ABSTRACT Objective: To identify the prevalence of sarcopenia among outpatient subjects in the physiotherapy unit of a public hospital in the Autonomous City of Buenos Aires and describe their characteristics. Materials and method: A descriptive, observational, prospective study was conducted in the physiotherapy unit of a public hospital in the Autonomous City of Buenos Aires between February and March 2023. Subjects over 18 years of age referred to the unit were included. The algorithm proposed by the European Working Group on Sarcopenia in Older People 2 was used for the diagnosis. Results: Of the 137 subjects evaluated, the prevalence of probable sarcopenia was 11.7% The mean age was 65.1 (SD 14.3) years, and 81.3% were women. Seventy-five percent of the subjects did not perform physical activity and had a body mass index (BMI) of 28,3 kg/m2 (SD 6,8). Conclusion: Even though no subjects with confirmed sarcopenia were found, the probable sarcopenia was 11.7%. The subjects had a mean age of 65.1 (SD 14.3) years, with a predominance of women. Most subjects did not perform physical activity and had a mean BMI indicative of overweight.

RESUMEN Objetivo: Es identificar la prevalencia de sarcopenia en sujetos ambulatorios del servicio de kinesiología de un hospital público de la Ciudad Autónoma de Buenos Aires y describir sus características. Materiales y método: Estudio descriptivo, observacional, prospectivo realizado en el servicio de kinesiología de un hospital público de Ciudad Autónoma de Buenos Aires entre febrero y marzo de 2023. Se incluyeron sujetos mayores de 18 años que fueron derivados a la unidad. Para el diagnóstico, se utilizó el algoritmo propuesto por el Grupo Europeo de Trabajo en Sarcopenia en Personas Mayores 2. Resultados: De 137 sujetos evaluados, se obtuvo una prevalencia de sarcopenia probable del 11,7%. La media de edad fue de 65,1 (DE 14,3) años, y el 81,3% eran mujeres. El 75% de los sujetos no realizaban actividad física y tenían un índice de masa corporal (IMC) de 28,3 kg/m2 (DE 6,8). Conclusión: Si bien no se encontraron sujetos con sarcopenia confirmada, la prevalencia de sarcopenia probable fue del 11,7%. Estos sujetos tenían una media de edad de 65,1 (DE 14,3) años, y predominaba el sexo femenino. La mayoría de los sujetos no realizaban actividad física y presentaban una media de IMC indicadora de sobrepeso.

RESUMO - RACIONAL: A obstrução do intestino delgado (OID) é uma causa frequente de admissões ao Serviço de Emergência. OBJETIVO: Determinar os fatores de risco de reoperações, eventos adversos pós-operatórios e mortalidade operatória (MO) em pacientes com OID tratados cirurgicamente. MÉTODOS: Estudo retrospectivo entre 2014 e 2017. Critérios de exclusão: obstrução da saída do estômago, obstrução do intestino grosso e história clínica incompleta. O STATA 14 foi utilizado para análise estatística, considerando significância estatística p<0,05 com IC de 95%. RESULTADOS: Duzentos e dezoito pacientes foram incluídos, 61,9% mulheres, 88,5% dos pacientes tinham cirurgia abdominal anterior. A ressecção intestinal foi necessária em 28,4% dos pacientes. O evento adverso pós-operatório (EAPO) esteve presente em 28,4%, a reoperação foi necessária em 9,2% dos casos e a mortalidade cirúrgica em 90 dias foi de 5,9%. A análise multivariada determinou que a ressecção intestinal, > 3 dias em UTI, > 7 dias com sonda nasogástrica (SNG), dor após o 3º dia de pós-operatório, EAPO cirúrgico foram fatores de risco para reoperações, enquanto idade, proteína C reativa, ressecção intestinal, > 3 dias em UTI, > 7 dias com SNG foram fatores de risco para EAPO. A MO foi determinada em > 5 dias com SNG e EAPO. CONCLUSÕES: A evolução pós-operatória é determinada principalmente pela idade do paciente, nível pré-operatório de proteína C reativa, necessidade de ressecção intestinal, variáveis clínicas pós-operatórias e presença de EAPO.

