Coherent states of the Laguerre-Gauss modes.

Large quantum photonic systems hold promise for surpassing classical computational limits, yet their state preparation remains a challenge. We propose an alternative approach to study multiparticle dynamics by mapping the excitation mode of these systems to physical properties of the Laguerre-Gauss modes. We construct coherent states establishing a direct link between excitation number dynamics and the evolution of the Laguerre-Gauss modes. This highlights the photon transverse spatial degree of freedom as a versatile platform for testing the fundamental aspects of quantum multiparticle systems.

Diagnostic, treatment, and follow-up of osteoporosis-position statement of the Latin American Federation of Endocrinology.

The Latin American Federation of Endocrinology position statement on osteoporosis was developed by endocrinologists from 9 countries. It encompasses the definition, diagnosis, treatment, and follow-up of the disease, the identification of barriers to healthcare, and proposals to improve the disease care in the region. INTRODUCTION: There is a gap in the understanding of osteoporosis in Latin America. The objective of this work is to state the position of the Latin American Federation of Endocrinology on osteoporosis care in postmenopausal women to better bridge this gap. METHODS: An experts' panel was formed comprising of 11 endocrinologists from 9 countries. A data search was conducted with a conceptual approach and data selection was based on the hierarchy of the EBHC pyramid. Unpublished data was considered for local epidemiological data and expert opinion for the identification of barriers to healthcare. An expert consensus based on the Delphi methodology was carried out. Experts were asked to respond on a 5-point Likert Scale to two provided answers to guiding questions. RESULTS: Consensus was agreed on the answer for the questions with the higher median on the Likert scale and synthetized on 16 statements covering the definition of osteoporosis, diagnostic approach, treatment options, and follow-up. Besides clinical topics, unmet needs in osteoporosis were identified in relation to local epidemiological data, barriers to treatment, and misclassification of programs within health systems. CONCLUSIONS: Through a process based on recognized methodological tools, FELAEN's position on osteoporosis was developed. This made it possible to state an optimum scenario for the care of the disease and helped to identify knowledge gaps. There is great variability in the approach to osteoporosis in Latin America and barriers in all the stages of healthcare persist.

Manejo terapéutico de aspergilosis invasiva en paciente trasplantado e isavuconazol como nueva alternativa antifúngica / Therapeutic management of invasive aspergillosis in a transplant patient and isavuconazole as a new antifungal alternative

Las infecciones oportunistas en pacientes sometidos a trasplante de órgano sólido (TOS) son una causa de morbimortalidad muy importante. Entre ellas las infecciones fúngicas, aunque menos frecuentes, destacan por su alta mortalidad. Una de las infecciones por hongos más usual es la ocasionada por Aspergillus. El tratamiento de elección de aspergilosis invasiva en un paciente con TOS es voriconazol.Presentamos el caso de un paciente inmunodeprimido tras trasplante renal con cuadro de sepsis grave de origen respiratorio en probable contexto de una aspergilosis invasiva. El interés del caso radica en la intervención farmacéutica en el complejo manejo farmacológico del paciente a lo largo de su estancia en la Unidad de Críticos y en la terapia antimicrobiana satisfactoria con isavuconazol, un nuevo antifúngico. (AU)

Opportunistic infections in patients undergoing solid organ transplantation (TOS) are a very important cause of morbidity and mortality. Among them, fungal infections, stand out for their higher mortality. One of the most frequent fungal infections is caused by Aspergillus. There are more than 150 species of Aspergillus, being Aspergillus fumigatus the most common agent of invasive fungal infections in human. Gold standard treatment for invasive aspergillosis in a patient with TOS is voriconazole.We present the case of a kidney transplanted and immunocompromised patient with severe sepsis of respiratory origin in context of invasive aspergillosis. Interest of this case lies on the multiple pharmaceutical interventions in the patient’s complex pharmacological management throughout his stay in the critics unit and satisfactory treat-ment with isavuconazole, a new antifungal. (AU)

Engineering SU(1, 1) ⊗ SU(1, 1) vibrational states.

