Diagnóstico de imagem radiológica como protocolo de certificação na prevenção de eventos adversos após sondagem naso/oro enteral / Diagnosis of radiological imaging as a certification protocol in the prevention of adverse events after naso/enteral oro probing / Diagnóstico de la imagen radiológica como protocolo de certificación en la prevención de eventos adversos tras el sondeo naso/enteral oro

Objetivo. Apontar para a forma como a sonda nasoenteral serve a várias finalidades, entre as quais estão a própria alimentação enteral, a administração de drogas, como meio de contraste ou carvão ativado, para fins de aspiração do conteúdo do estômago para descomprimir o estômago de fluido, ar ou sangue, para reduzir o risco de vômito ou aspiração e para outros fins. Método: Revisão de literatura, descritiva exploratória, escolhidas, pois descreve, discute e analisa de forma ampla a literatura publicada sobre o tema, sob o ponto de vista teórico ou contextual a respeito da relevância do diagnóstico por imagem radiológica nestes casos. Resultados: Deve-se garantir a segurança do paciente, para isso é essencial confirmar que a sonda foi introduzida de maneira correta e está no devido local (estômago ou parte do intestino), uma vez que a sonda pode inadvertidamente ter sido inserida nos pulmões, o que pode passar desapercebido em pacientes de alto risco. Conclusão: Deve-se usar a sonda naso/oro para terapia nutricional, além de se prevenir eventos adversos para que o processo seja efetivo.

Objective. Point out how the nasoenteral tube serves various purposes, among which are enteral feeding itself, administration of drugs such as contrast medium or activated charcoal, for the purpose of aspiration of stomach contents to decompress the stomach of fluid, air or blood, to reduce the risk of vomiting or aspiration, and for other purposes. Method: Literature review, descriptive and exploratory, chosen because it describes, discusses and analyzes widely the published literature on the subject, from a theoretical or contextual point of view regarding the relevance of radiological imaging diagnosis in these cases. Results: Patient safety must be ensured, for this it is essential to confirm that the tube has been inserted correctly and is in the right place (stomach or part of the intestine), since the tube may have been inadvertently inserted into the lungs, which may go unnoticed in high-risk patients. Conclusion: The naso/oro tube should be used for nutritional therapy, in addition to preventing adverse events for the process to be effective

Objetivo. Señalar cómo la sonda nasoenteral sirve para varios fines, entre los que se encuentran la alimentación enteral en sí, la administración de fármacos como medio de contraste o carbón activado, con el fin de aspirar el contenido del estómago para descomprimir el estómago de líquido, aire o sangre, para reducir la riesgo de vómito o aspiración, y para otros fines. Método: Revisión bibliográfica, descriptiva y exploratoria, elegida porque describe, discute y analiza ampliamente la literatura publicada sobre el tema, desde un punto de vista teórico o contextual respecto a la relevancia del diagnóstico por imágenes radiológicas en estos casos. Resultados: Se debe garantizar la seguridad del paciente, para ello es fundamental confirmar que la sonda se ha insertado correctamente y está en el lugar correcto (estómago o parte del intestino), ya que la sonda puede haber sido introducida inadvertidamente en los pulmones, que puede pasar desapercibido en pacientes de alto riesgo. Conclusión: La sonda naso/oro debe ser utilizada para la terapia nutricional, además de prevenir eventos adversos para que el proceso sea efectivo.

El material restaurador ideal en la era de la odontología de invasión mínima. Rescatando al oro directo / The ideal restorative material at the minimal invasive dentistry era. Rescuing direct gold

Los logros de los avances obtenidos en el manejo actual de la caries han dado la oportunidad a los odontólogos de detectar lesiones de caries en sus estadios incipientes. A pesar de la existencia de una gran variedad de materiales restauradores directos disponibles en el mercado actual y que pueden utilizarse para restaurar lesiones pequeñas de caries, el material que tiene más posibilidades de éxito para este tipo de lesiones es sin duda alguna el oro cohesivo, también conocido como oro directo (AU)

The goals obtained with the current management of dental caries has given the dentists the opportunity to detect incipient caries lesions in early stages. Although, the current existence of a great variety of direct restorative materials available in the market to restore small caries lesions, the material that may show better success for these type of lesions, is without any doubt: the gold foil or direct gold (AU)

Rendimiento diagnóstico de la prueba rápida fasciorap basada en la técnica de inmunocromatografía o flujo lateral para la detección de anticuerpos en pacientes con Fasciolosis humana

Objetivo : Determinar el rendimiento diagnóstico de la técnica de inmnunocromatografía o flujo lateral para la detección de anticuerpos en pacientes con Fasciolosis humana. Materiales y métodos : Estudio observacional, prospectivo y de corte transversal. Hemos desarrollado una prueba de flujo lateral (Fasciorap) para el diagnóstico serológico de las Fasciolosis humana por Fasciola hepatica, compuesta por antígenos de excreción-secreción de formas adultas conjugadas con orocoloidal de 40 nm y una proteína A e IgG de conejo anti Fasciola hepatica como reactivos detectores en la línea de prueba y control, flanqueados por almohadillas en un cassette. Se evaluaron 240 sueros, 120 positivos, 50 sueros de pacientes con otras parasitosis, 20 de pacientes con enfermedades infecciosas y 50 sueros de personas no parasitadas, la interpretación de resultados se realizó por inspección visual a los 15 minutos de aplicada las muestras. Resultados : La prueba detectó la presencia de anticuerpos en el suero de pacientes con fasciolosis, alcanzando una sensibilidad de 92,5%, una especificidad de 94,17%, un valor predictivo positivo de 94,07% y negativo de 92,62%; con 100% de concordancia en la repetibilidad y reproducibilidad. Conclusiones : Fasciorap detecta casos de fasciolosis, por lo tanto, es una potencial prueba diagnóstica en zonas endémicas donde se requiere pruebas de punto de atención

