Phytochemical screening of Cordia glabrata (MART.) A.DC. extracts and its potential antioxidant, photoprotective, antimicrobial and antiviral activities / Triagem fitoquímica de extratos de Cordia glabrata (MART.) A.DC. e sua potencial atividade antioxidante, fotoprotetora, antimicrobiana e antiviral

Species of the genus Cordia have shown biological activities, such as anti-inflammatory, analgesic, antioxidant, antiviral, and antifungal activities. The species Cordia glabrata (MART) A.DC. Has no information concerning its phytochemical profile and possible biological activities. Thus, this study aimed to evaluate this profile in ethanolic extracts of young, adult and senescent leaves, as well as their antioxidant, photoprotective, antimicrobial, and virucidal potentials. Phytochemical analysis was performed by TLC (thin-layer chromatography) and showed the presence of flavonoids, tannins, and terpenes. The evaluation by UPLC-MS/MS (Ultra performance liquid chromatography - tandem mass spectrometer) evidenced the presence of caffeic (3.89 mgL-¹), p-cumaric (6.13 mgL-¹), and ferulic (0.58 mgL-¹) acids, whilst, in GC/MS (Gas chromatography–mass spectrometry) analysis there was a greater amount of palmitic (51.17%), stearic (20.34%), linoleic (9.62%), and miristic (8.16%) fatty acids. The DPPH (2,2-Diphenyl-1-picrylhydrazyl) and ABTS+ (2′-Azino-bis(3-ethylbenzothiazoline-6-sulfonic acid)) radicals were used to verify the potential antioxidant activity, observing a better activity for the leaf extract in the adult phenological stage: 54.63 ± 1.06 µgmL-¹ (DPPH) and 44.21 ± 1.69 mM (ABTS). The potential photoprotective activity of the extracts was determined by spectrophotometry and the in vitro values of SPF (Sun Protection Factor) in young and adult leaves (5.47 and 5.41, respectively) showed values close to the minimum SPF of 6.0 required by ANVISA (Brazilian Health Regulatory Agency). It was not observed an antimicrobial activity for Staphylococcus aureus with a minimum inhibitory concentration of 2000 µgmL-¹, however the anti-herpetic assay against the Herpes simplex virus type 2 (HSV-2) showed a potent virucidal activity at the tested concentrations with CV50 value <0.195 µgmL-¹ and a Selectivity Index (SI = CC50 / CV50) greater than 448. The results [...].

Espécies do gênero Cordia apresentam atividades biológicas, como anti-inflamatória, analgésica, antioxidante, antiviral e antifúngica. Para a espécie Cordia glabrata (MART) A.DC., ainda não existem informações sobre seu perfil fitoquímico e possíveis atividades biológicas, deste modo, o presente estudo teve como objetivo avaliar este perfil em extratos etanólicos de folhas jovens, adultas e senescentes, bem como o potencial antioxidante, fotoprotetor, antimicrobiano e virucida. A análise fitoquímica foi realizada por CCD (Cromatografia em Camada Delgada), mostrando a presença de flavonóides, taninos e terpenos. Na avaliação por CLAE EM/EM (Cromatografia Líquida de Ultra Eficiência acoplada a Espectrometria de Massas) foi evidenciado a presença dos ácidos caféico (3,89 mgL-¹), p-cumárico (6,13 mgL-¹) e ferúlico (0,58 mgL-¹), paralelamente, na CG/EM (Cromatografia Gasosa acoplada a Espectrometria de Massas) verificou-se maior quantidade dos ácidos graxos palmítico (51,17%), esteárico (20,34%), linoléico (9,62%) e mirístico (8,16%). Os radicais DPPH (2,2-Difenil-1-picrilhidrazil) e ABTS+ (2′-Azino-bis (ácido 3-etilbenzotiazolina-6-sulfônico)) foram utilizados para verificar o potencial antioxidante, observando se uma atividade superior para o extrato da folha em sua fase fenológica adulta: 54,63 ± 1,06 µgmL-¹ (DPPH) e 44,21 ± 1,69 mM (ABTS+). A potencial atividade fotoprotetora dos extratos foi determinada espectrofotometricamente e os valores in vitro de FPS (Fator de Proteção Solar) em folhas jovens e adultas (5,47 e 5,41 respectivamente) apresentaram valores próximos ao FPS mínimo de 6,0 exigido pela ANVISA (Agência Nacional de Vigilância Sanitária). Não foi observada atividade antimicrobiana para Staphylococcus aureus sendo a concentração inibitória mínima de 2000 µgmL-¹, no entanto o ensaio anti-herpético contra o vírus Herpes simplex tipo 2 (HSV-2) mostrou uma potente atividade virucida nas concentrações testadas [...].

Phytochemical screening of Cordia glabrata (MART.) A.DC. extracts and its potential antioxidant, photoprotective, antimicrobial and antiviral activities

Abstract Species of the genus Cordia have shown biological activities, such as anti-inflammatory, analgesic, antioxidant, antiviral, and antifungal activities. The species Cordia glabrata (MART) A.DC. Has no information concerning its phytochemical profile and possible biological activities. Thus, this study aimed to evaluate this profile in ethanolic extracts of young, adult and senescent leaves, as well as their antioxidant, photoprotective, antimicrobial, and virucidal potentials. Phytochemical analysis was performed by TLC (thin-layer chromatography) and showed the presence of flavonoids, tannins, and terpenes. The evaluation by UPLC-MS/MS (Ultra performance liquid chromatography - tandem mass spectrometer) evidenced the presence of caffeic (3.89 mgL-1), p-cumaric (6.13 mgL-1), and ferulic (0.58 mgL-1) acids, whilst, in GC/MS (Gas chromatographymass spectrometry) analysis there was a greater amount of palmitic (51.17%), stearic (20.34%), linoleic (9.62%), and miristic (8.16%) fatty acids. The DPPH (2,2-Diphenyl-1-picrylhydrazyl) and ABTS+ (2-Azino-bis(3-ethylbenzothiazoline-6-sulfonic acid)) radicals were used to verify the potential antioxidant activity, observing a better activity for the leaf extract in the adult phenological stage: 54.63 ± 1.06 µgmL-1 (DPPH) and 44.21 ± 1.69 mM (ABTS). The potential photoprotective activity of the extracts was determined by spectrophotometry and the in vitro values of SPF (Sun Protection Factor) in young and adult leaves (5.47 and 5.41, respectively) showed values close to the minimum SPF of 6.0 required by ANVISA (Brazilian Health Regulatory Agency). It was not observed an antimicrobial activity for Staphylococcus aureus with a minimum inhibitory concentration of 2000 gmL-1, however the anti-herpetic assay against the Herpes simplex virus type 2 (HSV-2) showed a potent virucidal activity at the tested concentrations with CV50 value 0.195 gmL-1 and a Selectivity Index (SI = CC50 / CV50) greater than 448. The results obtained in this study suggest that extracts of leaves of C. glabrata in their adult phenological stage have potential antioxidant, photoprotective and virucidal activity, considering in vitro test results.

