Percepciones sobre la lactancia materna y características sociodemográficas de un grupo de madres adolescentes colombianas / Perceptions about breastfeeding and sociodemographic characteristics of a group of Colombian adolescent mothers

La baja adherencia a la lactancia materna en los primeros seis meses de vida del bebé es un gran problema en Colombia. Investigar las percepciones de las madres adolescentes es esencial para el incentivo a la lactancia materna exclusiva. Así, el objetivo de este estudio fue conocer las percepciones sobre la lactancia materna y describir las características sociodemográficas de madres adolescentes lactantes que participan en el Programa de Crecimiento y Desarrollo de la Corporación Hospital San Juan de Dios UniRemington en Colombia. Se trata de un estudio observacional cualitativo transversal realizado entre 2020 y 2021 mediante entrevistas semiestructuradas. Estas se realizaron según un guión de preguntas abiertas a madres adolescentes que amamantan a bebés menores de 2 años, utilizando grabadora de audio, diarios de campo y datos sociodemográficos obtenidos de registros hospitalarios. La muestra y resultados se basearon en la saturación de datos, según las narrativas organizados en temas a partir del análisis temático junto con repeticiones de observaciones y descripciones de datos sociodemográficos. De las diez jóvenes, el 70% tenía un bajo nivel de escolarización y su percepción de la lactancia estaba relacionada con su conocimiento de los beneficios de la lactancia para la nutrición del bebé y el vínculo madre-hijo, pero con muchas dificultades esta realidad se ha convertido en una utopía. Hubo una díada de alegría y dolor en las vivencias. Se concluyó que las percepciones estaban relacionadas con la falta de apoyo médico y familiar para madres adolescentes. Se sugieren más estudios en diferentes poblaciones maternas.

Low adherence to breastfeeding in the first six months of a baby's life is a major problem in Colombia. Investigating the perceptions of adolescent mothers is essential to encourage exclusive breastfeeding. Thus, the objective of this study was to learn about the perceptions of breastfeeding and to describe the sociodemographic characteristics of breastfeeding adolescent mothers who participated in the Growth and Development Program of the Hospital San Juan de Dios UniRemington Corporation in Colombia. This is a cross-sectional qualitative observational study conducted between 2020 and 2021 using semi-structured interviews. These were carried out according to a script of open-ended questions to teenage mothers who were breastfeeding babies under 2 years of age, using tape recorders and field diaries and sociodemographic data obtained from hospital registers. The sample and results were based on data saturation according to narratives organized into themes from the thematic analysis together with repetitions of observations and descriptions of sociodemographic data. Of the ten young women, 70% had a low level of schooling and their perception of breastfeeding was related to their knowledge of the benefits of breastfeeding for baby nutrition and mother-child bond, but with many difficulties this reality has become a utopia. There was a dyad of joy and pain in the experiences. It was concluded that the perceptions were related to the lack of medical and family support for adolescent mothers. Further studies in different maternal populations are suggested.

Utilidad del método pirogalol salicilato en la identificación de lactoperoxidasa tiocianato salival / Usefulness of the pyrogallol salicylate method in identifying the salivary lactoperoxidase thiocyanate

RESUMEN Introducción: La enzima lactoperoxidasa tiocianato se produce por células epiteliales de las glándulas salivales y desempeña funciones defensivas contra microorganismos patógenos de la cavidad oral, por tanto, identificar su presencia por métodos cualitativos podría ser de utilidad para investigar una de las causas de infecciones orales recurrentes como la periodontitis, gingivitis y caries dental, donde se ha reportado una relación con los niveles bajos de esta enzima en diferentes estudios. Objetivo: Demostrar la utilidad del método pirogalol salicilato en la identificación de la enzima lactoperoxidasa tiocianato salival. Métodos: Se desarrolló un estudio piloto, descriptivo, observacional y transversal, en el Centro de Inmunología y Productos Biológicos de la provincia Camagüey, en el período de junio a octubre de 2020 mediante el empleo del método del pirogalol salicilato para identificar la presencia de la enzima lactoperoxidasa tiocianato en saliva humana. Se utilizaron 14 muestras de saliva que se analizaron después de la transformación enzimática del sustrato a 405 nm. Los datos obtenidos fueron procesados mediante estadística descriptiva. Resultados: La enzima lactoperoxidasa tiocianato se encontró en todas las muestras salivales estudiadas. La absorbancia de las muestras se halló entre 0,406 y 0,939 unidades. Conclusiones: El método del pirogalol salicilato resulta útil en la identificación de la enzima lactoperoxidasa tiocianato salival lo cual puede ser favorable en el estudio de infecciones bucales.

ABSTRACT Introduction: The enzyme lactoperoxidase thiocyanate is produced by epithelial cells of the salivary glands and performs defensive functions against pathogenic microorganisms of the oral cavity, therefore, identifying its presence by qualitative methods could be useful when investigating the causes of recurrent oral infections such as periodontitis, gingivitis and dental caries, in which a relationship with low levels of this enzyme has been reported in different studies. Objective: To demonstrate the usefulness of the pyrogallol salicylate method in the identification of the salivary enzyme lactoperoxidase thiocyanate. Methods: An observational and cross-sectional pilot study was carried out at the Center of Immunology and Biological Products of Camagüey, from June to October 2020, using the pyrogallol salicylate method to identify the lactoperoxidase thiocyanate enzyme in human saliva. Fourteen saliva samples were analyzed by observation and spectrophotometry at a wavelength of 405 nm. Descriptive statistical methods were applied to process data. Results: The enzyme lactoperoxidase thiocyanate was found in all the salivary samples studied. The absorbance of the samples ranged between 0,406 and 0,939. Conclusions: The pyrogallol salicylate method is useful in identifying the salivary lactoperoxidase enzyme, which may be favorable in the study of oral infections.

Are salivary flow rates associated with histopathologic aspects in patients with rheumatoid arthritis?

