Evaluación de las propiedades psicométricas de la Escala de Curiosidad Epistémica de Litman en hispanohablantes

La Curiosidad Epistémica (CE) es el deseo que motiva a las personas a adquirir nuevo conocimiento. La escala de CE de Litman fue desarrollada para operacionalizar este constructo, y aunque su estructura latente ha sido validada en varios estudios, estos se han realizado en su mayoría en Alemania, EE. UU. y los Países Bajos, que son sociedades educadas, industrializadas, ricas y democráticas. Por consiguiente, el presente estudio evaluó las propiedades psicométricas de la escala de CE, en una muestra de adultos del noroeste de México (N = 334) con edades de 18 a 50 años. Al igual que en investigaciones previas, se compararon dos modelos: unidimensional y bidimensional, mediante análisis factoriales confirmatorios. Adicionalmente, se incluyeron los residuales correlacionados significativos, como parte de ambos modelos, y se examinó si el instrumento tiene invarianza de medición. Los resultados muestran que el modelo bifactorial presentó el mejor ajuste. La consistencia interna fue aceptable, y se comprobó que la escala posee invarianza configural, métrica, escalar y estricta. Usos potenciales de este constructo emergente incluyen su estudio como un factor motivacional relevante, en el nivel de involucramiento y las estrategias de formación de los estudiantes, así como su papel mediador en varios tipos de ansiedad en el aprendizaje.

Epistemic Curiosity (EC) is the desire that motivates people to acquire new knowledge. Litman's EC scale was developed to operationalize this construct, and although its latent structure has been validated in several studies, these have been conducted mostly in Germany, the Netherlands, and the United States, which are educated, industrialized, wealthy, and democratic societies. Therefore, the present study evaluated the psychometric properties of the EC scale in a sample of adults from northwestern Mexico (N = 334) aged 18 to 50 years. As in previous research, two models were compared: one unidimensional and one bidimensional, using Confirmatory Factor Analysis. Additionally, significantly correlated residuals were included as part of both models, and it was examined whether the instrument has measurement invariance. The results show that the bifactor model presented the best fit. The internal consistency was acceptable, and the scale was found to have configural, metric, scalar, and strict invariance. Potential uses of this emerging construct include its study as a relevant motivational factor in students' level of engagement and study strategies, as well as its mediating role in various types of learning anxiety.

Parálisis facial aislada posterior a infección por virus de chikunguña: un nuevo diagnóstico diferencial / Isolated facial palsy after Chikungunya infection: A novel differential diagnosis

En las últimas décadas, se ha incrementado el reporte de manifestaciones neurológicas asociadas con la infección por el virus de chikunguña. Se informa el caso de un adulto joven previamente sano que presentó parálisis facial izquierda aislada después de una infección reciente por el virus de chikunguña en el trópico colombiano. Se describen aspectos importantes de la fisiopatología del virus y su tropismo por el sistema nervioso central y periférico, y se sugiere considerar este virus en el diagnóstico diferencial de la parálisis facial en pacientes con infección confirmada por el virus de chikunguña en regiones tropicales endémicas o en aquellos con antecedente de viajes recientes a dichas regiones.

A significant raise in the reports of neurological manifestations due to Chikungunya virus has been described worldwide. Here, we describe a case report of a previously healthy young adult who developed isolated left facial palsy after a confirmed Chikungunya virus infection in the Colombian tropics. We suggest considering this virus as a differential diagnosis for facial palsy in patients with confirmed Chikungunya virus infection who live in endemic regions or report a history of recent travel to these regions.

Estudiantes con alta capacidad: explorando su distribución según tipo de establecimiento educativo / Gifted Students: Exploring their Distribution According to the Type of Educational Institution

Resumen Antecedentes: estudiantes con alta capacidad o potencial de talento académico, necesitan un entorno enriquecedor para alcanzar un desempeño sobresaliente, y fenómenos como la segregación escolar impactan negativamente la transformación del potencial intelectual en talento académico. Objetivo: comparar la distribución de estudiantes con alta capacidad de quinto básico a cuarto medio de la provincia de Concepción, Chile, provenientes de familias de nivel socioeconómico bajo, medio y alto, según el tipo de establecimiento educativo en que estudian. Método: participaron 650 estudiantes entre 11 y 17 años de edad, quienes respondieron el test de matrices progresivas de Raven, el cual permitió identificar el potencial intelectual según el puntaje de corte. Resultados: hay diferencias estadísticamente significativas en el potencial intelectual entre estudiantes de establecimientos públicos, particulares subvencionados y particulares pagados, así como diferencias en la distribución del potencial intelectual según el nivel educativo de los estudiantes y el nivel socioeconómico de sus familias. Conclusiones: al explorar la distribución de estudiantes con alta capacidad según el tipo de establecimiento educativo, hay una mayor concentración de estudiantes con alta capacidad en establecimientos educativos con familias de nivel socioeconómico alto y una menor concentración de estos en establecimientos educativos con familias de nivel socioeconómico bajo.

Abstract Background: Gifted students or students with academic potential need an enriching environment to achieve an outstanding performance. However, phenomena such as school segregation negatively affect the transformation of intellectual potential into academic talent. Objective: To compare the distribution of gifted students from the fifth grade of elementary school to the fourth year of high school in the Province of Concepción, Chile, coming from families of low, medium and high socioeconomic status, determined by the type of educational institution in which they study. Method: Six hundred fifty (650) students aged between 11 and 17 participated in the study and answered the Raven's Progressive Matrices Test, which allowed the identification of the intellectual potential based on the cut-off score. Results: Statistically significant differences were found in the intellectual potential among students from public, subsidized private and fee-paying private educational institutions, as well as differences in the distribution of the intellectual potential relative to the students' education level and their families' socioeconomic status. Conclusions: When exploring the distribution of gifted students according to the type of educational institution, there was a higher concentration of those students in educational institutions with families of high socioeconomic status, and a lower concentration in educational institutions with families of low socioeconomic status.

