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BACKGROUND: Sleep bruxism (SB) occurring during No-REM (nREM) sleep and increase in microarousals per hour have been described in adults, but not in children. OBJECTIVE: To assess the correlation between sleep architecture and masseter muscle activity related to sleep bruxism (SB/MMA) in children. MATERIALS AND METHODS: Forty-three children aged 7-12 years (mean age: 9.4 ± 1.3) with confirmed SB underwent a two-night polysomnographic (PSG) study in a sleep laboratory, for accommodation (first night) and data collection (second night). Data on sleep architecture (total sleep duration (TSD), sleep efficiency (SE), sleep onset latency (SOL), REM and nREM sleep duration and proportion and microarousals/hour during REM and nREM sleep) and episodes/hour of SB/MMA were recorded. Single and multiple-variable linear regression analyses were performed to assess the correlation between data on sleep architecture (predictors) and SB/MMA (dependent variable). RESULTS: Shorter TSD, REM and nREM stage 1 sleep duration, longer SOL and more microarousals/hour during REM and nREM sleep were found to be positive predictors of SB/MMA in children in the multiple-variable regression analysis (R2 = 0.511). CONCLUSION: Within the limitations of this study, it can be concluded that SB/MMA is correlated with altered sleep architecture in children (shorter total sleep duration (TSD), shorter nREM and REM sleep and higher microarousals during REM and nREM sleep). Nevertheless, the clinical significance of these findings need to be demonstrated in future studies.
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Bruxismo del Sueño , Adulto , Niño , Humanos , Músculo Masetero/fisiología , Polisomnografía , Sueño/fisiologíaRESUMEN
OBJECTIVE/BACKGROUND: Consumption of added sugar and excessive screen-time is increasing worldwide and is associated with sleeping and behavior disorders, which are related with possible Sleep Bruxism (SB) in children. Therefore, the objective of this investigation was to examine the relationship between screen-time and sugar-consumption and possible SB in children. PATIENTS/METHODS: A cross-sectional study, including parents of 460 4- to 8-year-old children, was performed. Frequency of possible SB was assessed with the Children's Sleep Habits Questionnaire; sugar consumption with the Health Behaviour in School-Aged Children Food-Frequency Questionnaire. Comprehensive measures of screen-time (including cell phones, computers, electronic devices, electronic games, and TV) were taken. The time was recorded in hour/day. All data were analyzed with STATA© data analysis and statistical software version 13.0 (Copyright 1996-2016; Stata-Corp LP, College Station, TX, USA). Spearman correlation test and ordinal-multiple-variable regression analyses were used. RESULTS: Data of 440 subjects Mean age 6.2 years (S.D. 1.8) were analyzed. Prevalence of possible SB was 35% and screen-time was available for 92.9% of the children. Mean screen-time was 2.1 h/day. Parents reported 73% of the children (n = 319) to consume added sugar once a day every day and 20% more than once every day. Correlations of possible SB were statistically significant with screen-time (Rho = 0.8; p = 0.002) and sugar-consumption (Rho = 0.7; p = 0.03). Associations were found between possible SB and increase-to-increase screen-time and sugar-consumption (OR > 2). CONCLUSION: The results of this study demonstrated that as screen-time and sugar consumption increased, the frequency of bruxism in children increased.
