Baixa fricção do sistema autoligado associado ao uso estratégico dos stops / Self-ligating system low friction associated with the strategic use of the stops

O uso dos braquetes autoligados tem sido cada vez mais difundido entre os ortodontistas de todo o mundo por apresentar muitas vantagens, como baixa fricção e níveis baixos de forças. O presente trabalho descreveu o tratamento ortodôntico de um paciente de 17 anos e um mês de idade, com apinhamento superior e inferior, e desvio de linha média dentária, cujos resultados demonstraram a efetividade do tratamento realizado com o sistema autoligado, otimizado por meio do uso estratégico dos stops.

The use of self-ligating brackets has been increasingly widespread among orthodontists from around the world by presenting many advantages such as low friction and low levels of forces. This paper describes the orthodontic treatment of a patient of 17 years and 1 month old, with upper and lower crowding and dental midline deviation, which results demonstrate the effectiveness of the treatment with the selfligating system, optimized by the strategic use of the stops.

Aparelho disjuntor fusionado em leque / Fan-type fused palatal expander

A correção da mordida cruzada posterior é realizada na maioria dos casos por aparelhos disjuntores, em especial o Hyrax e o Haas. Ambos têm efeitos semelhantes no complexo dentofacial, ligeiramente dentoalveolar com Hyrax e ortopédico com Haas. Modificações foram feitas com o objetivo de incorporar as vantagens de ambos, e o aparelho disjuntor fusionado de Almeida e Almeida se diferencia pela quantidade mínima de resina que recobre o parafuso. O presente caso descreve uma adolescente de 14 anos, com mordida cruzada bilateral, pré-molares e dentes anteriores em mordida topo-a-topo, que utilizou o aparelho disjuntor fusionado em leque, para maior expansão na região anterior. Após 14 dias de ativações de » de volta duas vezes por dia, o aparelho foi mantido como contenção por seis meses. Terminado esse período, o aparelho foi removido para a continuação do tratamento ortodôntico. Logo após a expansão, observou-se correção da mordida cruzada, com pouca extrusão dentária e fechamento da mordida topo-a-topo anterior durante a retração, devido à necessidade de exodontia dos segundos pré-molares. Comparando-se à opção da cirurgia ortognática, houve resposta favorável demonstrando que a indicação e a construção do aparelho disjuntor fusionado foram oportunas.

Correction of posterior crossbite in most cases is performed with disjunction appliances, in special, Hyrax and Haas. Both of them have similar effects on dentofacial complex, slightly dentoalveolar with Hyrax and orthopedic with Haas. Changes have been done on the appliances in order to incorporate advantages of both appliances in only one, and the Almeida & Almeida’s fusioned disjunction appliance is different regarding by minimum amount resin that covers the screw. The actual case describes a 14 years-old female adolescent, with bilateral posterior crossbite, bicuspids and anterior teeth in cusp-to-cusp relationship, who has worn a fan type fusioned disjunction appliance, in order to have more anterior lateral expansion. During 14 days of activation, » turn twice a day, the appliance was kept in position acting as retention for six months, after that it was removed for following orthodontic treatment. Finished the expansion, correction of the posterior crossbite was observed, with little dental extrusion and closure of the anterior cusp-to-cusp relationship during the retraction, due to necessity of second upper bicuspids extraction. When it is compared to the option of orthognathic surgery, there was favorable result suggesting the indication and building of the fusioned disjunction appliance were delivered in an appropriate time.

Tomografía computada multidetector de arterias coronarias: estado del arte. Parte II: Aplicaciones clínicas / Multidetector computed tomography of coronary arteries: state of the art. Second part: clinical applications

At the beginning of the evaluation of Coronary Artery Disease (CAD), Coronary Multidetector Computed Tomography (MDCT) was exclusively used to detect calcified plaques in coronary arteries through the Calcium Score, whose value by itself is limited. Nowadays, thanks to the technological advancements, potential clinical applications, with this method, include detection of coronary arterial stenosis, assessment of coronary bridges, and evaluation of anomalous coronaries. The intraluminal coronary stent evaluation is not possible yet, but this might become possible with the new-generation scanners. At the moment, the published results seem to be promising, nonetheless, the enthusiasm generated by this method should be accompanied by adequate training, as well as by its validation and certification.

Fundamentos de un programa comunitario para promover comportamientos saludables y prevenir enfermedades crónicas en Bogotá / Fundamentals of a community program to promote healthy behaviors and prevent chronic diseases in Bogotá

Las condiciones crónicas y sus factores de riesgos son altamente prevalentes en la población colombiana. Sin embargo, en la literatura se reportan pocos programas orientados a su prevención en el país, lo cual puede estar relacionado con la escasa información disponible acerca de cómo fundamentarlos conceptual, teórica y metodológicamente. Los objetivos de este artículo son describir los fundamentos conceptuales, teóricos y metodológicos de un programa comunitario para la prevención de las condiciones crónicas en Bogotá y dar cuenta de la aplicación de estos fundamentos en la ejecución del programa. Con este fin, entre abril de 2005 y noviembre de 2007 se llevó a cabo una evaluación de proceso que centró en analizar la coherencia entre el desarrollo del programa y sus fundamentos. Esta evaluación se llevó a cabo mediante un análisis de contenido temático, a partir de la recolección de información a través de entrevistas, fichas de sistematización y grupos focales. Emergieron cuatro categorías de análisis relacionadas con la ejecución del programa, las cuales estuvieron relacionadas con el uso del concepto positivo de salud, los modelos ecológicos en salud, las teorías críticas y el enfoque constructivista. La evaluación del proceso del programa muestra la importancia de conocer los elementos que fundamentan los programas de educación en salud, para poder analizar su desarrollo y valorarlos. En este caso los conceptos y constructos aplicados provienen de modelos contemporáneos en salud pública que exploran potenciales caminos para promover comportamientos saludables.

