Using sequential applications of a novel silver diamine fluoride gel and sodium fluoride varnish to arrest severe early childhood caries lesions: A clinical trial with single group assignment.

BACKGROUND: Silver diamine fluoride (SDF) gel was developed to overcome the clinical limitations of liquids with children. The authors conducted a clinical trial to determine caries lesion arrest in primary teeth at 1-year follow-up when 38% SDF gel and 2.5% sodium fluoride varnish were applied sequentially at the same appointment. Parent satisfaction was assessed. METHODS: The study design was an open-label prospective, clinical trial with single group assignment. Participants were 237 children aged 3 through 4 years at enrollment and from 5 centros educativos iniciales (preschools). Eligible children had 1 or more d3 (cavitation into dentin) active caries lesions. Teeth with active caries lesions (cavitation confined to enamel [d2] or d3) were treated by applying 1 or 2 drops of viscous 38% SDF gel (Advantage Silver Dental Arrest Gel, Elevate Oral Care, LLC) dabbing the excess with cotton. Treated teeth were covered with 2.5% sodium fluoride varnish (Fluorimax, Elevate Oral Care, LLC) to mask the taste. Treatment was repeated at 5 months postexamination. The primary outcome was caries lesion (d2-d3) arrest at 1 year. RESULTS: Two hundred nineteen children were available at the 1-year follow-up. There was a median of 21 (interquartile range [IQR], 13-34) active carious surfaces (d2-d3) at baseline. Median arrested carious surfaces was 92.6% (IQR, 81.1%-100.0%; 95% CI, 86.8% to 95.2%). When parents were asked whether they were bothered by the color change of teeth, the median response on a 10-point scale in which 1 equaled not bothered at all and 10 equaled very bothered was 1.0 (IQR, 1.0-2.0). CONCLUSIONS: Two applications of 38% SDF gel and 2.5% sodium fluoride varnish arrested greater than 90% of carious surfaces at 1 year and with high levels of parental satisfaction. PRACTICAL IMPLICATIONS: Combined treatment was highly efficacious in a population with many caries lesions. This clinical trial was registered at ClinicalTrials.gov. The registration number is NCT05395065.

Situational diagnosis of policies in Latin American and Caribbean countries for the use of fluoride and reduction of sugar consumption.

Policy evaluation and guidance on fluoride use and sugar consumption in Latin American and Caribbean countries (LACC) may provide a scientific evidence basis for policymakers, dental professionals, civil society organizations and individuals committed to improving public oral health. A cross-sectional study was conducted to evaluate the extent of implementation of policies/guidelines on fluoride use, and sugar consumption in LACC. The study had two stages. First a questionnaire covering four major areas was developed: fluoridation of public water supplies; salt fluoridation; fluoride dentifrices, and sugar consumption. Then, the questionnaire was applied to collect data among representative participants in public oral health from LACC. Ninety-six participants from 18 LACC answered the questionnaire. One-hundred seventy documents were attached, and 285 links of websites were provided by the respondents. Implementation of policies and guidelines on water and table salt fluoridation and processed and ultra-processed food consumption were found in most countries, with some issues in the consensus and coverage. Thus, differences were identified in the extent of implementation of public oral health strategies on sugar consumption and fluoridation among the countries. There is no consensus on the policies in LACC to reduce sugar consumption and for the use of fluoride. A few policies and guidelines were applied in isolated countries, with a variety of strategies and standards. For future actions, it will be important to encourage the development of strategies and public policies within countries, and to evaluate the effectiveness of existing policies in reducing dental caries and in improving oral health in LACC.

[Efficacy and safety of convalescent plasma administration in patients with COVID-19 infection]. / Eficacia y seguridad de la administración de plasma de convaleciente en pacientes con COVID-19.

INTRODUCTION: During the COVID-19 pandemic, several strategies were suggested for the management of the disease, including pharmacological and non-pharmacological treatments such as convalescent plasma (CP). The use of CP was suggested due to the beneficial results shown in treating other viral diseases. OBJECTIVE: To determine the efficacy and safety of CP obtained from whole blood in patients with COVID-19. METHODS: Pilot clinical trial in patients with COVID-19 from a general hospital. The subjects were separated into three groups that received the transfusion of 400ml of CP (n=23) or 400ml of standard plasma (SP) (n=19) and a non-transfused group (NT) (n=37). Patients also received the standard available medical treatment for COVID-19. Subjects were followed up daily from admission to day 21. RESULTS: The CP did not improve the survival curve in moderate and severe variants of COVID-19, nor did it reduce the degree of severity of the disease evaluated with the COVID-19 WHO and SOFA clinical progression scale. No patient had a severe post-transfusion reaction to CP. CONCLUSIONS: Treatment with CP does not reduce the mortality of patients even when its administration has a high degree of safety.