We propose an ideal scheme for preparing vibrational SU(1, 1) ⊗ SU(1, 1) states in a two-dimensional ion trap using red and blue second sideband resolved driving of two orthogonal vibrational modes. Symmetric and asymmetric driving provide two regimes to realize quantum state engineering of the vibrational modes. In one regime, we show that time evolution synthesizes so-called SU(1, 1) Perelomov coherent states, that is separable squeezed states and their superposition too. The other regime allows engineering of lossless 50/50 SU(2) beam splitter states that are entangled states. These ideal dynamics are reversible, thus, the non-classical and entangled states produced by our schemes might be used as resources for interferometry.

Highly HLA Sensitized Kidney Transplant Patients in a Transplant Center.

INTRODUCTION: Approximately 10% to 30% of patients on renal transplant waiting lists are sensitized, which gives them more time on the waiting list. Transplantation in this setting has a greater risk of rejection and decreased graft survival. New strategies of donor allocation through virtual crossmatching and optimization of immunosuppressive therapies in induction and maintenance have allowed the allocation of organs for this population, which in other circumstances would not be chosen for a kidney transplant. OBJECTIVE: To describe the experience of renal transplantation in highly sensitized patients with a panel reactive antibody of >80% in a transplant center, through virtual crossmatching, discarding unacceptable antigens, and without desensitization treatment. METHODS: An observational, descriptive, retrospective case series study was conducted on highly sensitized kidney transplant patients with a panel reactive antibody of ≥80% from 2010 to 2016. RESULTS: A total of 10 highly sensitized transplant patients were identified. Six patients were women, all of whom had a history of pregnancy; all patients had undergone blood transfusions, and 40% had undergone a first transplant. Average time spent on dialysis was 148.5 months, and on the waiting list, 45.8 months. Average follow-up was 42 months (range, 10-84 months). The estimated glomerular filtration rate by the Chronic Kidney Disease Epidemiology Collaboration method at year 1 was 75 mL/min/1.73 m2 body surface. Nine patients at 1 year posttransplantation had graft and patient survivals of 100%, as did 5 patients at >3 years posttransplantation. CONCLUSIONS: Renal transplantation based on virtual crossmatching is a good alternative for highly sensitized patients.

The role of animal reservoirs in social-environmental landscapes: remarks on the control of avian influenza and preparedness for pandemics.

Influenza viruses are well known for their ability to infect and cause disease in a broad range of hosts. Modern advances in reverse genetics have enabled scientists to probe the mutations that allow influenza viruses to perform host switching. Despite this detailed understanding of the molecular modifications that allow host switching and adaptation, there is a gap in knowledge regarding the factors external to the virus and their interactions that act as triggers leading to a pandemic. Studies on the ecology of zoonotic pathogens should be the new paradigm for understanding not only influenza viruses but any other infectious disease that can be a threat to animal and human health. The literature regarding influenza pandemics and influenza virus reservoirs was reviewed to analyse how social and economic changes can influence the appearance of new outbreaks of influenza. In addition, the importance of new research in a dynamic environment driven by the expansion of human territories and animal production systems is highlighted. A new paradigm is proposed for novel research approaches to infectious diseases such as influenza.

Les virus influenza se caractérisent par le large spectre d'hôtes qu'ils sont capables d'infecter et chez lesquels ils provoquent des maladies. Les avancées récentes de la génétique inverse ont permis aux chercheurs de suivre les mutations qui favorisent le passage des virus influenza d'un hôte à l'autre. Bien que les modifications moléculaires à l'origine du passage viral d'une espèce hôte à l'autre et de l'adaptation des virus à de nouveaux hôtes soient désormais bien comprises, d'importantes lacunes subsistent concernant les facteurs extérieurs aux virus et les interactions qui déclenchent la survenue de pandémies. L'étude de l'écologie des agents zoonotiques devrait constituer un nouveau paradigme de la recherche et permettra de mieux comprendre non seulement les virus influenza mais aussi toute maladie infectieuse présentant un danger pour la santé animale et publique. Les auteurs ont étudié la littérature consacrée aux pandémies de grippe et aux réservoirs des virus influenza et analysé l'influence des changements socio-économiques sur la survenue de nouveaux foyers de grippe. Ils soulignent également l'importance de conduire de nouveaux travaux de recherche dans un environnement dynamique transformé par l'extension des territoires utilisés par l'homme ainsi que par les systèmes de production animale. Un nouveau paradigme est ainsi proposé, qui permettra d'élaborer une méthodologie de recherche inédite dans le domaine des maladies infectieuses telles que les grippes.

