Photobiomodulation efficacy of major salivary glands in children with caries activity: study protocol for randomized, double-blind, placebo-controlled, parallel-group clinical trial / Efeito da fotobiomodulação das principais glândulas salivares em crianças com actividade de cárie: ensaio clínico aleatório duplo-cego

Background: Dental caries is one of the most prevalent diseases among children worldwide. Saliva plays a significant role in the demineralization/remineralization of the dental surface. Several salivary characteristics, such as flow rate, pH, and buffering capacity, provide relevant information regarding the development of carious lesions. Photobiomodulation has shown promising results in improving salivary flow rate and buffer capacity in the adult population. Purpose: of this trial was to evaluate the efficacy of photobiomodulation of the major salivary glands on salivary parameters in children with caries. Methods: This protocol details a randomized, double-blind, parallel-group, controlled trial that evaluated salivary parameters through photobiomodulation in children. Fifty 6- to 12-year-old participants will be randomly divided into two groups:1) photobiomodulation experimental group (G1) (n=25) and 2) photobiomodulation placebo group (G2) (n=25). Infrared light will be applied at 16 intra-and extraoral points and placebo, respectively. Unstimulated salivary samples will be collected before and immediately after application once a week for three consecutive weeks. Salivary samples will be analyzed for their flow rate, pH, and buffering capacity. The primary outcomes are the differences in salivary flow rates between G1 and G2. The secondary outcomes are differences in salivary pH and buffering capacity between G1 and G2. Discussion: The results of this clinical trial will offer evidence for the efficacy of photobiomodulation in salivary parameters and to support decision-making regarding non-invasive treatments to control dental caries.

Contexto: A cárie dentária é uma das doenças mais prevalentes entre as crianças em todo o mundo. A saliva desempenha um papel significativo na desmineralização/remineralização da superfície dentária. Várias características salivares, como a taxa de fluxo, o pH e a capacidade de tamponamento, fornecem informações relevantes sobre o desenvolvimento de lesões de cárie. A fotobiomodulação demonstrou resultados promissores na melhoria da taxa de fluxo salivar e da capacidade de tamponamento na população adulta. Objetivo: deste estudo foi avaliar a eficácia da fotobiomodulação das glândulas salivares principais sobre os parâmetros salivares em crianças com cárie. Métodos: Este protocolo detalha um estudo randomizado, duplo-cego, de grupos paralelos e controlado que avaliou parâmetros salivares por meio da fotobiomodulação em crianças. Cinquenta participantes de 6 a 12 anos de idade serão divididos aleatoriamente em dois grupos: 1) grupo experimental de fotobiomodulação (G1) (n=25) e 2) grupo placebo de fotobiomodulação (G2) (n=25). A luz infravermelha será aplicada em 16 pontos intra e extraorais e o placebo, respectivamente. Amostras salivares não estimuladas serão coletadas antes e imediatamente após a aplicação, uma vez por semana, durante três semanas consecutivas. As amostras salivares serão analisadas quanto à sua taxa de fluxo, pH e capacidade de tamponamento. Os resultados primários são as diferenças nas taxas de fluxo salivar entre G1 e G2. Os resultados secundários são as diferenças no pH salivar e na capacidade de tamponamento entre G1 e G2. Discussão: Os resultados desse ensaio clínico oferecerão evidências da eficácia da fotobiomodulação nos parâmetros salivares e apoiarão a tomada de decisões em relação a tratamentos não invasivos para o controle da cárie dentária.

Role of Cholangioscopy in a Patient With Hepatolithiasis and Caroli Disease.

Caroli disease is an infrequent congenital pathology that is part of the spectrum of fibrocystic diseases, characterized mainly by malformation of bile ducts. These patients often have stones and cholangitis, which respond poorly to conventional endoscopic retrograde cholangiopancreatography. To date, there is little evidence on the usefulness of cholangioscopy in this disease, so we describe the experience of performing cholangioscopy in a patient with hepatolithiasis and Caroli disease.

Analysis of Oxygen Blood Saturation/Respiratory Rate Index, NEWS2, CURB65, and quick Sequential Organ Failure Assessment Scores to Assess Prognosis in Patients with Mild Coronavirus Disease 2019.