Identification and phenotypic characterization of patients with LADA in a population of southeast Mexico.

Latent autoimmune diabetes in adults (LADA) has clinical and metabolic features of type 1 and type 2 diabetes. LADA does not have specific features for its diagnosis apart from autoantibody detection; however, these tests are not affordable in clinical settings. In this cross-sectional study, we analyzed clinical criteria, metabolic control, pharmacological treatment, and diabetic complications in two groups of patients with diabetes -LADA and T2D- in order to identify specific characteristic of these clinical entities. Finally, we evaluated if the estimated glucose disposal rate (eGDR) and age at diagnosis of diabetes could be used as a diagnostic criterion for LADA. Demographic, biochemical, clinical and treatment were measured in 377 individuals with diabetes. The diagnostics of LADA were determined using Glutamic acid decarboxylase autoantibodies levels. Chi-square test or t-Student test were used to establish differences between groups. To identify factors associated with LADA, a logistic regression analysis was used. Finally, a ROC curve was plotted to assess the possible variables as diagnostic criteria for LADA. The 377 patients with diabetes were separated into 59 patients with LADA and 318 patients with T2D. Patients with LADA showed lower fasting glucose values, fewer diabetic complications, younger age at diagnosis of diabetes, higher insulin use, and higher eGDR in comparison to patients with T2D. Both groups had a mean BMI classified as overweight. The ROC evaluated the sensitivity and specificity, this analysis indicated that an age younger than 40.5 years and an eGDR value higher than 9.75 mg/kg/min correlated better with LADA. These parameters could be useful to identify patients suspected to have LADA at the first level of medical care in the population of southeastern Mexico and refer them to a second level of care.

Mental Health Disorders and Coping Strategies in Healthcare Workers during the COVID-19 Pandemic: An Analytical Cross-Sectional Study in Southeastern Mexico.

Mental health disorders are relatively common in the general population and were already an important issue for the healthcare sector before COVID-19. COVID-19, being a worldwide crucial event and evidently a great stressor has increased both the prevalence and incidence of these. Therefore, it is evident that COVID-19 and mental health disorders are closely related. Moreover, several coping strategies exist to endure said disorders such as depression and anxiety, which are used by the population to confront stressors, and healthcare workers are not the exception. This was an analytical cross-sectional study, conducted from August to November 2022, via an online survey. Prevalence and severity of depression, anxiety, and stress were assessed via the DASS-21 test, and coping strategies were assessed via the CSSHW test. The sample consisted of 256 healthcare workers and of those, 133 (52%) were males with a mean age of 40.4 ± 10.35, and 123 (48%) were females with a mean age of 37.28 ± 9.33. Depression was prevalent in 43%, anxiety in 48%, and stress in 29.7%. Comorbidities were a significant risk factor for both depression and anxiety with an OR of 10.9 and 4.18, respectively. The psychiatric background was a risk factor for depression with an OR of 2.17, anxiety with an OR of 2.43, and stress with an OR of 3.58. The age difference was an important factor in the development of depression and anxiety. The maladaptive coping mechanism was prevalent in 90 subjects and was a risk factor for depression (OR of 2.94), anxiety (OR of 4.46) and stress (OR of 3.68). The resolution coping mechanism was a protective factor for depression (OR of 0.35), anxiety (OR of 0.22), and stress (OR of 0.52). This study shows that mental health disorders are highly prevalent among healthcare workers in Mexico and that coping strategies are associated with their prevalence. It also implies that not only occupations, age, and comorbidities might affect mental health, but also the way patients confront reality and the behavior and decisions they take towards stressors.

Analysis of risk variables for association with maxillary sinus mucosal thickenings: a cone-beam computed tomography-based retrospective study.

