[Open surgical management of recurrent pigmented villonodular synovitis: case report and literature review]. / Manejo quirúrgico abierto de la sinovitis villonodular pigmentada recurrente: reporte de caso y revisión de literatura.

INTRODUCTION: pigmented villonodular synovitis (PVNS) is a benign condition that affects the knee, leading to abnormal proliferation of the synovial membrane and the accumulation of hemosiderin in the joint cavity. Although it can be surgically treated, PVNS tends to have a high recurrence rate, potentially resulting in chronic joint damage. CASE REPORT: we present the case of a young woman who experienced localized pain in her right knee due to a recurrence of PVNS. Magnetic resonance imaging revealed multiple multilobulated cystic lesions affecting the entire joint, including the ligaments. The patient underwent open surgical resection with a favorable clinical outcome. Histopathological examinations confirmed the absence of malignancy. CONCLUSION: while arthroscopy is typically the preferred treatment for PVNS, this case highlights the tendency for recurrence associated with this approach. Open surgical resection, supported by benign histopathological findings in this case, suggests a favorable long-term prognosis.

INTRODUCCIÓN: la sinovitis villonodular pigmentada (SVNP) es una enfermedad benigna que afecta la articulación de la rodilla, que causa una proliferación anormal de la membrana sinovial y la acumulación de hemosiderina en la cavidad articular. A pesar de que es posible tratarla mediante cirugía, la SVNP tiende a tener una alta tasa de recurrencia, lo que puede resultar en daño articular crónico. REPORTE DEL CASO: se presenta el caso de una mujer joven que experimentó dolor localizado en la rodilla derecha debido a una recurrencia de SVNP. La resonancia magnética reveló múltiples lesiones quísticas multilobuladas que afectaban a toda la articulación, incluyendo los ligamentos. La paciente fue sometida a una resección quirúrgica abierta, con una evolución clínica favorable. Los exámenes histopatológicos confirmaron la ausencia de malignidad. CONCLUSIÓN: aunque la artroscopía se considera el tratamiento de elección para la SVNP, este caso ilustra la tendencia a la recurrencia asociada con este enfoque. La resección quirúrgica abierta, respaldada por los hallazgos histopatológicos benignos en este caso, sugiere un pronóstico favorable a largo plazo.

Urbanization, migration, and indigenous health in Peru.

INTRODUCTION: We compare demographic, socioeconomic, and anthropometric characteristics and blood pressure (BP), between rural and urban Peruvian indigenous women. These are preliminary results from a project on urbanization, migration, and health. METHODS: Data were collected cross-sectionally (2019) and compared between a rural (n = 92) and an urban (n = 93) community. RESULTS: Height: µ = 148.3 ± 5.0 cm (range = 137-162), weight: µ = 62.0 ± 11.5 (range = 37.5-108.7), median waist circumference = 89.0 (IQR = 15.8, range = 64.0-126.0), BMI = 28.3 (IQR = 6.2, range = 16.7-40.0), with no significant rural-urban differences. Systolic but not diastolic BP was significantly higher in urban versus rural women (median = 110, IQR = 18, range = 80-170 vs. median = 120, IQR = 10, range = 90-170, p = .002 and median = 70, IQR = 17, range = 50-100 vs. median = 70, IQR = 10, range = 60-100, p = .354), respectively. CONCLUSIONS: Despite major lifestyle differences, there were no anthropometric differences between rural and urban women. Higher systolic BP in urban women may reflect social/economic stressors rather than dietary factors.

Contenidos Mínimos de Cariología e indicadores de aplicación clínica en el Currículo de Pregrado para las Escuelas Dentales Chilenas / Minimum Contents of Cariology and Indicators of Clinical Application in the Undergraduate Curriculum for Chilean Dental Schools

RESUMEN Objetivo: El objetivo fue definir los contenidos mínimos y sus indicadores de aplicación clínica en el currículo de cariología para las escuelas de odontología chilenas. Metodología: Basados en los 5 dominios curriculares internacionales, se elaboró un documento que define los contenidos e indicadores de aplicación clínica para la enseñanza de cariología en Chile. Posteriormente, profesores de cariología de 20 de 21 escuelas de odontología chilenas (95%), sesionaron para revisar, retroalimentar y elaborar el documento final, denominado "Listado de contenidos mínimos e indicadores de aplicación clínica" en cariología para estudiantes de pregrado de odontología en Chile. Resultados: Se definieron 23 contenidos y 31 indicadores de aplicación clínica para la enseñanza de la cariología. La cantidad de contenidos e indicadores separados por dominio fueron respectivamente: conocimiento de base: 5 y 7; riesgo/detección y diagnóstico: 6 y 6; toma de decisiones/manejo preventivo no operatorio: 5 y 5; decisión de tratamiento operatorio: 4 y 9 y cariología basada en la evidencia: 3 y 4. Conclusiones: Se definieron los contenidos mínimos que tributan a cada dominio y sus indicadores de aplicación clínica para la enseñanza de la cariología en Chile.

ABSTRACT: The objective: was to define the minimum contents and their indicators of clinical application in the cariology curriculum for the Chilean Dental Schools. Methodology: Based on the 5 international curricular domains, a document defining the contents and indicators of clinical application for the teaching of cariology in Chile was elaborated. Later, cariology professors from 20 out of the 21 Chilean Dentistry Schools (95%) met to review, feedback and elaborate the final document, called "List of minimum contents and indicators of clinical application" in cariology for undergraduate dentistry students in Chile. Results: Twenty-three contents and 31 indicators of clinical application for the teaching of cariology were agreed upon. The amount of contents and indicators separated by domain respectively were: basic knowledge: 5 and 7; risk/detection and diagnosis: 6 and 6; decision making/non-operative preventive management: 5 and 5; decision of operative treatment: 4 and 9 and evidence-based cariology: 3 and 4. Conclusions: The minimum contents for each domain and its clinical application indicators for the teaching of cariology in Chile were defined.