BACKGROUND: Hospital bed saturation has been one of the problems to solve during the SARS-CoV-2 pandemic. However, not every patient who is admitted requires close monitoring or specific therapeutics. Mild cases could be managed in the outpatient setting. OBJECTIVE: Our study aimed to analyze the accuracy of the oxygen saturation/respiratory rate (sat/RR) index, NEWS2, CURB65, and quick Sequential Organ Failure Assessment (qSOFA) scores to predict supplemental oxygen requirement and prolonged hospital stay in patients with mild coronavirus disease 2019 (COVID-19). METHODS: A prospective cohort study in an academic medical center. We compared the values of these scores according to the occurrence or not of each outcome. When differences between groups were statistically significant, the discriminatory capacity of the score for that outcome was analyzed. RESULTS: We included 271 patients. Of them, 11.07% required supplemental oxygen, showing significantly higher values of NEWS2 score and qSOFA score, and lower values of Sat/RR index. About 38% presented prolonged hospital stay, with significantly higher values of NEWS2 score and lower values of sat/RR index. The ROC curve area under the curve (AUC) of sat/RR index to discriminate the requirement of supplemental oxygen was 0.72 (CI 95% 0.61-0.84). The ROC curve of NEWS2 and qSOFA for the same outcome was 0.75 (95% [95% CI 0.65-0.85]) and 0.66 (95% CI 0.57-0.76), respectively. The ability of the Sat/RR index to discriminate the requirement of prolonged hospitalization showed an AUC of 0.67 (95% [95% CI 0.60- 0.73]). The NEWS2 score showed an AUC of 0.63 (CI 95% 0.56-0.70) for the same outcome. CONCLUSIONS: sat/RR index and NEWS2 score have a good capacity to discriminate patients at risk of clinical worsening, being the Sat/RR index simpler and easier to calculate.

Preferencia de pacientes niños y sus padres respecto a la vestimenta y sexo del odontopediatra / Children's and parent’s preferences regarding the attire and sex of the pediatric dentists

Objetivo: evaluar si los niños y sus padres consideran que la vestimenta del odontopediatra es un aspecto importante en la relación paciente-profesional y cuál sería la de su preferencia. Métodos: se realizó un estudio transversal, analítico en 270 niños/as de 4 y 12 años y uno de sus respectivos padres, en una Clínica Privada y una Institución de Asistencia Colectivizada en Montevideo, Uruguay. El estudio incluyó un cuestionario dirigido a padres/madres y otro a niños/as, y fotografías de odontopediatras con diferente vestimenta: túnica blanca (Imagen 1 y 6), ambo de color lila para la mujer (I-2) y ambo de color verde para el hombre (I-7), equipo con diseños infantiles (I-3, I-8), vestimenta informal ( I-4, I-9) y vestimenta formal (I-5, I-10). Se les solicitó a los niños/as y padres/madres por separado que clasificaran sus preferencias. Resultados: el 29% de los niños/as manifestó preferencia por la imagen 2, seguida por un 25% por la imagen 3. Tanto para las madres como los padres, la imagen más elegida fue la número 3 con 47% y 10% respectivamente. En relación a las opiniones de los padres/madres con respecto a si la vestimenta del odontopediatra influye en el vínculo con su hijo/a, el 83% manifestó que sí, un 16% expresó que no y un 1% opinó “da igual”. Conclusiones: la vestimenta más elegida por los niños/as encuestados fue el ambo de color lila seguida por la vestimenta con diseño infantil, y la de menos preferencia fue la informal. Para los padres/madres la más elegida fue la vestimenta con diseño infantil. Los padres en general opinaron que la vestimenta influye en el vínculo entre el odontopediatra y su hijo/a; y el comportamiento del niño/a en el consultorio.

Objective: assess whether the children and their parents believe that the dentist’s attire is an important aspect of patient-professional relationship and, if so, which do they consider to be the most confidence-inspiring attire. Methods: a cross-sectional, analytical study was conducted on 270 children aged 4 -12 years old and one of their respective parents at one private clinic and an institution of assistance collectivized in Montevideo, Uruguay. The study included a questionnaire and photographs of pediatric dentists in different attire: white coat (picture 1 and 6), green scrub for man and violet scrub for women (picture 2 and 7), children's design on the scrubs (picture 3 and 8), casual attire (picture 4 and 9) and formal attire (picture 5 and 10). Children and parents separately asked to rate their preferences. Results: 29% of children expressed a preference for the image 2, followed by 25% by the image 3. For both mothers and fathers, the image was chosen n°3 with 47% and 10% respectively. With regard to the views of parents on whether the dentist dress influences in the bond between the professional and the child , the 83% said it has influence, while 16% said it doesn ́t matter. Only 1% said "do not care". Conclusions: the attire more chosen by children was the violet scrub followed by the scrub with children's design, and the less preference was the casual attire. For fathers and mothers the attire more chosen was the scrub with children's design, Both father and mother felt that clothing affects the bold between the pediatric dentist and his daughter/son; and behavior of the child in the dentist clinic.

