Consenso colombiano de la enfermedad inflamatoria intestinal pediátrica

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Introduction: Pediatric ulcerative colitis (CUP), pediatric Crohn's disease (PCD), and pediatric inflammatory bowel disease not classifiable (PIDNCID) have clinical and psychosocial particularities that differentiate them from those of adults and may condition different therapeutic approaches due to possible nutritional, growth and developmental repercussions, representing a challenge for the pediatrician and gastroenterologist. Objective: Develop expert consensus evidence-based recommendations for the timely and safe diagnosis and treatment of Pediatric Inflammatory Bowel Disease (PID) in children under 18 years of age for professionals caring for these patients and healthcare payers. Methodology: Through a panel of experts from the Colombian College of Pediatric Gastroenterology, Hepatology and Nutrition (COLGAHNP) and a multidisciplinary group, 35 questions were asked regarding the clinical picture, diagnosis, and treatment of PID. Through a critical review and analysis of the literature with particular emphasis on the main clinical practice guidelines (CPGs), randomized clinical trials (RCTs), and meta-analyses of the last ten years, from which the experts made 77 recommendations that responded to each of the research questions with their respective practical points. Subsequently, each of the statements was voted on within the developer group, including the statements that achieved > 80%. Results: All statements scored > 80%. PID has greater extension, severity, and evolution towards stenosis, perianal disease, extraintestinal manifestations, and growth retardation compared to adult patients, so its management should be performed by multidisciplinary groups led by pediatric gastroenterologists and prepare them for a transition to adulthood. Porto's criteria allow a practical classification of PID. In CPE, we should use the Paris classification and perform ileocolonoscopy and esophagogastroduodenoscopy, since 50% have upper involvement, using the SES-CD (UCEIS/Mayo in CUP) and taking multiple biopsies. Initial labs should include inflammatory markers and fecal calprotectin and rule out intestinal infections. Treatment, induction, and maintenance of PID should be individualized and decided according to risk stratification. Follow-up should use PCDAI and PUCAI for the last 48 hours. Immunologists and geneticists should evaluate patients with early and infantile PID. Conclusion: A consensus guideline is provided with evidence-based recommendations on timely and safe diagnosis and treatments in patients with ILD.

Initial oral microbiota and the impact of delivery mode and feeding practices in 0 to 2 month-old infants

Abstract The aim of this study was to describe the initial oral microbiota and how delivery mode and feeding practices impact its diversity in 0-2-month-old infants. This was a cross-sectional study that consisted of one collection of saliva samples from 0-2-month infants at baseline. Ten pairs of mothers and infants were selected. Medical health history, pregnancy, birth, feeding practices (breastfeeding or milk formula), and infant health status was obtained. Pooled microbial samples were obtained from the oral surfaces using a sterile cotton swab. Infants did not receive any breast milk before sampling. After collection, each swab was analyzed through microbiological culture-based procedures, using selective mediums. Cultures were analyzed for the presence of Streptococci, Lactobacillus, Staphylococcus, Enterobacterium , and Candida albicans . Twenty percent of the samples were serially diluted (10-2) to assess the number of bacteria expressed as CFU. Bacillota was the leading phylogenetic group in the infant's pooled microbial sample. The most prevalent genera were Streptococcus, Lactobacillus , and Staphylococcus . Two participants had a positive growth of Candida albicans . The association between genus group, type of delivery, and feeding practices was not statistically significant (p > 0.05). Lactobacillus genus was frequently present in the cesarean delivery group but with slightly higher counts in a vaginal delivery study subject. Exclusively breastfed infants showed presence of Streptococcus, Lactobacillus, Staphylococcus . The oral microbiome in infants (0-2 month-old) is highly heterogeneous and dynamic. Microbiota composition seems to be impacted by mode of delivery, with slight differences among groups. Breastmilk appears as an essential factor in maintaining the oral microbiome's stability and diversity.

Early-life sugar consumption and breastfeeding practices: a multicenter initiative in Latin America

Abstract The aim of this multicenter study was to explore the early-life sugar consumption and dietary practices in Latin America as well as to investigate the association between breastfeeding duration and the age at which foods and beverages with added sugars are introduced. A cross-sectional study was conducted with 805 1- to 3-year-old children from 10 Latin American countries, as a complementary study to the Research Observatory for Dental Caries of the Latin American Region (OICAL). A Food Frequency Questionnaire previously tested in different countries was applied to children's mothers and data on breastfeeding and age at introduction of sugary foods and beverages was collected. Statistical analysis included the Kruskal-Wallis test and Poisson regression with robust variance, with the calculation of crude and adjusted mean ratios (MR) and 95% of confidence intervals (CI). The average age at introduction of sugary foods and beverages was 10.1 months (95%CI 9.7-10.4) and 9.6 (95%CI 9.2-9.9) months, respectively, with a significant variation between countries (p < 0.001). The average daily frequency of sugary foods-beverages was 3.3 times per day (95%CI 3.1-3.5) and varied significantly between countries (p = 0.004). Breastfeeding duration of over six months was associated with an increase in the age of introduction of sweet drinks (16%; MR 1.16; 95%CI 1.05-1.28) and foods (21%; MR 1.21; 95%CI 1.10-1.33). In conclusion, most children from vulnerable settings in Latin America start consuming sugary products in the first year of life and a high frequency of consumption was reported through early childhood. Additionally, breastfeeding contributes to a delay in the introduction of sugary products.

