Neuromodulación eléctrica en el tratamiento del dolor neuropático refractario. Colocación del primer estimulador medular en Cuba / Electric neuromodulation in the treatment of refractory pain. Placement of the first spinal stimulator in Cuba

El dolor es una causa importante de sufrimiento físico y emocional. El tratamiento médico de los pacientes con dolor crónico refractario es un gran reto. Se presenta el caso de una paciente de 19 años con un cuadro radicular compresivo secundario a Hernia discal L5-S1 derecha, que se le aplicó una discectomía L5-S1 por técnica de Caspar. Al mes de evolución regresa con igual sintomatología. A pesar de múltiples terapias farmacológicas y procederes intervencionistas, el dolor neuropático no mejora, después de múltiples estudios y discusiones en colectivo se determina la posibilidad de la colocación de un neuroestimulador medular, proceder que se lleva a cabo con mejoría considerable de su cuadro doloroso(AU)

Pain is a major cause of physical and emotional suffering. The management of patients with refractory chronic pain is a great challenge. The case is presented of a 19-year-old female patient with compressive radicular symptoms secondary to right L5-S1 disc herniation, who underwent L5-S1 discectomy with Caspar technique. After one month of evolution, she returned with the same symptoms. Despite multiple pharmacological therapies and interventional procedures, the neuropathic pain did not improve. After multiple studies and collective discussions, the possibility of placing a spinal neurostimulator was decided. After the procedure, the patient improved considerably with respect to her painful symptoms(AU)

An Experimental Review on Deep Learning Architectures for Time Series Forecasting.

In recent years, deep learning techniques have outperformed traditional models in many machine learning tasks. Deep neural networks have successfully been applied to address time series forecasting problems, which is a very important topic in data mining. They have proved to be an effective solution given their capacity to automatically learn the temporal dependencies present in time series. However, selecting the most convenient type of deep neural network and its parametrization is a complex task that requires considerable expertise. Therefore, there is a need for deeper studies on the suitability of all existing architectures for different forecasting tasks. In this work, we face two main challenges: a comprehensive review of the latest works using deep learning for time series forecasting and an experimental study comparing the performance of the most popular architectures. The comparison involves a thorough analysis of seven types of deep learning models in terms of accuracy and efficiency. We evaluate the rankings and distribution of results obtained with the proposed models under many different architecture configurations and training hyperparameters. The datasets used comprise more than 50,000 time series divided into 12 different forecasting problems. By training more than 38,000 models on these data, we provide the most extensive deep learning study for time series forecasting. Among all studied models, the results show that long short-term memory (LSTM) and convolutional networks (CNN) are the best alternatives, with LSTMs obtaining the most accurate forecasts. CNNs achieve comparable performance with less variability of results under different parameter configurations, while also being more efficient.

Reverse shoulder arthroplasty in obese patients: analysis of functionality in the medium-term.

INTRODUCTION: Obesity is an epidemic nowadays and this fact conditions results in orthopaedic surgery. Very few studies evaluates if obesity is a risk factor for reverse shoulder arthroplasty. The aim of this study is to confirm if there are differences with regard to the outcomes in patients undergoing reverse shoulder arthroplasty according to their body mass index (BMI). MATERIALS AND METHODS: A total of 35 patients were enrolled in the study. Then divided into subpopulations according to their BMI and analyzed twice. First analysis set a division 30 of BMI and second set it in 35. ASES score, major complications, length of the hospital stay, radiolucent lines in components as well as scapular notching were assessed. RESULTS: No major complications were described in our patients. No differences were found related to hospital stay, radiolucent lines or scapular notching. However, in the second analysis (BMI < 35 and ≥ 35) statistical differences were found regarding ASES score. Poorer functional outcomes were described in the type-II obese and morbidly obese population. CONCLUSION: Functional outcomes of reverse shoulder arthroplasty are worse in patients with a BMI over 35.

