Bruxismo y su asociación con la disfunción temporomandibular en niños. Revisión de literatura / Bruxism and its association with temporomandibular disorders in children. Literature review

Resumen Introducción: El bruxismo está definido como una actividad oral motora que consiste en el apretamiento o rechinamiento involuntario (rítmico o espasmódico no funcional) de los dientes, con una prevalencia de 5,9% a 49,6% en niños. Lo que podría contribuir a problemas clínicos asociados con la articulación temporomandibular. La asociación entre la disfunción temporomandibular (DTM) y el bruxismo en niños aún no está totalmente establecida. Objetivo: El objetivo de esta revisión de literatura es recopilar información actualizada de estudios que hayan abordado la asociación entre el bruxismo y la disfunción temporomandibular en niños de 3 a 12 años. Metodología: Se realizó una búsqueda en las bases de datos de Scopus, Pubmed y Scielo usando los descriptores "Niño", "Niños", "Preescolar", "Bruxismo", "Bruxismo del sueño", "Disfunción Temporomandibular"; y, "Síndrome de la Disfunción de Articulación Temporomandibular". Fueron incluidos artículos publicados en los últimos 15 años en idiomas español, inglés y portugués. Fueron incluidos estudios transversales, de cohorte, casos controles y ensayos clínicos aleatorizados. Resultados: Se evaluaron 242 artículos, de los cuales solo 11 fueron incluidos de acuerdo a los criterios de inclusión. Entre los estudios incluidos, dos de ellos no encontraron asociación entre DTM y bruxismo, tres encontraron una tendencia o probable asociación y seis encontraron una asociación positiva. Conclusiones: Existen estudios que relatan asociación entre el bruxismo y las disfunciones temporomandibulares en niños de 3 a 12 años, relacionando la presencia de signos y síntomas de la DTM con el bruxismo, pudiendo ser este último, un factor de riesgo para la presencia de DTM.

ABSTRACT Introduction: Bruxism is defined as an oral motor activity that consists of involuntary clenching or grinding (non-functional rhythmic or spasmodic) of the teeth, with a prevalence rate ranging from 5.9% to 49.6% in children, which could contribute to clinical problems associated with the temporomandibular joint. The association between bruxism in children and temporomandibular dysfunction (TMD) is not yet fully established. Objective: The objective of this literature review is to collect up-to-date information on studies that have addressed the association between bruxism and temporomandibular dysfunction in children ranging 3 - 12 years of age. Methods: A search was performed in the Scopus, PubMed and SciELO databases using the descriptors "Child", "Children", "Child, Preschool", "Bruxism", "Sleep Bruxism", "Temporomandibular Dysfunction" and "Temporomandibular Joint Dysfunction Syndrome." Articles published in the last 15 years in the Spanish, English and Portuguese languages were included. Results: A total of seventy-two articles were assessed. Only 11 articles were included according to the inclusion criteria. Among the included studies, two of them found no association between TMD and bruxism, three found a trend or probable association, and six found a positive association. Conclusion: There are studies that report an association between bruxism and temporomandibular dysfunctions in children ranging 3 - 12 years old, relating the presence of signs and symptoms of TMD with bruxism.

Hotspots of microplastic accumulation at the land-sea transition and their spatial heterogeneity: The Po River prodelta (Adriatic Sea).

