Evaluación del riesgo de caídas en adultos mayores con Diabetes Mellitus tipo 2 / Evaluation of fall risk assessmentin in older adults with Type 2 Diabetes Mellitus / Avaliação do risco de quedas em idosos com Diabetes Mellitus tipo 2

Introducción: La diabetes mellitus 2 es una enfermedad frecuente en adultos mayores, con múltiples complicaciones que pueden llegar a afectar el equilibrio y la marcha e incrementar el riesgo de caída. Objetivo: Determinar el riesgo de caídas en dos grupos de adultos mayores, uno con padecimiento de DM2 y otro sin este padecimiento. Metodología: Estudio de enfoque cuantitativo, alcance descriptivo, diseño observacional, y de cohorte transversal; muestra poblacional de 120 adultos mayores en la ciudad de Guayaquil divididos en dos grupos: grupo A con 60 adultos mayores que no padecían DM2 y grupo B con 60 adultos mayores con DM2; que cumplen con los criterios de inclusión y a quienes se evalúan mediante las técnicas: observación, evaluación y entrevista; y los instrumentos: Escala de Berg, Mini-BESTest y formulario estándar. Se utilizó la prueba estadística Chi cuadrado para la comparación de los resultados obtenidos. Resultados: Los resultados indican que, en la determinación del riesgo de caídas, se encontraron diferencias estadísticamente significativas (p0.05). El estudio además encontró que los resultados obtenidos, en las dos pruebas de riesgo de caídas, difieren entre sí. Conclusiones: Los adultos mayores diabéticos presentan un mayor riesgo de caída a comparación de adultos mayores no diabéticos.

Introduction: Diabetes mellitus 2 is a common disease in older adults, with multiple complications that can affect balance and gait and increase the risk of falling. Objective: To determine the risk of falls in two groups of older adults, one with and the other without DM2. Methodology: Quantitative approach study, descriptive scope, observational design, and cross-sectional cohort; population sample of 120 older adults in the city of Guayaquil divided into two groups: group A with 60 older adults who did not suffer from DM2 and group B with 60 older adults with DM2; who meet the inclusion criteria and who are evaluated by means of the techniques: observation, evaluation and interview; and the instruments: Berg scale, Mini-BESTestest and standard form. The Chi-square statistical test was used to compare the results obtained. Results: The results indicate that, in the determination of the risk of falls, statistically significant differences (p0.05) were found. The study further found that the results obtained, in the two fall risk tests, differed from each other. Conclusions: Diabetic older adults present a higher risk of falling compared to non-diabetic older adults.

Introdução: O diabetes mellitus tipo 2 é uma doença comum em idosos, com múltiplas complicações que podem afetar o equilíbrio e a marcha e aumentar o risco de quedas. Objetivo: Determinar o risco de quedas em dois grupos de idosos, um com DM2 e outro sem essa condição. Metodologia: Estudo com abordagem quantitativa, escopo descritivo, desenho observacional e coorte transversal; amostra populacional de 120 idosos da cidade de Guayaquil dividida em dois grupos: grupo A com 60 idosos que não sofriam de DM2 e grupo B com 60 idosos com DM2; que atendam aos critérios de inclusão e que sejam avaliados pelas técnicas: observação, avaliação e entrevista; e os instrumentos: Escala de Berg, Mini-BESTest e formulário padrão. O teste estatístico Qui-quadrado foi utilizado para comparação dos resultados obtidos. Resultados: Os resultados indicam que, na determinação do risco de quedas, foram encontradas diferenças estatisticamente significativas (p0,05). O estudo também constatou que os resultados obtidos nos dois testes de risco de queda diferem entre si. Conclusões: Idosos diabéticos apresentam maior risco de queda em comparação aos idosos não diabéticos.

Construction and application of the “school-enterprise-community”linkage community pharmaceutical care mode based on the WeChat mini program / 中国药房

OBJECTIVE To construct the “school-enterprise-community” linkage community pharmaceutical care mode based on the WeChat mini program， upgrade the content and mode of community pharmaceutical care， and improve the quality of healthy life of the residents. METHODS Focusing on the pharmaceutical care needs of community residents， by integrating school， enterprise and community pharmaceutical resources， the WeChat mini program of “drug enjoying health” was created and the “online+offline” community pharmaceutical care mode was built. Using classified random sampling， mini program users were randomly selected as the observation group， and offline pair-assisted community residents as the control group. The intervention effects of the two groups were compared around the three aspects of medication health knowledge mastery， medication compliance and medication behavior. RESULTS The “drug enjoying health” mini program consisted of four modules：“ drug for health”，“ drug for warmth”，“ drug for safety”， and “personal information”. The “school-enterprise-community” linkage community pharmaceutical care mode based on the “drug enjoying health” mini program began to be applied in July 2022， with 6 185 users， 2 732 recovery records of expired drugs， 941 times of pharmaceutical care， and 3 354 consultation orders. After the intervention， the qualified rate of medication health knowledge mastery， complete compliance rate， and the correct rate of medication behavior in the observation group increased from 33.53% to 76.87%， 20.23% to 46.26%， and 49.71% to 89.80%， respectively； the proportion of the increase after the intervention was higher than that of the control group （P＜0.05）. CONCLUSIONS This mode has effectively improved the quality of community pharmaceutical care， improves the health awareness of community residents in drug use， and promotes the standardization， rationalization and safety of residents’ drug use.