Resumo Espécies do gênero Cordia apresentam atividades biológicas, como anti-inflamatória, analgésica, antioxidante, antiviral e antifúngica. Para a espécie Cordia glabrata (MART) A.DC., ainda não existem informações sobre seu perfil fitoquímico e possíveis atividades biológicas, deste modo, o presente estudo teve como objetivo avaliar este perfil em extratos etanólicos de folhas jovens, adultas e senescentes, bem como o potencial antioxidante, fotoprotetor, antimicrobiano e virucida. A análise fitoquímica foi realizada por CCD (Cromatografia em Camada Delgada), mostrando a presença de flavonóides, taninos e terpenos. Na avaliação por CLAE EM/EM (Cromatografia Líquida de Ultra Eficiência acoplada a Espectrometria de Massas) foi evidenciado a presença dos ácidos caféico (3,89 mgL-1), p-cumárico (6,13 mgL-1) e ferúlico (0,58 mgL-1), paralelamente, na CG/EM (Cromatografia Gasosa acoplada a Espectrometria de Massas) verificou-se maior quantidade dos ácidos graxos palmítico (51,17%), esteárico (20,34%), linoléico (9,62%) e mirístico (8,16%). Os radicais DPPH (2,2-Difenil-1-picrilhidrazil) e ABTS+ (2-Azino-bis (ácido 3-etilbenzotiazolina-6-sulfônico)) foram utilizados para verificar o potencial antioxidante, observando-se uma atividade superior para o extrato da folha em sua fase fenológica adulta: 54,63 ± 1,06 µgmL-1 (DPPH) e 44,21 ± 1,69 mM (ABTS+). A potencial atividade fotoprotetora dos extratos foi determinada espectrofotometricamente e os valores in vitro de FPS (Fator de Proteção Solar) em folhas jovens e adultas (5,47 e 5,41 respectivamente) apresentaram valores próximos ao FPS mínimo de 6,0 exigido pela ANVISA (Agência Nacional de Vigilância Sanitária). Não foi observada atividade antimicrobiana para Staphylococcus aureus sendo a concentração inibitória mínima de 2000 gmL-1, no entanto o ensaio anti-herpético contra o vírus Herpes simplex tipo 2 (HSV-2) mostrou uma potente atividade virucida nas concentrações testadas com um valor de CV50 0,195 gmL-1 e um Índice de Seletividade (IS = CC50 / CV50) maior que 448. Os resultados obtidos neste estudo sugerem que extratos de folhas de C. glabrata em seu estágio fenológico adulto apresentam potencial antioxidante, fotoprotetora e virucida, considerando os resultados de testes in vitro.

Phytochemical screening of Cordia glabrata (MART.) A.DC. extracts and its potential antioxidant, photoprotective, antimicrobial and antiviral activities / Triagem fitoquímica de extratos de Cordia glabrata (MART.) A.DC. e sua potencial atividade antioxidante, fotoprotetora, antimicrobiana e antiviral

Abstract Species of the genus Cordia have shown biological activities, such as anti-inflammatory, analgesic, antioxidant, antiviral, and antifungal activities. The species Cordia glabrata (MART) A.DC. Has no information concerning its phytochemical profile and possible biological activities. Thus, this study aimed to evaluate this profile in ethanolic extracts of young, adult and senescent leaves, as well as their antioxidant, photoprotective, antimicrobial, and virucidal potentials. Phytochemical analysis was performed by TLC (thin-layer chromatography) and showed the presence of flavonoids, tannins, and terpenes. The evaluation by UPLC-MS/MS (Ultra performance liquid chromatography - tandem mass spectrometer) evidenced the presence of caffeic (3.89 mgL-1), p-cumaric (6.13 mgL-1), and ferulic (0.58 mgL-1) acids, whilst, in GC/MS (Gas chromatography-mass spectrometry) analysis there was a greater amount of palmitic (51.17%), stearic (20.34%), linoleic (9.62%), and miristic (8.16%) fatty acids. The DPPH (2,2-Diphenyl-1-picrylhydrazyl) and ABTS+ (2′-Azino-bis(3-ethylbenzothiazoline-6-sulfonic acid)) radicals were used to verify the potential antioxidant activity, observing a better activity for the leaf extract in the adult phenological stage: 54.63 ± 1.06 µgmL-1 (DPPH) and 44.21 ± 1.69 mM (ABTS). The potential photoprotective activity of the extracts was determined by spectrophotometry and the in vitro values of SPF (Sun Protection Factor) in young and adult leaves (5.47 and 5.41, respectively) showed values close to the minimum SPF of 6.0 required by ANVISA (Brazilian Health Regulatory Agency). It was not observed an antimicrobial activity for Staphylococcus aureus with a minimum inhibitory concentration of 2000 μgmL-1, however the anti-herpetic assay against the Herpes simplex virus type 2 (HSV-2) showed a potent virucidal activity at the tested concentrations with CV50 value <0.195 μgmL-1 and a Selectivity Index (SI = CC50 / CV50) greater than 448. The results obtained in this study suggest that extracts of leaves of C. glabrata in their adult phenological stage have potential antioxidant, photoprotective and virucidal activity, considering in vitro test results.

