Prediction of the individual response to treatment of skeletal Class II malocclusions and their long-term stability. A Case Report.
Predicción de la respuesta al tratamiento de las maloclusiones Clase II esqueléticas y su estabilidad a largo plazo. Presentación de un caso.
Palabras clave:
cefalometría, aparato de Herbst, Modelo de Baccetti y Franchi
Resumen
La corrección no quirúrgica de las maloclusiones esqueléticas clase II se inicia en las edades tempranas, durante el crecimiento y desarrollo de la mandíbula, suelen ser tratamientos relativamente largos y generar compromisos financieros para la familia. Predecir el éxito y la estabilidad de los resultados puede resultar útil a los padres que desean saber sobre el pronóstico y tomar la decisión para iniciar el tratamiento.Este trabajo reporta los hallazgos de la predicción de la respuesta al tratamiento de una maloclusión clase II esquelética y su estabilidad a largo plazo, en un paciente masculino, de trece años de edad. Se aplicó el modelo cefalométrico de predicción individual de Baccetti y Franchi, y según este indicador, el tratamiento tendría “una gran respuesta”. El paciente fue tratado con un aparato de proyección anterior mandibular fijo tipo Herbst y apliques ortodóncicos para el detallado final de la oclusión. Dieciséis años después de finalizado el tratamiento, se mantuvo la corrección de la maloclusión Clase II, la sobremordida horizontal y la armonía en el perfil con la proyección de la mandíbula hacia adelante, mediante el aumento de la longitud total mandibular (13 mm), y por medio de la apertura del ángulo entre rama y cuerpo mandibular de 122° a 128°. En conclusión, el modelo cefalométrico de predicción individual aplicado particularmente en este reporte de caso permitió predecir de manera acertada la buena respuesta y estabilidad de los resultados faciales, dentales y esqueletales del tratamiento de la maloclusión esquelética clase II.
Descargas
La descarga de datos todavía no está disponible.
Citas
Han Y, Kim D-Y, Woo J, Kim J. Glu-ensemble: An ensemble deep learning framework for blood glucose forecasting in type 2 diabetes patients. Heliyon 2024;10:e29030.
Sahu MK, Tiwari SP. Epidemiology, patho-genesis and treatment of diabetes: A comprehensive review. World J Diabetes Res Pract 2024;1(1):1-9.
Szablewski L. Insulin resistance: the increased risk of cancers. Curr Oncol 2024;31(2):998-1027. https://doi.org/10.3390/curroncol31020075”31020075
Yan Y, Wu T, Zhang M, Li C, Liu Q, Li F. Prevalence, awareness and control of type 2 diabetes mellitus and risk factors in Chinese elderly population. BMC Public Health 2022;22(1):1382. https://doi. org/10.1186/s12889-022-13759-9”12889- 022-13759-9
Dludla PV, Mabhida SE, Ziqubu K, Nkambule BB, Mazibuko-Mbeje SE, Hanser S, Basson AK, Pheiffer C, Kengne AP. Pancreatic β-cell dysfunction in type 2 diabetes: Implications of inflammation and oxidative stress. World J Diabetes 2023;14(3):130-146. https://doi.org/10.4239%2Fwjd.v14. i3.130”3.130.
Galdón Sanz-Pastor A, Justel Enríquez A, Sánchez Bao A, Ampudia-Blasco FJ. Current barriers to initiating insulin therapy in individuals with type 2 diabetes. Front Endocrinol 2024;15:1-11. https://doi.org/10.3389/fendo.2024. 1366368”2024.1366368
Vlacho B, Rossell-Rusiñol J, Granado-Casas M, Mauricio D, Julve J. Chapter 1 Overview on chronic complications of diabetes mellitus. In: Mauricio D, Alonso N, editors. Chronic Complications of Diabetes Mellitus: Academic Press; 2024. p. 1-10.