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BACKGROUND: Temporomandibular disorders (TMD) are related to psychological factors. Adolescence is one of the stages in life with more psychosocial vulnerability, which is dissimilar in rural and urban zones. Thus, the aim of this investigation was to evaluate the association between psychological factors (symptoms of anxiety, depression and somatization) and TMD in adolescents between 12 and 15 years, belonging to urban and rural zones of Colombia. METHODS: 180 subjects aged 12-15 years (mean 13.8, SD 1.2), enrolled in public schools in the rural (n = 90) and urban (n = 90) zones were included. All subjects were evaluated using the DC/TMD instrument; the Axis I was applied for the clinical examination and the Axis II for the psychological evaluation. Data were analyzed by means of T-student, Mann-Whitney, Kruskall-Wallis tests, Pearson Chi square and multiple-variable analysis with logistic regression. RESULTS: Forty percent of the included subjects presented some type of TMD. TMD related to pain were the most common (25.5% of the studied adolescents), being myalgia the most common (20% of the adolescents in urban zone and 31.1% of the adolescents in the rural zone). There was no difference between the TMD present in males and females, but there were differences in the symptoms of Anxiety, and Somatization (p < 0.05). TMD and psychological factors were more prevalent in children with 13 years of age. A statistically significant association between TMD and symptoms of Anxiety (Pearson Chi squared 25.57, p = 0.04), depression (Pearson Chi squared 33.28, p = 0.03) and somatization (Pearson Chi squared 25.79, p = 0.04) was found in subjects from rural zones. No associations between psychological aspects and TMD were found in subjects from urban zones, but overall all psychological factors significantly influenced TMD. CONCLUSION: This study indicates Myalgia to be the most prevalent TMD in studied Colombian adolescents. Pain-related TMDs are associated with psychological factors in the adolescent population of rural Colombia. Symptoms of anxiety, depression and somatization were found to be associated to TMD, even when the frequency was not necessarily severe.
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Depresión , Trastornos de la Articulación Temporomandibular , Adolescente , Ansiedad/epidemiología , Niño , Colombia/epidemiología , Depresión/epidemiología , Femenino , Humanos , Masculino , Dolor , Trastornos de la Articulación Temporomandibular/epidemiologíaRESUMEN
Anterior open bite (AOB) is related to functional alterations of the stomatognathic system. There are no studies concerning brain activation of the cortex comparing children with and without AOB during rest and activities such as deglutition and phonation. The aim of this study was to determine the activity of the brain cortex of children with AOB at rest and during phonation and deglutition and to evaluate the association of intelligence quotient (IQ), attention (Test of Variables of Attention, known as TOVA), beats per minute (BPM), and oxygen saturation measurement (SpO2) with brain activity in subjects with AOB. Fourteen children (seven with AOB and seven without AOB) with mixed dentition, aged 10-13 years, underwent an IQ test, TOVA, SpO2, and quantitative electroencephalography (QEEG). Electrodes were set in the scalp, according to the 10-20 protocol. Data were analyzed using statistical tests to assess comparisons between children with and without AOB. The results showed that IQ, TOVA, SpO2, or BPM did not show any statistically significant differences between the groups, except for the response time (contained in TOVA) (p = 0.03). Significant differences were found for the brain activity during rest (Condition 1) of the tongue, between children with and without AOB (p < 0.05 for alpha/theta and alpha peaks), whereas there were no differences during function (Condition 2). The findings of this investigation provide insights about the cortex activity of the brain while the tongue is in the resting position in children with AOB. This may imply an altered activity of the brain cortex, which should be considered when diagnosing and treating AOB. Other diagnostic techniques derived from investigations based on neuroscience could develop new diagnostic and therapeutic techniques to give better solutions to children with malocclusions. Treatments should be focused not only on the teeth but also on the brain cortex.
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Background Traumatic brain injury (TBI) is a global public health problem. In Colombia, it is estimated that 70% of deaths from violence and 90% of deaths from road traffic accidents are TBI related. In the year 2014, the Ministry of Health of Colombia funded the development of a clinical practice guideline (CPG) for the diagnosis and treatment of adult patients with severe TBI. A critical barrier to the widespread implementation was identified-that is, the lack of a specific protocol that spans various levels of resources and complexity across the four treatment phases. The objective of this article is to present the process and recommendations for the management of patients with TBI in various resource environments, across the treatment phases of prehospital care, emergency department (ED), surgery, and intensive care unit. Methods Using the Delphi methodology, a consensus of 20 experts in emergency medicine, neurosurgery, prehospital care, and intensive care nationwide developed recommendations based on 13 questions for the management of patients with TBI in Colombia. Discussion It is estimated that 80% of the global population live in developing economies where access to resources required for optimum treatment is limited. There is limitation for applications of CPGs recommendations in areas where there is low availability or absence of resources for integral care. Development of mixed methods consensus, including evidence review and expertise points of good clinical practices can fill gaps in application of CPGs. BOOTStraP (Beyond One Option for Treatment of Traumatic Brain Injury: A Stratified Protocol) is intended to be a practical handbook for care providers to use to treat TBI patients with whatever resources are available. Results Stratification of recommendations for interventions according to the availability of the resources on different stages of integral care is a proposed method for filling gaps in actual evidence, to organize a better strategy for interventions in different real-life scenarios. We develop 10 algorithms of management for building TBI protocols based on expert consensus to articulate treatment options in prehospital care, EDs, neurological surgery, and intensive care, independent of the level of availability of resources for care.