Abstract The aim of this retrospective cross-sectional study was to verify the association between salivary flow rates (SFR) and the histopathologic aspects of labial salivary glands (LSG) in patients with rheumatoid arthritis (RA). Patients presenting rheumatologic diseases referred for oral evaluation were included in the study if they had RA and had SFR measured and LSG biopsy performed. Patients were excluded if they had systemic conditions that affect SFR or if they were being treated for hyposalivation. Cases without enough material for histopathologic analysis were also excluded. Data were collected through questionnaires, oral examination, resting and stimulated SFR, and LSG biopsies. A histopathologic reevaluation was carried out in order to seek for additional histopathologic aspects. Fifty-one patients met the inclusion criteria. The mean age was 53.5 years (25-77), and 94.1% were women. The median resting and stimulated SFRs were 0.24 mL/min and 1.02 mL/min, respectively. The presence of lymphocytic focus and fibrosis were significantly associated with stimulated SFR, but not with resting SFR. The odds ratio of patients who had hyposalivation for presenting a positive lymphocytic focus was 7.33 (confidence interval CI: 1.53-35.23) by the stimulated technique, and 2.56 (CI: 0.57-11.40) in resting SFR. In the medical records, 14 (31.80%) patients had been diagnosed with secondary Sjögren's syndrome. In conclusion, stimulated SFR represent a good screening test to predict lymphocytic focus in LSG in patients with RA, which represents the most specific test to diagnose Sjögren's syndrome.

O que o Cirurgião-Dentista Precisa Saber Sobre a Doença de Crohn? / What do Dentists Need to Know About Cronh's Disease?

A doença de Crohn é descrita como uma doença inflamatória intestinal de alta complexidade, caracterizando-se por apresentar lesões e inflamações transmurais que podem acometer todo o trato gastrointestinal. A doença de Crohn pode apresentar manifestações bucais, tais como lesões na mucosa, alterações do fluxo salivar e envolvimento periodontal. Para este artigo de revisão, foi realizada uma busca de literatura nas bases de dados PubMed, Scielo e Academic Google, com espaço temporal de 2010 a 2020, utilizando palavras-chaves obtidas de acordo com o descritor em ciência da saúde. Foi encontrado que as lesões bucais estão presentes em cerca de 46,75% dos pacientes jovens e 22% dos pacientes idosos com doença de Crohn, podendo ser bastante incômodas, persistentes e de difícil tratamento. Apresentam-se com diversos aspectos clínicos como: ulcerações lineares ou aftosas, nodularidades da mucosa e aumento de volume labial. Essas lesões estão diretamente relacionadas com a doença, mas algumas lesões podem surgir de forma indireta, como complicação da doença de Crohn ou como efeitos adversos do tratamento. As manifestações bucais podem ser os primeiros sinais da doença de Crohn, logo, o reconhecimento de seus aspectos clínicos pode contribuir para um diagnóstico precoce. Cabe ao cirurgião-dentista reconhecer, diagnosticar e tratar, junto a uma equipe multiprofissional, as manifestações bucais da doença de Crohn, promovendo melhoras no quadro clínico dos pacientes.

Crohn's disease is described as a complex inflammatory bowel disease, characterized by transmural lesions and inflammation that can affect the entire gastrointestinal tract. Crohn's disease can present oral manifestations, such as mucosal lesions, changes in salivary flow rates and periodontal involvement. For this review, a literature search was carried out using PubMed, Scielo and Scholar Google platforms, within the time range from 2010 to 2020, using keywords obtained according to the Health Science Descriptor. We found that oral lesions are present in approximately 46.75% of young patients and 22% of elderly patients with Crohn's disease, which can be uncomfortable, persistent and difficult to treat. They are associated with various clinical aspects such as: linear or aphthous ulcers, mucosal nodularities and increased lip volume. These lesions are directly related to the disease, but some lesions may appear indirectly, as a complication of Crohn's disease or as adverse effects of the treatment. Oral manifestations can be the first signs of Crohn's disease, so the recognition of its clinical aspects can contribute to an early diagnosis. Dentists should be able to recognize, diagnose and treat, along with a multidisciplinary team, the oral manifestations of Crohn's disease, promoting improvements in the patient's clinical condition.

Anatomia macroscópica interna e avaliação elétrica do coração de Bradypus variegatus / Internal macroscopic anatomy and electrical evaluation of the Bradypus variegatus heart

The Bradypus variegatus species presents peculiar anatomophysiological properties and many aspects of its organic systems still need to be clarified, especially regarding the cardiovascular system, given its participation in vital activities. Disorderly anthropic action has had drastic consequences in sloth populations and the need to treat sick and injured animals is increasingly common. To this end, the importance of knowing its characteristics is emphasized. Therefore, this study proposed to describe the internal macroscopic structures of the sloth's heart, as well as to measure the ventricular walls and indicate the electrical activity of the organ. For the dissections, 15 Bradypus variegatus cadavers were used (1 young female, 9 adults females and 5 adult males) belonging to the Área de Anatomia of the Departamento de Morfologia e Fisiologia Animal (DMFA), Universidade Federal Rural de Pernambuco (UFRPE), Recide, PE, Brazil. After they were fixed and preserved, the specimens received a midsagittal incision in the chest, followed by soft tissue folding and removal of ribs to access the heart. The organ was derived from the cavity and sectioned sagittal medially to identify its internal anatomy. Ventricular walls and interventricular septum were measured with a steel caliper (150 mm / 0.02 mm). An electrocardiogram was performed to determine the electrical profile on 5 healthy B. variegatus sloths, living under semi-livestock conditions at the Recife Zoo, PE, Brazil. The electrodes were taken from the regions, scapular and glutes of the animals that were called hugging a keeper during the procedure, carried out in the Zoo itself, using a portable device. Based on the data obtained, sloths have cardiac chambers separated by septa, however between atria and ventricles, in both antimeres, there are atrioventricular ostia, where valves are found, consisting of 3 valves on the right and 2 on the left. The atria are practically smooth inside and have their cavity enlarged by the atria, the right being larger than the left, these having a greater amount of pectineal muscles in relation to the atria. The ventricles have trabeculae and papillary muscles, 3 on the right and 2 on the left. These muscles hold the tendinous chords that connect the valves. The existence of trabeculae marginal septum was not evidenced. The thickness of the wall of the left ventricle, as well as that of the interventricular septum, proved to be greater than the thickness of the wall of the right ventricle, regardless of the age or sex of the animals. Based on the electrocardiographic recordings, the sloths presented sinus rhythm, with a heart rate between 67 and 100 bpm. The electrical axis ranged from -60º to -90º. The P wave is smoother than the QRS complex. While the S-T segment was classified as isoelectric. The T wave was shown to be + and predominantly > or = at 25% of the S wave, which characterized an rS type QRS deflection in both females and males. The general characteristics of the cardiac chambers in sloths are similar to those observe in other domestic and wild mammals. However, the presence of pectineal muscles associated with the atria and auricles differs from that observed in mammals such as the paca and raccoon and in birds such as the ostrich, which have trabecular structures in these cavities. The number of valves in sloths is equal to the anteater. However, it has a marginal trabeculae septum, not seen in Bradypus variegatus. According to the electrocardiographic findings, the rhythm was sinus, but much lower than that observed in the capuchin monkey, which also maintains arboreal habits.(AU)