Tratamiento farmacológico para la Osteoporosis y su influencia en el proceso de consolidación de las fracturas / Pharmacologic treatment for osteoporosis and its influence on fracture healing

Las fracturas por fragilidad o secundarias a la osteoporosis se pueden considerar como un importante problema de Salud Pública por las consecuencias en términos de mortalidad y morbilidad que generan. Y las previsiones para el futuro, teniendo en cuenta el progresivo envejecimiento de la población y el aumento de la esperanza de vida, no son nada optimistas. Suponen y supondrán un importante consumo de recursos. Una de las estrategias que ha demostrado eficacia para su prevención, es el tratamiento farmacológico. Pero este tratamiento puede afectar de una manera u otra al proceso de consolidación, uno de los objetivos primarios fundamentales en su manejo. En este trabajo de revisión queremos establecer, en base a la evidencia actual, cómo afectan todos y cada uno de los fármacos indicados para el tratamiento de la osteoporosis al proceso de consolidación de las fracturas por fragilidad, una cuestión que genera dudas e incertidumbres en el traumatólogo, cuya responsabilidad y papel en el escenario de la prevención, es fundamental

Osteoporotic fragility fractures can be seen as a major public health problem because their consequences in terms of mortality and morbidity. Taking into account the progressive ageing of the population and the increase in life expectancy, the expectative in the next future are not optimistic. They are and will be an important focus of health resources consumption. One of the strategies that have proven be effective for fracture prevention, is the antiosteoporotic pharmacological treatment. This type of treatments can affect bone healing process in one way or another. In this review, based on the current scientific evidence, we want to establish how each one of the drugs prescribed for the osteoporosis treatment affects the bone healing process of fragility fractures, an issue that generates doubts and uncertainties in the orthopaedic surgeon, whom responsibility and role in fracture prevention is essential

Arthroscopic findings in melorheostosis.

Melorheostosis is a rare dysplastic bone formation disease that can also affect the joints. We present a case of a patient with knee pain that was radiographically diagnosed as melorheostosis because of "dripping wax" image. An exploratory arthroscopy was made. In the joint, we found hyperplasic synovial tissue and an increased retropatellar Hoffa pad, which was surrounding an intra-articular ossification resulting from the disease. This was removed and led to a clinical and functional improvement.

The comparison of measurement accuracy among three different imaging modalities in evaluating elastofibroma dorsi. An analysis of 52 cases.

PURPOSE: Elastofibroma dorsi (ED) is a rare soft-tissue tumour. Diagnosis is made using imaging, mainly magnetic resonance due to its higher sensitivity and specificity in soft tissues. No agreement exists when deciding which imaging test must be used. Often multiple tests are made in the same patient, increasing time and costs. The aim of this paper is to compare the usual imaging exams and evaluate which one is the most accurate when diagnosing and measuring ED. METHODS: A retrospective review was made of those patients who were diagnosed and operated for ED since January 2006 to December 2013. Fifty-two ED were included (19 men, 25 women), and eight of them were bilaterally affected. They were divided into three different groups according to the imaging test used: ultrasound (US) computed tomography (CT) and magnetic resonance (MR). After surgery the pieces were sized and compared with the measurements made by imaging exams. RESULTS: Two hundred fourteen measures were analysed (40 US, 33 CT and 34 MR with their pathological equivalent). When CT group and its corresponding AP were analysed, no significant differences between them were founded (p > 0.05). Moreover, we analysed absolute differences between measures. In the US group a mean difference of 2.23 ± 1.87 cm was obtained. In the CT group, the mean difference was 1.22 ± 0.97 cm. Likewise, the difference of the MR group was 1.62 ± 1.15 cm. CONCLUSIONS: This study demonstrates that the CT obtains a higher correlation than MR when determining the size of ED.

