Consideraciones en nuevos conceptos de las teorías del dolor crónico asociado a disfunciones músculo-esqueléticas; ¿hacia dónde van nuestros enfoques de tratamiento?. Parte I / Considerations in the new concepts of chronic pain theories associated with muscle-skeletal dysfunctions; where were our treatment approaches going?. First part

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Regional solar radiation is inversely correlated with incidence and severity of tuberculosis in Chile.

Vitamin D (VD) deficiency has been linked to increased incidence and morbidity of tuberculosis (TB). Chile has large variations in solar radiation (SR; a proxy of VD status) and high prevalence of VD deficiency in its southernmost regions with low SR. We investigated the correlation between regional SR and rates of TB incidence, admissions and deaths in Chile by reviewing national records on prospectively collected mandatory disease notifications, admissions and mortality between 2001 and 2011. Over the study period, 26 691 new TB notifications were registered. The TB incidence rate was 14·77 (95% confidence intervals (CIs) 14·60-14·95), admission rate was 12·12 (95% CI 11·96-12·28) and mortality rate was 1·61 (95% CI 1·55-1·67) per 100 000 population per year. Multivariable linear regressions adjusting for significant demographic TB risk factors in Chile (regional prevalence of HIV infection, rates of migration from TB-endemic countries and rates of imprisonment) revealed an independent and highly statistically significant inverse association between SR and TB incidence rate (ß -1·05, 95% CI -1·73 to -0·36, P = 0·007), admission rate (ß -1·58, 95% CI -2·23 to -0·93, P < 0·001), and mortality rate (ß -0·15, 95% CI -0·23 to -0·07, P = 0·002). These findings support a potential pathogenic role of VD deficiency in TB incidence and severity.

Estilos de aprendizaje y rendimiento teórico-práctico de alumnos de imagenología, tercer año de odontología / Learning styles and theoretical-practical performance

El estilo de aprendizaje de cada alumno influye en la forma como percibe y procesa la información. A 62 estudiantes de Odontología de la Universidad de los Andes se les aplicó el inventario de Estilos de Aprendizaje de Kolb. Los resultados obtenidos se relacionaron con los promedios de notas de estos alumnos en las áreas cognoscitiva y práctica en la asignatura de Imagenología. La mayoría de los alumnos resultaron ser convergentes y se concluyó que existe relación entre el estilo de aprendizaje y las calificaciones de los alumnos. Los alumnos convergentes y divergentes obtuvieron mejor calificación en el área práctica respecto del área cognoscitiva. La mayoría de las malas notas que se registran en el área cognoscitiva corresponden a alumnos divergentes.

The learning style of each student influences in the form it perceives and it processes the received information. To 62 dental students of the Universidad de Los Andes the Inventory of Learning Styles by Kolb was applied to them. The obtained results were related to the averages of cognitive and practical notes of these students in Radiology. Most of the students they turned out to be convergent and one concluded that it exists relation between the style of learning and the qualifications of the students. The convergent and divergent students obtained better qualification in the practical area respect to the cognitive area. Most of bad mark that is registered in the cognitive area they correspond to divergent students.

Imagenes por resonancia mágnetica de la articulación temporomandibular / Images for magnetic resonance of the temporomandibular joint

The term temporomandibular disorder embraces a number of clinical problems that involve the masticatory musculature, the temporomandibular joint (TMJ) and its associated structures, or both. The most common intra-articular abnormality of the TMJ is internal deragement, which is defined as an abnormal relationship of the articular disk to the mandibular condyle and the articular tubercle. Magnetic resonance imaging is considered the optimum modality for imaging the TMJ in patients with temporomandibular disorders, because could demonstrate fine anatomic details and pathologic changes and provide valuable information for determining the type and stage of joint abnormality. This article consists of a revision of the subject, accompanied by some selected images of made studies in the Centro de Imagenología, Hospital Clínico Universidad de Chile.

Epidemiología de las intoxicaciones en Chile: una década de registros / Epidemiology of intoxications in Chile: ten years of registry

Background: The existence of Poison Centers for management and prevention of intoxications has been endorsed by the international experience. In Chile, the Toxicological Information Center at the Pontifical Catholic University of Chile has been active since 1992, receiving about 130.000 calls until 2002. Aim: To analyze the statistical data gathered throughout the first ten years of our Research Center. To delineate the epidemiological pattern of intoxications in Chile. Material and methods: Retrospective study in which records from calls for toxicological information received during the 1992-2002 period reviewed. Analyzed data were total calls per year, place of call, exposure circumstances, age, sex, route of exposure and involved agents. Results: 96,468 calls analyzed. The main exposure circumstance was ½unintentional¼ (78.6 per cent), followed by ½intentional¼ (16.9 per cent). Intoxications in children under 5 years old motivated 50 per cent of calls. According to route of exposure, ingestions involved 75,992 calls (78.8 per cent). Medications were the most common substances, accounting for 49.2 per cent of calls, followed by cleaning products (12.1 percent), pesticides (11.3 per cent), industrial and chemical products (10.5 per cent) and cosmetics (2.7 per cent). Medications acting on the CNS were the most recurrent, with 19,096 reports. Conclusions: The epidemiological pattern for intoxications in Chile is very similar to that reported in developed and other Latin American countries. Children under 5 years old, are a high risk group for intoxications. It is imperative to improve the recording and follow-up of patients that call to the Center, to improve epidemiological data of intoxications in Chile.