Periodontal management of a patient with chronic kidney disease: a case report

The association between periodontal disease and chronic kidney disease (CKD) has been recognized over the years. Gingival overgrowth may be a side effect of some of the drugs prescribed for patients with CKD. Objective: The objective of this manuscript was to report the dental management of a patient with chronic renal disease who presented periodontitis and gingival overgrowth. Case report: A 55 years old male patient sought dental treatment, and was diagnosed with generalized periodontitis in advanced stage and gingival overgrowth. The overgrowth was associated to the use of amlodipine, a longacting calcium channel blocker. The treatment consisted of interruption of amlodipine, sessions of oral hygiene instruction and basic periodontal therapy. Thereafter, conventional periodontal therapy, with scaling and root planning of the four hemiarches, surgical periodontal therapy and gingivectomy of the overgrowth were performed. Considering periodontal sites with a probing depth (PD) > 4mm at baseline, mean PD was reduced (baseline: 5.94 ± 1.80; follow-up: 2.76 ± 1.38), as well as mean clinical attachment loss (baseline: 5.55 ± 1.51; followup: 4.52 ± 1.47). Periodontal disease was controlled and there was no recurrence of gingival overgrowth after 18 months of follow-up. Conclusion: The management of the reported patient with CKD and periodontal involvement included discontinuation of amlodipine, basic and advanced periodontal therapy and gingivectomy. Proper oral hygiene may help to prevent recurrence of the gingival overgrowth and to maintain periodontal health.

Introdução: A associação entre doença periodontal e doença renal crônica (DRC) tem sido reconhecida nos últimos anos. O crescimento gengival excessivo pode ser um efeito colateral de alguns medicamentos prescritos para pacientes com DRC. Objetivos: O objetivo deste estudo foi relatar o manejo odontológico de um paciente com DRC que apresentava periodontite e aumento gengival. Relato do caso: Um paciente do sexo masculino, 55 anos, procurou atendimento odontológico e foi diagnosticado com periodontite generalizada em estágio avançado e crescimento gengival associado ao uso de anlodipina, um bloqueador dos canais de cálcio de ação prolongada. O tratamento consistiu em interrupção da anlodipina, sessões de instruções de higiene bucal e terapia periodontal básica. Posteriormente, foi realizada terapia periodontal convencional, com raspagem e alisamento radicular dos quatro hemiarcos, seguida de cirurgia periodontal a retalho e gengivectomia. Considerando os sítios periodontais com profundidade de bolsa à sondagem (PBS) > 4mm no início do tratamento, a média de PBS foi reduzida (início: 5,94 ± 1,80; final: 2,76 ± 1,38), bem como a média do nível clínico de inserção (início: 5,55 ± 1,51; final: 4,52 ± 1,47). A doença periodontal foi controlada e não houve recorrência do crescimento gengival após 18 meses de acompanhamento. Conclusão: O tratamento odontológico deste paciente com DRC e envolvimento periodontal incluiu a interrupção da anlodipina, terapia periodontal básica e avançada e gengivectomia. A higiene bucal adequada pode ajudar a prevenir a recorrência do crescimento gengival excessivo e a manutenção de um estado periodontal saudável.

Mapping of supernumerary elements in patients seeking orthodontic treatment

Dimension, number and shape alterations are frequently observed dental anomalies. Objective: The aim of this study was to map the frequency, the preferred location and the most prevalent types of supernumerary teeth, in the studied population. In addition, to assess the interference that supernumerary teeth may cause in the ectopic eruption of the normal dental series teeth. Methods: This is an observational retrospective study. Data collection was performed by evaluation of dental records of patients treated in an orthodontic clinic. Patients' radiographs, photographs and gypsum dental models were analyzed and data recorded in protocol files, by previously trained undergraduate and postgraduate students. Records from 1984 to 2019 were evaluated, and evaluation lasted two months. Data were stored in Microsoft Office Excel (version 2016) for descriptive analysis. Results: From the 920 patients' records analyzed, 2.7% presented at least one supernumerary tooth, with preferred location on the anterior maxillary area and mandibular parapremolar area. The most prevalent type was the supplemental tooth, with normal eruption orientation and normal alveolar location. Conclusion: The supernumerary teeth of the studied population showed little interference in the ectopic eruption of the normal dental series. Most of the supernumerary teeth were impacted, and, approximately one third of the supernumerary teeth showed deviated eruptions.

Introdução: Alterações de dimensão, número e forma são anomalias dentárias comumente observadas. Objetivo: O objetivo foi mapear a frequência de dentes supranumerários na população estudada, sua localização preferida e os tipos mais prevalentes. Além disso, avaliar a interferência que os dentes supranumerários podem causar na erupção ectópica da série dental normal. Métodos: A pesquisa possui desenho retrospectivo observacional. A coleta de dados foi realizada pela avaliação de prontuários odontológicos dos pacientes atendidos em uma clínica ortodôntica. Foram analisados radiografias, fotografias e modelos de gesso dental dos pacientes e as informações foram registradas em arquivos de protocolo do estudo. A coleta de dados foi realizada por uma estudante de graduação e uma da pós-graduação, previamente calibradas. A coleta durou dois meses e foram avaliados registros de 1984 a 2019. Os dados foram tratados no programa Microsoft Office Excel (version 2016) com análise descritiva dos dados. Resultados: Dos 920 prontuários analisados, 2,7% apresentavam pelo menos um dente supranumerário, com localização preferida na área superior anterior e na área parapremolar mandibular. O tipo mais prevalente foi o dente suplementar, com orientação de erupção normal e localização alveolar normal. Conclusão: Os dentes supranumerários da população estudada neste estudo mostraram pouca interferência na erupção ectópica da série dental normal. A maioria dos dentes supranumerários estava em posição de impactação. E, aproximadamente um terço dos dentes supranumerários apresentaram desvios de erupção.