Es bien conocida la capacidad que tienen los virus de la influenza de infectar y causar enfermedades a un conjunto muy heterogéneo de organismos anfitriones. Valiéndose de los últimos avances de la genética inversa, los científicos han podido utilizar sondas génicas con las mutaciones que permiten a los virus de la influenza pasar de un anfitrión a otro. Pese al detallado conocimiento que se tiene de las modificaciones moleculares que hacen posible el cambio de anfitrión y las correspondientes adaptaciones, no se sabe gran cosa de los factores externos al virus y del modo en que estos factores interaccionan para ejercer de desencadenantes de una pandemia. Los estudios sobre la ecología de patógenos zoonóticos deben ser el nuevo paradigma para comprender no solo los virus de la influenza, sino también los de otras enfermedades infecciosas que puedan constituir una amenaza sanitaria o zoosanitaria. Los autores repasan la bibliografía existente sobre pandemias de influenza y reservorios de este virus con el fin de analizar la repercusión que pueden tener los cambios sociales y económicos en la aparición de nuevos brotes de influenza. Además, se detienen a recalcar la importancia de las nuevas investigaciones en un entorno dinámico, cuya fuerza motriz es la expansión de los territorios humanos y los sistemas de producción animal. Los autores proponen un nuevo paradigma a partir del cual investigar con planteamientos novedosos enfermedades infecciosas como la influenza.

Factores relacionados con la presencia de eventos adversos en la UCIN de un hospital de 3er nivel de atención / Factors related to the presence of adverse events in the NICU of a 3rd level hospital

En la actualidad, la seguridad en la atención de los pacientes es uno de los aspectos más importantes que requieren revisarse y desarrollarse para establecer un proceso efectivo de garantía de calidad en la atención del personal de salud. Para que la seguridad pueda establecerse como un valor necesario en el cuidado del personal de salud, es necesario conocer cuáles son las situaciones adversas que pueden presentarse cuando se realiza algún procedimiento, con el fin de evitar o controlar los factores que predisponen a los eventos adversos (EA) y que atentan contra la seguridad de los pacientes. Objetivo: Analizar la relación existente entre los factores intrínsecos, extrínsecos y del sistema relacionados con la presencia de los eventos adversos reportados por enfermería en la Unidad de Cuidados Intensivos a nivel Hospitalario. Material y Método: Se trata de un estudio de modalidad cuantitativo: con alcance correlacional no experimental, transversal, prolectivo.

At present, security in patient attention is one of the most importantaspects that need reviewed and developed to establish an effective quality assurance in health care staff. For that security can be established as a necessary value in the health care staff is necessary to identify adverse situations that may occur when performing a procedure, in order to avoid or control factors predisposing to adverse events (EA) and that threaten patient safety. Objective: To analyze the relationship between the intrinsic factors, extrinsic and system related to the presence of adverse events reported by nurses in the Intensive Care Unit at the Hospital. Material and Methods: This is a quantitative study mode: no correlation with experimental reach, cross prolective.

Motion estimation in cardiac fluorescence imaging with scale-space landmarks and optical flow: a comparative study.

Motion artifacts are a major disadvantage of cardiac optical mapping studies. Pixel misalignment due to contraction is a main cause of the presence of gross motion artifacts in action potential recordings. This study is focused on methods for identifying landmarks and tracking the motion of cardiac tissue for preparations in optical mapping recordings. This is a first step toward our long-term goal to implement a landmark-based image registration technique to correct for pixel misalignment in cardiac optical mapping fluorescence videos and, hence, for gross motion artifacts. Preliminary results for the registration step are presented as an initial proof of concept. The characteristics of the optical mapping images are challenging, since their lack of contrast and well-defined features impose a limitation on the techniques than can be used for landmark selection and motion tracking. This paper compares results of motion estimation of the cardiac surface with two approaches that do not rely on high-contrast features: 1) Scale-invariant feature transform (SIFT) detected "keypoints," to be used as landmarks for motion tracking, as well as 2) a classical global optical flow (OF) algorithm. Both are applied to low-contrast and low-resolution cardiac fluorescence images. We demonstrate that the performance of SIFT is superior to that of OF for pixel motion tracking in cardiac optical mapping images with simulated motion. Results for action potential recovery and action potential duration calculation after landmark-based image registration show that SIFT landmark-based registration yields superior performance in this regard as well.