Mansour A, Mousa M, Abdelmannan D, Tay G, Hassoun A, Alsafar H. Microvascular and macrovascular complications of type 2 diabetes mellitus: Exome wide association analyses. Front Endocrinol 2023;14:1143067. https://doi.org/10.3389%2Ffendo.2023.1143067”2023.1143067
El Sayed NA, Aleppo G, Aroda VR, Ban- nuru RR, Brown FM, Bruemmer D, Collins BS, Hilliard ME, Isaacs D, Johnson EL, Kahan S, Khunti K, Leon J, Lyons SK, Perry ML, Prahalad P, Pratley RE, Seley JJ, Stanton RC, Gabbay RA, on behalf of the American Diabetes Association. 2. Classification and Diagnosis of Diabetes: Standards of Care in Diabetes-2023. Diabetes Care 2023;46(1):S19-S40 https:// doi.org/10.2337%2Fdc23-S002”002
Tourkmani AM, Alharbi TJ, Rsheed AMB, Alotaibi AF, Aleissa MS, Alotaibi S, Almutairi AS, Thomson J, Alshahrani AS, Alroyli HS, Almutairi HM. A hybrid model of in-person and telemedicine diabetes education and care for management of patients with uncontrolled Type 2 diabetes nellitus: findings and implications from a multicenter prospective study. Telemedicine Reports 2024;5(1):46-57. https://doi. org/10.1089/tmr.2024.0003”2024.0003
Garedow AW, Jemaneh TM, Hailemariam AG, Tesfaye GT. Lifestyle modification and medication use among diabetes mellitus patients attending Jimma University Medical Center, Jimma zone, south west Ethiopia. Sci Rep 2023;13(1):4956. https://doi. org/10.1038%2Fs41598-023-32145-y”-y
Firman CH, Mellor DD, Unwin D, Brown Does a ketogenic diet have a place within diabetes clinical practice? Review of current evidence and controversies. Diabetes Ther 2024;15(1):77-97. https://doi.org/10.1007%2Fs13300-023-0 1492-4” 13300-023-01492-4.
Zhu H, Bi D, Zhang Y, Kong C, Du J, Wu X, Wei Q, Qin H. Ketogenic diet for human diseases: the underlying mechanisms and potential for clinical implementations. Signal Transduct Target Ther 2022;7(1):11. https://doi.org/10.1038%2Fs41392-021- 00831-w”-w
Masood W, Annamaraju P, Khan Suheb MZ, Uppaluri KR. Ketogenic Diet. Stat- Pearls. Treasure Island (FL): StatPearls Publishing LLC; 2024.
Wu J, Yang K, Fan H, Wei M, Xiong Q. Targeting the gut microbiota and its metabolites for type 2 diabetes mellitus. Front Endocrinol 2023;14:1-12. https://doi.org/10.3389/fendo.2023.111 4424”2023.1114424
Lin Y. The role of ketogenic diet in gut microbiota. Highl Sci Eng Technol 2022;19:36-43.
Koutentakis M, Kuciński J, Świeczkowski D, Surma S, Filipiak KJ, Gąsecka A. The ketogenic effect of SGLT-2 inhibitors-be- neficial or harmful? J Cardiovasc Dev Dis 2023;10(11):465. https://doi.org/10.3390%2Fjcdd10110465”10110465
Sadat A. Alarming surge in early-onset Type 2 diabetes: A global catastrophe on the horizon. Touch REV Endocrinol 2023;19(2):7-8. https://doi.org/10.17925%2FEE.2023.19.2.5”2023.19.2.5
Committee ADAPP. 2. Classification and Diagnosis of Diabetes: Standards of Medical Care in Diabetes—2022. Diabetes Care 2021;45(Supplement_1):S17-S38. https://doi.org/10.2337/dc22-S002”002
Chandgude D, Tambat P, Tale V. A comprehensive review on keto diet on management of Type 2 diabetes and obesity. J Chem Health Risks 2024;13(4):609-614.