Oral health status of patients with multiple myeloma

ABSTRACT Objective: To describe the oral health status of patients with multiple myeloma and compare to a control group. Materials and methods: The medical history of the studied subjects was obtained from the medical records and through interviews. Trained examiners evaluated the oral mucosa, teeth, periodontium and imaging aspects. The dental status was evaluated by the decayed, missing and filled teeth index. The presence of bone lesions was investigated with cone beam computer tomography images of the jaws. Results: The most common oral mucosa features were paleness (31%) and coated tongue (14.3%) in the multiple myeloma group (N = 42); and coated (21.4%) and fissured tongue (10.7%) in the control group (N = 28). The mean DMFT index of patients with multiple myeloma was high, but not significantly different from controls (14.57 versus 19.69, p = 0.975). Hypodense lesions suggestive of multiple myeloma were observed in the jaws of 73.8% of the patients. Hypodense lesions related to teeth were detected in 33.3% of the patients and in 53.6% of the controls (p = 0.832). Conclusions: The studied population of multiple myeloma patients presented many oral health issues that needed attention. Thus, oral care should be included in the routine treatment to improve the quality of the oral status in these patients.

Características bacteriológicas, físicas y pH del agua de consumo humano del municipio de Une-Cundinamarca / Bacteriological and physical characteristics and pH of water for human consumption in the municipality of Une-Cundinamarca

Resumen Objetivo. Determinar características bacteriológicas, físicas y pH del agua para consumo humano que abastece al municipio de Une, Cundinamarca-Colombia. Métodos. Se tomaron 13 muestras de agua: 10 de la zona rural y 3 de la zona urbana. Del total de muestras tomadas en la zona rural, 7 no tenían ningún tratamiento, mientras que 3 tenían algún tipo de tratamiento. Las 3 muestras tomadas en la cabecera municipal, todas tenían tratamiento. Se utilizó la técnica de filtración por membrana para los análisis bacteriológicos, y los métodos nefelométrico, turbidimétrico y potenciométrico, para los análisis físicos y el pH. Resultados. Se obtuvo como resultado pH inferior a 6; 12 puntos superan el valor máximo de turbiedad y 5 puntos para la determinación de color. Se observó la presencia de Coliformes totales, E. coli y Enterococcus en las muestras analizadas, en cantidad que sobrepasa lo establecido en la normativa colombiana.

Abstract Objective. To determine bacteriological and physical characteristics and pH of water for human consumption that supplies the municipality of Une, Cundinamarca-Colombia. Methods. Thirteen water samples were taken: 10 from the rural area and 3 from the urban area. Of the total number of samples taken in the rural area, 7 had no treatment at all, while 3 had some type of treatment. The 3 samples taken in the municipal capital, all had treatment. The membrane filtration technique was used for bacteriological analysis and the nephelometric, turbidimetric and potentiometric methods for physical analysis and pH. Results. The result was pH lower than 6; 12 points exceed the maximum value turbidity and 5 points for the determination of color. The presence of total Coliforms, E. coli and Enterococcus was observed in the analyzed samples, in an amount that surpasses the established in the Colombian regulations.

Calidad bacteriológica del agua del humedal Gualí-Tres Esquinas, Funza, Cundinamarca / Bacteriological quality of the water of the Guali-Tres Esquinas Wetland, Funza, Cundinamarca

Resumen Objetivo. Realizar el diagnóstico de la calidad bacteriológica del agua del Humedal Gualí-Tres Esquinas, por medio de indicadores de aguas residuales (coliformes totales, Escherichia coli y Enterococcus spp). Métodos. Se tomaron catorce muestras de agua de diferentes puntos del humedal (7 en la zona Tres Esquinas y 7 en la zona del parque industrial Cofradía). El recuento de microorganismos se realizó por el método de filtración de membrana siguiendo el Standard Methods, los microrganismos fueron identificados mediante BBL Crystal. Resultados. El agua del Humedal Gualí-Tres Esquinas contiene un alto número de E.coli, coliformes totales y Enterococcus spp., lo que confirma la contaminación de origen fecal en todo el ecosistema, los recuentos más altos se encontraron en la zona parque industrial La Cofradía para coliformes totales y Enteroccocus spp. y en la zona de Tres Esquinas para E. coli.

Abstract Objective. To evaluate the bacteriological quality of the water of the wetland Gualí-Tres Esquinas, using residual waters indicators (total coliforms, Escherichia coli and Enterococcus). Methods. Fourteen water samples were taken from different points of the wetland (7 in the Tres Esquinas zone and 7 in the Cofradía industrial park zone). The count of microorganisms was made by the membrane filtration method following the Standard Methods, the microorganisms were identified by BBL Crystal. Results . The water of the Gualí-Tres Esquinas Wetland contains a high number of E. coli, total coliforms and Enterococcus spp., confirming fecal contamination throughout the ecosystem, the highest counts were found in the La Cofradía industrial park zone for total coliforms and Enteroccocus spp. and in the Tres Esquinas zone for E. coli.

Aseguramiento metrológico para la implementación de un sistema de gestión de la calidad / Metrological assurance for the implementation of a quality management system

RESUMEN Fundamento: la implementación de un sistema de gestión de la calidad basado en la norma NC: ISO 9001 conlleva el establecimiento de la metrología como garantía de calidad de la confiabilidad de sus equipos de medición. Objetivo: demostrar la importancia del aseguramiento metrológico para la implementación de un sistema de gestión de la calidad. Métodos: se realizó un estudio descriptivo de corte transversal en el Centro de Inmunología y Productos Biológicos en la Universidad de Ciencias Médicas de Camagüey, en el período enero de 2014 a mayo de 2018. Resultados: en el primer levantamiento metrológico realizado ninguno de los instrumentos estaba verificado, se realizó un subregistro en el 2014, en el 2017 se incrementó el número de instrumentos registrados en la universidad, durante el estudio se actualizó el plan de verificación y se logró la verificación de la mayoría de los instrumentos de medición que posee el centro. Se constató la necesidad de contar con una asignación en el presupuesto para la adquisición de algunos instrumentos en déficit. Conclusiones: el diagnóstico realizado como parte del aseguramiento metrológico permitió conocer la situación real de los instrumentos de medición en el Centro de Inmunología y Productos Biológicos y lograr la verificación de un número importante de los mismos.

