Prevalência do uso de fotoproteção e fatores associados em feirantes / Prevalence of the use of photoprotection and associated factors in marketers / Prevalencia del uso de fotoprotección y factores asociados en feirantes

Objetivo: estimar a prevalência do uso de fotoproteção e associar aos fatores sociodemográficas, fototipo e fatores de riscos em feirantes. Métodos: trata-se de um estudo transversal com amostra de 150 feirantes cadastrados na Central de Abastecimento do Norte de Minas. Utilizou-se questionário acerca do perfil sociodemográfico, hábitos de exposição solar, medidas de fotoproteção e fatores de risco para neoplasia cutânea. Descreveram-se as frequências simples e porcentagens. A análise bivariada realizou-se por meio do teste qui-quadrado (x²) e Teste Exato de Fisher's. Considerou-se relevância estatística p < 0,05. Resultado: observou-se elevada prevalência do não uso da fotoproteção solar pelos feirantes (50%). Ademais, houve uma associação significativa entre fotoproteção e as variáveis cor dos olhos (p = 0,039), tempo de exposição (p = 0,000), horário de exposição (p = 0,057) e assistência médica (p = 0,005). Conclusão: feirantes de olhos escuros, que se expõem ao sol por mais de 3 horas, o dia inteiro e não procuram assistência médica, não usam fotoproteção

Objective: to estimate the prevalence of photoprotection use and to associate sociodemographic factors, phototype and risk factors in marketers. Methods: this is a cross-sectional study with a sample of 150 marketers registered at the Northern Minas Supply Center. A questionnaire about the sociodemographic profile, habits of sun exposure, measures of photoprotection and risk factors for cutaneous neoplasia was used. Simple frequencies and percentages were described. The bivariate analysis was performed using the chi-square test (x²) and Fisher's Exact Test. Statistical relevance was considered p <0.05. Results: there was a high prevalence of solar photoprotection not being used by farmers (50%). In addition, there was a significant association between photoprotection and the variables eye color (p = 0.039), exposure time (p = 0.000), exposure time (p = 0.057) and medical care (p = 0.005). Conclusion: dark-eyed marketers, who are exposed to the sun for more than 3 hours, all day and do not seek medical attention, do not use photoprotection

Objetivo: estimar la prevalencia del uso de fotoprotección y asociar a los factores sociodemográficos, fototipo y factores de riesgo en feriantes. Métodos: se trata de un estudio transversal con muestra de 150 feriantes registrados en la Central de Abastecimiento del Norte de Minas. Se utilizó un cuestionario sobre el perfil sociodemográfico, hábitos de exposición solar, medidas de fotoprotección y factores de riesgo para neoplasia cutánea. Se describieron las frecuencias simples y porcentajes. El análisis bivariado se realizó por medio de la prueba qui-cuadrado (x²) y la prueba exacta de Fisher's. Se consideró relevancia estadística p <0,05. Resultado: se observó elevada prevalencia del no uso de la fotoprotección solar por los feirantes (50%). Además, hubo una asociación significativa entre fotoprotección y las variables color de los ojos (p = 0,039), tiempo de exposición (p = 0,000), horario de exposición (p = 0,057) y asistencia médica (p = 0,005). Conclusión: los ojos oscuros, que se exponen al sol durante más de 3 horas, todo el día y no buscan asistencia médica, no usan fotoprotección

Manejo quirúrgico del paciente con hemofilia sometido a cirugía bucal: Reporte de un caso clínico / Surgical management of the patient with hemophilia undergoing oral surgery: A case report