Objective : To determine the diagnostic performance of the immunochromatography technique or lateral flow for the detection of antibodies in patients with human fasciolosis. Materials and methods : Observational, prospective and cross-sectional study. We have developed a lateral flow test (Fasciorap) for the serological diagnosis of fasciolosis due to F. hepatica, composed of excretion-secretion antigens of adult forms conjugated with orocolloid of 40 nm and a protein A and IgG of rabbit anti F. hepatica as detector reagents in the test and control line, flanked by pads in a cassette. 240 sera were evaluated, 120 positive, 50 sera from patients with other parasites, 20 from patients with infectious diseases and 50 sera from non-parasitized people, the interpretation of results was performed by visual inspection 15 minutes after applying the samples. Results : The test detected the presence of antibodies in the serum of patients with fasciolosis, reaching a sensitivity of 92.5%, a specificity of 94.17%, a positive predictive value of 94.07% and a negative predictive value of 92.62%; with 100% agreement on repeatability and reproducibility. Conclusions : Fasciorap detects cases of fascioliasis, therefore, it is a potential diagnostic test in endemic areas where point-of-care testing is required

Sports-related facial trauma in the Indian population - A systematic review

Background: Sports injuries are a growing concern which requires immediate attention. Dental injuries are the most common type of orofacial injuries sustained during sports activities. Objectives: This study aims to review the prevalence of sports-related facial trauma in India, to identify the most common types of oro-facial injury incurred due to sports, and to assess the level of awareness regarding preventive measures used in sports. Methodology: The present review was performed in accordance with preferred reporting items for systematic reviews and meta-analyses guidelines. All articles published from 2005 to 2019 on sports-related facial trauma were analyzed. PubMed, Google Scholar, and Cochrane reviews databases were searched using primary keywords. Results: A total of 24 articles published in the period of 2005–2019 were included. The prevalence of sports-related facial trauma was found to be the highest in the study conducted by Selva et al., in 2018, at a rate of 75%, whereas it was found to be minimal in the study conducted by Bali et al. in 2013. While the awareness of mouthguards was reported the highest in a study conducted by Ramagoni et al., in 2007. Conclusion: This study shows that there is a definite need to improve the awareness as well as the usage of protective gear, from the level of schooling, where children are introduced to sports. Prevention of sports-related facial trauma is essential to avoid the serious and lifelong consequences which could be the aftermath of such injuries.

Clinical effects of intermittent oro-esophageal tube feeding combined with Xuanqiaoliyan decotion in stroke patients with dysphagia / 中华危重病急救医学

Objective:To investigate the clinical effects of intermittent oro-esophageal tube feeding (IOE) combined with Xuanqiaoliyan decotion in stroke patients with dysphagia.Methods:A prospective study was conducted. Stroke patients with dysphagia admitted to Yidu Central Hospital Affiliated Hospital of Weifang Medical University from January 2018 to December 2019 were enrolled. According to the simple random sampling method, the patients were divided into control group and observation group, with 50 cases in each group. The control group was given routine swallowing function training, including low-frequency pulse electrical stimulation, swallowing function training and acupuncture treatment. The observation group was given IOE and Xuanqiaoliyan decoction (prescription composition: Rhizoma acori tatarinowii 15 g, Radix polygalae 10 g, Rhizoma gastrodiae 15 g, Arisaema cum bile 6 g, Rhizoma typhonii 6 g, Scorpio 6 g, Bombyx batryticatus 6 g, Perilla frutescens 10 g, Rhizoma pinelliae 10 g, Pericarpium citri reticulatae 10 g, Rhizoma zingiberis recens 3 tablets, decoction 200 mL, twice in the morning and evening by oral or nasal feeding) on the basis of the control group. Both groups were treated for 14 days. The standard swallowing function assessment (SSA) and water swallow test were used to evaluate the swallowing function before and after treatment. The time required for the improvement of swallowing function, total hospitalization time and the therapeutic effects were observed and the safety assessment was conducted. Results:There were no significant differences in the gender, age, course of disease, and location and frequency of stroke between the two groups. After treatment, both the SSA scores in the two groups were decreased, and the grading of water swallow test was improved. The SSA scores in the observation group were significantly lower than that in the control group (19.8±1.8 vs. 23.2±3.2, P < 0.05), the recovery degree of water swallow test was higher than that in the control group [complete recovery (cases): 18 vs. 13, basic recovery (cases): 23 vs. 18, effective (cases): 9 vs. 19, χ 2 = -2.107, P = 0.008]. The total effective rate of swallowing function in the observation group was higher than that in the control group (94.0% vs. 80.0%, Z = 4.684, P = 0.012), the time for improvement (days: 12.8±2.6 vs. 16.9±4.3, t = 11.628, P = 0.008) and total hospitalization time (days: 20.8±4.2 vs. 33.5±5.6, t = 10.924, P = 0.015) were shorter than those in the control group. In the observation group, there was 1 case of throat discomfort during the operation of IOE, and the symptoms disappeared after the operation; there was 1 case of mild elevation of alanine aminotransferase (ALT) and blood urea nitrogen (BUN) respectively, which returned to normal after the treatment. No adverse symptoms and damage to the liver and kidney were observed in the control group. Conclusion:IOE combined with Xuanqiaoliyan decotion could significantly improve the swallowing function of stroke patients with dysphagia, shorten the hospitalization time, and improve the curative effects and lifequality.