ABSTRACT Background: the implementation of a quality management system based on the NC standard: ISO 9001 entails the establishment of metrology as a guarantee of the reliability quality of its measuring equipments. Objective: to demonstrate the importance of metrology assurance for the implementation of a quality management system. Methods: a descriptive cross-sectional study was carried out at the Center of Immunology and Biological Products of the Camagüey University of Medical Sciences, from January 2014 to May 2018. Results: according to the first metrological survey none of the instruments had been verified, there was an underreporting in 2014, in 2017 the number of registered instruments in the university was increased, during the study the verification plan was updated and most of the measuring instruments were verified. It was found that there is a need of a budget allocation for the acquisition of some of the lacking instruments. Conclusions: the diagnosis made as part of the metrology assurance allowed to know the actual situation of the measuring instruments in the Center of Immunology and Biological Products and to verify an important number of them.

Procedimiento metodológico para el estudio del extendido de sangre periférica en la licenciatura en Bioanálisis Clínico / Methodological procedure for the study of extended peripheral blood in the degree in Clinical Bioanalysis

RESUMEN Fundamento: el extendido de sangre periférica o lámina periférica, como también se conoce, es la evaluación morfológica semicuantitativa de las tres series hematopoyéticas en una extensión de sangre periférica coloreada y observada a través del microscopio. Objetivo: elaborar un procedimiento metodológico para el extendido de sangre periférica desde una perspectiva interdisciplinar en la licenciatura en Bioanálisis Clínico. Métodos: se realizó un estudio descriptivo transversal desde septiembre a noviembre de 2018, en la facultad Tecnológica perteneciente a la Universidad de Ciencias Médicas de Camagüey. Se emplearon métodos teóricos como el análisis y síntesis, el inductivo y deductivo. De los métodos empíricos, fueron aplicados el análisis de documentos, la prueba diagnóstica exploratoria, resultados de controles a clases, la entrevista y encuesta para la validación de la propuesta. Resultados: insuficiencias en cuanto al establecimiento de las relaciones interdisciplinarias entre los contenidos de Histología y el componente hematológico de la asignatura Diagnóstico de Laboratorio I, los estudiantes mostraron dificultades en la realización de la técnica y no lograron caracterizar morfológicamente algunas de las células hematopoyéticas. Conclusiones: se elaboró un procedimiento metodológico para la técnica lámina periférica desde una perspectiva interdisciplinar y la validación de la propuesta mediante el método de consenso conformado por un grupo nominal, donde resultan las categorías de muy adecuado y adecuado para el desarrollo de la técnica lámina periférica, pues la observación de extendidos periféricos es un elemento importante en la orientación del análisis de las diferentes enfermedades, componente esencial del diagnóstico integral del laboratorio clínico.

ABSTRACT Background: the peripheral blood extension or peripheral lamina, as it is also known, is the semi-quantitative morphological evaluation of the three hematopoietic series, in an extension of peripheral blood colored and observed through the microscope. Objective: to develop a methodological procedure for the extension of peripheral blood from an interdisciplinary perspective in the degree in Clinical Bioanalysis. Methods: cross-sectional descriptive study in the period from September to November 2018, in the Technological Faculty belonging to the University of Medical Sciences of Camagüey. Theoretical methods such as analysis and synthesis and inductive and deductive methods were used. Of the empirical methods, the analysis of documents, the exploratory diagnostic test, results of controls to classes, the interview and survey for the validation of the proposal were applied. Results: insufficiencies regarding the establishment of interdisciplinary relationships between the contents of Histology and the hematological component of the Laboratory Diagnostic subject I, the students showed difficulties in performing the technique and failed to characterize morphologically some of the hematopoietic cells. Conclusions: a methodological procedure was developed for the peripheral lamina technique from an interdisciplinary perspective and the validation of the proposal by means of the consensus method formed by a nominal group where the categories of very adequate and suitable for the development of the peripheral lamina technique result. The observation of extension peripherals is an important element in the orientation of the analysis of the different diseases, an essential component of the integral diagnosis of the clinical laboratory.

Caracterización morfológica de las células de sangre de cordón umbilical / Morphological characterization of umbilical cord blood cells

Introducción: El cordón umbilical se ha convertido en un elemento de interés para la medicina regenerativa en los últimos años, pues constituye una fuente importante de células madres y progenitores hematopoyéticos. Objetivo: Caracterizar morfológicamente la sangre del cordón umbilical para terapia regenerativa en recién nacidos del Hospital Universitario Ginecobstétrico Ana Betancourt de Mora. Métodos: Estudio observacional, analítico y transversal realizado en el Centro de Inmunología y Productos Biológicos de Camagüey, entre enero y diciembre de 2017. Se evaluaron 35 muestras de sangre del cordón umbilical obtenidas de recién nacidos, que fueron partos eutócicos y sus madres no tuvieron procesos de enfermedades infecciosas. Resultados: El promedio mayor de células mononucleares correspondió a los linfocitos. En el conteo diferencial los polimorfonucleares neutrófilos ocuparon el primer lugar, seguido de los linfocitos, con medias de 0,50 y 0,46 x 109/L, respectivamente. De las células presentes en el frotis del botón, fueron más frecuente los linfocitos con 0.59 x 109/L; se observó un promedio de monocitos de 0,00-0,07 x 109/L. Conclusiones: La obtención de células mononucleares viables a través de la vena umbilical, constituye una técnica promisoria en las investigaciones biomédicas. Entre las células mononucleares predominaron los linfocitos, tanto en la sangre del cordón umbilical como en el botón celular aislado(AU)

