Estudio Costo-Efectividad de Lidocaína tópica como adyuvante a Pregabalina y Gabapentina en dolor neuropático periférico en una I.P.S de Bogotá 2011.

Introducción: el dolor neuropático es una patología de considerable prevalencia e impacto socio-económico en la población latinoamericana, la evidencia clínica sugiere que los ligandos de canales de calcio y el parche de Lidocaína pueden tratar exitosamente el dolor neuropático periférico y localizado. Metodología: se realizo una evaluación económica tipo costo-efectividad, observacional y retrospectiva con datos extraídos de las historias clínicas de pacientes atendidos en la clínica de dolor de la IPS. La variable primaria de efectividad fue la mejoría del dolor medida mediante escala visual análoga. Resultados: se estudiaron 94 pacientes tratados con: Gabapentina (G) 21, Pregabalina (P) 24, Gabapentina+ lidocaína (G/P) 24, Pregabalina + Lidocaína (P/L) 25, los costos asociados al tratamiento son los siguientes COP$114.070.835, COP$105.855.920, COP$88.717.481 COP$89.854.712 respectivamente, el número de pacientes con mejoría significativa de dolor fue: 8,10,9 y 21 pacientes respectivamente. El ICER de G/L con respecto a G fue: COP$ -25.353.354. El ICER de P/L con respecto a P fue: COP$ -1.454.655. Conclusiones: la adición del parche de lidocaína a la terapia regular con P/L represento una disminución de consumo de recursos en salud como uso de medicamentos co-analgésicos, analgésicos de rescate y fármacos para controlar reacciones adversas, de la misma forma que consultas a profesionales de la salud. Cada paciente manejado con P/L representa un ahorro de COP $1.454.655 al contrario si se manejase con el anticonvulsivante de manera exclusiva, en el caso de G/L este ahorro es de COP $ 25.353.354 frente a G sola.

Asociación entre relaciones románticas y la calidad de sueño percibida por jóvenes universitarios

Introducción: Uno de los aspectos con mayor variación durante la adolescencia es el sueño, el cual se ve afectado por factores biológicos así como por los estados afectivos y emocionales. En esta etapa, los individuos establecen sus primeras relaciones sentimentales románticas, vínculos esenciales para la maduración de las relaciones sociales y psicosexuales. Este trabajo busca determinar la asociación existente entre las relaciones sentimentales románticas y sus características, con la calidad sueño percibida por los jóvenes. Metodología: Estudio realizado en una población de 1794 estudiantes de ciencias de la salud entre los 18 y 25 años de edad en Bogotá, Colombia, entre 2012 y 2013. Se obtuvo una muestra probabilística con asignación proporcional de 443 sujetos, estratificada por programa académico y sexo. Utilizando dos cuestionarios de auto reporte se exploraron las características de las relaciones sentimentales y la calidad de sueño percibida. Resultados: El 64% (IC 95%: 59,4-68,9%) de la población estudiada se encontró en una relación sentimental romántica. Estos sujetos tuvieron latencias de sueño prolongadas con menor frecuencia que quienes no tenían en una relación (p <0,05). La calidad de sueño percibida se asoció al nivel de satisfacción que tuvieron los sujetos en su relación, así como la atracción por su pareja. Rasgos obsesivos, ansiosos, temerosos y evitativos en la relación disminuyeron la calidad de sueño percibida. Conclusión: Las relaciones sentimentales románticas y sus características se asocian con la calidad de sueño percibida por los individuos. Se requieren estudios que determinen causalidad en esta asociación y definan potenciales estrategias de intervención al respecto.