Resumo Espécies do gênero Cordia apresentam atividades biológicas, como anti-inflamatória, analgésica, antioxidante, antiviral e antifúngica. Para a espécie Cordia glabrata (MART) A.DC., ainda não existem informações sobre seu perfil fitoquímico e possíveis atividades biológicas, deste modo, o presente estudo teve como objetivo avaliar este perfil em extratos etanólicos de folhas jovens, adultas e senescentes, bem como o potencial antioxidante, fotoprotetor, antimicrobiano e virucida. A análise fitoquímica foi realizada por CCD (Cromatografia em Camada Delgada), mostrando a presença de flavonóides, taninos e terpenos. Na avaliação por CLAE EM/EM (Cromatografia Líquida de Ultra Eficiência acoplada a Espectrometria de Massas) foi evidenciado a presença dos ácidos caféico (3,89 mgL-1), p-cumárico (6,13 mgL-1) e ferúlico (0,58 mgL-1), paralelamente, na CG/EM (Cromatografia Gasosa acoplada a Espectrometria de Massas) verificou-se maior quantidade dos ácidos graxos palmítico (51,17%), esteárico (20,34%), linoléico (9,62%) e mirístico (8,16%). Os radicais DPPH (2,2-Difenil-1-picrilhidrazil) e ABTS+ (2′-Azino-bis (ácido 3-etilbenzotiazolina-6-sulfônico)) foram utilizados para verificar o potencial antioxidante, observando-se uma atividade superior para o extrato da folha em sua fase fenológica adulta: 54,63 ± 1,06 µgmL-1 (DPPH) e 44,21 ± 1,69 mM (ABTS+). A potencial atividade fotoprotetora dos extratos foi determinada espectrofotometricamente e os valores in vitro de FPS (Fator de Proteção Solar) em folhas jovens e adultas (5,47 e 5,41 respectivamente) apresentaram valores próximos ao FPS mínimo de 6,0 exigido pela ANVISA (Agência Nacional de Vigilância Sanitária). Não foi observada atividade antimicrobiana para Staphylococcus aureus sendo a concentração inibitória mínima de 2000 μgmL-1, no entanto o ensaio anti-herpético contra o vírus Herpes simplex tipo 2 (HSV-2) mostrou uma potente atividade virucida nas concentrações testadas com um valor de CV50 <0,195 μgmL-1 e um Índice de Seletividade (IS = CC50 / CV50) maior que 448. Os resultados obtidos neste estudo sugerem que extratos de folhas de C. glabrata em seu estágio fenológico adulto apresentam potencial antioxidante, fotoprotetora e virucida, considerando os resultados de testes in vitro.

Caracterización de la hidradenitis supurativa en centro dermatológico colombiano durante el periodo del 2016 al 2019 / Characterization of hidradenitis suppurativa on a Colombian dermatological center, 2016-2019

Resumen Antecedentes: La hidradenitis supurativa (HS) es una enfermedad inflamatoria crónica de la piel. Se relaciona con diferentes factores que podrían incrementar la severidad, pero algunos son poco conocidos o controvertidos. Dado su alto impacto social, deterioro de la calidad de vida y falta de estudios epidemiológicos en Colombia, decidimos describir las variables relacionadas en pacientes con HS atendidos en un centro dermatológico colombiano. Métodos: Se realizó un estudio descriptivo y retrospectivo en un centro dermatológico de Bogotá. Los datos se obtuvieron de los registros médicos de enero de 2016 a diciembre de 2019. Analizamos edad, sexo, índice de masa corporal (IMC), hipertensión, relación premensual, antecedentes familiares de HS, presencia de acné, severidad y ubicación de las lesiones. Resultados: De 24 pacientes, 18 eran mujeres. La mediana de edad fue de 30 años. La mediana del IMC fue de 22,8 Kg / m². El 25% de los casos eran fumadores, el 12,5% tenía hipertensión arterial, el 25% tenía antecedentes familiares de HS, el 20,8% coexistió con acné. Además, el 38,9% de las mujeres informaron un empeoramiento de la sintomatología de la HS en el período premenstrual. La localización más común fue la axila (58,3%). El estadio I de Hurley fue el más frecuente (41,7%). Conclusiones: Este es el primer estudio epidemiológico en Colombia y uno de los pocos publicados en Latinoamérica. Estamos ante una enfermedad crónica con un diagnóstico frecuentemente retrasado, de difícil tratamiento y que afecta la calidad de vida. Es importante hacer una intervención temprana para mejorar el pronóstico. Finalmente se necesitan más estudios sobre las principales características de la HS.

Abstract Background: Hidradenitis suppurativa (HS) is a chronic inflammatory skin disease. It is related to different factors that could increase the severity, but some are not well known or are controversial. Given its high social impact and quality of life impairment and the lack of epidemiological studies in Colombia, we described disease variables in patients with HS treated at a colombian dermatological center. Methods: A descriptive and retrospective study was carried out in a dermatological center in Bogota. Data were collected from medical records from January 2016 to December 2019. We analyzed age, sex, boy mass index (BMI), hypertension, pre-monthly relationship, family history of HS, acne presence, severity and lesion locations. Results: Of 24 patients, 18 were women. The median age was 30 years . The BMI median was 22,8 Kg/m². The 25% of cases were smoker, 12,5% had arterial hypertension, 25% had family history of HS, 20.8% had coexistence with acne. Also, 38.9% of women reported worsening symptomatology of HS in the premenstrual period. The most common location was the armpit (58.3%). Hurley stage I was the most frequent (41.7%). Conclusions: This is the first epidemiological study in Colombia and one of the few published in Latinamerica. We are facing a chronic disease with a frequently delayed diagnosis, which is difficult to treat and affects quality of life. Is important to do an early intervention to improve the prognosis. Further studies are needed about HS main characteristics.

Tratamiento quirúrgico de fracturas de cóndilo mandibular: reducción asistida por endoscopio como complemento al tratamiento convencional / Surgical treatment of mandibular condyle fractures: endoscope-assisted reduction as a complement to conventional treatment

Resumen Introducción: Las fracturas de cóndilo presentan una alta incidencia dentro de las fracturas de mandíbula. Son principalmente tratadas por reducción abierta y fijación interna mediante elementos de osteosíntesis (ORIF) o por reducción cerrada (CR) con fijación máxilo-mandibular (MMF). El tratamiento asistido por endoscopio de estas fracturas, ofrece una alternativa y complemento quirúrgico a las limitaciones que se pueden presentar en la ORIF clásica. Objetivo: Describir la técnica de reducción quirúrgica asistida por endoscopio mediante acceso transoral y acceso retromandibular, como complemento a la técnica quirúrgica convencional para el tratamiento de fracturas de cóndilo mandibular, evaluando criterios clínicos en una serie de casos operados por esta técnica. Materiales y Método: Estudio descriptivo de presentación de serie de casos de pacientes con fractura de cóndilo, tratados con reducción quirúrgica asistida por endoscopio mediante accesos transoral y retromandibular, entre los años 2017 y 2018. Resultados: De los siete pacientes operados, un 85,7% presentó una función mandibular normal, un 100% presentó una función motora neurológica facial normal y un 71,4% no presentó dolor posoperatorio en el control de los 6 meses. Todos los pacientes recuperaron la oclusión que tenían de forma previa a la fractura mandibular. No se reportaron casos que tuvieran la necesidad de reintervención quirúrgica. Conclusiones: La reducción quirúrgica asistida por endoscopio para las fracturas de cóndilo mandibular es una técnica que ofrece un complemento a la técnica quirúrgica convencional, permitiendo mayor visibilidad de las estructuras, menor morbilidad quirúrgica y complicaciones mínimas en relación a las técnicas convencionales descritas.