Galicia-Garcia U, Benito-Vicente A, Jebari S, Larrea-Sebal A, Siddiqi H, Uribe KB, Ostolaza H, Martín C. Pathophysiology of Type 2 diabetes mellitus. Int J Mol Sci 2020;21(17):6275. https://doi.org/10.3390%2Fijms21176275”21176275
Li S, Yuan S, Lin G, Zhang J. Effects of a two meals-a-day ketogenic diet on newly diagnosed obese patients with type2 diabetes mellitus: a retrospective observational study. Medicine (Baltimore). 2023;102(43):e35753. https://doi.org/10. 1097%2FMD.0000000000035753”0000000000035753
Zhou C, Wang M, Liang J, He G, Chen N. Ketogenic diet benefits to weight loss, glycemic control, and lipid profiles in overweight patients with Type 2 diabetes mellitus: A meta-analysis of randomized controlled trails. Int J Environ Res Public Health 2022;19(16):10429. https://doi.org/10.3390%2Fijerph191610429”191610429
Yuan X, Wang J, Yang S, Gao M, Cao L, Li X, Hong D, Tian S, Sun C. Effect of the ketogenic diet on glycemic control, insulin resistance, and lipid metabolism in patients with T2DM: a systematic review and meta-analysis. Nutr Diabetes 2020;10(1):38. https://doi.org/10.1038/ s41387-020-00142-z”-z
Vidić V, Ilić V, Toskić L, Janković N, Ugarković D. Effects of calorie restricted low carbohydrate high fat ketogenic vs. non-ketogenic diet on strength, body-composition, hormonal and lipid profile in trained middle-aged men. Clin Nutr 2021;40(4):1495-1502. https://doi.org/10.1016/j.clnu.2021. 02.028”2021.02.028
Patikorn C, Saidoung P, Pham T, Phisalprapa P, Lee YY, Varady KA, Veettil SK, Chaiyakunapruk N. Effects of ketogenic diet on health outcomes: an umbrella review of meta-analyses of randomized clinical trials. BMC Medicine 2023;21(1):196. https://doi.org/10.1186/s12916-023- 02874-y”-y
Yang Q, Vijayakumar A, Kahn BB. Metabolites as regulators of insulin sensitivity and metabolism. Nat Rev Mol Cell Biol 2018;19(10):654-672. “https://doi. org/10.1038/s41580-018-0044-8”41580- 018-0044-8
Dowis K, Banga S. The potential health benefits of the ketogenic diet: A narrative review. Nutrients 2021;13(5):1654. “https://doi.org/10.3390%2Fnu1305 1654”13051654
Yang Z, Mi J, Wang Y, Xue L, Liu J, Fan M, Zhang D, Wang L, Qian H, Li Y. Effects of low-carbohydrate diet and ketogenic diet on glucose and lipid metabolism in type 2 diabetic mice. Nutrition 2021;89:111230. “https://doi.org/10.1016/j.nut.2021.1 11230”2021.111230
Skow SL, Jha RK. A ketogenic diet is effective in improving insulin sensitivity in individuals with Type 2 diabetes. Curr Diabetes Rev 2023;19(6):e250422203985.“https://doi.org/10.2174/1573399818666220425093535”1573399818666220425093535
Paoli A, Bianco A, Moro T, Mota JF, Coelho-Ravagnani CF. The effects of ketogenic diet on insulin sensitivity and weight loss, which came first: the chicken or the egg? Nutrients 2023;15(14):3120. “https://doi. org/10.3390%2Fnu15143120”15143120
Rafiullah M, Musambil M, David SK. Effect of a very low-carbohydrate ketogenic diet vs recommended diets in patients with type 2 diabetes: a meta-analysis. Nutr Rev 2022;80(3):488-502. “https://doi.org/10.1093/nutrit/nuab040”040
Zaki HA, Iftikhar H, Bashir K, Gad H, Fahmy AS, Elmoheen A. A comparative study evaluating the effectiveness between ketogenic and low-carbohydrate diets on glycemic and weight control in patients with type 2 diabetes mellitus: a systematic review and meta-analysis. Cureus 2022;14(5). “https://doi.org/10.7759/cu reus.25528”25528
Müller TD, Finan B, Bloom SR, D’Alessio D, Drucker DJ, Flatt PR, Fritsche A, Gribble F, Grill HJ, Habener JF, Holst JJ, Langhans W, Meier JJ, Nauck MA, Perez-Tilve D, Pocai A, Reimann F, Sandoval DA, Schwartz TW, Seeley RJ, Stemmer K, Tang-Christensen M, Woods SC, DiMarchi RD, Tschöp MH. Glucagon-like peptide 1 (GLP-1). Mol Metab 2019;30:72-130.“https://doi.org/10.1016%2Fj.molmet. 2019.09.010”2019.09.010
Widiatmaja DM, Lutvyani A, Sari D, Kurniasari H, Meiliana I, Fasitasari M, Yamaoka Y, Rejeki P. The effect of long-term ketogenic diet on serum adiponectin and insulin-like growth factor-1 levels in mice. J Basic Clin Physiol Pharmacol 2021;33(5):1-11. “http://dx.doi. org/10.1515/jbcpp-2021-0287”2021-0287
Deledda A, Palmas V, Heidrich V, Fosci M, Lombardo M, Cambarau G, Lai A, Melis M, Loi E, Loviselli A, Manzin A, Velluzzi F. Dynamics of gut microbiota and clinical variables after ketogenic and mediterranean diets in drug-naïve patients with Type 2 diabetes mellitus and obesity. Metabolites 2022;12(11):1092. “https://doi.org/1 0.3390%2Fmetabo12111092”12111092
Paoli A, Mancin L, Bianco A, Thomas E, Mota JF, Piccini F. Ketogenic diet and microbiota: friends or enemies? Genes 2019;10(7):534. “https://doi.org/10.3390/genes10070534”10070534
Sahu MK, Tiwari SP. Epidemiology, patho-genesis and treatment of diabetes: A comprehensive review. World J Diabetes Res Pract 2024;1(1):1-9.