Deltas are the locus of river-borne sediment accumulation, however, their role in sequestering plastic pollutants is still overlooked. By combining geomorphological, sedimentological, and geochemical analyses, which include time-lapse multibeam bathymetry, sediment provenance, and µFT-IR analyses, we investigate the fate of plastic particles after a river flood event providing an unprecedented documentation of the spatial distribution of sediment as well as of microplastics (MPs), including particles fibers, and phthalates (PAEs) abundances in the subaqueous delta. Overall sediments are characterized by an average of 139.7 ± 80 MPs/kg d.w., but display spatial heterogeneity of sediment and MPs accumulation: MPs are absent within the active sandy delta lobe, reflecting dilution by clastic sediment (ca. 1.3 Mm3) and sediment bypass. The highest MP concentration (625 MPs/kg d.w.) occurs in the distal reaches of the active lobe where flow energy dissipates. In addition to MPs, cellulosic fibers are relevant (of up to 3800 fibers/kg d.w.) in all the analyzed sediment samples, and dominate (94 %) with respect to synthetic polymers. Statistically significant differences in the relative concentration of fiber fragments ≤0.5 mm in size were highlighted between the active delta lobe and the migrating bedforms in the prodelta. Fibers were found to slightly follow a power law size distribution coherent with a one-dimensional fragmentation model and thus indicating the absence of a size dependent selection mechanism during burial. Multivariate statistical analysis suggests traveling distance and bottom-transport regime as the most relevant factors controlling particle distribution. Our findings suggest that subaqueous prodelta should be considered hot spots for the accumulation of MPs and associated pollutants, albeit the strong lateral heterogeneity in their abundances reflects changes in the relative influence of fluvial and marine processes.

Actualización en el manejo clínico basado en la evidencia de pólipos endometriales / Update on evidence-based clinical management of endometrial polyps

Los pólipos endometriales representan un trastorno común en la práctica habitual en ginecología. Si bien se han identificado factores de riesgo asociados a su proliferación, se desconoce la causa exacta de su aparición. En ocasiones su manejo es controvertido, siendo difícil para el clínico optar en muchos casos por una actitud expectante con seguimientos periódicos dado que el riesgo de malignidad de esta entidad no es despreciable. El objetivo del presente artículo es la realización de una revisión exhaustiva de la literatura, a partir de las principales bases de datos, sobre el diagnóstico y manejo de pólipos endometriales, así como de la fisiopatología y epidemiología, con el fin de conocer la última evidencia científica sobre esta entidad.(AU)

Endometrial polyps are a common disorder in routine gynaecological practice. Although risk factors associated with their proliferation have been identified, the exact cause of their onset is unknown. Sometimes their management is controversial, in many cases it being difficult for the clinician to opt for a wait-and-see approach with periodic follow-ups, given that the risk of malignancy with this entity is not negligible. The objective of this article was to carry out an exhaustive review of the literature, based on the main databases, on the diagnosis and management of endometrial polyps, and their pathophysiology and epidemiology, to determine the latest evidence and scientific information regarding this entity.(AU)

[Quality guidelines for radiopharmacy: Development of a risk-assessment tool]. / Référentiel qualité en radiopharmacie : création d'un outil d'analyse des risques.

OBJECTIVES: The medical management of patients, which involves securing the drug circuit, is a major public health objective. As part of quality management, a number of risk assessment and risk management tools in care units are validated and available. However, medication management in radiopharmacy departments represents a complex and specific process. The aim of the "Quality guidelines for radiopharmacy" working group of the French society of radiopharmacy (SoFRa) was to develop a risk-assessment tool that is a priori adapted to radiopharmacy activity. METHODS: A qualitative risk matrix was developed, based on available analysis tools and current regulations concerning radiopharmacy practice. The tool was then programmed to obtain a summary and scoring for each risk category, as well as a quantitative analysis of the risks identified in radiopharmacy. RESULTS: Our tool contains 262 issues. The qualitative study integrates the risks related to the circuit of radiopharmaceuticals, but also risks related to personnel. The quantitative study makes it possible to carry out an automated analysis of the actions to carry out in priority to improve the practices. CONCLUSIONS: This work led to the development of a self-assessment tool for the a priori analysis of risks that are adapted to the practice of radiopharmacy. It allows easy analysis of the entire circuit of radiopharmaceuticals from a single tool and meet the expectations of health authorities. This common and validated tool is available to the pharmaceutical community.

Ectoparasite Activity During Incubation Increases Microbial Growth on Avian Eggs.