ABSTRACT - BACKGROUND: Small bowel obstruction (SBO) is a frequent cause of emergency department admissions. AIM: This study aimed to determine risk factors of reoperations, postoperative adverse event, and operative mortality (OM) in patients surgically treated for SBO. METHODS: This is a retrospective study conducted between 2014 and 2017. Exclusion criteria include gastric outlet obstruction, large bowel obstruction, and incomplete clinical record. STATA version 14 was used for statistical analysis, with p-value <0.05 with 95% confidence interval considered statistically significant. RESULTS: A total of 218 patients were included, in which 61.9% were women. Notably, 88.5% of patients had previous abdominal surgery. Intestinal resection was needed in 28.4% of patients. Postoperative adverse event was present in 28.4%, reoperation was needed in 9.2% of cases, and a 90-day surgical mortality was 5.9%. Multivariate analysis determined that intestinal resection, >3 days in intensive care unit (ICU), >7 days with nasogastric tube (NGT), pain after postoperative day 3, POAE, and surgical POAE were the risk factors for reoperations, while age, C-reactive protein, intestinal resection, >3 days in ICU, and >7 days with NGT were the risk factors for POAE. OM was determined by >5 days with NGT and POAE. CONCLUSIONS: Postoperative course is determined mainly for patient’s age, preoperative level of C-reactive protein, necessity of intestinal resection, clinical postoperative variables, and the presence of POAE.

Resumo Introdução: A fístula faringocutânea é a complicação mais significativa após laringectomia total de resgate em pacientes que receberam tratamento prévio com radioterapia com ou sem quimioterapia. Objetivo: Revisar a taxa de fístula em pacientes irradiados submetidos a laringectomia total de resgate, para determinar se o uso de interposição de retalho do peitoral maior reduz a incidência e a duração da fístula e examinar outros fatores de risco. Método: Fizemos uma revisão retrospectiva de pacientes submetidos à laringectomia total de resgate para câncer exclusivamente laríngeo após falha da radioterapia curativa primária entre 2000 e 2017. Dados gerais dos pacientes, fatores de risco e outras complicações foram analisados. Resultados: Foram identificados 27 pacientes com média de 66,4 anos, principalmente do sexo masculino (92,5%). O grupo de fechamento primário sem retalho de peitoral maior incluiu 14 pacientes e o grupo de fechamento com retalho de peitoral maior incluiu 13 pacientes. Fístula faringocutânea esteve presente em 15 pacientes (55,5%). A taxa global de fístula faringocutânea foi maior no grupo de pacientes sem retalho de peitoral maior em comparação com aqueles que receberam o retalho (78,6% vs. 30,8%, p = 0,047). Além disso, as fístulas faringocutâneas que precisaram ser reparadas através de cirurgia (64,3% vs. 7,7%, p = 0,03) e grandes faringostomias (64,3% vs. 0%, p = 0,0004) apresentaram uma taxa mais alta no grupo fechado primariamente sem retalho do peitoral maior. Não encontramos outros fatores de risco com significância estatística. O início da dieta oral (84 dias vs. 21,5 dias, p = 0,039) e a duração da internação (98,3 dias vs. 27,2 dias, p = 0,0041) foram muito menores nos pacientes com uso preventivo do retalho do peitoral maior. Dois pacientes morreram em consequência de complicações de grandes faringostomias. Conclusões: O uso profilático do retalho do peitoral maior reduziu a incidência, a gravidade e a duração da fístula e deve ser considerado durante a laringectomia total de resgate.

Abstract Introduction: Pharyngocutaneous fistula is the most significant complication after salvage total laryngectomy in patients who have received previous treatment with radiotherapy with or without chemotherapy. Objective: Our purpose is to review the fistula rate in radiated patients undergoing salvage total laryngectomy, to determine if the use of pectoralis major flap interposition reduces the incidence and duration of fistula and to examine other risk factors. Methods: We made a retrospective review of patients undergoing salvage total laryngectomy for exclusively larynx cancer after failure of primary curative radiotherapy between 2000 and 2017. General data from patients, risk factors and other complications were analyzed. Results: We identified 27 patients whose mean age was 66.4 years, mainly male (92.5%). The primary closure group without pectoralis major flap included 14 patients, and the group with pectoralis major flap closure included 13 patients. Pharyngocutaneous fistula was present in 15 patients (55.5%). Global pharyngocutaneous fistula rate was higher in the group of patients without pectoralis major flap comparing with those were the flap was interposed (78.6% versus 30.8%, p = 0.047). Also the pharyngocutaneous fistulas which need to be repaired with surgery (64.3% versus 7.7%, p = 0.03) and large pharyngostomes (64.3% versus 0%, p = 0.0004) were present in a higher rate in the group closed primary without pectoralis major flap. We did not find other risk factors with statistical significance. Oral diet initiation (84 days versus 21.5 days, p = 0.039) and the duration of hospitalization (98.3 days versus 27.2 days, p = 0.0041) were much lower in patients with a preventive pectoralis major flap. Two patients died as a consequence of complications of large pharyngostomes. Conclusions: Prophylactic pectoralis major flap reduced the incidence, severity and duration of fistula and should be considered during salvage total laryngectomy.

