Systemic Manifestations, Tooth Eruption and Enamel Defects in Children with Congenital Zika Virus Syndrome: 36-Month Follow-up Case Series

Abstract Objective: To describe systemic manifestations, the characteristics related to tooth eruption, and the occurrence of enamel defects in children with Congenital Zika Virus Syndrome (CZS). Material and Methods: Prospective case series based on nine children with confirmed CZS diagnosis assisted at a reference center in a municipality in the Northeast Region of Brazil. Through a structured interview directed to mothers, information related to prenatal, delivery, and postpartum periods was collected. Tooth eruption was monitored through clinical examinations for 36 months. The modified developmental defect of enamel index (DDE) was used to identify opacities and hypoplasia. Data were presented using descriptive statistics. Results: A high proportion (77.8%) had microcephaly, and 55.5% had low birth weight. Musculoskeletal disorders, swallowing difficulty, and self-injury practices were present in all children. Among the systemic findings, visual impairment (77.8%) and seizures (77.8%) were widely reported. Concerning disorders related to the stomatognathic system, bruxism (66.7%) and difficulty in sucking (33.3%) were present. For most children (77.8%), the deciduous right lower central incisor was the first tooth to erupt (minimum 8 months and maximum 17 months). Enamel defects were diagnosed in only two children (22.2%). Conclusion: A wide range of systemic manifestations was observed in children with CZS, including visual impairment and musculoskeletal disorders. Delayed eruption of the first deciduous tooth was also observed. Enamel defects were present in a small proportion of children.

Efecto preventivo de los agentes desensibilizantes en pacientes con indicaciones de raspado y alisado radicular / Preventive effect of desensitizing agents on patients with indications of scaling and root planning treatment

La hipersensibilidad dentinaria (HD) posterior al raspado y alisado radicular (RAR) ha sido poco estudiada desde una perspectiva preventiva a pesar de su relevancia clínica. El objetivo de esta investigación fue evaluar el efecto de las cremas desensibilizantes en pacientes con indicaciones de raspado y alisado radicular. Para ello, se realizó un estudio longitudinal cuasi-experimental con una muestra no probabilística de 18 pacientes (hombres y mujeres) entre 20 y 50 años de edad, que requerían tratamiento con RAR en dientes posteriores (premolares y primer molar), quienes fueron asignados al azar en cada uno de los tres grupos a evaluar. Las cremas desensibilizantes utilizadas en esta investigación contienen citrato de potasio, nitrato de potasio, fluoruro de sodio y triclosan estas se indicaron un mes antes de realizar los RAR en todos los grupos. Para medir la presencia de hipersensibilidad dentinaria se aplicaron estímulos táctiles y térmicos a los 8, 15 y 22 días posteriores al tratamiento de RAR y se usó la Escala Visual Análoga Graduada (EVAG) para evaluar el dolor. Como resultado se obtuvo menor presencia de HD en el grupo que utilizó citrato de potasio 5.04% y monofluorfosfato 1.1%, aun cuando en los tres grupos se observó disminución de HD durante los tres periodos de medición. Llegando a la conclusión que es pertinente prescribir cremas desensibilizantes con citrato de potasio 5.04% y monofluorfosfato 1.1% a los pacientes con necesidades clínicas similares a los de este estudio un mes antes de planificar los RAR.

The presence of dentine hypersensitivity (DH) after scaling and root planning treatment (RPT) has been scarcely studied from a preventive perspective in spite the clinical relevance of the issue. The aim of this research was to evaluate the preventive effect of some desensitizing dentifrices in patients previous to a RPT. In this sense, a cuasi-experimental, longitudinal study was performed. The non probabilistic sample was constituted by 18 patients (women and men) aged between 20 and 50; all of them diagnosed as requiring scaling and root planning treatment for posterior teeth (premolars and first molars). Subjects were randomly assigned to one of the three groups. The desensitizing toothpaste used in the study contained potassium citrate, potassium nitrate, sodium fluoride and triclosan. These paste were prescribed for patients a month before the RPT. Dentine hypersensitivity was evaluated by using tactile and thermal stimuli applied 8, 25 and 22 days after RPT; the Visual Analogue Scale (VSA) was used to assess pain. Results showed lower presence DH in the 5.04% potassium citrate group and 1.1% monofluor fosfate, even when there was a decrease of DH for the three measurement periods. It was concluded that it would be good to prescribe 5.04% potassium citrate group and 1.1% monofluorfosfate desensitizing agents to patients with clinical needs similar to the ones described in this study, a month before the RPT.

Potencialidade do conceito de vulnerabilidade para a compreensão das doenças transmissíveis / The potential of the concept of vulnerability in understanding transmissible diseases / Potencialidad del concepto de vulnerabilidad para la comprensión de las enfermedades contagiosas

O artigo traz a evolução e a contribuição da produção científica relacionada ao conceito de vulnerabilidade e sua potencialidade em estudos das doenças transmissíveis. Apresenta-se o conceito de Vulnerabilidade e a produção do conhecimento em Enfermagem, particularmente desenvolvida no Grupo Pesquisa Vulnerabilidade, Adesão e Necessidades em Saúde, do CNPq. Tem como finalidade ampliar a compreensão de agravos de saúde, com base neste conceito, além de possibilitar a proposição de intervenções para o seu enfrentamento, que extrapolem o âmbito do indivíduo, mas contemple a organização do trabalho nos serviços de saúde e a determinação social do processo saúde-doença.

