ABSTRACT
Introduction: Dental bleaching is the first choice to improve smile esthetics, but, in some cases, it needs to be associated with resin composite restoration to obtain a satisfactory result. Unfortunately, the bonding of resin-based materials can be impaired due to residual oxygen molecules, which can decrease the durability of the restoration. Objectives: To evaluate the effect of the antioxidant application on the bond strength of bleached enamel after 24 hr and 3 years of water storage. Methods: In total, 84 bovine teeth were used in this study. Of these, 77 were bleached with 35% hydrogen peroxide in a single session for three cycles of 15 min. Then, the specimens were divided into groups (n = 7 each): control (without bleaching), without antioxidant (WA) use; application of 10% sodium ascorbate (SA) gel, grape seed (GS) extract, and aloe vera (AV). The restorative procedure was performed immediately after bleaching, 7 and 14 days after bleaching. Specimens were sectioned and evaluated using microtensile bond strength (µTBS). Half of the resin-enamel sticks were tested after 24 hr, and the remaining half after 3 years of water storage. µTBS data were analyzed using a three-way analysis of variance, Tukey's test, and Dunnett's test. Results: The lowest µTBS values were observed when the restoration was performed immediately after bleaching in the AV, GS, and WA groups when compared with the SA group (p < 0.005). However, no significant differences were observed among all groups after 3 years of water storage (p < 0.001). Conclusions: SA at 10% was the most effective antioxidant agent for improving the immediate bond strength. However, independent of the antioxidant agent used, the bond strength values were maintained or recovered after 3 years of water storage. SA at 10% could be used to avoid delayed bonding procedures after in-office whitening without compromising bond strength over time. Clinical Significance. The use of antioxidants after dental bleaching can be effective in improving the bonding durability of the adhesive restorations.
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ntroducción: El miedo a las caídas se presenta en el 30% de las personas mayores sin historia de caída previa, porcentaje que se duplica en aquellos que han tenido antecedentes de caída, con mayor prevalencia en personas mayores de edad más avanzada, lo que genera consecuencias negativas como pérdida de autonomía y aislamiento. Objetivo: Analizar la correlación entre el miedo a caer y los factores sociodemográficos, biomédicos y de la valoración geriátrica integral de un grupo de personas mayores que viven en la comunidad. Metodología: Estudio descriptivo, analítico, realizado en 113 personas mayores de 60 años que asistieron a control médico ambulatorio. Se midieron las siguientes variables: demográficas, biomédicas, funcionales, estado cognitivo y estado afectivo. El miedo a caer se midió mediante la versión acortada Short Scale International. Para estos análisis se usó estadística descriptiva y análisis bivariado, medidas de correlación de Pearson y Spearman, y se consideró una significación ≤ 0,05. Esta investigación contó con la aprobación del comité de ética. Resultados: La mayoría de las personas mayores presentó un grado moderado de miedo a caer. El miedo a caer tuvo una correlación negativa entre nivel educacional, índice de Barthel y escala de depresión geriátrica de Yesavage, y una correlación positiva con satisfacción con su vida y autopercepción de salud. Conclusiones: Nivel educacional, funcionalidad, ánimo, satisfacción con la vida y autopercepción de salud fueron las variables correlacionadas con el miedo a caer que tienen las personas mayores que viven en la comunidad. Es importante reconocer este fenómeno a nivel de la atención primaria de salud y la forma de abordarlo oportunamente para incentivar el envejecimiento positivo (AU)
Introduction: Concern about falling occurs in 30% of older people with no history of previous fall, a percentage that doubles in those who have had a history of falling, with a higher prevalence in older people of older age, generating negative consequences such as loss of autonomy and isolation. Objective: To analyze the correlation between worry about falling and sociodemographic, biomedical factors and the comprehensive geriatric assessment of a group of older people living in the community. Methodology: Descriptive, analytical study carried out on 113 people over 60 years of age who attended an outpatient medical check-up. The following variables were measured: demographic, biomedical, functional, cognitive and affective status. Concern about falling was measured by the shortened version Short Scale International. For these analyzes, descriptive statistics and bivariate analysis were used, Pearson and Spearman correlation measures considering a significance ≤ 0.05. This investigation had the approval of the ethics committee. Results:Most of the PM presented a moderate degree of concern about falling. Concern about falling had a negative correlation between educational level, Barthel index, Yesavage geriatric depression scale; and a positive correlation with satisfaction with her life and self perception of health. Conclusions: Educational level, functionality, encouragement, life satisfaction and self-perception of health were the variables correlated with the concern to fall that have the PM that live in the community. It is important to recognize this phenomenon at the level of primary health care in a timely manner to encourage positive aging (AU)