Resumen Introducción: La hemofilia es una deficiencia congénita de un factor de la coagulación, la cual consta en un trastorno recesivo asociado al cromosoma X, generando disminución o ausencia de actividad funcional del factor. Objetivo: Presentar una revisión narrativa de la literatura sobre pacientes hemofílicos, junto con un caso de manejo de un paciente con la condición. Metodología: Paciente de sexo femenino, 18 años, acude al postgrado de Cirugía y Traumatología bucomaxilofacial de la Universidad Andrés Bello de Santiago de Chile, derivada para realizar exodoncia de terceros molares debido al término de su mecánica ortodóntica. Al realizar la anamnesis próxima, la paciente relata padecer hemofilia A leve, y hace 6 meses presentó un 38% de factor VIII. Previo al tratamiento quirúrgico se solicitó un hemograma completo con examen de coagulación para medir el TTPA. Además, se realizó una interconsulta con el hematólogo tratante para evaluación de su patología y recomendaciones para efectuar la misma con la menor cantidad de riesgos intraquirúrgicos y postquirúrgicos, el cual sugirió la administración de factor VIII previo, y posterior al acto quirúrgico. Así mismo, se aplicaron medidas de hemostasia locales para mejor control y un correcto manejo analgésico postquirúrgico. Conclusión: La hemofilia, es un trastorno que requiere un minucioso manejo tanto pre, intra y postoperatorio de parte del odontólogo, donde los exámenes complementarios, comunicación con el hematólogo, procedimiento atraumático y un correcto manejo de la hemostasia, son fundamentales para el éxito del tratamiento.

Abstract Introduction: Hemophilia is a congenital deficiency of a coagulation factor, associated to a recessive pattern located in the X chromosome, which induces a lower or even absent functional activity of that factor. Objective: To provide a narrative review of the literature about haemophiliac patients, as well as a case report of a patient. Methods: Female patient, 18 years old, attended in the postgraduate of Maxillofacial Surgery of the Andrés Bello University to Santiago, Chile, derived to perform extractions of wisdom teeth due to the end of its orthodontic mechanics. At the anamnesis, the patient reports to suffer from mild hemophilia A, and 6 months ago she had 38% VIII factor. Prior to surgical treatment, a complete blood count with a coagulation test was requested to measure TTPA. In addition, an interconsultation was made with the treating hematologist to perform a correct management to assess of her pathology and recommendations to carry out it with the least amount of intrasurgical and post-surgical risks. Suggested the administration of factor of freeze-dried VIII factor before and after surgery. Local hemostasis measures were also applied for better control and proper post-surgical pain management. Conclusion: Hemophilia, requires the dentist to perform a thorough management pre, intra and postoperatory, in which complementary tests, communication with the hematologist, atraumatic procedure and a precise management of hemostasis, are key for the treatment's success.

Bone Marrow Edema: A Case of Regional Migratory Osteoporosis.

Bone marrow edema represents a typical pattern on magnetic resonance imaging consisting of an area of abnormal bone signal with low to intermediate intensity on T1-weighted images and a high intensity on fat-suppressed T2-weighted images. Bone marrow edema syndromes are a group of entities characterized by idiopathic bone marrow edema and osteoporosis. Regional migratory osteoporosis is a bone marrow edema syndrome characterized by a self-limited migrating arthralgia of the lower limbs not related to trauma or other events. Its clinical presentation is variable and may include a less frequent form of migration of the bone marrow edema within the same joint, illustrated here by means of a case report. Conservative treatment is the preferred approach to this condition, and usually, it resolves completely and with no sequelae. Physicians should be made aware of this condition to avoid unnecessary and costly diagnostic and therapeutic measures.

Using Persuasive Systems Design Model to Evaluate "Cuida tu Ánimo": An Internet-Based Pilot Program for Prevention and Early Intervention of Adolescent Depression.

Background: "Cuida tu Ánimo" (CTA [Take Care of Your Mood]) is an internet-based program for prevention and early intervention of adolescent depression implemented in Chile and Colombia. In the pilot application of the program, participants interacted with the program through a website that provided psychoeducational information, chat, and telephone appointments as well as monitoring and feedback messages. To date, most similar programs were not developed taking design features into consideration. The persuasive systems design (PSD) model is a comprehensive framework developed to aid in the design and evaluation of systems capable of influencing users' attitudes or behaviors. The purpose of this study was to evaluate the persuasiveness of CTA pilot program using the PSD model. Methods: The methodology used was expert evaluation, where specialists evaluate the program against a list of design principles. Results: Although the PSD model was not used to design the program, system features proposed by PSD were present, mainly "Dialogue support" features. Persuasion context analysis was not carried out by the developers. No aspects of the program could be related to "Primary task support" features because the developers did not define a primary task. Discussion: Key aspects of the PSD model could be incorporated in the CTA program to enhance system persuasiveness and improve adherence.