Situational diagnosis of policies in Latin American and Caribbean countries for the use of fluoride and reduction of sugar consumption

Abstract Policy evaluation and guidance on fluoride use and sugar consumption in Latin American and Caribbean countries (LACC) may provide a scientific evidence basis for policymakers, dental professionals, civil society organizations and individuals committed to improving public oral health. A cross-sectional study was conducted to evaluate the extent of implementation of policies/guidelines on fluoride use, and sugar consumption in LACC. The study had two stages. First a questionnaire covering four major areas was developed: fluoridation of public water supplies; salt fluoridation; fluoride dentifrices, and sugar consumption. Then, the questionnaire was applied to collect data among representative participants in public oral health from LACC. Ninety-six participants from 18 LACC answered the questionnaire. One-hundred seventy documents were attached, and 285 links of websites were provided by the respondents. Implementation of policies and guidelines on water and table salt fluoridation and processed and ultra-processed food consumption were found in most countries, with some issues in the consensus and coverage. Thus, differences were identified in the extent of implementation of public oral health strategies on sugar consumption and fluoridation among the countries. There is no consensus on the policies in LACC to reduce sugar consumption and for the use of fluoride. A few policies and guidelines were applied in isolated countries, with a variety of strategies and standards. For future actions, it will be important to encourage the development of strategies and public policies within countries, and to evaluate the effectiveness of existing policies in reducing dental caries and in improving oral health in LACC.

Impact on oral health-quality of life in infants: Multicenter study in Latin American countries

Abstract To assess the impact of oral conditions on oral health-related quality of life (OHRQoL) in infants in ten Latin America countries (LAC). A cross-sectional study was conducted with 930 pairs of 1-to-3-year-old children/parents from 10 LAC, as a complementary study of the Research Observatory for Dental Caries of the Latin American Region. The scale ECOHIS, previously tested and valid in ten countries, was applied to parents/caregivers of children to measure OHRQoL. Statistical analysis included descriptive data analysis and one-way analysis of variance (ANOVA-One-Way) were performed to compare age groups with OHRQoL. Bootstrapping procedures (1000 re-samplings; 95%CI Bca) were performed. The mean scores of the 'Child Impact' section in the LAC was 4.0(±8.3), in the 'Family Impact' section was 2.0(±4.0), and in overall ECOHIS score was 6.0(±12.0). In the 'Child Impact' section, Argentina 10.0(+2.4) and Venezuela 17.8(±17.5) demonstrated mean scores higher than the LAC total data. In the 'Family Impact' section, the countries with higher mean scores were Argentina 4.9(±2.0), Ecuador 2.1(±3.1) and Venezuela 7.9(±7.8). In the overall ECOHIS score, Argentina 15.1 (±4.1) and Venezuela 25.7(±25.2) has higher mean scores than the values of LAC. There is an association between children's age and parents' report of impact on the OHRQoL (p<0.001). Three-year-olds had a higher mean when compared to one- and two-year-olds, both in the Impact on the Child and Impact on the Family (p<0.001) sections, as well as in the overall ECOHIS (p<0.001). In conclusion, there are differences in OHRQoL among Latin American countries, impacting older children more significantly.

Resumo Avaliar o impacto das condições bucais na qualidade de vida relacionada à saúde bucal (QVRSB) em crianças de dez países da América Latina (AL). Foi realizado um estudo transversal com 930 pares de crianças/pais de 1 a 3 anos de 10 países da AL, como estudo complementar do Research Observatory for Dental Caries of the Latin American Region. A escala ECOHIS, previamente testada e validada em dez países, foi aplicada a pais/cuidadores de crianças para mensurar a QVRSB. A análise estatística incluiu análise descritiva de dados e análise de variância unidirecional (ANOVA-One-Way) para comparar grupos etários com QVRSB. Procedimentos de bootstrapping (1000 reamostragens; 95%IC Bca) foram realizados. A pontuação média da seção 'Impacto na Criança' na AL foi 4,0 (±8,3), na seção 'Impacto na Família' foi 2,0 (±4,0) e no escore total do ECOHIS foi 6,0 (±12,0). Na seção 'Impacto na Criança', Argentina 10,0(+2,4) e Venezuela 17,8(±17,5) demonstraram pontuações médias superiores aos dados totais da AL. Na seção 'Impacto na Família', os países com pontuações médias mais altas foram Argentina 4,9(±2,0), Equador 2,1(±3,1) e Venezuela 7,9(±7,8). No escore total do ECOHIS, Argentina 15,1 (±4,1) e Venezuela 25,7(±25,2) apresentaram escores médios superiores aos valores de AL. Houve associação entre a idade das crianças e o relato dos pais de impacto na QVRSB (p<0,001). As crianças de três anos tiveram média maior quando comparadas às de um e dois anos, tanto nas seções 'Impacto na Criança' e 'Impacto na Família' (p<0,001), quanto no escore total ECOHIS (p<0,001). Em conclusão, houveram diferenças na QVRSB entre os países da América Latina, impactando de forma mais significativa as crianças mais velhas.