Comportamiento de traumatismos dentoalveolares en niños deportistas del área "Ciro Frías", del municipio de Arroyo Naranjo / Behavior of dentoalveolar traumas among children from Ciro Frías sports area in the municipality of Arroyo Naranjo

Introducción: los traumatismos dentoalveolares constituyen una de las principales urgencias estomatológicas. Objetivo: caracterizar el comportamiento de los traumatismos dentarios en niños deportistas del área "Ciro Frías". Métodos: se realizó un estudio observacional descriptivo, de corte transversal, en deportistas menores de 19 años del área "Ciro Frías", del municipio Arroyo Naranjo, La Habana, desde febrero de 2011 hasta febrero de 2012. El universo estuvo constituido por 57 niños. Se utilizó un formulario de datos creado por los autores y validado por un comité de expertos; se realizó examen bucal y facial; se vaciaron los datos y se procesaron utilizando estadística descriptiva. Las variables estudiadas fueron: edad, sexo, deporte, momento del traumatismo, dientes lesionados, localización en la arcada, tipo de trauma dentario, etiología, asistencia al estomatólogo y tratamiento. Resultados: los niños que más traumatismos dentarios presentaron fueron los de 12 a 14 años (45,6 por ciento) y el sexo más afectado fue el masculino (77,2 por ciento). Los traumas ocurrieron principalmente fuera del entrenamiento (61,4 por ciento) y el deporte con más niños afectados fue el Karate (19,3 por ciento). Los dientes más dañados fueron los incisivos centrales superiores (62,9 por ciento). La fractura no complicada de la corona (32,3 por ciento) fue la lesión más acentuada. La etiología principal de los traumas fue la práctica de deportes (36,8 por ciento). El 68,4 por ciento de los niños no recibieron tratamiento. Conclusiones: predominaron los traumas en el sexo masculino, entre 12 a 14 años, fuera del entrenamiento. El deporte con más niños afectados fue el Karate. Los dientes más lesionados fueron los incisivos centrales superiores. Los traumatismos más frecuentes fueron las fracturas no complicadas de la corona y la infractura del esmalte...(AU)

Introduction: dentoalveolar traumas are one of the main causes of dental emergencies. Objective: characterize the behavior of dental traumas among children from "Ciro Frías" sports area. Methods: an cross-sectional observational descriptive study was conducted with children under 19 years of age from Ciro Frías sports area in the municipality of Arroyo Naranjo, Havana, from February 2011 to February 2012. The study universe was composed of 57 children. Data collection was based on a form developed by the authors and validated by an experts committee. Oral and facial examination was performed, and the information was recorded and processed using descriptive statistics. The variables studied were age, sex, sport, time of trauma, injured teeth, location in the arcade, type of dental trauma, etiology, visit to the dentist and treatment. Results: dental traumas predominated in the 12-14 age group (45,6 percent) and the male sex (77,2 percent). Most (61,4 percent) occurred outside training sessions, and karate was the sport with most injured children (19,3 percent). Upper central incisors were the most commonly affected teeth (62,9 percent). Uncomplicated crown fracture was the most common injury (32,3 percent). Sports practice was the main etiology of traumas (36,8 percent). 68,4 percent of the children injured did not receive any treatment. Conclusions: there was a predominance of the male sex, the 12-14 age group and occurrence outside training sessions. Karate was the sport with most children injured. Upper central incisors were the most commonly affected teeth. The most common traumas were uncomplicated fractures of the crown and the enamel infrastructure. The most common causes of dental traumas were sports practice and falls. There was a predominance of children not visiting the dentist and not receiving treatment(AU)

Comportamiento de traumatismos dentoalveolares en niños deportistas del área "Ciro Frías", del municipio de Arroyo Naranjo / Behavior of dentoalveolar traumas among children from Ciro Frías sports area in the municipality of Arroyo Naranjo