Effects of soil organic matter content on cadmium toxicity in Eisenia fetida: implications for the use of biomarkers and standard toxicity tests.

Bioavailability is affected by soil physicochemical characteristics such as pH and organic matter (OM) content. In addition, OM constitutes the energy source of Eisenia fetida, a well established model species for soil toxicity assessment. The present work aimed at assessing the effects of changes in OM content on the toxicity of Cd in E. fetida through the measurement of neutral red uptake (NRU) and mortality, growth, and reproduction (Organisation for Economic Co-operation and Development [OECD] Nos. 207 and 222). Complementarily, metallothionein (MT) and catalase transcription levels were measured. To decrease variability inherent to natural soils, artificial soils (Organization for Economic Cooperation and Development 1984) with different OM content (6, 10, and 14%) and spiked with Cd solutions at increasing concentrations were used. Low OM in soil decreased soil ingestion and Cd bioaccumulation but also increased Cd toxicity causing lower NRU of coelomocytes, 100 % mortality, and stronger reproduction impairment, probably due to the lack of energy to maintain protection mechanisms (production of MT).Cd bioaccumulation did not reflect toxicity, and OM played a pivotal role in Cd toxicity. Thus, OM content should be taken into account when using E. fetida in in vivo exposures for soil health assessment.

Computer simulation of cardiac propagation: effects of fiber rotation, intramural conductivity, and optical mapping.

Cardiac propagation characteristics such as anisotropy ratio and conduction velocities are often determined experimentally from epicardial measurements. We hypothesize that these measurements have inaccuracies due to intramural fiber rotation and transmural electrotonic interactions. We also hypothesize that optical mapping (OM) recordings compound the error, due to contributions from deeper layers. In this study, we studied propagation in a three-dimensional computer model of a slab of tissue with varying thickness and a 120° fiber rotation. Simulation results were further processed to reconstruct OM signals. As expected, simulation results demonstrated that the direction of wave propagation on the epicardial surface is not aligned with the epicardial fiber orientation. This angle difference was most pronounced for thin tissue, and decreased with decreasing intramural conductivity and increasing tissue thickness. This difference also increased with time elapsed poststimulus, as the contribution from deeper layers increased. Observations were confirmed experimentally with OM measurements from isolated rat hearts. Simulations also predicted that OM causes an additional error in measurements due to activity in deeper layers being less aligned. Several alternative approaches for the estimation of fiber orientation and anisotropy ratio were evaluated. Those based on conduction velocity measurements yielded the most accurate estimates when applied to noise-free simulated data.

Accuracy of working length measurement: electronic apex locator versus cone-beam computed tomography.

AIM: To compare the accuracy of working length (WL) determination using the Raypex 6(®) electronic apex locator and cone-beam computed tomography (CBCT). METHODOLOGY: A total of 150 extracted human teeth were decoronated and randomly assigned to five groups (n = 30). WL was measured with the Raypex 6(®) at both the 'constriction' and the 'apex' marks under dry conditions (group 1) or with 2.5% NaOCl, distilled water or Ultracain(®) (groups 2-4). The radiological WL (group 5) was calculated from bucco-lingual and mesio-distal CBCT sections. Differences between electronic, CBCT measurements and actual length (AL) were calculated. Positive and negative values, respectively, indicate measurements falling short or long of AL. Two-way anova and the Bonferroni and Welch tests were used to compare mean differences amongst groups. The chi-squared and Fisher's exact tests were used to compare percentages of precise, ±0.5 and ±1.0 mm of the AL measurements amongst the experimental groups. Statistical analysis was performed at α = 0.05. RESULTS: Mean differences with respect to AL ranged from 0.26 to -0.36 mm and from 0.05 to 0.18 mm, respectively, for the electronic measurements at the 'constriction' mark and 'apex' mark. CBCT measurements were an average of 0.59 mm shorter than AL. Percentages of electronic measurements falling within ±0.5 mm of the corresponding AL referred to the 'apex' mark were greater than at the 'constriction' mark, but the differences were only significant in group 4 (with Ultracain(®) ). Percentages of CBCT measurements falling within ±0.5 mm of AL (46.7%) were significantly lower than electronic measurements, regardless of the condition of the root canal. In 30-38.5% of the measurements taken at the 'apex' mark and in 3.4-13.3% of those at the 'constriction' mark, the file tip extended beyond the foramen. CONCLUSIONS: Electronic measurements were more reliable than CBCT scans for WL determination. The Raypex 6(®) was more accurate in locating the major foramen than the apical constriction under the experimental set-up.

