Abstract Background: Premature loss of deciduous teeth is the exfoliation or extraction before physiological replacement with < 50% or < 75% of the root of the substitute tooth formed or if there is > 1 mm of alveolar bone covering the permanent successor tooth organ. This study aimed to estimate the prevalence of premature tooth loss in children and identify associated factors in a health center in Acapulco, Guerrero. Methods: We conducted a cross-sectional study in which we collected information from 109 clinical records of children examined from January 2019 to August 2021. Sociodemographic data of the children and parents were collected: socioeconomic level, non-pathological personal history, and the history of premature deciduous tooth loss. Multivariate analysis to identify factors associated with premature deciduous tooth loss was performed with CIETmap statistical software. Odds ratio (OR) and 95% confidence interval (CI) were calculated to estimate the strength of the association. Results: The prevalence of premature loss of primary teeth was 40% (43/109). The leading cause was caries (84%, 36/43). The tooth organ with the highest loss occurrence was the lower right second molar (33%, 14/43). Gender was identified as an associated factor, with males having a higher risk of loss (ORa = 2.97; CI95% = 1.33-6.65). Conclusions: Our results were similar to those reported in other studies. Strategies aimed at health promotion directed at parents and children should be reinforced.

Resumen Introducción: Se considera como pérdida prematura de dientes deciduos a la exfoliación o extracción antes del recambio fisiológico con < 50% o < 75% de la raíz del diente sustituto formado, o si existe > 1 mm de hueso alveolar cubriendo al órgano dentario sucesor permanente. El objetivo de este trabajo fue estimar la prevalencia de pérdida prematura dental en niños e identificar factores asociados en un centro de salud de Acapulco, Guerrero. Métodos: Se llevó a cabo un estudio transversal en el que se recopiló información de 109 expedientes clínicos de niños atendidos de enero de 2019 a agosto de 2021. Se recolectaron datos sociodemográficos de los niños y los padres: nivel socioeconómico, antecedentes personales no patológicos y el antecedente de la pérdida prematura del diente deciduo. Se realizó un análisis multivariado para identificar factores asociados con la pérdida prematura de dientes deciduos con el software estadístico CIETmap. Se calcularon la razón de momios (OR) y el intervalo de confianza (IC) del 95% para estimar el grado de la asociación. Resultados: La prevalencia de pérdida prematura de dientes primarios fue del 40% (43/109). La principal causa fue por caries (84%, 36/43). El órgano dentario con más ocurrencia de pérdida fue el segundo molar inferior derecho (33%, 14/43). Se identificó el sexo como factor asociado, y se observó que el sexo masculino presenta mayor riesgo de pérdida (ORa = 2.97; IC95% = 1.33-6.65). Conclusiones: Nuestros resultados fueron similares a lo reportado en otros estudios. Deben reforzarse las estrategias de promoción de la salud dirigidas a los padres de familia y a sus hijos.

Abstract Introduction: In high-volume trauma centers, especially in developing countries, penetrating cardiac box injuries are frequent. Although many aspects of penetrating chest injuries have been well established, video-assisted thoracoscopy is still finding its place in cardiac box trauma and algorithmic approaches are still lacking. The purpose of this manuscript is to provide a streamlined recommendation for penetrating cardiac box injury in stable patients. Methods: Literature review was carried out using PubMed/MEDLINE and Google Scholar databases to identify articles describing the characteristics and concepts of penetrating cardiac box trauma, including the characteristics of tamponade, cardiac ultrasound, indications and techniques of pericardial windows and, especially, the role of video-assisted thoracoscopy in stable patients. Results: Penetrating cardiac box injuries, whether by stab or gunshot wounds, require rapid surgical consultation. Unstable patients require immediate open surgery, however, determining which stable patients should be taken to thoracoscopic surgery is still controversial. Here, the classification of penetrating cardiac box injury used in Colombia is detailed, as well as the algorithmic approach to these types of trauma. Conclusion: Although open surgery is mandatory in unstable patients with penetrating cardiac box injuries, a more conservative and minimally invasive approach may be undertaken in stable patients. As rapid decision-making is critical in the trauma bay, surgeons working in high-volume trauma centers should expose themselves to thoracoscopy and always consider this possibility in the setting of penetrating cardiac box injuries in stable patients, always in the context of an experienced trauma team. Introduction highvolume high volume countries frequent established videoassisted video assisted lacking Methods PubMedMEDLINE PubMed MEDLINE tamponade ultrasound Results wounds consultation however controversial Here detailed Conclusion decisionmaking decision making bay team