Characteristics and behaviour of liposomes when incubated with natural bile salt extract: implications for their use as oral drug delivery systems.

The use of liposomes for oral administration of drugs and for food applications is based on their ability to preserve entrapped substances and to increase their bioavailability. Bile salts are one of the agents that affect the liposome structure during intestinal digestion and the main reported studies on liposome/bile salt systems used only one bile salt. The aim of this work is to characterise the interaction of liposomes with a natural bile salt extract (BSE) at physiological pH and temperature. Three types of liposomes (fluid, gel-state and liquid-ordered bilayers) were studied. Phase diagrams were obtained and a very different behaviour was found. Fluid bilayers were completely permeable to an entrapped dye with partial or complete disruption of vesicles (final size 10 nm). Gel-state bilayers released their content but BSE led to the formation of large mixed structures (2000 nm). Liquid-ordered bilayers formed mixed vesicles (1000 nm) and, surprisingly, retained a high percentage of their aqueous content (about 50%). As a consequence, each type of liposome offers singular features to be used in oral applications due to their specific interaction with bile salts.

Routine HIV testing among hospitalized patients in Argentina. is it time for a policy change?

INTRODUCTION: The Argentinean AIDS Program estimates that 110,000 persons are living with HIV/AIDS in Argentina. Of those, approximately 40% are unaware of their status, and 30% are diagnosed in advanced stages of immunosuppression. Though studies show that universal HIV screening is cost-effective in settings with HIV prevalence greater than 0.1%, in Argentina, with the exception of antenatal care, HIV testing is always client-initiated. OBJECTIVE: We performed a pilot study to assess the acceptability of a universal HIV screening program among inpatients of an urban public hospital in Buenos Aires. METHODS: Over a six-month period, all eligible adult patients admitted to the internal medicine ward were offered HIV testing. Demographics, uptake rates, reasons for refusal and new HIV diagnoses were analyzed. RESULTS: Of the 350 admissions during this period, 249 were eligible and subsequently enrolled. The enrolled population was relatively old compared to the general population, was balanced on gender, and did not report traditional high risk factors for HIV infection. Only 88 (39%) reported prior HIV testing. One hundred and ninety (76%) patients accepted HIV testing. In multivariable analysis only younger age (OR 1.02; 95%CI 1.003-1.05) was independently associated with test uptake. Three new HIV diagnoses were made (undiagnosed HIV prevalence: 1.58%); none belonged to a most-at-risk population. CONCLUSIONS: Our findings suggest that universal HIV screening in this setting is acceptable and potentially effective in identifying undiagnosed HIV-infected individuals. If confirmed in a larger study, our findings may inform changes in the Argentinean HIV testing policy.

Soluciones para el ronquido y/o alteraciones del sueño producidas por obstrucción respiratoria / Solutions for snoring and/or sleep disturbances caused by airway obstruction

Los trastornos del sueño son una patología muy frecuente tanto aislada, o asociada a otros trastornos. Se caracteriza clínicamente poruna perturbación del patrón respiratorio del sueño, incluyendo a las Apneas Obstructivas, las Hipoapneas y a los esfuerzos respiratorios asociados a microdespertares. Los factores de riesgo, los mecanismos fisiopatológicos implicados y sus alternativas terapéuticas clásicas incluyen varias disciplinas con el fin de ser diagnosticada precozmente y tratada oportunamente.Los dispositivos de avance mandibular (DAM) modifican las vías aéreas superiores para reducir los casos de ronquido como así también los casos leves y moderados de SAHS. (Síndrome de Apnea-Hipoapnea del Sueño). Permiten un avance milimétrico regulable de la mandíbula, además de movimientos de apertura, cierre y lateralidad. Por otra parte la fonoaudiología representa una nueva alternativa en el tratamiento de los pacientes con síndrome de Apneas obstructivas del sueño a partir de la terapia miofuncional oral.