Fuentes de información bibliográfica (XIX). Pediatría basada en la evidencia y revistas secundarias / Sources of bibliographic information (XIX). Evidencebased paediatrics and secondary journals

El objetivo de las publicaciones secundarias es informar a los clínicos acerca de los avances más importantes alcanzados en medicina, cuyos resultados tengan la máxima probabilidad de ser verdaderos y útiles. Para ello, se seleccionan artículos publicados en revistas médicas primarias y se presentan en un formato de resumen estructurado, seguido de un comentario crítico realizado por expertos en la materia. Las revistas secundarias de interés en Pediatría son AAP GrandRounds, The PedsCCM Evidence-Based Journal, la sección «Current Best Evidence» de Journal of Pediatrics, la sección «Archimedes» de Archives of Disease in Childhood, y la sección «Atención Primaria Basada en la Evidencia» de Formación Médica Continuada, Revista Evidencia Actualización en la Práctica Ambulatoria y Evidencias en Pediatría. Analizamos con cierto detalle Evidencias en Pediatría, una revista secundaria pediátrica y en español, órgano oficial de la Asociación Española de Pediatría (AEP), y también avalada por la Asociación Latinoamericana de Pediatría (ALAPE)(AU)

The purpose of secondary publications is to alert clinicians to important advances in medicine whose results are most likely to be both true and useful. For this goal, they select from the biomedical literature the original and review artcles that are summarised in abstracts and commented by clinical experts. The most important secondary publications in pediatrics are AAP GrandRounds, PedsCCM Evidencie-Based Journal, the section of «Current Best Evidence» from the Journal of Pediatrics, the section of «Archimedes» from Archives Disease in Childhood, the section of «Atención Primaria Basada en la Evidencia» from Formación Médica Continuada, Revista Evidencia Actualización en la Práctica Ambulatoria y Evidencias en Pediatría. We review in detail Evidencias en Pediatría, a seconday publication in spanish from the Asociación Española de Pediatría (Spanish Association of Pediatrics) (AEP) and endorsed by the Asociación Latinoamericana de Pediatría (Latin American Association of Pediatrics) (ALAPE)(AU)

[Clinical management of patient with benign prostatic hyperplasia in Spain]. / Manejo asistencial del paciente con hiperplasia benigna de próstata en España.

OBJECTIVES: To identify clinical management of benign prostatic hyperplasia (BPH) in Spain and its associated health care resources. MATERIAL AND METHODS: A qualitative cross-sectional study was conducted through telephone interviews to general practitioners (GP) and urologists. Information about diagnosis, pharmacologic treatment and follow-up was collected. Results were clustered according to the key variables considered as drivers of clinical practice patterns: BPH diagnosis, severity classification, treatment initiation and follow up of patients. RESULTS: 153 GP and 154 urologists participated in the study. 7 different clinical patterns were identified in primary care (PC). Resource use during diagnosis is relatively homogeneous, reporting a range of 2.0 to 2.6 visits employed and being the most frequent test performed PSA and urine test. Follow-up is heterogeneous; frequency of follow-up visits oscillates from 3.2 to 7.0 visits/patient/year and type of tests performed is different among patterns and within the same pattern. In Urology, 3 clinical patterns were identified. Resource use is homogeneous in the diagnosis and in the follow-up; urologists employed 2 visits in diagnosis and a range of 2.1 to 3.2 visits/patient/year in the follow-up. The most frequent tests both in diagnosis and follow-up are PSA and digital test. CONCLUSIONS: BPH management shows variability in PC, identifying 7 different clinical practice patterns with different resource use during the follow-up among patterns and within the same pattern. The implementation of clinical guidelines could be justified to reduce heterogeneity.

En niños alérgicos con asma o rinitis, ¿es útil la inmunoterapia? / In allergic children with asthma or rhinitis, is immunotherapy useful?

