Guillain Barré syndrome in the paediatric population. Consequence of active infection or long Covid?

Background: Guillain-Barre syndrome is a polyradiculoneuropathy that has been associated with infectious diseases as triggers. There is currently little medical evidence exploring the relationship between the development of Guillain-Barre syndrome caused by SARS-CoV-2 infection and long Covid. Objective: To synthesize the medical evidence that describes the relationship between post Covid syndrome and Guillain-Barre syndrome in the paediatric population. Methodology: A scoping review was developed using Scopus and PubMed databases, including analytical and/or descriptive experimental and observational studies. Results: The main clinical manifestations presented by paediatric patients were distal and ascending weakness in the lower limbs and myalgia. The diagnostic approach was based on clinical findings, imaging findings on spinal magnetic resonance and electromyography. The therapeutic strategy is based on the use of intravenous human immunoglobulins. Conclusion: Guillain-Barre syndrome is a frequent disease in the paediatric population with active SARS-CoV-2 infection or in survivors, however, it is necessary to encourage further clinical studies that increase the medical literature that describes this association.

Introducción: El síndrome de Guillain-Barré es una polirradiculoneuropatía que se ha asociado con enfermedades infecciosas como desencadenantes. En la actualidad es escasa la evidencia médica que explore la relación entre el desarrollo del síndrome de Guillain-Barré causado por la infección por SARS-CoV-2 y la COVID prolongada. Objetivo: Sintetizar la evidencia médica que describe la relación entre el síndrome pos-COVID y el síndrome de Guillain-Barré en la población pediátrica. Metodología: Se realizó una revisión exploratoria utilizando las bases de datos de Scopus y PubMed, incluyendo estudios experimentales y observacionales analíticos o descriptivos. Resultados: Las principales manifestaciones clínicas presentadas por los pacientes fueron debilidad distal y ascendente en miembros inferiores y mialgias. El enfoque diagnóstico se apoyó en los hallazgos clínicos, hallazgos imagenológicos por resonancia magnética de columna y electromiografía. La estrategia terapéutica se basó en el uso de inmunoglobulinas humanas intravenosas. Conclusión: El síndrome de Guillain-Barré es una enfermedad frecuente en la población pediátrica con infección activa por SARS-CoV-2 o en sobrevivientes, sin embargo, es necesario incentivar el desarrollo de estudios clínicos que incrementen la literatura médica que describe esta asociación.

Modulated photoactivation methods--effect on marginal and internal gap formation of restorations using different restorative composites.

UNLABELLED: This study evaluated the effect of modulated photoactivation methods on gap formation of restorations using different composites. METHODS: Sixty human third molars were selected, sectioned (two fragments), and ground to expose a flat enamel area. A cavity (5 mm long x 2 mm wide x 2 mm deep--outer margins in enamel and inner margins in dentin) was prepared on the central area of flattened surface. Single bond adhesive system was applied according to manufacturer's instructions. The specimens were assigned into 12 groups (n = 10), according to the restorative composite (Filtek Z250, Herculite XRV, and Heliomolar) and the photoactivation method [continuous light (CL); soft-start (SS); pulse delay (PD); and intermittent light (IL)]. Outer margins were stained using Caries Detector, observed under stereomicroscope, and images were transferred to a computer measurement program. Then, the specimens were sectioned in slices and the internal gaps were assigned using the same method. The length of gaps was expressed as a percentage of total length of the margins. Data (internal adaptation) were submitted to ANOVA and Tukey's test. RESULTS: All restorations showed perfect seal of the enamel outer margins. Modulated photoactivation methods (SS, PD, and IL) showed a significant reduction on internal gap formation when compared with CL, regardless of the composite. Filtek Z250 showed the best internal adaptation, regardless of the photoactivation method. CONCLUSION: Modulated photoactivation methods decrease the internal gap formation of composite restorations, and should be encouraged on clinical practice.