Introduction: In recent years, the umbilical cord has become an element of interest for regenerative medicine, based on its importance as a source of stem cells and hematopoietic progenitors. Objective: To characterize the morphology of umbilical cord blood for regenerative therapy in newborns from Ana Betancourt de Mora Gyneco-obstetric University Hospital. Methods: Observational, analytical and cross-sectional study carried out at the Center of Immunology and Biological Products in Camagüey, between January and December 2017. We evaluated 35 samples of umbilical cord blood obtained from newborns who were eutocic deliveries and whose mothers did not have infectious disease processes. Results: The highest average of mononuclear cells corresponded to lymphocytes. In the differential count, neutrophil polymorphonuclear cells ranked first, followed by lymphocytes, with averages of 0.50x109 and 0.46x109 per liter, respectively. Of the cells present in the button cell smear, lymphocytes were more frequent, with 0.59x109 per L; an average of monocytes was observed, with 0.00-0.07x109 per L was observed. Conclusions: Obtaining viable mononuclear cells through the umbilical vein is a promising technique in biomedical research. Among the mononuclear cells, lymphocytes predominated, both in the cord blood and in the isolated cell button(AU)

Implementación del Convenio Marco de la Organization Mundial de la Salud para el Control del Tabaco y la Prevention del Cáncer en Colombia / Implementation in Colombia of the Framework Convention on Tobacco Control to Prevent Cancer: Achievements and Challenges / Implementação do Convenção-Quadro para o Controle do Tabaco e a prevenção do cancro na Colômbia

Resumen Introducción: el tabaquismo es un problema global. Un problema tan importante que hizo que la Organización Mundial de la Salud liderara el Convenio Marco Para el Control del Tabaco, del cual son parte la gran mayoría de países del mundo. En ese contexto, Colombia ha realizado varias acciones para reducir la prevalencia del tabaquismo; estas acciones están enmarcadas en el Plan Decenal para el Control del Cáncer 2012-2021. Desarrollo: se analizó la implementación de las acciones planteadas por el Plan Decenal para el Control del Cáncer y su correlación con el Convenio Marco de la Organización Mundial de la Salud, bajo la implementación del Plan de Medidas MPOWER. Conclusiones: Colombia ha implementado varias estrategias para el control del tabaco, enmarcadas en el Plan Decenal para el Control del Cáncer. Entre estas estrategias, se encuentra un sistema de vigilancia del consumo de tabaco, políticas de control, espacios cien por ciento libres de humo de tabaco, el Programa para la Cesación del Consumo de Tabaco y Atención del Tabaquismo, advertencias sanitarias moderadas, campanas de comunicación, prohibición completa de publicidad, promoción y patrocinio, así como un aumento de los impuestos al tabaco. A pesar de estas implementaciones, el reto actual es intervenir aquellas medidas en las que menos se ha trabajado o que han tenido menor resultado para lograr que el control del tabaquismo sea más efectivo; también es necesario hacer frente al uso de cigarrillos electrónicos. Las medidas descritas deberían implementarse sin la interferencia de la industria tabacalera.

Abstract Introduction: Smoking is a global issue that motived the World Health Organization to lead the Framework Convention on Tobacco, adopted by many countries. In that context, Colombia has carried out some actions to reduce smoking prevalence, taking into account the Ten-Year Plan for Cancer Control 20122021. Development: This article analyzes the implementation of the actions proposed by the Ten-Year Plan for Cancer Control 2012-2021 and its correlation with the Framework Convention on Tobacco's MPOWER Package. Conclusion: Colombia has implemented some strategies to control smoking through the Ten-Year Plan for Cancer Control 2012-2021, such as the smoking monitoring system, control policies, smoke-free areas, the National Program for Smoking Cessation, moderate health warnings, communication campaigns, total restriction to any kind of advertisement and promotion, and raising tax of tobacco products. In spite of those achievements, it is necessary to strengthen the weakest strategies to reduce smoking, as well as facing electronic cigarette use. These actions must be carried out without tobacco industry interference.

Resumo Introdução: o tabaquismo é um problema global que orientou à Organização Mundial da Saúde a liderar o Convenção-Quadro para o Controle do Tabaco, do qual são parte a grande maioria de países. Nesse contexto, a Colômbia tem realizado várias ações para reduzir a prevalência do tabaquismo enquadradas no Plano Decenal para o Controle do Cancro 2012-2021. Desenvolvimento: se analisa a implementação das ações apresentadas pelo Plano Decenal para o Controle do Cancro e sua correlação com a Convenção-Quadro sob a implementação do Plano de Medidad MPOWER. Conclusões: a Colômbia tem implementado várias estratégias para o controle do tabaco enquadradas no Plano Decenal para o Controle do Cancro entre as que se encontra o sistema de vigilância de consumo de tabaco, políticas de controle, espaços 100 % livres de fumo de tabaco, o Programa Nacional para a Cessação, advertências sanitárias moderadas, campanhas de comunicação, proibição completa de publicidade, promoção e patrocínio e aumento dos impostos ao tabaco. Apesar do anterior, o desafio é intervir nas medidas com maior retrocesso para conseguir que o controle do tabaquismo seja mais efetivo; também é necessário enfrentar ao uso de cigarros eletrônicos. O anterior, sem interferência da indústria do tabaco.

Diferencias evitables en el cumplimiento de las medidas para el control del tabaco: Colombia, Costa Rica, Ecuador y Perú, 2017 / Avoidable differences in the compliance with tobacco control measures: Colombia, Costa Rica, Ecuador and Peru, 2017

Resumen El Convenio Marco para el Control del Tabaco que es considerado el primer tratado global de Salud Pública, expone la idea de que el mundo retroceda la epidemia del tabaquismo al implementar una serie de estrategias, entre las que se encuentra el paquete de medidas MPOWER. El objetivo de este artículo es revisar el avance del cumplimiento de estas medidas y las diferencias entre Colombia, Costa Rica, Ecuador y Perú, con una mirada crítica en la implementación de las medidas. Se realizó una búsqueda de literatura en Medline y Lilacs de la evolución de estas estrategias y los informes MPOWER publicados por la OMS hasta el 2017. Este análisis muestra el detalle de implementación de las estrategias por cada país y permite observar las diferencias en Colombia e identificar las brechas que es necesario cubrir con estrategias que impacten positivamente la carga de la enfermedad.

Abstract The Framework Convention on Tobacco Control (FCTC) is considered the first global public health treaty, it is expected to reverse the tobacco worlds epidemic by implementing a series of strategies, among which is the MPOWER package of measures. This paper is a review of the measures level of compliance, and to identifies the differences between Colombia, Costa Rica, Ecuador and Peru in terms of tobacco control progress, making special emphasis in the level of implementation in Colombia. This paper is based on literature review from LILACS and Medline on tobacco control measures in these four countries, using the MPOWER reports published by WHO until 2017. The analysis of the progress made in each country, give a critical look to continue smoking control and strengthen actions, in order to achieve a positive impact on the burden of the disease.