Valoración participativa de impactos socioambientales y sanitarios en minería de oro: Buriticá (Antioquia), Colombia / Participatory assessment of socio-environmental and health impacts in gold mining: Buriticá (Antioquia), Colombia / Avaliação participativa de impactos socioambientais e sanitários em mineração de ouro: Buriticá (Antioquia), Colômbia

Resumen Objetivo: Conocer la valoración que habitantes de Buriticá, Antioquia, hacen de los impactos socioambientales y sanitarios por la actividad minera aurífera en la región. Metodología: Estudio investigativo de método mixto, con enfoque cualitativo y cuantitativo, con participación de funcionarios de la Alcaldía, habitantes de zona rural y de la cabecera municipal, y personal administrativo y operarios de una asociación minera del municipio en proceso de legalización. Los actores identificaron, valoraron, priorizaron y categorizaron los impactos percibidos, para lo que se utilizaron los métodos Leopold (1971) y Empresas Públicas de Medellín-Arboleda (1985) modificados. Resultados: La migración de mineros a Buriticá generó explotación aurífera informal con: impactos críticos (76-100 puntos) de contaminación de aguas, choque cultural, pérdida de identidad, aumento de alcoholismo, drogadicción, prostitución y delincuencia; impactos severos (50-75 puntos) de colapso de servicios públicos, aparición de plagas, construcciones de alto riesgo, tala de árboles y migración de animales; impactos positivos, como aumento del sentido de pertenencia de las personas autóctonas, incremento del comercio y del empleo, y aprendizaje del hospital para superar condiciones de capacidad instalada frente a la atención de urgencias, traumas, accidentes e intoxicaciones. Conclusión: El auge de la minería causó impactos identificados por diferentes actores: estos visualizaron que el aumento de la población foránea no es solo uno de los impactos más significativos que se han dado a partir de la minería, sino que también es el causante de muchos otros que han surgido en los tres componentes evaluados (social, ambiental y sanitario).

Abstract Objective: To determine the assessment of Buriticá's (Antioquia) inhabitants on the socio-environmental and health impacts of gold mining activity in the region. Methodology: Mixed method research study with a qualitative and quantitative approach, with the participation of officials from the Mayor's Office, inhabitants of rural areas and the municipal area, and administrative personnel and operators of a mining association in the municipality in the process of legalization. The actors identified, assessed, prioritized and categorized the perceived impacts, for which the modified Leopold (1971) and Empresas Públicas de Medellín-Arboleda (1985) methods were used. Results: The migration of miners to Buriticá generated informal gold mining that in turn generated: critical impacts (76-100 points) in terms of water contamination, culture shock, loss of identity, increased alcoholism, drug addiction, prostitution and crime; severe impacts (50-75 points) in terms of the collapse of public services, appearance of pests, high-risk buildings, felling of trees and animal migration; positive impacts, such as an increase in the sense of belonging of indigenous people, an increase in commerce and employment, and hospital training to overcome conditions of installed capacity in the face of emergency care, trauma, accidents and poisoning. Conclusion: The mining boom caused impacts identified by different actors: these visualized that the increase in the foreign population is not only one of the most significant impacts that have occurred from mining, but is also the cause of many others that have emerged in the three components evaluated (social, environmental and health).

Resumo Objetivo: Conhecer a avaliação que os habitantes de Buriticá, Antioquia, fazem dos impactos socioambientais e sanitários devido à atividade de mineração aurífera na região. Metodologia: Foi usado o método misto em pesquisa, com abordagem qualitativa e quantitativa, com a participação de funcionários da prefeitura, habitantes da zona rural e do município, pessoal administrativo e trabalhadores de uma associação mineira do município em processo de legalização. Foram identificados, avaliados, priorizados e categorizados os impactos detectados, usando os métodos Leopold (1971) e Empresas Públicas de Medellín -Arboleda (1985) modificados. Resultados: A migração de mineiros à Buriticá gerou uma exploração aurífera informal com impactos críticos (76-100 pontos), contaminação de águas, choque cultural, perda da identidade, aumento de alcoolismo, dependência de drogas, prostituição e delinquência; impactos severos (50-75 pontos) de colapso de serviços públicos, surgimento de pragas, construções de alto risco, derrubada de árvores e migração de animais; impactos positivos como aumento do sentimento de pertencimento das pessoas autóctones, aumento do comércio e do emprego e a aprendizagem do hospital para superar condições de capacidade derivada da atenção de urgências, traumas, acidentes e intoxicações. Conclusão: O auge da mineração causou impactos identificados por diferentes fatores: é evidente que o aumento da população recém-chegada não é só um dos impactos mais significativos derivados da mineração, mas é também o causador de muitos outros que apareceram nos três componentes avaliados (social, ambiental e sanitário).