PURPOSE: This study aimed to determine which patient-related, anatomical, pathologic, or iatrogenic variables may be directly associated with and which may have a modifying effect on the generation of maxillary sinus (MS) mucosal thickenings. METHODS: A total of 278 cone-beam computed tomography (CBCT) scans obtained from 114 males and 164 females were evaluated. The protocol included the assessment of 21 candidate variables, of which 18 were bilateral and 3 were unique. The relationship among the study variables and the mucosal thickenings were examined individually and adjusted for confounding using univariate and multivariate binary logistic regression models. RESULTS: The prevalence of mucosal thickenings was 71.20% at patient level and 53.40% at sinus level. The ostium height > 28.15 mm, the infundibulum length ≤ 9.55 mm, the infundibulum width ≤ 0.50 mm, along the occurrence of periapical lesions and slight-to-severe periodontal bone loss acted as strong/independent risk variables for MS mucosal thickenings. Confounding and interaction relationships between MS height and depth, and between the alveolar process type and the presence of foreign materials with respect to age stratum > 47.50 years might be also associated with the mucosal thickenings. CONCLUSIONS: While increased ostium height, decreased infundibulum length/width, the presence of periapical lesions and periodontal involvement might be the foremost indicator variables for MS mucosal thickenings, there are synergistic relationships among the increased sinus height and depth as well as aging regarding atrophic/partially atrophic alveolar process status and the presence of foreign materials that may be also associated with a greater proportion of these mucosal abnormalities.

Situational diagnosis of policies in Latin American and Caribbean countries for the use of fluoride and reduction of sugar consumption

Abstract Policy evaluation and guidance on fluoride use and sugar consumption in Latin American and Caribbean countries (LACC) may provide a scientific evidence basis for policymakers, dental professionals, civil society organizations and individuals committed to improving public oral health. A cross-sectional study was conducted to evaluate the extent of implementation of policies/guidelines on fluoride use, and sugar consumption in LACC. The study had two stages. First a questionnaire covering four major areas was developed: fluoridation of public water supplies; salt fluoridation; fluoride dentifrices, and sugar consumption. Then, the questionnaire was applied to collect data among representative participants in public oral health from LACC. Ninety-six participants from 18 LACC answered the questionnaire. One-hundred seventy documents were attached, and 285 links of websites were provided by the respondents. Implementation of policies and guidelines on water and table salt fluoridation and processed and ultra-processed food consumption were found in most countries, with some issues in the consensus and coverage. Thus, differences were identified in the extent of implementation of public oral health strategies on sugar consumption and fluoridation among the countries. There is no consensus on the policies in LACC to reduce sugar consumption and for the use of fluoride. A few policies and guidelines were applied in isolated countries, with a variety of strategies and standards. For future actions, it will be important to encourage the development of strategies and public policies within countries, and to evaluate the effectiveness of existing policies in reducing dental caries and in improving oral health in LACC.

Prevalence and Risk Factors of Adverse Effects and Allergic Reactions after COVID-19 Vaccines in a Mexican Population: An Analytical Cross-Sectional Study.

Vaccinations have helped to control the COVID-19 pandemic; however, few studies focus on the adverse effects and allergic reactions of these vaccines and fewer have a scope in the Latin American population. The objective of this study was to assess the associations between vaccinations, sex, age, allergic reactions, and adverse effects. This was an analytical cross-sectional study conducted between 1 July and 1 October 2022. The sample consisted of 443 surveyed participants, with a total of 1272 COVID-19 vaccine doses. Seven vaccines (Pfizer BioNTech, Oxford-AstraZeneca, CanSino, Moderna, Johnson and Johnson, Sinovac, and Sputnik V) were evaluated. A total of 12.6% of those surveyed had at least one allergic reaction posterior to vaccination, and females had a greater chance of developing one (p < 0.001, OR 3.1). The most common allergic reaction was chest pain, and Pfizer-BioNTech and Oxford-AstraZeneca were associated with the onset of allergic reactions (p < 0.005). A total of 54.6% of those surveyed developed adverse effects, the most common of which were myalgia, fever, cephalea, asthenia or adynamia, and arthralgia; moreover, older age was associated with the onset of adverse effects (p < 0.5). This study concludes that the BNT162b2 (Pfizer BioNTech) and ChAdOX1 nCOV-19 (Oxford-AstraZeneca) vaccines are strongly associated with the onset of allergic reactions, with ORs of 1.6 (CI 95%, 1.18 to 2.3) and 1.87 (CI 95%, 1.35 to 2.6), respectively. In addition, females have a greater chance of developing allergic reactions associated with COVID-19 vaccinations, and there was a relation found between older age and a greater prevalence of comorbidities, adverse effects after vaccination, and COVID-19 infection after vaccination.

COVID-19, Long COVID Syndrome, and Mental Health Sequelae in a Mexican Population.

