Suicide in a Colombian indigenous community: Beyond mental illness.

BACKGROUND: Among the causes associated with suicide there are social factors such as forced displacement has been described and health factors in general that have an impact on pediatric mental health. AIMS: To describe clinical and psychosocial factors, and their relationship with suicidal behavior in a Colombian indigenous community. PARTICIPANTS AND SETTING: The mean age were 9.23 years old, 53.7% male and 46.3% female. METHOD: Mixed approach study. A thematic analysis was carried out with the youth of the community to investigate emotional aspects. A descriptive cross-sectional study was carried out and correlations between variables were made. RESULTS: Correlations were found between suicidal behavior and medical findings. When comparing the mental health disorders and nutritional problems, statistically significant differences were found in the Suicide Risk domain (<.001). This was reaffirmed in the thematic analysis, where factors such as migration and difficulty understanding the language are highlighted as related to suicidal behavior in the pediatric population. CONCLUSIONS: Suicidal behavior should not be approached solely from psychopathology. Hunger, the weakening of one's own culture, armed conflict, migration, and other clinical conditions are found to be associated with suicidal behavior.

Rendimiento de escalas de trauma ISS, NISS y RTSen accidentes de tránsito para predecir mortalidad en un hospital de alta complejidad / Performance of ISS, NISS, and RTS trauma scales in traffic accidents to predict mortality in a high-complexity hospital

Introducción. La población mundial crece y con ello los accidentes de tránsito, incrementando la morbimortalidad. La combinación de factores clínicos y paraclínicos mediante las escalas de trauma impacta en los desenlaces al permitir tomar acciones oportunas. Métodos. Estudio de corte transversal en el que se incluyeron pacientes con lesiones por colisión en accidentes de tránsito, atendidos entre 2017 y 2018, en urgencias del Hospital Universitario San José de Popayán, Colombia, un hospital de alta complejidad. Se recolectaron variables sociodemográficas y biológicas y se aplicaron tres escalas de trauma, Revised Trauma Score, Injury SeverityScore y New Injury Severity Score. Posteriormente, se evaluó su rendimiento para predecir mortalidad. Resultados. Se atendieron en el servicio de urgencias 650 pacientes con lesiones en accidentes de tránsito y se presentaron 16 muertes. Al evaluar el rendimiento de las escalas de trauma se encontró que la sensibilidad para mortalidad varía entre el 75 % para Revised Trauma Score y el 93,8 % para Injury Severity Score y New Injury Severity Score, con una especificidad que varía entre 89,1 % y 96,8 %. Se identificó que la mejor razón de verosimilitud positiva fue para Revised Trauma Score, mientras que la mejor razón de verosimilitud negativa fue para Injury Severity Scorey New Injury Severity Score. Conclusiones. Los resultados evidencian un adecuado rendimiento de las escalas de trauma evaluadas para predecir mortalidad. La escala que presentó mejor rendimiento fue Injury Severity Score por su sensibilidad, especificidad y razón de verosimilitud positiva.

Background. The global population is on the rise and with such motor vehicle collisions, increasing the morbidity and mortality of individuals implicated in traffic accidents. The combination of clinical and paraclinical factors, as done by the different trauma scales, have an impact upon morbidity and mortality by allowing timely actions.Methods. Cross-sectional study that included patients with collision injuries in traffic accidents, treated at an emergency department from 2017 to 2018 at Hospital Universitario San José in Popayán, Colombia, a high-complexity hospital. The study defined the universe, collected sociodemographic and biological variables, and applied three trauma scales: Revised Trauma Score, Injury Severity Score, and New Injury Severity Score. Subsequently, its performance in predicting mortality was evaluated. Results. Six-hundred-fifty patients with collision injuries were treated in the emergency department with lesions due to collisions in traffic accidents; 16 deaths were reported. We found that the sensitivity varies between 75% for the Revised Trauma Score to 93.8% for the Injury Severity Score and the New Injury Severity Score. Likewise, an adequate specificity varying from 89,1% for the Injury Severity Score to 96,8% for the Revised Trauma Score. The best positive likelihood ratio was for the Revised Trauma Score. The negative likelihood ratios for the Injury Severity Score and the New Injury Severity Score were adequate.Conclusion. The results show an adequate performance of the trauma scales evaluated to predict mortality. The scale that presented the best performance was Injury Severity Score due to its sensitivity, specificity and positive likelihood ratio.

Paget's disease of the jaws: Histopathological features of a series of 31 cases.

The aim of the present study was to analyze the histopathological features of Paget's disease of the jaws observed in a series comprising 31 cases. The study comprised all cases of Paget's disease of the jaws filed in the archives of the Surgical Pathology Laboratory of the Oral Pathology Department, School of Dentistry, University of Buenos Aires, between 1960 and 2018. Their microscopic features were evaluated, and available clinical data and radiographic studies were analyzed. Paget's disease of the jaws accounted for 0.05% of retrieved oral-maxillofacial pathologies. Microscopically, all cases showed lamellar bone trabeculae with the characteristic mosaic pattern. Twenty cases (64%) showed osteoblastic-osteoclastic activity, and all showed areas of necrosis. Cemento-osseous trabeculae were observed in 15 cases (48%), and cementicles were observed in 13 (42%). Osteomyelitis was seen in 11 cases (35%), all of which showed cemento-osseous trabeculae with a mosaic structure, sclerosis and necrosis, and chronic inflammation with abscess formation. Mean age was 61 years (44-85 years); 19 cases were women. Localization was the maxilla in 13 cases (42%), and the disease involved other skeletal bones in five cases. To our knowledge, this is the largest series of Paget's disease of the jaws reported to date. Paget's disease is infrequent in the jaws and has distinct histopathological features that not only differ from those observed at other skeletal sites but also require differential diagnosis from other pathologies affecting the jaws exclusively.