Introduction: Condyle fractures have a high incidence within jaw fractures. They are mainly treated by open reduction and internal fixation with osteosynthesis elements (ORIF), or by closed reduction (CR) with maxillomandibular fixation (MMF). Endoscopic-assisted treatment of these fractures offers an alternative and surgical complement to the limitations that can occur in classic ORIF. Aim: To describe the technique of endoscope-assisted surgical reduction using transoral access and retromandibular access, as a complement to the conventional surgical technique for the treatment of mandibular condyle fractures, evaluating clinical criteria in a series of cases operated by this technique. Materials and Method: Descriptive study of case series presentation of patients with condyle fracture, treated with endoscopic assisted surgical reduction by transoral and retromandibular access, between the years 2017 and 2018. Results: Of the seven patients operated on, 85.7% presented normal jaw function, 100% presented normal facial neurological motor function, and 71.4% presented no postoperative pain at the 6-month control. All patients recovered the occlusion they had prior to the mandibular fracture. There were no reported cases in need of surgical reintervention. Conclusions: Endoscope-assisted surgical reduction for mandibular condyle fractures is a technique that offers a complement to the conventional surgical technique, allowing greater visibility of the structures, less surgical morbidity and minimal complications in relation to the conventional techniques described.

Fracturas Mandibulares Conminutadas por Impacto de Proyectil Balístico: Resultados Clínicos de Tratamiento Con Método de Fijación Alternativo

RESUMEN: Las fracturas mandibulares conminutadas por impacto de proyectil balístico son un desafío terapéutico debido a la presencia de múltiples fragmentos óseos y el compromiso a nivel de periostio, plano muscular y mucoso. Su tratamiento inicial requiere de una estabilización de las urgencias médico - quirúrgicas y posteriormente tratar los segmentos óseos fracturados. La fijación externa con tutores mandibulares permite estabilizar los segmentos mandibulares de forma cerrada manteniendo así la viabilidad de los fragmentos sin interrumpir su suministro de sangre. El objetivo de este trabajo es presentar los resultados post operatorios obtenidos en tres casos clínicos de pacientes con diagnóstico de fractura mandibular conminutada por trauma por impacto de proyectil balístico, tratados por un método alternativo a los tutores de fijación externa convencional.

ABSTRACT: Comminuted mandibular fractures from ballistic missile impact are a therapeutic challenge due to the presence of multiple bone fragments and the involvement of periosteum, muscle and mucous membrane. Their initial treatment requires emergency medical and surgical stabilization and later treatment of the fractured bone segments. External fixation with mandibular stakes makes it possible to stabilize the mandibular segments in a closed manner, thus maintaining the viability of the fragments without interrupting their blood supply. The aim of this work is to present the post-surgical results obtained in three clinical cases of patients with diagnosis of comminuted mandibularfracture by ballistic missile impact, treated by an alternative method to the conventional external fixation tutors.

Asociación entre gastritis biliar y gastritis por Helicobacter pylori en pacientes con reflujo duodenogástrico en el Hospital Central Militar / Association between biliary gastritis and gastritis by Helicobacter pylori in patients with duodenogastric reflection in the Military Central Hospital

Resumen Introducción: Esta investigación está orientada a conocer si existe una asociación (directa o indirecta) entre el reflujo duodenogástrico y las gastritis crónicas por Helicobacter pylori. Material y Metodo: Se recolectaron los datos de pacientes a quienes se les realizó panendoscopía diagnóstica en el departamento de endoscopia del Hospital Central Militar desde marzo del 2018 a febrero del 2019, por medio de una entrevista clínica y una hoja de recolección de datos. Resultados: Del grupo evaluado con reflujo duodenogástrico, el 44.1% (202 casos) presentaron gastritis química por reporte histopatológico. En el grupo de pacientes con reflujo duodenogástrico y gastritis química o biliar (n=202), el 22.7% (46 casos) presentó en el reporte histopatológico gastritis por Helicobacter pylori. En los pacientes con reflujo duodenogástrico y sin gastritis biliar (n=256), el 92.57% (237 casos) presentó gastritis por Helicobacter pylori en el reporte histopatológico. Discusión: Existe una asociación alta de tipo indirecto entre la gastritis biliar y gastritis por Helicobacter pylori en pacientes con reflujo duodenogástrico o biliar. Aproximadamente la mitad de los pacientes con reflujo duodenogástrico presentan gastritis biliar con el riesgo de desarrollar metaplasia intestinal. La gastropatía mixta (gastritis biliar y por Helicobacter pylori) es un factor de riesgo para mayor daño a la mucosa gástrica, como es la expresión de metaplasia intestinal.

Abstract Introduction: This research is oriented to know if there is an association (direct or indirect) between duodenogastric reflux and chronic gastritis by Helicobacter pylori. Material and Method: We collected data from patients who underwent diagnostic panendoscopy in the endoscopy department of the Central Military Hospital from March 2018 to February 2019, through a clinical interview and a data collection sheet. Results: Of the group evaluated with duodenogastric reflux, 44.1% (202 cases) presented chemical gastritis due to histopathological report. In the group of patients with duodenogastric reflux and chemical or biliary gastritis (n = 202), 22.7% (46 cases) presented gastritis due to Helicobacter pylori in the histopathological report. In patients with duodenogastric reflux and without biliary gastritis (n = 256), 92.57% (237 cases) presented gastritis due to Helicobacter pylori in the histopathological report. Discussion: There is a high association of indirect type between biliary gastritis and gastritis due to Helicobacter pylori in patients with duodenogastric or biliary reflux. Approximately half of the patients with duodenogastric reflux present biliary gastritis with the risk of developing intestinal metaplasia. Mixed gastropathy (biliary gastritis and Helicobacter pylori) is a risk factor for greater damage to the gastric mucosa, such as the expression of intestinal metaplasia.