While direct detrimental effects of parasites on hosts are relatively well documented, other more subtle but potentially important effects of parasitism are yet unexplored. Biological activity of ectoparasites, apart from skin injuries and blood-feeding, often results in blood remains, or parasite faeces that accumulate and modify the host environment. In this way, ectoparasite activities and remains may increase nutrient availability that may favour colonization and growth of microorganisms including potential pathogens. Here, by the experimental addition of hematophagous flies (Carnus hemapterus, a common ectoparasite of birds) to nests of spotless starlings Sturnus unicolor during incubation, we explore this possible side effect of parasitism which has rarely, if ever, been investigated. Results show that faeces and blood remains from parasitic flies on spotless starling eggshells at the end of incubation were more abundant in experimental than in control nests. Moreover, eggshell bacterial loads of different groups of cultivable bacteria including potential pathogens, as well as species richness of bacteria in terms of Operational Taxonomic Units (OTUs), were also higher in experimental nests. Finally, we also found evidence of a link between eggshell bacterial loads and increased embryo mortality, which provides indirect support for a bacterial-mediated negative effect of ectoparasitism on host offspring. Trans-shell bacterial infection might be one of the main causes of embryo death and, consequently, this hitherto unnoticed indirect effect of ectoparasitism might be widespread in nature and could affect our understanding of ecology and evolution of host-parasite interactions.

[Computerized prescription for medical devices: examples, interest and limits]. / Vers la prescription informatisée des dispositifs médicaux : exemples d'application, intérêts et limites.

INTRODUCTION: Related to the good practice contract implemented in hospitals, the prescription dedicated to medical devices, such as pharmaceuticals, could promote safety and good practice. MATERIAL AND METHOD: We attempted to implement a computerized prescription for medical devices. In order to illustrate the method, two examples were selected: the Negative Pressure Wound Therapy (NPWT) and the Drug Eluting Stents (DES). RESULTS: In partnership with the medical teams was elaborated a computerized protocol which included all the needed items for the good use of NPWT. For DES, a pre-existing questionnaire was used. We updated it in order to integrate new items such as the prescriber's name, the patient's name, the characteristics of the wound, the DES references and the indications. DISCUSSION AND CONCLUSION: Computerized prescriptions for high-risk and expensive medical devices seem to be an interesting approach to guarantee the patient care safety and to reduce the budget impacts. In order to monitor the indications funded as fee-for-service medical devices, a prescription will emerge as a gold standard in the future in France. Eventually, this study highlights a new activity of clinical pharmacy for hospital pharmacists dealing with medical devices.

Evolution of tolerance by magpies to brood parasitism by great spotted cuckoos.

Hosts may use two different strategies to ameliorate negative effects of a given parasite burden: resistance or tolerance. Although both resistance and tolerance of parasitism should evolve as a consequence of selection pressures owing to parasitism, the study of evolutionary patterns of tolerance has traditionally been neglected by animal biologists. Here, we explore geographical covariation between tolerance of magpies (Pica pica) and brood parasitism by the great spotted cuckoo (Clamator glandarius) in nine different sympatric populations. We estimated tolerance as the slope of the regression of number of magpie fledglings (i.e. host fitness) on number of cuckoo eggs laid in non-depredated nests (which broadly equals parasite burden). We also estimated prevalence of parasitism and level of host resistance (i.e. rejection rates of mimetic model eggs) in these nine populations. In accordance with the hypothetical role of tolerance in the coevolutionary process between magpies and cuckoos we found geographical variation in tolerance estimates that positively covaried with prevalence of parasitism. Levels of resistance and tolerance were not associated, possibly suggesting the lack of a trade-off between the two kinds of defences against great spotted cuckoo parasitism for magpies. We discuss the results in the framework of a mosaic of coevolutionary interactions along the geographical distribution of magpies and great spotted cuckoos for which we found evidence that tolerance plays a major role.