ABSTRACT The aim of this study was to determine the phylogenetic groups of Escherichia coli isolated from alpacas with diarrhoea. The presence of E. coli was determined in 150 samples of diarrheal faeces collected from young alpacas from the central highlands of Peru, and the distribution of phylogenetic groups was determined by the Clermont method. E. coli was present in 79.3% (119/150) of animals with diarrhoea. The strains were classified into phylogenetic groups A, B1, B2 and D, which showed a frequency of 13.5% (16/119), 65.5% (78/119), 1.68% (2/119) and 19.33% (11/23), respectively. Moreover, 21% (25/119) of isolated strains of E. coli belonged to phylogenetic groups B2 and D, mainly extraintestinal pathogenic strains, and 79% (94/119) to groups B1 and A, which are mainly commensal strains.

RESUMEN El objetivo del presente estudio fue la determinación de grupos filogenéticos de Escherichia coli obtenidos de alpacas con diarrea. Se determinó la presencia de E. coli en 150 muestras de heces diarreicas recolectadas de crías de alpaca de la sierra central del Perú, y se determinó la distribución de los grupos filogenéticos mediante el método de Clermont. E. coli estuvo presente en el 79.3% (119/150) de los animales con diarrea, pudiendo clasificarse en los grupos filogenéticos A, B1, B2 y D, los cuales mostraron una frecuencia de 13.5% (16/119), 65.5% (78/119), 1.68% (2/119) y 19.33% (23/119), respectivamente. El 21% (25/119) de cepas aisladas de E. coli pertenecen a los grupos filogenéticos B2 y D, principalmente cepas patógenas extraintestinales, y el 79% (94/119) a los grupos B1 y A, que son principalmente cepas comensales.

ABSTRACT Objective: to provide evidence based clinical recommendations for the diagnosis and therapy of the acute stage of ischemic cerebrovascular accident in EsSalud. Materials and methods : a group for producing the guideline was conveyed, including specialized physicians and methodologists. The group prepared 8 clinical questions to be answered by the guideline. Systematic searches of previous reviews were performed, and - when it was deemed necessary - primary studies in Medline and the Cochrane Controlled Registry of Trials for 2018 were reviewed. Evidence was selected aiming to respond each one of the proposed clinical questions. Certainty of the evidence was determined using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) methodology. In periodic work sessions, the group used GRADE methodology for reviewing the evidence and generated recommendations, good clinical practice items, and designed flow charts for both diagnosis and therapy. Finally, the guide was approved with the decree N° 128-IETSI-ESSALUD-2019. Results : this clinical practice guideline focused in 8 clinical questions, which were divided into four topics: screening, diagnosis, therapy, support and rehabilitation. On the basis of these questions, 28 recommendations were formulated (8 strong and 20 conditional), 38 items for good clinical practice, 1 implementation note, and 2 flow charts. Conclusion : this paper summarizes both evidence based methodology and conclusions from a new clinical practice guide for diagnosis and therapy of the acute stage of a cerebrovascular accident in EsSalud.

