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.

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.

Transvaginal ultrasound evaluation of the ureter

Objective@#In this video, we present our technique for ureter assessment during pelvic ultrasound examination. @*Methods@#We used a general electric Voluson E10 (General electric, Wauwatosa, WI, USA) to perform transvaginal ultrasonography. These images were shared after thorough counselling, and obtaining informed consent from the patient. This video was edited using FinalCut ProX® (Apple Inc, Cupertino, CA, USA). @*Results@#We systematized this routine after assessing the cervix, uterus, and adnexa. The vaginal probe was slightly removed to focus on the urethra. Next, we approached the hand on the contralateral thigh to the ureter. At this point, the probe was directed to the lateral pelvic wall where the ureteric orifice was found. Then, we raised our hands and perform an internal rotation movement to ascend the ureteral segments until it is related to the iliac vessels. @*Conclusion@#The urinary tract may be involved in gynecological pathologies. Transvaginal ultrasound is an easy, reproducible, and well-tolerated examination that can be used to evaluate the ureters below the pelvic brim.

Creación de un Currículo de Competencias en Cariología para Estudiantes de Pregrado de Odontología en Chile / Development of a Competency-based Curriculum in Cariology for Undergraduate Dental Students in Chile

RESUMEN: Objetivo: Creación de un currículo de competencias mínimas en Cariología, para la formación de los Cirujano-Dentistas egresados de las escuelas de Odontología de Chile. Metodologías: A partir de una reunión de académicos de las Universidades de Talca y de Chile (año 2011), se elaboró una propuesta de currículo inicial, basado en los dominios propuestos por la Unión Europea (Schulte AG y cols). Durante el año 2016, dicha propuesta fue analizada mediante diálogos digitales y grupos de trabajo, con la participación del 96% de las Escuelas de Odontología existentes en el país, que concluyeron en un documento intermedio. Este documento fue analizado, discutido y perfeccionado durante el Taller para el Desarrollo de un Currículo de Competencias Mínimas en Cariología para las Escuelas de Odontología Chilenas (22/Mayo/2017, Talca, organizado por la Universidad de Talca y la Universidad de Chile) con la asistencia de representantes del 96% de las escuelas dentales chilenas, Ministerio de Salud de Chile, Colegio de Cirujano-Dentistas de Chile y con la asesoría de los profesores de Cariología Dres. Margherita Fontana y Carlos González-Cabezas (Universidad de Michigan, Ann Arbor, EEUU). Cada grupo de trabajo revisó el documento y envió nuevos comentarios, los que fueron incorporados en el documento final por una comisión asesora. Resultados: El documento del Currículo en Cariología se organizó en 5 Dominios: 1. Conocimientos base; 2. Determinación de Riesgo, diagnóstico de caries y detección de lesiones de caries; 3. Toma de decisiones y manejo preventivo no operatorio; 4. Toma de decisiones y manejo operatorio y 5. Cariología basada en la evidencia, en la práctica clínica y de salud pública. Se consensuaron las definiciones operacionales, las competencias principales y las sub-competencias para cada uno de los dominios. Las sub-competencias fueron clasificadas en tres niveles: A: Ser competente en; B: Tener conocimientos sobre y C: Estar familiarizado con. El documento final fue enviado a todos los participantes del taller para su aprobación y difusión en cada una de las instituciones involucradas. Conclusiones: Se logró, por medio de consenso, la construcción del Currículo de Competencias mínimas en Cariología para estudiantes de pregrado de Odontología en las universidades chilenas.