Niveles referenciales séricos de urea y creatinina en Huanganas (Tayassu pecari) criadas en un zoológico de Lima / Reference serum values of urea and creatinine in captive white-lipped peccary (Tayassu pecari) in a Lima zoo

The objective of this research was to establish reference serum values for urea and creatinine in the captive white-lipped peccary (Tayassu pecari). Serum samples from 44 adult animals (23 males and 21 females) from a captive colony in the Parque de las Leyendas Zoo (Lima, Peru) were collected after chemical inmobilization. Urea and creatinine were analyzed using colorimetric assays, and values were 27.4 ± 2.7 mg/dl and 2.8 ± 0.2 mg/dl respectively. No significant differences between sexes were found. Urea value was greater than those obtained in other studies probably due to the high protein content of the zoo diet.

The effects of the 5-HT(6) receptor agonist EMD and the 5-HT(7) receptor agonist AS19 on memory formation.

Growing evidence indicates that 5-hydrohytryptamine (5-HT) receptors mediate learning and memory. Particularly interesting are 5-HT(6) and 5-HT(7) receptors, which are localized in brain areas involved in memory formation. Interestingly, recently selective 5-HT(6) and 5-HT(7) receptor agonists and antagonists have become available. Previous evidence indicates that 5-HT(6) or 5-HT(7) receptors antagonists had no effects, improved memory formation and/or reversed amnesia. Herein, the effects of EMD (a 5-HT(6) receptor agonist) and AS19 (a 5-HT(7) receptor agonist) in the associative learning task of autoshaping were studied. Post-training systemic administration of EMD (1-10 mg/kg) or AS19 (1-10 mg/kg) were tested in short-term memory (STM) and long-term memory (LTM). Results showed that only EMD 5.0mg/kg impaired both STM and LTM. AS19 at 1-10 mg/kg significantly impaired STM but not LTM. In those groups used to test only LTM, EMD impaired it; while AS19 improved LTM. Moreover, in the interaction experiments, the STM EMD-impairment effect was partially reversed by the selective 5-HT(6) receptor antagonist SB-399885 (10 mg/kg). The STM AS19-impairment effect (5.0 mg/kg) was not altered by the selective 5-HT(1A) antagonist WAY 100635 (0.3 mg/kg) but reversed by the selective 5-HT(7) receptor antagonist SB-269970 (10.0 mg/kg). The AS19-SB-269970 combination impaired LTM. Taken together these data suggest that the stimulation of 5-HT(6) impaired both STM and LTM. 5-HT(7) receptors stimulation impaired STM but improved LTM. And these results are discussed in the context of their possible neural bases.

Avaliação do aprendizado de pacientes com doença pulmonar obstrutiva crônica em um programa de reabilitação pulmonar / Evaluation of learning in patients with chronic obstructive pulmonary disease during a pulmonary rehabilitation program

INTRODUÇÃO: Os pacientes que realizam um programa de reabilitação pulmonar participam, também, de um programa educativo com aulas expositivas abordando assuntos referentes à sua doença e ao tratamento. Esse programa visa levar o conhecimento necessário para que o paciente possa lidar com a doença e suas repercussões. OBJETIVO: Avaliar se o programa educativo aplicado aos pacientes submetidos a reabilitação pulmonar tem resultados efetivos no aprendizado dos mesmos. CASUíSTICA E MÉTODO: Estudo prospectivo, envolvendo 22 pacientes que se submeteram a um programa de reabilitação pulmonar, com idade 63 (DP ± 11,8). Inicialmente foi aplicado um questionário desenvolvido e validado pelo Centro de Reabilitação Pulmonar da UNIFESP/LESF para avaliar o conhecimento da doença pré e pós-intervenção do programa educacional. Os pacientes foram divididos em dois grupos: um grupo com programa educativo e um grupo controle (sem programa educativo). O grupo educativo respondeu ao questionário duas vezes, pré e pós-programa, já o grupo controle respondeu ao questionário apenas uma vez. RESULTADOS: Os pacientes que foram submetidos ao programa educativo apresentaram aumento no percentual de respostas corretas quando comparados o pré e o pós-intervenção, 69 por cento e 84 por cento respectivamente, e uma diminuição na porcentagem de erros quando comparados o pré e o pós-intervenção, 20 por cento e 14 por cento respectivamente. CONCLUSÃO: O programa educativo aplicado aos pacientes do programa de reabilitação pulmonar mostrou-se efetivo, pois aumentou o conhecimento dos pacientes no que se refere à doença, suas conseqüências e seu tratamento.