RESUMEN Objetivo: proveer recomendaciones clínicas basadas en evidencia para el diagnóstico y tratamiento de la etapa aguda del ataque cerebrovascular isquémico en EsSalud. Materiales y métodos: se conformó un grupo elaborador de la guía (GEG) que incluyó médicos especialistas y metodólogos. El GEG formuló 8 preguntas clínicas a ser respondidas por la presente GPC. Se realizó búsquedas sistemáticas de revisiones sistemáticas y -cuando fue considerado pertinente- estudios primarios en Medline y Cochrane Controlled Register of Trials durante el 2018. Se seleccionó la evidencia para responder cada una de las preguntas clínicas planteadas. La certeza de la evidencia fue evaluada usando la metodología Grading of Recommendations Assessment, Development, and Evaluation (GRADE). En reuniones de trabajo periódicas, el GEG usó la metodología GRADE para revisar la evidencia y formular las recomendaciones, los puntos de buenas prácticas clínicas y el flujograma de diagnóstico y tratamiento. Finalmente, la GPC fue aprobada con Resolución N° 128-IETSI-ESSALUD-2019. Resultados: la presente GPC abordó 8 preguntas clínicas, divididas en cuatro temas: tamizaje, diagnóstico, tratamiento, soporte y rehabilitación. En base a estas preguntas se formularon 28 recomendaciones (8 fuertes y 20 condicionales), 38 puntos de buena práctica clínica, 1 nota de implementación y 2 flujogramas. Conclusión: el presente artículo resume la metodología y las conclusiones basadas en evidencias de la GPC para el diagnóstico y tratamiento de la etapa aguda del ataque cerebrovascular isquémico en EsSalud.

Abstract This study describes the histological characteristics and distribution of gastrointestinal tract endocrine cells (ECs) of Prochilodus lineatus (detritivorous fish) using immunohistochemical procedures. The digestive tract of P. lineatus was divided into seven portions: stomach (cardial and pyloric), pyloric caeca, and intestine (anterior, glandular, middle and posterior). A pool of specific antisera against cholecystokinin (CCK-8), -neuropeptide Y (NPY), -ghrelin (Ghre) and -leu-enkephalin (Leu-ENK) to identify ECs were used. According to the morphological characteristics of ECs, two different types were identified and classified as open or closed-type. The number of ECs varied throughout the gastrointestinal tract, though a high abundance was found in the anterior intestine and pyloric caeca. A large number of ECs immunoreactive to CCK-8 and NPY were recorded in the anterior, glandular and middle intestine. ECs immunopositive to Leu-ENK were distributed in the stomach and pyloric caeca. For Ghre, immunopositive ECs were restricted to the glandular intestine. The results of the present study indicate that P. lineatus presents an ECs distribution pattern with species-specific particularities. However, CCK showed a distribution similar to that of omnivores, which is possibly related to local signaling functions in order to achieve the correct digestion of the various organisms found in the detritus.

Abstract This research was implemented in the Colombian Amazon forest area; to assess the effect of Tween-80® surfactant in the degradation of the Total Petroleum Hydrocarbons (TPH) in bioremediation treatments under aerobic conditions in the laboratory and pilot-scale. One control treatment, Natural Attenuation (AT) and four biostimulation treatments with leonardite with four different dosages of Tween-80® were proposed. The efficacy of organic stimulators and nonionic surfactant in soil microbiota was studied at laboratory and pilot scales, the latter in a passive aeration reactor. The test that presented a better performance was carried out with a Convective Flow Reactor (CFR) at pilot-scale. The results showed that bioremediation strategies improved the natural degradation process; the best outcomes were obtained in a treatment that includes Leonardite and Tween-80® (1.5 g/L) with 52% TPH degradation in 80 days (d).Tween-80® produced an effect in TPH solubility, and increased the production of CO2 in distinctive bioremediation treatments in both periods. The kinetics of CO2 production showed that the system required a periodic addition of a co-substrate as well as an increase of soil microbiota through the addition of compost (pilot scale). In this stage more than 76% of contaminant was degraded in 60d.

Abstract Background: The aim of the present study was to evaluate the isolation of extended spectrum beta-lactamase (ESBL)-producing Escherichia coli (E. coli) strains in patients with urinary tract infections. Materials and methods: A retrospective study was conducted on patients seen at the Departamento de Salud de Castellón, Spain, within the time frame of January 2012 to December 2016, whose urine cultures were positive for E. coli. The following variables were analyzed: age, sex, type of patient (outpatient or hospitalized), and risk factors. The prevalence of ESBL-producing E. coli was determined through a descriptive analysis. The statistical analysis was carried out utilizing the SPSS 18.0 program. The quantitative variables were analyzed using the Student’s t test and the qualitative variables with the chi-square test. Results: A total of 11,740 cultures were obtained that were positive for E. coli and 446 (3.79%) of them had the ESBL-producing E. coli strains. The percentage per year of ESBL-producing E. coli infection ranged from 1.7% to 6.5%, showing an increasing trend in the isolation of the resistant strains in more recent years. Mean patient age was 68.9 years, and there were no differences between the sexes. A total of 350 cultures corresponded to outpatients (78.7%), 70.5% of whom were women. The risk factors most associated with ESBL were: having presented with a urinary tract infection (UTI) within the past year and having received antibiotic treatment within the previous 3 months. Fifty percent of the patients that had received an antibiotic had been given a beta-lactam. Conclusions: The isolation of ESBL-producing E. coli strains was similar to that found in other case series. There was an increase in the prevalence of those difficult-to-treat infections. The majority of the patients were outpatients, had previously been treated with antibiotics, and presented with recurrent UTIs.