The efficiency of a customized distalizer with Variety SP® screws anchored on palatal miniscrews for upper molar distalization

ABSTRACT Objective: To assess the effectiveness of a customized distalizer with Variety SP® screws anchored on palatal miniscrews for upper molar distalization. Methods: Seventeen patients aged between 12.5 and 24 years underwent distalization with a customized distalizer. Lateral cephalogram and cast analysis were performed before and after distalization. Linear and angular parameters of the upper first molar, first premolar, and central incisor were assessed. Results: Distalization with the force passing near the center of resistance (CRes) of the upper first molars resulted in distal movement, with minimal distal tipping (2.8±0.45°, p<0.05). However, distalization passing occlusal to the CRes led to greater distal tipping (13.6±1.63°, p<0.05). Statistically significant spontaneous distal tipping and distal movement of the upper first premolars occurred, with a mean of 6.2±1.24° (p<0.05) and 0.68±0.34 mm (p<0.05), respectively. The positional change of the upper central incisors presented a mean of -0.23±0.1 mm (p>0.05) and 2.65±1.1° (p<0.05). Upper first molar intrusion was statistically significant, with a mean of 0.88±0.2 mm (p<0.05). Upper right and left first molars rotation towards palatal midline presented mean of 4.1±0.19° (p<0.05) and 3.4 ±0.1° (p<0.05), respectively. Additionally, the distance between upper right and left first molars increased significantly, with a mean of 2.54±0.01 mm (p<0.05). Conclusion: The study successfully demonstrated the efficiency of molar distalization without anchorage loss using a customized distalizer anchored on palatal miniscrews.

RESUMO Objetivo: Avaliar a eficácia de um distalizador personalizado com parafusos Variety SP® ancorado em mini-implantes palatinos para distalização de molares superiores. Métodos: Dezessete pacientes com idade entre 12,5 e 24 anos foram submetidos à distalização com o distalizador customizado. Análises das radiografias cefalométricas laterais e dos modelos de gesso foram realizadas antes e depois da distalização. Foram avaliados parâmetros lineares e angulares dos primeiros molares, primeiros pré-molares e incisivos centrais superiores. Resultados: A distalização com a força passando perto do centro de resistência (CRes) dos primeiros molares superiores resultou em distalização com inclinação mínima (2,8 ± 0,45°, p<0,05). Entretanto, a distalização passando oclusal ao CRes levou a uma maior inclinação para distal (13,6 ± 1,63°, p<0,05). Ocorreu inclinação distal espontânea e movimento distal estatisticamente significativo dos primeiros pré-molares superiores, com média de 6,2 ± 1,24° (p<0,05) e 0,68 ± 0,34 mm (p<0,05), respectivamente. A mudança de posicionamento dos incisivos centrais superiores apresentou média de -0,23 ± 0,1 mm (p>0,05) e 2,65 ± 1,1° (p<0,05). A intrusão dos primeiros molares superiores foi estatisticamente significativa, com média de 0,88 ± 0,2 mm (p<0,05). A rotação dos primeiros molares superiores direito e esquerdo em direção à linha média palatina apresentou média de 4,1 ± 0,19° (p<0,05) e 3,4 ± 0,1° (p<0,05), respectivamente. Além disso, a distância entre os primeiros molares superiores direito e esquerdo aumentou significativamente, com média de 2,54 ± 0,01 mm (p<0,05). Conclusão: O estudo demonstrou com sucesso a eficiência da distalização de molares sem perda de ancoragem utilizando um distalizador customizado ancorado em mini-implantes palatinos.

Pedagogia do esporte e a Educação Física escolar: possibilidades entre o teaching games for undestanding (TGfU) e o minivoleibol / Sport pedagogy and schollar Physical Education: possibilities between teaching games for understanding (TGfU) and mini volleyball / Pedagogía del deporte y Educación Física escolar: posibilidades entre los juegos didácticos para la comprensión (TGfU) y el mini voleibol

Este texto apresenta reflexões e duas sugestões de aulas sobre o minivoleibol com a utilização do Teaching Games for Understanding, juntamente com as lentes da Pedagogia do Esporte. Consideramos que, por via das mudanças curriculares e que vão em direção ao ensino técnico dos esportes, este trabalho traz ideias de utilização do TGfU para os professores de Educação Física no âmbito escolar, na direção de ampliar os conhecimentos pedagógicos. Observamos que, em cenários que o TGfU foi operado, houve mudança significativa e positiva à aprendizagem dos estudantes. Por fim, as estratégias quanto ao uso do minivoleibol e sua operacionalização devem ser repensados em todos os contextos que estão inclusos pois é evidenciado a melhora no desempenho tático e cognitivo dos participantes.

This text presents reflections and two lesson suggestions about mini volleyball using Teaching Games for Understanding, through the lens of Sport Pedagogy. We consider through curricular changes that move towards technical sports education, this work brings ideas and the use of TGfU to Physical Education teachers in school, in the direction of expanding pedagogical knowledge. We observed that, in scenarios where TGfU was operated, there was a significant and positive change in student learning. Finally, the strategies for the mini volleyball and this operationalization should be reconsidered in all the contexts included, because it is evidence of the tactical and cognitive development.