BACKGROUND: Patients who undergo pulmonary rehabilitation programs also participate in an educational program with classes covering matters related to their disease and treatment. Such programs aim to provide patients with the knowledge needed for them to be able to deal with their disease and its repercussions. OBJECTIVE: To evaluate whether the educational program applied to patients undergoing pulmonary rehabilitation has effective results regarding their learning. METHOD:This was a prospective study involving 22 patients who underwent a pulmonary rehabilitation program. Their mean age was 63 years (SD ± 11.8). Initially, a questionnaire developed and validated by the Pulmonary Rehabilitation Center of UNIFESP/LESF was applied to evaluate the patients' knowledge about the disease before and after the educational intervention. The patients were divided into two groups: one with the educational program and the other serving as a control group (no educational program). The educational program group answered the questionnaire twice (before and after the intervention), and the control group answered only once. RESULTS:The patients who underwent the educational program presented an increase in the percentage of correct answers, from before to after the intervention (69 percent versus 84 percent, respectively), and a decrease in the percentage of mistakes, from before to after the intervention (20 percent versus 14 percent, respectively). CONCLUSION: The educational program applied to patients in the pulmonary rehabilitation program was effective to increase the patients' knowledge about their disease, its consequences and its treatment.

A quantitative trait locus for recognition of foreign eggs in the host of a brood parasite.

Avian brood parasites reduce the reproductive output of their hosts and thereby select for defence mechanisms such as ejection of parasitic eggs. Such defence mechanisms simultaneously select for counter-defences in brood parasites, causing a coevolutionary arms race. Although coevolutionary models assume that defences and counter-defences are genetically influenced, this has never been demonstrated for brood parasites. Here, we give strong evidence for genetic differences between ejector and nonejectors, which could allow the study of such host defence at the genetic level, as well as studies of maintenance of genetic variation in defences. Briefly, we found that magpies, that are the main host of the great spotted cuckoo in Europe, have alleles of one microsatellite locus (Ase64) that segregate between accepters and rejecters of experimental parasitic eggs. Furthermore, differences in ejection rate among host populations exploited by the brood parasite covaried significantly with the genetic distance for this locus.

Petiole twisting in the crowns of Psychotria liminesis: implications for light interception and daily carbon gain.

We used Y-plant, a computer-based model of crown architecture, to examine the implications of leaf reorientation resulting from petiole bending in Psychotria limonensis (Rubiaceae) seedlings. During this reorientation process, bending of the petioles of lower leaves that are potentially self-shaded by the upper leaves rotates the lamina around the stem's orthotropic axis so that self-shading is reduced. Simulations of daily light capture and assimilation revealed a 66% increase in daily C gain due to reorientation of the leaves as compared to simulations where the leaves remained in their characteristic opposite decussate pattern set by the phyllotaxy. This was due to enhanced carbon (C) gain of the lower leaves because of the reduction of shading by upper developing leaves in the same vertical plane. The light signal for this movement was experimentally examined by placing leaf-shaped filters above already fully expanded leaves and following the resulting shade-avoiding movements. The filters were either neutral density shade cloth that reduced the photon flux density (PFD) but did not alter the red to far red ratio (R:FR) or a film that reduced the PFD equivalently but also reduced the R:FR. Leaf reorientation was much more rapid and complete under the low R:FR as compared to the high R:FR indicating involvement of a phytochrome photosensory system that detected the presence of a shading leaf. Plants in gaps were found to lack a reorientation response indicating that the reorientation is specific to the shaded understory environment.

Comparison of the effects of basic and neutral zinc salts on chicks infected with Ascaridia galli.

