Sistema Regional de Información
en línea para Revistas Científicas de América Latina,
el Caribe, España y Portugal

Introduction: The late identification of the retention of permanent maxillary canines has negative consequences for the health of the pediatric population. Objective: To design and validate a predictive model for the retention of permanent maxillary canines. Methods: A case-control, analytical, research-development, and innovation study was conducted from 2022 to 2024. A probability sample of 50 cases and 100 controls was obtained. The variables studied were: sex, skin color, directional abnormalities, position, and microdontia of the maxillary lateral incisors, negative bone-tooth discrepancy, trauma, presence of supernumerary teeth and diastemas in the upper anterior region, premature loss of primary teeth, persistence of maxillary primary canines and hereditary history of this retention. Odds ratios were calculated, and a chi-square hypothesis test for homogeneity was performed with a 95% confidence interval. In cases of association, the explanatory variable was included in the multiple logistic regression to design the predictive model. Results: Female sex (OR: 2.33 p= 0.031), white skin color (OR: 2.35 p= 0.034), presence of diastemas in the upper anterior sector (OR: 4.75 p= 0.000), persistence of maxillary temporary canines (OR: 41.15 p= 0.000) and hereditary history of this retention (OR: 9.79 p= 0.000) were identified as predictors. The overall accuracy of the predictive model was 87.3%. Conclusions: The designed model allows for the prediction of the retention of permanent maxillary canines, and the evaluated parameters recognized the model as a valid tool.

Introduction: Degenerative scoliosis is a common condition in older adults that causes functional disability, dependency, and compromises perceived quality of life. Early identification and proper assessment allow for more appropriate therapeutic approaches. Objective: To describe the diagnostic elements and radiological evaluation of degenerative scoliosis. Methods: A bibliographic review of documents published in the last 5 years in journals indexed in regional databases (Scielo, Latindex, Lilacs, and Redalyc) and high-impact databases (Scopus, PubMed, Ice Web of Science, and Medline) was conducted using Google Scholar as the search engine. Search tools included health descriptors in English, Spanish, and Portuguese, and the Boolean operators OR, NOT, and AND, which allowed for increased and optimized results in the information retrieval process. A total of 71 documents were identified, of which 22 contributed information to the study. Development: The study focused on describing the factors that enable the diagnosis of degenerative scoliosis, as well as the characteristics of radiological evaluation and its importance in defining the therapeutic approach. Conclusions: The factors that enable the diagnosis of degenerative scoliosis include advanced age, chronic pain, the presence of neuropathic manifestations, and a Cobb angle greater than 10°. Radiological evaluation allows, in addition to diagnosis, the planning of the appropriate course of action in each case.

Introduction: Aceclofenac (ACE), a BCS class II non-steroidal anti-inflammatory drug, has limited bioavailability due to poor aqueous solubility. Objective: To investigate the effects of spray drying temperature on the physicochemical properties and entrapment efficiency of ACE in dry emulsions. Methods: Dry emulsions were prepared by spray drying an oil-in-water emulsion containing maltodextrin, HPMC E6, and Aerosil 200 at temperatures ranging from 110°C to 160°C. The powders were characterized for moisture content and water activity using a rapid moisture analyzer and a water activity meter, respectively. Powder yield, bulk density, and particle size were determined using standard gravimetric and sizing methods. Aceclofenac entrapment efficiency was assessed by UV spectrophotometry. FTIR spectroscopy was used to evaluate drug-excipient interactions, and in vitro drug release was assessed using the USP 24 paddle method. Results: The dry emulsion powder formed at 130°C had a high yield (53.5%), good particle integrity, and small powder particle size. With the spray drying temperature increasing from 110°C to 160°C, the entrapment efficiency of ACE in dry emulsion powder decreased from 78.09% to 70.52%. Conclusions: Spray drying temperature has a significant impact on the physicochemical properties and entrapment efficiency of aceclofenac in dry emulsions. Higher temperatures led to decreased entrapment efficiency. The formulation dried at 130°C showed optimal yield, particle integrity, and size. Thus, 130°C is the most suitable temperature for producing effective aceclofenac-loaded dry emulsion powders.

Introduction: Older adults present gait disturbances and rehabilitative treatment is part of the therapeutic scheme. The dual-task training provides benefits in the recovery of the gait pattern. Objective: To identify the benefits of dual-task training on gait in older adults. Methods: The literature review included documents published between 2019 and 2024 in journals indexed in databases such as Scielo,Latindex, Redalyc, Scopus, Web of Science,PubMed and Medline. In order to increase and optimize the results of the search, health descriptors were used in English, Spanish and Portuguese (elderly, fall accidents, gait and rehabilitation) and Boolean operators (OR, NOT and AND). Seventy-one documents were identified, of which 23 were used in the research. Development: The gait disorders present in older adults and the physiotherapeutic principles of dual-task training that favor gait in this population group were described. The benefits of this type of therapy on gait pattern were identified as well as the main exercises used for this purpose. Conclusions: Benefits of dual-task training include improvements in gait speed and stability, reduction of fall risk through increased attention and confidence, and optimization of functional capacity in daily activities.