Este texto presenta reflexiones y dos sugerencias de lecciones sobre mini voleibol utilizando Juegos de Enseñanza para la Comprensión, a través del lente de la Pedagogía Deportiva. Consideramos que, mediante cambios curriculares que avancen hacia la educación técnico deportiva, este trabajo aporta ideas y el uso de TGfU a los profesores de Educación Física en la escuela, en la dirección de ampliar el conocimiento pedagógico. Observamos que, en los escenarios donde se operó TGfU, hubo un cambio significativo y positivo en el aprendizaje de los estudiantes. Finalmente, las estrategias para el mini voleibol y esta operacionalización deben ser reconsideradas en todos los contextos incluidos, porque es evidencia del desarrollo táctico y cognitivo.

Three-level thoracic disc herniation: transthoracic decompression without fixation / Hernia discal dorsal de tres niveles: descompresión transtorácica sin fijación

Abstract Thoracic disc herniation is a rare pathology com pared to the rest of the herniated discs. Due to their difficult access to the area of compromise and proximity to the spinal cord they represent a real challenge for the spine surgeon. The objective is to report an atypical case with three symptomatic dorsal disc herniations which required surgical treatment. Surgery was performed in two times with a lapse of 12 months between interven tions. It was done a minimally invasive transthoracic decompression and intersomatic arthrodesis without instrumentation. The patient presented good neurologi cal recovery without any serious sequelae.

Resumen La hernia de disco dorsal es una afección poco fre cuente en comparación con el resto de las hernias discales. Por su difícil acceso a la zona de compromiso y cercanía de la médula espinal representan un verda dero desafío para el cirujano de columna. El objetivo del trabajo es presentar un caso atípico con tres hernias de disco dorsales sintomáticas en forma sincrónica que requirió tratamiento quirúrgico. La cirugía se hizo en dos tiempos con un lapso de 12 meses entre las intervenciones. Se realizó descompresión transtorácica mínimamente invasiva y artrodesis intersomática sin instrumentación en cada nivel. El paciente presentó buena recuperación neurológica sin ninguna secuela grave.

Implementación del mini-CEX en el pregrado médico: Una experiencia con simulación / Implementation of the Mini-CEX in Medical Undergraduate Education: A Simulation-Based Experience

Resumen La evaluación es un proceso sistemático que resulta en un juicio de valor para tomar decisiones. Los instrumentos empleados para obtener datos sobre el desempeño de los estudiantes requieren de un proceso sistemático y objetivo para su implementación. El mini-CEX es un instrumento de observación directa que ha sido empleado para la evaluación de la competencia clínica en los estudiantes de pre y posgrado desde su invención en 1955. Cuenta con diferentes evidencias de validez para su uso en distintos contextos educativos y clínicos. Permite realizar evaluaciones rápidas, acompañadas de realimentación y que proporcionan información relevante del desarrollo de la competencia clínica. El objetivo de este escrito es exponer la experiencia de la implementación del mini-CEX en el pregrado médico para la evaluación formativa de los estudiantes utilizando la simulación con pacientes estandarizados. Para lograr este objetivo se empleó la siguiente secuencia: búsqueda, planeación, integración y aplicación. Posterior a estos pasos se dan una serie de recomendaciones para la implementación del mini-CEX. Se concluye que la evaluación de la competencia clínica es importante para la mejora continua y permanente de los estudiantes de pre y posgrado. Es necesario sistematizar la evaluación ajustada siempre a objetivos y necesidades específicas de la evaluación.

Abstract Evaluation is a systematic process that results in a judgment to make decisions. The instruments used to obtain data on student performance require a systematic and objective process for their implementation. The mini-CEX is a direct observation tool that has been used for the evaluation of clinical competence in undergraduate and postgraduate students since its invention in 1955. It has different validity evidence for use in different educational and clinical contexts. It allows rapid evaluations, accompanied by feedback and providing relevant information on the development of clinical competence. The objective of this paper is to expose the experience of the implementation of the mini-CEX in the medical undergraduate for the formative evaluation of students using simulation with standardized patients. To achieve this goal, the following sequence was used: search, planning, integration, and application. After these steps we make some recommendations for the implementation of the mini-CEX. Its is concluded that the evaluation of clinical competence is important for the continuous and permanent improvement of undergraduate and graduate students. It is necessary to systematize the evaluation always adjusted to objectives and specific needs of the evaluation.

Minimally Invasive Surgery with the Bentall-De Bono Technique. Initial Experience at Hospital Italiano de Buenos Aires / Cirugía de Bentall de Bono por abordaje miniinvasivo. Experiencia inicial del Hospital Italiano de Buenos Aires