Los traumatismos dentoalveolares constituyen una de las principales urgencias estomatológicas. Objetivo: caracterizar el comportamiento de los traumatismos dentarios en niños deportistas del área Ciro Frías. Métodos: se realizó un estudio observacional descriptivo, de corte transversal, en deportistas menores de 19 años del área Ciro Frías, del municipio Arroyo Naranjo, La Habana, desde febrero de 2011 hasta febrero de 2012. El universo estuvo constituido por 57 niños. Se utilizó un formulario de datos creado por los autores y validado por un comité de expertos; se realizó examen bucal y facial; se vaciaron los datos y se procesaron utilizando estadística descriptiva. Las variables estudiadas fueron: edad, sexo, deporte, momento del traumatismo, dientes lesionados, localización en la arcada, tipo de trauma dentario, etiología, asistencia al estomatólogo y tratamiento. Resultados: los niños que más traumatismos dentarios presentaron fueron los de 12 a 14 años (45,6 por ciento) y el sexo más afectado fue el masculino (77,2 por ciento). Los traumas ocurrieron principalmente fuera del entrenamiento (61,4 por ciento) y el deporte con más niños afectados fue el Karate (19,3 por ciento). Los dientes más dañados fueron los incisivos centrales superiores (62,9 por ciento). La fractura no complicada de la corona (32,3 por ciento) fue la lesión más acentuada. La etiología principal de los traumas fue la práctica de deportes (36,8 por ciento). El 68,4 por ciento de los niños no recibieron tratamiento. Conclusiones: predominaron los traumas en el sexo masculino, entre 12 a 14 años, fuera del entrenamiento. El deporte con más niños afectados fue el Karate. Los dientes más lesionados fueron los incisivos centrales superiores. Los traumatismos más frecuentes fueron las fracturas no complicadas de la corona y la infractura del esmalte. Las causas de traumatismos dentarios más frecuentes fueron la práctica de deportes y las caídas. Prevalecieron los niños que no asistieron a consulta estomatológica y que no recibieron tratamiento(AU)

Dentoalveolar traumas are one of the main causes of dental emergencies. Objective: characterize the behavior of dental traumas among children from "Ciro Frías" sports area. Methods: an cross-sectional observational descriptive study was conducted with children under 19 years of age from Ciro Frías sports area in the municipality of Arroyo Naranjo, Havana, from February 2011 to February 2012. The study universe was composed of 57 children. Data collection was based on a form developed by the authors and validated by an experts committee. Oral and facial examination was performed, and the information was recorded and processed using descriptive statistics. The variables studied were age, sex, sport, time of trauma, injured teeth, location in the arcade, type of dental trauma, etiology, visit to the dentist and treatment. Results: dental traumas predominated in the 12-14 age group (45,6 percent) and the male sex (77,2 percent). Most (61,4 percent) occurred outside training sessions, and karate was the sport with most injured children (19,3 percent). Upper central incisors were the most commonly affected teeth (62,9 percent). Uncomplicated crown fracture was the most common injury (32,3 percent). Sports practice was the main etiology of traumas (36,8 percent). 68,4 percent of the children injured did not receive any treatment. Conclusions: there was a predominance of the male sex, the 12-14 age group and occurrence outside training sessions. Karate was the sport with most children injured. Upper central incisors were the most commonly affected teeth. The most common traumas were uncomplicated fractures of the crown and the enamel infrastructure. The most common causes of dental traumas were sports practice and falls. There was a predominance of children not visiting the dentist and not receiving treatment(AU)

Oral plus nasal corticosteroids improve smell, nasal congestion, and inflammation in sino-nasal polyposis.

OBJECTIVES/HYPOTHESIS: To assess the effect of oral plus intranasal corticosteroids on subjective outcomes (smell and nasal congestion) and objective outcomes (tissue eosinophilia and nitric oxide) in severe nasal polyposis (NP). STUDY DESIGN: After a 4-week steroid washout period (w0), severe NP were randomized into a treatment group (n = 67) that receive oral prednisone for 2 weeks (w2) plus intranasal budesonide for 12 weeks (w12), and a control group (n = 22) that received no steroid treatment. METHODS: Barcelona Smell Test 24 (BAST-24), nasal congestion, tissue eosinophilia, and nasal nitric oxide (nNO) were assessed. RESULTS: Before treatment, patients showed a significant impairment of smell detection (30.7 ± 39.5%), identification (7.1 ± 16.1%), and forced choice (13.8 ± 23.3%) in BAST-24 compared to healthy population. At w2, the treatment group showed a significant improvement in detection, identification, and forced choice. Positive effect was also seen after 12 weeks of intranasal corticosteroids. A significant reduction of nasal congestion (1.17 ± 1.0 vs. 2.73 ± 0.5) and polyp tissue eosinophilia (10.9 ± 4.2 vs. 41.2 ± 12.2) with an increase of nNO (650 ± 317 vs. 420 ± 221 ppb) were observed at w2 compared to w0 and to the control group. These effects were also seen at w12. CONCLUSIONS: Combined oral and intranasal corticosteroids improve smell and nasal congestion and decrease nasal inflammation, as measured by reduced tissue eosinophilia and increased detection of nNO. Severity of smell loss correlates with degree of nasal congestion but not with inflammation, as measured by tissue eosinophilia or nasally exhaled nNO. Our findings suggest that improvement in smell may be related to improved conduction of odorants to the olfactory neuroepithelium.