Szablewski L. Insulin resistance: the increased risk of cancers. Curr Oncol 2024;31(2):998-1027. https://doi.org/10.3390/curroncol31020075”31020075
Yan Y, Wu T, Zhang M, Li C, Liu Q, Li F. Prevalence, awareness and control of type 2 diabetes mellitus and risk factors in Chinese elderly population. BMC Public Health 2022;22(1):1382. https://doi. org/10.1186/s12889-022-13759-9”12889- 022-13759-9
Dludla PV, Mabhida SE, Ziqubu K, Nkambule BB, Mazibuko-Mbeje SE, Hanser S, Basson AK, Pheiffer C, Kengne AP. Pancreatic β-cell dysfunction in type 2 diabetes: Implications of inflammation and oxidative stress. World J Diabetes 2023;14(3):130-146. https://doi.org/10.4239%2Fwjd.v14. i3.130”3.130.
Galdón Sanz-Pastor A, Justel Enríquez A, Sánchez Bao A, Ampudia-Blasco FJ. Current barriers to initiating insulin therapy in individuals with type 2 diabetes. Front Endocrinol 2024;15:1-11. https://doi.org/10.3389/fendo.2024. 1366368”2024.1366368
Vlacho B, Rossell-Rusiñol J, Granado-Casas M, Mauricio D, Julve J. Chapter 1 Overview on chronic complications of diabetes mellitus. In: Mauricio D, Alonso N, editors. Chronic Complications of Diabetes Mellitus: Academic Press; 2024. p. 1-10.
Mansour A, Mousa M, Abdelmannan D, Tay G, Hassoun A, Alsafar H. Microvascular and macrovascular complications of type 2 diabetes mellitus: Exome wide association analyses. Front Endocrinol 2023;14:1143067. https://doi.org/10.3389%2Ffendo.2023.1143067”2023.1143067
El Sayed NA, Aleppo G, Aroda VR, Ban- nuru RR, Brown FM, Bruemmer D, Collins BS, Hilliard ME, Isaacs D, Johnson EL, Kahan S, Khunti K, Leon J, Lyons SK, Perry ML, Prahalad P, Pratley RE, Seley JJ, Stanton RC, Gabbay RA, on behalf of the American Diabetes Association. 2. Classification and Diagnosis of Diabetes: Standards of Care in Diabetes-2023. Diabetes Care 2023;46(1):S19-S40 https:// doi.org/10.2337%2Fdc23-S002”002
Tourkmani AM, Alharbi TJ, Rsheed AMB, Alotaibi AF, Aleissa MS, Alotaibi S, Almutairi AS, Thomson J, Alshahrani AS, Alroyli HS, Almutairi HM. A hybrid model of in-person and telemedicine diabetes education and care for management of patients with uncontrolled Type 2 diabetes nellitus: findings and implications from a multicenter prospective study. Telemedicine Reports 2024;5(1):46-57. https://doi. org/10.1089/tmr.2024.0003”2024.0003
Garedow AW, Jemaneh TM, Hailemariam AG, Tesfaye GT. Lifestyle modification and medication use among diabetes mellitus patients attending Jimma University Medical Center, Jimma zone, south west Ethiopia. Sci Rep 2023;13(1):4956. https://doi. org/10.1038%2Fs41598-023-32145-y”-y
Firman CH, Mellor DD, Unwin D, Brown Does a ketogenic diet have a place within diabetes clinical practice? Review of current evidence and controversies. Diabetes Ther 2024;15(1):77-97. https://doi.org/10.1007%2Fs13300-023-0 1492-4” 13300-023-01492-4.