ABSTRACT Background : Cardiac surgery avoiding full sternotomy began to emerge in the 1990s with the first hemi-sternotomies and mini-thoracotomies. Aortic valve and root surgery is one of the most common procedures in our field. In this paper, we analyze our experience in minimally invasive cardiac surgery (MICS) for the aortic root with the Bentall-De Bono technique (MICS-Bentall). Objective : To analyze the surgical results in the first 10 patients underwent a MICS-Bentall procedure at our site. Materials and Methods : A retrospective observational study was carried out including patients with valve disease and aortic root dilation who underwent a surgery with the MICS-Bentall procedure in a tertiary care hospital from December 2019 to December 2020. Continuous variables were expressed as mean and standard deviation or median and interquartile range according to the observed distribution. Categorical variables were expressed as absolute and relative frequency. Results : Out of 165 patients undergoing aortic root surgery, 10 patients were included. Mean age was 56 ± 17.03 years, 70% male; all cases were elective. Median (interquartile range, IQR) STS PROM % was 1.48 (1- 2.02). Eighty percent had bicuspid valve. Fifty percent of patients were extubated within 6 hours. In the 30-day follow-up, no death was recorded, and two complications were registered: one patient experienced atrial fibrillation without hemodynamic decompensation and another a wound infection. The mean hospital length of stay was 5 days. Conclusion : In our experience, MICS using the Bentall technique showed satisfactory results in terms of low perioperative mortality, early extubation, and short hospital stay.

RESUMEN Introducción : La cirugía cardíaca libre de esternotomía completa surge en los años 90 con las primeras esternotomías y toracotomías mínimas. La cirugía de la válvula y la raíz aórtica constituyen uno de los procedimientos más frecuentes en nuestro campo. En este trabajo analizamos nuestra experiencia en Cirugía Cardíaca Miniinvasiva (MICS) de la raíz aórtica con la técnica Bentall de Bono (MICS-Bentall). Objetivo : Analizar los resultados quirúrgicos en los primeros 10 pacientes intervenidos con MICS-Bentall en nuestra institución. Material y métodos : Se realizó un estudio observacional retrospectivo en el que se incluyeron los casos de valvulopatía y dilatación de la raíz aórtica intervenidos quirúrgicamente mediante MICS-Bentall en un hospital de alta complejidad durante el periodo diciembre 2019 - diciembre 2020. Las variables continuas se expresan como media y desvío estándar o mediana y rango intercuartílico según la distribución observada. Las variables categóricas como frecuencia absoluta y relativa. Resultados : Sobre 165 pacientes sometidos a cirugía de la raíz aórtica, se incluyeron 10 pacientes. La edad media fue de 56 ± 17,6 años, 70% de sexo masculino, todos fueron electivos. La mediana de STS PROM % fue de 1,48 (1-2,02). En el 80% la válvula aórtica era bicúspide. El 50% de los pacientes fue extubado dentro de las 6 horas. En seguimiento a 30 días no se registraron óbitos, y hubo 2 complicaciones: un paciente presentó fibrilación auricular sin descompensación hemodinámica, y otro, infección de herida. La estadía hospitalaria fue en promedio de 5 días. Conclusión : En nuestra experiencia con MICS con la técnica Bentall se obtuvieron resultados satisfactorios con baja mortalidad perioperatoria, extubación precoz y tiempos cortos de estancia hospitalaria.

Malnutrición asociada con factores sociodemográficos en adultos mayores de Medellín (Colombia) / Malnutrition Associated with Sociodemographic Factors in Older Adults in Medellin, Colombia / Má nutrição associada a fatores sociodemográficos em idosos em Medellín-Colômbia

Introducción: los adultos mayores (AM) presentan riesgo de malnutrición (exceso o déficit de peso) debido a cambios fisiológicos, alimentarios, psicológicos y sociales derivados del envejecimiento. Objetivo: estimar la frecuencia de malnutrición por antropometría y el Mini Nutritional Assessment (MNA) en AM de Medellín (Colombia) y explorar su asociación con factores sociodemográficos. Materiales y métodos: estudio trans- versal con 1187 adultos ≥60 años, derivado del proyecto Propuesta técnica para el desarrollo del perfil de seguridad alimentaria y nutricional 2015, realizado en hogares de zona urbana y rural. Se tomaron como variables independientes las sociodemográficas, y como dependientes, las antropométricas y el MNA. La asociación entre malnutrición y variables sociodemográficas se determinó por modelos de regresión logística binaria y multinomial. Resultados: 65.2 % fueron mujeres, la edad promedio fue 70.0 ± 8.0 años; 61.5 % de estrato socioeconómico bajo, 65.9 % con nivel educativo primaria o inferior. Según el índice de masa corporal, 57.6 % presentó malnutrición, 20.8 % déficit de peso y 36.8 % exceso de peso. Según el MNA, 41.4 % tenía riesgo de desnutrición, y 5.4 %, desnutrición. Ambas condiciones se presentaron con mayor frecuencia en mujeres (OR = 2.0; IC95 %: 1.5-2.6), edades ≥75 años (OR = 1.7; IC95 %: 1.2-2.4), estrato socioeconómico bajo (OR = 3.2; IC95 %: 1.5-6.8), del área rural (OR = 1.7; IC95 %: 1.1-2.5), con estudios de primaria (OR = 2.1; IC95 %: 1.1-4.4) o sin educación (OR = 3.4; IC95 %: 1.5-7.5). Conclusión: la malnutrición en AM de Medellín es elevada y constituye un problema de salud pública, más frecuente en mujeres, edades avanzadas, zonas rurales, estratos socioeconómicos bajos y niveles educativos inferiores; condiciones que deben tenerse en cuenta para la implementación de políticas públicas

