Factors influencing professionalism during dental training at the University of Chile: perception of students and patients.

BACKGROUND: The University should be considered a favourable space and agent for the training and transmission of values and attitudes related to professionalism, such as responsibility, teamwork and ethical commitment. In addition, dentistry is a profession with a deep social sense that seeks to solve the oral health problems of the population to improve the quality of life. In this context, our aim was to explore the perception of students and patients about the contribution of the curriculum to the development of professionalism and to identify the factors that strengthen and weaken this perception. METHODS: A qualitative approach was carried out through focus groups and semi-structured interviews with students from the 4th, 5th and 6th year of training and patients treated at the Dental Clinic of our Faculty. RESULTS: In the opinion of patients and students, the factors that debilitate the training in professionalism are associated with weakened professional values/behaviours in the training, the lack of teacher training of the professors and factors of educational environment. On the contrary, factors strengthening the professionalism are mainly related to hallmark values/ professional behaviours trained in the institution and to the good evaluation by patients. The respondents also perceive the implementation of a new curriculum as a positive factor for the training in professionalism. CONCLUSION: The patients and students interviewed believe that the main strength for the training in professionalism in the institution is the development of adaptability for the future professionals to any social context, especially to a vulnerable one, the ability to solve the problems they face and the responsibility towards the patients and their treatment.

Plasmodium vivax cerebral malaria with pancytopenia in the peruvian amazon: case report. / Malaria cerebral con pancitopenia por plasmodium vivax en la amazonía peruana: reporte de caso.

Plasmodium vivax causes 81% of all malaria cases and is the most common species in the Peruvian Amazon. We present the case of a male patient with cerebral malaria caused by Plasmodium vivax, who had general malaise and fever, and then presented seizures more than twice a day with loss of consciousness and motor functional limitation. Plasmodium vivax trophozoites were detected by thick blood smear, besides, we also observed low counts of all three blood cell types. Treatment began with artesunate and clindamycin for five days, then one unit of packed red blood cells was transfused; treatment continued with primaquine for seven days. The patient showed clinical improvement with neurological sequelae in one lower limb.

Plasmodium vivax es la especie más común en la Amazonía peruana y ocasiona el 81% del total de casos de malaria. Presentamos el caso de un paciente adulto varón con malaria cerebral por Plasmodium vivax, que inicia con malestar general y fiebre, luego presenta convulsiones más de dos veces al día con pérdida de consciencia y limitación funcional motora. Se le realiza gota gruesa donde se observa trofozoítos de Plasmodium vivax y depresión de las tres series sanguíneas. Se inicia tratamiento con artesunato y clindamicina por cinco días, se le transfunde un paquete globular, y continua con primaquina por siete días. El paciente muestra mejoría clínica con secuela neurológica en extremidad inferior izquierda.

Malaria cerebral con pancitopenia por plasmodium vivax en la amazonía peruana: reporte de caso / Plasmodium vivax cerebral malaria with pancytopenia in the peruvian amazon: case report

RESUMEN Plasmodium vivax es la especie más común en la Amazonía peruana y ocasiona el 81% del total de casos de malaria. Presentamos el caso de un paciente adulto varón con malaria cerebral por Plasmodium vivax, que inicia con malestar general y fiebre, luego presenta convulsiones más de dos veces al día con pérdida de consciencia y limitación funcional motora. Se le realiza gota gruesa donde se observa trofozoítos de Plasmodium vivax y depresión de las tres series sanguíneas. Se inicia tratamiento con artesunato y clindamicina por cinco días, se le transfunde un paquete globular, y continua con primaquina por siete días. El paciente muestra mejoría clínica con secuela neurológica en extremidad inferior izquierda.

ABSTRACT Plasmodium vivax causes 81% of all malaria cases and is the most common species in the Peruvian Amazon. We present the case of a male patient with cerebral malaria caused by Plasmodium vivax, who had general malaise and fever, and then presented seizures more than twice a day with loss of consciousness and motor functional limitation. Plasmodium vivax trophozoites were detected by thick blood smear, besides, we also observed low counts of all three blood cell types. Treatment began with artesunate and clindamycin for five days, then one unit of packed red blood cells was transfused; treatment continued with primaquine for seven days. The patient showed clinical improvement with neurological sequelae in one lower limb.