Resumen Introducción: El objetivo de este estudio es evaluar el aislamiento de cepas Escherichia coli (E. coli) resistentes a las betalactamasas (ECRB) en pacientes con infección del tracto urinario. Material y método: Se realiza un estudio retrospectivo entre enero 2012 y diciembre de 2016. Se incluyeron pacientes con cultivos de orina positivos para E. coli en el Departamento de Salud de Castellón, España. Se analizaron las siguientes variables: edad, sexo, procedencia del paciente (medio ambulatorio u hospitalario) y factores de riesgo. Se analizó la prevalencia de ECRB mediante un análisis descriptivo. Se utilizó el programa SPSS 18.0 para el análisis estadístico, en el caso de las variables cuantitativas se utilizó la prueba t de student y para las variables cualitativas se usó la prueba de chi-cuadrada. Resultados: Se obtuvieron 11,740 cultivos positivos para E. coli, de estos 446 (3.79%) fueron ECRB. El porcentaje por año de ECRB fue entre un 1.7% y un 6.5% evidenciando una tendencia a el aumento de aislamiento de cepas resistentes en los últimos años. La edad media fue 68,9 años, sin diferencias entre sexos. Un total de 350 cultivos procedían de pacientes ambulatorios (78.7%), 70.5 % de ello correspondían a mujeres. Los factores de riesgo más asociados a ECBR fueron presentar infección de tracto urinario (ITU) el último año y haber recibido tratamiento antibiótico en los tres meses previos, de estos 50% recibió un betalactámico. Conclusiones: El aislamiento de ECRB es similar a otras series observando un aumento en la prevalencia de estas infecciones de difícil tratamiento. La mayoría de pacientes fueron procedentes de medio ambulatorio, tratados previamente con antibióticos y con episodios de ITU recurrentes.

Objective To investigate the state of sexual and reproductive health in students at a public university in the Colombian Caribbean, with an emphasis on sexually transmitted diseases (STDs), fertility, sexuality, pregnancy and violence. Methods Cross-sectional survey study. University students, enrolled in the second semester of 2010 and who completed a self-administered survey based on the Reproductive Health survey of the Pan American Health Organization, were selected. Qualitative data was tabulated and graphed using measures of central tendency for quantitative variables. Results The age of population studied was around 20 years old, came from the urban area (57.9 %; IC95 %=54.7-61.1), was predominantly heterosexual (89.7 %), with an age of initiation of sexual activity of less than 18 years old, 11.8 % promiscuity, mainly using the condom as a Family Planning Method (FPM) (55 %). Although they had prior information on sexual health, STDs and FPMs, they did not behave according to this due to low education about HIV transmission routes, low incidence of serological tests for STDs, and high risk behavior (sex/alcohol/drugs). It was observed that 12.3 % had a history of pregnancy, physical violence (21.6 %) and sexual violence (4.6 %) with a predominant silence from the victims of sexual abuse (61.8 %). Conclusion The sample reflects the student population in this region of Colombia. We plan to organize a health program with medical and psychological support to reduce the rates of STDs and unplanned pregnancies, preparing the adolescent for this important step in their life and serving as a model for other Latin American universities.