Caries experience and associated risk factors in Venezuelan 6-12-year-old schoolchildren

Abstract: This research aims to provide updated information on caries experience and associated risk factors in children 6-12 years old. A cross-sectional and descriptive study design was carried out with a non-probabilistic, convenient sample of 209 children male and female. Clinical examinations were performed by calibrated dental students following WHO detection criteria. Caries indices dmft and DMFT were calculated. Caries Risk Assessment data was collected using an adapted CAMBRA instrument; following the International Caries Care guidelines. Descriptive statistics were performed to analyze the results and Chi-square test, Contingency Coefficient (C) and Corrected Typified Residues were calculated to determine the association between variables. 58% of the total population had dental caries lesions in its more severe stages (cavitation) and 42% were apparently healthy (AHS) without any cavitated lesions. The mean dmft index was 1.34 ± 1.93, and the mean DMFT index was 0.63 ± 1.22. Lesion severity remained between 1-2 teeth affected on both dentitions. A statistically significant association (p = 0.035) between the health condition and toothbrushing was stablished with a degree of dependence of C = 0.144. A positive standardized residual of 2.1 was evident for schoolchildren that experience caries lesion that never brush their teeth and AHS that brushed their teeth more than once. No association (p = 0.081) was found between health condition and intake of sugary snacks and beverages. A severe dental caries experience with a statistically significant association between the health condition and toothbrushing with fluoridated toothpaste 1450 ppm > 1 a day and a positive correlation in schoolchildren that experience caries lesion that never brush their teeth.

Management of dental caries lesions in Latin American and Caribbean countries

Abstract Caries management at the lesion level is dependent on the lesion activity, the presence of a cavitation (either cleanable or non-cleanable), and lesion depth as evaluated via radiographic examination. A variety of non-invasive, micro-invasive, and minimally invasive treatment (with or without restoration) options are available for primary and permanent teeth. Non-invasive strategies include oral hygiene instructions, dietary counseling, and personal as well as professional use of fluoridated products that reduce demineralization and increase re-mineralization. Micro-invasive procedures include the use of occlusal resin sealants and resin infiltrants, while minimally invasive strategies comprise those related to selective removal of caries tissues and placement of restorations. Deep caries management includes indirect pulp capping, while exposed pulp may be treated using direct pulp capping and partial or complete pulpotomy. The aim of the present study was to review available evidence on recommended preventive and restorative strategies for caries lesions in Latin American/Caribbean countries, and subsequently develop evidence-based recommendations for treatment options that take into consideration material availability, emphasize ways to adapt available treatments to the local context, and suggest ways in which dentists and health systems can adopt these treatments.

Mirada del estudiante de enfermería sobre el aprendizaje y la aplicación del proceso de atención de enfermería / Nursing students’ view on learning and implementing the nursing process

Resumen:

Introducción: el proceso de atención de enfermería (PAE) es una herramienta para sistematizar y evaluar el cuidado a la persona; por ello, es imprescindible que durante el proceso formativo de los estudiantes de licenciatura de enfermería se promueva el desarrollo de competencias intelectuales, técnicas y relaciónales que les permitan la buena práctica de dicha herramienta. Objetivo: analizar los factores que favorecen o limitan el aprendizaje y la práctica del PAE a los estudiantes de licenciatura de enfermería.

Metodología: se realizó un abordaje mixto en dos fases: la fase cuantitativa descriptiva incluyó a 235 estudiantes de licenciatura en enfermería, procedentes de dos instituciones educativas; para esta, se estructuró una encuesta para la recolección de los datos. En la fase cualitativa se trabajó con dos grupos focales, cada grupo de siete estudiantes por institución educativa. Resultados: más del 50 % de los estudiantes tienen conocimientos de promoción de la salud, comunicación y teorías y modelos, entre otros aspectos. Consideran que una limitante es el tiempo que se dedica para realizar esas actividades y que saber utilizar las taxonomías les facilitó hacerlo. Al respecto, los estudiantes de los grupos focales coinciden al opinar que los profesores proporcionaron herramientas para realizar el proceso de enfermería; sin embargo, una limitante fue la metodología de enseñanza y los criterios de evaluación empleados por los profesores. Conclusión: se debe mejorar en el proceso educativo en cuanto a enseñanza y evaluación.

Abstract:

Introduction: Nursing Process (NP) is a tool to systematize and evaluate care to the individual, so it is essential that during the learning process of undergraduate nursing students the development of intellectual, technical and relationship skills is promoted to allow the good practice of this tool. Objective: To analyze the factors that favor or hinder learning and practicing of NP for undergraduate nursing students.

Methods: A mixed approach was conducted in two phases, descriptive quantitative phase included 235 undergraduate nursing students from two educational institutions; a survey for data collection was structured. In the qualitative phase, the work was developed with two focus groups, each group of seven students per school.

Results: More than 50 % of students have knowledge of health promotion, communication and theories and models, among others. They consider that a limitation is the time spent to do it, to know how to use taxonomies made easier for them to develop NP. In this regard, students in the focus groups agree to review that teachers provided tools to perform the nursing process; however, a limitation was teaching methodology and evaluation criteria used by teachers. Conclusion: Although the results with the two approaches are similar, it should be considered improvements in the educational process in regard to the teaching and assessment.