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OBJECTIVE: To perform the content and construct validation of the Diagnostic Criteria for Temporomandibular Disorders (DC/TMD) Axis I, for children 7-11 years old. MATERIALS AND METHODS: A Delphi process was used to perform the content validity of the DC/TMD Axis I. One hundred eighty-nine 7- to 11-year-old children were assessed with the adapted instrument. Confirmatory factor analysis (CFA) was used to investigate construct validity of the DC/TMD for children. A baseline one-factor model was compared against a two-factor (Model 2) and a seven-factor (Model 3) models based on the original DC/TMD. Root mean squared error of approximation (RMSEA), comparative fit index (CFI), chi-square, change in chi-square and Cronbach's α were used to analyse the data. All analyses were performed in STATA© version 13.0. RESULTS: Items of the DC/TMD were reduced, "history time" was changed to 2 weeks, pain intensity was assessed through a face scale, and language was adapted to be better understood by children. The amount of muscle pressure was maintained as in the original DC/TMD Axis I. The CFA led to a two- and a seven-factor model, with good fit. The internal consistency of Model 2 was .91 and of Model 3, .94. CONCLUSION: The results of this study provide evidence to support a seven-factor representation of the DC/TMD Axis I for 7- to 11-year-old children, as well as a two-factor structure. Such findings will begin to provide researchers with confidence in the properties of this instrument when considering its inclusion in clinical research.
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Trastornos de la Articulación Temporomandibular , Niño , Análisis Factorial , Humanos , Lenguaje , Psicometría , Reproducibilidad de los Resultados , Encuestas y CuestionariosRESUMEN
Orofacial clefts (OFCs) are among the most prevalent craniofacial birth defects worldwide and create a significant public health burden. The majority of OFCs are non-syndromic, and the genetic etiology of non-syndromic OFCs is only partially determined. Here, we analyze whole genome sequence (WGS) data for association with risk of OFCs in European and Colombian families selected from a multicenter family-based OFC study. This is the first large-scale WGS study of OFC in parent-offspring trios, and a part of the Gabriella Miller Kids First Pediatric Research Program created for the study of childhood cancers and structural birth defects. WGS provides deeper and more specific genetic data than using imputation on present-day single nucleotide polymorphic (SNP) marker panels. Genotypes of case-parent trios at single nucleotide variants (SNV) and short insertions and deletions (indels) spanning the entire genome were called from their sequences using human GRCh38 genome assembly, and analyzed for association using the transmission disequilibrium test. Among genome-wide significant associations, we identified a new locus on chromosome 21 in Colombian families, not previously observed in other larger OFC samples of Latin American ancestry. This locus is situated within a region known to be expressed during craniofacial development. Based on deeper investigation of this locus, we concluded that it contributed risk for OFCs exclusively in the Colombians. This study reinforces the ancestry differences seen in the genetic etiology of OFCs, and underscores the need for larger samples when studying for OFCs and other birth defects in populations with diverse ancestry.
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Cromosomas Humanos Par 21/genética , Labio Leporino/genética , Fisura del Paladar/genética , Predisposición Genética a la Enfermedad , Polimorfismo de Nucleótido Simple , Población Blanca/genética , Secuenciación Completa del Genoma/métodos , Niño , Colombia , Femenino , Estudio de Asociación del Genoma Completo , Genotipo , Humanos , MasculinoRESUMEN
Pituicytoma is a rare tumor that arises from the glial cells of the neurohypophysis. For a long time, it was believed that pituicytomas only appeared in adults. Currently, at least three cases of this entity occurring in children have been reported in the literature. The aim of the present report is to describe the case of a 5-year-old girl who presented to the emergency department with visual disturbances, and the diagnosis was a recurrent pituicytoma. Therefore, the clinical presentation, the radiological features of the tumor, and the corresponding surgical management are described. Additionally, a brief review of the management of this unusual entity was performed.