Regional anesthesia for compartment syndrome as a complication of ECMO. Case report / Anestesia regional para síndrome compartimental como complicación de ECMO. Reporte de caso

Abstract We present the case of a patient intervened for mechanical mitral replacement, tricuspid annuloplasty, and correction of a total anomalous pulmonary venous return, which required Extracorporeal Membrane Oxygenation (ECMO) in the immediate postoperative period because of refractory cardiogenic shock. After withdrawal of the arterial cannula, the patient developed compartment syndrome of the right lower limb, requiring urgent intervention. Also, the patient went into respiratory failure, requiring support with high flow oxygen cannula. Given the patient's condition, general anesthesia was discarded. An ultrasound-guided popliteal block and sedation with dexmedetomidine and ketamine was performed instead, maintaining the high flow nasal cannula. Regional anesthesia along with dexmedetomidine and ketamine could be an alternative for a surgical procedure in patients with high risk of cardiovascular and respiratory complications.

Resumen Presentamos el caso de una paciente femenina sometida a remplazo de válvula mitral mecánica, anuloplastia y corrección de retorno venoso pulmonar anómalo total, quien requirió oxigenación con membrana extracorpórea (ECMO) en el postoperatorio inmediato debido a shock cardiogénico refractario. Una vez retirada la cánula arterial, la paciente desarrolló síndrome compartimental de la extremidad inferior derecha, requiriendo intervención urgente. Adicionalmente, presentó insuficiencia respiratoria que requirió soporte de oxígeno por cánula de alto flujo. En vista de la condición de la paciente se descartó la anestesia general, optando a cambio por un bloqueo poplíteo guiado por ultrasonido más sedación con dexmedetomidina y ketamina, manteniendo la cánula nasal de alto flujo. La anestesia regional junto con dexmedetomidina y ketamina puede ser una alternativa para procedimientos quirúrgicos en pacientes de alto riesgo cardiovascular y complicaciones respiratorias.

Homonegatividad Internalizada en una Muestra Colombiana: Asociación con el Grado de Identificación con la Homosexualidad y las Variables Sociodemográficas / Internalized Homonegativity: Association with the Degree of Identification with Homosexuality and Sociodemographic Variables

Resumen Introducción: diferentes autores señalan la necesidad de realizar más estudios sobre las variables asociadas con la homonegatividad internalizada (HI) en Latinoamérica. Objetivo: explorar la asociación entre la HI, la autoidentificación con la homosexualidad y las variables sociodemográficas (género, edad, nivel educativo y desigualdad económica). Método: un muestreo no probabilístico tipo "Bola de nieve" fue realizado en un grupo de 489 personas con un promedio de 23.4 años de edad (DE=6.6) en cinco ciudades colombianas (Bogotá, Barranquilla, Pereira, Villavicencio y Tunja). El grado de autoidentificación con la homosexualidad fue estimado con la escala de Kinsey. También se utilizó un cuestionario de HI. Resultados: un análisis de regresión lineal jerárquica mostró que la HI está asociada significativamente con el género, el grado de identificación con la orientación sexual y la edad, pero no con el nivel educativo o la desigualdad económica. A pesar de que todas las variables estudiadas aportaron algún grado de varianza al modelo, la autoidentificación con la homosexualidad y el género aportaron el mayor porcentaje de varianza para explicar la asociación con HI. Discusión: este estudio permite una primera aproximación empírica al estudio de la HI en Colombia y resalta la importancia de implementar políticas públicas y el uso de terapias afirmativas para disminuirla, particularmente en hombres jóvenes en proceso de autoidentificación con la homosexualidad.

Abstract Introduction: Different authors highlight the need to conduct more studies on the variables associated with internalized homonegativity in Latin America. Objective: To explore the association between internalized homonegativity, self-identification with homosexuality and sociodemographic variables (i.e., sex, age, educational level, and economic inequality). Methods: Non-probabilistic type snowball sampling in a group of 489 people with an average of 23.4 years of age (SD = 6.6) from five Colombian cities (Bogotá, Barranquilla, Pereira, Villavicencio and Tunja). The degree of self-identification with homosexuality was measured with the Kinsey scale. An internalized homonegativity questionnaire was also used. Results: A linear hierarchical regression analysis showed that internalized homonegativity is significantly associated with sex, the degree of identification with sexual orientation and age, but not with educational level or economic inequality. Although all the variables contributed to some extent to the model, the identification with sexual orientation and sex showed the greatest contribution in variance to explain the association with internalized homonegativity. Discussion: This study is a first empirical approach to the study of internalized homonegativity in Colombia and highlights the importance of implementing public policies and the use of affirmative therapies to reduce internalized homonegativity, particularly in young men in the process of self-identification with homosexuality

Basic behavior guidance techniques A survey of members of the Spanish Society of Paediatric Dentistry