Sleep disorders are a common pathology somewhat isolated or associated with other disorders. It is characterized clinically by a disturbance of sleep breathing pattern, including the Obstructive apneas, hypopneas and the Respiratory efforts associated with arousals. Risk factors, pathophysiological mechanisms and therapeutic alternatives include several classical disciplines in order to be diagnosed early and treated promptly.Mandibular advancement devices (MAD) modify the upper airway to reduce snoring cases as mild and moderate cases of OSA. They have a well-controlled forward movement millimeter opening, closing and laterality. Besides speech therapy represents a new alternativein the treatment of patients with syndrome of obstructive sleep apnea from Miofuctional oral therapy.

[Hyperammonemic encephalopathy and fibrolamellar hepatocellular carcinoma]. / Encefalopatía hiperamoniémica y hepatocarcinoma fibrolamelar.

We present the case of a young woman, 22 years old, with an aggressive form of fibrolamellar hepatocellular carcinoma. She began with the signs and symptoms of a hyperammonemic encephalopathy, an uncommon form of presentation. Fibrolamellar carcinoma is a rare liver tumor, which affects young patients without previous liver disease. Its etiology is unknown, and it has been considered as a tumor with a better prognosis than the classic hepatocellular carcinoma.

Encefalopatía hiperamoniémica y hepatocarcinoma fibrolamelar / Hyperammonemic encephalopathy and fibrolamellar hepatocellular carcinoma

Presentamos el caso de una mujer de 22 años con hepatocarcinoma fibrolamelar agresivo, metastásico, de rápida evolución y con una rara forma de comienzo, como una encefalopatía hiperamoniémica. El hepatocarcinoma fibrolamelar es un tumor hepático raro, que se presenta en pacientes jóvenes, sin antecedentes de hepatopatía viral o cirrótica. Su etiología es desconocida, y tradicionalmente fue considerado como de mejor pronóstico que el carcinoma hepatocelular clásico.(AU)

We present the case of a young woman, 22 years old, with an aggressive form of fibrolamellar hepatocellular carcinoma. She began with the signs and symptoms of a hyperammonemic encephalopathy, an uncommon form of presentation. Fibrolamellar carcinoma is a rare liver tumor, which affects young patients without previous liver disease. Its etiology is unknown, and it has been considered as a tumor with a better prognosis than the classic hepatocellular carcinoma.(AU)

Encefalopatía hiperamoniémica y hepatocarcinoma fibrolamelar / Hyperammonemic encephalopathy and fibrolamellar hepatocellular carcinoma

Presentamos el caso de una mujer de 22 años con hepatocarcinoma fibrolamelar agresivo, metastásico, de rápida evolución y con una rara forma de comienzo, como una encefalopatía hiperamoniémica. El hepatocarcinoma fibrolamelar es un tumor hepático raro, que se presenta en pacientes jóvenes, sin antecedentes de hepatopatía viral o cirrótica. Su etiología es desconocida, y tradicionalmente fue considerado como de mejor pronóstico que el carcinoma hepatocelular clásico.

We present the case of a young woman, 22 years old, with an aggressive form of fibrolamellar hepatocellular carcinoma. She began with the signs and symptoms of a hyperammonemic encephalopathy, an uncommon form of presentation. Fibrolamellar carcinoma is a rare liver tumor, which affects young patients without previous liver disease. Its etiology is unknown, and it has been considered as a tumor with a better prognosis than the classic hepatocellular carcinoma.

Investigación a nivel curricular en odontología / Research in the dental curriculum

La Facultad de Odontología de la Universidad Católica del Uruguay incorporó dentro del Programa de la carrera de Pre-Grado, la asignatura Metodología de la Investigación. Se busca contribuir a la formación integral del estudiante fomentando su espíritucrítico y brindándole los elementos necesarios para su educación continua. En este trabajo presentamos algunas consideraciones generales acerca del Programa desarrollado y un ejercicio de investigación realizado por estudiantes dentro de esta disciplina.

The Faculty of Dentistry of the Catholic University in Montevideo, Uruguay has included the subject Research Methodology in the undergraduate teaching program; in search of a contribution to an integral education, promoting critical thinking andproviding necessary skills in continuing education. This paper presents an approach to the developed program and a research exercise carried out by students of Research Methodology.