El objetivo del presente trabajo fue analizar las características histopatológicas de la enfermedad de Paget en los maxilares en una serie de 31 casos. El estudio comprendió todos los casos de enfermedad de Paget de los maxilares provenientes del Laboratorio de Patología Quirúrgica de la Cátedra de Anatomía Patológica de la Facultad de Odontología de la Universidad de Buenos Aires, entre 1960 y 2018. Se evaluaron las características microscópicas y se analizaron los datos clínicos y estudios radiográficos disponibles. La enfermedad de Paget en los maxilares representó el 0,05% de las patologías buco-maxilofaciales. Microscópicamente, todos los casos mostraron trabéculas óseas laminares con el característico patrón en mosaico. Veinte casos (64%) mostraron actividad osteoblástica-clástica y todos los casos mostraron necrosis focal. En 15 casos (48%) las trabéculas presentaron aspecto cemento-óseo y en 13 casos (42%) se observaron cementículos. Once casos (35%) presentaron cuadros osteomielíticos y todos ellos mostraron trabéculas cemento-óseas con estructura en mosaico, esclerosis y necrosis, e infiltrado inflamatorio crónico con formación de abscesos. La media de edad fue 61 años (44-85 años), y 19 fueron mujeres. Trece casos (42%) se localizaron en maxilar superior y 5 casos presentaron compromiso de otros huesos. A nuestro entender, esta es la serie más grande de enfermedad de Paget en los maxilares reportada hasta la fecha. La enfermedad de Paget es poco frecuente en los maxilares y presenta características histopatológicas que además de ser diferentes a las observadas en otros sitios del esqueleto plantean el diagnóstico diferencial con otras entidades que se presentan exclusivamente en los maxilares.

Paget's disease of the jaws: Histopathological features of a series of 31 cases / Enfermedad de Paget en los maxilares. Características histopatológicas de una serie de 31 casos

ABSTRACT The aim of the present study was to analyze the histopathological features of Paget's disease of the jaws observed in a series comprising 31 cases. The study comprised all cases of Paget's disease of the jaws filed in the archives of the Surgical Pathology Laboratory of the Oral Pathology Department, School of Dentistry, University of Buenos Aires, between 1960 and 2018. Their microscopic features were evaluated, and available clinical data and radiographic studies were analyzed. Paget's disease of the jaws accounted for 0.05% of retrieved oral-maxillofacial pathologies. Microscopically, all cases showed lamellar bone trabeculae with the characteristic mosaic pattern. Twenty cases (64%) showed osteoblastic-osteoclastic activity, and all showed areas of necrosis. Cemento-osseous trabeculae were observed in 15 cases (48%), and cementicles were observed in 13 (42%). Osteomyelitis was seen in 11 cases (35%), all of which showed cemento-osseous trabeculae with a mosaic structure, sclerosis and necrosis, and chronic inflammation with abscess formation. Mean age was 61 years (44-85 years); 19 cases were women. Localization was the maxilla in 13 cases (42%), and the disease involved other skeletal bones in five cases. To our knowledge, this is the largest series of Paget's disease of the jaws reported to date. Paget's disease is infrequent in the jaws and has distinct histopathological features that not only differ from those observed at other skeletal sites but also require differential diagnosis from other pathologies affecting the jaws exclusively.

RESUMEN El objetivo del presente trabajo fue analizar las características histopatológicas de la enfermedad de Paget en los maxilares en una serie de 31 casos. El estudio comprendió todos los casos de enfermedad de Paget de los maxilares provenientes del Laboratorio de Patología Quirúrgica de la Cátedra de Anatomía Patológica de la Facultad de Odontología de la Universidad de Buenos Aires, entre 1960 y 2018. Se evaluaron las características microscópicas y se analizaron los datos clínicos y estudios radiográficos disponibles. La enfermedad de Paget en los maxilares representó el 0,05% de las patologías buco-maxilofaciales. Microscópicamente, todos los casos mostraron trabéculas óseas laminares con el característico patrón en mosaico. Veinte casos (64%) mostraron actividad osteoblástica-clástica y todos los casos mostraron necrosis focal. En 15 casos (48%) las trabéculas presentaron aspecto cemento-óseo y en 13 casos (42%) se observaron cementículos. Once casos (35%) presentaron cuadros osteomielíticos y todos ellos mostraron trabéculas cemento-óseas con estructura en mosaico, esclerosis y necrosis, e infiltrado inflamatorio crónico con formación de abscesos. La media de edad fue 61 años (44- 85 años), y 19 fueron mujeres. Trece casos (42%) se localizaron en maxilar superior y 5 casos presentaron compromiso de otros huesos. A nuestro entender, esta es la serie más grande de enfermedad de Paget en los maxilares reportada hasta la fecha. La enfermedad de Paget es poco frecuente en los maxilares y presenta características histopatológicas que además de ser diferentes a las observadas en otros sitios del esqueleto plantean el diagnóstico diferencial con otras entidades que se presentan exclusivamente en los maxilares.