Background: Over the last 20–30 years social trends, educational and parenting patterns, and the ethical and legal factors guiding them have led to the revaluation and even abandonment of some traditionally used behavior guidance techniques (BGTs). Aims: To profile the professionals providing specialized pediatric treatments in Spain and understand changes in their preferences and use of basic BGTs, and the evolution of these preferences. Settings and Design: A cross-sectional, descriptive, and correlational study was designed. Methods: One hundred and twenty-six dentists completed a previously validated survey. Statistical Analysis: Descriptive statistics and Chi-square tests were performed to analyze the questionnaire data. Results: The most common BGTs were “Tell/Show/Do” (98%) and positive reinforcement (92.1%), and the most abandoned BGT was: “hand-over-mouth” (15%), because it was rejected by parents and because of potential legal problems and psychological consequences for the patients. Of note, 37% of the professionals allowed the patient's parents to be present during the treatment. Conclusions: There has been a notable decrease in the use of certain BGTs in Spain, especially hand-over-mouth and voice control, because they are becoming less socially acceptable as the way society relates to and educates children changes.

Análisis bibliométrico de las funciones ejecutivas de adultos mayores en Iberoamérica / Bibliometric analysis of executive functions of older adults in Ibero-America

RESUMEN Objetivos: a) Verificar la cantidad de estudios efectuados en Iberoamérica sobre función ejecutiva (FE) en adultos mayores; b) Identificar los instrumentos utilizados para medir las FE en adultos mayores durante los años 2009-2018. Material y métodos: Se efectuó un estudio bibliométrico sobre las FE en adultos mayores de Iberoamérica. La búsqueda de información se hizo en las base de datos Scopus y Scielo. Se consideraron estudios iberoamericanos publicados en idioma español y portugués, utilizándose ocho palabras clave y cinco indicadores registrados. Resultados: Se identificaron un total de 12 investigaciones originales en seis países iberoamericanos (España, Argentina, Chile, Colombia, Cuba, y Perú). La mayor cantidad de investigaciones relacionadas con FE en asultos mayores tuvo lugar en los periodos 2009-2010 y 2013-2014. En estos estudios, se han utilizado varios instrumentos con el Trail Making Test (TMT) y la Frontal Assessment Battery (FAB) como los de uso más frecuente. Conclusiones: Parece existir un interés limitado por investigar las FE en adultos mayores de Iberoamérica. La mayoría de los estudios idntificados en esta indagación utilizaron como tests cognitivos el TMT y la FAB.

SUMMARY Objectives: a) To verify the number of studies on executive functions (EF) in older adults carried out in Ibero-America; b) To identify the instruments used to measure EF in older adults during the years 2009-2018. Material and methods: A bibliometric study on EF in older adults in Latin America was carried out through the Scopus and Scielo databases. Studies published in Spanish and Portuguese languages using eight keywords and five registered indicators. Results: Between 2009 and 2018, a total of 12 original investigations have been carried out in six Iberoamerican countries (Spain, Argentina, Chile, Colombia, Cuba, and Peru). Most EF-related investigations were reported duing the 2010-2009 and 2013-2014 periods. Several instruments were used, the Trail Making Test and the Frontal Assessment Battery being the most frequent. Conclusions: There seems to be a limited interest in investigating EF in older adults in Ibero-America. Most of these studies identified in this inquiry used the TMT and the FAB as cognitive tests.

A prospective and randomized clinical trial evaluating the effectiveness of ART restorations with high-viscosity glass-ionomer cement versus conventional restorations with resin composite in Class II cavities of permanent teeth: two-year follow-up

Abstract Objective To compare the effectiveness of ART restorations using High Viscosity Glass-ionomer cement (HVGIC) with conventional restorations using resin composite in Class II cavities of permanent teeth, in a 2-year follow-up. Methodology Seventy-seven restorations were made with each restorative material, Equia Fil-GC Corporation (ART restorations) and Z350-3M (conventional restoration), in 54 participants in this parallel and randomized clinical trial. Restorations were evaluated at 6 months, 1 and 2 years using the ART and the modified United States Public Health Service (USPHS) criteria. Chi-square test and Survival Analysis (p<0.05) were used for statistical analysis. Results The success rates for ART restorations were 98.7% (6 months) and 95.8% (1 year) for both criteria. At 2 years, success rate was 92% and 90.3% when scored by the modified USPHS and ART criteria (p=0.466), respectively. The success rates for conventional restorations were 100% (6 months), 98.7% (1 year) and 91.5% (2 years) for both assessment criteria. ART restorations presented a lower survival rate by the criterion of ART (83.7%) when compared to the modified USPHS criterion of (87.8%), after 2 years (p=0.051). The survival of conventional restorations was 90.7% for both evaluation criteria. Conclusion At the 2-years follow-up evaluation, no statistically significant difference was observed between the success rate of ART restorations with HVGIC compared to conventional restorations with resin composite in Class II cavities of permanent teeth.

