Socioeconomic inequalities in dental visits among high school students in Chile, years 2013 and 2017.

OBJECTIVE: To analyze prevalence changes in dental visits and socioeconomic inequalities among high school students in Chile, years 2013 and 2017. METHODS: Analysis of nationally representative data from 2013 and 2017 waves of the Chilean National Socioeconomic Characterization Survey (CASEN). In a sample of high school students aged 14 to 20 years old (n=12699 in 2013; n=11122 in 2017) we investigated prevalence of dental visits in the last 3 months, by urban-rural residence, sex, type of health insurance, type of school, income level and benefit of dental care at school. For inequality analysis we estimated prevalence ratio of dental visits in the last 3 months according to study variables. RESULTS: There was a significant increase in the prevalence of dental visits in the last 3 months and the receipt of dental care at school between years 2013 and 2017. The highest prevalence of dental visits in the last 3 months was found among students living in urban residence, women, with private insurance, in the highest income level, that attended private schools. Inequalities persist but the gap associated with type of residence, health insurance and between the lowest income quintiles decreased over the years. CONCLUSIONS: The Comprehensive Dental Care for senior year high school students, a public policy that began in 2015 in Chile, could have aided the gap reduction and the increase in visits to the dentist in the last 3 months in this group.

Scanning electron microscopy of bacteria Tetrasphaera duodecadis.

This study reports the characterization of the Tetrasphaera duodecadis bacteria and the techniques used therein. In order to evaluate the morphological characteristics of the T. duodecadis bacteria scanning electron microscope (SEM) was used throughout its different growth stages. These microorganisms were grown in vitamin B12 broths with 1% tryptone, 0.2% yeast extract, and 0.1% glucose. The turbidimetric method was employed for the determination of bacterial concentration and growth curve. The SEM results show small agglomerates of 0.8 ± 0.05 µm during the lag phase, and rod-like shapes during the exponential phase with similar shapes in the stationary phase.

Prevalence, risk factors, and antimicrobial resistance profiles of Salmonella from commercial broiler farms in two important poultry-producing regions of Colombia.

Salmonella is one of the most common foodborne pathogens associated with diarrheal disease in humans. Food animals, especially poultry, are important direct and indirect sources of human salmonellosis, and antimicrobial resistance is an emerging problem of public health concern. The use of antimicrobials benefits producers but contributes to the emergence of antimicrobial resistant bacteria. As a step toward implementing the Colombian Integrated Program for Antimicrobial Resistance Surveillance, this study was conducted to establish the prevalence, distribution of serovars, antimicrobial resistance profiles, and risk factors for Salmonella on poultry farms in the two largest states of poultry production in Colombia. Salmonella was isolated from 41% of farms and 65% of the 315 chicken houses sampled. Salmonella Paratyphi B variant Java was the most prevalent serovar (76%), followed by Salmonella Heidelberg (23%). All Salmonella isolates were resistant to 2 to 15 of the antimicrobial drugs tested in this study. For Salmonella Paratyphi B variant Java, 34 drug resistance patterns were present. The predominant resistance pattern was ciprofloxacin, nitrofurantoin, tetracycline, trimethoprim-sulfamethoxazole, ceftiofur, streptomycin, enrofloxacin, and nalidixic acid; this pattern was detected in 15% of isolates. The resistance pattern of tetracycline, ceftiofur, and nalidixic acid was found in over 40% of the isolates of Salmonella Heidelberg. Of the biosecurity practices considered, two factors were significantly associated with reduction in Salmonella: cleaning of fixed equipment and composting of dead birds on the farm. Findings from the present study provide scientific evidence to inform implementation of official policies that support new biosecurity legislation in an effort to decrease the prevalence of Salmonella on Colombian poultry farms.

Metacarpal index and bone mineral density in healthy African-American women.

Bone mineral density (BMD) reference data of non-Caucasian women is scarce but greatly needed for African-American women. The objective of this study was to establish a metacarpal normative reference database for African-American women using digital X-ray radiogrammetry (DXR) and hand radiographs and compare these values to existing Caucasian data. Two hundred and fifty healthy African-American women between the ages of 20 and 79 years old, 14 of whom were excluded, were recruited to participate from four different clinical sites. The study population was recruited in approximately equal number into the following groups: 20-29, 30-39, 40-49, 50-59, 60-69 and 70-79 years of age. A radiograph was acquired of each subject's non-dominant hand. The radiographs were scanned and analyzed using radiogrammetric techniques, and the BMD, MCI (Metacarpal Index), bone width and cortical thickness were calculated. The regression curve that best fit the data was a second order polynomial. The BMD and MCI of young adult women (20-40 years of age) were used to calculate T-score parameters. The young reference BMD and MCI with their associated standard deviations were found to be 0.6045 g/cm2+/-0.0529 g/cm2 and 0.5096 and 0.0792, respectively. However, the MCI was found to be approximately 2.5% lower (-0.0118) compared to Caucasian women. The African-American metacarpal BMD was found to be 3.5% (0.0207 g/cm2) higher across all ages when compared to existing Caucasian reference data acquired in a similar way. The differences were found to be entirely due to larger bone size, cortical diameter and bone width in the African-American women.

Experience in management of Fournier's gangrene.

We report our experience and results in the management of Fournier's gangrene. Fournier's gangrene is a synergistic infective necrotizing fasciitis, which involves perianal, perineal and genital regions, originated mostly from colorectal and genitourinary sources. Charts and records from 28 patients with Fournier's gangrene diagnosed between 1993 and 1997 were reviewed. The mean patients age was 57.8 years (range, 22-82 years); mean hospital stay was 19 days. Eighteen patients (64.3%) were diabetic. The most common source of gangrene was ischiorectal abscess in 22 patients (78.6%). Colostomy was performed on 14 patients (50%) and cystostomy on 7 patients (25%). Ten patients (35.7%) died because of sepsis. In conclusion, medical and surgical treatment should be aggressive. Colostomy should only be performed if sphincter complex is damaged. Multidisciplinary management is mandatory, because of high morbidity and mortality.

Protocolo kinésico en artrodesis lumbar / Kinesic therapy protocol in lumbar arthrodesis

Se expone un protocolo de tratamiento kinésico en relación a las artrodesis tóraco-lumbares y lumbosacras, describiendo los distintos objetivos y acciones kinésicas en cada etapa de la evolución de este tipo de cirugía