Abstract Posterior reversible encephalopathy syndrome is a clinical-radiological syndrome, characterized by images compatible with vasogenic edema, whose pathophysiology is not fully clarified. There are multiple described causes of this syndrome, mainly severe arterial hypertension, renal insufficiency, sepsis, preeclampsia or eclampsia, immunosuppressive therapy and others. We report a case of a 38-year-old man, renal post-transplant in treatment with mycophenolate and prednisone, with renal failure of the transplant and chronic anemia, hospitalized by urinary focus sepsis plus lymph node tuberculosis, who after receiving 1 concentrate of red blood cells presents seizures, Hb elevation of 3.1 g/dl and images compatible with vasogenic edema and almost complete resolution of them at 16 days.

Resumen El síndrome de encefalopatía posterior reversible, es un síndrome clínico-radiológico, caracterizado por imágenes compatibles con edema vasogénico, cuya fisiopatología no está esclarecida por completo. Existen múltiples causas descritas de este síndrome, principalmente hipertensión arterial severa, insuficiencia renal, sepsis, preeclampsia o eclampsia, terapia inmunosupresora, entre otras. Presentamos a continuación el caso de un paciente de 38 años, postrasplante renal en tratamiento con micofenolato y prednisona, con falla renal del trasplante y anemia crónica, hospitalizado por sepsis de foco urinario más tuberculosis ganglionar, quien tras recibir un concentrado de glóbulos rojos presenta convulsiones tónico clónicas, elevación de Hb de 3.1 g/dl e imágenes compatibles con edema vasogénico y resolución casi completa de las mismas a los 16 días.

RESUMO Objetivo: Avaliar se algum medicamento tópico anti-glaucoma aumenta o risco de obstrução do sistema de drenagem lacrimal ou se a presença de conservantes é su fi cien te para gerar obstrução. Métodos: Este estudo de caso-controle aninhado comparou um grupo de pacientes com obstrução do ducto lacrimal que receberam medicações tópicas anti-glaucoma contra um grupo controle de pacientes sem obstrução. Resultados: Foram revistos os prontuários de 255 pacientes com glaucoma que consultaram a Seção de Oculoplástica com queixas de olhos lacrimejantes. Dentre esses pacientes, 59 apresentavam obstrução da via lacrimal de drenagem. Noventa e quatro por cento dos pacientes com obstrução usaram betabloqueadores e 41% usaram análogos de prostaglandinas. Um modelo de regressão logística foi utilizado para ajustar a idade, sexo e o uso de outros medicamentos. Não foram observadas diferenças significativas em relação às medicações tópicas anti-glaucoma usadas entre os grupos. Conclusão: Nenhum medicamento anti-glaucoma tópico único demonstrou uma associação mais forte com o desenvolvimento de obstrução do ducto lacrimal.

ABSTRACT Purpose: To evaluate whether any topical anti-glaucoma medications increase the risk of lacrimal drainage system obstruction or whether the presence of preservatives alone is sufficient to generate obstruction. Methods: This nested case-control study compared a group of patients with lacrimal duct obstruction who received topical anti-glaucoma medications to a control group of patients without obstruction. Results: The medical records of 255 patients with glaucoma who consulted the Oculoplastic Section with complaints of watery eyes were reviewed. Among these patients, 59 exhibited lacrimal drainage obstruction. Ninety-four percent of patients with lacrimal drainage obstruction used beta-blockers, and 41% used prostaglandin analogs. A logistic regression model was used to adjust for age, sex, and the use of other medications. No significant differences were observed regarding the topical anti-glaucoma medications used between groups. Conclusion: No single topical anti-glaucoma medication demonstrated a stronger association with the development of lacrimal duct obstruction.