Reporte de caso: Bloqueo del erector de la espina en resección transuretral de próstata / Case report: Erector spine block for transuretral prostatic resection

The Erector Spinae Plane (ESP) block, described in 2016 by Dr. Forero et al, was used to treat neuropathic pain and postoperative acute pain. It was described as an interfascial block in the erector spinae plane, where it manages to block both ventral and dorsal branches of the spinal nerve. Due to scarce literature on its applicability in urological endoscopic surgeries, we formulate the hypothesis that it would be an effective opioid-sparing analgesic alternative in patients undergoing TULIP. Therefore, bilateral ESP was performed in a 69-year-old patient, who underwent transurethral prostatectomy guided by laser induced (TULIP) for benign prostatic hyperplasia. The patient did not require rescue medication, reported a maximum VAS of 4/10. At 72 hours postoperatively, the patient kept a VAS of 0/10, without nausea and vomiting, with a Likert satisfaction level of 1

El bloqueo del plano erector de la espina (ESP) fue descrito en 2016 por el Dr. Forero et al., con el afán de tratar el dolor neuropático y el dolor agudo posoperatorio. Consiste en un bloqueo interfascial en el plano del erector de la espina, en el cual se logra el bloqueo tanto de ramas ventrales como dorsales de los nervios espinales. Debido a la falta de literatura sobre su indicación en cirugías endoscópicas urológicas se formula la hipótesis de que podría considerarse como una alternativa analgésica efectiva ahorradora de opioides en pacientes sometidos a RTU-P. Por lo anterior se realizó el bloqueo ESP de manera bilateral a un paciente de 69 años, el cual fue sometido a prostatectomía transuretral guiado por láser inducido (TULIP) por hiperplasia prostática benigna. El paciente no requirió opioides de rescate, con EVA 0/10 en posoperatorio, valor que se mantuvo de la misma manera por 72 h, tanto en reposo como en movimiento, sin la presencia de náuseas o vómitos y una escala de satisfacción de Likert de 1.

Dental caries spectrum profile in Brazilian public school children and adolescents

Abstract Dental caries remains a major public health problem, with a higher prevalence among in adolescence. The present study aimed to assess the dental caries spectrum profile in children and adolescents in Brazilian public schools. A cross-sectional study was performed in two public schools in Brazil to examine the permanent teeth of children and adolescents. The dental caries were assessed by applying the Caries Assessment Spectrum and Treatment (CAST) instrument, and the results were distributed as per disease status (healthy/codes 0-2; pre-morbidity/code 3; morbidity/code 4-5; severe morbidity/codes 6-7; mortality/code 8) and by severity as per the CAST-F1 formula (no severity, mild, moderate, and severe). The CAST data were described by age groups (8-9 y, 10-11 y, 12-13 y, 14-15 y, 16-17 y, and 18-19 y). The Kruskal-Wallis test was used to investigate differences in CAST prevalence and severity among the groups (p < 0.05). Total 598 students were enrolled. Most of the subjects were male (53.34%) and belonged to the age group of 12-13 y (34.95%). The variables CAST 0/1 (p = 0.024), CAST (p = 0.024), and CAST-F1 (p = 0.029) showed significant differences among age groups, and the post hoc test showed the differences in these variables as per the age groups of 14-15 y and 16-17 y (CAST 0/1, p = 0.047; CAST, p = 0.047; CAST-F1, p = 0.033). The dental caries spectrum increased from 8 to 19 y with a peak in the prevalence and severity in the middle of adolescence.

Metodologías innovadoras sobre maltrato infantil para una formación integral de los futuros odontólogos Iberoamericanos. Revisión bibliográfica. / Metodologias inovadoras sobre abuso infantil para para uma formação integral dos futuros odontólogos na Iberoamérica. Revisão bibliográfica / Innovative methodologies in dental teaching about child abuse for a comprehensive training of future oral health professionals in Ibero-America. A bibliographic review

Según la Organización Mundial de la Salud, los odontólogos tienen un papel fundamental en el diagnóstico y la denuncia de posibles casos de maltrato infantil. Además, en la mayoría de los países, se han ido implementando regulaciones legales para la protección infantil que exigen a los profesionales de salud incluyendo a los odontólogos, informar de cualquier sospecha justificada, sin embargo el porcentaje de profesionales de la salud oral que lo hacen no es consecuente con las cifras anuales publicadas sobre este grave problema social, indicando muchas veces como principal razón un déficit en el entrenamiento académico durante los estudios universitarios de Odontología. Metodologías innovadoras sobre maltrato infantil para una formación integral de los futuros odontólogos Iberoamericanos. Revisión bibliográfica.Noemi Gutierrez Vigo,1........Dra. Ana María Leyda Menéndez,2........ Fátima González Galván,3........Dra. María José Gavara Navarro,2........Revista de Odontopediatría Latinoamericana¹ Odontopediatra de práctica privada2 Profesora asociada del Máster Propio en Odontopediatría Integral. Universidad CEU Cardenal Herrera. Valencia. España³ Profesora asociada de Odontopediatría y del Máster Propio en Odontopediatría Integral. Universidad CEU Cardenal Herrera. Valencia. España.Artículo de RevisiónDOI: 10.47990/alop.v11i2.273En otros casos, la formación académica recibida parece mejorar los conocimientos teóricos sobre el tema, pero no fortalece la confianza de los odontólogos para reconocer un posible caso, y definir la ruta de atención al menor posible víctima de malos tratos. Actualmente, las facultades de Odontología han fortalecido sus procesos de enseñanza-aprendizaje de la práctica clínica. Este estudio realizó una revisión de la literatura sobre las nuevas metodologías de aprendizaje que pueden colaborar a mejorar la formación, capacitación y compromiso de los estudiantes de Odontología en relación al maltrato infantil planteando una propuesta docente al respecto.