Resultados posoperatorios y satisfacción en pacientes operados de cirugía ortognática durante los años 2011-2018 en Hospital San José, Chile

Resumen Introducción: Las dismorfosis dentofaciales (DDF) corresponden a un conjunto de alteraciones en la forma, posición o tamaño de los huesos maxilares. La cirugía ortognática es el tratamiento quirúrgico de elección para tratar este tipo de alteraciones, permitiendo la reposición de los maxilares y restitución de las funciones masticatorias, fonéticas y respiratorias, así como la estética facial. Objetivo: Describir resultados posoperatorios y el grado de satisfacción de los pacientes que optaron por la cirugía ortognática durante los años 2011-2018 por el equipo de Cirugía Maxilofacial del Hospital San José. Material y Método: Estudio retrospectivo, se evaluaron los protocolos operatorios de 44 pacientes operados de cirugía ortognática. Criterio de inclusión: pacientes mayores de 15 años con diagnóstico de DDF clases II y III no asociado a síndrome craneofacial. Se aplicó una encuesta a estos pacientes para conocer el grado de satisfacción con respecto a la cirugía ortognática efectuada, presencia de pérdida de sensibilidad neurológica y localización anatómica de ésta si la hubiese. Posteriormente, se relacionaron las variables género, edad del paciente al momento de la cirugía, pérdida de sensibilidad neurológica, tiempo de evolución posoperatorio y clase esqueletal con el nivel de satisfacción del paciente respecto a la cirugía ortognática. Resultados: Un 90,9% de los pacientes está satisfecho con los resultados de la cirugía. No existe una relación estadísticamente significativa entre el grado de satisfacción con la cirugía ortognática y las variables, sexo, edad de operación, pérdida de sensibilidad neurológica (del nervio mentoniano, que da inervación sensitiva al tejido blando del mentón, labio inferior, encía por vestibular de incisivos, canino y primer premolar inferior), tiempo de evolución posterior a la cirugía y clase esqueletal. Conclusión: Existe un alto nivel de satisfacción en los pacientes intervenidos mediante cirugía ortognática. Las cinco variables analizadas no influyen en el nivel de satisfacción de los pacientes posterior a la cirugía ortognática.

Abstract Introduction: Dentofacial deformities are a set of alterations in the shape, position or size of the maxillary bones. Orthognathic surgery is the surgical treatment of choice for this type of alterations, allowing the replacement of the maxillary and restitution of masticatory, phonetic and respiratory functions, as well as facial aesthetics. Aim: Describe post-operative results and level of satisfaction in patients who opted for orthognathic surgery during the years 2011-2018 by the Maxillofacial Surgery team of San José Hospital. Material and Method: Retrospective study, the surgical protocols of 44 patients who underwent orthognathic surgery were evaluated. Inclusion criteria: patients over 15 years old with diagnosis of DDF class II and III not associated with any craniofacial syndrome. A survey was applied to these patients to know the degree of satisfaction with respect to the orthognathic surgery carried out, the presence of loss of neurological sensitivity and its anatomical location, if any. Subsequently, the variables gender, patient age at the time of surgery, loss of neurological sensitivity, time of postoperative evolution and skeletal class were related to the level of satisfaction of patients with orthognathic surgery. Results: 90.9% of patients are satisfied with the results of the surgery. There is no statistically significant relationship between the level of satisfaction patients with orthognathic surgery and the variables, gender, age at the time of surgery, loss of neurological sensitivity (of the mentonian nerve, that gives sensitive innervation to the soft tissue of the chin, lower lip, gum by vestibular of incisors, canine and first lower premolar), time of postoperative evolution and skeletal class. Conclusion: There is a high level of satisfaction in patients undergoing orthognathic surgery. The five variables analyzed do not influence the level of patient satisfaction after orthognathic surgery.

Sistemática en el Tratamiento Quirúrgico de las Fracturas Panfaciales Aplicado a un Caso Clínico De Alta Complejidad / Systematic in the Surgical Treatment of Panfacial Fractures Applied to a Highly Complex Clinical Case

RESUMEN: Las fracturas panfaciales son aquellas que afectan de forma simultánea al tejido óseo de dos o más tercios del rostro. El manejo inicial de estos pacientes es resolver o estabilizar las urgencias médico - quirúrgicas que puedan presentar, debido a que la gran mayoría de estas fracturas están asociadas a traumatismos de alta energía cinética, las que determinan la presencia de lesiones concomitantes que pueden comprometer la vida del paciente. El tratamiento quirúrgico de las fracturas panfaciales puede abarcar desde la intervención quirúrgica inicial de control de daños, estabilización, reducción y fijación quirúrgica de los segmentos fracturados mediante osteosíntesis hasta intervenciones mediatas para la reconstrucción de los tejidos afectados por el traumatismo. Para el tratamiento de las fracturas panfaciales existe una sistemática quirúrgica que tiene por objeto contener y/o minimizar daños agudos y permitir una reducción morfológica y funcional. Reportamos un caso clínico de fractura panfacial cuyo tratamiento siguió esta sistemática terapeútica.

ABSTRACT: Panfacial fractures affect bone tissue in two or more thirds of the face simultaneously. The initial management of these patients is to resolve or stabilize the medical-surgical emergencies that they may present. Most of these fractures are associated to trauma of high kinetic energy, which determine the presence of concomitant inju- ries that can compromise the life of the patient. The surgical treatment of panfacial fractures may include from the initial surgical intervention of damage control, stabilization, reduction and surgical fixation of fractured segments through osteosynthesis, to mediate the reconstruction of tissues affected by the trauma. For the treatment of panfacial fractures there is a surgical approach that aims to contain and/or minimize acute damage and allow for morphological and functional reduction. We report a clinical case of panfacial fracture whose treatment followed this therapeutic approach.

Screening de lesiones orales malignas y potencialmente malignas en funcionarios de Universidad de Valparaíso y Universidad Viña del Mar durante los años 2016 - 2017 / Screening of malignant and potentially malignant oral lesions in employee of the University of Valparaíso and the University of Viña del Mar during 2016 - 2017

El objetivo de este estudio es determinar la prevalencia de lesiones orales malignas y potencialmente malignas (LPM) en funcionarios de la Universidad de Valparaíso y de Viña del Mar durante los años 2016 - 2017. Fueron citados 161 funcionarios, quienes accedieron a una encuesta que evaluaba factores de riesgo de cáncer oral (tabaco y alcohol) y si habían escuchado de la patología, sumado a un examen clínico. De los pacientes examinados, se diagnosticaron 121 lesiones de las cuales 2 fueron diagnosticadas como lesiones potencialmente malignas: Liquen plano y Leucoplasia, con una prevalencia de 1,7 %. El 50,3 % de los pacientes sabía de la existencia de cáncer oral. El Screening es una medida que permite dar a conocer a la población la existencia de cáncer oral y alertarlos sobre la importancia de su examen para su identificación de manera temprana.