Oral health status of patients in intensive care unit: a cross-sectional study

Introduction: Patients in intensive care unit (ICU) may present oral alterations asa result of patients' systemic conditions, the use of medications, intubation orpoor oral hygiene. Oral alterations should be detected and treated because theymay aggravate patients' condition. The objective of this study was to evaluate thetypes and frequencies of clinically detected oral alterations in inpatients of an ICU.Methods: This is a cross-sectional study in which an oral evaluation of patientshospitalized in an ICU of a public hospital was performed. Demographic, socialand clinical characteristics were collected from medical records. Oral examswere performed by two trained dentists, with reliability checked by intra-classcorrelation coefficient, while patients were lying in the hospital bed, using a frontalheadlamp, tongue depressor and sterile gauze. All data were recorded in studyprotocol forms and transferred to a data base for analysis. Results: Thirty-sevenpatients, with similar distribution between genders, withmedian age of 62 yearswere evaluated. The most frequent causes for hospitalization were postoperativecare (51.35%) and respiratory problems (29.72%). About 90% of the inpatientspresented some type of oral alterations during the hospitalization period. Themost common clinical alterations were dry lips (86.5%); coated tongue (61.1%);paleness of the oral mucosa (54.1%); oral foci of infection (37.8%) and candidiasis(13.5%). Conclusion: The majority of inpatients of the ICU presented some type oforal alteration, and the most frequent were dry lips and coated tongue. Dataobserved in this study reinforce the need of the dental team support during theperiod of hospitalization.

Introdução: Pacientes em unidade de terapia intensiva (UTI) podem apresentaralterações orais como resultado das condições sistêmicas dos pacientes, uso demedicamentos, intubação ou falta de higiene bucal. Alterações orais devem serdetectadas e tratadas, pois podem agravar a condição do paciente. O objetivodeste estudo foi avaliar os tipos e frequências de alterações orais clinicamentedetectadas em pacientes internados em uma UTI. Métodos: Estudo transversalem que foi realizada avaliação oral de pacientes internados em uma UTI de umhospital público. Características demográficas, sociais e clínicas foram coletadasdos prontuários médicos. Os exames orais foram realizados por dois dentistastreinados, com confiabilidade verificada pelo coeficiente de correlação intra-classe, enquanto os pacientes estavam deitados na cama do hospital, utilizandofrontal, abaixador de língua e gaze estéril. Todos os dados foram registrados emformulários de protocolo do estudo e transferidos para uma base de dados paraanálise. Resultados: Foram avaliados 37 pacientes, com distribuição semelhanteentre os sexos, com mediana de idade de 62 anos. As causas mais frequentes deinternação foram cuidados pós-operatórios (51,35%) e problemas respiratórios(29,72%). Cerca de 90% dos pacientes internados apresentaram algum tipo dealteração bucal durante o período de internação. As alterações clínicas maiscomuns foram lábios secos (86,5%); língua (61,1%); palidez da mucosa oral (54,1%);focos orais de infecção (37,8%) e candidíase (13,5%). Conclusão: A maioria dospacientes internados em UTI apresentou algum tipo de alteração oral, sendo osmais frequentes lábios secos e língua. Os dados observados neste estudo reforçama necessidade do apoio da equipe odontológica durante o período de internação.

Calidad del agua de una clínica odontológica universitaria de Bogotá / Water quality of a university dental clinic in Bogotá

Resumen Objetivo. Determinar la calidad microbiológica del agua usada en las unidades odontológicas de una clínica universitaria en Bogotá, mediante los indicadores microbiológicos coliformes totales, Escherichia coli, Enterococcus y Pseudomonas. Métodos. Se tomaron muestras de agua de la pieza de mano y de la jeringa triple en 9 unidades odontológicas y tres muestras de los tanques de suministro de agua para un total de 21 muestras. El recuento de microorganismos se realizó mediante la técnica de filtración por membrana. Se aislaron algunos microorganismos presentes en las diferentes muestras a través del kit de pruebas rápidas BBL CRYSTAL. Resultados. El agua no cumple con la Resolución 2115 de 2007 que reglamenta las normas del agua apta para consumo humano. Se aislaron bacterias importantes como Shigella sp. (microorganismo productor de la disentería e indicador de contaminación fecal), Klebsiella y Pseudomonas. Se sugiere implementar medidas correctivas y/o preventivas para minimizar la contaminación y mejorar la calidad del agua usada en estas unidades odontológicas.

Abstract Objectives. To determine the microbiological quality of the water used in dental units of a University Clinic in Bogotá, through the microbiological indicators like total coliforms, Escherichia coli, Enterococcus and Pseudomonas. Methods. Water samples from hand piece and the triple syringe 9 dental units and three samples of tanks for water supply for a total of 21 samples were taken. The microorganism counting was performed by membrane filtration method according to the Standard Methods. Some microorganisms present in different samples were isolated through the BBL CRYSTAL rapid test kit. Results. The water does not comply with the Resolution 2115 2007, which regulates the water suitable for human consumption standards. Important bacteria such as Shigella sp. (producer of dysentery and a fecal pollution indicator organism), Klebsiella and Pseudomonas were isolated. It is suggested to implement corrective or preventive measures to minimize the pollution and improve the quality of the water used in these dental units.