Backbone Hydrocarbon-Constrained Nucleic Acids Modulate Hybridization Kinetics for RNA.

The binding affinity of therapeutic oligonucleotides (ONs) for their cognate RNA is determined by the rates of association (ka) and dissociation (kd). Single-stranded ONs are highly flexible and can adopt multiple conformations in solution, some of which may not be conducive for hybridization. We investigated if restricting rotation around the sugar-phosphate backbone, by tethering two adjacent backbone phosphonate esters using hydrocarbon bridges, can modulate hybridization kinetics of the modified ONs for complementary RNA. Given the large number of possible analogues with different tether lengths and configurations at the phosphorus atoms, we employed molecular dynamic simulations to optimize the size of the hydrocarbon bridge to guide the synthetic efforts. The backbone-constrained nucleotide trimers with stereodefined configurations at the contiguous backbone phosphorus atoms were assembled using a ring-closing metathesis reaction, then incorporated into oligonucleotides by an in situ synthesis of the phosphoramidites followed by coupling to solid supports. Evaluation of the modified oligonucleotides revealed that 15-membered macrocyclic-constrained analogues displayed similar or slightly improved on-rates but significantly increased off-rates compared to unmodified DNA ONs, resulting in reduced duplex stability. In contrast, LNA ONs with conformationally preorganized furanose rings showed similar on-rates to DNA ONs but very slow off-rates, resulting in net improvement in duplex stability. Furthermore, the experimental data generally supported the molecular dynamics simulation results, suggesting that this strategy can be used as a predictive tool for designing the next generation of constrained backbone ON analogues with improved hybridization properties.

Design And Synthesis Of An Azabicyclic Nucleoside Phosphoramidite For Oligonucleotide Antisense Constructs.

We report the synthesis and biophysical evaluation of an azabicycle dinucleotide with restricted γ, ß, and ε torsion angles, featuring the introduction of a piperidine ring that locks the conformation of the nucleoside into an RNA-type nucleic acid. The conceptual basis of the design is predicated upon the notion that the conformation of the phosphate group linking two RNA nucleotides can be approximated with an azabicyclic phosphoramidite which may also benefit from a unique stereoelectronic effect.

Values related to professionalism in dental education at the University of Chile: Student and faculty perceptions.

OBJECTIVE: It is recognised that professionalism should play a central role in dental education. However, its implementation into the curricula of dental schools is still limited. Our objective was to identify the main values related to professionalism based on the perceptions of students and faculty members from the Faculty of Dentistry, University of Chile. METHODS: A Dental Values Survey was validated and culturally adapted in order to guarantee the greatest possible internal validity. The adapted survey was administered to students and faculty members (416 and 225, respectively). The final survey contained 64 items rated on a Likert scale of 1-5. Each item was categorised according to five dimensions: Altruism, Consciousness, Personal Satisfaction, Quality of Life and Professional Status. The values were compared between faculty and students and among students at different courses. A values scale was constructed by selecting the five items with the highest average score for each dimension. RESULTS: Survey respondents composed 34.32% of the universe, of which 50.46% were faculty and 49.54% were students. Values associated with Altruism, Consciousness and Professional Status, were the highest rated by students and faculty. Values associated with Personal Satisfaction and Quality of Life received the lowest scores for both groups. CONCLUSIONS: To provide the best possible attention to patients (Consciousness), and that patients have access to affordable dental care (Altruism), are the values at the top of our scale. On the other hand, to maintain financial stability and to be well paid (Quality of Life) were the less considered.

Conception and Synthesis of Oxabicyclic Nucleoside Phosphonates as Internucleotidic Phosphate Surrogates in Antisense Oligonucleotide Constructs.

The stereocontrolled synthesis of a novel oxabicyclic nucleoside phosphonate comprising a perhydrofuropyran core unit was achieved. It was incorporated in an oligonucleotide sequence as a 5'-3' phosphonate-phosphate insert, and the stability properties of the resulting duplex were measured. The oxabicyclic nucleoside framework was designed so as to restrict rotation around angles γ, δ, and ε of a natural nucleoside.