ABSTRACT: Objective: Development of a minimum set of competencies in Cariology that every dentist graduated from a Dental School in Chile must have. Methodology: Starting from a meeting of scholars from the Universities of Talca and Chile (year 2011), an initial proposal for a curriculum was developed, based on the domains proposed by the European Cariology Curriculum (Schulte, et al, 2011). During 2016, this proposal was discussed through online dialogues and working groups, with the participation of 95.2% of the Chilean dental schools, which resulted in an intermediate document. This document was analyzed, discussed and refined during the Workshop for the Development of a Curriculum of Minimum Competencies in Cariology for Chilean Dental Schools (May 22, 2017, Talca, organized by the Universities of Talca and Chile) with the attendance of representatives from 95.2% of the Chilean dental schools, the Chilean Ministry of Health, Chilean College od Dentists and with the assistance of the professors of Cariology Margherita Fontana and Carlos González-Cabezas (University of Michigan, Ann Arbor, USA). Each working group revised the document and provided feedback, which was incorporated in the final document by an advisory committee, elected on the day of the workshop, including the authors of the present article. Results: The Cariology Curriculum was organized in 5 Domains: 1. Basic knowledge; 2. Risk assessment, caries diagnosis and caries lesion detection; 3. Decision-making and non-operative preventive treatment; 4. Decision making and operative treatment; and 5. Evidence-based, clinical and public health practice. Operational definitions, main competencies and sub-competencies for each domain were agreed. Sub-competencies were classified into three levels: A: Be competent in; B: Have knowledge about, and C: Be familiar with. The final document was sent to all the participants of the workshop for dissemination in each of the institutions involved. Conclusions: The development of the Competency-based Curriculum in Cariology for undergraduate dental students at Chilean universities was achieved through consensus.

Características de la oclusión dentaria en niños de 4 y 5 años / Characteristic of the occlusion in 4 and 5 years children

Se realizó un estudio observacional, descriptivo y transversal de los 86 niños de 4 y 5 años de edad, pertenecientes al quinto y sexto años de vida del Círculo Infantil Ana de Quesada de Santiago de Cuba, de octubre del 2015 a marzo del 2016, a fin de caracterizarles en cuanto a la oclusión dentaria. En la serie se obtuvo que al menos 17,4 por ciento de los niños examinados presentaban alteración en la oclusión permanente respecto a la relación de los molares temporales, con más frecuencia del sobrepase de media corona (31,4 por ciento) y menos reiteración de la oclusión de los dientes de borde a borde (con solo 9 niños). Por último, pudo concluirse que 46,6 por cientode los párvulos presentó una oclusión anómala

An observational, descriptive and cross-sectional study of the 86 4 and 5 years old children, belonging to the fifth and sixth years from Ana de Quesada child day care center in Santiago de Cuba was carried out from October, 2015 to March, 2016, in order to characterize them as for their occlusions. In the series it was obtained that at least 17,4 percent of the examined children presented changes in the permanent occlusion regarding the relationship of the temporary molars, with more frequency of the overbite of half crown (31,4 percent) and less reiteration of the occlusion of border to border teeth (just in 9 children). Lastly, it could be concluded that 46,6 percent of the children presented an anomalous occlusion

Modified glass ionomer and orthodontic band: an interim alternative for the treatment of molar incisor hypomineralization: a case report

Introduction: Molar incisor hypomineralization (MIH) is a developmental condition resulting in defects in the enamel characterized by demarcated opacities mainly affecting first permanent molars and occasionally permanent incisors in 1 of every 6 children worldwide. Affected molars have greater susceptibility to post eruptive breakdown, extensive caries and, in severe cases, are difficult to restore. When the MIH-affected molar presents severe crown destruction, it is necessary to perform an intermediate restoration to preserve the remaining dental structure in order to maintain occlusion, proper hygiene and periodontal health. The case of an 11-year-old patient with severe MIH is reported. The patient had extensive crown destruction by caries in tooth 1.6 without clinical or radiographic signs of pulp pathology. After an initial preventive intervention, enamel without dentin support and carious dentin were removed from tooth 1.6. Subsequently, crown restoration was performed with resin-modified glass ionomer, followed by the cementation of an orthodontic band. After 18 months of follow-up, the patient reported no pain or discomfort. The restoration was preserved intact, maintaining occlusal functionality, pulp and gingival health. Conclusion: The interim treatment, cementing an orthodontic band over a tooth restored with glass ionomer seems to favor retention and compressive strength, keeping the MIH-affected molar asymptomatic for at least 18 months. Further studies evaluating this treatment option in similar clinical situations are recommended.