Tratamiento de las fracturas periarticulares de rodilla mediante artroplastia total primaria. Presentación de tres casos / Treatment of the periarticular knee fractures with a primary total knee arthroplasty: Report of three cases

Objetivo: Analizar los resultados obtenidos en pacientes tratados mediante una artroplastia total primaria tras sufrir una fractura periarticular de rodilla, en el Hospital Universitario Reina Sofía de Córdoba. Material y métodos: Estudio de tres casos de pacientes con fracturas periarticulares de la rodilla que fueron tratados mediante una artroplastia total primaria, consecutivamente desde junio de 2009 hasta agosto de 2010: Una mujer de 75 años con fractura de cóndilo femoral externo, un varón de 70 años con fractura-hundimiento de meseta tibial interna, y un varón de 80 años con fractura-hundimiento de meseta tibial externa. El período de seguimiento medio fue de 12 meses. En la evaluación de resultados se utilizaron las siguientes escalas: Knee Society Score (KSS), Escala Visual Analógica y la escala de valoración de la fuerza muscular de Daniels. Resultados: No hubo complicaciones intraoperatorias ni postoperatorias graves. Dos de los tres pacientes necesitaron valoración por Rehabilitación. Al finalizar el seguimiento todos los pacientes se mostraron satisfechos con los resultados, refiriendo un adecuado control del dolor, y el balance articular fue superior a 0-100 grados en dos de los tres casos. Durante el seguimiento no se observaron signos radiográficos de fracaso de la técnica y no huboindicación para cirugía de revisión en ninguno de los casos. Conclusión: Los resultados a corto plazo indican, al igual que otras series de casos publicadas, que la artroplastia primaria total en pacientes ancianos con fracturas periarticulares de la rodilla es una opción válida de tratamiento (AU)

Objective: Analyze the results obtained in patients with primary total arthroplasty after having suffered a periarticular knee fracture, at the Reina Sofia University Hospital in Cordoba (Spain). Material and method: Three cases of patients with periarticular fractures of the knee were studied using primary total arthroplasty, all consecutive from June 2009 until August 2010: a 75 year old woman with external femoral chondral fracture, a 70 year old man with collapsed fracture of the internal tibial plateau and an 80 year old male with a collapsed fracture of the external tibial plateau. Average follow-up was 12 months. Results were assessed using the following scales: Knee Society Score (KSS), CVAS (Cosmetic Visual Analogue Scale) and the Daniels Muscle Testing scale. Results: There were no inter-operative or serious post-operative complications. Two of the three patients needed assessment for rehabilitation. Once follow-up concluded, all patients were satisfied with the results, referring to an adequate control of pain and the articular balance was greater than 0-100 degrees in two of the three cases. Throughout follow-up, no radiographic signs of failure of the technique were observed and there was no indication that the surgery needed revision in any of the cases. Conclusion: The short-term results indicate that as with the other series of cases published, primary total knee arthroplasty in elderly patients with periarticular knee fractures is a valid treatment option (AU)

Empleo de la laserterapia en la reparación ósea periapical / Use of laser therapy in periapical bone repair