Introduction: Older adults (OA) are at risk of malnutrition (overnutrition or undernutrition) due to physio- logical, feeding, psychological, and social changes associated with aging. This study aimed to estimate the frequency of malnutrition using anthropometry and the Mini-Nutritional Assessment (MNA) among OA in Medellin, Colombia, and explore the association of malnutrition with sociodemographic factors. Methods: A cross-sectional study derived from the Technical Proposal for the Development of the Food and Nutrition Security Profile, 2015 was performed with 1187 adults aged ≥60 years old among urban and rural households. The sociodemographic characteristics were considered as independent variables, and anthropometric and MNA data were defined as dependent variables. To establish the association between malnutrition and sociodemographic variables, binary and multinomial logistic regression models were used. Results: The average age of the participants was 70.0 ± 8.0 years old; 65.2% were women; 61.5% were of low socioeconomic status; and 65.9% attained primary education or lower. Based on body mass index, 57.6% had malnutrition, 20.8% were undernutrition, and 36.8% were overweight/obese. According to the MNA, 5.4% had malnutrition, while 41.4% were at risk of malnutrition. Both conditions occurred more frequently in women (OR = 2.0; 95% confidence interval [CI]: 1.5­2.6), aged ≥75 years old (OR = 1.7; 95% CI: 1.2­2.4), with low socioeconomic status (OR = 3.2; 95% CI: 1.5­6.8), from rural areas (OR = 1.7; 95% CI: 1.1­2.5), with primary education (OR = 2.1; 95% CI: 1.1­4.4) or no education (OR = 3.4; 95% CI: 1.5­7.5). Conclusion: Malnutrition among OA in Medellin, Colombia, is high, especially among women living in rural areas with low socioeconomic status and education level. The study findings indicate a public health problem. These conditions must be considered in the implementation of public policies

Introdução: os idosos (AM de adultos mayores) estão sob risco de má nutrição (excesso de peso ou desnu- trição) devido às alterações fisiológicas, dietéticas, psicológicas e sociais decorrentes do envelhecimento. O objetivo deste estudo foi estimar a frequência de má nutrição por antropometria e pelo Mini Nutritional Assessment (MNA) em AM de Medellín-Colômbia e explorar sua associação com fatores sociodemográficos. Materiais e métodos: estudo transversal com 1187 adultos ≥ 60 anos, derivados do projeto Proposta técnica para elaboração do perfil de Segurança Alimentar e Nutricional 2015, realizado em domicílios de áreas urbanas e rurais. Variáveis sociodemográficas foram consideradas como variáveis independentes e as variáveis antropométricas e MNA como variáveis dependentes. A associação entre a má nutrição e as variáveis sociodemográficas foi determinada por modelos de regressão logística binária e multinomial. Resultados: 65.2% eram mulheres, idade média 70.0 ± 8.0 anos; 61.5% de estrato socioeconômico baixo, 65.9% com nível de escolaridade fundamental ou inferior. De acordo com o índice de massa corporal (IMC), 57.6% apresentaram desnutrição, 20.8% magreza e 36.8% excesso de peso. Segundo o MNA, 41.4% estavam em risco de desnutrição e 5.4% já apresentavam desnutrição. Ambas as condições ocorreram com maior frequência em mulheres (or = 2.0; Ic 95%: 1.5-2.6), idade ≥ 75 anos (or = 1.7; Ic 95%: 1.2-2.4), baixo nível socioeconômico (or = 3.2; Ic 95%: 1.5-6.8), da zona rural (or = 1.7; Ic 95%: 1.1-2.5), com ensino fundamental (or = 2.1; Ic 95%: 1.1-4.4) ou sem escolaridade (or = 3.4; Ic 95%: 1.5-7.5). Conclusão: a má nutrição em AM de Medellín é alta, constituindo um problema de saúde pública, mais frequente em mulheres, idades avançadas, áreas rurais, estratos socioeconômicos baixos e níveis educacionais mais baixos; condições que devem ser levadas em conta para a implementação de políticas públicas

The Use of Escherichia coli for Recombinant Human Insulin Production

Insulin is the essential hormone produced by the pancreas. which is accountable for sanctioning glucose we acquire from our food sources to be deposited in our body cells. Without insulin, our bodies cannot control blood sugar levels, so insulin is a vital hormone for survival. A diabetic person either does not produce insulin or is resilient to it for a multiple reasons. Because of this, they need insulin injections to process glucose. It has become stress-free for patients around the world to acquire insulin with the production of recombinant human insulin produced by Escherichia coli . This short review will provide an overview of the steps engaged in constructing recombinant human insulin utilizing the K12 strain of E. coli along with the prominence of recombinant insulin and why E. coli is most commonly used for insulin production.

Intrusión acelerada con miniimplantes y corticotomía para crear espacio protésico para implante

La ausencia de un diente puede originar sobre-erupción de su antagonista debido al movimiento fisiológico. Distintos métodos se han empleado para lograr la rehabilitación en espacios interoclusales reducidos, la mayoría implica un tallado del diente antagonista o incluso la extracción dental. La intrusión dental periodontalmente asistida (corticotomía), es una alternativa terapéutica en la que el tallado del diente extruido ya no es necesario, conservando su integridad coronaria. Reporte de caso: Paciente femenino de 56 años con ausencia del 4.7, además presenta sobre-erupción del 1.7, limitando el espacio interoclusal y su rehabilitación. Se realizó intrusión del 1.7 mediante corticotomía con el Piezoeléctrico (técnica Piezocision) así como la colocación de minitornillos de ortodoncia para anclaje. Obtenido dicho espacio interoclusal, se rehabilitó con un implante dental. Conclusiones: La intrusión de molares con el apoyo de mini-implantes y corticotomías es un procedimiento que tiene como beneficio la creación de un espacio interoclusal para su restauración en un periodo corto de tiempo, sin tallar la estructura dentaria.