Dental caries experience in schoolchildren and the impact of non-cavitated lesions on the caries index

El objetivo de este artículo fue evaluar la experiencia de caries en escolares de 11 a 13 años de edad del Municipio Sucre y el impacto de las lesiones no cavitadas en el índice de caries. Seseleccionó una muestra a conveniencia de 12 escuelas ubicadas en el Municipio Sucre, Estado Miranda, Venezuela. Previo consentimiento informado, se examinaron 1484 niños utilizandoluz artificial, espejo #5 y explorador #23; siguiendo los criterios propuestos por Radike (1972), modificados por Acevedo et al (2005). La detección de las lesiones iniciales se realizó previaprofilaxis y secado del diente durante 5 segundos (con jeringa triple). Resultados: La prevalencia de caries fue de 94,07 por ciento y el índice CPOS promedio fue de 4,35±4,21 aumentandosignificativamente a 6,45±5,01 cuando se incorporaron las lesiones iníciales (p<0,05). De acuerdo al género, seobservó un CPOS mayor en las niñas (4,51±4,45) al compararlo con los varones (4,21±3,97), sin diferencia estadísticamente significativa (p>0,05). El mismo patrón se observó cuando seincorporaron las lesiones iníciales al CPOS, 6,67±5,15 para niñas y 6,26±4,88 para varones. Las lesiones no cavitadas representaron el 33 por ciento del total de lesiones cariosas. Conclusión: Los resultados indican una alta prevalencia de caries en lapoblación estudiada, así como la importancia de incluir las lesiones no cavitadas al índice CPOS.

Detection of infectious bronchitis virus and Avian metapneumovirus by a duplex semi-nested reversetranscription–polymerase chain reaction assay / Detecção do vírus da bronquite infecciosa das galinhas e do metapneumovírus aviário utilizando uma reação de transcrição reversa com reação em cadeia pela polimerase duplex

Duplex RT-PCR assay is reported for the simultaneous detection of avian infectious bronchitis virus (IBV) and avian metapneumovirus (aMPV), the causative agents of major diseases in poultry. The duplex RT-PCR assay optimized showed a detection limit of 10-3 (101 EID50/50m L for IBV and 100.5 EID50/50m L for aMPV, respectively when two viruses were mixed and 10-1 for each one separated (103 EID50/50m L for IBV and 102.5 EID50/50m L for aMPV, respectively. It was specific, sensitive and applicable for the rapid detection of these viruses in clinical samples.

Descreve-se um ensaio de duplex RT-PCR assay para a detecção simultânea do vírus da bronquite infecciosa das galinhas (IBV) e do metapneumovirus aviário (aMPV), agentes etiológicos de doenças de elevada importância em avicultura. A duplex RT-PCR otimizada mostrou um limiar de detecção de 10-3 (101 EID50/50m L para IBV e 100.5 EID50/50m L para aMPV, respectivamente, quando da combinação dos dois vírus e 10-1 para cada um dos vírus em separado(103 EID50/50m L para IBV e 102.5 EID50/50m L para aMPV, respectivamente. O ensaio foi demonstrado como específico, sensível e aplicável à rápida detecção destes vírus em amostras clínicas.

Sistemas de representación mental utilizados por estudiantes de enfermería con diferentes modelos pedagógicos / Mental representation systems used for students of nursery with different pedagogic models

Resumen

Introducción: en la enseñanza resulta importante que el docente considere en su práctica a los Sistemas de Representación Mental (SRM) como vías perceptuales de acceso de la información visión, audición movimiento, favorece en el estudiante un aprendizaje significativo.

Objetivo: caracterizar los sistemas de representación mental utilizados por los estudiantes de enfermería con modelos pedagógicos diferentes.

Metodología: estudio transversal descriptivo que compara dos grupos de estudiantes de enfermería procedentes de la Universidad de Colima y del Centro Universitario del Sur Universidad de Guadalajara, a los cuales se les aplicó un instrumento de 15 preguntas de opción múltiple, elaborado y adecuado a partir de otros instrumentos previamente validados, para determinar los SRM más utilizados en su formación. El instrumento fue piloteado con 30 alumnos de dos facultades diferentes. Los resultados fueron analizados mediante estadística descriptiva y χ2.

Resultados: el SRM más utilizado en la población estudiantil de ambas instituciones educativas fue el visual con 48.80 %, seguido del auditivo 31.42 % y el kinestésico 8.80 %. Analizándolos por institución (UdC/ UdG) se tiene lo siguiente: visual (50/47.66 %), auditivo (30/32.71%) y kinestésico (9.2/8.4 %).

Conclusiones: la utilización de un sistema de representación mental que favorezca el aprendizaje y adquisición del conocimiento no es determinado por los modelos pedagógicos en los cuales se forman los estudiantes de enfermería.

Summary

Introduction: in education it is important that teachers consider in their practice the Mental Representation Systems (MRS) as perceptual access to information channels (vision, hearing, movement), this helps better in effective student learning.

Objective: to characterize the MRS used by nursing students from the University of Colima and South University Center of University of Guadalajara than to educate under different pedagogic models.