O pituicitoma é um tumor raro que surge das células gliais da neurohipófise. Durante muito tempo, acreditou-se que os pituicitomas só aparecessem em adultos. Atualmente, pelo menos três casos desta entidade ocorrendo em crianças foram relatados na literatura. O objetivo do presente artigo é descrever o caso de uma menina de 5 anos que chegou à emergência com distúrbios visuais, e o diagnóstico foi um pituicitoma recorrente. A apresentação clínica, as características radiológicas do tumor, e o correspondente manejo cirúrgico foram, portanto, descritos. Além disso, foi realizada uma breve revisão do tratamento desta entidade incomum.
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Humanos , Femenino , Preescolar , Pediatría , Neoplasias Hipofisarias , Neoplasias Hipofisarias/patología , Neoplasias Hipofisarias/cirugíaRESUMEN
BACKGROUND: Polysomnography (PSG) is the gold standard for sleep bruxism (SB) assessment. High economical costs, complex technical equipment, and unfamiliar laboratory setting limit its use in children. AIM: To determine the night-to-night variability of electromyography (EMG) episodes during a five-night recording with the GrindCare Measure (GCM), and the agreement in the assessment of masticatory muscle activity (MMA) between GCM and PSG in children. DESIGN: Forty-seven children from clinics of Universidad CES participated. Each participant was assessed with GCM for five consecutive nights. The last night, children underwent a single-night PSG study, together with the GCM. Spearman correlation coefficients were used to analyze data. RESULTS: The frequency of SB occurrence was 'sometimes' in 12 (25.5%) and 'usually' in 19 (40.4%) children. Simultaneous measurements with GCM and PSG obtained during the fifth night of measurement were not significantly correlated. Correlation between GCM total EMG episodes and EMG episodes/h and PSG total SB episodes, SB episodes/h, total bursts and burst/h measured with PSG was also not significant. CONCLUSION: EMG measurement with GCM was not accurate to detect PSG/SB in children. There was not advantage of multiple assessment for five nights with GCM, reducing the impact of night-to-night EMG episodes' variability on the GCM/PSG correlation.
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Electromiografía , Músculos Masticadores/fisiopatología , Polisomnografía , Bruxismo del Sueño/diagnóstico , Bruxismo del Sueño/fisiopatología , Niño , Femenino , Humanos , MasculinoRESUMEN
BACKGROUND: Tooth wear has a multifactorial etiology, thus it should be assessed within a multiple-variable framework. The objective of this investigation was to assess the association of dietary habits and parental-reported sleep tooth grinding (STG) with tooth wear in children with mixed dentition. METHODS: One hundred twenty-one (N = 121) subjects (mean age 9.6 years) participated in a cross-sectional study. Wear of 1637 teeth was evaluated using the screening module of the Tooth Wear Evaluation System (TWES). Parental-report of STG was evaluated by means of the Children's Sleep Habits Questionnaire (CSHQ), whilst dietary habits were investigated by means of the Health Behaviour in School-Aged Children Food-Frequency Questionnaire (HBSC-FFQ). Data were analyzed with the Spearman correlation test and ordinal-multiple-variable regression analyses. Odds Ratio (OR) and ordinal OR were obtained for the independent variables included in the models. RESULTS: Parental-report of STG is not associated with tooth wear in the mixed dentition; some dietary habits were found to be correlated with specific tooth wear patterns, but the correlation values were weak. Associations were found between dietary habits and the increase-to-increase severity of occlusal/incisal and non-occlusal/non-incisal tooth wear of some teeth (OR > 2). CONCLUSIONS: A strong correlation of dietary habits and sleep tooth grinding with tooth wear in the mixed dentition was not demonstrated. However, dietary habits showed to have effects in terms of increase-to-increase severity.