Ayurveda management of oro-facial herpes: a case report

Viral infections are one of the challenging health hazards of the present medical care. One among such viral infections is “Oro-facial Herpes”, caused by the Varicella Zoster Virus (HSV-1). This case report shows the successful treatment of “Oro-facial herpes” and its complication only through Ayurveda. In which, there will be closed grouped vesicles on an erythematous base in the dermatomal pattern, with burning type of pain. The condition in Ayurveda can be co- related to ‘Visarpa’. We present a case of 72-year, male, with sudden onset of edema over upper gums, with 3 to 4 vesicles over the left upper lip, left part of face within 2 days, along with reduced sensation to touch and temperature. The patient had redness, watering and burning sensation of left eye. Clinically the patient was diagnosed with “Oro- Facial Herpes”. As pitta dosha and raktadhatu vitiation was noticed the case was managed by Nitya pitta rechaka (cholegogue), the dravy’s with tikta, sheetaveerya and ruksha in nature. The patient showed improvement over 5 months of treatment from 10-Apr to 15-Aug-2018. The complaints of pain in the lesions reduced from 8 to 2, headache from 8 to 1 (VAS) and burning sensation reduced by 90%.

¿Son válidos los métodos manuales modificados para determinar la Velocidad de Eritrosedimentación Globular (VSG) en laboratorios clínicos? / Are modified manual methods valid to establish Erythrocyte Sedimentation Rate (ESR) in clinical laboratories? / Os métodos manuais modificados são válidos para determinar a velocidade de hemossedimentação(VHS) nos laboratórios clínicos?

Resumen Se evaluó estadísticamente la validez de cuatro métodos para determinar la Velocidad de Eritrosedimentación Globular (VSG) alternos al de Westergren, el que se tomó como "gold standard". Los métodos evaluados fueron Wintrobe (WB), Wintrobe inclinado (WI) a 45° y dos micrométodos capilares, uno vertical (MM) y otro inclinado a 45° (MMI). Se procesaron 419 muestras por los cinco métodos. Se evaluó la concordancia (C), la sensibilidad (S), especificidad (E), valor predictivo positivo (VPP) y valor predictivo negativo (VPN). Los resultados de S, E, VPP, VPN y C fueron: 93,8%, 93,6, 98,8%, 72,8% y 71% en el de WB; 86,3%, 85,7%, 97,2%, 52,4% y 54% en el de WI; 94,6%, 66,6%, 94,1%, 71,4% y 54% para MM y 91,9%, 72,4%, 94,8%, 60,8% y 55% para MMI. El índice kappa mostró una concordancia "buena" entre el método de Westergren y el método de Wintrobe y "moderada" con los métodos de WBI, MM y MMI. Los resultados del presente estudio muestran que el método de Wintrobe es confiable para su uso en el laboratorio clínico comparado con el de Westergreen.

Abstract Four methods were statistically evaluated for their validity to determine the alternative Erythrocyte sedimentation rate to that of Westergren, which was taken as the "gold standard". The methods evaluated were Wintrobe (WB), Wintrobe inclined (WI) at 45° and two capillary micromethods, one vertical (MM) and one inclined at 45° (MMI). A total of 419 samples were processed by the five methods. Concordance (C), sensitivity (S), specificity (E), positive predictive value (PPV) and negative predictive value (NPV) were evaluated. The results for S, E, PPV, NPV and C were: 93.8%, 93.6, 98.8%, 72.8% and 71% for WB; 86.3%, 85.7%, 97.2%, 52.4% and 54% for WI; 94.6%, 66.6%, 94.1%, 71.4% and 54% for MM and 91.9%, 72.4%, 94.8%, 60.8% and 55% for MMI. The kappa index showed "good" agreement between the Westergren method and the Wintrobe method and "moderate" agreement with the WBI, MM and MMI methods. The results of the present study show that the Wintrobe method is reliable for use in the clinical laboratory compared to the Westergren method.

Resumo Neste trabalho, foi avaliada estatisticamente a validez de quatro métodos para determinar a Velocidade de Eritrosedimentação Globular (VSG) alternos ao Westergren, que foi considerado como o "Método Padrão". Os métodos avaliados foram Wintrobe (WB), Wintrobe inclinado a 45° (WI) e dois micro-métodos capilares, um vertical (MM) e outro inclinado a 45° (MMI). 419 amostras foram processadas pelos cinco métodos. Envalou-se a concordância (C), sensibilidade (S), especificidade (E), assim como os valores preditivos positivos (VPP) e negativos (VPN). Os resultados de S, E, VPN e VPP foram: 93.8%, 93.6%, 98.8%, 72.8% e 71% com o WB; 86.3%, 85.7%, 97.2%, 52.4% e 54% com o WI; 94.6%, 66.6%, 94.1%, 71.4% e 54% para MM e 91.9%, 72.4%, 94.8%, 60.8% e 55% para o MMI. O índice kappa apresentou "boa" concordância entre os métodos de Westergren e Wintrobe, enquanto teve concordância "moderada" com os métodos WBI, MMe MMI. Os resultados deste estudo revelaram que o método de Wintrobe é confiável para seu uso no laboratório clínico comparado com o método de Westergren.

Biodégradation of cyanide via recombinant cyanide dehydratase from Bacillus pumilus expressed heterologously in Escherichia coli / Biodegradación de cianuro por la enzima cianuro dihidratasa de Bacillus pumilus expresada heterologamente en Escherichia coli

ABSTRACT Despite its high toxicity, cyanide is used in several industrial processes, and as a result, large volumes of cyanide wastewater need to be treated prior to discharge. Enzymatic degradation of industrial cyanide wastewater by cyanide dihydratase, which is capable of converting cyanide to ammonia and formate, is an attractive alternative to conventional chemical methods of cyanide decontamination. However, the main impediment to the use of this enzyme for the biodegradation of cyanide is its intolerance to the alkaline pH at which cyanide waste is kept and its low thermoresistance. In the present study, the catalytic properties of whole Escherichia coli cells overexpressing a cyanide dihydratase gene from Bacillus pumilus were compared to those of the purified enzyme under conditions similar to those found in industrial cyanide wastewater. In addition, the capacity of whole cells to degrade free cyanide in contaminated wastewater resulting from the gold mining process was also determined. The characteristics of intracellular enzyme, relative to purified enzyme, included increased thermostability (>60% activity at 50°C), as well as greater tolerance to heavy metals, and to a lesser extent pH (20% activity remaining at pH 9.0) On the other hand, enzymatic degradation of 70% of free cyanide (initial concentration 528 mM) in the industrial sample was achieved only after dilution. Nevertheless, the increased thermostability observed for intracellular CynD suggest that whole cells of E. coli overexpressing CynD are suited for process that operate at elevated temperatures (50°C), a limitation observed for the purified enzyme.