Evaluación del tratamiento de agua para consumo humano mediante filtros Lifestraw® y Olla Cerámica / Evaluation of drinking-water treatment by Lifestraw® and Ceramic-pot filters

Objetivo Evaluar la eficiencia de dos sistemas de filtración casera: LifeStraw® family (FM) y Filtro de Olla Cerámica (FOC) en el tratamiento del agua para consumo humano bajo condiciones controladas de laboratorio y en términos de remoción de Turbiedad y E.coli. Métodos Ambos sistemas se operaron durante 6 meses tratando diariamente 7,5 litros de sustrato sintético. La turbiedad del sustrato se ajustó con Caolín y la concentración de E.coli con la réplica de la cepa ATCC 95922. Los resultados obtenidos en términos de remoción de turbiedad y E. coli fueron evaluados con un análisis de varianza (ANOVA) y considerando aspectos operativos y de mantenimiento. Resultados La turbiedad del sustrato sintético presentó un promedio 32,3 ± 2,8 UNT y la concentración de E. coli 3,9 x105 UFC/100mL. Ambos sistemas de filtración disminuyeron la turbiedad a niveles menores de 2 UNT y lograron la inactivación del 100 % de E.coli. Se encontraron diferencias significativas en la remoción de turbiedad siendo más eficiente el FM (99,2 % ± 0,4) que el FOC (97,6 % ± 1.14). Conclusiones Los dos sistemas de filtración son adecuados para el tratamiento del agua a nivel casero, cumpliendo con la reglamentación Colombiana. El FM resultó más eficiente en remoción de turbiedad y tasa de filtración; Sin embargo, cuando se tienen en cuenta aspectos como aceptabilidad social operación, mantenimiento y vida útil, el filtro de olla cerámica parece más apropiado especialmente en áreas rurales.(AU)

Objective To evaluate under laboratory conditions, the removal efficiency of turbidity and E. coli of two household water filters: LifeStraw® family (MF) and ceramic pot filter (CPF). Methods The two systems were operated over 6 months using two identical control units per system, treating 7.5 L/d of a synthetic substrate used as raw water. The turbidity of the substrate was adjusted with Kaolinite and the E. coli concentration, with a replica of the ATCC 95922 strain. The differences of effluent quality of the systems, in terms of turbidity and E. coli, were evaluated with Analysis of Variance (ANOVA). Operative and maintenance aspects, that could limit or enhance the use of the systems, were also considered in the evaluation. Results The water synthetic substrate quality had an average of 32.2 ± 2.8 NTU for turbidity and 3,9x105 UFC/100 mL for E. coli. Both systems reduce the turbidity to values below 2 NTU with an inactivation of 100 % of E. coli. Statistical differences were found between the systems in terms of turbidity removal, MF being more efficient than the CPF (99,2 ± 0.4 % and 97.6 % ± 1.14, respectively). Conclusions Both systems are suitable for household water supply treatment, acheiving the water quality standards established by Colombian regulations. The MF was more efficient for suspended solids removal and filtration rate, but when economic, operative, and maintenance aspects along with social acceptability and lifespan are considered, the CPF seems more suitable, especially in rural areas.(AU)

Riesgo de transmisión de Trypanosoma cruzi en el municipio de Metztitlán, estado de Hidalgo, México, mediante la caracterización de unidades domiciliares y sus índices entomológicos / Transmission risk of Trypanosoma cruzi in Metztitlán municipality from Hidalgo state, México, by characterization of domiciliary units and their entomologic indexes

In order to determine the risk of transmission of Trypanosoma cruzi by triatomines in Metztitlan municipality, Hidalgo State, Mexico, entomological indexes were calculated and the characteristics of dwellings were described. A transversal, retrospective, descriptive, and observational study was performed by means of an intentional not probabilistic and expertise sampling from January to December of 2005 in 10 localities in which presence of triatomines were investigated either intra or peridomestic environmental in 699 houses. Building material and presence of infected triatomines with T. cruzi were registered to determine entomologic indexes. The triatomine species collected were: Triatoma barberi (Usinger) and T. mexicana (Herrich-Schaeffer) (Hemiptera: Reduviidae). The results indicated that natural infection index varied from 7.7 percent to 50 percent; colonization index reached 80 percent; infestation index varied from 7.7 percent to 25 percent; dispersion index was 70 percent. Stone-walled houses were more infested. We can conclude that it is necessary to establish T. cruzi transmission control measures against triatomines in localities from Metztitlan, primarily in stone-walled houses where T. barberi occurs, as it was the most important vector species in the transmission of T. cruzi in this municipality.