Intoxicación por cloroquina / Chloroquine poisoning

Desde el punto de vista toxicológico, la cloroquina es probablemente, el mes peligroso agente antimicrobiano disponible en la actualidad. Utilizada como droga primaria en el tratamiento y profilaxis de la malaria, y como agente antirreumßtico e inmunosupresor, posee un estrecho margen terapeutico lo que la transforma en una droga de alto riesgo de intoxicaciones. Su uso se ha extendido dado el aumento de viajes a países endÚmicos para la malaria, aumentando el riesgo de sobredosis intencionales y no intencionales. Por ello es importante disponer de información actualizada del tratamiento de esta intoxicación.

Estudio de la reabsorción radicular: actualización e imagen radiográfica / A study of root resorption: update and radiographic image

La reabsorción radicular es una condición asociada a un proceso fisiológico o a uno patológico. Consiste en la pérdida de estructura por disolución de los tejidos que componen la raíz de una pieza dentaria, como son el cemento y la dentina. En el presente artículo se expone un análisis de los distintos tipos de reabsorción radicular, considerando los factores que condicionan su manifestación y la descripción de su imagen radiográfica

Estudio radiográfico de terceros molares inferiores en una muestra de individuos de 18 a 20 años / Radiographic study of lower third molar in subjects from 18 to 20 year of old

El propósito de este trabajo fue estudiar las imágenes radiográficas de la zona de terceros inferiores obtenidas de 116 individuos (58 hombres y 58 mujeres) con un promedio de edad de 22,3 años, con un rango entre los 18 y 25 años. Los parámetros que se consideraron para analizar las imágenes fueron los siguientes: presencia o ausencia, grado de evolución, inclinación en el plano sagital, posición antero-posterior, espacio pericoronario y ubicación en latura del tercer molar inferior. Se obtuvo un 19,8 por ciento de agenesias de terceros molares inferiores. La mayoría de estas piezas dentarias estudiadas ya terminaron su evolución, están semiincluídas, en mesioversión, tienen espacio suficiente para erupcionar o les falta un poco, presentan un espacio pericoronario normal y su cara oclusal se ubica bajo la línea cervical del segundo molar inferior o a nivel de la cara oclusal de este último. Las mujeres tenían un poco de espacio para el tercer molar inferior en su mandíbula, mientras que los hombres presentaban terceros molares con un grado de evolución más avanzado

[Personality disorders and adult behavior according to ICD-10]. / Trastornos de la personalidad y del comportamiento del adulto según la CIE-10.

Diagnostic criteria for Personality Disorders and Adult Behavior according I.C.D.-10 are reviewed. The authors point out that I.C.D.-10 considers the Personality Disorders as an entity in constant interaction with the environment. This fact allows to include the adult traumatic perturbations within this category. So the range becomes a wider one the traditional which locates the Personality Disorders only in young ages. The authors consider important that the Schizotypic and Cycloid Personality Disorders are left out since they both exceed the criteria for Personality Disorders. Developmental Disorders and Sexual Orientation presents conceptual inconsistencies that deserve further reflections. It is of interest that Borderline Disorders be considered a subtype of Emotional Disorders differentiating them from Impulsive type which agrees with clinic and neurobiological studies. They also think that incorporation of flexible quantitative cut off would be important to allow the clinician to ponder and value according to clinical evidences. They conclude that this chapter orders and propose clear and discriminative criteria for the Diagnosis of Personality Disorders and Adult Behavior.

Trastornos de la personalidad y del comportamiento del adulto según la CIE-10 / [Personality disorders and adult behavior according to ICD-10]

Diagnostic criteria for Personality Disorders and Adult Behavior according I.C.D.-10 are reviewed. The authors point out that I.C.D.-10 considers the Personality Disorders as an entity in constant interaction with the environment. This fact allows to include the adult traumatic perturbations within this category. So the range becomes a wider one the traditional which locates the Personality Disorders only in young ages. The authors consider important that the Schizotypic and Cycloid Personality Disorders are left out since they both exceed the criteria for Personality Disorders. Developmental Disorders and Sexual Orientation presents conceptual inconsistencies that deserve further reflections. It is of interest that Borderline Disorders be considered a subtype of Emotional Disorders differentiating them from Impulsive type which agrees with clinic and neurobiological studies. They also think that incorporation of flexible quantitative cut off would be important to allow the clinician to ponder and value according to clinical evidences. They conclude that this chapter orders and propose clear and discriminative criteria for the Diagnosis of Personality Disorders and Adult Behavior.

Trastornos de la personalidad y del comportamiento del adulto según la CIE-10. / [Personality disorders and adult behavior according to ICD-10]

Diagnostic criteria for Personality Disorders and Adult Behavior according I.C.D.-10 are reviewed. The authors point out that I.C.D.-10 considers the Personality Disorders as an entity in constant interaction with the environment. This fact allows to include the adult traumatic perturbations within this category. So the range becomes a wider one the traditional which locates the Personality Disorders only in young ages. The authors consider important that the Schizotypic and Cycloid Personality Disorders are left out since they both exceed the criteria for Personality Disorders. Developmental Disorders and Sexual Orientation presents conceptual inconsistencies that deserve further reflections. It is of interest that Borderline Disorders be considered a subtype of Emotional Disorders differentiating them from Impulsive type which agrees with clinic and neurobiological studies. They also think that incorporation of flexible quantitative cut off would be important to allow the clinician to ponder and value according to clinical evidences. They conclude that this chapter orders and propose clear and discriminative criteria for the Diagnosis of Personality Disorders and Adult Behavior.