Congenital muscular torticollis: where are we today? A retrospective analysis at a tertiary hospital.

BACKGROUND: The congenital muscular torticollis is characterized by a persistent lateral flexion of the head to the affected side and cervical rotation to the opposite side due to unilateral shortening of the sternocleidomastoid muscle. The majority of the cases resolve with conservative management, with parents/caregivers education and physical therapy.The aim of this study was to assess demographic and clinical characteristics, treatment options, and outcome, amongst infants referred to pediatric rehabilitation consultation due to congenital muscular torticollis. METHODS: Retrospective cohort study of infants diagnosed with congenital muscular torticollis between January 2012 and December 2014. Obstetric and perinatal data, clinical presentation, comorbidities, treatment, and outcome were abstracted from clinical records. RESULTS: One hundred six infants were included. There was no sex predominance and mean age at first pediatric rehabilitation consultation was 11.6 (10.4) weeks. Most women were primiparous (76.4%), dystocic labor predominated (73.6%), and pelvic fetal presentation occurred in 20.8%. At examination, 49.1% of the infants had abnormalities, beyond the tilt cervical, mainly range of motion restrictions and palpable nodule in sternocleidomastoid muscle. Among the 87 children who performed the cervical ultrasound, 29 (27.4%) had anomalies. Associated clinical conditions such as hip dysplasia were identified. The majority (71.7%) were submitted to conservative treatment, 30.2% in the Pediatric Rehabilitation Department. Most infants (97.2%) showed a complete resolution of the torticollis. CONCLUSIONS: Congenital muscular torticollis is the most common cause of torticollis in the infants. Early diagnosis, parent/caregivers education, and conservative treatment are crucial to achieving good results.

Progression of aerobic exercise intensity in a cardiac rehabilitation program.

INTRODUCTION AND OBJECTIVES: To describe the progression of aerobic exercise intensity in patients on a cardiac rehabilitation (CR) program. METHODS: We conducted a retrospective analysis of a random sample of patients referred for CR after acute coronary syndrome between 2008 and 2016. The weekly peak exercise intensity achieved during aerobic exercise was estimated by treadmill speed and grade at peak effort and the corresponding perception of effort was assessed using the Borg scale. Initial exercise intensity was prescribed as 60-80% of reserve heart rate plus resting heart rate, and was modified according to perceived exertion. Peak heart rate/intensity and perceived exertion index were used as variables to characterize the response to the intensity achieved. Variables were compared at different time points: T1 (1st week), T2 (4th week) and T3 (8th week). RESULTS: Of the total of 868, 238 patients were randomly selected. At peak heart rate during the session, exercise intensity (in metabolic equivalents) was: T1: 7.2±2.0, T2: 9.0±2.2, and T3: 9.4±2.2 (p<0.01). The peak heart rate/intensity index was T1: 16.8±5.4, T2: 13.4±3.6 and T3: 13.1±3.8 (p<0.01) and the perceived exertion index was T1: 1.8±0.6; T2: 1.4±0.5; T3: 1.4±0.5 (p<0.01). CONCLUSIONS: Increasing exercise intensity during CR, associated with lower perception of effort and lower heart rate necessary to achieve such intensity, leads to significant improvement in functional capacity.