The objective of this study is to determine the prevalence of malignant and potentially malignant oral lesions (PML) in University of Valparaíso and Viña del Mar employees, during the years 2016 - 2017. We cited 161 employees, who accessed a survey evaluating risk factors for oral cancer (tobacco and alcohol) and if they had heard of the disease. In addition, a clinical examination was carried out. Of the patients examined, 121 lesions were diagnosed, of which 2 were diagnosed as potentially malignant lesions: Lichen planus and Leukoplakia, with a prevalence of 1.6 %. 50.3 % of patients knew of the existence of oral cancer. Epidemiological designs are needed to better establish causality between risk factors and malignant or, potentially malignant lesions.

Anomalías Vasculares de la Cavidad Oral: Revisión de la Clasificación y Tratamiento Aplicado a dos Casos Clínicos / Vascular Anomalies of the Oral Cavity: Review of Classification and Treatment Applied to Two Clinical Cases

RESUMEN: Las anomalías vasculares de cabeza y cuello son un grupo de lesiones que afectan vasos sanguíneos y linfáticos donde el tratamiento sigue siendo un desafío. La clasificación actualizada de anomalías vasculares de cabeza y cuello es la clasificación de Mulliken modificada, que las subdivide en a) tumores vasculares y, b) malformaciones vasculares. En este reporte, presentamos dos casos clínicos de pacientes de sexo masculino, con diagnóstico de anomalías vasculares que afectan al labio y paladar duro, diagnosticados como malformación arteriovenosa y malformación venosa, respectivamente. Dichas lesiones remitieron completamente mediante tratamientos conservadores (agentes esclerosantes) y/o quirúrgicos (exéresis quirúrgica completa de la lesión) logrando una remisión completa. Consecutivamente, presentamos una revisión de la literatura enfocado a la clasificación actual, enfoques terapéuticos actuales y futuros.

ABSTRACT: Vascular anomalies of the head and neck are a group of lesions that affect blood and lymph vessels where treatment remains a challenge. The updated classification of head and neck vascular anomalies is the modified Mulliken classification, which subdivides them into a) vascular tumors and b) vascular malformations. In this report, we present two clinical cases of male patients, with diagnosis of vascular anomalies affecting the lip and hard palate, diagnosed as arteriovenous malformation and venous malformation, respectively. These lesions were completely treated with conservative (sclerosing agents) and/or surgical (complete surgical exeresis of the lesion) treatments, achieving a complete remission. Consequently, we present a review of the literature focused on the current classification, current and future therapeutic approaches.

Tutoría por pares de distinto año académico en la enseñanza de habilidades quirúrgicas básicas en estudiantes de pregrado de medicina / Peer tutoring in the teaching of basic surgical skills in medical undergraduate students

Resumen Objetivo: Nuestro objetivo es comparar la efectividad de la tutoría impartida por pares de 6° versus 14° semestre en la adquisición de habilidades procedimentales básicas en estudiantes de medicina. Materiales y Método: Estudio cuasi-experimental, antes y después. La intervención consta inicialmente de un curso de formación de monitores de sutura (MS) para dos estudiantes de 6° y dos de 14° semestre de medicina. Posteriormente se implementó un taller de sutura tutorizado por MS a 23 estudiantes de 8° semestre de medicina. Se evaluó sutura continua y discontinua mediante el instrumento: "The Objective Structured Assessment Of Technical Skills" (OSATS) y satisfacción mediante encuesta tipo Likert validada por expertos. Se describen y comparan los resultados pre y postintervención y satisfacción de los estudiantes, de acuerdo al semestre cursado del MS. Se aplicó consentimiento informado. Se utilizó SPSS24® para análisis estadístico mediante prueba de Mann Whitney. Se consideró significativo p < 0,05. Resultados: Ambos grupos progresaron significativamente en la escala OSATS, grupo tutorizado por MS de 6° semestre: 18,1 vs 28,1 (p < 0,001) y grupo tutorizado por MS de 14° semestre: 15,5 vs 27,8 (p < 0,001). Los puntajes finales no presentan diferencias significativas. La intervención fue evaluada con 66 de 68 puntos, sin diferencias significativas según el semestre cursado del MS. Conclusión: Nuestra experiencia muestra que es posible utilizar la tutoría por pares entrenados para la enseñanza de habilidades quirúrgicas, independientemente si la tutoría es impartida por pares de cursos inferiores o superiores, logrando un progreso significativo y un desempeño procedimental equivalente, además de una alta satisfacción entre los estudiantes.

Aim: Our objective is to compare the effectiveness of tutoring taught by 6th versus 14th semester peer students in the acquisition of basic procedural skills in medical students. Materials and Method: Quasi experimental study, before and after. The intervention initially consists of a training workshop for suture monitors (SM) for two students of 6th and two students of 14th semester of medicine. Subsequently, a suture workshop taught by SM to 23 fourth-year medical students was implemented. Continuous and discontinuous suture was evaluated using the instrument: "Objective structured evaluation of technical skills" (OSATS) and satisfaction through a survey validated by experts. The results of pre and post intervention and student satisfaction are described and compared, according to the semester attended by the SM. Informed consent was applied. Excel® and SPSS24® were used for statistical analysis by Mann Whitney test. It was considered significant p < 0.05. Results: Both groups progressed significantly on the OSATS scale, group tutored by 6° semester SM: 18.1 vs 28,1 (p < 0.001) and group tutored by 14° semester SM: 15.5 vs 27,8 and (p < 0.001). The final scores did not they present significant differences. The intervention was well evaluated with 66 out of 68 points, without significant differences according to the semester coursed of the SM. Conclusion: Our experience shows that it is possible to use peer tutoring by trained tutors to teach surgical skills, regardless of whether the teaching is given by pairs of lower or higher courses, achieving significant progress and equivalent procedural performance, in addition to high satisfaction among students.