This article presents the evolution and the contribution of the scientific production related to the concept of vulnerability and its potential to help studying transmissible diseases. It presents the concept of vulnerability and the production of knowledge in nursing, developed particularly by the CNPq Research Group Vulnerability, Adherence, and Health Needs. The purpose is to improve the understanding of health issues, based on this concept, and permit the proposition of coping interventions that surpass the individual domain, thus contemplating the organization of health care work and the social determination of the health-disease process.

El artículo se refiere a la evolución y a la contribución de la producción científica relacionada al concepto de vulnerabilidad y su potencialidad en estudios de las enfermedades contagiosas. Se presenta el concepto de Vulnerabilidad y la producción de conocimiento en Enfermería, particularmente, desarrollada en el Grupo de Investigación Vulnerabilidad, Adhesión y Necesidades en Salud, del CNPq. Tiene como finalidad ampliar la comprensión de perjuicios de salud con base en este concepto, además de posibilitar la propuesta de intervenciones para su enfrentamiento que extrapolen el ámbito del individuo, pero que contemple la organización del trabajo en los servicios de salud y la determinación social del proceso salud-enfermedad.

The potential of the concept of vulnerability in understanding transmissible diseases. / Potencialidade do conceito de vulnerabilidade para a compreensão das doenças transmissíveis.

This article presents the evolution and the contribution of the scientific production related to the concept of vulnerability and its potential to help studying transmissible diseases. It presents the concept of vulnerability and the production of knowledge in nursing, developed particularly by the CNPq Research Group Vulnerability, Adherence, and Health Needs. The purpose is to improve the understanding of health issues, based on this concept, and permit the proposition of coping interventions that surpass the individual domain, thus contemplating the organization of health care work and the social determination of the health-disease process.

Incidence and severity of infections according to the development of neutropenia during combined therapy with pegylated interferon-alpha2a plus ribavirin in chronic hepatitis C infection.

The evolution of treatment of chronic hepatitis C virus infection has led to improved therapeutic efficacy. However, a major problem is the presence of side effects that require modification or withdrawal of drug therapy in 15-20% of cases. This could potentially influence the lack of sustained viral response in 50% of the cases. Side effects are common, even with pegylated interferon. This study aimed to assess the incidence and severity of infections based on the development of neutropenia associated with combined therapy with pegylated interferon-alpha2a plus ribavirin in 209 patients with chronic hepatitis C infection. All patients were administered pegylated interferon-alpha2a (180 microg/week) plus ribavirin (800 mg/day for 24 weeks in cases of nongenotype 1, or 1000-1200 mg/day for 48 weeks for genotype 1, according to whether patients weighed more or less than 75 kg). Patients with preexisting neutropenia of any cause or cirrhosis were excluded. Neutropenia was defined as a neutrophil count (NC) of <1500 cells/microl. Neutropenia was classified into three levels during treatment: 750

Applicability of MNDO techniques AM1 and PM3 to ring-structured polymers.

Semiempirical Hartree-Fock techniques are widely used to study properties of long ring-structured chains, although these types of systems were not included in the original parametrization ensembles. These techniques are very useful for an ample class of studies, and their predictive power should be tested. We present here a study of the applicability of some techniques from the NDDO family (MNDO, AM1, and PM3) to the calculation of the ground state geometries of a specific set of molecules with the ring-structure characteristic. For this we have chosen to compare results against ab initio Restricted Hartree-Fock 6-31G(d,p) calculations, extended to Møller-Plesset 2 perturbation theory for special cases. The systems investigated comprise the orthobenzoquinone (O(2)C(6)H(4)) molecule and dimers (O(2)C(6)H(4))(2), as well as trimers of polyaniline, which present characteristics that extend to several systems of interest in the field of conducting polymers, such as ring structure and heterosubstitution. We focus on the torsion between rings, because this angle is known to affect strongly the electronic and optical properties of conjugated polymers. We find that AM1 is always in qualitative agreement with the ab initio results, and is thus indicated for further studies of longer, more complicated chains.

Determination of normative criteria and validation of the SKT for use in Spanish-speaking populations.

Most of the tests, questionnaires, and neuropsychological batteries for the assessment of dementia have been translated and adapted for use in the Hispanic population without having normative data, which results in a high number of false positives when age and educational level are not considered. The Short Cognitive Performance Test (SKT) is a psychometric instrument evaluating memory and attention deficits that has been developed and standardized in Germany (Erzigkeit, 1989a, 1989b). The objective of this study was to adapt the SKT, to establish normative criteria that take into consideration age and educational level, and to establish its concurrent validity in comparison to other neuropsychological tests: Brief Neuropsychological Evaluation for Spanish-Speaking Subjects (Ostrosky-Solis et al., 1994), the Mini-Mental State Examination (Folstein et al., 1975), and the Blessed Functional Scale (Blessed et al., 1968) in 238 neurologically intact subjects and 97 subjects with mild to moderate dementia. The SKT showed adequate sensitivity (80.5%) and specificity (80.3%) in subjects with medium and high educational level; however, the sensitivity and specificity diminished (75% and 56.7%) in subjects with no education or low educational level. The adapted and validated version of the SKT in the Mexican population has been shown to be a psychometric instrument that in subjects with medium educational level can detect cognitive alterations and is able to determine the severity of deterioration; however, in subjects with low educational level and severe dementia, the SKT cannot be usefully administered.