En la actualidad, uno de los principales obstáculos de las organizaciones de desarrollo de software en la implementacion del Modelo CMMI-Dev es como iniciar su implementación y aumentar la probabilidad de éxito en una evaluación SCAMPI. Este método de evaluación permite validar, establecer e identificar las oportunidades de mejora de procesos para obtener un nivel de madurez. Sin embargo, el método de evaluación SCAMPI no garantiza una evaluación exitosa, debido a que el proceso de evaluación es empírico basado en la experiencia del equipo auditor experto en Mejora de Procesos de Software con respecto a este modelo. Este artículo propone la identificacion de alternativas de caminos a traves de una herramienta para lograr una efectiva implementación en el modelo CMMI-DEV Nivel 2, considerando sus objetivos de negocio de la organización

One of the main obstacles of software development organizations in the implementation of the CMMI-Dev Model is how to start its implementation and increase the probability of success in a SCAMPI evaluation. This evaluation method allows to validate, establish and identify opportunities for process improvement to obtain a level of maturity in this model. However, the SCAMPI evaluation method does not guarantee a successful evaluation, because the evaluation process is empirical based on the experience of the expert audit team in Software Process Improvement with respect to this model. This article proposes the identification of paths alternatives through a tool to achieve an effective implementation in the CMMI-DEV v1.3 Level 2 model, considering its business objectives of the organization

Abstract: Objective: REMEHIP is a prospective, multicentre registry on pulmonary hypertension. The main objective will be to identify the clinical profile, medical care, therapeutic trends and outcomes in adult and pediatric Mexican patients with well-characterized pulmonary hypertension. Methods: REMEHIP a multicenter registry began in 2015 with a planned recruitment time of 12 months and a 4-year follow-up. The study population will comprise a longitudinal cohort study, collecting data on patients with prevalent and incident pulmonary hypertension. Will be included patients of age >2 years and diagnosis of pulmonary hypertension by right heart catheterization within Group 1 and Group 4 of the World Health Organization classification. The structure, data collection and data analysis will be based on quality current recommendations for registries. The protocol has been approved by institutional ethics committees in all participant centers. All patients will sign an informed consent form. Currently in Mexico, there is a need of observational registries that include patients with treatment in the everyday clinical practice so the data could be validated and additional information could be obtained versus the one from the clinical trials. In this way, REMEHIP emerges as a link among randomized clinical trials developed by experts and previous Mexican experience.

Resumen: Objetivo: REMEHIP es un registro prospectivo, multicéntrico en hipertensión pulmonar. El objetivo principal será identificar el perfil clínico, atención médica, tendencias terapéuticas y evolución en pacientes mexicanos adultos y pediátricos con hipertensión pulmonar bien caracterizada. Métodos: El REMEHIP comenzó en el año de 2015 y se planea un reclutamiento de 12 meses con un seguimiento de 4 años. La población en estudio será una cohorte longitudinal y se obtendrán datos de pacientes prevalentes e incidentes con hipertensión pulmonar. Se incluirán pacientes con edad > 2 años con diagnóstico de hipertensión pulmonar demostrado por cateterismo cardiaco derecho del Grupo 1 y Grupo 4 de la clasificación de la Organización Mundial de la Salud. La estructura, colección de datos y el análisis se establecerá a través de las recomendaciones actuales de calidad para los registros. El protocolo ha sido aprobado por los comités de ética de todos los centros participantes. Todos los pacientes firmarán un consentimiento informado. Actualmente en México existe una necesidad de registros observacionales que incluyan a pacientes con tratamiento en la práctica clínica cotidiana, de tal forma que los datos obtenidos podrían validarse y el resto de la información podría compararse con la derivada de los estudios clínicos. De esta forma REMEHIP surge como un vínculo entre los estudios clínicos aleatorizados conducidos por expertos y la experiencia mexicana previa.