The absence of a tooth can cause over-eruption of its antagonist due to a physiological movement. Different methods have been used to achieve rehabilitation in reduced interocclusal spaces. Most of them involve the wear of the opposing tooth or even dental extraction. Periodontal-assisted dental intrusion is a therapeutic alternative that does not require the reduction of the extruded tooth and preserves its structure. Case report: 56-year-old female patient with absence of tooth 4.7, also presenting an over-eruption of 1.7, limiting the interocclusal space and rehabilitation. Intrusion of tooth 1.7 was performed with corticotomy using the piezocision technique and placement of mini-screws followed by the placement of a dental implant. Conclusions: The intrusion of molars aided by orthodontic mini-screws and piezocision technique is an effective treatment, whose benefit is the creation of an ideal prosthetic space in a short period of time, avoiding the reduction of dental structure.

Corneal Abscess on Mini-scleral Contact Lens: Clinical Case

Mini-scleral lens’ are large diameter rigid lenses that are used to rehabilitate vision when the corneal shape is distorted from disease, scarring or after a corneal graft procedure, however, there are relatively few reports regarding their potential complications, in this case we describe the case of a corneal abscess in a mini-scleral lens wearer with keratoconus in order to determine whether this type of contact lens presents an increased risk of infection.

A cross-sectional study to determine the cognitive impairment and depression among elderly in a rural area of West Bengal

Background: The increase in worldwide life expectancy among the elderly is contributing to an increase in cognitive impairment (CI). A more complicated etiology makes CI an essential clinical concern for elderly patients with depression. Ageing populations as a result of demographic change have accelerated the development of certain geriatric conditions, including CI and depression. Aims and Objectives: The objective was to identify the prevalence and contributing factors of CI and depression in the elderly rural community. Materials and Methods: A descriptive, cross-sectional, and community-based study was conducted in rural field practice area of Medical College, Kolkata, among 133 geriatric people during time period of March–June, 2022. The prevalence of CI was measured using the Mini-Mental State Examination (MMSE) scale and depression was assessed using the geriatric depression scale. Data were analyzed in SPSS software version 16. Results: Mean age of the participants was 65.68 (±6.03) years. The prevalence of CI was 86.5%, with a mean MMSE score of 19.27 ± 4.34, and the depression was 77.5% and 7.07 ± 3.39. Conclusion: Almost two-third of the geriatric population is suffering from depression and CI. To handle the issue of CI, depression, and its resulting effects, new and modified geriatric health policies are very much needed.

Three years of COVID-19 pandemic: comparative analysis of incidence, lethality and mortality among the States of the south region of Brazil / Três anos de pandemia da COVID-19: análise comparativa da incidência, letalidade e mortalidade entre os Estados da região sul do Brasi

Introduction: the first COVID-19 case in Brazil was confirmed on February 26, 2020. As of March 17, 2023, the Ministry of Health reported 699,634 deaths from COVID-19, with a case fatality rate of 1.9%. The impact of the COVID-19 pandemic in Brazil extends to socioeconomic and healthcare systems, reflecting significant regional disparities. Objective: To analyze mortality, incidence, and case fatality rates for COVID-19 in the states of Paraná and Santa Catarina, in the southern region of Brazil. Methods: This is an ecological time-series study using official Brazilian secondary data for COVID-19 cases and deaths. Data were extracted from the dashboard of the State Health Department of Santa Catarina and Paraná. Temporal series were developed for trend analysis using the Prais-Winsten regression model. Statistical analyses were performed using STATA 14.0 software (College Station, TX, USA, 2013). Results: In the analysis of rates over the entire period, trends for mortality, case fatality, and incidence in the state of Santa Catarina are decreasing, decreasing, and stationary, respectively. In Paraná, rates over the entire period showed a stationary trend for mortality, decreasing for case fatality, and increasing for incidence. Conclusion: COVID-19 had a devastating effect on the states of Santa Catarina and Paraná. Both states experienced the progression of the COVID-19 pandemic, with higher case fatality and mortality rates observed in Paraná, while Santa Catarina had a higher incidence rate over the three years of the COVID-19 pandemic.

Nutritional status and food environment of the elderly population residing in tea gardens of a block of Darjeeling District, West Bengal, India