Preparation and characterization of iron-containing liposomes: their effect on soluble iron uptake by Caco-2 cells.

The aim of this work was to study the iron uptake of Caco-2 cells incubated with five different formulations of liposomes containing iron. The vesicles were also characterized before, during, and after in vitro digestion. Caco-2 cells were incubated with digested and nondigested liposomes, and soluble iron uptake was determined. Nondigested liposomes made with chitosan (CHI) or the cationic lipid, DC-Cholesterol (DC-CHOL), generated the highest iron uptake. However, these two formulations were highly unstable under in vitro digestion, resulting in nonmeasurable iron uptake. Digested conventional liposomes composed of soybean phosphatidylcholine (SPC), hydrogentated phosphatidylcholine (HSPC), or HSPC and cholesterol (CHOL) presented the highest iron-uptake values. These liposomal formulations protected iron from oxidation and improved iron uptake from intestinal cells, compared to an aqueous solution of ferrous sulphate.

Combined strategies for liposome characterization during in vitro digestion.

Three types of pyranine (HPTS)-containing liposomes were prepared by high-pressure homogenization under optimized conditions. At 37 degrees C, they were 1) fluid-state vesicles made from soybean phosphatidylcholine (SPC), 2) gel-state liposomes made from hydrogenated SPC (HSPC), and 3) solid-disordered membranes obtained from HSPC and cholesterol (HSPC-Chol). These liposome formulations were characterized before, during, and after in vitro digestion, which involved the presence of pH gradients, enzymes, and bile salts. Mean sizes and size distributions of the vesicles were determined by DLS; (31)P-NMR (nuclear magnetic resonance) was used to quantify lyso-PC forms; internal pH was monitored throughout digestion with two different fluorescent pH probes; and changes in bilayer permeability and HPTS encapsulation were determined by size-exclusion chromatography and fluorimetry. Differential scanning calorimetry analysis was also performed in order to study the effect of digestion on HSPC vesicles. SPC liposomes were physically stable during digestion; they presented 8% lyso-forms and an HPTS encapsulation around 85% after in vitro digestion. However, they were extremely permeable to ions, so that the internal pH immediately equilibrated with the bulk pH. HSPC liposomes were the most affected by the digestive process. Even though they were chemically stable, as inferred from the low lyso-PC content, very important changes in their size distribution were observed. A final 50% HPTS leakage was quantified after in vitro digestion. Nevertheless, they were the least permeable to protons under pH gradients. HSPC-Chol vesicles presented intermediate permeability to protons, having their internal pH decreased from approximately 6.8 to 4.6 after 1 hour of incubation at pH 2. This was the most chemically stable formulation and showed the highest encapsulation, even after in vitro digestion. Therefore, HSPC-Chol liposomes would be the most adequate choice for the design of lipid products for oral administration.

Comparation of liposomal formulations of ALA Undecanoyl ester for its use in photodynamic therapy.

ALA administration has been used to induce the endogenous photosensitiser Protoporphyrin IX for photodynamic therapy (PDT) of tumours. However, the hydrophilic nature of ALA limits its ability to penetrate through skin restricting the use of ALA-PDT to superficial diseases. Lipophilic derivatives of ALA such as ALA Undecanoyl ester (Und-ALA) were designed to have better diffusing properties. However, Und-ALA, applied topically on the skin over the tumour, induced low porphyrin content. To improve Und-ALA efficacy we tested the efficacy of Und-ALA as porphyrin inducer, delivered in phosphatidylcholine and phosphatidylglycerol (PC-PG) or phosphatidylcholine and phosphatidic acid (PC-PA) liposomal formulations. Entrapment of Und-ALA into PC-PA or PC-PG liposomes resulted in a dramatic impairment of toxicity in the mammary tumour LM3 cells. However, liposomal Und-ALA induced lower intracellular porphyrin content compared to free ALA, although total porphyrins content (intracellular+media) from free Und-ALA resulted equal compared to liposomal Und-ALA, due to induction of porphyrins release induced by the latter. Topical administration of Und-ALA in PC-PG or PC-PA liposomes over the skin of LM3 subcutaneously injected mice, induced equal amount of tumour porphyrins as compared to free Und-ALA. The kinetics of porphyrins synthesis from Und-ALA is similar for free and liposomal formulations both in vivo and in vitro, showing that release of Und-ALA from liposomes is not gradual and suggesting that liposome membranes either fuses or binds to the cell membranes. To sum up, the incorporation of Und-ALA into liposomes of PC-PA or PC-PG composition does not improve the rate of porphyrin synthesis either in vitro or in vivo, due to a massive release of extracellular porphyrins and a poor cytoplasmatic release of the liposome content. The design of new liposome compositions either favouring endocytosis or coated with natural polymers to prevent Und-ALA interaction with cellular membrane are desired to overcome intracellular porphyrin release after long-chained ALA esters treatment.