Conclusiones de los autores del estudio: en niños y adolescentes con rinoconjuntivitis alérgica, la inmunoterapia no ha mostrado beneficio para disminuir los síntomas o la utilización de medicación. En el asma alérgica la inmunoterapia subcutánea parece reducir los síntomas y el uso de medicación, pero la evidencia es limitada en cuanto a la magnitud del efecto. Además, no está exenta de efectos secundarios. La inmunoterapia sublingual en dosis altas produce mejoría sintomática y disminuye el uso de medicación en niños con asma y alergia a polen de gramíneas. Comentario de los revisores: la prevalencia de las enfermedades alérgicas está aumentando, generando importante morbilidad. El tratamiento con inmunoterapia no ha demostrado su eficacia, ya que produce mejorías estadísticamente significativas pero clínicamente poco importantes y con riesgo de efectos secundarios. Por ello no debe generalizarse su uso, reservándolo solo para casos concretos evaluados detenidamente (AU)

Authors’ conclusions: There is at present insufficient evidence that immunotherapy in any administration form has a positive effect on symptoms and/or medication use in children and adolescents with allergic rhino conjunctivitis. In allergic asthma, the subcutaneous immunotherapy appears to reduce symptoms and use of medication but the evidence is limited concerning the size of benefit. It is not free of side effects. High dose sublingual immunotherapy produces symptomatic improvement and decreases the medication use in children with asthma and allergies to grass pollen. Reviewers’ commentary: The prevalence of allergic diseases is increasing, and its burden is substantial. The efficacy of the treatment with allergen-specific immunotherapy has not been demonstrated; although the improvement has statistical significance, the clinical relevance is poor, with an increased risk of adverse reactions. Due to that, the use of immunotherapy should not be generalised, reserving it for cases thoroughly evaluated (AU)

Dissolving efficacy of eucalyptus and orange oil, xylol and chloroform solvents on different root canal sealers.

AIM: To evaluate the solubility of five root canal sealers in orange oil, eucalyptol, xylol and chloroform solvents. METHODOLOGY: The solubility of RoekoSeal, Sealer 26, Epiphany, Endomethasone and EZ-Fill sealers was assessed in orange oil, eucalyptol, xylol, chloroform and distilled water. Seventy-five samples of root canal sealers were prepared and then divided into five groups for immersion in solvent for 2, 5 or 10 min. The means of loss weight were determined for each material in each solvent at all immersion periods, and the values were compared by factorial analysis of variance (anova) and SNK multiple comparisons. RESULTS: In the orange and eucalyptus oil groups, there was no significant difference among RoekoSeal, Sealer26, Epiphany and EZ-Fill at the three immersion periods (P > 0.05). With xylol, no significant differences were found at 5 and 10 min (P > 0.05) for each root sealer. Orange and eucalyptus oil solvents were as effective as chloroform at 2 min in dissolving all the root sealers. CONCLUSIONS: Xylol was the most effective solvent followed by the chloroform and the essential oils (eucalyptol and orange oil). Orange oil behaved in a similar way to eucalyptus oil.

Topographical evaluation of the major apical foramen in permanent human teeth.

AIM: To determine the distance from the anatomical root apex to the major apical foramen and the position of the major foramen on the root apex. METHODOLOGY: Crowns of 926 human teeth were sectioned at the cementum-enamel junction. Specimens were mounted on microscope slides for measurement parallel to the long axis of the teeth. The major foramen was identified as the largest-diameter opening at the root apex. A total of 1331 root specimens were evaluated using an optical stereomicroscope to an accuracy of 0.01 mm at 40 x (+/-10) magnification. The distance from the anatomical apex to the most apical point of the major foramen was measured, and its location (central, buccal, lingual, mesial and distal) was recorded. RESULTS: The mean distance between the major foramen and the anatomical root apex was 0.69 mm; the mean distance was larger in posterior teeth (0.82 mm) and smaller in anterior teeth (0.39 mm). A wide range of anatomical apex to major foramen distances were observed in all tooth groups: the greatest distance was in maxillary molars (0.95 mm) followed by mandibular pre-molars (0.87 mm) and mandibular molars (0.80 mm). The major foramen was at the tip of the root in 40% of teeth. The most frequent deviations of the foramen were to the buccal (20%) and distal (14%). CONCLUSION: In this sample of teeth without apical resorption the distance between the major foramen and the anatomical root apex was always <1 mm. Deviation of the major foramen from the anatomic apex varied widely amongst tooth groups.