Introduction: Dengue and leptospirosis are common causes of acute febrile illness in patients in developing countries. Co-infection with these entities has a high mortality rate if not suspected early. Objective: To perform the clinical approach to a pregnant patient with dengue and leptospirosis coinfection. Clinical Case: This manuscript presents the case of a pregnant patient with an acute febrile illness, which turned out to be a co-infection with dengue and leptospirosis, who presented multiple organ failure during hospitalization. However, the patient recovered due to the timely management of these entities. Conclusions: Coinfection in pregnant women is rarely described in the literature, but a high level of suspicion should be maintained as symptoms may overlap with other obstetric conditions. Timely diagnosis and management are important to significantly reduce severity and mortality.

Introduction: Pulmonary contusion is a complication of thoracic trauma. It is uncommon in falls from low heights and can initially mimic other illnesses such as pneumonia due to its acute presentation. Objective: To address the case of a 12-year-old boy who suffered a simple back fall and developed severe respiratory distress. Case Report: A 12-year-old boy was admitted to the emergency department with hypoxemia, hemoptysis, and severe respiratory distress. Chest X-ray revealed heterogeneous alveolar radiopacities on both sides. He was initially diagnosed with severe pneumonia and received high-flow nasal cannula oxygen and antibiotics. During his stay in emergency, a family member who understood and spoke Spanish helped provide further medical history. The patient mentioned that he had fallen backward from a height of one meter while playing with his friends, and that respiratory symptoms had subsequently begun. Based on these findings, he was diagnosed with pulmonary contusion. Fluids were restricted, and the patient improved within 48 hours. Conclusions: Pulmonary contusion can occur in falls from low heights and should be considered in the differential diagnosis of acute respiratory illnesses such as pneumonia.

The Marianao Obelisk as a supposed tribute to Dr. Carlos J. Finlay

Helsinki Update, advances in ethics and protection of medical research

Introduction: The incorporation of laparoscopic surgery as a diagnostic and therapeutic alternative in emergency medicine revolutionized the treatment of the acute surgical abdomen, since it allowed diagnosis by direct vision of the intra-abdominal organs, avoiding in many cases unnecessary laparotomy and other advantages that allow a rapid reincorporation of the individual to society. Objective: To characterize patients with acute surgical abdomen operated by laparoscopic surgery. Methods: Descriptive, prospective, longitudinal study of 248 patients with acute abdomen operated on laparoscopically from January 2019 to February 2024. The mean, range and standard deviation of quantitative variables and absolute frequency distributions for qualitative variables were calculated. To determine the degree of relationship between the categorical variables, the Phi-square and Cramer's V were used. Results: Female sex predominated (64.92%) and age between 18 and 29 years. The most frequent diagnosis was acute appendicitis (52.42%) and appendectomy was the most frequently performed surgical procedure. The mean surgical time was 34.79 minutes. Complications occurred in 11.69% of patients and only 3.63% required reoperation, which was performed laparoscopically. In most of the operated patients (46.37%) the hospital stay was one day. Conclusions: A small percentage of patients required conversion to laparotomy; repeat surgeries were performed laparoscopically. Most patients remained hospitalized for less than two days.

Introduction: Dengue is a common arbovirus with a high incidence of complications in children and in which thickening of the vesicular wall is a frequent ultrasound finding. Objective: To evaluate the correlation between thickening of the vesicular wall and clinical, laboratory and ultrasound findings in patients with dengue. Methods: A cross-sectional study was carried out in 119 patients admitted with a diagnosis of dengue in the period between January and October 2024. The variables studied are: clinical warning signs upon admission, presence of leukopenia, thrombocytopenia, hemoconcentration or hypertransaminasemia, ultrasound findings, IgM results and development of severe dengue or dengue shock. Statistically, the Phi coefficient is used, chi-square, sensitivity, specificity, positive and negative predictive value and odds ratio are calculated. Results: Vesicular wall thickening is present in 31.9% of cases and values ​​≥ 9 mm were strongly associated with hepatomegaly (0.37), hypertransaminasemia (0.26), hemoconcentration (0.19), localized abdominal pain (0.18) and laminar free fluid (0.17). The positive predictive value is 93.5%. The development of severe dengue and positive IgM are 10 and 16 times more frequent in cases with vesicular wall thickening. Conclusions: Thickening of the gallbladder wall correlates with clinical, laboratory and ultrasound signs that are linked to the liver, in addition to predicting the evolution to severe forms of the disease.