Objectives: In India, poverty, illiteracy, and difficult terrains make the tea garden elderly population more vulnerable to malnutrition. The food environment shows the interface through which consumers interact with their food system. Hence, the present study was done to assess the nutrition status and identify the sociodemographic and food environmental factors affecting the nutritional status of the elderly population residing in tea gardens of Naxalbari block, Darjeeling district, West Bengal, India. Materials and Methods: A community-based cross‑sectional study was conducted in all tea gardens of Naxalbari block, Darjeeling, from March 2022 to September 2022, among older people aged 60 years and above selected by simple random sampling. Using the predesigned, pretested questionnaire, the Mini Nutritional Assessment tool for nutritional assessment and the elderly population’s perceived food environment was determined based on five points Likert’s scale. Perceived food environment clusters were identified using a two‑stage cluster analysis. Binary logistic regression was used to determine predictors of nutritional status. Results: Out of the 294 study participants, the majority of 190 (64.6%) of the older people were at the risk of malnutrition, 18 (6.1%) malnourished, and 86 (29.3%) had normal nutritional status. Binary logistics regression showed older people who were illiterate (adjusted odds ratio [AOR] 14.864; 95% confidence interval [CI]; 4.311–51.457) and not working (AOR 3.775; 95% CI; 1.753–8.128) had significantly higher odds of being undernourished. Older people who perceived a favorable food environment (AOR 0.408; 95% CI; 0.214–0.775) had significantly lesser odds of being undernourished. Conclusion: Tea garden older population is at higher risk of malnutrition. Illiteracy, working status, and perceived favorable food environment plays important role in altering the nutritional status of the elderly. Prior interventions such as awareness regarding food nutrition and developing elderly friendly food environment are needed.

Cognitive profile in mild cognitive impairment with Lewy bodies

INTRODUCTION@#This study aimed to elucidate the cognitive profile of patients with mild cognitive impairment with Lewy bodies (MCI-LB) and to compare it to that of patients with mild cognitive impairment due to Alzheimer's disease (MCI-AD).@*METHODS@#Subjects older than 60 years with probable MCI-LB (n = 60) or MCI-AD (n = 60) were recruited. All patients were tested with Mini-Mental State Examination (MMSE) and Montreal Cognitive Assessment (MoCA) to assess their global cognitive profile.@*RESULTS@#The MCI-AD and MCI-LB patients did not differ in total MMSE and MoCA scores. However, some sub-items in MMSE and MoCA were shown to be screening markers for differentiating MCI-LB from MCI-AD. In the visuoconstructive test, the total score and hands subitem score in the clock-drawing test were significantly lower in MCI-LB than in MCI-AD. As for the executive function, the 'animal fluency test', 'repeat digits backward test' and 'take paper by your right hand' in MMSE all showed lower scores in MCI-LB compared with MCI-AD. As for memory, 'velvet' and 'church' in MoCA and 'ball' and 'national flag' in MMSE had lower scores in MCI-AD than in MCI-LB.@*CONCLUSION@#This study presents the cognitive profile of patients with MCI-LB. In line with the literature on Dementia with Lewy bodies, our results showed lower performance on tests for visuoconstructive and executive function, whereas memory remained relatively spared in the early period.

Clinical efficacy of super-mini-percutaneous nephroscope combined with flexible ureteroscopic lithotripsy in oblique supine lithotomy position in the treatment of 2.0-3.0 cm renal calculi / 现代泌尿外科杂志

【Objective】 To compare the clinical safety and effectiveness of super-mini-percutaneous nephroscope (SMP) combined with flexible ureteroscopic lithotripsy (FURL) in oblique supine lithotomy position and FURL alone in the treatment of 2.0-3.0 cm renal calculi. 【Methods】 Clinical data of 55 patients treated during Jan.2018 and May 2021 were retrospectively analyzed, including 47 cases complicated renal calculi, and 14 cases of lower calyceal calculi with infundibulopelvic angle ≤30°. SMP combined with FURL was performed in 23 cases (combined group), and FURL alone was performed in 32 cases (FURL group). The operation time, hemoglobin reduction, postoperative hospital stay, hospitalization expenses, stone-clearance rate and complications were compared. 【Results】 All operations were successful. Compared with the FRUL group, the combined group had significantly more hemoglobin reduction [(16.30±10.17) g/L vs. (6.94±6.61) g/L], longer postoperative hospital stay [(5.35±1.61) d vs. (3.19±1.26) d], and higher hospitalization expenses [(22 481±2 234) yuan vs. (18 209±2 584) yuan] (P0.05]. One month after surgery, CT results showed that the combined group had higher stone-clearance rate (91.30% vs. 65.63%, P=0.027). There was no difference in the complication rate (21.74% vs. 21.88%, P>0.05). One case (4.35%) in the combined group and 5 cases (15.63%) in the FURL group received retreatment (P>0.05). 【Conclusion】 SMP combined with FURL in oblique supine lithotomy position is safe and effective in the treatment of 2.0-3.0 cm renal calculi, with high stone-clearance rate and low complication rate.

Nutritional status of patients with pulmonary tuberculosis and anti-tuberculosis treatment effect / 中国热带医学