RESUMEN A pesar de su alta toxicidad, el cianuro es usado en diversos procesos industriales, y como resultado, grandes volúmenes de aguas residuales de cianuro deben ser tratados antes de su descarga. Una alternativa atractiva a los métodos químicos convencionales de descontaminación es la degradación enzimática por la enzima cianuro dihidratasa, la cual es capaz de convertir cianuro en amonio y ácido fórmico. No obstante, la inactivación de esta enzima a pH superior a 8.5 y su poca termoestabilidad han sido el principal impedimento para la implementación exitosa de esta alternativa de biorremediación. En el presente estudio, las propiedades catalíticas de células completas de Escherichia coli que sobre expresan el gen de cianuro dihidratasa de Bacillus pumilus se estudian bajo condiciones similares a las encontradas en aguas residuales industriales de cianuro y los resultados se discuten en comparación con las de la enzima purificada. Además, se determinó la capacidad de las células completas para degradar el cianuro libre en aguas residuales resultantes del proceso de extracción de oro. Las características de la enzima intracelular, relativa a la enzima purificada, incluyeron un incremento en la termoestabilidad (>60% actividad a 50°C), así como mayor tolerancia a metales pesados y en menor medida al pH (20% actividad residual a pH 9.0). Por otra parte, la degradación enzimática del 70% del cianuro libre en la muestra industrial (concentración inicial 528 mM) se logró solo después de la dilución de la muestra. Sin embargo, el incremento en la termoestabilidad observado para CynD intracelular sugiere que las células completas de E. coli que sobre expresan CynD son adecuadas para procesos que operan a temperaturas elevadas (50°C), una limitación observada para la enzima purificada.

Soaking oro-pharyngeal pack with triamcinolone acetonide lowers discomfort in functional endoscopic sinus surgeries / Pack orofaringeo con triamcinolone disminuye molestias luego de cirugía endoscópica sinusal

BACKGROUND: Postoperative sore throat (POST) is defined as pain or discomfort in the throat following general anesthesia. Throat packs are used by many surgical subspecialties for different benifits, however they may increase the incidence of POST. Many interventions can be used to decrease incidence of POST. Triamcinolone acetonide (TA) is a moderately potent topical corticosteroid preparation. In this study, we hypothesized that soaking the throat pack with TA may decrease POST. METHODS AND MATERIAL: This prospective interventional comparative study was performed on 54 patients planned for Functional Endoscopic Sinus Surgeries (FEES) surgery. After endotracheal intubation, a standard length of oro-pharyngeal pack was placed, then patients were randomly allocated into: Group I: Oro-pharyngeal packs were soaked with 15 mg Triamcinolone acetonide 0.1% and Group II: packs were soaked with the same volume of lubricating gel (K-Y gel®). The patients were postoperatively asked about: sore throat, dysphagia, hoarseness of voice and nausea and vomiting. RESULTS: Thirty minutes and 24 hours after extubation, Group I patients showed lower but statistically insignificant sore throat scores. Two to six hours after extubation, Group I showed a statistically significant reduction in sore throat scores. Six patients suffered dysphagia in group I compared with 8 patients in group II. Hoarseness of voice occurred in 1 patient in group I and 3 patients in group II. No patient complained of nausea or vomiting. cONCLUSIÓN: Soaking oropharyngeal pack with triamcinolone acetonide in orabase gel was able to decrease POST in FESS patients.

Colgajo lingual de base anterior para cierre de fistula palatina anterior / Retalho lingual de base anterior para fechamento de fístula palatina anterior / Closure of anterior palatal fistula by anterior base lingual flap

Introdução: Fístulas oro-nasais são as sequelas mais comuns após o reparo falho da fissura palatina primária, gerando problemas funcionais e emocionais para as pessoas que sofrem desta complicação. Fístulas grandes são difíceis de fechar e podem exigir retalhos de grande comprimento, largura e profundidade, sendo o retalho lingual de base anterior uma das opções de retalho mais bem sucedidas para fechamento devido às semelhanças com tecidos locais. e sua vascularização abundante, havendo taxas significativamente menores de recorrência da fístula após a cirurgia. Relato de caso: O objetivo deste artigo é apresentar o caso de um paciente previamente diagnosticado com fissura labiopalatina que tem história de seis procedimentos cirúrgicos malsucedidos que apresentaram resultados satisfatórios após a realização deste procedimento. Considerações finais: Ao longo dos anos, foi demonstrado que o retalho de língua é confiável e fácil de obter, devido à vascularização abundante e à grande quantidade de tecido que este órgão fornece para o reparo de fístulas maiores que 5 mm, formadas por complicações pós-cirurgia para fechamento de fenda palatina ou tentativas anteriores de fechamento de fístula com diferentes tipos de técnicas. A flexibilidade do retalho, juntamente com a técnica, a qualidade e a quantidade de tecido, tornam este procedimento de escolha para o fechamento das fístulas palatinas anteriores... (AU)