Se realizó un estudio experimental, prospectivo y de control en un grupo de pacientes de ambos sexos, mayores de 15 años con procesos crónicos periapicales, que fueron atendidos en el departamento de Endodoncia de la Clínica Estomatológica Docente Severino Rossel González del municipio Artemisa, en el período comprendido desde junio de 2010 hasta junio de 2011 que constituyó el universo del estudio, con el objetivo de evaluar la aplicación de la laserterapia en la reparación ósea periapical, tomándose una muestra no probabilística de sujetos voluntarios de 50 pacientes, de los cuales se tomó un grupo de control al que se le realizó el tratamiento de endodoncia convencional y otro grupo experimento, al que además de la endodoncia se le aplicaron 10 sesiones de laserterapia. La información fue procesada en el software estadístico SPSS 11,5, utilizando como medida el porcentaje, la prueba de Chi cuadrado. Los pacientes fueron examinados a los tres y seis meses, y al año de haber recibido el tratamiento se evaluó el grado de reparación ósea y tamaño de la lesión en ambos grupos constatando de que a pesar de que existía independencia entre las variables analizadas en el grupo que se empleo la laserterapia se obtuvo una más rápida regeneración ósea periapical; las lesiones pequeñas y moderadas se regeneraron totalmente en su gran mayoría en ambos grupos. Se concluye que la laserterapia resultó ser más efectiva que el proceder acostumbrado y no desencadenó reacciones adversas en ninguno de los casos (AU)

It was carried out an experimental, prospective and control study in a group of patients of both sexes, older than 15 years with chronic periapical processes that were assisted at the Endodontics Department of Severino Rossel González Teaching Stomatologic Clinic of Artemisa municipality, in the period from June 2010 to June 2011 which constituted the universe of the study, with the aim of evaluating the application of laser therapy in periapical bone repair, it was taken a non probabilistic sample of volunteer subjects of 50 patients, out of whom it was taken a control group that underwent conventional endodontic treatment and another experiment group to which in addition to endodontics, it was applied 10 sessions of laser therapy. The information was processed using SPSS 11,5 statistical software, using percentage as measurement the Chi-squared test. Patients were examined at three and six months, and one year after receiving the treatment it was assessed the degree of bone repair and lesion size in both groups noting that although there was independence between the variables analyzed in the group in which was used the laser therapy, a faster bone periapical regeneration was obtained; small to moderate lesions fully regenerated mostly in both groups. Concluding that laser therapy was more effective than the usual procedure and did not trigger adverse reactions in any of the cases (AU)

Empleo de la laserterapia en la reparación ósea periapical / Use of laser therapy in periapical bone repair

Se realizó un estudio experimental, prospectivo y de control en un grupo de pacientes de ambos sexos, mayores de 15 años con procesos crónicos periapicales, que fueron atendidos en el departamento de Endodoncia de la Clínica Estomatológica Docente Severino Rossel González del municipio Artemisa, en el período comprendido desde junio de 2010 hasta junio de 2011 que constituyó el universo del estudio, con el objetivo de evaluar la aplicación de la laserterapia en la reparación ósea periapical, tomándose una muestra no probabilística de sujetos voluntarios de 50 pacientes, de los cuales se tomó un grupo de control al que se le realizó el tratamiento de endodoncia convencional y otro grupo experimento, al que además de la endodoncia se le aplicaron 10 sesiones de laserterapia. La información fue procesada en el software estadístico SPSS 11,5, utilizando como medida el porcentaje, la prueba de Chi cuadrado. Los pacientes fueron examinados a los tres y seis meses, y al año de haber recibido el tratamiento se evaluó el grado de reparación ósea y tamaño de la lesión en ambos grupos constatando de que a pesar de que existía independencia entre las variables analizadas en el grupo que se empleo la laserterapia se obtuvo una más rápida regeneración ósea periapical; las lesiones pequeñas y moderadas se regeneraron totalmente en su gran mayoría en ambos grupos. Se concluye que la laserterapia resultó ser más efectiva que el proceder acostumbrado y no desencadenó reacciones adversas en ninguno de los casos