Inyección de sustancias esclerosantes vasculares en el manejo de lesiones vasculares orbitarias / Injection of vascular sclerosing agent in the treatment of orbital vascular lesions

Objetivo: Evaluar el efecto de la inyección de espuma de polidocanol como sustancia esclerosante vascular en la reducción del tamaño de hemangiomas y linfangiomas orbitarios. Material y Métodos: Estudios prospectivo intervencional de 2 casos con diagnóstico de hemangioma capilar, 7 casos de linfangioma de la región orbitaria y 1 malformación vascular superficial preseptal, que recibieron una o más inyecciones de polidocanol intralesional. Se evaluaron el tipo de tumor, disminución de su tamaño, variación de ptosis palpebral, proptosis y presencia de complicaciones con el procedimiento. Resultados: Se realizaron 4,5 inyecciones promedio con una dosificación final de 0,6 cc al 0,5 por ciento de polidocanol. El seguimiento promedio fue 16,2 meses. Todos los pacientes redujeron el tamaño de la lesión significativamente. La principal complicación fue dolor postinyección. Conclusiones: El uso de inyecciones de polidocanol en el tratamiento de hemangiomas capilares y linfangiomas orbitarios sería una alternativa novedosa y efectiva para reducir el tamaño de las lesiones sin mayores complicaciones.

Cirugía de labio y paladar hendido en el Hospital General de Ensenada, BCN / Surgery of cleft lip and palate in General Hospital of Ensenada, BCN

Se revisaron 9 496 expedientes de los Servicios de Ginecología y Neonatología del Hospital General de Ensenada, BCN sobre un período de cinco años (1989-1993), para localizar las distintas malformaciones presentadas en ese lapso. Fueron registrados 7 917 nacimientos, con una incidencia de 96 malformaciones congénitas y de éstas sólo nueve con labio y/o paladar hendido, tres casos correspondieron al sexo masculino. Se encontraron cuatro fisuras unilaterales izquierdas y una derecha; tres fisuras bilaterales; todas asociadas a fisura palatina. Así como un caso de paladar secundario. También se analiza la edad materna, la cual es considerada como factor de riesgo en estos casos. Se hace una descripción de esta padecimiento, se informa sobre el manejo de los pacientes con esta patología en nuestro Servicio y se mencionan las técnicas quirúrgicas empleadas en su tratamiento. Asimismo, se hace referencia a las actividades realizadas por el autor principal durante 14 años en este Servicio en relación a la cirugía de labio y/o paladar hendido

Fístula biliodigestiva y abstrucción intestinal por cálculo biliar: reporte de un caso / Biliodigestive fistula and intestinal obstruction by a bile calculi: report of a case

Una fístula biliodigestiva es toda comunicacion anomala producida entre cualquier segmento del arbol biliar con el tubo digestivo. Pueden ser secundarias a litiasis biliar o a ulcera duodenal. La frecuencia es variable oscilando entre 0.1 por ciento y 5 por ciento , es mas frecuente en el sexo femenino en proporcion de 4:1, y ocurre generalmente en paciente con edad avanzada. Reportamos el caso de una femenina de 73 años de edad con historia de colelitiasis, la cual presento cuadro caracterizado por dolor en epigastrio de fuerte intensidad, nauseas y vomitos, asi como distension abdominal y fiebre. Presentado 4 dias mas tarde cuadro dr obstruccion intestinal. Una serie gastroduodenal revelo defecto de llenado en duodeno compatible con fistula, una TAC de abdomen revelo distension asas intestinales. La paciente fue sometida a cirugia encontrandose calculo biliar en asas yeyunales medias, responsable del cuadro obstructivo