Innovative methodologies in dental teaching about child abuse for a comprehensive training of future oral health professionals in Ibero-America. A bibliographic review. Article of revisionAbstractAccording to the World Health Organization, dentists have a fundamental role in the diagnosis and reporting of possible cases of child abuse. In addition, in most countries, legal regulations for the protection of children have been implemented that require health professionals, including dentists, to report any justified suspicion. However, the percentage of oral health professionals who do so is not consistent with the annual figures published on this serious social problem, often indicating as the main reason a deficit in academic Metodologías innovadoras sobre maltrato infantil para una formación integral de los futuros odontólogos Iberoamericanos. Revisión bibliográfica.e-320200Vol 11 N° 2 Julio - Diciembre 2021ResumoDe acordo com a Organização Mundial da Saúde, os dentistas desempenham um papel fundamental no diagnóstico e reporte dos potenciais casos de abuso infantil, além disso, na maioria dos países, foram implementados regulamentos legais para a proteção da criança que exigem que os profissionais de saúde, incluindo os dentistas, reportem quaisquer suspeitas justificadas, no entanto a percentagem de profissionais de saúde oral que o fazem não é consistente com os números anuais publicados sobre este grave problema social, muitas vezes indicando como a principal razão para um défice na formação académica durante os estudos universitários em Medicina Dentária. Noutros casos, a formação académica recebida parece melhorar o conhecimento teórico sobre o assunto, mas não reforça a confiança dos médicos dentistas em reconhecer um possível caso, e definir o percurso de cuidados para a menor vítima possível de maus tratos.Atualmente, as faculdades de medicina dentária reforçaram os seus processos de ensino-aprendizagem da prática clínica. Este estudo realizou uma revisão literária sobre as novas metodologias de aprendizagem que podem ajudar a melhorar a formação e envolvimento dos estudantes de medicina dentária em relação ao abuso infantil apresentando uma proposta docente a este respeito.

According to the World Health Organization, dentists have a fundamental role in the diagnosis and reporting of possible cases of child abuse. In addition, in most countries, legal regulations for the protection of children have been implemented that require health professionals, including dentists, to report any justified suspicion. However, the percentage of oral health professionals who do so is not consistent with the annual figures published on this serious social problem, often indicating as the main reason a deficit in academic

Survival rates of advanced estrogen-receptor positive breast cancer. Analysis of 211 cases

ABSTRACT Background: About 80% of breast cancer (BC) cases express estrogen receptor (ER), which has been correlated with good prognosis and response to estrogen deprivation Aim: To characterize ER positive advanced BC (ABC) patients treated at our institution assessing the impact of clinical pre-sentation (stage IV, de novo disease at diagnosis versus systemic recurrence) and BC subtype on survival rates. Material and Methods: We evaluated 211 ER+ advanced BC (ABC) patients, treated between 1997 and 2017. Results: The median overall survival (OS) was 37 months. Median OS for the period 1997/2006 and 2007/2017 were 33 and 42 months, respectively (p = 0.47). Luminal A, ABC stage IV disease at diagnosis displayed better OS rates than Luminal B stage IV tumors (100 and 32 months respectively, p < 0.01). Conclusions: Clinical presentation (stage IV vs. systemic recurrence) and tumor subtype are key determinants of OS in ABC.

Antecedentes: Casi el 80% de los casos de cáncer de mama (CM) son positivos para receptores de estrógenos (RE+). Éstos se caracterizan por una mejor sobrevida y respuesta a terapia endocrina. Objetivo: Caracterizar a pacientes con CM avanzado (CMA), RE+, y determinar sobrevida según presentación clínica y subtipos. Material y Métodos: Analizamos en nuestra base de datos los antecedentes de 211 pacientes con CMA RE+, tratados en nuestra institución en el período 1997-2017. Se evaluó el impacto de la presentación clínica (estadio IV al diagnóstico, enfermedad de novo, versus recurrencia sistémica) y subtipo de CM, en los niveles de sobrevida. Resultados: La mediana de sobrevida global (SG) fue de 37 meses. La mediana de SG para el período 1997/2006 y 2007/2017 fue de 33 y 42 meses; respectivamente (p = 0,47). Pacientes con CMA, estadio IV, Luminal A al momento del diagnóstico mostraron mejores tasas de SG frente al estadio IV del Luminal B (100 y 32 meses respectivamente (p < 0,01). Conclusiones: La presentación clínica (estadio IV, de novo, versus recurrencia sistémica) y subtipo son determinantes clave de la SG en CMA.

Farmacocinética da micafungina em pacientes tratados com oxigenação por membrana extracorpórea: um estudo observacional prospectivo / Pharmacokinetics of micafungin in patients treated with extracorporeal membrane oxygenation: an observational prospective study

RESUMO Objetivo: Determinar os níveis plasmáticos e o comportamento farmacocinético da micafungina em pacientes tratados com oxigenação por membrana extracorpórea. Métodos: As amostras foram colhidas por meio de pontos de acesso antes e depois da membrana, em dois hospitais espanhóis de nível terciário. Os momentos para o cálculo das curvas farmacocinéticas foram antes da administração do fármaco, e 1, 3, 5, 8, 18 e 24 horas após o início da infusão nos dias 1 e 4 de tratamento. Calcularam-se a área sob a curva, a depuração do fármaco, o volume de distribuição e a meia-vida plasmática por meio de análise farmacocinética não compartimental. Resultados: Os valores farmacocinéticos analisados no primeiro e quarto dias de tratamento não mostram qualquer diferença de concentração entre amostras colhidas antes da membrana e após a membrana, e o comportamento farmacocinético foi similar na vigência de diferentes falências de órgãos. A área sob a curva antes da membrana no dia 1 foi de 62,1 (IC95% 52,8 - 73,4) e a área sob a curva após a membrana nesse mesmo dia foi de 63,4 (IC95% 52,4 - 76,7), com p = 0,625. A área sob a curva antes da membrana no dia 4 foi de 102,4 (IC95% 84,7 - 142,8), enquanto a área sob a curva após a membrana nesse mesmo dia foi de 100,9 (IC95% 78,2 - 138,8), com p = 0,843. Conclusão: Os parâmetros farmacocinéticos da micafungina não foram alterados significantemente.