@#Abstract: Objective To investigate the nutritional status of patients with pulmonary tuberculosis and its effects on conventional anti-tuberculosis treatment, so as to provide a basis for improving the efficacy of conventional treatment of pulmonary tuberculosis. Methods The relevant data of 168 patients with pulmonary tuberculosis admitted to Suining Central Hospital from April 2020 to April 2022 were retrospectively analyzed. Nutritional status of the patients before treatment was investigated using the Mini Nutritional Assessment (MNA) score, and the influencing factors of nutritional status before treatment were analyzed. Therapeutic effects of anti-tuberculosis drugs in the non-nutritional risk group and the nutritional risk group were comparatively analyzed. Results Among the 168 patients, 64 were assessed as having good nutritional status before treatment, 59 had the risk of malnutrition and 45 were malnourished according to the MNA score. Univariate analysis and linear regression analysis showed that age, underlying diseases, and clinical symptoms were factors affecting the MNA score before treatment (t=3.173, 3.718, 2.018, P all<0.05); whereas gender and education level were not factors affecting MNA score before treatment (t=0.065, 0.059, P all>0.05). According to the MNA score before treatment, the patients were dividedinto a non-nutritional risk group (MNA score > 23.5) and a nutritional risk group (MNA score ≤23.5). The negative conversion rate of sputum bacteria, effective rate of focal absorption in the non-nutritional risk group were 92.19% (59/64)and90.63% (58/64) , respectively, which were significantly higher than corresponding 79.85% (82/104)and76.92% (80/104) in the nutritional risk group. The drug resistance rate, adverse reaction rate, and average treatment cost of the no nutritional risk group and nutritional risk group were 7.81% (5/64) and 21.15% (12/104), 15.63% (10/64) and 31.73% (33/104), (0.62±0.13) million yuan and (0.89±0.26) million yuan, respectively, with significant differences (χ2=5.228, 5.071, 7.685, 5.396, 7.728, P all<0.05). Conclusions Patients with pulmonary tuberculosis exhibit poor nutritional status before treatment. The patients’nutritional status is easily affected by age, underlying diseases, and clinical symptoms, thereby affecting the effect of anti-tuberculosis treatment. Therefore, early nutritional intervention for tuberculosis patients should be recommended in order to prevent malnutrition and enhance the effectiveness of anti-tuberculosis treatment.

Mini health technology assessment of weekly preparations of glucagon-like peptide-1 receptor agonist / 中国药房

OBJECTIVE To comprehensively evaluate four weekly preparations of glucagon-like peptide-1 receptor agonist （GLP-1RA） marketed in China，and to provide evidence for hospitals to optimize drug catalogs and clinical rational drug use. METHODS Mini health technology assessment method was used to establish detailed evaluation rules according to A Quick Guideline for Drug Evaluation and Selection in Chinese Medical Institutions， and conduct comprehensive evaluation of four GLP- 1RA weekly preparations from aspects of pharmaceutical characteristics， effectiveness， safety， economy and other attributes. RESULTS Mini health technology assessment scores of the four GLP-1RA weekly preparations from high to low were dulaglutide 78.60 points， semaglutide 77.35 points，polyethylene glycol loxenatide 67.40 points， and exenatide microspheres 65.50 points， respectively. Dulaglutide had advantages in reducing blood sugar， arteriosclerotic cardiovascular disease， kidney benefits， and cost- effectiveness. Semaglutide had advantages in reducing blood sugar and weight loss， but its cost-effectiveness was lower than that of dulaglutide. Exenatide microspheres had advantages in the use of children， but its daily average treatment cost is the highest. Polyethylene glycol loxenatide needed further clinical evidence. CONCLUSIONS Four GLP-1RA weekly preparations all have high pharmaceutical comprehensive scores. Dulaglutide and semaglutide may have more comprehensive pharmaceutical value among them， while the use of exenatide microspheres for children is unique.

A Novel Three-minute Game-based Cognitive Risk Screening Tool-WeChat Mini-program-based Design and Large-sample Feasibility Studies / 中国医疗器械杂志

OBJECTIVE@#To develop a novel cognitive screening tool for older adults in China.@*METHODS@#"Game-based Cognitive Assessment-3 Minute Version"(G3) was designed and developed based on WeChat mini-program. And its feasibility was analyzed.@*RESULTS@#G3 mini-program contains three one-minute mini digital games and supports users' self-assessment of cognitive functions with instant access to reports. G3 had a good correlation with Montreal Cognitive Assessment Basic (MoCA-B) with Pearson's r =0.611 (P<0.001). Among natural users aged 50 and older (71 179), the G3 initiation and completion rates were 99.55% and 92.28%, respectively. The average time to complete G3 assessments was (278.5±73.73) seconds.@*CONCLUSIONS@#The novel G3 mini-program has good feasibility and usability for older Chinese adults, and can be used for cognitive screening and home self-assessment.

A novel biological sources consistency evaluation method reveals high level of biodiversity within wild natural medicine: A case study of Amynthas earthworms as "Guang Dilong"

For wild natural medicine, unanticipated biodiversity as species or varieties with similar morphological characteristics and sympatric distribution may co-exist in a single batch of medical materials, which affects the efficacy and safety of clinical medication. DNA barcoding as an effective species identification tool is limited by its low sample throughput nature. In this study, combining DNA mini-barcode, DNA metabarcoding and species delimitation method, a novel biological sources consistency evaluation strategy was proposed, and high level of interspecific and intraspecific variations were observed and validated among 5376 Amynthas samples from 19 sampling points regarded as "Guang Dilong" and 25 batches of proprietary Chinese medicines. Besides Amynthas aspergillum as the authentic source, 8 other Molecular Operational Taxonomic Units (MOTUs) were elucidated. Significantly, even the subgroups within A. aspergillum revealed here differ significantly on chemical compositions and biological activity. Fortunately, this biodiversity could be controlled when the collection was limited to designated areas, as proved by 2796 "decoction pieces" samples. This batch biological identification method should be introduced as a novel concept regarding natural medicine quality control, and to offer guidelines for in-situ conservation and breeding bases construction of wild natural medicine.