TGF-beta alterations in oral squamous cell carcinoma: narrative review / Alteraciones de TGF-beta en el carcinoma oral de células escamosas: revisión narrativa

The transforming growth factor beta (TGF-beta) is a cytokine that plays crucial roles in the regulation of angiogenesis, immune response, proliferation, migration and apoptosis of cells. In addition, it can inhibit cell progression and stimulate apoptosis in early stages of cancer. TGF-beta is a multifunctional homodimeric protein secreted by various cell lines, which have three different isoforms: TGF-beta1, TGF-beta2 and TGF-beta3. In normal conditions, TGF-beta1 activates some tumor suppressor cell signaling pathways that inhibit proliferation and are involved in cell migration, differentiation and apoptosis. However, in more advanced stages of cancer, when TGF-beta1 is altered, it acts as a promoter of tumorigenesis and may cause: 1) increased TGF-beta1, 2) overexpression of TGF-beta1 receptors (TbetaR), 3) TbetaR mutations, and 4) downregulation of TGF-beta receptor. In oral squamous cell carcinoma, the path is altered especially at the level of transmembrane receptors, with the TbetaR-II and TbetaR-III subtypes being the most affected. However, there is little information on the prognostic role it plays in the various types of cancers. It is important to study the signaling pathways of TGF-beta in order to develop techniques that may help detect their alterations and restore their normal operation. The objective of this review is to describe the alterations of TGF-beta in oral squamous cell carcinoma.

El factor de crecimiento transformante beta (TGF-beta) es una citocina que cumple funciones fundamentales en la regulación de la angiogénesis, respuesta inmune, proliferación, migración y apoptosis celular. Además, puede inhibir la progresión celular y estimular la apoptosis en etapas tempranas del cáncer. El TGF-beta es una proteína homodimérica multifuncional secretada por diversas líneas celulares, que presentan 3 isoformas: TGF-beta1, TGF-beta2 y TGF-beta3. En condiciones normales TGF-beta1 activa a algunas vías de señalización celular supresoras de tumores que inhiben la proliferación, y participan en la migración, diferenciación y apoptosis. Sin embargo, cuando esta se ve alterada, en etapas más avanzadas del cáncer actúa como promotor de la tumorogénesis, pudiendo producir: 1) aumento del TGF-beta1, 2) sobre expresión de los receptores del TGF-beta1 (TbetaR), 3) mutaciones de TbetaR, y 4) falla en la regulación negativa de TbetaR. En el carcinoma oral de células escamosas, la vía se ve alterada especialmente a nivel de sus receptores transmembranales, siendo los subtipos TbetaR-II y TbetaR-III los más afectados. Sin embargo, es escasa la información sobre el rol pronóstico que juega en los diversos tipos de cánceres. Es importante estudiar las vías de señalización de TGF-beta para desarrollar técnicas que detecten sus alteraciones y restauren el funcionamiento del sistema. El objetivo de esta revisión es describir las alteraciones de TGF-beta en carcinoma oral de células escamosas.

Manejo quirúrgico del paciente con hemofilia sometido a cirugía bucal: Reporte de un caso clínico

Introducción: La hemofilia es una deficiencia congénita de un factor de la coagulación, la cual consta en un trastorno recesivo asociado al cromosoma X, generando disminución o ausencia de actividad funcional del factor. Objetivo: Presentar una revisión narrativa de la literatura sobre pacientes hemofílicos, junto con un caso de manejo de un paciente con la condición. Metodología: Paciente de sexo femenino, 18 años, acude al postgrado de Cirugía y Traumatología bucomaxilofacial de la Universidad Andrés Bello de Santiago de Chile, derivada para realizar exodoncia de terceros molares debido al término de su mecánica ortodóntica. Al realizar la anamnesis próxima, la paciente relata padecer hemofilia A leve, y hace 6 meses presentó un 38% de factor VIII. Previo al tratamiento quirúrgico se solicitó un hemograma completo con examen de coagulación para medir el TTPA. Además, se realizó una interconsulta con el hematólogo tratante para evaluación de su patología y recomendaciones para efectuar la misma con la menor cantidad de riesgos intraquirúrgicos y postquirúrgicos, el cual sugirió la administración de factor VIII previo, y posterior al acto quirúrgico. Así mismo, se aplicaron medidas de hemostasia locales para mejor control y un correcto manejo analgésico postquirúrgico. Conclusión: La hemofilia, es un trastorno que requiere un minucioso manejo tanto pre, intra y postoperatorio de parte del odontólogo, donde los exámenes complementarios, comunicación con el hematólogo, procedimiento atraumático y un correcto manejo de la hemostasia, son fundamentales para el éxito del tratamiento.