Objetivo Investigar en una universidad estatal del Caribe colombianoel estado de la salud sexual y reproductiva especialmente conocimientos sobre Enfermedades de Transmisión Sexual (ETS), fertilidad, sexualidad, embarazo y violencia. Métodos Estudio transversal tipo encuesta. Se seleccionaron estudiantes matriculados en el segundo período de 2010 que llenaron voluntariamente la encuesta. Los datos cualitativos fueron tabulados y graficados usando medidas de tendencia central para variables cuantitativas. Resultados La población tenía alrededor de 20 años de edad, provenía de la zona urbana (57,9%; IC95%=54,7-61,1), predominantemente heterosexual (89,7%) con edad de inicio de vida sexual antes de los 18 años, con 11,8 % de promiscuidad que usaba principalmente el preservativo como Método de Planificación Familiar (MPF) (55 %). Aunque poseían información previa sobre salud sexual, MPF y ETS, no se comportaban acorde con ello, por la desinformación sobre formas de transmisión del VIH, bajo nivel de realización de pruebas serológicas para ETS, así como conductas de riesgo (sexo/alcohol/drogas). El 12,3% tuvo antecedente de embarazo, violencia física (21,6%) y sexual (4,6%) con un predominante silencio de las víctimas de abuso sexual (61,8%). Conclusiones La muestra refleja la población universitaria de esta región del país. Se planea organizar un programa con apoyo médico y psicológico que permita disminuir los índices de ETS, embarazos no planificados, preparando al adolescente en esta importante etapa de su vida, sirviendo de modelo para otras universidades latinoamericanas.

Objetivo Investigar en una universidad estatal del Caribe colombianoel estado de la salud sexual y reproductiva especialmente conocimientos sobre Enfermedades de Transmisión Sexual (ETS), fertilidad, sexualidad, embarazo y violencia. Métodos Estudio transversal tipo encuesta. Se seleccionaron estudiantes matriculados en el segundo período de 2010 que llenaron voluntariamente la encuesta. Los datos cualitativos fueron tabulados y graficados usando medidas de tendencia central para variables cuantitativas. Resultados La población tenía alrededor de 20 años de edad, provenía de la zona urbana (57,9%; IC95%=54,7-61,1), predominantemente heterosexual (89,7%) con edad de inicio de vida sexual antes de los 18 años, con 11,8 % de promiscuidad que usaba principalmente el preservativo como Método de Planificación Familiar (MPF) (55 %). Aunque poseían información previa sobre salud sexual, MPF y ETS, no se comportaban acorde con ello, por la desinformación sobre formas de transmisión del VIH, bajo nivel de realización de pruebas serológicas para ETS, así como conductas de riesgo (sexo/alcohol/drogas). El 12,3% tuvo antecedente de embarazo, violencia física (21,6%) y sexual (4,6%) con un predominante silencio de las víctimas de abuso sexual (61,8%). Conclusiones La muestra refleja la población universitaria de esta región del país. Se planea organizar un programa con apoyo médico y psicológico que permita disminuir los índices de ETS, embarazos no planificados, preparando al adolescente en esta importante etapa de su vida, sirviendo de modelo para otras universidades latinoamericanas.

Objective To investigate the state of sexual and reproductive health in students at a public university in the Colombian Caribbean, with an emphasis on sexually transmitted diseases (STDs), fertility, sexuality, pregnancy and violence. Methods Cross-sectional survey study. University students, enrolled in the second semester of 2010 and who completed a self-administered survey based on the Reproductive Health survey of the Pan American Health Organization, were selected. Qualitative data was tabulated and graphed using measures of central tendency for quantitative variables. Results The age of population studied was around 20 years old, came from the urban area (57.9 %; IC95 %=54.7-61.1), was predominantly heterosexual (89.7 %), with an age of initiation of sexual activity of less than 18 years old, 11.8 % promiscuity, mainly using the condom as a Family Planning Method (FPM) (55 %). Although they had prior information on sexual health, STDs and FPMs, they did not behave according to this due to low education about HIV transmission routes, low incidence of serological tests for STDs, and high risk behavior (sex/alcohol/drugs). It was observed that 12.3 % had a history of pregnancy, physical violence (21.6 %) and sexual violence (4.6 %) with a predominant silence from the victims of sexual abuse (61.8 %). Conclusion The sample reflects the student population in this region of Colombia. We plan to organize a health program with medical and psychological support to reduce the rates of STDs and unplanned pregnancies, preparing the adolescent for this important step in their life and serving as a model for other Latin American universities.