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Bruxismo/complicaciones , Dieta/efectos adversos , Desgaste de los Dientes/etiología , Niño , Estudios Transversales , Dentición Mixta , Conducta Alimentaria , Femenino , Humanos , Modelos Logísticos , Masculino , PadresRESUMEN
OBJECTIVE: To describe and explore the association between proxy-reported sleep bruxism (SB) and quality of life (QoL) in a population of Colombian children belonging to different social layers. METHODS: The parents of 1556, 6-13-year-old school children, were administered the Pediatric Inventory of Quality of Life (PedsQL4.0™) and an evaluation of their sociodemographic and socioeconomic conditions. Associations between such proxy-reported, viz., "possible" SB and QoL features were assessed by means of the linear-by-linear association test on the overall sample and for distinct socioeconomic groups. RESULTS: No significant associations were shown between proxy-reported sleep bruxism and the total and domain PedsQL scores, with the exception of a weak correlation with the School Functioning Score. As for the specific QoL items, only two variables of the Emotional Functioning Scale of the PedsQL4.0 (i.e., "feeling afraid or scared" and "trouble sleeping") and a feature of the School Functioning Scale (i.e., "forgetting things") were weakly correlated with SB, with correlation coefficients ranging from 0.092 to 0.119. Considering the different socioeconomic groups, no associations were found in the low layer. In the medium socioeconomic group, a significant association was pointed out with one emotional functioning aspect, while in the high layer an association was found with two emotional features and three school functioning variables. CONCLUSION: The results pointed out only a few associations between proxy-reported SB and the emotional and school functioning aspects of children's quality of life, both in the total sample as well as in children belonging to medium and high socioeconomic status, while no associations were found with physical health and social functioning domains. CLINICAL RELEVANCE: This article gives information to help clinicians evaluating the QoL, sociodemographic, and socioeconomic characteristics in children with possible sleep bruxism.
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Calidad de Vida , Bruxismo del Sueño/epidemiología , Adolescente , Niño , Colombia/epidemiología , Femenino , Humanos , Masculino , Factores SocioeconómicosRESUMEN
BACKGROUND: Polysomnography (PSG) is the gold standard for sleep bruxism (SB) diagnosis. PSG/SB children's criteria are not available; thus, parental-report SB is widely used. AIM: Assessing the diagnostic accuracy of parental report of sleep tooth grinding (STG) with a PSG/SB diagnosis in children, adopting adult criteria. DESIGN: Thirty-seven children from clinics of Universidad CES were included. Parents filled the Children's Sleep Habits Questionnaire (CSHQ) assessing the single-observation report - CSHQ - of STG with a No/Yes answer and five ordinal answers. A 5-day diary reporting the presence/absence of STG (multiple-observation report) was also completed. Each child underwent a single-night PSG study. Sensitivity, specificity, positive predictive value, negative predictive value, accuracy, likelihood ratios, Spearman correlation coefficient, and Cohen's kappa coefficient were used to analyze data. RESULTS: Single observation, using No/Yes answer, showed acceptable specificity and NPV, while low PPV and sensitivity. Accuracy and likelihood ratios were low. When using the five ordinal answers, weak correlation and fair agreement (r = 0.34 and κ = 0.40) with PSG/SB adult criteria were found. Multiple-observation evaluation of STG presented moderate correlation and agreement (r = 0.50 and κ = 0.48). CONCLUSIONS: Although multiple-observation report achieved better agreement than single-observation report, our results failed supporting the validity of report strategies for the diagnosis of SB in children, as an equivalent of PSG/SB adult criteria.