Hipomineralización Molar-Incisiva (MIH): una patología emergente / Molar Incisor Hipomineralization

El aumento en la prevalencia de hipomineralización del esmalte preocupa a la Odontopediatría. Las lesiones abarcan desde opacidades delimitadas blanco amarillentas o amarronadas hasta la ruptura del esmalte, siempre afectando a los primeros molares e incisivos permantentes. Por tal motivo se define esta patología con el nombre de "Molar Incisor Hipomineralization", lo que motiva el uso internacional de la sigla MIH. Se trata de una lesión de hipomineralización del esmalte, de origen sistémico y etiología variada que se desarrolla en el primer año de vida del individuo. Se debe hacer el diagnóstico diferencial con hipoplasias del esmalte, fluorosis y amelogénesis imperfecta. Las lesiones tienen un significativo impacto en las necesidades de tratamiento, incluso en poblaciones con baja actividad de caries, dificultan las técnicas adhesivas y requieren procedimientos rehabilitadores de alto costo en el adulto. La prevalencia reportada a nivel internacional varía entre 3 y 23,4%, afectando por igual a ambos sexos. En nuestro país son necesarios estudios para determinar su prevalencia.

Characterisation of liposomes containing aminolevulinic acid and derived esters.

Liposomes of different compositions have been designed to improve delivery of aminolevulinic acid (ALA) and its esterified derivatives ALA-Hexyl ester (He-ALA) and ALA-Undecanoyl ester (Und-ALA) for its use in photodynamic therapy (PDT). Egg yolk phosphatidyl choline (PC), phosphatidic acid (PA) and phosphatidyl glycerol (PG) were employed in the preparation of the liposomes. Sonicated vesicles composed of PC, PC-PG (80:20) or PC-PA (80:20) containing ALA or derivatives were obtained and purified by a minicolumn centrifugation method. PC liposomes presented encapsulation percentages around 6% for 2 mM ALA, 13% for 2 mM He-ALA and 51% for 2 mM Und-ALA. The addition of PG or PA to the formulation, resulted in an increased entrapment: 19% for 2 mM ALA, 69% for 2 mM He-ALA and 87% for 2 mM Und-ALA in PC-PG liposomes and 21% for 2 mM ALA, 60% for 2 mM He-ALA and 87% for 2 mM Und-ALA in PC-PA liposomes. Higher concentrations of ALA or derivatives resulted in lower percentages of entrapment. The three formulations containing ALA or derivatives were stable up to 1 week upon storage at 4 degrees C. However, upon dilution with medium, ALA leaked from the liposomes, while on the contrary, He-ALA was highly retained, being therefore a good choice for its use in PDT. The stability of Und-ALA upon dilution could not be tested, but Und-ALA proved to have the highest entrapment efficacy.

Situación de salud oral de los niños uruguayos portadores del virus de la inmunodeficiencia humana / Oral health in Uruguayan children infected with HIV

La mayoría de los niños infectados con el virus de la inmunodeficiencia humana presentan, dentro de los primeros signos de la enfermedad, manifestaciones orales. Algunas de estas lesiones orales tienen valor pronóstico de cara a la evolución de la infección y la aparición de SIDA. El propósito de este trabajo es determinar el estado de salud oral de los niños uruguayos portadores del VIH que asisten al Centro Nacional de Referencia Obstétrico-Pediátrico del Centro Hospitalario Pereira Rossell. Fueron examinados 76 niños con edades comprendidas entre 1 y 17 años, con una media de 7,5 años. Los resultados obtenidos muestran un índice ceo de 4,52±6,2 para el grupo de dentición caduca, 4,42±3,35 en el de dentición mixta. El índice CPO fue de 1,28±1,72 en el grupo de dentición mixta y 2,8±2,4 en el grupo de dentición permanente. Un 51,8% de la población estudiada presentó algún tipo de maloclusión, mientras un 75% presentaba gingivitis. La prevalencia de candidiasis alcanzó el 16% de la población, 8% de lesiones herpéticas, 11,6% de hipertrofia parotídea, 2,4% de leucoplasia vellosa y un caso de GUNA (0,7%).