Zhu H, Bi D, Zhang Y, Kong C, Du J, Wu X, Wei Q, Qin H. Ketogenic diet for human diseases: the underlying mechanisms and potential for clinical implementations. Signal Transduct Target Ther 2022;7(1):11. https://doi.org/10.1038%2Fs41392-021- 00831-w”-w
Masood W, Annamaraju P, Khan Suheb MZ, Uppaluri KR. Ketogenic Diet. Stat- Pearls. Treasure Island (FL): StatPearls Publishing LLC; 2024.
Wu J, Yang K, Fan H, Wei M, Xiong Q. Targeting the gut microbiota and its metabolites for type 2 diabetes mellitus. Front Endocrinol 2023;14:1-12. https://doi.org/10.3389/fendo.2023.111 4424”2023.1114424
Lin Y. The role of ketogenic diet in gut microbiota. Highl Sci Eng Technol 2022;19:36-43.
Koutentakis M, Kuciński J, Świeczkowski D, Surma S, Filipiak KJ, Gąsecka A. The ketogenic effect of SGLT-2 inhibitors-be- neficial or harmful? J Cardiovasc Dev Dis 2023;10(11):465. https://doi.org/10.3390%2Fjcdd10110465”10110465
Sadat A. Alarming surge in early-onset Type 2 diabetes: A global catastrophe on the horizon. Touch REV Endocrinol 2023;19(2):7-8. https://doi.org/10.17925%2FEE.2023.19.2.5”2023.19.2.5
Committee ADAPP. 2. Classification and Diagnosis of Diabetes: Standards of Medical Care in Diabetes—2022. Diabetes Care 2021;45(Supplement_1):S17-S38. https://doi.org/10.2337/dc22-S002”002
Chandgude D, Tambat P, Tale V. A comprehensive review on keto diet on management of Type 2 diabetes and obesity. J Chem Health Risks 2024;13(4):609-614.
Galicia-Garcia U, Benito-Vicente A, Jebari S, Larrea-Sebal A, Siddiqi H, Uribe KB, Ostolaza H, Martín C. Pathophysiology of Type 2 diabetes mellitus. Int J Mol Sci 2020;21(17):6275. https://doi.org/10.3390%2Fijms21176275”21176275
Li S, Yuan S, Lin G, Zhang J. Effects of a two meals-a-day ketogenic diet on newly diagnosed obese patients with type2 diabetes mellitus: a retrospective observational study. Medicine (Baltimore). 2023;102(43):e35753. https://doi.org/10. 1097%2FMD.0000000000035753”0000000000035753
Zhou C, Wang M, Liang J, He G, Chen N. Ketogenic diet benefits to weight loss, glycemic control, and lipid profiles in overweight patients with Type 2 diabetes mellitus: A meta-analysis of randomized controlled trails. Int J Environ Res Public Health 2022;19(16):10429. https://doi.org/10.3390%2Fijerph191610429”191610429
Yuan X, Wang J, Yang S, Gao M, Cao L, Li X, Hong D, Tian S, Sun C. Effect of the ketogenic diet on glycemic control, insulin resistance, and lipid metabolism in patients with T2DM: a systematic review and meta-analysis. Nutr Diabetes 2020;10(1):38. https://doi.org/10.1038/ s41387-020-00142-z”-z
Vidić V, Ilić V, Toskić L, Janković N, Ugarković D. Effects of calorie restricted low carbohydrate high fat ketogenic vs. non-ketogenic diet on strength, body-composition, hormonal and lipid profile in trained middle-aged men. Clin Nutr 2021;40(4):1495-1502. https://doi.org/10.1016/j.clnu.2021. 02.028”2021.02.028
Patikorn C, Saidoung P, Pham T, Phisalprapa P, Lee YY, Varady KA, Veettil SK, Chaiyakunapruk N. Effects of ketogenic diet on health outcomes: an umbrella review of meta-analyses of randomized clinical trials. BMC Medicine 2023;21(1):196. https://doi.org/10.1186/s12916-023- 02874-y”-y
Yang Q, Vijayakumar A, Kahn BB. Metabolites as regulators of insulin sensitivity and metabolism. Nat Rev Mol Cell Biol 2018;19(10):654-672. “https://doi. org/10.1038/s41580-018-0044-8”41580- 018-0044-8