ABSTRACT Objective: To determine micafungin plasma levels and pharmacokinetic behavior in patients treated with extracorporeal membrane oxygenation. Methods: The samples were taken through an access point before and after the membrane in two tertiary hospitals in Spain. The times for the calculation of pharmacokinetic curves were before the administration of the drug and 1, 3, 5, 8, 18 and 24 hours after the beginning of the infusion on days one and four. The area under the curve, drug clearance, volume of distribution and plasma half-life time with a noncompartmental pharmacokinetic data analysis were calculated. Results: The pharmacokinetics of the values analyzed on the first and fourth day of treatment did not show any concentration difference between the samples taken before the membrane (Cin) and those taken after the membrane (Cout), and the pharmacokinetic behavior was similar with different organ failures. The area under the curve (AUC) before the membrane on day 1 was 62.1 (95%CI 52.8 - 73.4) and the AUC after the membrane on this day was 63.4 (95%CI 52.4 - 76.7), p = 0.625. The AUC before the membrane on day 4 was 102.4 (95%CI 84.7 - 142.8) and the AUC was 100.9 (95%CI 78.2 - 138.8), p = 0.843. Conclusion: The pharmacokinetic parameters of micafungin were not significantly altered.

Biodentine y su uso en dentición temporal. Revisión de la literatura

La biocompatibilidad y bioactividad se han convertido en características casi imprescindibles en cualquier material de uso dental. De manera reciente disponemos del Biodentine®. Se trata de un cemento con altas propiedades físico-mecánicas que comenzó a ser comercializado en el 2009 y fue especialmente diseñado como sustituto dentinario. Para la odontopediatría, esta búsqueda de nuevos materiales eficaces, resistentes y biocompatibles es especialmente importante en algunos tratamientos como la pulpotomía en los que los fármacos clásicamente utilizados, como el formocresol, han sido apartados del uso clínico por su potencial tóxico. Debido, por un lado, a un mayor uso del Biodentine® en la clínica dental, especialmente en el tratamiento odontopediátrico, y por otro, a la mayor producción científica al respecto, se ha creído conveniente realizar esta revisión de la literatura con el objetivo de recoger de manera sistematizada el conocimiento actualizado sobre este material y su empleo en odontopediatría.

Molecular response of pulp fibroblasts after stimulation with pulp capping materials

Abstract This in vitro study evaluated cell viability and metabolism, nitric oxide release and production of two chemokines and one cytokine by cultured human dental pulp fibroblasts (HDPF) in contact with two glass ionomer cements (Ketac Molar-KM and Vitrebond-VB), Single Bond (SB) and calcium hydroxide (Dycal-DY). Cultures of HDPF were established by means of an explant technique. The specimens were prepared under sterile conditions and in disks measuring 5 mm x 2 mm obtained from a prefabricated mold and placed on a permeable membrane to avoid direct contact with the cells. Cytotoxicity was assessed by Trypan Blue exclusion method and 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT) assay. Nitric oxide release in cell supernatant was detected by the Griess Method whereas stromal derived factor-1 alpha (SDF-1α or CXCL12), chemokine (C-X-C motif) ligand 8 [Interleukin 8 (IL-8 or CXCL8)] and interleukin-6 (IL-6) were detected by ELISA. RT-qPCR was employed for gene expression analysis. Statistical analyses were performed by One-way ANOVA followed by Tukey's post hoc test for materials independent of the time, and Two-way ANOVA followed by Bonferroni correction test for the comparisons between materials and experimental time (p<0.05). Cytotoxic tests showed significant differences only for DY. Protein levels and mRNA expression were significantly increased for IL-8 for both periods of time. IL-6 production increased when fibroblasts were stimulated by KM. SDF-1α protein production and mRNA expression were not affected by any of the materials. There was a decrease in nitrate/nitrite levels only for KM. Although DY caused intense cell death and did not stimulate the production of the inflammatory mediators evaluated in this work, it is known that this event seems to be fundamental for the process of repair of the pulp tissue and formation of mineralized barrier. KM and VB increased production of proteins related to the inflammatory process, thus favoring tissue repair. Therefore, although these glass ionomer cements did not lead to large cell death, they should be used with caution.