Design, synthesis, and duplex-stabilizing properties of conformationally constrained tricyclic analogues of LNA.

The design, synthesis and biophysical evaluation of two highly-constrained tricyclic analogues of locked nucleic acid (LNA), which restrict rotation around the C4'-C5'-exocyclic bond (torsion angle γ) and enhance hydrophobicity in the minor groove and along the major groove, are reported. A structural model that provides insights into the sugar-phosphate backbone conformations required for efficient hybridization to complementary nucleic acids is also presented.

[Lessons learned in the control of Aedes aegypti to address dengue and the emergency of chikungunya in Iquitos, Peru]. / Lecciones aprendidas en el control de Aedes aegypti para afrontar el dengue y la emergencia de chikungunya en Iquitos, Perú.

Dengue has affected Iquitos since 1990 causing outbreaks of major impact on public health and for this reason great efforts have been made for its temporal control. Currently, with the expansion of the chikungunya virus in the Americas and the threat of the emergence of the virus in Iquitos, we reflect on lessons learned by way of the activities undertaken in the area of vector control; epidemiological surveillance, diagnosis and clinical management during periods of outbreaks of dengue, in a way that will allow us to better face the threat of an outbreak of chikungunya virus in the largest city in the Peruvian Amazon.

Lecciones aprendidas en el control de Aedes aegypti para afrontar el dengue y la emergencia de chikungunya en Iquitos, Perú / Lessons learned in the control of Aedes aegypti to address dengue and the emergency of chikungunya in Iquitos, Peru

El dengue ha afectado a Iquitos desde 1990 causando varios brotes de gran impacto en la salud pública y por el que se desplegaron grandes esfuerzos para su control temporal. Actualmente, ante la expansión del virus chikungunya en las Américas y la amenaza de la emergencia del virus en Iquitos, reflexionamos a modo de lecciones aprendidas las actividades emprendidas en el área del control vectorial; la vigilancia epidemiológica; el diagnóstico y el manejo clínico durante los periodos de brotes de dengue, de modo que nos permita enfrentar mejor la amenaza de un brote del virus chikunguña en la ciudad más grande de la Amazonía peruana.

Dengue has affected Iquitos since 1990 causing outbreaks of major impact on public health and for this reason great efforts have been made for its temporal control. Currently, with the expansion of the chikungunya virus in the Americas and the threat of the emergence of the virus in Iquitos, we reflect on lessons learned by way of the activities undertaken in the area of vector control; epidemiological surveillance, diagnosis and clinical management during periods of outbreaks of dengue, in a way that will allow us to better face the threat of an outbreak of chikungunya virus in the largest city in the Peruvian Amazon.

Alternative syntheses of (S)-cEt-BNA: a key constrained nucleoside component of bioactive antisense gapmer sequences.

Approaches to the synthesis of the constrained 5-methyluracil nucleoside (S)-cEt-BNA, a key "gapmer" unit in a number of biologically relevant antisense oligonucleotides, are described using 5-methyluridine as starting material. In the shorter synthesis, a nine-step linear sequence afforded a O-protected (S)-cEt-BNA consisting of a [2.2.1]dioxabicycloheptane core in 7% overall yield. A competing reaction in an intramolecular cyclization of a tosylate led to a bicyclic oxetane.

[Acute gastrointestinal involvement in dengue disease by serotype 4: a case report and literature review]. / Compromiso gastrointestinal agudo en pacientes con dengue por serotipo 4: Comunicación de un caso y revisión de la literatura.

Dengue fever is the world's most important arboviral disease, presenting a wide clinical spectrum. We report for the first time in Peru, a case caused by dengue virus serotype 4 with significant gastrointestinal involvement (acute acalculous cholecystitis and acute hepatitis). In addition we carried out a review of the literature atypical presentation illustrating the importance of the characteristics of abdominal pain (right upper quadrant); presence of Murphy's sign, ultrasound, and liver enzymes levels, for appropriate diagnosis and clinical management.

[Report of four clinical cases of filariasis in Alto Nanay, Loreto]. / Reporte de cuatro casos clínicos de filariasis en Alto Nanay, Loreto.