Methodology: sectional descriptive study comparing two groups of nursing students from the University of Colima and the South University Center, University of Guadalajara, in which we applied an instrument of 15 multiple choice questions, drawn and appropriate from other instruments previously validated to determine the most commonly used MRS in its formation. The instrument was piloted with 30 students from two different faculties, doing minimal modifications. The results were analyzed by descriptive statistics and χ2 square using the Office Excel 2003.

Results: the most commonly used MRS in the student population of both institutions was the visual with 48.80 %, followed by auditory 31.42 % and kinesthetic 8.80 %. Analyzed by institution (UdC/UdG) we have the following: visual (50/47.66 %), auditory (30/32.71%) and kinesthetic (9.2/8.4 %).

Conclusions: choice of a mental representation system that promotes learning and knowledge acquisition is not determined by pedagogical models where students are trained nurses.

Métodoa convencionales y no convencionales para la detección de lesión inicial de caries: revisión bibliográfica / Conventional and unconventional methods to detect initial caries lesion: a review

El conocimiento sobre la caries como enfermedad, así como los conceptos y métodos de diagnóstico, han evolucionado desde Miller hasta Fejerskov, quien postula que la caries dental es un proceso dinámico, resultado de un desequilibrio en el mecanismo de desmineralización y remineralización como consecuencia del metabolismo microbiano y de los efectos que este proceso tiene sobre los tejidos duros del diente. De acuerdo a esta nueva visión de lo que es la caries dental, surge la inquietud de desarrollar métodos diagnósticos más sensibles y específicos para detectar la lesión desde sus estadios más tempranos con el fin de promover la remineralización de la lesión evitando la pérdida de estructura dentaria. No obstante, existen diferencias sustanciales en cuanto a cómo el odontólogo afronta el diagnóstico, prevención y manejo de la caries dental, lo que nos hace pensar que no solo es cuestión de un buen método de detección de caries, sino de la utilización de criterios que conlleven a un diagnóstico más acertado. Sin embargo, todavía no se desarrolla un método lo suficientemente sensible como para sustituir a la exploración visual-táctil, aunque éste, por su baja sensibilidad, requiera en algunos casos de la utilización de un método auxiliar que incremente la detección o confirme el resultado de la exploración, para lo cual es necesario conocer los métodos de detección de caries con los cuales contamos en la actualidad

Our knowledge about tooth decay as an illness as well as the concepts and diagnostic methods, have evolved from Miller to Fejerskov who postulates that caries is a dynamic process brought about by a lack of equilibrium connected to the mechanism of remineralization and demineralization. This situation is generated by the microbial metabolism and by the effect that this process has over the hard dental tissues. According to this new perspective about what dental decay is all about, we are forced to design new and more sensitive and specifics diagnostic methods which enable us to detect the lesion already in its initial stage and be able to promote remineralization not to loose the dental structure. Notwithstanding there is controversy about the dentist´s diagnostic and his decision about the best way to prevent and handle dental decay. This makes us think that there need more than a good method to detect the lesion, but the operator must be able to use criteria which enables de dentist to arrive to a better diagnostic. However, we have no developed a sensitive method yet to replace the tactil-visual exploration, this method is sensitivity, and in sometimes need an auxiliary method to increase the detection of a carious event or confirm the exploration outcomes. To attain this, is necessary to be acquainted with the commonly used today method to detect carious lesions

Teorías y factores etiológicos involucrados en la hipersensibilidad dentinaria

La hipersensibilidad dentinaria se caracteriza por un dolor breve y agudo ocasionado por la exposición de la dentina a estímulos típicamente térmicos, táctiles, osmóticos, químicos o aquellos que producen evaporación del líquido dentinario, que no puede ser atribuido a ninguna forma de patología o defecto dental. Se considera de etiología multifactorial. La teoría que mejor explica la aparición del la sensibilidad dentinaria es la hidrodinámica propuesta por Brannström. Los factores etiológicos mas relacionados a la hipersensibilidad dentinaria son: El raspado y alisado radicular, colocación de restauraciones adhesivas, la erosión dental, la abrasión, la abfracción y el blanqueamiento.

The dentinary hipersensitivity is caracterizad by ana cute and short duration pain produced by the exposition of dentine to termal, evaporatorios, tactile, osmotic or chemical stimulants, that can not be atribuited to any pathology or dental detect. It is considerated to have a multifactorial etiology. The theory that best explains the aparition of dentinary sensibility is the hydrodinamic one proponed by Brannström. The etiological factors mostly related to dentinary hypersensitivity are: root planning treatment, adhesive restorations, dental erosion, abrasion, abfraction and whitening.

Frequency and distribution of mutans Streptococci in dental plaque from caries-free and caries-affected Venezuelan children