Subject(s)
Humans , Male , Female , Middle Aged , Aged , Aged, 80 and over , Geriatric Assessment , Fear , Accidental Falls , Socioeconomic Factors , Cross-Sectional StudiesABSTRACT
RESUMEN Objetivo: Determinar la relación entre la anemia materna del primer trimestre y el bajo peso al nacer de cuatro centros de salud maternos de Lima-Sur durante el 2019. Materiales y métodos: Se realizó un estudio cohorte retrospectivo de una base de datos secundaria donde se incluyeron gestantes atendidas en cuatro Centros de Salud con nivel de complejidad I-4 de Lima-Sur; cuyos partos se registraron durante el 2019, excluyendo a los recién nacidos pretérmino. Una hemoglobina del primer trimestre <11 g/dl se definió como anemia y un peso <2500 g como bajo peso al nacer. Se calculó la incidencia acumulada según anemia y se halló el riesgo relativo (RR) ajustado a potenciales confusores. Resultados: Se incluyó 221 gestantes y el 76 % tuvo una edad entre 18 a 35 años. Un 42 % fue primigesta, un 52 % presentó exceso de peso y el 60 % realizó 6 o más controles prenatales. Un 23,5 % de gestantes presentó anemia en el primer trimestre y se halló una incidencia de 2,7 % casos con bajo peso al nacer. La anemia del primer trimestre elevó en 11 veces la incidencia de recién nacidos con bajo peso, independiente de la edad, índice de masa corporal y paridad (RR ajustado = 11,1; IC 95 % 1,3 - 97,2; p=0,029). Conclusiones: De la muestra estudiada, una de cada cuatro gestantes presenta anemia durante el primer trimestre incrementando la incidencia acumulada de tener un neonato con bajo peso hasta en 11 veces.
ABSTRACT Objective: To determine the relationship between maternal anemia in the first trimester of pregnancy and low birth weight in four mother-and-child-health centers in Southern Lima during 2019. Material and methods: A retrospective cohort study from a secondary database was performed, where pregnant women from 4 middle-complexity Health Centers from Southern Lima were included. Deliveries took place during 2019, excluding preterm newborns. First trimester hemoglobin concentration <11 g/dL was defined as anemia and birth weight <2500 g was defined as low birth weight. Cumulative incidence for anemia was calculated, and relative risk (RR) adjusted for potential confounders was also calculated. Results: Two hundred and twenty one pregnant women were included. Seventy-six per cent were between 18 and 35 years old. Forty-two percent were primigravida, fifty-two percent had excess body weight, and sixty percent had six or more prenatal control visits. Nearly one quarter (23,5%) of all pregnant women had anemia during the first trimester, and there were 2,7% cases of low birth weight. Anemia during the first trimester of pregnancy increased 11 times the frequency of newborns with low birth weight, independently of age, body mass index, and parity (adjusted RR = 11,1; 95% CI: 1,3-97,2; p= 0,029). Conclusions: In the studied sample, one out of four pregnant women had anemia during the first trimester of pregnancy, increasing up to 11 times the cumulative incidence for having a neonate with low birth weight.
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Las crisis epilépticas en Pediatría son un importante motivo de consulta. En este artículo se revisará la importancia de la primera crisis epiléptica, cómo enfrentarse a esta situación desde los antecedentes y el examen físico, diagnósticos diferenciales y además se revisará el manejo de la crisis en urgencia y su posterior estudio.
Pediatric seizures are a major complaint. In this article the importance of the first seizure is reviewed, how to deal with this situation from the history and physical examination, and further management and study will be reviewed.
Subject(s)
Humans , Child , Diagnosis, Differential , Epilepsy/diagnosis , Seizures/diagnosis , Epilepsy/classification , Epilepsy/drug therapy , Anticonvulsants/therapeutic useABSTRACT
Introducción: La epilepsia afecta la calidad de vida, tanto por la frecuencia de crisis como por factores relacionados a la atención, tratamiento, complicaciones, etc. Existen escalas para evaluación de este parámetro, como Encuesta de Calidad de Vida del niño con Epilepsia (CAVE). Objetivos: Evaluar calidad de vida en niños con Epilepsia Refractaria (ER), controlados en policlínico especializado. Determinar si atención en este policlínico mejora significativamente calidad de vida. Métodos: Se reclutaron pacientes de 0 a 18 años con ER, controlados en policlínico especializado, se aplicó encuesta CAVE en 2 oportunidades. Resultados: De los 35 pacientes, en la primera evaluación, 27 asistían al colegio, 20 presentaban autonomía catalogada como muy mala o mala, 20 evaluaban percepción de frecuencia de crisis como muy mala y mala, contrastando con opinión general de calidad de vida, donde 22 puntuaron en buena o muy buena. Al seguimiento, 2 iniciaron asistencia escolar, con mejoría significativa en percepción de intensidad de crisis, sin diferencias en otros ítems. Discusión: Se evaluó impacto de una intervención (policlínico especializado) en calidad de vida en ER mostrando una mejoría estadísticamente significativa solo en el parámetro percepción de intensidad de crisis, siendo necesario seguimiento a más largo plazo.