¿Hay que tratar a los niños con talla baja idiopática con hormona de crecimiento? / Children with idiopathic short stature, have to be treated with growth hormone?

La talla baja idiopática (TBI), o talla baja sin causa definida es un diagnóstico de exclusión. Implica una respuesta normal a las pruebas de estimulación de la hormona del crecimiento (HC). En el año 2003, la FDA aprobó el uso de HC para el tratamiento de los niños con talla baja idiopática con una talla inferior a -2,25 desviaciones estándar y pronóstico de talla por debajo del rango normal. Existe un importante debate sobre los beneficios de tratar a niños bajitos, por otra parte sanos. En estudios realizados la ganancia de talla parece estar entre 3 y 7 cm, con una duración media del tratamiento (que implica inyecciones diarias) de 6 años. Además no se ha demostrado que los niños con TBI tengan problemas psicosociales, ni que el tratamiento con HC mejore la calidad de vida relacionada con la salud. Existe preocupación acerca de posibles efectos a largo plazo por la administración de dosis suprafisiologías de HC durante años, además del elevado coste. El fondo de la cuestión es si la TBI es una enfermedad o una variante de la normalidad y si el tratamiento con HC es una intervención médica o estética (AU)

Idiopathic short stature, or short stature of undefined cause, is a diagnosis of exclusion. Implicit in the diagnosis is a normal growth hormone responses to stimulation testing- In 2003, the FDA approved the use of recombinant growth hormone (GH) for treatment of idiopathic short stature, defined by height SDs < 2.25 and adult height prognosis bellow the normal range. Considerable debate exits about the benefits of therapy in otherwise healthy short children. Studies suggest that growth hormone therapy increases adult height between 3 and 6 cm, with a mean duration of therapy (regimen of daily injections) of about 6 years. In addition, the studies have failed to prove that children with short stature have psychosocial problems; moreover growth hormone therapy has not showed to improve quality of life. Concern exists about potentially long-term adverse effects with administration of supraphysiologic GH doses apart from its high cost. At the core of controversy is the question about whether short stature is a disease or a normal variant development and therefore whether growth hormone therapy is a therapeutic or a cosmetic intervention (AU)

[Poland syndrome: description of two patients in the same family]. / Síndrome de Poland: descripción de dos casos familiares.

Poland syndrome is a congenital condition that consists of the unilateral absence of the large pectoral muscle, ipsilateral sympbrachydactyly, and is occasionally associated with other malformations of the anterior chest wall and breast. The aetiology of Poland's syndrome is unknown, although it is believed to be caused by an interruption or reduction in the embryonic circulation during pregnancy, and the majority of reported cases are sporadic. Only in a few instances there is a familial incidence. We describe the occurrence of Poland's syndrome in two cousins and the malformation is mainly in the large pectoral muscle.

Síndrome de Poland: descripción de dos casos familiares / Poland syndrome: description of two patients in the same family

El síndrome de Poland es una alteración congénita consistente en la ausencia total o parcial del músculo pectoral mayor y anomalías de la mano homolateral. Se puede asociar con otras malformaciones pectorales, cervicales, intratorácicas e incluso braquiales. Se desconoce su causa exacta, pero parece corresponder a una alteración en la circulación embrionaria durante la gestación. La mayoría de los casos descritos son esporádicos. Sólo de forma excepcional se han comunicado casos familiares. Se presentan dos casos cuya peculiaridad es que son casos familiares (primos) y que su malformación afecta principalmente a los músculos pectorals (AU)

Poland syndrome is a congenital condition that consists of the unilateral absence of the large pectoral muscle, ipsilateral sympbrachydactyly, and is occasionally associated with other malformations of the anterior chest wall and breast. The aetiology of Poland's syndrome is unknown, although it is believed to be caused by an interruption or reduction in the embryonic circulation during pregnancy, and the majority of reported cases are sporadic. Only in a few instances there is a familial incidence. We describe the occurrence of Poland's syndrome in two cousins and the malformation is mainly in the large pectoral muscle (AU)