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Polisomnografía/métodos , Bruxismo del Sueño/diagnóstico , Niño , Colombia , Exactitud de los Datos , Femenino , Humanos , Masculino , Padres , Autoinforme , Sensibilidad y Especificidad , Encuestas y CuestionariosRESUMEN
BACKGROUND: Periodontal disease has a multifactorial etiology; however, dental plaque and possible sleep bruxism (SB) have not been tested together in children as predictors of periodontal disease. AIM: To assess the variation of SB, dental biofilm (DBF), gingival index (GI), and plaque index (PI) between localized and generalized pathological probing depth (PPD), crestal bone loss (CBL), and lack of delineation of lamina dura (LD) and to establish the association of DBF, GI, PI and SB with PPD, CBL, and LD in children with mixed dentition. METHODS: Fifty children were assessed for SB and underwent a clinical and radiographic periodontal examination. anova and three multiple variable analysis were used to analyze the data. RESULTS: One-way anova was found to be statistically significant for SB, between localized and generalized PPD (P = 0.03), CBL (P = 0.01), and LD (P = 0.005) and for DBF between localized and generalized CBL (P = 0.02). The three multiple variable analysis showed statistically and clinically significant associations of DBF with PPD (OR = 3.33); GI (OR = 2.37), and PI (OR = 1.46) with CBL and SB (OR = 7.66) and DBF (OR = 9.87) with LD. PI presented statistically significant association with CBL. CONCLUSION: Significant associations of SB, DBF, GI, and PI with PD, CBL, and LD and the variations of the same factors between localized and generalized PPD, CBL, and LD suggest the necessity of evaluating SB, DBF, GI, and PI when children are screened in regular dental visits.
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Placa Dental/complicaciones , Enfermedades Periodontales/etiología , Bruxismo del Sueño/complicaciones , Biopelículas , Niño , Colombia/epidemiología , Índice de Placa Dental , Dentición Mixta , Femenino , Humanos , Masculino , Enfermedades Periodontales/epidemiología , Índice Periodontal , Prevalencia , Factores de RiesgoRESUMEN
Cerebrospinal fluid leaks of the cranial vault, constitute one of the most common complications after neurosurgical procedures. In this paper we introduce to you an observational study, in which a series of patients with this complication where managed by using elastic compression hat during 18 hours per day, for two weeks to four months. Every one of them presented complete resolution of the leak, without any recurrence until actual controls. After that we perform a review of the literature, demonstrating this is a new therapeutic management, being us the first group on reporting it. According to the observed results, it was concluded that despite more studies are required, the use of elastic compression hats for this kind of patients could be effective and safe.
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Pérdida de Líquido Cefalorraquídeo/terapia , Vendajes de Compresión , Procedimientos Neuroquirúrgicos/efectos adversos , Complicaciones Posoperatorias/terapia , Adulto , Pérdida de Líquido Cefalorraquídeo/etiología , Preescolar , Vestuario , Femenino , Humanos , Masculino , Cráneo , Resultado del Tratamiento , Adulto JovenRESUMEN
El tumor Rabdoide/Teratoide atípico (AT/RT) representa un subtipo tumoral primario de sistema nervioso central bastante raro, con un alto grado de malignidad y de pobre pronóstico (grado IV según OMS) encontrándose principalmente en niños menores de 3 años sin antecedentes de importancia y con cuadros clínicos bastante insidiosos que representa un reto en cuanto al diagnóstico y tratamiento teniendo en cuenta la limitada cantidad de casos reportados a nivel mundial, así como poca literatura disponible. Presentamos el caso de una paciente femenina de 23 meses de edad quien ingresa al servicio de urgencias del Hospital Militar Central (Bogotá, Colombia) en coma con midriasis izquierda, deshidratación grado 2, con escanografía cerebral simple de ingreso donde se observa lesión ligeramente isodensa fronto parieto occipital izquierda con sangrado intralesional que ejerce importante efecto de masa desplazando la línea media 22 mm y produce herniación del uncus, paraclínicos que reportan anemia, trombocitopenia y tiempos de coagulación prolongados, por lo cual se decide ingresar a salas de cirugía como urgencia vital realizando resección de lesión macroscópica de aspecto grisáceo, muy vascularizada, similar al tejido cerebral con sangrado fácil y muy difícil de controlar. 72 horas después requiere nueva intervención quirúrgica por inestabilidad hemodinámica durante el postoperatorio encontrando lesión de similares características, se envían muestras a patología reportando diagnóstico patológico definitivo: tumor Teratoide Rabdoide atípico grado IV OMS.