Abstract Breast cancer (BC) is the most common malignancy among women worldwide. A major advance in the understanding of the genetic etiology of BC was the discovery of BRCA1 and BRCA2 (BRCA1/2) genes, which are considered high-penetrance BC genes. In non-carriers of BRCA1/2 mutations, disease susceptibility may be explained of a small number of mutations in BRCA1/2 and a much higher proportion of mutations in ethnicity-specific moderate- and/or low-penetrance genes. In Central and South American populations, studied have focused on analyzing the distribution and prevalence of BRCA1/2 mutations and other susceptibility genes that are scarce in Latin America as compared to North America, Europe, Australia, and Israel. Thus, the aim of this review is to present the current state of knowledge regarding pathogenic BRCA variants and other BC susceptibility genes. We conducted a comprehensive review of 47 studies from 12 countries in Central and South America published between 2002 and 2017 reporting the prevalence and/or spectrum of mutations and pathogenic variants in BRCA1/2 and other BC susceptibility genes. The studies on BRCA1/2 mutations screened a total of 5956 individuals, and studies on susceptibility genes analyzed a combined sample size of 11,578 individuals. To date, a total of 190 different BRCA1/2 pathogenic mutations in Central and South American populations have been reported in the literature. Pathogenic mutations or variants that increase BC risk have been reported in the following genes or genomic regions: ATM, BARD1, CHECK2, FGFR2, GSTM1, MAP3K1, MTHFR, PALB2, RAD51, TOX3, TP53, XRCC1, and 2q35.

RESUMO A síndrome de Kounis é definida como a ocorrência concomitante de reação alérgica e síndrome coronariana aguda secundária ao vasoespasmo. Os medicamentos anti-inflamatórios estão incluídos como uma das múltiplas causas. Os dados atuais disponíveis sobre essa síndrome são provenientes de relatos de caso. Relatamos o caso de um paciente que apresentou síndrome de Kounis com choque cardiogênico e assistolia após infusão intravenosa de metamizol e no qual não foram observadas lesões na coronariografia.

ABSTRACT Kounis syndrome is defined as the coincidental occurrence of allergic reaction and acute coronary syndrome secondary to vasospasm. Anti-inflammatory drugs are included as one of the multiple causes. Current data available about this syndrome come from case reports. We present the case of a patient who suffered Kounis syndrome with cardiogenic shock and asystole after intravenous infusion of Metamizole, and in which no lesions were observed in coronariography.

Resumo O caso das tecedoras mapuche da 9a Região do Chile nos permite reconsiderar os fenômenos de identidade cultural e etnicidade à luz das tensões e dos processos de subjetividade que medeiam a construção da memória cultura. São analisados tanto o cenário microgenético dos trabalhos de identidade quanto um cenário macrogenético, nos quais os processos identitários, as técnicas comerciais e religiosas do contexto mapuche se relacionam em permanente transmutação. Discute-se o conceito de etnicidade com o objetivo de aprofundar a compreensão de um fenômeno que está longe de manifestar-se como uma simples homogeneidade. A discussão procura abordar a multiplicidade de tomadas de posição na experiência das tecedoras, enfatizando um olhar para a etnicidade como um processo em permanente devir, no qual a memória social do grupo reconduz uma seleção interessada de tradições orientando a construção de uma identidade potencial face ao porvir.

Abstract The case of Mapuche weavers from the IX Region of Chile allows us to reconsider the phenomenon of cultural identity and ethnicity in light of the tensions and subjectivity processes that mediate the construction of cultural memory. We analyze both a microgenetic scenario of identity works and a macrogenetic scenario where identity processes and commercial and religious techniques of Mapuche context relate to each other in constant transmutation. The concept of ethnicity is discussed to contribute to shed light into a phenomenon that is far from manifest itself as a simple homogeneity. A discussion is made considering the multiplicity of position statements on the experience of the weavers, emphasizing a look at ethnicity as a process in constant development, in which the social memory of the group shapes a biased selection of traditions that guides the building up of a potential identity facing the future.

Resumen El caso de tejedoras mapuche de la IX Región de Chile nos permite reconsiderar los fenómenos de identidad cultural y etnicidad a la luz de las tensiones y procesos de subjetividad que median la construcción de memoria cultural. Se analiza tanto un escenario microgenético de los trabajos de identidad - como un escenario macrogenético, donde los procesos identitarios, las técnicas comerciales y religiosas del contexto mapuche se relacionan entre sí en permanente transmutación. Se discute el concepto de etnicidad con el fin de contribuir a ahondar en un fenómeno que está lejos de manifestarse como simple homogeneidad. Se realiza una discusión dando cuenta de la multiplicidad de tomas de posición en la experiencia de las tejedoras, enfatizando una mirada a la etnicidad como un proceso en permanente devenir, donde la memoria social del grupo reconduce una selección interesada de tradiciones orientando la construcción de una identidad potencial de cara al porvenir.