Introduction: Oro-nasal fistulas are the most common complication after the failed repair of the primary cleft palate, creating functional and emotional problems to people with this issue. Large fistulas are difficult to close and may require flaps with great length, width and depth, the anterior base lingual flap is one of the most successful options for fistula closure due to the similarities with local tissues, great vascularization and significantly lower fistula recurrence rates of the after surgery. Case Report: The objective of this article is to present the case of a patient previously diagnosed patient with cleft lip and palate with six previous unsuccessful surgical procedures on the palate, this patient presented satisfactory results after undergoing tongue flap surgery. Final Considerations: Over the years it has been shown that the lingual flap is reliable and easy to obtain, due to the abundant vascularization and large amount of tissue that this organ provides for the repair of fistulas larger than 5mm that are formed by complications post surgery either for cleft palate closure or previous attempts at fistula closure with different types of techniques. The flexibility of the flap, together with the technique, quality and quantity of tissue make this procedure of choice for the closure of anterior palatine fistulas... (AU)

Introduccioón: Las fístulas oro-nasales son las secuelas más comunes posteriores a la reparación fallida de paladar hendido primario, generando problemas funcionales y emocionales a las personas que padecen esta complicación. Las fístulas de gran tamaño son difíciles de cerrar y pueden requerir de tejido adyacente de gran longitud, ancho y profundidad para su cierre, siendo el colgajo lingual de base anterior una de las opciones más exitosas para cierre de la misma debido a sus similitudes con los tejidos locales y su abundante vascularización, existiendo tasas significativamente menores de recidiva de la fístula después de la cirugía. Descripción del Caso: El objetivo de este artículo es presentar el caso de un paciente previamente diagnosticado con labio y paladar hendido que presenta antecedente de seis intervenciones quirúrgicas en paladar sin éxito que presentó resultados satisfactorios tras someterse a este procedimiento. Consideraciones Finales: Con el paso de los años se ha demostrado que el colgajo lingual es confiable y fácil de obtener, debido a la abundante vascularización y gran cantidad de tejido que este órgano proporciona para la reparación de fístulas mayores a 5mm que se forman por complicaciones posteriores a cirugía ya sea para cierre de paladar hendido o intentos previos de cierre de fístula con diferentes tipos de técnicas. La flexibilidad del colgajo, junto con la técnica, calidad y cantidad de tejido hacen que este procedimiento sea de elección para el cierre de fistulas palatinas anteriores... (AU)

A Lateral Cephalometric Study to Evaluate Relation of Oro-Facial Structures with Pharynx in Bengali Population

Background: The relationship between respiratory disordersand changes in craniofacial morphology has been extensivelydebated in the literature. Hence we planned to assess relationof oro-facial structures with pharynx in the present study.Materials & Methods: The present study included assessmentof relation of oro-facial structures with pharynx in Bengalipopulation. A total of 30 males and 30 females of Bengaliethnicity were included in the present study. Lateralcephalogram was obtained in all the patients. Separatecalculation of airway areas of the nasopharynx and oropharynxwas done.Results: Significant results were obtained while comparing themean distance between Ho perpendicular and ANS-PNSplane, Ba-PNS, t-ppw, distance between anterior and posteriorpharyngeal wall and the distance between hyoid bone andanterior pharyngeal wall between Bengali male and female.Conclusion: Cautious evaluation of airway space might delivervaluable evidence in relation to potential malocclusion.

Swallowed Oro-esophageal Tube: A Case Report / 대한연하장애학회지

Tube feeding is used to provide nutritional support to patients who have difficulty taking food orally. A nasogastric tube is commonly used for these patients but there are some complications. Therefore, the oro-esophageal tube feeding method was developed to avoid these disadvantages. A 33-year-old male with a history of right basal ganglia intracranial hemorrhage was admitted to the rehabilitation department for the treatment of dysphagia caused by a new onset left basal ganglia intracranial hemorrhage. After the videofluoroscopic swallowing study, the nasogastric tube feeding was changed to intermittent feeding via an oro-esophageal tube. Unfortunately, the patient swallowed the tube during insertion. Hence, an emergent endoscopy was performed for tube removal. This article reports a rare case of a patient who underwent oro-esophageal tube removal with an esophagogastroduodenoscopy after tube swallowing during insertion. The insertion of an oro-esophageal tube requires a careful approach after considering the cognitive function, muscle strength, and family education.

Implante de pesa de oro palpebral en el tratamiento del lagoftalmo paralítico / Palpebral gold weight implantation in the paralytic lagophthalmos treatment

El lagoftalmo secundario a daño del nervio facial trae como consecuencia alteraciones funcionales y estéticas que pueden tributar a serias complicaciones corneales y eventualmente a la ceguera. El correcto manejo depende de su severidad y del tiempo de recuperación. El implante de pesas de oro en el párpado superior juega un importante papel en el tratamiento a mediano y largo plazo de esta afección. Se presenta un paciente masculino de 74 años con síntomas y signos de parálisis facial periférica derecha, incluyendo lagoftalmo ipsilateral con gran deterioro corneal. Se le implantó una pesa de oro pretarsal en el párpado superior para corregir el lagoftalmo paralítico y se obtuvieron excelentes resultados funcionales y estéticos. Mientras novedosas modalidades de tratamiento se encuentran en el horizonte con gran potencial para alterar el algoritmo de tratamiento actual, este proceder continúa siendo una técnica confiable, segura y efectiva para la rehabilitación permanente del párpado superior(AU)