The COVID-19 pandemic is currently a worldwide threat and concern, not only because of COVID-19 itself but its sequelae. The aim of this study was to evaluate whether a relation between COVID-19, Long COVID, and the prevalence of mental health disorders exist. A total of 203 people from Tabasco were included in this study, answering a survey integrated by three dominions: General and epidemiological data, the DASS-21 test (to determine the presence of signs or symptoms suggestive of depression, anxiety, and/or stress) and an exploratory questionnaire about Long COVID syndrome. A descriptive and inferential statistical analysis was made via Microsoft Excel and Graphpad Prism software, evaluating differences through the Mann−Whitney U test and considering p < 0.05 as statistically significant. Of the 203 people surveyed, 96 (47.29%) had had COVID-19 and 107 (52.71%) had not; from the ones that had COVID-19, 29 (30.21%) presented mental health disorders and 88 (91.66%) presented at least one symptom or sign of Long COVID syndrome; meanwhile, 31 (32.29%) presented 10 or more symptoms or signs. From the comparison between the population with previous mental health disorders and COVID-19 and those without background disorders or COVID-19, the results were the following: 27.58% vs. 16.82% presented severe depression, 48.27% vs. 17.75% presented severe anxiety, and 27.58% vs. 20.56% presented severe stress. A high prevalence of mental health effects was observed in patients without COVID-19 and increased in the population with Long COVID syndrome and previous mental health disorders.

Resistant Starch Consumption Effects on Glycemic Control and Glycemic Variability in Patients with Type 2 Diabetes: A Randomized Crossover Study.

We previously observed beneficial effects of native banana starch (NBS) with a high resistant starch (RS) content on glycemic response in lean and obese participants. Here, we aimed to determine the effects of NBS and high-amylose maize starch (HMS) on glycemic control (GC) and glycemic variability (GV) in patients with type 2 diabetes (T2D) when treatments were matched for digestible starch content. In a randomized, crossover study, continuous glucose monitoring (CGM) was performed in 17 participants (aged 28-65 years, BMI ≥ 25 kg/m2, both genders) consuming HMS, NBS, or digestible maize starch (DMS) for 4 days. HMS and NBS induced an increase in 24 h mean blood glucose during days 2 to 4 (p < 0.05). CONGA, GRADE, and J-index values were higher in HMS compared with DMS only at day 4 (p < 0.05). Yet, NBS intake provoked a reduction in fasting glycemia changes from baseline compared with DMS (p = 0.0074). In conclusion, under the experimental conditions, RS from two sources did not improve GC or GV. Future longer studies are needed to determine whether these findings were affected by a different baseline microbiota or other environmental factors.

Effects of Non-Nutritive Sweeteners on Energy Intake, Body Weight and Postprandial Glycemia in Healthy and with Altered Glycemic Response Rats.

The aim of this study was to evaluate the effects of non-nutritive sweeteners (NNS) consumption on energy intake, body weight and postprandial glycemia in healthy and with altered glycemic response rats. Animals on normal diet (ND) or high-fat diet (HFD) were divided to receive NNS (sucralose, aspartame, stevia, rebaudioside A) or nutritive sweeteners (glucose, sucrose) for 8 weeks. The NNS were administered at doses equivalent to the human acceptable daily intake (ADI). A test using rapidly digestible starch was performed before and after treatments to estimate glycemic response. No effects of NNS consumption were observed on energy intake or body weight. Sucrose provoked an increased fluid consumption, however, energy intake, and weight gain were not altered. In ND, no effects of NNS on glycemic response were observed. In HFD, the glycemic response was increased after sucralose and stevia when only the final tolerance test was considered, however, after including the baseline test, these results were no longer significant compared to glucose. These findings provide further evidence suggesting that at the recommended doses, NNS do not alter feeding behavior, body weight or glycemic tolerance in healthy and with altered glycemic rats.