Experiencia en nefrectomía: serie de casos de cuatro años

Introducción: Las indicaciones por las cuales un paciente requiere una nefrectomía son múltiples: las neoplasias, la hidronefrosis y la exclusión funcional son las principales. En manos expertas la nefrectomía es un procedimiento seguro, especialmente porque en la actualidad el abordaje por excelencia es realizar una técnica mínimamente invasiva con conservación de nefronas. Se presenta el análisis de la experiencia en Mederi, Hospital Universitario Mayor en esta intervención. Metodología: Se realizó una serie de casos de pacientes llevados a nefrectomía entre mayo de 2008 y mayo de 2012. Se incluyeron la totalidad de los casos. Resultados: Se analizaron 72 registros, 49 mujeres y 25 hombres; 13 de ellas fueron laparoscópicas. La edad promedio fue de 58,6 años. El tiempo medio operatorio fue 169,23 minutos (118-220 minutos). El sangrado operatorio promedio fue de 680,63 ml (IC95%: 2,83-1358 ml). El tiempo de hospitalización promedio fue de 4,88 días IC95%. La mayoría de los pacientes se distribuyeron en estadios medios de la enfermedad tumoral, con poco compromiso ganglionar y metástasis; el diagnóstico histológico y estadio dominante fueron el carcinoma de células renales grado 3 de Fuhrman respectivamente. Se reportan 13 casos de compromiso de la capsula de Gerota y 11 con compromiso del hilio. Discusión: La experiencia en nefrectomía de la institución es muy positiva por el bajo número de mortalidad y complicaciones. En cuanto a la técnica, es importante promover la técnica laparoscópica

Equilibrium studies on mixed ligand complex formation of Co(II), Ni(II), Cu(II) and Zn(II) with N-(2-hydroxybenzyl)-L-histidine (H(2)hb-L-his) and typical N,N donor ligands: Crystal structure of [Ni(hb-L-his)(bipyridine)]center dot H2O complex

Equilibrium study on complex formation of Co(II), Ni(II), Cu(II) and Zn(II), hereafter M(II), with the quadridentate (O-, N, O-, N) donor ligand, N-(2-hydroxybenzyl)-L-histidine (H(2)hb-L-his, hereafter H2L), in the absence and in the presence of typical (N, N) donor bidentate ligands, 1,10 phenanthroline(phen), 2, 2'-bipyridine(bipy), ethylenediamine(en), hereafter B, in aqueous solution at 25 +/- 1 degrees C was done at a fixed ionic strength, I = 0.1 mol dm(-3) (NaNO3) by combined pH-metric, UV-Vis and EPR measurements provide evidence for the formation of mononuclear and dinuclear binary and mixed ligand complexes of the types: M(L), M(L)(2)(2-), M-2(L)(2+), M-2(H-1L)(+), M(L)(B), (B)M(H-1L)M(B)(+). The imidazole moiety of the ligand is found to act as a bridging bidentate ligand in the dinuclear M-2(L)(2+), M-2(H-1L)(+) and (B)M(H-1L)M(B)(+) complexes, using its N-3 atom and N1-H deprotonated moiety. Stability constants of the complexes provide evidence of discrimination of Cu(II) from the other M(II) ions by this ligand. Solid complexes: [Ni(L)(H2O)(2)] (1), [Cu(L)(H2O)] (2), and [Ni(L)(bipy)] (.) H2O (3) have been isolated and characterized by various physicochemical studies. Single crystal X-ray diffraction of the ternary complex, 3, shows an octahedral [(O-,N,N,O-)(N,N)] geometry with extensive pi-pi stacking of the aromatic rings and H-bonding with imidazole (N1-H), secondary amino N-atom, the lattice H2O molecule, and the carboxylate and phenolate O-atoms. (c) 2006 Elsevier B.V. All rights reserved.

Clinical Viability of Immediate Loading of Dental Implants: Part I-Factors for Success

Two-stage procedure for dental implants presents corroborated clinical success over 40 years. The evolution of surgical techniques, development of diagnostic methods, knowledge about tissue biology, and quality of implants regarding design and surface supported studies with I surgical stage followed by immediate prosthesis placement. However, several factors influence the treatment success with immediate loading. SO, this Study aimed to evaluate some factors regarding the success and characteristics of implants and patients.

Influence of Ridge Inclination and Implant Localization on the Association of Mandibular Kennedy Class I Removable Partial Denture

The aim of this study was to evaluate the tendency of displacement of the supporting structures of the distal extension removable partial denture (DERPD) associated to the implant with different inclinations of alveolar ridge and implant localizations through a two-dimensional finite-element method. Sixteen mandibular models were fabricated, presenting horizontal, distally descending, distally ascending, or descending-ascending ridges. All models presented the left canine and were rehabilitated with conventional DERPD or implant-retained prosthesis with the ERA system. The models were obtained by the AutoCAD software and transferred to the finite-element software ANSYS 9.0 for analysis. A force of 50 N was applied on the cusp tips of the teeth, with 5 points of loading of 10 N. The results were visualized by displacement maps. For all ridge inclinations, the assembly of the DERPD with distal plate retained by an anterior implant exhibited the lowest requisition of the supporting structures. The highest tendency of displacement occurred in the model with distally ascending ridge with incisal rest. It was concluded that the association of the implant decreased the displacement of the DERPD, and the anterior positioning of the implant associated to the DERPD with the distal plate preserved the supporting structures for all ridges.