Los Streptococcus del “grupo” mutans en especial Streptococcus mutans y Streptococcus sobrinus han sido considerados como las principales bacterias responsables del desarrollo dela caries dental. El propósito principal de este estudio fue determinar la frecuencia de estreptococos del grupo mutans presentes en la placa dental de niños venezolanos divididos en tres grupos etarios, 2-6, 7-12 y 13-19 años, con caries y libres de caries y establecer una posible asociación con el desarrollo de caries dental. Muestras de placa dental de 30 (62,5%) niños con caries y 18 (37,5%) niños libres de caries fueron recolectadas de todas las superficies disponibles utilizando una espátula Hollenbak. Las muestras fueron recolectadas e inmediatamente suspendidas en solución Ringer, luego de lo cual se realizaron diluciones seriadas. Las muestras de placa dental fueron cultivadas en Agar Mitis Salivarius para la identificación de Streptococcus totales y en Agar Mitis Salivarius con Bacitracina para la determinación de Streptococcus del “grupo” mutans y posteriormente identificadas utilizando el sistema API Rapid Strep. El examen clínico para determinar el ceod y CPOD fue realizado siguiendo los criterios de Klein y Palmer (1941). El ceod y CPOD promedio fueron 6,4 ±3,2 y 4,4 ± 2,9, respectivamente. De los 30 niños con caries evaluados solo en 10 (33%) de estos se encontró Streptococcus del grupo mutans en la placa dental. Las especies del grupo mutans que se identificaron fueron S. mutans (20 %), S. sobrinus (10 %), y S. rattus(3,3%). Estos resultados indican que el porcentaje de niños que presentaron Streptococcus del grupo mutans en su placa dental fue similar en los niños afectados por caries como en los libres de caries, lo que sugiere que otras especies acidogénicas de la cavidad bucal diferentes a las del grupo mutans parecieran estar jugando un papel importante en el desarrollo de caries dental.

Frecuencia de hipersensibilidad dentinaria posterior al raspado y alisado radicular en un grupo de pacientes evaluados en el postgrado de periodoncia de la Facultad de Odontología Universidad Central de Venezuela: estudio piloto / Frequency of dentin hypersensitivity after scaling and root planing in a group of patients evaluated in the graduate periodontics Facultad de Odontología Universidad Central de Venezuela: a pilot study

Evaluar la frecuencia de la hipersensibilidad dentinaria posterior al tratamiento de raspado y alisado radicular. De un universo total de 49 sujetos que asistieron al a Postgrado de Periodoncia de la Universidad Central de Venezuela entre el 01 de abril y el 30 de mayo de 2005, se seleccionaron 14 pacientes basándose en los criterios de inclusión y exclusión. A cada individuo se le realizó una encuesta constituida por 9 preguntas cuyo objetivo principal fue determinar la presencia o no de hipersensibilidad dentinaria antes y después de realizarse el raspado y alisado radicular. El 71 por ciento de los pacientes presentó hipersensibilidad después de realizado el raspado y alisado radicular. El 60 por ciento consideró que esta hipersensibilidad era leve y el 90 por ciento lo asoció al estímulo frío. De acuerdo a los resultados obtenidos en esta investigación; se puede sugerir que en la población estudiada el raspado y alisado radicular pudiera ser un factor causante de hipersensibilidad dentinaria

The aim of this study was to determine the frequency of Dentinal Hypersensitivity after a root planning treatment. From a total of 49 individuals that assisted to Periodontal Program at the Central University of Venezuela between April 01 to May 30 2005, 14 patients were selected following the including and excluding criteria. To each of the participants a questionnaire was given in order to determine the presence or absence of Dentinal Hypersensitivity before and after the treatment. 71 percent of the patients showed Dentinal Hypersensitive after root planning treatment, 60 percent reported a mild Hypersensitivity and 90 percent of the total sample indicated that cool was the main stimulus that trigged the symptom. These results suggested that the root planning treatment could be associated with Dentinal Hypersensitivity in the study population

Evaluación de un método de extracción de glicoproteína de glándulas submaxilares de bovino / Evaluation of an extraction method glycoprotein bovine submaxillary glands

Los métodos utilizados para la obtención de glicoproteínas de glándulas submaxilares de bovino consisten en esquemas que implican la eliminación de compuestos acuoinsolubles, aislamiento y purificación de las glicoproteínas. El propósito de este estudio fue evaluar un método de obtención de glicoproteínas (Escalona y col. 1989) a partir de glándulas de bovino para obtener un extracto mucínico destinado a la elaboración de un sustituto salival, con el fin de conocer el tipo y cantidad de proteínas presentes y su asociación con la viscosidad. Se analizaron 6 fases acuosas posteriores a la primera centrifugación. De cada una de las fases acuosas se tomó una alícuota y se determinó la cantidad de proteínas totales, y la viscosidad. La viscosidad aparente se midió con un viscosímetro Marca Brokfield modelo LVT con un eje Nº4 a una velocidad de desplazamiento a 73.42seg-1, y las proteínas se caracterizaron por electroforesis en geles de SDS-PAGE al 8 por ciento. Cada uno de los geles se escaneo y la densitometría se realizó en forma computarizada (un programa MultiAnalystTM /PC -Bio Rad- Versión 1.1). Se observó que a medida que se avanzaba en el esquema de extracción de glicoproteínas disminuía la cantidad de proteínas totales, el patrón electroforético mostró diferencias cualitativas entre las muestras evaluadas lo cual se reflejó en una disminución estadísticamente significativa (p<0,05) de la viscosidad aparente. Al expresar la viscosidad con relación al contenido proteico ésta aumentaba, lo que nos permitió inferir que a pesar que hubo una perdida de proteínas se preservaron las glicoproteínas viscosas a expensa del rendimiento proteico