Caracterización anatómica del conducto nasopalatino mediante tomografía computarizada de haz cónico en una población peruana / Anatomic characterization of the nasopalatine canal through cone beam computed tomography in a Peruvian population

RESUMEN El Conducto Nasopalatino (CNP) es una estructura importante que puede ser susceptible de daño durante procedimientos quirúrgicos en el maxilar superior anterior; por lo tanto examinar meticulosamente la anatomía y variantes del CNP se hace imperativo para un buen diagnóstico y un apropiado plan de tratamiento. Objetivo: Realizar una caracterización anatómica del CNP utilizando Tomografía Computarizada de Haz Cónico (TCHC). Material y métodos: Se evaluaron 154 imágenes de TCHC, en las que se analizó CNP en cuanto a su longitud, forma, e inclinación con respecto al paladar duro y el diámetro anteroposterior del foramen incisivo (FI) en hombres y mujeres de 18 años de edad en adelante. Resultados: A la evaluación del CNP en cortes sagitales de TCHC presentó diferentes formas; se encontró que la forma más común fue la cilíndrica en 89 pacientes (58%), seguida de la forma de embudo en 38 (25%), y las menos frecuentes fueron la forma a de reloj de arena en 20 (13%) y de huso en 7 (5%). La longitud promedio del CNP fue de 10,83 mm (± 2,13), el promedio del diámetro anteroposterior del FI fue de 3,44 mm (± 0,80) y la angulación promedio en relación al paladar duro fue de 16,44° (± 7,32). Conclusiones: El estudio mostró la variabilidad del CNP en la población peruana, tanto en la forma, longitud e inclinación, así como también en el diámetro del FI.

SUMMARY Nasopalatine Canal (NPC) is an important structure that may be susceptible to damage during surgical procedures in the anterior maxilla, therefore a thorough examination of the anatomy and variants of the NPC is imperative for a good diagnosis and an appropriate treatment plan. Objective: To perform an anatomic characterization of NPC using Computed Beam Computed Tomography (CBCT). Material and methods: 154 images of CBCT were evaluated, in which the NPC was analyzed in terms of length, shape, and inclination with respect to the hard palate and the maximum anteroposterior of the incisive foramen (IF) in men and women of 18 years of age and onwards. Results: to the evaluation of the NCP in sagittal slices of CBCT, it presented different forms, it was found to the cylindrical shape as the most common in 89 patients (58%), followed by the funnel shape in 38 (25%), and the less frequent were the shape of hourglass in 20 (13%) and spindle (5%). The average length of the NCP was 10.83 mm (± 2.13), the average of the anteroposterior diameter of the FI was 3.44 mm (± 0.80) and the average angulation of the CNP in relation to the hard palate was 16.44 ° (± 7.32). Conclusions: The study showed the variability of NCP in the Peruvian population, like in shape, length and inclination, as well as the diameter of the FI.

Quality of life of Latin-American individuals with type 2 diabetes mellitus: A systematic review.

OBJECTIVE: Diabetes mellitus is a serious public health problem that causes a decrease in the patients' quality of life. The present study was aimed to analyze the quality of life of patients with diabetes mellitus in Latin-American population through a systematic review, using the two instruments of greater validity and reliability at international level, SF-36 and WHOQOL. METHODS: We performed extensive searches in Redalyc, SciELO, PubMed, Scopus and Web of Science databases. To delimit our search, we only included countries that are members of the Latin American Association of Diabetes. We identified 2168 articles, where 35 were considered relevant for this systematic review. RESULTS: Our results showed that patients that regularly receive guidance and treatment to control the diabetes, showed better quality of life; in contrast, patients with foot ulcers or comorbidities showed the worse quality of life. CONCLUSION: The current literature analysis suggests that this disease greatly influences in the quality of life of the patients.

[Anticancer effect of modified banana (Musa cavendish AAA) starch in rats with 1.2-dimethylhydrazine]. / Efecto anticancerígeno del almidón modificado de banano (Musa cavendish AAA) en ratas con 1,2-dimetilhidrazina.

INTRODUCTION: Introduction: resistant starch (RS) is not completely digested in the human intestine but is fermented in the colon; intestinal pH decreases as short-chain fatty acids are produced. This is beneficial for health, and for preventing and treating rectal colon cancer. Pyrodextrinization and enzymatic hydrolysis are modifications to native starch (NS) that may increase the amount of RS. Objective: the objective of this project was to evaluate the effects of M. cavendish AAA native and both chemically and enzymatically modified starches on tumor markers in rats. Methods: modifications (chemical and enzymatic) were made to M. cavendish AAA NS, and were evaluated in rats with 1,2-DMH. Male Sprague Dawley rats (25) were used, divided into five experimental groups: PC, NC, NS, PI, and ERM. During 4 weeks they received the experimental diet assigned to each group. The PC, NS, PI and ERM groups received 2 weekly s.c. (subcutaneous) injections of 1,2-DMH (40 mg/kg) (third and fourth week). In feces, pH, ß-glucuronidase enzyme, and short-chain fatty acids were evaluated, and a histopathological study was performed of the intestine to detect microscopic lesions. Results: the activity of ß-glucuronidase decreased (p < 0.05) for NS, PI and ERM vs. PC. The highest proportion of butyric acid was observed in the NS (p < 0.05) vs. NC group. Sixty percent of enteritides were severe in grade in the PC group, and 40 % in the experimental groups. Conclusions: native starch granules resisted pyrodextrinization, but treatment with α-amylase broke the structure of the pyrodextrin granule. According to the treatments given to the rats, as the amount of RS present in the diet increases (NS), the neoplastic cells do not advance beyond the basement membrane, suggesting a possible cell-protective or anticancer effect.