Importancia de un sistema de gestión de la calidad en la Universidad de Ciencias Médicas / Importance of a quality management system at the university of medical sciences

RESUMEN Fundamento: el sistema de la calidad se define como un conjunto de políticas, objetivos, procesos, documentos y recursos que conducen a asegurar la calidad, no solo del producto sino de la organización como un todo, al buscar la máxima satisfacción de los clientes o los usuarios. Objetivo: divulgar elementos teóricos sobre la importancia de la implementación de un sistema de gestión para garantizar la calidad en la docencia, en las investigaciones y en la asistencia médica. Métodos: con los descriptores sistema de gestión de la calidad y calidad en salud, se realizó una búsqueda bibliográfica en las plataformas de acceso a bases de datos de la red de información de salud cubana Infomed, dentro de ellas en EBSCOhost, PubMed/Medline y SciELO, y una revisión documental de la base normativa que establece los requisitos a cumplir para la implementación del sistema. Desarrollo: se aborda la importancia de la implementación de un sistema de gestión de la calidad en la Universidad de Ciencias Médicas y las numerosas ventajas que ofrece; las más señaladas son una mayor optimización de los recursos, y mejoría de la comunicación interna y de la imagen externa de la organización. Conclusiones: el sistema de evaluación y acreditación de instituciones y programas universitarios constituye el motor impulsor de la gestión de la calidad universitaria, se demuestra la importancia de implementar un sistema de gestión de la calidad en la universidad médica para lograr resultados superiores en el proceso de formación y desarrollo de los profesionales de la salud.

ABSTRACT Background: the quality system is defined as a set of policies, objectives, processes, documents and resources that lead to quality assurance, not only of the product but of the organization as a whole, seeking the maximum satisfaction of the clients or the users. Objective: to spread theoretical elements on the importance of the implementation of a management system to ensure quality in teaching, research and medical assistance. Methods: with the descriptors health quality and quality management system, a bibliographic search was carried out in the access platforms to databases of the Cuban health information network Infomed, ​​within them in EBSCOhost, PubMed/Medline and SciELO, and a documents' review of the normative bases that establish the requirements to be met for the implementation of the system. Development: it is addressed the importance of the implementation of a Quality Management System at the University of Medical Sciences and the many advantages it offers; the most indicated are a greater optimization of resources, and improvement of internal communication and the external image of the organization. Conclusions: the system of evaluation and accreditation of university institutions and programs is the driving force of the University Quality Management, demonstrating the importance of implementing a quality management system in the medical university to achieve superior results in the process of training and development of health professionals.

The frequency of oral conditions detected in hematology inpatients

ABSTRACT Background: Oral manifestations may be the first signs of hematologic diseases, and may occur due to the disease itself or to treatment. Objective: To evaluate the frequency and types of oral conditions presented by patients on a hematology ward. Methods: Data were collected by oral examinations during weekly visits to a hematology ward. Six trained dentists performed the oral assessment based on the principles of oral semiology. All patients who accepted to be examined were included in the study. Patients who were unavailable or unable to have oral examinations were excluded. Data were recorded on protocol forms and in the electronic records of the institution. A descriptive analysis was performed. Results: Seventy-nine patients were included in the analysis; 50.6% were female and the mean age was 41.49 years. The most common reasons for hospitalization were chemotherapy and complications (81%), relapse (13.9%) and pre-transplant preparation (5%). The most frequent underlying diseases were multiple myeloma (17.7%), acute myeloid leukemia (15.4%) and acute lymphocytic leukemia (11.5%). Oral conditions were found in 36 (45.6%) patients, some of whom presented more than one condition. The most common oral conditions were dry lips (12.6%), mucositis (10.1%), petechiae (8.9%) and candidiasis (7.6%). Of the detected oral conditions, 56.9% were related to the underlying disease or chemotherapy and 20.2% were not related to the disease. Conclusion: This study shows the types and frequency of oral conditions observed in hematological inpatients. Awareness of these conditions is important for prevention and planning the care of patients with hematological diseases.

Osteoporosis, tooth loss and functional dentition in elderly women: a cross-sectional study

Objectives: The objective of this study was to investigate whether osteoporosis is an indicator of missing teeth and lack of functional dentition in elderly women. Methods: A cross-sectional study involving women aged more than 60 years was performed at the Brazilian's Navy Dental Center (Odontoclínica Central da Marinha) , Rio de Janeiro, Brazil. Demographic data and general health status information of the group were obtained through individual interviews. In addition, the number of natural teeth was recorded in oral examination. Women presenting at least one tooth were divided in groups presenting or not osteoporosis. The number of natural teeth was compared between groups, with adjustment for smoking and diabetes mellitus. The association between functional dentition and osteoporosis was evaluated using odds ratios (ORs) and their respective 95% confidence intervals. Results: Data on oral examination were available for 256 of the 360 elderly women registered in the database. The groups were composed by 55 women with osteoporosis and 201 not presenting osteoporosis. The prevalence of chronic diseases and smoking, was similar between groups. The mean number of teeth for osteoporotic women was significantly lower than in those without this disease (14,69 ± 7,69 versus 18,19 ± 7,20, p= 0.002), remaining significant after adjustment for potential confounders. Women without osteoporosis exhibited greater chance to present functional dentition than those with osteoporosis (OR = 2.10, 95% CI [1.21 to 3.66], p =0.006). Conclusion: Osteoporosis was an indicator for tooth loss and lack of functional dentition in the studied population of elderly women.

Objetivos: O objetivo deste estudo foi investigar se a osteoporose é um indicador de perda dentária e de falta de dentição funcional em idosas. Métodos: Um estudo transversal envolvendo mulheres com mais de 60 anos foi realizado na Odontoclínica Central da Marinha, Rio de Janeiro, Brasil. Dados demográficos e médicos foram obtidos através de entrevistas individuais. Os dentes naturais foram contados no exame oral. Mulheres com um ou mais dentes foram divididas em dois grupos: com e sem osteoporose. O número de dentes naturais foi comparado entre os grupos, com controle para tabagismo e diabetes mellitus. A associação entre a dentição funcional e a osteoporose foi avaliada por meio de odds ratios (OR) e seus respectivos intervalos de confiança de 95%. Resultados: Dentre 360 idosas cadastradas no banco de dados, 256 tinham registro de exame oral. Os grupos foram compostos por 55 mulheres com osteoporose e 201, sem. A prevalência de doenças crônicas e tabagismo foi semelhante entre os grupos. O número médio de dentes para mulheres com osteoporose foi significativamente menor do que as que não tinham a doença (14,69 ± 7,69 versus 18,19 ± 7,20, p = 0,002), permanecendo significativo após o ajuste para possíveis fatores de confundimento. Mulheres sem osteoporose tiveram maior chance de apresentar dentição funcional do que as outras (OR = 2,10, IC 95% [1,21-3,66], p = 0,006). Conclusão: A osteoporose foi um indicador de perda dentária e de ausência de dentição funcional na população estudada.