For the obtainment of glycoproteins from bovine submaxillary glands methods are used that encompass the elimination of insoluble compounds, and fractionation and purification procedures. This study was designed to evaluate a particular method (Escalona et al. 1989) for the obtainment of glycoprotein to be used in the preparation of a salivary substitute, and aimed to gathering information on the type and amount of present proteins and their association with viscosity. For this purpose, the six aqueous phases following a centrifugation step in the fractionation scheme were analyzed for protein content (Lowry et al 1951), aparent viscosity (Brookfield viscometer, model LVT), and 8 percent SDS-PAGE electrophoresis with electronic processing of the densitograms (Bio-Rad/multi Analyst). The protein content, aparent viscosity (statistically significant P<0.05), and number of electrophoretic bands showed a decrease with the progress of the fractionation procedure. However, when aparent visxosity was ex pressed in terms of protein content it showed an increase, which is consonous with the relative enrichmentain of the fractions glycoprotein along the purification procedure

El papel de los tutores en la auto-dirección del aprendizaje de los estudiantes de Enfermería / The role of tutors in self-directing the learning of the students of nursing

Introducción: El Método de Aprendizaje Basado en Problemas se fundamenta en las teorías constructivistasdel aprendizaje, en los principios del aprendizaje de los adultos y en el desarrollo de modelos andragógicos.Tiene el propósito de ayudar a los estudiantes a desarrollar habilidades para dirigir su propio aprendizaje.Objetivo: Analizar el papel de los profesores en su rol de facilitadores del aprendizaje autodirigido de los estudiantes de Licenciatura en Enfermería de la Universidad de Colima, México. Metodología: Estudiodescriptivo y transversal; se utilizó una muestra por conveniencia de 121 estudiantes. Para evaluar si los profesores facilitan la formación de habilidades,se diseñó un instrumento tipo inventario con 20 reactivos, los cuales fueron integrados en tres áreas: administración de la información, proceso de grupo, reflexión y pensamiento crítico. Por medio del alpha de Cronbach se obtuvo una confiabilidad de 0.96. Resultados: Al aplicar la prueba Kruskal-Wallis se encontraron diferencias estadísticamente significativas sólo para la dimensión “Proceso de grupo” entre los grupos de 4º y 6º semestres (H = 6.77; P < 0.05). Sin embargo, aunque en las otras dimensiones no se encontraron diferencias estadísticamente significativas, sí se logra identificar cambios en la tendencia de la opinión de los estudiantes hacia el rol de los tutores. Conclusiones: La evaluación sobre las tareas del tutor es favorable; los estudiantes afirman que “casi siempre” facilita, ayuda, promueve o colabora en el desarrollo de las habilidades que les permitirán ser estudiantes autodirigidos

Problem-Based Learning method is based on constructivist theories of learning, the principles of adult learning and the development of andragogical models. Its objective is to help students develop skills to direct their own learning. Objective: to analyse the role of professors of the bachelor’s degree in nursing as facilitators of self-directed learning Licenciatura in nursing of the University of Colima Mexico. Methodology: with the use of a descriptive survey integrated with 20 items answered by 121 students, we assessed the role of the professors of a bachelor’s degree in nursing. The 20 items assessed three areas of the facilitation process: Management of information, group process and reflection and critical thinking. These items were verified with Cronbach’s alpha and a reliability of 0.96. Results: when the Kruskal-Wallis survey was conducted, statistically significant differences were found only with regard to the “Group processing” dimension among sophomores and juniors (H = 6.77; P < 0.05). Even though no statistically significant differences were found with regard to the other dimensions, it is possible to detect shifts in the students’ opinion trend about the role of tutors. Conclusion: The overall average score per scale makes it possible to conclude that the “the work of the tutor” is viewed favourably, considering that the students report that their tutor “almost always” facilitates, assists, promotes or collaborates on the development of the skills for being a self directed learner

Experiencia de caries y fluorosis dental en escolares que consumen agua con diferentes concentraciones de fluoruro en Maiquetía Estado Vargas Venezuela / Dental caries and fluorosis in children consuming water with different fluoride concentrations in Maiquetía Vargas State Venezuela

El objetivo del estudio fue determinar la experiencia de caries y fluorosis dental en escolares que consumen agua con diferentes concentraciones de fluoruro en Maiquetía, Estado Vargas, Venezuela. Se examinaron 421 niños distribuidos en grupos de 84 niños para las edades de 8, 9, 10, 11 y 85 para la edad de 12 años. El examen clínico fue realizado por un personal calibrado, se utilizó el índice de Dean para fluorosis dental para lo cual se examinaron los 6 dientes antero-superiores y el índice CPOD y ceod para caries dental, según los criterios propuesto por la OMS. Adicionalmente se realizó una encuesta socioeconómica y se tomaron muestras de agua y de sal en la localidad. De la muestra seleccionada el 33 por ciento fueron niños y el 67 por ciento niñas. Los resultados revelaron un índice CPOD promedio de 0,91, un ceod de 1,88 y un promedio total de dientes afectados por caries de 2,17. De igual manera se identificó el componente cariado como el más elevado en ambas denticiones. La prevalencia promedio de fluorosis dental para toda la población evaluada fue de 16,6 por ciento, siendo más frecuente el grado de fluorosis muy leve (8,5 por ciento). La Unidad Educativa María May fue la más afectada por fluorosis dental (41,5 por ciento) y la concentración de fluoruro en el agua recolectada de esta unidad educativa fue de 1,58 ppm. De acuerdo a los resultados obtenidos en este estudio se concluye que existe una relación inversa entre la concentración de fluoruro presente en las aguas de los colegios y la prevalencia de fluorosis dental en la dentición permanente de los niños evaluados, pero no en la dentición primaria.