INTRODUCCIÓN: Introducción: el almidón resistente (AR) no se digiere completamente en el intestino humano sino que se fermenta en colon; disminuye el pH intestinal, ya que se producen ácidos grasos de cadena corta, interviniendo de manera benéfica en el tratamiento preventivo y curativo del cáncer de colon rectal. La pirodextrinización y la hidrólisis enzimática son modificaciones al almidón nativo (AN) que pueden incrementar la cantidad de AR. Objetivo: el objetivo de este proyecto fue evaluar los efectos del almidón nativo de M. cavendish AAA y de los almidones modificados química y enzimáticamente sobre diversos marcadores tumorales en ratas. Métodos: se realizaron modificaciones (química y enzimática) del AN del banano M. cavendish AAA y se evaluaron en ratas tratadas con 1,2-DMH. Se utilizaron 25 ratas Sprague Dawley machos divididas en cinco grupos experimentales: CP, CN, AN, PI y MER. Durante 4 semanas recibieron la dieta experimental asignada a cada grupo. Los grupos CP, AN, PI y MER recibieron 2 inyecciones s.c. (subcutáneas) semanales de 1,2-DMH (40 mg/kg) (semanas 3 y 4). En las heces se evaluaron el pH, la enzima ß-glucuronidasa y los ácidos grasos de cadena corta, y se realizó un estudio histopatológico del ciego y el colon para detectar lesiones microscópicas. Resultados: la actividad de ß-glucuronidasa disminuyó (p < 0,05) para los grupos AN, PI y MER en comparación con el CP. La mayor proporción de ácido butírico se observó en el AN (p < 0,05) frente al CN. El 60 % de las enteritis fueron de grado severo en el CP, mientras que en los grupos experimentales fueron de 40 %. Conclusiones: los gránulos de almidón nativo resistieron la pirodextrinización pero el tratamiento con α-amilasa rompió la estructura del gránulo de pirodextrina. De acuerdo a los tratamientos suministrados a las ratas, conforme mayor es la cantidad de AR presente en la dieta (AN), las células neoplásicas no avanzan más allá de la membrana basal, sugiriendo un posible efecto protector o anticancerígeno celular.

Lack of Association of Coffee Consumption with the Prevalence of Self-Reported Type 2 Diabetes Mellitus in a Mexican Population: A Cross-Sectional Study.

It is estimated that almost 366 million people are currently suffering from diabetes mellitus worldwide. However, it has been suggested that coffee consumption has a protective effect against the development of type 2 diabetes mellitus. This association has been observed in many regions around the world. Today, there are no reports in Mexico regarding this association. Therefore, the aim of this study was to assess the association between coffee intake and self-reported type 2 diabetes mellitus in the southeastern part of Mexico. This study included 1277 residents of Comalcalco, a municipality of Tabasco State, Mexico. We calculated the prevalence for diabetes and performed multivariate analysis using multiple logistic regressions to evaluate the combined association with type 2 diabetes mellitus. The prevalence of the diabetes was 12.52% (95% CI: 10.67⁻14.38). The majority of people surveyed (77.29%; 95% CI: 74.95⁻79.60) indicated they were coffee drinkers. The results of multivariate analysis showed a non-significant relationship between the number of cups of coffee drank and type 2 diabetes mellitus. The adjusted odds ratio gave the following values: 1.20, (95% CI: 0.59⁻2.41) for non-daily consumption; 1.66 (0.82⁻3.34), for 1 cup of coffee peer day, and 1.49 (0.78⁻2.86) for 2⁻3 cups. Subsequently, an adjustment was made for age, gender, marital status, education, alcohol consumption, and cigarette smoking. In our population, we did not observe an association between coffee intake and its protective relationship with self-reported type 2 diabetes mellitus.