Implementación de taller de monitores de sutura en alumnos de pregrado de medicina / Implementation of suture monitor workshop in undergraduate medical students

INTRODUCCIÓN: Las técnicas de sutura básicas se consideran competencias mínimas de un egresado de medicina y son fundamentales en el ejercicio de la medicina general. Actualmente, los estudiantes de la Universidad de Concepción no poseen una instancia formal para adquirir estas competencias. OBJETIVOS: Evaluar la validez de un programa de formación de alumnos monitores de sutura a través de los resultados obtenidos mediante un método de evaluación estandarizado, realizado en estudiantes de pregrado de medicina de la Universidad de Concepción. METODOLOGÍA: Estudio preexperimental antes y después. Se realizó intervención teórico-práctica para seis estudiantes de medicina de distintos semestres cursados, entre los meses de mayo y julio de 2017. Consistió en tres módulos: clases teóricas, práctica en modelo biológico y módulo en pabellón quirúrgico supervisado por subespecialistas. Se evaluó punto de sutura continuo y discontinuo en modelo biológico mediante la escala "The Objective Structured Assessment Of Technical Skills" (OSATS). Se describen y comparan resultados de la escala OSATS antes y después del curso. Se aplicó consentimiento informado. Se utilizó SPSS® para análisis estadístico mediante prueba de Mann-Whitney para variables no paramétricas. Se consideró significativo p < 0,05. RESULTADOS: Todos los participantes mejoraron puntuación en escala OSATS. Los participantes progresaron significativamente sus resultados en las distintas escalas OSATS (5,2 vs 8,8; p < 0,05 y 16,5 vs 27,2; p < 0,05) al comparar resultados pre vs posintervención respectivamente. DISCUSIÓN: Nuestra experiencia demuestra que es posible crear un taller de formación de MS con muy buenos resultados, para estudiantes de medicina, a través de una capacitación trimodal, con clases teóricas, simulación y práctica in vivo. Además, constituye la base de futuras investigaciones que buscan solucionar la inexistencia de un programa formal de enseñanza de técnicas de sutura a los estudiantes de medicina de nuestra facultad.

INTRODUCTION: Suture techniques are considered the minimum of a medical examination and are fundamental in the practice of medicine. Currently, the students of the Universidad de Concepción do not have a formal instance to acquire these competences. AIM: To evaluate the validity of a training program for Suture Instructor (SI) students through the results obtained through a standardized assessment method, carried out in undergraduate students of medicine at the University of Concepción. METHOD: Preexperimental before and after study. A theoretical-practical intervention was carried out for six medical students of different semesters of the career, between the months of May and July 2017. It consisted of three modules: theoretical classes, practice in biological model and module in surgical pavilion supervised by subspecialists. Continuous and interrupted sutures were evaluated in the biological model using the "The Objective Structured Assessment of Technical Skills" (OSATS) scale. Results of the OSATS scale are described and compared before and after the course. Informed consent was applied. SPSS® was used for statistical analysis by Mann-Whitney test for non-parametric variables. It was considered significant p < 0.05. Results: All participants improved score on OSATS scale. The participants progressed significantly their results in the different OSATS scales (5.2 vs 8.8, p < 0.05 and 16.5 vs 27.2, p < 0.05) when comparing pre vs post intervention results respectively. DISCUSSION: Our experience shows that it is possible to create an SI training workshop with excellent results for medical students, through a three phase training program, with theory classes, simulation and "in vivo" practice. It also constitutes the basis of future research that seeks to solve the lack of a formal program of teaching suture techniques to medical students of our university.

The ERBB2 gene polymorphisms rs2643194, rs2934971, and rs1058808 are associated with increased risk of gastric cancer

Gastric cancer (GC) is the third most lethal type of cancer worldwide. Single nucleotide polymorphisms (SNPs) in regulatory sites or coding regions can modify the expression of genes involved in gastric carcinogenesis, as ERBB2, which encodes for the tyrosine-kinase receptor HER-2. The aim of this work was to analyze the association of the polymorphisms: rs2643194, rs2517951, rs2643195, rs2934971, and rs1058808 with GC, as they have not yet been analyzed in GC patients, as well as to report their frequency in the general Mexican population (GMP). We studied genomic DNA from subjects with GC (n=74), gastric inflammatory diseases (GID, n=76 control subjects), and GMP (n=102). Genotypes were obtained by means of real-time PCR and DNA-sequencing. The risks for GC were estimated through odds ratio (OR) using the Cochran-Armitage trend test and multinomial logistic regression. Increased risk for GC was observed under the dominant inheritance model for the rs2643194 TT or CT genotypes with an OR of 2.75 (95%CI 1.12−6.75, P=0.023); the rs2934971 TT or GT genotypes with an OR of 2.41 (95%CI 1.01−5.76, P=0.043), and the rs1058808 GG or CG genotypes with an OR of 2.21 (95%CI 1.00−4.87, P=0.046). The SNPs rs2643194, rs2934971, and rs1058808 of the ERBB2 gene were associated with increased risk for GC.

Asociación entre síntomas depresivos del cuidador principal y problemas conductuales en una muestra de preescolares chilenos de 30 a 48 meses de edad / Association between primary caregiver depressive symptoms and behavioral problems in a sample of chilean preschool children age 30 to 48 months

Resumen Introducción: La salud mental del cuidador influye en el desarrollo de los niños; sin embargo, desconocemos si existe una asociación entre síntomas depresivos del cuidador y problemas conductuales en preescolares chilenos. El objetivo fue analizar la asociación entre los síntomas depresivos del cuidador principal y la presencia de problemas conductuales en preescolares usuarios de la red pública de salud chilena. Método: Estudio transversal. Muestreo por conglomerados estratificados bietápico. Muestra de 1.377 preescolares de 2,5-4 años y sus cuidadores principales. Con consentimiento informado se aplicó encuesta sociodemográfica y Child Behavior Checklist 1½-5. Los síntomas depresivos del cuidador se evaluaron mediante Entrevista Diagnóstica Internacional Compuesta abreviada. Resultados: Edad promedio del preescolar 40,95 ± 4,6 meses, 51,3% varones. 97,5% fueron cuidadoras mujeres, edad promedio 31,6 ± 10,2 años y escolaridad 9,5 años. Se encontró problemas conductuales de rango clínico en las tres escalas: total de problemas conductuales 21,4%, conductas internalizantes 23,1% y externalizantes 16,4%. Se encontró sintomatologia depresiva en 9,1% de los cuidadores, la que aumenta a 14,5,% y 16,1% en cuidadores de preescolares con conductas internalizantes y externalizantes respectivamente. En el análisis de regresión logística multinomial ajustando por variables confundentes, la asociación bivariada con los problemas conductuales internalizantes desaparece, sin embargo, se mantiene para el total de problemas conductuales y conductas externalizantes. Conclusiones: La asociación entre síntomas depresivos del cuidador y problemas conductuales en preescolares chilenos es consistente y modulada por otras variables médicas y psicosociales, esto sugiere la importancia de la identificación, prevención e intervención temprana de la díada y su entorno.