Influence of Implant Inclination Associated With Mandibular Class I Removable Partial Denture

The aim of this study was to use two-dimensional finite element method to evaluate the displacement and stress distribution transmitted by a distal extension removable partial denture (DERPD) associated with an implant placed at different inclinations (0, 5, 15, and 30 degrees) in the second molar region of the edentulous mandible ridge. Six hemimandibular models were created: model A, only with the presence of the natural tooth 33; model B, similar to model A, with the presence of a conventional DERPD replacing the missing teeth; model C, similar to the previous model, with a straight implant (0 degrees) in the distal region of the ridge, under the denture base; model D, similar to model C, with the implant angled at 5 degrees in the mesial direction; model E, similar to model C, with the implant angled at 15 degrees in the mesial direction; and model F, similar to ME, with the implant angled at 30 degrees in the mesial direction. The models were created with the use of the AutoCAD 2000 program (Autodesk, Inc, San Rafael, CA) and processed for finite element analysis by the ANSYS 8.0 program (Swanson Analysis Systems, Houston, PA). The force applied was vertical of 50 N on each cusp tip. The results showed that the introduction of the RPD overloaded the supporting structures of the RPD and that the introduction of the implant helped to relieve the stresses of the mucosa alveolar, cortical bone, and trabecular bone. The best stress distribution occurred in model D with the implant angled at 5 degrees. The use of an implant as a support decreased the displacement of alveolar mucosa for all inclinations simulated. The stress distribution transmitted by the DERPD to the supporting structures was improved by the use of straight or slightly inclined implants. According to the displacement analysis and von Mises stress, it could be expected that straight or slightly inclined implants do not represent biomechanical risks to use.

Evaluation of Bone Insertion Level of Support Teeth in Class I Mandibular Removable Partial Denture Associated With an Osseointegrated Implant: A Study Using Finite Element Analysis

Purpose: This study evaluated the influence of distal extension removable partial denture associated with implant in cases of different bone level of abutment tooth, using 2D finite element analysis.Materials and Methods: Eight hemiarch models were simulated: model A-presenting tooth 33 and distal extension removable partial denture replacing others teeth, using distal rest connection and no bone lost; model B-similar to model A but presenting distal guide plate connection; model C-similar to model A but presenting osseointegrated implant with ERA retention system associated under prosthetic base; model D-similar to model B but presenting osseointegrated implant as described in model C; models E, F, G, and H were similar to models A, B, C, and D but presenting reduced periodontal support around tooth 33. Using ANSYS 9.0 software, the models were loaded vertically with 50 N on each cusp tip. For results, von Mises Stress Maps were plotted.Results: Maximum stress value was encountered in model G (201.023 MPa). Stress distribution was concentrated on implant and retention system. The implant/removable partial denture association decreases stress levels on alveolar mucosa for all models.Conclusions: Use of implant and ERA system decreased stress concentrations on supporting structures in all models. Use of distal guide plate decreased stress levels on abutment tooth and cortical and trabecular bone. Tooth apex of models with reduced periodontal support presented increased stress when using distal rest. (Implant Dent 2011;20:192-201)

Incidence of Maxillary Sinusitis Following Le Fort I Osteotomy: Clinical, Radiographic, and Endoscopic Study

Purpose: The correction of maxillomandibular deformities may require maxillary osteotomy procedures that usually present low rates of postoperative complications, such as maxillary sinusitis. The present study evaluated the incidence of maxillary sinusitis after Le Fort I osteotomy in 21 adult patients who underwent maxillary surgery (Le Fort I osteotomy) or bimaxillary surgery (Le Fort I osteotomy plus sagittal mandibular osteotomies) for correction of dentofacial deformities.Patients and Methods: Verification of the presence of maxillary sinusitis was assessed through a brief questionnaire, x-rays (Waters views), and nasal endoscopy before surgery and 6 to 8 months after surgery.Results: Analysis of results showed an incidence of 4.76% of maxillary sinusitis as a postoperative complication in the studied population.Conclusion: Symptomatic patients with a positive radiographic finding or an increased risk for postoperative sinusitis will benefit from endoscopic evaluation to aid in treatment planning and follow-up. 0 2011 American Association of Oral and Maxillofacial Surgeons J Oral Maxillofac Surg 69:346351, 2011