Effects of modified banana (Musa cavendish)starch on glycemic control and blood pressure in rats with high sucrose diet.

INTRODUCTION: insulin resistance (IR) is the preliminary stage of diseases such as diabetes and hypertension. These diseases can be controlled through medication, yet the consumption of functional foods (FF) may be one complementary treatment option. Ingredients for these FF could be the pyrodextrin and enzymatically resistant maltodextrin (ERM) obtained from the native starch (NS) of M. cavendishin this study. OBJECTIVE: to evaluate the effects of modified banana starch on glycemic control and blood pressure in rats with high sucrose diet (HSD). METHODS: we utilized 25 male Wistar rats 20 of which received a HSD and five were fed a normal diet and purified water (PW) for 12 weeks. At the end of week 8, the rats fed a HSD were divided into four groups: positive control (PC), native starch (NS), pyrodextrin (PI), and enzymatically resistant maltodextrin (ERM). The negative control (NC) comprised the five rats fed PW. We evaluated the glucose tolerance test, blood pressure (BP), insulin levels, total cholesterol (TC), high-density lipoproteins (HDL), and triglycerides. RESULTS: differential scanning calorimetry and scanning electron microscopy of the modified starches demonstrated that the pyroconversion treatment did not visibly affect the NS granules, while ERM was modified by the action of α-amylase. Starch treatments reduced glucose, insulin, HOMA-IR, and BP in comparison with PC (p < 0.05). Glucose AUC (0-120 min) was also decreased after starch treatments with respect to PC (p < 0.05). CONCLUSION: NS and its modified products exerted beneficial effects on glycemic control, lipid metabolism, and BP in obese rats fed a HSD. Although the modified starches presented lower resistance to digestion than NS, their expected properties were maintained.

Síndrome antifosfolipídico secundario a lupus eritematoso sistémico en paciente que debuta con síndrome de Evans / Antiphopholipid Syndrome secondary to system lupus Erythematosus in a patient with Evans Syndrome

Introducción: El Lupus Eritematoso Sistémico (LES) es una enfermedad autoinmune crónica de causa desconocida, gran heterogeneidad clínica y pronóstico variable. Reporte de caso: Mujer de 42 años, con antecedente de Síndrome de Evans, Vasculitis Urticariana, consumidora crónica de anovulatorios; acude al Hospital Nacional Almanzor Aguinaga Asenjo(HNAAA), con edema de pierna izquierda, signo ollow y signo de homans positivos. Eco-Doppler sugirió Tronvosis venosa profunda (TVP), Anticuerpos para Sindrome Antifosfolipídico (SAF) positivos, diagnosticándose SAF. Conclusión: El estudio para LES, detectó: ANA positivo, Anti-DNA-dc y Anti-Sm negativos; la Biopsia Renal, reveló Nefritis Lúpica I, diagnosticándose LES.

Parental-caregiver perceptions of child oral health-related quality of life (P-CPQ): Psychometric properties for the peruvian spanish language.

OBJECTIVES: The aim of the study was to cross-culturally adapt the Parental-Caregiver Perceptions Questionnaire (P-CPQ) to the Peruvian Spanish language and assess its reliability and validity. STUDY DESIGN: To translate and cross-cultural adapt the instrument, 60 parents answered the P-CPQ in two pilot tests. The final version of the P-CPQ was evaluated in 200 parents of children aged 11 to 14 years, who were clinically examined for dental caries. The internal consistency was assessed by Cronbach's alpha coefficient while repeat administration of the P-CPQ on the same 200 children facilitated the test-retest reliability via intraclass correlation coefficient (ICC). Construct and discriminant validity were based on associations of the P-CPQ with global ratings of oral health and clinical groups, respectively. RESULTS: The mean (standard deviation) P-CPQ score was 15.64(11.89). Internal consistency was confirmed by a Cronbach's alpha of 0.84. Test-retest reliability revealed excellent reproducibility (ICC= 0.94). Construct validity was satisfactory, demonstrating significant correlations between global ratings (oral health and overall well-being) and the total scale and for subscale. Discriminant validity was significant (p<0.001), supporting its ability to discriminate between clinical groups. CONCLUSIONS: The Peruvian Spanish P-CPQ has satisfactory psychometric properties to assess parental-caregivers perceptions on their children's oral health-related quality of life.

Cross-cultural adaptation and psychometric properties of the Child Perceptions Questionnaire 11-14 (CPQ11-14) for the Peruvian Spanish language.