Resumo Este estudo avalia in vitro a viabilidade e metabolismo celular, a liberação de óxido nítrico e a produção de duas quimiocinas e uma citocina por fibroblastos de polpa dentária humana em cultura (FPDH) em contato com dois cimentos de ionômero de vidro (Ketac Molar-KM e Vitrebond-VB), Single Bond (SB) e hidróxido de cálcio (Dycal-DY). As culturas de FPDH foram estabelecidas por meio de uma técnica de explante. As amostras foram preparadas em condições estéreis e em discos de 5 mm x 2 mm, obtidas de um molde pré-fabricado e colocadas em uma membrana permeável (Maxicell 24 W 0,4 µm) para evitar o contato direto com as células. A citotoxicidade foi avaliada pelo método de exclusão de Trypan Blue e pelo ensaio de MTT. A liberação de óxido nítrico no sobrenadante celular foi detectada pelo método Griess, enquanto fator 1 derivado do estroma (SDF-1α ou CXCL12), interleucina-8 (IL-8 ou CXCL8) and interleucina-6 (IL-6) foram detectados por ELISA. RT-qPCR foi empregada para análise de expressão gênica. As análises estatísticas foram realizadas por ANOVA a 1 critério, seguida pelo pós-teste de Tukey para os materiais independentes do tempo, e ANOVA a 2 critérios, seguida pelo teste de correção de Bonferroni para comparações entre materiais e tempo experimental (p<0,05). Os testes citotóxicos mostraram diferenças significativas apenas para DY. Os níveis da proteína e a expressão de RNAm para IL-8 aumentaram significativamente para ambos os tempos estudados. A produção de IL-6 aumentou quando os fibroblastos foram estimulados por KM. A produção da proteína e a expressão de RNAm para SDF-1α não foram afetadas por nenhum dos materiais. Houve uma diminuição nos níveis de nitrato/nitrito apenas para KM. Embora o DY tenha causado intensa morte celular e não tenha estimulado a produção dos mediadores inflamatórios avaliados neste trabalho, sabe-se que esse evento parece ser fundamental para o processo de reparo do tecido pulpar e formação de barreira mineralizada. Os cimentos de ionômero de vidro utilizados aumentaram a produção de proteínas relacionadas ao processo inflamatório, favorecendo a reparação tecidual e, portanto, esses materiais, embora não causem grande morte celular, devem ser utilizados com cautela.

Correlation between mechanical properties and stabilization time of chemical bonds in glass-ionomer cements

Abstract The objective was to evaluate the compressive strength (CS), diametral tensile strength (DTS), flexural strength (FS), and Knoop microhardness (KH) of different conventional restorative glass-ionomer cements (GICs) and to correlate these mechanical properties (MP) with the stabilization time (ST) of their chemical bonds. Eighteen GICs were tested: Bioglass [B], Chemfil Rock [CR], Equia Forte [EF], Gold Label 2 [GL2], Gold Label 9 [GL9], Glass Ionomer Cement II [GI], Ionglass [IG], Ion Z[ IZ], Ionomaster [IM], Ionofil Plus [IP], Ionostar Plus [IS], Ketac Molar Easymix [KM], Magic Glass [MG], Maxxion R [Ma], Riva Self Cure [R], Vidrion R [V], Vitro Fil [VF] and Vitro Molar [VM]. The mechanical strength tests were performed in a universal testing machine. KH readings were done with a diamond indenter. STs were examined by Fourier Transform Infrared spectroscopy (FTIR). Data were analyzed with ANOVA and Tukey test (p<0.05). The Spearman rank test was used to evaluate the dependence between the MPs and ST results. The highest MP values were EF, GL2, GL9, GI and KM and the lowest for MG, MA, B, VF and IM. The longest ST was for GL2 and the shortest was for B. ST correlated positively with MP. GICs with longer chemical bonds ST are generally stronger and the ST value obtained from FTIR was useful in predicting the strength of GICs tested.

Factores predictores de reconsulta por gastroenteritis aguda en urgencias pediátricas: estudio de casos y controles / Predictor factors for emergency department revisiting of children with acute gastroenteritis: case-control study

INTRODUCCIÓN: El objetivo de este trabajo es describir factores de riesgo de reconsulta en pacientes con diagnóstico de gastroenteritis aguda, identificables en su primera visita a Urgencias. PACIENTES Y MÉTODO: Estudio casos-control, incluye pacientes entre 0-16 años que consultan en Urgencias de un hospital terciario durante 4 años. Se define caso el episodio de Urgencias con diagnóstico de gastroenteritis que reconsulta durante las 72 h posteriores. Se seleccionó un control por cada caso, siendo este el primer paciente que consultó tras cada caso con el mismo diagnóstico y que no reconsultó posteriormente. Se estudiaron variables epidemiológicas, clínicas e intervenciones diagnóstico-terapéuticas llevadas a cabo durante la primera visita, realizándose análisis uni y multivariable del riesgo de reconsulta utilizando modelos de regresión logística. RESULTADOS: Los diagnósticos de gastroenteritis supusieron el 5,3% de todas las visitas a urgencias. 745 pacientes (6,2%) reconsultaron en las siguientes 72 h. En el análisis multivariado se encontró asociación entre la reconsulta con cada año de aumento de edad (OR 0,94; IC 95%: 0,91-0,97), ausencia de vacunación de rotavirus (OR 1,47; IC 95%: 1,11-1,95), no valoración previa en atención primaria (OR 1,55; IC 95%: 1,09-2,19), mayor número de deposiciones en las últimas 24 h (OR 1,06; IC 95% 1,02-1,10) y recogida de coprocultivo en Urgencias (OR 1,54; IC 95%: 1,05-2,24). CONCLUSIONES: Los pacientes de menor edad con elevada frecuencia de deposiciones son especialmente susceptibles de volver a consultar en los servicios de Urgencias. La vacunación frente a rotavirus podría disminuir las reconsultas. Ninguna de las actuaciones diagnóstico-terapéuticas realizadas parece disminuir el número de revisitas a Urgencias.