The identification of beta-thalassemia mutants in Brazilians with high Hb F levels

As hemoglobinopatias são um grupo de afecções genéticas que representam problema de saúde pública em muitos países em que sua incidência é alta, com significativa morbidade. Objetivamos identificar defeitos moleculares que pudessem explicar o perfil laboratorial obtido por eletroforese e HPLC com Hb F elevada, em um grupo de indivíduos adultos sem sinais ou sintomas de anemia. Encontramos cinco diferentes mutações que originam beta talassemia por PCR-ASO: três casos com CD 6 (-A), um CD 39, um IVS 1-5, um -87 todas de origem mediterrânea, e um IVS II-654 de origem asiática. As mutações CD 6 (-A), -87 e IVS II-654 foram descritas pela primeira vez na população brasileira.

Study of alternative schemes for the parameterization step of the continuation power flow method based on physical parameters, part I: Mathematical modeling

The conventional power flow method is considered to be inadequate to obtain the maximum loading point because of the singularity of Jacobian matrix. Continuation methods are efficient tools for solving this kind of problem since different parameterization schemes can be used to avoid such ill-conditioning problems. This paper presents the details of new schemes for the parameterization step of the continuation power flow method. The new parameterization options are based on physical parameters, namely, the total power losses (real and reactive), the power at the slack bus (real or reactive), the reactive power at generation buses, and transmission line power losses (real and reactive). The simulation results obtained with the new approach for the IEEE test systems (14, 30, 57, and 118 buses) are presented and discussed in the companion paper. The results show that the characteristics of the conventional method are not only preserved but also improved.

Influence of δβ-thalassemia or regulatory elements in individuals with increased fetal Hb levels in the São Paulo northwest population

Fetal hemoglobin (Hb F), formed by two alpha globin chains (α) and two gamma chains (γ) (α2 γ2), has reduced expression in adults, ranging from 0 to 1% of total hemoglobin. Increased levels of Hb F are due to mutations in the β-globin family, which cause hereditary persistence of fetal hemoglobin (HPFH) and delta-beta thalassemia (δβ-thalassemia).The control of the production takes place by the regulatory region and regions outside the β-globin family, among them 2q16, 6q23, 8q, and Xp22.2.The aims of this study were to determine the presence and frequency of two mutations for δβ-thalassemia, the XmnI polymorphism and β-globin haplotypes in healthy individuals with increased Hb F in the State of São Paulo. We analyzed 60 samples of peripheral blood of healthy adults, without complaints of anemia. The samples were separated into two groups according to Hb F level: group I - 34 samples with Hb F ranging from 2 to 15% and group II - 26 samples with Hb F over 15%. In relation to the polymorphisms examined, we found three heterozygous individuals (5%) for Spanish δβ-thalassemia, belonging to group I, whose Hb F levels were within the normal range.The Sicilian δβ-thalassemia mutation was not found, indicating the need to study other polymorphisms related to the increase of Hb F in adult life.The frequency of XmnI polymorphism was 33.3% and the mean Hb F levels were 15.48 ± 11.69%.The frequency observed in our study for this polymorphic site is higher than that found in the literature for healthy subjects.This polymorphism was more prevalent in individuals with Hb F levels below 15%. For four samples positive for this polymorphism, the Hb F levels were explained by the presence of HPFH and Spanish δβ-thalassemia mutations, so that the presence of the XmnI polymorphic site was not a determinant in the overexpression of γ-globin genes. Regarding β-globin haplotypes, 18 alleles and 27 distinct genotypic patterns were found.The pattern Atp1/Atp2 was the mostfrequent genotype (13.72%).Of the 18 alleles, 13 showed atypical patterns.The results show that the haplotype V was the most frequent (27.45%), followed by atypical Atp2 (13.72%) and Atp1 (11.76%), and that there was a higher correlation with the presence of HPFH and XmnI polymorphism.The high frequency of haplotype V in our samples and high frequency of atypical haplotypes may reflect a high rate of miscegenation in this population, suggesting an ethnic characteristic for the Brazilian population, requiring the evaluation of population genetic markers to corroborate this hypothesis. © FUNPEC-RP.

APPROXIMATE CALCULATION OF SUMS I: BOUNDS FOR THE ZEROS OF GRAM POLYNOMIALS

Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)