature based on the length of the middle fingers are as follows: for R-MFL, Stature = 91.265 + (8.092 x R-MFL), and for L-MFL, Stature = 83.967 + (8.889 x L-MF). Based on these results, it was found that the length of the middle finger of both hands is predictive of stature.

La biometría y la osteología forense desempeñan un papel relevante en la identificación humana, dado que la singularidad morfológica de cada individuo permite la diferenciación y reconocimiento de restos óseos. Mediante el análisis meticuloso de los restos humanos, es posible determinar atributos demográficos clave como la estatura, un parámetro significativo en el proceso de identificación forense. Esta información posee relevancia práctica para la identificación de personas en contextos de desastres, accidentes vehiculares, ataques terroristas, conflictos armados e investigaciones forenses. El objetivo de este estudio fue determinar la correlación entre la longitud del dedo medio de la mano con la estatura, en un grupo de estudiantes chilenos. Se evaluaron 211 estudiantes de ambos sexos de la región de La Araucanía, Chile. Tras obtener el consentimiento informado para participar voluntariamente en el estudio, se sometió a cada individuo a un examen antropométrico general, seguido de una evaluación específica de la longitud del dedo medio (MFL) de ambas manos. Los resultados del análisis de las regresiones lineales múltiples indicaron una significativa predicción de estatura utilizando la longitud de los dedos medios derecho (R-MFL) e izquierdo (L-MFL), F (2, 207) = 79.80, p < 0.001. Las ecuaciones para estimar estatura basados en la longitud de los dedos medios son las siguientes: para R-MFL, Stature = 91.265 + (8.092 x R-MFL) y para L-MFL, Stature = 83.967 + (8.889 x L- MF). A partir de estos resultados, se encontró que la longitud del dedo medio de ambos manos es predictora de estatura.

Anatomical Study of the Pterion in a South African Population of KwaZulu-Natal / Estudio Anatómico del Pterion en una Población Audafricana de KwaZulu-Natal

SUMMARY: Morphologically the Pterion marks the location of the four cranial bones, viz. frontal bone, sphenoid angle of the parietal bone, squamous part of the temporal bone and the greater wing of the sphenoid bone. Population-specific differences exists in the position and union of the Pterion. The Pterion is also an important neurosurgical landmark for surgical procedures, viz. Pterional/lateral approach, as it provides wide access to the base of the skull. This study aimed to determine the position and incidence of the various sutural patterns of the Pterion in a South African population of KwaZulu-Natal. This retrospective study was conducted bilaterally on 36 dry human skulls (11 females and 25 males) obtained from the Department of Clinical Anatomy at University of KwaZulu-Natal. Ethical clearance obtained from the Biomedical Research Ethics Committee. The morphometric parameters of the Pterion were measured using a digital Vernier caliper, while the morphological characteristics were examined using Murphy's classification scheme to determine (if any) laterality or sex differences exists. The mean distance of the Centre of the pterion from midpoint of zygoma was 44.4+/-4.1 mm in males and 45.1+/-4.6 mm in females. While the distance from frontozygomatic suture was 32.7+/-4.7 mm and 32.6+/-4.8 mm in males and females, respectively. Sphenoparietal type of pterion was most prevalent at 55.6 %, followed by the frontotemporal, stellate and epipteric type with an incidence of 27.8 %; 11.1 % and 5.6 %, respectively. No statistically significant difference for sex or laterality were documented in this study. The present study concluded that the sphenoparietal type of sutural pattern was most prevalent with an incidence of 55.6 %. While the epipteric type was the least prevalent. The comprehensive data about the position of the Pterion is important to neurosurgeons, forensics scientists and anthropologists.

Morfológicamente, el pterion marca la ubicación de los cuatro huesos craneales: hueso frontal, ángulo esfenoidal del hueso parietal, parte escamosa del hueso temporal y el ala mayor del hueso esfenoides. Existen diferencias específicas de la población en la posición y unión del pterion. El pterion es también un hito neuroquirúrgico importante para los procedimientos quirúrgicos en el bordaje pterional/lateral, ya que proporciona un amplio acceso a la base del cráneo. Esta investigación tuvo como objetivo determinar la posición y la incidencia de los diversos patrones suturales del pterion en una población sudafricana de KwaZulu-Natal. Este estudio retrospectivo se realizó bilateralmente en 36 cráneos humanos secos (11 mujeres y 25 hombres) obtenidos del Departamento de Anatomía Clínica de la Universidad de KwaZulu-Natal. ALa autorización ética fue otorgada porel Comité Ético de Investigación Biomédica. Los parámetros morfométricos del pterion se midieron usando un calibrador Vernier digital, mientras que las características morfológicas se examinaron usando el esquema de clasificación de Murphy para determinar, si existe alguna lateralidad o diferencias sexuales. La distancia media del centro del pterion desde el punto medio del cigoma fue de 44,4+/- 4,1 mm en hombres y de 45,1+/-4,6 mm en mujeres. Mientras que la distancia desde la sutura frontocigomática fue de 32,7+/-4,7 mm y 32,6+/-4,8 mm en hombres y mujeres, respectivamente. El tipo de pterion esfenoparietal fue el más prevalente con un 55,6 %, seguido del tipo frontotemporal, estrellado y epiptérico con una incidencia del 27,8 %; 11,1 % y 5,6 %, respectivamente. En el estudio no se documentaron diferencias estadísticamente significativas para el sexo o la lateralidad. Concluimos que el tipo de patrón de sutura esfenoparietal fue el más prevalente con una incidencia del 55,6 %. Mientras que el tipo epiptérico fue el menos prevalente. Los datos completos sobre la posición del pterion son importantes para los neurocirujanos, los científicos forenses y los antropólogos.