INTRODUCTION: The objective of this work is to describe risk factors for reconsultation in patients with an acute gastroenteritis diagnosis, identifiable in their first visit to the Emergency Department. PATIENTS AND METHOD: Case-control study, including patients aged between 0-16 years who consulted in the Emer gency Department (ED) of a tertiary hospital for 4 years. The case is defined as the episode with a gastroenteritis diagnosis that reconsulted within 72 hours. A control was selected for each case, which was the first patient to consult after each case with the same diagnosis and not reconsulted later. Epidemiological and clinical variables, and diagnostic-therapeutic interventions carried out during the first visit were studied. Univariate and multivariate analyses of the reconsultation risk were per formed using logistic regression models. RESULTS: Gastroenteritis diagnoses accounted for 5.3% of all ED visits. 745 patients (6.2%) reconsulted within 72 hours. Multivariate analysis found association between reconsultation with each year of increasing age (OR 0.94, 95% CI 0.91-0.97), absence of rotavirus vaccination (OR 1.47, 95% CI: 1.11-1.95), no prior assessment in primary care (OR 1.55, 95% CI 1.09-2.19), increased stool output in the last 24 hours (OR 1.06, 95% CI 1.02-1.10), and stool collection in the ED (OR 1.54, 95% CI 1.05-2.24). CONCLUSIONS: Younger patients with an increased stool output are especially susceptible to return to the ED for consultation. Rotavirus vaccination could reduce reconsultation. None of the diagnostic-therapeutic actions carried out seems to reduce the number of visits to the ED.

Proximal retention grooves may increase early fracture strength of ART restorations / Sulcos de retenção proximal podem aumentar a resistência a fratura precoce de restaurações de ART

Objective: To evaluate the fracture resistance (RF) of Class II Glass-ionomer Cement (GIC) ART restorations with and without proximal retentions. Material and Methods: 20 freshly extracted human molars were used. Forty (40) standard Mesial-Occlusal (MO) and DistalOcclusal (DO) preparations (20 for each material) were performed with a 245 bur. The unprepared surfaces of the teeth were protected with nail polish and the specimens submerged in 0.5Mol EDTA solution, pH 7.4 for 8h under stirring. The preparations were finished with dentine spoons and 50% received proximal retention with # 3 excavators. 20 cavities were restored with Chemfil Rock (10 with retention and 10 without retention) and 20 cavities were restored with Equia Fil (10 with retention and 10 with no retention) and were stored in an oven at 37ºC and 100% relative humidity for 24h and submitted to axial compression loading in Test Machine - EMIC at a rate of 0.5 mm / minute, until restoration fracture occurred. The values were analyzed by two-way ANOVA (p<0.05). Results: ChemFil Rock presented 300.84 (69.20) (without retention) and 361.70 (81.08) (with retention) and Equia Fil showed 314.60 (69.97) (without retention) and 366.67 (103.38) (with retention). Data obtained with retention were statistically superior to those obtained with non-retained ART restorations (p=0.014). No statistical differences were detected between materials (p=0.761). Conclusion: Retentive grooves improved fracture resistance of Class II GIC ART restorations. (AU)

Objetivo: avaliar a resistência à fratura (FR) de restaurações de ART de Classe II de Cimento de ionômero de vidro (CIV) com e sem retenções proximais. Material e Métodos: Foram utilizados 20 molares humanos recém-extraídos. 40 cavidades padronizadas no sentido Mesial-Oclusal (MO) e Oclusal-Distal (OD) (20 para cada material) foram realizadas com uma broca 245. Os preparos cavitários foram submersos em solução 0,5 mol Mol EDTA, pH 7,4 por 8h sob agitação e foram finalizados com colheres de dentina, nos quais 50% receberam retenções proximais com escavadores #3. 20 cavidades foram restauradas com Chemfil Rock (10 com e 10 sem retenção) e 20 cavidades foram restauradas com Equia Fil (10 com e 10 sem retenção) e armazenadas em estufa a 37ºC e 100% de umidade relativa por 24h e submetidos a carga axial de compressão na máquina de ensaios EMIC a uma taxa de 0,5mm/min, até que a fratura de restauração ocorresse. Os valores foram analisados por ANOVA twoway (p<0,05). Resultados: ChemFil Rock apresentou 300.84 (69.20) (sem retenção) e 361.70 (81.08) (com retenção) e o Equia Fil apresentou 314.60 (69.97) (sem retenção) e 366.67 (103.38) (com retenção). Os dados obtidos com retenção foram estatisticamente superiores àqueles sem retenção (p=0.014). Não houve diferença estatística entre os materiais (p=0.761). Conclusão: Os sulcos retentivos melhoraram a resistência à fratura de restaurações de ART de Classe II de Cimento de ionômero de vidro (CIV).(AU)

Mechanical and optical properties of conventional restorative glass-ionomer cements - a systematic review

Abstract Objectives To perform a systematic review of test methodologies on conventional restorative glass-ionomer cement (GIC) materials for mechanical and optical properties to compare the results between different GICs. Material and Methods Screening of titles and abstracts, data extraction, and quality assessments of full-texts were conducted in search for in vitro studies on conventional GICs that follow the relevant specifications of ISO standards regarding the following mechanical and optical properties: compressive strength, flexural strength, color, opacity and radiopacity. Sources The Latin American and Caribbean Health Sciences (LILACS), Brazilian Bibliography of Dentistry (BBO) databases from Latin-American and Caribbean System on Health Sciences Information (BIREME) and PubMed/Medline (US National Library of Medicine - National Institutes of Health) databases were searched regardless of language. Altogether, 1146 in vitro studies were selected. Two reviewers independently selected and assessed the articles according to pre-established inclusion/exclusion criteria. Among all the properties investigated, only one study was classified as being of fair quality that tested compressive strength and was included. It was observed that many authors had not strictly followed ISO recommendations and that, for some properties (diametral tensile strength and microhardness), there are no guidelines provided. Conclusions It was not possible to compare the results for the mechanical and optical properties of conventional restorative GICs due to the lack of standardization of studies.