This study describes the clinical, parasitological and laboratory findings of four patients who lived in the district of Alto Nanay, Maynas, Loreto, Peru and were infected with Mansonella ozzardi microfilariae. Clinical examinations by ophthalmologists, cardiologists and nephrologists were performed. In case 1, the presence of 2 subcutaneous lumps was the most important finding, one at dorsal level and the other in the lower third of the left leg; in case 2, there was a sensation of tingling or coldness in the legs; in case 3, an associated chronic hepatitis B infection was found, and in case 4, a large lump was detected in the left lumbar region. All 4 patients were infected with Mansonella ozzardi and had eosinophilia, 3 of them in percentages of 20%. The lump found in case 4 was due to a herniation of bowel content. Further clinical studies and an evaluation of the actual pathogenic effect of microfilariae are to be performed. A study of the genetic diversity of filariae in the Peruvian Amazon would also be important.

Compromiso gastrointestinal agudo en pacientes con dengue por serotipo 4: Comunicación de un caso y revisión de la literatura / Acute gastrointestinal involvement in dengue disease by serotype 4: a case report and literature review

Dengue fever is the world's most important arboviral disease, presenting a wide clinical spectrum. We report for the first time in Peru, a case caused by dengue virus serotype 4 with significant gastrointestinal involvement (acute acalculous cholecystitis and acute hepatitis). In addition we carried out a review of the literature atypical presentation illustrating the importance of the characteristics of abdominal pain (right upper quadrant); presence of Murphy's sign, ultrasound, and liver enzymes levels, for appropriate diagnosis and clinical management.

El dengue es la arbovirosis más importante del mundo y causa un amplio espectro clínico. Presentamos el primer caso de dengue causado por el serotipo 4 (DENV-4) en Perú con compromiso gastrointestinal (colecistitis aguda alitiásica y hepatitis aguda moderada). Se presenta una revisión de la literatura médica sobre este tipo de presentación, enfatizando la importancia y características del dolor abdominal (hipocondrio derecho), el signo de Murphy, los hallazgos ultrasonográficos y la medición de las enzimas hepáticas para establecer el diagnóstico y manejo adecuado.

Reporte de cuatro casos clínicos de filariasis en Alto Nanay, Loreto / Report of four clinical cases of filariasis in Alto Nanay, Loreto

El presente estudio describe los hallazgos clínicos, parasitológicos y de laboratorio de cuatro pacientes residentes en el distrito de Alto Nanay, Maynas, Loreto, Perú; infectados con microfilarias de Mansonella ozzardi. La evaluación clínica incluyó las especialidades de oftalmología, cardiología y nefrología. En el caso 1, destaca la presencia de dos tumoraciones subcutáneas, una a nivel dorsal y la otra en el tercio inferior de la pierna izquierda; en el caso 2, la sensación de “hormigueo o frío en las piernas”; en el caso 3 se encontró asociada una infección crónica por hepatitis B y en el caso 4 una tumoración de gran tamaño en región lumbar izquierda. En los cuatro pacientes se encontró Mansonella ozzardi y eosinofilia, tres presentaron valores mayores a 20%. La tumoración en el caso 4 correspondió a una hernia de contenido intestinal. Es necesario ejecutar más estudios clínicos y evaluar su verdadero efecto patógeno, es también pertinente estudiar la diversidad genética de filarias de la Amazonia peruana.

This study describes the clinical, parasitological and laboratory findings of four patients who lived in the district of Alto Nanay, Maynas, Loreto, Peru and were infected with Mansonella ozzardi microfilariae. Clinical examinations by ophthalmologists, cardiologists and nephrologists were performed. In case 1, the presence of 2 subcutaneous lumps was the most important finding, one at dorsal level and the other in the lower third of the left leg; in case 2, there was a sensation of tingling or coldness in the legs; in case 3, an associated chronic hepatitis B infection was found, and in case 4, a large lump was detected in the left lumbar region. All 4 patients were infected with Mansonella ozzardi and had eosinophilia, 3 of them in percentages of 20%. The lump found in case 4 was due to a herniation of bowel content. Further clinical studies and an evaluation of the actual pathogenic effect of microfilariae are to be performed. A study of the genetic diversity of filariae in the Peruvian Amazon would also be important.