Lagophthalmos secondary to facial nerve damage brings about functional and esthetic alterations which may result in serious corneal complications and eventual blindness. Appropriate management depends on severity and recovery time. Gold weight implantation in the upper eyelid plays an important role in the medium- and long-term treatment of this condition. A male 74-year-old patient presents with signs and symptoms of right-side peripheral facial paralysis, including ipsilateral lagophthalmos with great corneal deterioration. A pretarsal gold weight was implanted in the upper eyelid to correct the paralytic lagophthalmos, and excellent functional and esthetic results were obtained. While novel treatment modes lie in the horizon with great potential to alter the algorithm of current treatment, this procedure continues to be a reliable, safe and effective technique for the permanent rehabilitation of the upper eyelid(AU)

Contaminación por mercurio de leche materna de madres lactantes de municipios de Antioquia con explotación minera de oro / Mercury contamination in breast milk of nursing mothers in gold mining municipalities of Antioquia, Colombia

Resumen Introducción. La leche materna es esencial para el desarrollo del ser humano, pero puede contener sustancias tóxicas provenientes de la contaminación ambiental, especialmente en las áreas mineras. Objetivo. Determinar la prevalencia de la contaminación con mercurio de la leche materna de mujeres lactantes residentes en los municipios con explotación minera de oro. Materiales y métodos. Se hizo un estudio transversal de 150 madres lactantes de cuatro municipios mineros de Antioquia (El Bagre, Segovia, Remedios y Zaragoza), a quienes se les hizo una encuesta sobre factores sociodemográficos, ocupacionales y ambientales relacionados con el mercurio, y se les tomaron muestras de leche materna, de orina y de cabello. Se calculó el promedio de la concentración de mercurio y las prevalencias municipales de contaminación. Resultados. El promedio de la concentración de mercurio en la leche materna fue de 2,5 (± desviación estándar 9,2) µg/L. La prevalencia de muestras de leche materna con niveles altos de mercurio fue de 11,7 %. Conclusión. En este estudio se evidencia un grave problema en las regiones mineras auríferas de Antioquia por el efecto de la contaminación con mercurio en sectores de la población más vulnerable.

Abastract Introduction: Breast milk is essential for human development, but it may contain toxics derived from environmental pollution, especially in mining areas. Objective: To assess the prevalence of mercury contamination in breast milk and factors associated with its transfer to nursing mothers living in municipalities with gold mining. Materials and methods: We conducted a cross-sectional study with 150 nursing mothers in four municipalities of Antioquia (El Bagre, Segovia, Remedios and Zaragoza) with a mining tradition. We surveyed these mothers to obtain information on their sociodemographic, occupational and environmental factors related to mercury, and we took breast milk, urine and hair samples. We calculated mercury level averages and the contamination prevalence per municipality. Results: Mercury average in breast milk was 2.5 (± standard deviation: 9.2) mg/L. The prevalence of mercury contamination in samples with a high level of mercury was 11.7%. Conclusion: This study shows that there is a serious problem of mercury contamination in gold mining regions of Antioquia, with significant involvement of the most vulnerable population.

A smart approach for delivery of aripiprazole via oro-soft palatal mucosal route for improved therapeutic efficacy

Effective management of schizophrenia, acute mania, mixed episodes associated with bipolar disorders, and depression can be managed with aripiprazole moiety. In the present research work an attempt was made to minimize the dose related side effects thus improving the quality life of the patients. A novel biopolymer was isolated from the fruits of Trachyspermum ammi. Ten optimized nanosized aripiprazole loaded formulations were prepared in 1-5% concentration of biopolymer (FA1-FA5) and sodium CMC (FM1-FM5) by solvent casting technique. The formulated flexy films were evaluated for thickness, folding endurance, weight uniformity, surface pH, mucoadhesivity, In-vitro drug release studies, In-vivo pharmacodynamic study and stability studies. The isolated biopolymer showed inbuilt fimability and mucoadhesivity and consists of carbonyl, hydroxyl and thiocarbonyl functional groups. All formulations showed folding endurance from 153 to 170, mucoadhesion time in the range of 24-48hrs., and in-vitro drug release was performed using dynamic Franz Diffusion cell and analyzed using BIT-SOFTWARE. The experimental animals showed improved activity score on actophotometer. The formulated nanosized aripiprazole loaded bio-flexy films showed pharmacotherapeutic response. Conclusion can be drawn that optimized formulation showed effective Pharmacodynamic activity and can be used as for improving therapeutic efficacy of aripiprazole through this platform.

Clinical analysis of acellular dermal matrix and acellular bone matrix in oro-antral fistula repair / 华西口腔医学杂志

OBJECTIVE@#This study aimed to investigate the application of acellular dermal matrix and acellular bone matrix in the management of oro-antral fistula.@*METHODS@#Nine patients with oro-antral fistula (with defect greater than 5 mm×5 mm) after maxillary cyst resection or maxillary molar extraction were selected. The defects were repaired by the simultaneous implantation of acellular dermal matrix and acellular bone matrix.@*RESULTS@#The incisions of nine patients were all primary healing. After 6 months of follow-up, the oro-antral communication healed well, and no symptom such as nasal congestion or runny nose was observed. The clinical and CT examinations confirmed wound healing.@*CONCLUSIONS@#The usage of acellular dermal matrix and acellular bone matrix is a reliable repairing method for ora-antral fistula.