Introduction: Hemophilia is a congenital deficiency of a coagulation factor, associated to a recessive pattern located in the X chromosome, which induces a lower or even absent functional activity of that factor. Objective: To provide a narrative review of the literature about haemophiliac patients, as well as a case report of a patient. Methods: Female patient, 18 years old, attended in the postgraduate of Maxillofacial Surgery of the Andrés Bello University to Santiago, Chile, derived to perform extractions of wisdom teeth due to the end of its orthodontic mechanics. At the anamnesis, the patient reports to suffer from mild hemophilia A, and 6 months ago she had 38% VIII factor. Prior to surgical treatment, a complete blood count with a coagulation test was requested to measure TTPA. In addition, an interconsultation was made with the treating hematologist to perform a correct management to assess of her pathology and recommendations to carry out it with the least amount of intrasurgical and post-surgical risks. Suggested the administration of factor of freeze-dried VIII factor before and after surgery. Local hemostasis measures were also applied for better control and proper post-surgical pain management. Conclusion: Hemophilia, requires the dentist to perform a thorough management pre, intra and postoperatory, in which complementary tests, communication with the hematologist, atraumatic procedure and a precise management of hemostasis, are key for the treatment's success.

Age does not determine the physical, functional and psychosocial response to a cardiac rehabilitation program.

INTRODUCTION: Despite increasing prevalence of coronary heart disease among the elderly and their greater susceptibility to its clinical, functional and psychosocial sequelae, referral to and participation in cardiac rehabilitation programs (CRPs) remains low in this age group. We aimed to assess the effect of age on the hemodynamic, biochemical, anthropometric, functional and psychosocial response to a CRP. METHODS: We prospectively studied 105 patients admitted to a CRP within three months of a successful percutaneous cularization procedure after an acute coronary syndrome. The CRP included nutritional counseling, group psycho-educational sessions, and two months of twice-weekly supervised exercise sessions at an intensity of 60-80% of chronotropic reserve. Younger (<55 years) vs. older (> or = 55 years) patients were compared in terms of their baseline characteristics, differences after CRP and proportion of patients achieving secondary prevention goals at baseline and after CRP completion. RESULTS: At baseline older patients had a worse cardiovascular risk factor profile, with higher prevalence of previous coronary heart disease, hypertension, diabetes, overweight and inactivity, and lower functional capacity. The two groups showed similar improvements in anthropometric parameters (waist circumference: -1.20 cm [3.82], p < 0.05 in younger vs. -3.17 cm [3.49], p < 0.01 in older patients), lipid profile and quality of life scores (summary physical component: +3.65 [7.83], p < 0.01 vs. +3.23 [6.66], p < 0.01; summary mental component: +3.60 [10.01], p < 0.05 vs. +3.02 [11.92], p < 0.05, in younger and older patients, respectively). Neither group showed significant changes in blood pressure, high-density lipoprotein or depressive symptoms. Older patients, who were initially less physically active (median [interquartile range]: 693 [12.96-1929.5] vs. 2376 [205-4293] MET*min/week), showed a significant increase in physical activity (+267%, p < 0.001), which was not observed i younger patients (+4%, p = 0.68). The pro portion of patients achieving secondary prevention goals improved similarly in both groups for lipid profile, smoking cessation and minimum physical activity levels, with no improvement in blood pressure or anthropometric parameters. CONCLUSION: Participation in a CRP results in significant improvements in cardiovascular risk profile, functional capacity and quality of life, regardless of age. Specific strategies are needed to ensure adequate referral and participation of elderly patients in exercise-based CRPs.