It was carried out an experimental, prospective and control study in a group of patients of both sexes, older than 15 years with chronic periapical processes that were assisted at the Endodontics Department of Severino Rossel González Teaching Stomatologic Clinic of Artemisa municipality, in the period from June 2010 to June 2011 which constituted the universe of the study, with the aim of evaluating the application of laser therapy in periapical bone repair, it was taken a non probabilistic sample of volunteer subjects of 50 patients, out of whom it was taken a control group that underwent conventional endodontic treatment and another experiment group to which in addition to endodontics, it was applied 10 sessions of laser therapy. The information was processed using SPSS 11,5 statistical software, using percentage as measurement the Chi-squared test. Patients were examined at three and six months, and one year after receiving the treatment it was assessed the degree of bone repair and lesion size in both groups noting that although there was independence between the variables analyzed in the group in which was used the laser therapy, a faster bone periapical regeneration was obtained; small to moderate lesions fully regenerated mostly in both groups. Concluding that laser therapy was more effective than the usual procedure and did not trigger adverse reactions in any of the cases

Persistent asthma has an accumulative impact on the loss of smell in patients with nasal polyposis.

BACKGROUND: Loss of sense of smell is one of the most frequent complaints in patients with nasal polyposis (NP). The aim of this study was to evaluate the impact of asthma and its severity on the sense of smell. MATERIAL AND METHODS: Patients with massive NP and healthy controls were included. More than half of patients presented with asthma. Olfactometry by Barcelona Smell Test 24, nasal symptoms score, nasal endoscopy, allergy study, and paranasal sinus CT scan were assessed. RESULTS: NP patients showed a significant impairment in smell detection, identification, and forced choice compared to the control. Asthmatics reported lower scores for detection, identification, and forced choice than non-asthmatic patients. Patients with persistent asthma had an increased impairment of sense of smell on detection, identification, and forced choice than patients with intermittent asthma. No significant differences were found between mild, moderate, and severe persistent asthmatics. Paranasal sinuses opacification was inversely correlated with smell detection, identification and forced choice. CONCLUSION: These findings suggest that patients with NP have an impaired sense of smell, that asthma -particularly persistent asthma- has a further impact on sense of smell, and that loss of smell may be used as a clinical tool to identify the severity of both NP and asthma.

Role of perioperative intravenous iron therapy in elderly hip fracture patients: a single-center randomized controlled trial.

BACKGROUND: The main objective of this study was to determine the efficacy of intravenous (IV) iron sucrose therapy reducing transfusion requirements in elderly patients undergoing hip fracture surgery. STUDY DESIGN AND METHODS: This study was a prospective randomized controlled trial involving 200 patients undergoing hip fracture surgery. Group A (100 patients) received standard treatment, while Group B (100 patients) received iron sucrose (600 mg IV). The primary endpoint was the number of patients that were transfused postoperatively. The secondary endpoints were the rate of red blood cell units used, hematimetric variables of blood tests, mortality, infection rates, length of hospital stay, and appearance of side effects. RESULTS: Differences in the percentage of patients requiring transfusion (Group A 41.3% vs. Group B 33.3%) and in the number of concentrates transfused (0.87±1.21 for Group A vs. 0.76±1.16 for Group B) were not significant for the patient group as a whole, but were significant for patients with intracapsular fractures (45.7% required transfusion in Group A vs. 14.3% in Group B; p<0.005) and in patients with a baseline hemoglobin (Hb) level of 12 g/dL or more (35.2% required transfusions in Group A vs. 19% in Group B; p<0.05). CONCLUSIONS: Transfusion requirements in patients with intracapsular fracture or baseline Hb level of 12 g/dL or more appear to be reduced by IV iron sucrose therapy, but there was no difference in morbidity, mortality, or length of hospital stay. The treatment is safe and hastens recovery from blood loss.