Atypical teratoid rhabdoid tumor (AT/RT) represents a subtype of malignant CNS neoplasms quite rare, with a high degree of malignancy and poor prognosis (WHO grade IV) found mainly in children younger than 3 years old without medical history of diseases and with Clinical characteristics quite insidious that represents a challenge in the diagnosis and treatment taking into account the limited number of cases reported, as well as little literature available. We report a 23 months of age female who is admitted to the emergency room of the Central Military Hospital (Bogotá, Colombia) in coma with mydriasis, dehydration, In the cranial scan showed injury slightly isodensa fronto-parieto-occipital left with intralesional bleeding that exerts important mass effect by moving the Midline of the brain 22 mm and produces herniation of the uncus, paraclinical reported anemia, thrombocytopenia and prolonged coagulation times, by which it decides to enter rooms for surgery making resection of macroscopic lesion of grayish look, highly vascularized, similar to the brain tissue with easy bleeding and very difficult to control. 72 hours after requires new surgical intervention for hemodynamic instability during the postoperative period finding similar lesion characteristics, samples are sent to Pathology reporting final pathological diagnosis: tumor atypical Teratoid Rhabdoid WHO grade IV by OMS.
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Humanos , Femenino , Lactante , Neoplasias del Sistema Nervioso Central , Teratoma , Tumor Rabdoide/cirugía , Tumor Rabdoide/diagnóstico , Colombia , Diagnóstico por Imagen/métodos , HemorragiaRESUMEN
ABSTRACT Background: Alzheimer's disease is the most leading cause of dementia in the world; the mutation PS-1 E280A alters the gene of the Presenilin-1 and causes an early onset familial Alzheimer's disease. This mutation has been found in large kindred of Antioquia, Colombia. The objective of this study was to find differences revealed by electroencephalogram between healthy subjects and asymptomatic carriers that can be used as clinical markers of the disease in this population. Methods: EEG was recorded in 15 asymptomatic E280A carriers and 15 healthy non carriers during resting and a memory task using 64 channels amplifier. Two conditions in the memory task were analyzed: encoding and retrieval, the process of recording and evocating information, respectively. Power spectrum was calculated in delta (0. 5-4. 0 Hz), theta (4. 0-8. 0 Hz), alpha-1 (8. 0-10. 0 Hz), alpha-2 (10. 0-13. 0 Hz), beta (13. 0-25. 0 Hz) and gamma (25. 0-50 Hz) frequency bands for four regions of interest. Changes were evaluated in different conditions by ANOVA analysis.. Results: In resting condition a significant decrease was found in theta (p=0. 0001) and an increase in alpha-2 frequencies (p=0.037) in carriers compare with controls. During encoding of the memory task theta was significantly lower in carriers compared with controls (p=0. 008) and comparing resting versus retrieval process for each group, there was more theta synchronization in carriers. Conclusions: Early changes in theta frequencies were observed in the EEG recordings, it could be use as clinical markers in this population. Also it seems carriers activate additional cortical regions in order to conserve successful cognitive functions before clinical impairment.
RESUMEN Introducción: la enfermedad de Alzheimer es la principal causa de demencia en el mundo; la mutación PS-1 E280A altera el gen presenilin-1 y causa una variante familiar de la enfermedad que se caracteriza por una aparición temprana. La mutación se ha descubierto en un grupo de familias de Antioquia, Colombia. El objetivo de este estudio fue encontrar diferencias, a partir de registros electroencefalográficos de personas portadores de la mutación en una etapa asintomática y sujetos sanos para evaluar si pueden ser utilizadas como un marcador temprano de la enfermedad en la población portadora de la mutación. Metodología: se realizaron registros EEG en 15 portadores asintomáticos de la mutación E280A y 15 personas sanas no portadoras durante una tarea de memoria y en reposo utilizando un amplificador de 64 canales. En la tarea de memoria se evaluaron dos condiciones: codificación y evocación; el proceso de memorizar y recuperar la información, respectivamente. La potencia espectral fue calculada en las bandas de frecuencia delta (0,5-4,0 Hz), teta (4,0-8,0 Hz), alfa-1 (8,0-10,0 Hz), alfa-2 (10,0-13,0 Hz), beta (13,0-25,0 Hz) y gamma (25,0-50 Hz) para cuatro regiones de interés. Los cambios del espectro fueron evaluados por análisis de varianza ANOVA. Resultados: bajo la condición de reposo se encontró una disminución importante en la potencia de la banda teta (p=0,0001) y un incremento en la banda alfa-2 (p=0,037) en portadores comparados con controles. Durante la tarea de codificación, los portadores mostraron una disminución significativa en la banda teta (p=0,008). Al comparar reposo contra memoria de evocación se encontró una mayor sincronización en teta en los portadores de la mutación. Conclusión: se encontraron cambios tempranos de la potencia en la banda teta que pueden ser utilizados como un marcador clínico de la enfermedad en esta población. Una hipótesis adicional basada en los resultados es que los portadores necesitan ...