Chronic diseases and its risks factors are highly prevalent in the Colombian population. However, few programs have been oriented to their prevention in the country, which could be related to the little information available as to how to ground them conceptually, theoretically and methodologically. The objectives of this study are to describe the conceptual, theoretical, and methodological fundamentals of a program to prevent these diseases in Bogota and to assess the application of these fundamentals. In order to achieve these objectives between April 2005 and November 2007 was conducted a process evaluation focused on establishes the coherence between the above fundamentals and the implantation of this program. The evaluation was carried out through a thematic content analysis. The information was collected mediating interviews, systematisation tools and focal groups. Four categories emerged from the analyses. These categories were related with the use of a positive concept of health, the ecological model in health and the critical theories and the constructivist approach. The process evaluation reveals the importance of knowing the program’s foundations to analyze and asses its implementation. In this case the concepts and constructs applied belong to contemporary models in public health that explore ways to promote healthy behaviours.

Tomografía computada multidetector de arterias coronarias: estado del arte. Parte I: aspectos técnicos / Computer multidetector tomography of coronary arteries: state-of-the-art. Part 1: technical aspects

The study of atherosclerotic disease in coronary arteries is fundamental since it is the first cause of death in the Western hemisphere. The gold standard for its diagnosis is invasive angiography, but it contributes to an increase in costs for this group of patients. Nowadays fourth generation computed tomography (CT) equipments can construct acquisition data of up to 256 images in only 400 milliseconds (ms), which is 900 to 1000 times faster than first generation apparatus. CT multidetector (CTMD) is the noninvasive choice diagnosis method for a vascular evaluation of the thorax. Its role in the study of the heart was limited, but today it is possible to obtain three-dimensional heart and whole body images in only seconds. CTMD is a fast, low-cost, noninvasive method that generates cardiac and extra cardiac images without adjacent structure interference. The higher temporal resolution due to an increase of the gantry's rotation and new reconstruction algorithms, as well as its higher spatial resolution and elevated time acquisition due to the presence of more detectors, have permitted CTMD to give significantly better and precise diagnosis of coronary arteries.

Toxicidad y efecto hipotensor de oxoborolidinona de L-arginina y su modulación por azul de metileno. Comparación con L-arginina, nitrito y nitrato / Toxicity and hypotensor effect of Oxoborolidinona of L-arginine and its modulation by methylene blue as compared to L-arginine

El óxido nítrico es sintetizado a partir de L-arginina, reacción catalizada por la enzima óxido nítrico sintasa, esta molécula de vida efímera participa en varios procesos como: regulación de presión arterial, citotoxicidad y comunicación celular. Un gran número de sus acciones son inhibidas por azul de metileno, inhibidor de la guanilato ciclasa. Moléculas análogas a la L-arginina con grupo guanidino libre, pueden funcionar como aportadores de óxidos de nitrógeno y tener acciones semejantes al óxido nítrico. En este trabajo se reporta el efecto hipotensor y toxicidad aguda de oxoborolidinona de L-arginina comparativamente con L-arginina, nitrito y nitrato, y su modulación con azul de metileno. La dosis letal media, en rata Wistar, para oxoborolidinona fue 169.0 ñ 5 mg kg-1 vía intraperitoneal y la dosis hipotensora media 10 hmoles kg-1 vía femoral; ambos parámetros fueron desplazados claramente a la derecha por el pretratamiento con azul de metileno, juzgado por las dosis letal y dosis efectiva medias, la oxoborolidinona tuvo un efecto más potente que la L-arginina y nitrato pero semejante a nitrito. En todos los casos, excepto para nitrato, los efectos fueron modulados por azul de metileno, lo que sugiere que los efectos estudiados son mediados vía óxidos de nitrógeno.

Insuficiencia renal aguda intrahospitalaria / intrahospitable acute renal Insufficiency

La insuficiencia renal aguda, es una entidad patológica frecuente en nuestro medio y más aún en el área hospitalaria, donde el médico debe enfrentar situaciones graves, pero en su mayoría reversibles, generalmente asociada a yatrogenia, por lo cual nos proponemos determinar las principales causas. Estudiamos todos los casos de insuficiencia renal aguda ocurridos en el Hospital Pablo Arturo Suárez, en las áreas clínicas y quirúrgicas, excepto en Ginecobstetricia, en un período de seis meses, 35 pacientes (2.33 por ciento) presentaron elevación de la creatinina sérica con valores mayores del 50 por ciento del valor basal. Se analizó su etiología, factores desencadenantes, patologías preexistentes y tiempo de evolución. Se presentó con más frecuencia en mayores de 60 años, con una edad media de presentación de 62.9. Entre las causas que adquieren mayor importancia se encuentran las de tipo hemodinámico...