Detection of Approximal Caries Lesions in Adults: A Cross-sectional Study.

Detection and management of posterior approximal caries lesions are still problematic. Inspection of approximal surfaces is challenging, and bitewing radiographs are used when direct vision is not possible. Unfortunately, there is no definite radiographic appearance to identify lesion cavitation with absolute certainty. Many lesions detected radiographically within the outer half of dentin are not cavitated, often resulting in unnecessary restorative treatment. Our study compared radiographic depth of approximal caries lesions with presence of cavitation in adults using visual inspection following temporary tooth separation (TTS). We conducted this observational descriptive cross-sectional study at two dental schools in two cities in Chile. Clinicians were unaware of radiographic depths of lesions and examined 147 participants (57.3% female and 42.7% male) following TTS. Using the common classification system that consists of E0 (no lesion), E1 (lesion within the outer half of enamel), E2 (lesion within the inner half of enamel), D1 (lesion within the outer third of dentin), D2 (lesion within the middle third of dentin), and D3 (lesion within the inner third of dentin), a trained dentist evaluated all the processed films. Cavitation was detected in only three sites (0.22%) within the E0 category, seven sites (3.41%) in E1, five sites (14.8%) in E2, four sites (14.8%) in D1, six sites (50%) in D2, and eight sites (61.5%) in D3. Considering that restorative treatment should be indicated strictly for cavitated lesions, our findings support indication for restorative treatment for D3 lesions and the rationale for TTS for D1-D2 caries lesions to allow direct visual inspection to determine whether there is surface cavitation.

Validación de un Cuestionario para Evaluar Riesgo de Caries en Preescolares en Santiago, Chile / Validation of a Questionnaire to Assess Risk of Caries in Preschool-Age Children in Santiago, Chile

RESUMEN: La Caries Temprana de la Infancia (CTI) es una forma de caries dental agresiva que afecta a niños, y en el último reporte nacional reveló una prevalencia de caries del 50 % en niños de 4 años de edad de la Región Metropolitana de Santiago (Soto et al., 2007). El objetivo de este estudio es validar un cuestionario que permita recolectar información relacionada con diversos factores de riesgo de caries en niños preescolares. Para la validación del cuestionario se determinó la validez de convergencia y discriminación, la consistencia interna y la confiabilidad test retest del instrumento en dos muestras independientes. Se aplicó el instrumento al cuidador principal de 118 preescolares entre 24 a 71 meses de edad, que asisten a jardines infantiles de dependencia particular (bajo riesgo de caries) y la Fundación INTEGRA (alto riesgo de caries) en la Región Metropolitana de Santiago, Chile. Se realizaron exámenes clínicos dentales por 2 odontólogos calibrados utilizando en el criterio OMS e ICDAS II. Se estimó un modelo de regresión logística y se evalúo la capacidad de discriminación del puntaje a través de una curva ROC. El cuestionario mostró una validez de discriminación de 0,95 entre ambos grupos y de la pregunta global 0,61 y una consistencia interna del cuestionario de 0,72. En la validez de convergencia se encontró que no existe asociación estadísticamente significativa entre el puntaje del cuestionario y la pregunta global dicotomizada (OD) 1,061. No obstante, se evidenció que si existe asociación estadísticamente significativa entre el puntaje del cuestionario y el grupo riesgo de caries (bajo y alto) (OD) 1,961. La estabilidad temporal mediante comparaciones Test - Retest calculado con el índice de Kappa osciló entre 0,37 a 1. Por lo tanto, se puede concluir que el presente cuestionario es un instrumento válido para discriminar riesgo de caries, permitiendo un mejor análisis de los determinantes de la caries dental en la población preescolar chilena.

ABSTRACT: Early Childhood Caries (ECC) is an aggressive form of tooth decay, and the last national unpublished reports reveal a caries prevalence of 50 % at 4 years of age in children, in the Santiago Metropolitan Region (Soto et al., 2007). The objective of this study is to validate a questionnaire that allows the collection of information related to several caries risk factors in preschoolchildren. For the validation of the questionnaire, the convergence and discrimination validity, the internal consistency and the retest, test reliability of the instrument were determined in two independent samples. The instrument was applied to the main caregiver of 118 preschoolers between 24 and 71 months of age, who attend private childcare centers (low caries risk) and the INTEGRA Foundation childcare (high caries risk) in the Metropolitan Region of Santiago, Chile. Dental clinical examinations were performed by two calibrated dentists using the OMS and ICDAS II criteria. A logistic regression model was estimated and the ability to discriminate the score through an ROC curve was evaluated. The questionnaire showed a validity of discrimination of 0.95 between both groups and of the global question 0.61 and an internal consistency of the questionnaire of 0.72. In the convergence validity, it was found that there is no statistically significant association between the questionnaire score and the dichotomized global question (RE) 1.061. However, it was evidenced that there is a statistically significant association between the questionnaire score and the caries risk group (low and high) (OD) 1.961. Temporal stability by means of Test - Retest comparisons calculated with the Kappa index ranged from 0.37 to 1. Therefore, it can be concluded that the present questionnaire is a valid instrument for discriminating caries risk, allowing a better analysis of the determinants of dental caries in the Chilean preschool population.