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OBJECTIVES: To evaluate the effectiveness of occlusal splints to reduce the signs and symptoms of temporomandibular disorders (TMD), dental wear and anxiety in a group of bruxist children. METHODS: All of the subjects were 3 to 6 years old, had complete primary dentition, class I occlusion and were classified as bruxist according to the minimal criteria of the ICSD for bruxism. For each child, anxiety was evaluated with the Conners' Parent Rating Scales (CPRS). The TMD were evaluated using the RDC/TMD. The dental wear was processed in digital format with Mat Lab® and Lab view® software to determine its size and form. The children were randomized into an experimental (n=19) and a control (n=17) group. The children in the experimental group used rigid bite plates for a two-year period, until mixed dentition. Afterwards, the CPRS and the RDC/TMD were applied again and dental casts were taken. Comparisons of the variables regarding dental wear, signs and symptoms of TMD and anxiety before and after treatment among the groups were analyzed using the t-test, the Wilcoxon rank sum test and the Mann-Whitney test. RESULTS: The subjects in the experimental group showed no statistically significant difference regarding anxiety levels and dental wear when compared with the control group. The signs and symptoms of TMD were not reduced except for the deviation in mouth opening. CONCLUSIONS: The use of rigid occlusal bite plates was not efficient in reducing the signs of bruxism as a whole but did reduce the deviation in mouth opening.
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La presente investigación tuvo como objetivo evaluar las relaciones entre la resiliencia, la depresión y la calidad de vida relacionada con la salud en 36 adolescentes escolarizados de la ciudad de Medellín, Colombia. El diseño del estudio fue exploratorio-correlacional-transversal. Se utilizaron como instrumentos de medida el cuestionario de calidad de vida infantil Kid-Kindl, la escala de resiliencia para adolescentes ARS y el inventario de depresión infantil CDI. Los resultados a nivel descriptivo evidenciaron una calidad de vida favorable, altas puntuaciones de resiliencia y niveles clínicamente no significativos de depresión infantil. En el análisis de regresión lineal múltiple se encontró que la dimensión regulación emocional de la escala ARS tuvo un peso positivo sobre la calidad de vida mientras que la depresión infantil tuvo un peso negativo sobre esta variable. En conclusión, la percepción de calidad de vida en los adolescentes puede verse modulada positiva o negativamente por la resiliencia y la depresión.
The present research had as aim to evaluate the relationships between resilience, depression and the health-related quality of life in 36 adolescents from schools in the city of Medellin, Colombia. The design of this study was exploratory-transversal-correlation. The instruments used were: the quality of life questionnaire for children Kid-Kindl, the adolescent resilience scale -ARS; children's depression inventory -CDI. The results to descriptive levels demonstrate a favorable quality of life, high resilience scores and not clinically significant levels of childhood depression. In multiple linear regressions analysis showed that emotion regulation dimension ARS scale had a positive weight on the quality of life as childhood depression had a negative weight on this variable. In conclusion, the perception of quality of life in adolescents can be modulated positive or negatively by the resilience and depression.
RESUMEN
El bruxismo puede tener consecuencias en la dentición, musculatura, ATM y la postura cefálica y corporal de quien lo sufre. El objetivo de este estudio fue evaluar y comparar las dimensionesde la vía aérea superior entre pacientes adultos jóvenes bruxómanos y no bruxómanos.