Hábitos de higiene bucal y el nivel socioeconómico de niños entre 15 y 20 meses de edad / Oral hygiene habits and socioeconomic level of 15- to 20-year-old children

Tooth brushing and dentifrice use have been undoubtedly reported by several studies as the primary oral hygiene practices carried out to reduce and control caries development, observing differences among social levels. Objective: The aim of this study was to associate oral hygiene habits with the social levels of children among 15 to 20 months. Methods: One hundred and twelve children were selected from 10 different daycare centers. The criteria of selection included, children among 15 to 20 months, apparently healthy, with a consent form signed by the parent and attending the daycare. Questionnaires assessed tooth-brushing patterns and fluoride dentifrice use considering other possible oral hygiene practices developed at the moment and reporting when these were initiated. A socioeconomic form was also completed for each child. Results: According to Graffar, only 39.3% belonged to the lower social class and the rest of the children (21.4%-39.3%) were classified within the middle and the higher social levels, respectively. The average age of introducing oral hygiene habits was 12.8 months. From the 112 children evaluated, 42 (37.5%) developed any oral hygiene routine, 19.0% of the children's teeth were brushed or cleaned only with water, 76.2% of them used fluoridated dentifrice, and 81.3% of the mothers placed the dentifrice on the toothbrush. Conclusions: The results of this study showed the absence of a significant relationship between parents' socioeconomic status and dental hygiene habits observed in children between 15 to 20 months of age. An important finding was that a high percentage of the children at this age did not show any oral hygiene habit, as well as, mothers played the most important role.

Numerosos estudios han reportado que el cepillado y el uso de cremas dentales fluoruradas constituyen uno de los principales hábitos de higiene bucal destinados a la disminución y control de la caries dental, cuya práctica podría variar según el estrato socio-económico. Objetivo: El propósito fundamental de éste estudio fue el de asociar la práctica de hábitos de higiene bucal con el estrato social en niños entre 15 y 20 meses. Materiales y métodos: Un total de 112 niños fueron seleccionados de 10 maternales ubicados en la Zona Metropolitana de Caracas. Se completo un cuestionario que registraría información acerca de los patrones de cepillado, el uso de cremas dentales fluoruradas y la posible práctica de otros hábitos de higiene bucal. Una encuesta socio-económica según los criterios de Graffar modificado por Méndez Castellano 1986 también fue registrada para cada niño. Resultados: De acuerdo con la encuesta socio-económica solo el 39,3 por ciento de los niños pertenecía a los estratos más bajos, el resto de los niños formaba parte de los estratos Alto-medio alto y medio (21,4 por ciento-39,3 por ciento) respectivamente. El promedio de la edad de inicio de alguna práctica de higiene bucal fue de 12,8 meses. De los 112 niños evaluados solo 42 (37,5 por ciento) tenían algún hábito de cuidado bucal. Por otra parte, el 19,0 por ciento se cepillaba solo con agua y 4,8 por ciento no incluía el cepillo en la limpieza de sus dientes. El 81,3 por ciento de las madres colocaba la crema dental en el cepillo y asistía al niño durante el cepillado. Conclusiones: Los resultados de este estudio indicaron la ausencia de una relación significativa entre la práctica de hábitos de higiene bucal y el nivel socioeconómico de los padres. Cabe mencionar como un hallazgo importante que un alto porcentaje de los niños a estas edades aun no se cepillan y las madres siguen jugando un papel fundamental en las rutinas de cuidado bucal.

Urinary fluoride excretion in children aged 3 to 5 years exposed to fluoridated salt at 60 to 90 mgF/Kg in two Venezuelan cities: a pilot study

Streptococcus mutans es el principal microorganismo asociado a la caries dental, esta bacteria se une al esmalte a través de su interacción con las proteínas de la película adquirida yla proteína de superficie celular comúnmente denominada PAc. Por lo menos dos sitios de PAc interactúan in vitro con los receptores salivales, uno está dentro de la región más conservadade esta proteína que comprende los residuos de 816-1213 y el otro dentro de la secuencia rica en Alanina, residuos186-469. El objetivo del presente trabajo fue establecer similitudes o diferencias en la interacción de péptidos de PAc con los componentes salivales de individuos con y sin experiencia de caries, para lo cual se tomaron muestras de saliva por salivación espontánea de 20 individuos con caries y 20 sin caries. A partir de las muestras de saliva se extrajeron las proteínas de la película adquirida (PA) utilizando hidroxilapatitasintética y fueron sometidas a la interacción con tres péptidos sintéticos de los segmentos de unión de PAc con loscomponentes salivales: PAc (301-319), PAc (365-377) y PAc (1024-1044). Los resultados muestran una baja interacción entre los componentes de la PA y los péptidos en todos losindividuos, sugiriendo que con base en las similitudes entre los individuos sanos y los individuos con la enfermedad lospéptidos de PAc estudiados no son relevantes en la adhesión inicial de S. mutans.