One of the first signs of disease of most children infected with HIV is oral. Some of them are a preview of the disease evolution and the appearance of AIDS. The purpose of this paper is to establish the oral health of HIV infected Uruguayan children at the Centro Nacional de Referencia Obstétrico-Pediátrico VIH- SIDA of the Centro Hospitalario Pereira Rossell. 76 children from ages 1 to 17 were examined, the average age was 7,5. The DMF-s in the deciduous dentition group was 4,52±6,2. The dmf-s in the mixed dentition group was 4.42 ±3,35 and the DMF-s was 1,28±1,72. The DMF-s in the permanent group was 2,8±2,4. On the total, malocclusions occurred in 51,8% and gingivitis in 75%. Candidiasis prevailed in 16% of the population, herpetic lesions in 8%, parotid hyperplasia 11,6%, and oral hairy leukoplakia 2,4% and there was one case of ANUG (0,7%).

Systemic manifestations during eruption of primary teeth in infants.

PURPOSE: The purpose of this study was to describe the most frequent objective clinical manifestations found during the eruption of primary teeth and to assess the correlation between those symptoms and the eruption of various groups of teeth. METHODS: The study was conducted in the Clinica Infantil Colsubsidio in Bogota, Colombia. Five hundred and eighty-five children participated in the study. One-hundred and forty-five children ages 4 to 36 months who had at least 1 erupting tooth were included in the study group. The other 357 children served as a control group. Parents were asked to complete a short questionnaire and children were then checked by one of the authors. Chi-square analysis was performed to analyze information obtained for the 2 groups. Level of significance was set at P < .05. RESULTS: There were 81 girls (56%) and 64 boys (44%) in the study group, and 183 girls (54%) and 157 boys (46%) in the control group. The most frequent clinical manifestations were: drooling (15%), diarrhea (13%) and drooling-diarrhea (8%). The presence of fever and fever-diarrhea was shown in a lower percentage (8%). In the study group, boys demonstrated a higher prevalence of diarrhea than girls (P < .05). No statistical significance regarding other clinical manifestations and gender were observed. In the control group, 93% of the children did not show any clinical manifestation. CONCLUSIONS: An association has been shown between general objective manifestations like drooling (the most prevalent), fever and diarrhea, and the eruption of primary teeth. Most manifestations appeared during the eruption of the primary incisors.

A comparison of warmed and room-temperature anesthetic for local anesthesia in children.

PURPOSE: The purpose of this study was to assess children's reactions and record their sensations while receiving a warmed local anesthetic solution for dental procedures (37 degrees C; W) compared with one at room temperature (21 degrees C; RT). METHODS: Forty-four children between the ages of 6 to 11 (mean age = 7.9 +/- 2.2 years) who were undergoing dental treatment participated in the study. A random crossover design was used. Each patient was randomly assigned to receive either a W or a RT local anesthesia on the first visit and the alternate local anesthesia on the second visit. During the injection, the modified Behavioral Pain Scale (BPS) was used. For subjective evaluation, the Wong-Baker FACES Pain Rating Scale (FPS) and the Visual Analogue Scale (VAS) were used. RESULTS: No significant difference was found between the W or RT local anesthesia when used during the first or second visit. In all parameters, children's reactions to both types of injection were similar, with no statistically significant difference. Using the FPS, 19 boys (91%) ranked the experience of local anesthesia as a positive experience (0 to 2 in the scale) while 4 boys (9%) ranked the same experience as negative. This was true for both types (W and RT). All 21 girls who participated in the study ranked the local anesthesia experience using the FPS as a positive experience (0 to 2 in the scale). No significant difference was found in the mean VAS scores between the room-temperature group and the warm group (23.4 +/- 21.8 and 20.8 +/- 18.9, respectively). CONCLUSIONS: There is no advantage to warming local anesthetic solution prior to injection.