Résumé Le cas des tisseuses "mapuche" de la IX Région du Chili nous permet de reconsidérer les phénomènes de l'identité culturelle et de l' éthnicité à la lumière des tensions et des processus de subjectivité qui médiatisent la construction d'une mémoire culturelle. On analyse une scène microgénétique des travaux d'identité aussi bien que la scène macrogénétique où les processus identitaires, les techniques commerciales et religieuses du contexte "mapuche" se rapportent entre eux dans une transmutation permanente. On débat le concept d'éthnicité pour contribuer à l'approfondissement dans un phénomène complexe qui est loin de se manifester comme une simple homogénéité. Pour reconnaître la densité des nuances et de la multiplicité de choix à l'expérience des tisseuses, la discussion réalisée suggère qu'il faut souligner le regard sur l'éthnicité comme processus en évolution constant, où la mémoire sociale d'un groupe reconduit à une sélection intéressée des traditions pour orienter la construction d'une identité potentielle à l'attente du futur.

Objectives: the present study was made in order to find possible prognostic factors in oral squamous cell carcinoma, given that it is a frequent disease (3-4% of all malignant tumors) and is the cause of a high morbidity and mortality which justifies any attempt to contribute something towards the understanding of this pathology. Study design: 81 oral squamous cell carcinomas, treated with the same procedure, and retrieved from the archive of the Hospital Universitario Marqués de Valdecilla (Santander) were studied. Flow cytometry was carried out on 67 of the samples. Results: no statistically significant differences were found between the cellular proliferative index and the mitotic index, ploidy and the S-phase factor. Likewise, none of the cytometric variables studied presented any association with the appearance of local relapse, distant metastases or survival. Conclusions: these variables cannot be used as a prognostic factors in squamous cell carcinomas of the oral cavity.

Objetivos: el presente estudio se realizó para encontrar posibles factores pronósticos del Carcinoma oral de células escamosas puesto que es una enfermedad frecuente (3 - 4 % de los tumores malignos) que origina una gran morbilidad y mortalidad y que justifica cualquier intento que trate de aportar algo para conocer mejor esta patología. Diseño del estudio: hemos realizado un estudio sobre 81 carcinomas orales de células escamosas extraídos del archivo del Hospital Universitario Marqués de Valdecilla (Santander), tratados con el mismo procedimiento, de los cuales en 67 de ellos se realizó citometría de flujo. Resultados: No hemos encontrado diferencias estadísticamente significativas entre el índice de proliferación celular y el índice mitótico, la ploidía y la fase S. Así mismo ninguna de las variables citométricas estudiadas ha presentado relación con la aparición de recidiva loco-regional, metástasis a distancia ni con la supervivencia. Conclusiones: no podemos utilizar éstas variables como factor pronóstico en el carcinoma de células escamosas de la cavidad oral.

The double headed mandible condyle is a rare alteration that is frequently diagnosticated as an incidental finding in a panoramic radiograph. The different theories about its etiology are explained in this article. Symptoms described with bifid condyles vary from case to case, but in most instances are absent. Computer tomography is the ideal imaging method to evaluate the condyle morphology and to role out any degenerative process to achieve the differential diagnosis. Treatment is conservative for symptomatic patients with TMJ disorders, surgical treatment is described in literature in TMJ ankylosis that develops in bifid condyles secondary to trauma.

En este artículo, a propósito de un caso clínico, se presenta el cóndilo bífido como una rara alteración mandibular con muchas incógnitas. Su diagnóstico suele ser un hallazgo casual en radiografías panorámicas de rutina. El número de casos relatados en literatura ha experimentado en los últimos años un crecimiento debido al aumento de pruebas radiológicas que se realizan. Se discute sobre las diferentes teorías existentes con respecto a la etiología de este proceso. En lo referente a la relevancia clínica del cóndilo bífido señalamos que la gran mayoría son asintomáticos. Es importante realizar un buen diagnóstico diferencial de éste proceso con otras lesiones que producen alteraciones morfológicas condilares, la prueba de elección es la tomografía computerizada. El tratamiento conservador suele ser efectivo en los casos con clínica de disfunción articular leve, la cirugía tan sólo suele indicarse en casos de anquilosis condilar, normalmente éstos casos son secundarios a traumatismos.