The present study was undertaken to investigate if the use of basic salts of zinc in the treatment of ascaridiosis in chicks may present advantages over the use of neutral zinc salts. To evaluate this, an infection of Ascaridia galli was induced in young male Hisex chicks of 14 and 30 days of age. The performance of the infected chicks was improved to a greater extent with the basic salt in doses of 30 mg Zn2+ kg-1 body weight. Parasite burden, body weight gain and liver zinc level were used to assess this performance.

[Soil contamination in Ciudad de La Habana province with Toxocara canis eggs]. / Contaminación de suelos en Ciudad de La Habana con huevos de Toxocara canis.

Toxocara canis is a commun ascarid of dogs worldwide. The ingestion of helminths eggs by humans may cause visceral larva. Knowing the prevalence of T. canis in domestic dogs from Havana City (17.9%), it was decided to study for the first time the contamination of soil in the city with canine nematode ova, and thus, understand the magnitude of the rich for our population, thus, mainly children, for developing the disease three soil samples were taken in different residential areas from 15 municipalities of Havana City, and they were processed by Willis flotation technique (1921). Nineteen out of 45 samples were positive to T. canis eggs accounting for 42.2% of prevalence. Only 3 municipalities were found to have negative results. 38.2% of egg were embryonate. Findings are discussed.

Histerectomía por videolaparoscopía usando técnica C.I.S.H / Hysterectomy by videolaparoscopy using C.I.S.H technic

Se informa sobre 110 casos de histerectomías translaparoscópicas sin colpotomía, utilizando la técnica C.I.S.H. del Dr. Kurt Semm, con morcelación de útero y su extracción a través de un macromorcelador abdominal de punta aserrada de 1,5 cm de diámetro. las medias de edad, paridad y abortos fueron 41,8; 2,93 y 0,52 respectivamente. Ochenta y dos pacientes tenían antecedentes de cirugía abdominal previa. El tiempo quirúrgico medio fue de 116 minutos y no hubo complicaciones importantes en el tiempo operatorio. La media de estadía en clínica fue de 46,18 horas

Histerectomía por videolaparoscopía: uso de técnica Cash / Hysterectomy by videolaparascopy: use of Cash technic

Se informa sobre 9 casos de histerectomías translaparoscópicas utilizando la técnica CASH del Dr. Kurt Semm (Kiel, Alemania), con morcelación de útero y su extracción a través de un macromorcelador abdominal de punta aserrada de 1,5 cm de diámetro

Hepatitis No A No B (NANB) en el Perú?: estudio de marcadores serológicos en 100 pacientes con diagnóstico clínico de hepatitis viral en Huanta-Ayacucho / Non A Non B hepatitis in Perú: study of serological markers in 100 patients with clinical diagnosis of viral hepatitis in Huanta-Ayacucho

Se estudia, mediante marcadores serológicos. 100 sueros de pacientes con diagnóstico clínico de hepatitis viral aguda que concurren al Hospital Central de Huanta-Ayacucho, durante los meses de mayo 1985 a febrero 1986, y 36 sueros de población normal ayacuchana (grupo control). Se utiliza la técnica de microenzimainmunoensayo (Hepanostika, Organon-Teknika). La edad promedio fue de 21.1 y 27.4 años de edad respectivamente (4-76 años), 55 mujeres y 81 varones. En ellos se anota, además de la ictericia, los valores de transaminasas y, bilirrubinas séricas. se encontró que 29% de los casos no presentaron evidencias de hepatitis, mientras que el 29% fue Hepatitis B. el 23% NANM y el 19% Hepatitis A. El 14% de los pacientes con HBV cursan con hepatitis fulminante, sin co-infección Delta. No se encontró portadores de HBV en la población menor de 10 años. En el grupo control, el 94% tiene algún marcador de hepatitis (89% HAV y 41% HBV). Existe una alta prevalencia serológica de Hepatitis A.B y NANB en la zona. este sería el primer reporte de Hepatitis NANB en el Perú