OBJECTIVES: Oral-Health-Related Quality of Life (OHRQoL) instruments, such as the Child Perceptions Questionnaire 11-14 (CPQ11-14), are broadly used in oral health surveys around the world. However, there is a lack of these instruments in Spanish language limiting the comparison of OHRQoL outcomes among countries, cultures and ethnic groups. The aim of the present study was to cross-culturally adapt the CPQ11-14 to the Peruvian Spanish language and assess its reliability and validity. MATERIAL AND METHODS: To test the translation and cross-cultural adaptation, 60 children aged 11-to-14-years answered the CPQ11-14 in two pilot tests. After that, the questionnaire was tested on 200 children of the same age, who were clinically examined for dental caries. The internal consistency was assessed by Cronbach's alpha coefficient while repeat administration of the CPQ11-14 on the same 200 children facilitated the test-retest reliability via intraclass correlation coefficient (ICC). Construct and discriminant validity were based on associations of the CPQ11-14 with global ratings of oral health and clinical groups respectively. RESULTS: The mean (standard deviation) CPQ11-14 score was 20.18(13.07). Internal consistency was confirmed by a Cronbach's alpha of 0.81. Test-retest reliability revealed excellent reproducibility (ICC= 0.92). Construct validity was confirmed demonstrating statistically significant associations between total CPQ11-14 score and global ratings of oral health (p=0.035) and overall well-being (p<0.001). The measure was also able to discriminate between children with dental caries experience and those without (mean scores: 26.32 and 12.96 respectively; p<0.001). CONCLUSION: The Spanish CPQ11-14 has satisfactory psychometric properties and is applicable to children in Peru.

Validez concurrente y predictiva de la escala de cribado de estilo de vida delictivo revisada ECEViD R / Predictive and concurrent validity of the criminal lifestyle scale revised -LCSF-R

Antecedentes: La metodología de evaluación del riesgo de violencia ha evolucionado en los últimos tiempos. Las predicciones efectuadas en el sistema judicial requieren determinaciones basadas en evidencias y transparencia en sus procedimientos. Objetivos. Evaluar la validez concurrente y predictiva de la versión argentina de la Lifestyle Criminality Screening Form Revised -LCSF-R-, denominada escala de cribado de estilo de vida delictivo revisada -ECEViD R-. Material y métodos. Luego de traducir al español y adaptar al medio local la LCSF-R, se evaluó una cohorte de 100 personas candidatas consecutivas a liberación o alta del servicio penitenciario de la provincia de Buenos Aires con la ECEViD R y otras tres escalas: la Psychopathic Checklist Revised (PCL R), la Assessing Risk For Violence (HCR 20) y la Violence Risk Appraisal Guide (VRAG). El reclutamiento duró quince meses y el seguimiento, en promedio, dos años y medio. Se consignaron eventos violentos y delitos no violentos; se chequearon pérdidas por fallecimiento y salida del país. Se recabó la información mediante fuentes de información múltiples. Resultados. Éstos permiten sostener la validez concurrente de la ECEViD. Respecto de la validez predictiva no se obtuvieron resultados positivos significativos. Conclusión. Los autores sugieren que la ECEViD R resulta ser un instrumento candidato apropiado para el cribado en evaluaciones de riesgo de violencia, dado el comportamiento similar presentado con instrumentos más complejos.

Background: The violence risk assessment methodology has evolved in recent times. The predictions made in the judicial system require evidence based determinations and transparency in its procedures. Objective. To evaluate the concurrent and predictive validity of the Argentinean version of Lifestyle Criminality Screening Form Revised -LCSF-R-, denominated escala de cribado de estilo de vida delictivo revisada -ECEViD R-. Materials and method. After the translation into Spanish and adaptation to the local way of LCSF-R. A cohort of 100 candidates to liberation or discharge of the Penitentiary Service of the State of Buenos Aires was evaluated with ECEViD and with other three scales: Psychopathic Checklist Revised -PCL R-, Assessing Risk for Violence -HCR 20- and Violence Risk Appraisal Guide -VRAG-. The recruitment lasted 15 months and the follow-up, in average, 2 years and a half. Violent events and not violent crimes were recorded; losses were checked by death and by exit of the country. Multiple sources of information were used. Results. The results allow to supporting the concurrent validity of the ECEViD. With regard to the predictive validity no significant positives results were obtained. Conclusions. The authors suggest that the ECEViD R turns out to be an instrument suitable candidate for the screening in violence risk evaluations, because of their similar behavior to more complex instruments.