Introduction: Epilepsy affects the quality of life, both in seizure frequency as factors related to care, treatment, complications, etc. There are scales to evaluate this parameter, like Quality of Life in Children with Epilepsy (CAVE). Objectives: To evaluate quality of Life in children with Refractory Epilepsy (RE), controlled in a specialized polyclinic. To determine whether this specialized polyclinic care significantly improves quality of life. Patients and Methods: Patients were recruited from 0 to 18 years, with ER and in control in specialized polyclinic. They were surveyed with CAVE on 2 occasions in an 11 month period. Results: Of the 35 patients in the first evaluation, 27 were attending to school, 20 had self-classified as poor or very poor, 20 assessed perceived frequency of seizures as very bad and poor, in contrast to general opinion of quality of life, where 22 rated in good or very good. Monitoring, 2 began scholar assistance, with significant improvement in perceived intensity of crisis, no differences in other items. Discussion: We evaluate the impact of an intervention (specialized polyclinic) on Quality of Life in RE with a significantly improvement in intensity of crisis perception. It is necessary a long termfollow-up.
Subject(s)
Humans , Male , Adolescent , Female , Infant, Newborn , Infant , Child, Preschool , Child , Quality of Life , Epilepsy/psychology , Hospitals, Pediatric , Personal Autonomy , Prospective Studies , Follow-Up Studies , Data CollectionABSTRACT
Las crisis epilépticas constituyen una de las manifestaciones más frecuentes y específicas de alteración neurológica en el período neonatal, y tienen la mayor incidencia en el primer mes de vida. El objetivo de este artículo es realizar una revisión de las alternativas terapéuticas disponibles actualmente para el manejo de convulsiones neonatales. Hasta la fecha, existe poco conocimiento sobre la farmacocinética y farmacodinamia de la mayoría de los fármacos antiepilépticos en población neonatal, por lo que no existen consensos de manejo que estén basados en la evidencia. A pesar de ello, en la práctica clínica existen diversas alternativas terapéuticas para el manejo de las convulsiones neonatales. A nivel mundial, pareciera haber consenso en que el fenobarbital es la droga de primera línea. La droga de segunda línea es actualmente tema de discusión, existiendo recomendaciones que sugieren el uso de levetiracetam, fenitoína o lidocaína, sin evidencia científica que demuestre claramente la superioridad de una sobre otra.
Seizures represent one of the most frequent and distinctive signals of neurological disorder in the newborn period and they occur primarily during the first month of life. The aim of this article is to review the therapeutic options currently available for managing neonatal seizures. To date, little is known about the pharmacokinetics and pharmacodynamics of most antiepileptic drugs used in neonatal population; hence, there is no evidence-based consensus regarding such management. Not with standing the foregoing, there are many treatment options in clinical practice. There seems to be worldwide consensus that phenobarbital is the first line drug in neonatal seizures treatment. On the contrary, second-line drugs are the subject of current discussion within the field. There are recommendations suggesting the use of levetiracetam, phenytoin or lidocaine, but without any scientific evidence that clearly proves the superiority of one of them over the rest.
Subject(s)
Humans , Infant, Newborn , Anticonvulsants/therapeutic use , Seizures/drug therapy , Seizures/etiologyABSTRACT
Parálisis cerebral es un término que define una serie de trastornos motores de origen cerebral, no progresivos que constituyen la causa más frecuente de discapacidad motora en la infancia. No obstante ser una denominación antigua, no ha perdido vigencia ni valor si se le utiliza como término sindromático que supone un estudio etiológico acucioso y una conducta terapéutica que incluye múltiples áreas de intervención y de especialistas coordinados a fin de lograr la máxima funcionalidad posible del niño desde el punto de vista motor, intelectual, de comunicación y la máxima integración social, teniendo en cuenta que el grado de desarrollo de una sociedad se mide por el cuidado que otorga a sus minusválidos.
Cerebral palsy (CP) results from a static brain lesion during pregnancy or early life and remains the most common cause of physical disability in children. Despite being an "old" name, it has not lost its usefulness if used as syndromic term that implies a thorough etiologic study and a therapeutic approach that includes multiple areas of intervention and coordinated work of specialists in order to achieve the maximum possible functionality, optimizing motor, intellectual, communication and social integration, considering that the degree of development of a society is measured by the care given to its disabled people.