Relación del estado de salud bucal con algunos factores socioeconómicos en niños de 2-5 años / Relation of the oral health state to some socioeconomic factors in children aged 2-5

Determinar la asociación de algunos factores de riesgo con el estado de salud bucal en la primera infancia; identificar la relación de la salud bucal de dichos niños con: la higiene bucal, el tipo de dieta, escolaridad de los padres, ocupación de los padres. El estudio se llevó a cabo en el municipio Bauta, provincia La Habana, en 2 etapas: la primera, descriptiva, de corte transversal, la segunda, analítica, de acuerdo con la metodología de casos y controles (200 niños de cada tipo), en el período comprendido desde junio del 2005 hasta junio del 2006. Se utilizaron las variables: estado de salud bucal, escolaridad, ocupación de los padres, higiene bucal, tipo de dieta. El comportamiento de la higiene bucal fue inadecuado en el 39,5 por ciento de los casos y en el 5,5 por ciento de los controles; en el grupo de casos prevaleció la dieta cariogénica 65,0 por ciento, mientras que en el grupo control se incrementó la aceptable, con el 44,0 por ciento. En cuanto a la influencia de la escolaridad y la ocupación de los padres, en el estado de salud bucal los resultados no mostraron significación estadística. La adecuada higiene bucal y la dieta no cariogénica incrementaron la posibilidad de tener un estado adecuado de salud bucal. Tanto la escolaridad como la ocupación de los padres no guardaron correlación con la salud bucal de sus hijos(AU)

To determine the association of some risk factors with the oral health state in the early childhood, to identify the connection of the oral health of these children with oral hygiene, the type of diet, parents' educational level and parents' job. A 2-stage study was carried out in Bauta municipality, Havana province from June 2005 to June 2006. The first stage was descriptive and cross-sectional, and the second was analytical according to the case-control methodology (200 children of each type). The following variables were used: oral health state, educational level, parents' occupation, oral hygiene and type of diet. The behavior of oral hygiene was inadequate in 39,5 percent of the cases and in 5,5 percent of the controls. The cariogenic diet prevailed in the case group (65,0 percent), whereas the acceptable diet increased in the control group (44,0 percent). As regards the influence of educational level on the oral health state, the result did not show statistical significance. The adequate oral hygiene and the non-cariogenic diet rose the possibility of having an appropriate oral health state. The educational level and the occupation of the parents had no correlation with the oral health of their children(AU)

Algunos factores coadyuvantes del bienestar del niño y su relación con la salud bucal / Some coadjutant factors of child's wellbeing and their relation to oral health

Determinar la relación existente entre algunos indicadores que influyen en la salud bucal en la infancia. Se realizó un estudio analítico del tipo de casos y testigos en el municipio Bauta, provincia La Habana, en el período comprendido de junio del 2005 hasta junio del 2006. El universo estuvo integrado por 2 408 niños comprendidos entre las edades de 2 a 5 años, del cual se extrajo una muestra de 400 niños. Se utilizaron las variables: estado de salud bucal, peso al nacer, edad gestacional y lactancia materna. Para las variables cuya asociación con el estado de salud bucal resultó ser significativa, se obtuvo el Odds Ratio, siempre que fue posible, para identificar el aumento o la disminución de la probabilidad de adolecer de mala salud bucal en presencia de los factores de riesgo considerados. El 10 por ciento de los niños bajo peso al nacer mostraron afectado el estado de salud bucal, el 6,5 por ciento de los niños que nacieron pretérmino se consideraron casos, el 39,5 por ciento de los que no recibieron lactancia materna, su salud bucal declinó. El bajo peso al nacer y la no lactancia materna afectan el estado de salud bucal, no así la edad gestacional(AU)

To determine the relation existing among some indicators influencing on oral health during childhood. An analytical case and control study was conducted in the municipality of Bauta, Havana province, from June 2005 to June 2006. The universe was composed of 2 408 children aged 2-5. A sample of 400 children was taken from it. The following variables were used: oral health status, birth weight, gestational age and maternal breastfeeding. The odds ratio was obtained whenever it was possible for the variables whose association with the oral health state proved to be significant aimed at identifying the increase or reduction of the probability of having a poor oral health in the presence of the risk factors taken into account. 10 percent of the low birth weight children had an affected oral health state, 6,5 percent of the preterm children were considered cases, and oral health declined in 39,5 percent of the children that were not breast-fed. Low birth weight and the non-maternal lactation affect the oral health state, but gestational age does not(AU)