Toothpaste use in Peruvian children during COVID-19 pandemic: results from a National Demographic and Health Survey.

PURPOSE: To determine the impact of COVID-19 pandemic on use of toothpaste in Peruvian children. METHODS: A national database of Peruvian children from 0 to 11 years old was used to develop a cross-sectional study, with a final sample of 51, 013 subjects. Data were obtained of results of the Demographic and Family Health Survey (ENDES); the questionnaire was self-reported. The use of toothpaste and fluoride concentration in toothpaste were dependent variables, and for the independent variable, the year was considered; in addition, other covariates were included. The statistical analyses applied were descriptive, bivariate, and multivariate tests. RESULTS: Use of toothpaste was 98.99% (n = 50,134), while fluoride toothpaste with < 1000 ppm was used by 77.29% (n = 27,366). For bivariate analysis, use of toothpaste was associated with place and area of residence, altitude, natural region, and age; for use of fluoride toothpaste with minimum 1000 ppm, there was an association with place and area of residence, natural region, wealth index, and age. In a multivariate manner, year only presented a positive association with use of fluoride toothpaste < 1000 ppm (RPa:1.04; 95%CI 1.01-1.07). CONCLUSIONS: Year 2020 of COVID-19 pandemic had a positive impact on the use of < 1000 ppm fluoride toothpaste in Peruvian children.

Social gradients in dental attendance among older adults: Findings from the National Survey on Demographics and Health in Peru.

OBJECTIVE: To assess the presence of inequalities in attendance to dental services in relation to socio-economic position (SEP) in a national sample of older adults in Peru. BASIC RESEARCH DESIGN: A cross-sectional study using multivariate regression analysis of secondary data obtained from the National survey on demographics and family health in Peru (Encuesta Nacional en Demografía y Salud familiar, ENDES). PARTICIPANTS: 4749 ≥60-year-olds. MAIN OUTCOME MEASURE: Attendance at dental health services in the last 2 years. Independent variable: Wealth Index as a measure of SEP. Covariates: Sex, age, natural region of residence, place of residence and health insurance coverage. RESULTS: There was a social gradient for the association between attendance to dental health services and SEP, with older adults from the richest (fifth) quintile showing a 3.01 times higher probability of visiting dental services (95%CI 2.15-4.19), those in the fourth quintile PR=2.19 (95%CI 1.61-3.00), third quintile PR=2.00 (95%CI 1.49-2.69), and those in the second quintile PR=1.42 (95%CI 1.10-1.84), when compared to the poorest quintile after adjusting for sex, age, residence, natural region and health insurance coverage. CONCLUSIONS: There is a clear social gradient in dental attendance among older adults in Peru. This is important to provide further insights into current national programmes and relevant long-term policies.

Adolescents and epilepsy: hormonal aspects.

Epilepsy is one of the most frequent disease in children, particularly in adolescents. Some types of epilepsy begin typically in the peripubertal period and many studies found changes in frequency or features of seizures in adolescents. This is probably related to sex hormone effects on neuronal excitability. Estrogens seem to decrease neuronal electric threshold with proconvulsant effects. On the contrary progesterone seems to have anticonvulsivant action, as well as testosterone. Changes in hormone serum levels that occur during pubertal period are probably related to modifications in seizure features and are involved in some types of epilepsy that begin typically in adolescence.

Influence of sex hormones on brain excitability and epilepsy.

Epilepsy is one of the most common neurologic problems worldwide. In spite of the many studies carried out, our understanding of generalized epileptogenesis remains far from complete. In recent years many data have clarified the effects of sexual hormones on brain excitability. Female and male sexual hormones may be considered pharmacoactive compounds that alter the seizure threshold, changing the frequency and semeiology of the seizures. In particular, estrogens may increase neuronal excitability while progesterone enhances inhibitions and increases the seizure threshold; on the other hand, androgens can decrease ictal activity in the human brain. This review provides an overview of the current knowledge in this field and highlights some of the prevailing hypotheses about the effects of sexual hormones on neuronal excitability analysing data from both animal and clinical studies.

Update of the medical treatment of West syndrome.

West syndrome is a generalized epilepsy syndrome composed of infantile spasms and onset is usually within the first year of life. Although West syndrome is well known clinical epileptic syndrome, there is no agreement about the first- and second-line treatments. In the last years a great progress in the development of new antiepileptic drugs allow us to have a large choice of treatment options to control the seizures. This review outlines the usefulness of the different antiepileptic drugs for the treatment of West syndrome.

Levetiracetam monotherapy for children and adolescents with benign rolandic seizures.

To assess the efficacy, tolerability and safety of Levetiracetam (LEV) therapy, we identified 21 (15 male; 6 female) patients with a history of benign epilepsy with centrotemporal spikes (BECTS), with and without secondarily generalization in children and adolescents aged between 5.0 and 12.1 years. LEV was administered as a first drug (number of patients=9) or converted after previous treatment with other AEDs (number of patients=12). The patients were subdivided into two groups: "newly diagnosed" patients and "converted" patients. Patients were followed up for 12 months and all patients were able to continue on LEV treatment. At the end of follow-up (12 months), all patients were seizure free or showed a reduction of seizures >50%. LEV dosage ranged from 1000 to 2500mg/daily. Overall, 100% of patients completed the 12 months study, without any important side effect. Somnolence and irritability occurred in two (9.5%) patients. Our results support findings that LEV monotherapy is effective and well tolerated in children with BECTS. Prospective, large, long-term double-blind studies are needed to confirm these findings.

Topiramate in frontal lobe epilepsy.

BACKGROUND: Frontal lobe epilepsy (FLE) is a type of epilepsy that is difficult to treat and there are few studies about the use of topiramate (TPM). AIM OF THE STUDY: To evaluate the efficacy and tolerability of TPM monotherapy in FLE. METHODS: The study group consisted of 55 (33 male; 22 female) patients. TPM was administered as a first drug (n = 16) or converted after previous treatment (n = 39). All patients were followed every 3 months for at least 1 year. The patients were subdivided into two groups: 'newly diagnosed' patients and 'difficult-to-treat' patients. RESULTS: Overall, all patients completed the 1-year study. At the end of follow-up, 10 patients showed disappearance of seizures and 33 patients showed improvement in seizure frequency. In particular, among the newly diagnosed patients 6/16 patients showed complete cessation of seizures and 5/16 patients showed very good response; in the other group, 4/39 patients showed complete cessation and 4/39 patients showed a very good response. No patients of both groups had worsening of seizures. No treatment-limiting adverse events associated with TPM were reported. CONCLUSIONS: TPM is effective in newly diagnosed patients with FLE; TPM can be considered for the treatment of FLE.

Multiple and giant mandibular osteomas in a Gardner's syndrome. Case report.

Though rare, Gardner's syndrome is a systemic disease with frequent jawbones involvement. Dento-maxillo-facial lesions both in early and in advanced stages should be known by dentists and other specialists. In fact, these lesions should be sought in patients with intestinal polyposis, while they could be the first sign of Gardner's syndrome not yet diagnosed.