Dowis K, Banga S. The potential health benefits of the ketogenic diet: A narrative review. Nutrients 2021;13(5):1654. “https://doi.org/10.3390%2Fnu1305 1654”13051654
Yang Z, Mi J, Wang Y, Xue L, Liu J, Fan M, Zhang D, Wang L, Qian H, Li Y. Effects of low-carbohydrate diet and ketogenic diet on glucose and lipid metabolism in type 2 diabetic mice. Nutrition 2021;89:111230. “https://doi.org/10.1016/j.nut.2021.1 11230”2021.111230
Skow SL, Jha RK. A ketogenic diet is effective in improving insulin sensitivity in individuals with Type 2 diabetes. Curr Diabetes Rev 2023;19(6):e250422203985.“https://doi.org/10.2174/1573399818666220425093535”1573399818666220425093535
Paoli A, Bianco A, Moro T, Mota JF, Coelho-Ravagnani CF. The effects of ketogenic diet on insulin sensitivity and weight loss, which came first: the chicken or the egg? Nutrients 2023;15(14):3120. “https://doi. org/10.3390%2Fnu15143120”15143120
Rafiullah M, Musambil M, David SK. Effect of a very low-carbohydrate ketogenic diet vs recommended diets in patients with type 2 diabetes: a meta-analysis. Nutr Rev 2022;80(3):488-502. “https://doi.org/10.1093/nutrit/nuab040”040
Zaki HA, Iftikhar H, Bashir K, Gad H, Fahmy AS, Elmoheen A. A comparative study evaluating the effectiveness between ketogenic and low-carbohydrate diets on glycemic and weight control in patients with type 2 diabetes mellitus: a systematic review and meta-analysis. Cureus 2022;14(5). “https://doi.org/10.7759/cu reus.25528”25528
Müller TD, Finan B, Bloom SR, D’Alessio D, Drucker DJ, Flatt PR, Fritsche A, Gribble F, Grill HJ, Habener JF, Holst JJ, Langhans W, Meier JJ, Nauck MA, Perez-Tilve D, Pocai A, Reimann F, Sandoval DA, Schwartz TW, Seeley RJ, Stemmer K, Tang-Christensen M, Woods SC, DiMarchi RD, Tschöp MH. Glucagon-like peptide 1 (GLP-1). Mol Metab 2019;30:72-130.“https://doi.org/10.1016%2Fj.molmet. 2019.09.010”2019.09.010
Widiatmaja DM, Lutvyani A, Sari D, Kurniasari H, Meiliana I, Fasitasari M, Yamaoka Y, Rejeki P. The effect of long-term ketogenic diet on serum adiponectin and insulin-like growth factor-1 levels in mice. J Basic Clin Physiol Pharmacol 2021;33(5):1-11. “http://dx.doi. org/10.1515/jbcpp-2021-0287”2021-0287
Deledda A, Palmas V, Heidrich V, Fosci M, Lombardo M, Cambarau G, Lai A, Melis M, Loi E, Loviselli A, Manzin A, Velluzzi F. Dynamics of gut microbiota and clinical variables after ketogenic and mediterranean diets in drug-naïve patients with Type 2 diabetes mellitus and obesity. Metabolites 2022;12(11):1092. “https://doi.org/1 0.3390%2Fmetabo12111092”12111092
Paoli A, Mancin L, Bianco A, Thomas E, Mota JF, Piccini F. Ketogenic diet and microbiota: friends or enemies? Genes 2019;10(7):534. “https://doi.org/10.3390/genes10070534”10070534
Publicado
2024-08-20
Cómo citar
Duarte-Inguanzo, S., Duarte-López, A., Zambrano, O., & Luengo-Fereira, J. A. (2024). Prediction of the individual response to treatment of skeletal Class II malocclusions and their long-term stability. A Case Report.: Predicción de la respuesta al tratamiento de las maloclusiones Clase II esqueléticas y su estabilidad a largo plazo. Presentación de un caso. Investigación Clínica, 65(3), 369-377. https://doi.org/10.54817/IC.v65n3a09
Sección
Reporte de Caso