Introduction: The mental health of the caregiver influences the development of children; however we do not know if there is an association between depressive symptoms of the caregiver and behavioral problems in Chilean preschoolers. The objective was to analyze the association between primary caregiver depressive symptoms and behavioral problems in preschoolers users of the Chilean public health network. Method: Cross-sectional study. Two-stage stratified cluster sampling. Sample 1377 preschool children 2,5-4 years old and their primary caregivers. In order to assess child behavior, a sociodemographic survey and Child Behavior Checklist ½-5 we applied to each caregiver, under informed consent. Caregiver depressive symptoms were assessed using the International Diagnostic Composite Interview Short Form. Results: Preschool age was 40.95 ± 4.6 months, 51.3% were boys. 97.5% of caregivers were female, (ages 31.6 ± 10.2 yr, average schooling 9.5 years). Behavioral problems of clinical rank were found in the three scales: total behavioral problems 21.4%, internalizing 23.1%, and externalizing behaviors 16.4%. 9.1% of caregivers experienced depressive symptomatology. In preschool children with internalizing behavioral, caregivers showed depressive symptoms in 14,5% of cases, and 16,1% in those with an externalizing behavioral. In multinomial logistic regression analysis adjusted for confounding variables, bivariate association for internalizing behavioral problems was lost, but persisted for total behavioral problems and for externalizing behavioral. Conclusions: The association between caregiver's depressive symptoms and behavioral problems in Chilean preschool children is consistent and modulated by other medical and psychosocial variables, suggesting the importance of identification, prevention and early intervention of the dyad and their environment.

Colitis de Crohn: resultados del tratamiento quirúrgico y evolución alejada / Outcome of surgery for Crohn's colitis: review of 28 cases

Background: Exclusive involvement of the colon or rectum in Crohn's disease, called Crohn's colitis, (CC) occurs in about 25% of these patients. Aim: To analyze early surgical results and long-term outcomes of patients undergoing surgery for CC. Material and Methods: Review of a prospective database, identifying patients with Crohn's disease operated between 2003 and 2015 and excluding those with ileocecal disease. We analyzed demographic data, pre and postoperative pharmacological treatment, operations, morbidity and the need for a second bowel resection at follow-up. Results: We reviewed data from 28 patients aged 17 to 72 years (15 men). Twenty-seven (96.4%) had previous pharmacological treatment, 11 received monoclonal antibodies. The most common indications for surgical treatment were failure of medical treatment in 15 cases, acute severe colitis in 12 and anemia/malnutrition in eight. Total colectomy was performed in 17 (61%) patients, proctocolectomy in 8 (29%) and segmental colectomies in 3 (11%). Sixteen (57%) were operated laparoscopically. Major postoperative complications were observed in 5 (18%). Four needed a reintervention. There was no operative mortality. During a 55 months median follow-up of 27 patients, seven (26%) required a second bowel resection, one of them for recurrence. Nineteen (70%) patients had an ostomy, which was permanent in 11. Fifteen patients are without medical treatment. Conclusions: Most of the reviewed patients required total colectomy for the control of the disease with a low surgical morbidity. Two-thirds required an ileostomy, which became permanent in half of them.

Ascitis quilosa post cirugía abdominal: caso clínico y revisión de la literatura / Chylous ascites management: clinical case and literature review

Chylous ascites is a peritoneal collection with milky appearance, rich in triglycerides produced by the presence of thoracic or intestinal lymph in the abdominal cavity. The increasing number of surgical interventions has meant an increase of this disease in the last time. We present the case of a 39-yearsold woman with a history of a retroperitoneal cystic lesion in the abdominal ultrasound, which was a finding, and was followed up for 5 years. In the last control abdominal ultrasound showed an accelerated growth, the study was complemented with a Magnetic Resonance Imaging of the abdomen showed a retroperitoneal cystic lesion, 7 cm larger diameter in contact with aorta, left ureter and lower pole of the left kidney, suspecting malignancy, reason why its surgical resection was decided. It evolved after the surgical intervention with progressive increase of the abdominal perimeter, diffuse pain and early satiety, performing abdominal ultrasound showing a liver of normal structure with moderate ascites. The diagnostic paracentesis gave out 1,000 mL of milky-white liquid with triglycerides of 1,287 mg/dL. The diagnosis of chylous ascites was proposed, secondary to thoracic duct injury and it was managed with a diet with low intake of saturated, polyunsaturated and monounsaturated fats, with medium chain triglycerides with favorable results. The pathophysiology, etiology, nutritional and non-nutritional management of chylous ascites are discussed.

La ascitis quilosa es una colección peritoneal con apariencia lechosa, rica en triglicéridos producido por la presencia de linfa torácica o intestinal en la cavidad abdominal. El creciente número de intervenciones quirúrgicas ha significado un aumento de esta patología en el último tiempo. Se presenta el caso de una mujer de 39 años, con historia de una lesión retroperitoneal quística en la ecotomografía abdominal, que fue un hallazgo, realizándose seguimiento por 5 años. En la última ecotomografía de control presentó crecimiento acelerado por lo que se complementa estudio con una Resonancia Nuclear Magnética de abdomen que muestro lesión quística retroperitoneal de 7 cm de diámetro mayor en contacto con aorta, uréter izquierdo y polo inferior del riñón izquierdo, sospechándose malignidad, por lo que se decide su resección. Evolucionó posterior a la intervención quirúrgica con aumento progresivo del perímetro abdominal, dolor difuso y saciedad precoz, realizándose ecotomografía abdominal que muestra un hígado de estructura normal con ascitis moderada. La paracentesis diagnóstica dio salida a 1.000 mL de líquido blanquecino de aspecto lechoso con triglicéridos de 1.287 mg/dL. Se planteó el diagnóstico de ascitis quilosa, secundario a lesión del conducto torácico y se manejó con dieta con bajo aporte en grasas saturadas, poliinsaturadas y monoinsaturadas, con aporte de triglicéridos de cadena media con resultados favorables. Se discuten la fisiopatología, etiología, manejo nutricional y no nutricional de la ascitis quilosa.