Tratamiento de fistula palatina anterior mediante colgajo de lengua / Treatment of anterior palatal fistula through tongue flap

La fístula palatina anterior es la comunicación anormal entre la cavidad oral y la nariz que se presenta después del cierre quirúrgico de la fisura palatina, ésta ocurre con más frecuencia en defectos de paladar duro. El colgajo de lengua está indicado para la reconstrucción de grandes fístulas palatinas y con excesivas cicatrices palatinas luego de varios procedimientos insatisfactorios. El colgajo ofrece varias ventajas ya que presenta abundante tejido, excelente irrigación y es de fácil rotación. El resultado fue satisfactorio.

The anterior palatal fistula is the abnormal communication between the oral cavity and nose that occurs after surgical closure of cleft palate, this occurs more frequently in hard palate defects. Tongue flap is indicated for the reconstruction of large fistulas and excessive palatal scars after several unsatisfactory procedures. The flap offers several advantages since it presents abundant tissue, excellent irrigation and easy rotation. The result was satisfactory.

La materia terapéutica en La Arcadia, de Lope de Vega / The therapeutic subject in La Arcadia by Lope de Vega

En la actualidad, aún se desconoce el verdadero alcance de la vasta cultura de Lope de Vega, pues, aunque se sabe que fue un gran lector, que legó más de 1500 libros, sus títulos se han perdido a lo largo de la historia. No obstante, en sus obras trasciende una serie de textos que contribuyeron a su formación. En el presente trabajo se analiza La Arcadia (1598), considerada la novela pastoril más erudita del Siglo de Oro, desde la perspectiva de los agentes terapéuticos. En esta obra se mencionan remedios de procedencia herbal (romero, helenium, verbena, lupino, narciso, lirio, jacinto, lechuga o lino), de procedencia mineral (rubí, diamante, esmeralda, pórfido y oro) y también de procedencia animal (sustancias obtenidas del asno, caballo, conejo, zorro, víboras o arañas, entre otros animales). Los resultados confirman que Lope de Vega pudo utilizar una serie de textos científicos en sus citas sobre la materia terapéutica. Entre ellos cabe destacar a Andrés Laguna y su Dioscórides y Plinio el Viejo, cuya Historia Natural pudo haber consultado como fuente primaria, a través de alguna traducción comentada, como la de Gerónimo de Huerta o a través de alguna otra obra basada en ella, como el opúsculo de Constantino Castriota, pues, en este último caso, se encuentran párrafos muy similares y, en algunos casos, casi literales.

Nowadays, the true extent of the vast culture of Lope de Vega is still largely unknown. Although it is known that he was a great reader, who bequeathed more than 1500 books, his titles have been lost throughout history. However, a series of texts that contributed to his education become known in his works. In the present paper, La Arcadia (1598), considered the most erudite pastoral romance of Spanish Golden Age, is analyzed from the therapeutic perspective. Remedies of herbal origin (rosemary, helenium, verbena, lupine, narcissus, lily, hyacinth, lettuce or flax, among others), of mineral origin (ruby, diamond, emerald, porphyry and gold) and also of animal origin (substances obtained from donkeys, horses, rabbits, foxes, vipers or spiders, among other animals) are mentioned in this novel. The results achieved confirm that Lope de Vega was able to use a series of scientific texts in his quotations on the therapeutic subject. Among them, it is worth mentioning Andres Laguna (and his Dioscorides), and Pliny the Elder, whose Natural History could have been consulted as a primary source, through some commented translation, such as that of Geronimo de Huerta, or through some other work based on it, like Constantino Castriota's opuscule. In the latter case, there are very similar and, in some cases, almost literal paragraphs.

Paciente con síndrome oro-facio-digital tipo II. Reporte del caso / Paciente com síndrome oral-facial-digital tipo II. Reporte do caso / Oro-facial-digital syndrome type II. Report of the case

El síndrome oro-facio-digital (OFD) es un trastorno raro del desarrollo embrionario, cuya incidencia en la población general fluctúa entre menos de 1/1 000 000 y 1/250 000 nacidos vivos. Los pacientes suelen presentar complicaciones del desarrollo de la boca, la cara, las manos y los pies. Hasta el momento se desconoce la mayoría de los genes implicados por lo que el diagnóstico es clínico. Se presenta el caso de un paciente en edad escolar con alteraciones orales, faciales, digitales y auditivas compatibles con el síndrome OFD; por sus características fenotípicas se hizo el diagnóstico de la variante tipo II. La discusión se basa en los criterios para las variantes del síndrome.

Oro-facial-digital syndrome (OFD) is a rare congenital disorder. Its incidence in the general population ranges from less than 1/1.000.000 to 1/250.000 living births. Patients usually present developmental disorders that affect the mouth, face, hands and feet. So far, most of the genes involved are unknown, so diagnosis is clinical. We report the case of a child with oral, facial, and digital alterations, and hearing impairment suggestive of the OFD syndrome. Phenotype was consistent with the type II variant. Discussion is based on the criteria for variants of the syndrome.

A síndrome oral-facial-digital (OFD) é um transtorno raro do desenvolvimento embrionário, cuja incidência na população geral flutua entre menos de 1/1 000 000 e 1/250 000 nascidos vivos. Os pacientes normalmente apresentam complicações do desenvolvimento da boca, a face, as manas e os pies. Até o momento se desconhece a maioria dos genes implicados pelo que o diagnóstico é clínico. Se apresenta o caso de um paciente em idade escolar com alterações orais, faciais, digitais e auditivas compatíveis com a síndrome OFD; por suas características fenotípicas se fez o diagnóstico da variante tipa II. A discussão se baseia nos critérios para as variantes da síndrome.