Ischemic Stroke During Dengue Infection: A Report of 2 Cases.

BACKGROUND Involvement of the central nervous system during infection with dengue virus (DENV) is recognized. However, ischemic stroke is rarely reported. Herein are described 2 cases of patients with ischemic stroke in which DENV infection was demonstrated. CASE REPORT The first patient was a 51-year-old woman that presented altered consciousness, monoparesis, facial palsy, dysarthria, Babinski sign, and syncope 7 days from the onset of fever. She had a history of carotid artery atherothrombosis and previous stroke. Magnetic resonance imaging (MRI) showed an acute infarction of the right middle cerebral artery. DENV was confirmed by the presence of NS1 and IgM in serum. The patient was treated with intravenous fluids and recovered well, with only right facial paresis still present at discharge. The second patient was a 50-year-old man who presented with headache, altered consciousness, and mutism after a febrile episode 1 week prior. This patient had a previous history of stroke, glioblastoma resection, epilepsy, hypothyroidism, and diabetes. MRI demonstrated a subacute ischemic event. The diagnosis of dengue was confirmed by serum NS1 and IgM and by RT-PCR in serum and cerebrospinal fluid. DENV-1 serotype was observed in serum and cerebrospinal fluid. The patient was treated with intravenous fluids and was discharged in good condition. In both patients, thrombocytopenia and leukopenia was demonstrated, and hemoconcentration was demonstrated in the second patient. CONCLUSIONS In tropical and subtropical countries, DENV infection can represent a potential cause of ischemic stroke in patients with a history of comorbidities, including stroke.

Terminal efficiency, Lag and dropout in cohorts from 2007 to 2014 of dental students at the University of Costa Rica / Eficiencia terminal, rezago y abandono en las cohortes del 2007 al 2014 de estudiantes de Odontología de la Universidad de Costa Rica

Abstract Determine the terminal efficiency, lag and dropout in the cohorts of students who entered the dentistry career at the Faculty of Dentistry at University of Costa Rica in the lapse 2007 to 2014. Data from 736 files were collected. The variables considered were sex, admission age, nationality, marital status, children, admission note, domicile and high school. The data was collected from the Student Application System, the physical files, and the data base from the Supreme Court of Elections of Costa Rica. Descriptive statistics, bivariate and multivariate analysis were made, which were implemented from two logistic regression models. 98% of the students were Costa Rican, 68% women, 79% entered according to the admission note, 43% entered with an age of 18 years or less, 50% came from a public school, 77% resided in the Greater Metropolitan Area and 95% were single and remained without children. The average terminal efficiency was 6%; 46% of students have graduated with lag, 16% are still enrolled and 32% dropped out. Sex, age, admission note, and motherhood are sociodemographic variables that are associated with terminal efficiency and dropout. The average terminal efficiency in the cohorts from 2007 to 2014 in the courses at the Faculty of Dentistry University of Costa Rica was very low, almost half of the students graduated with lag and about a third dropped out the studies. The grade from the admission note seems to be a predictor of students'academic behavior, higher grade had more chances of graduating and less likely to dropout.

Resumen Determinar la eficiencia terminal, el rezago y el abandono en las cohortes de los estudiantes que ingresaron a la carrera de Odontología de la Facultad de Odontología UCR en el período 2007 al 2014. Se recopilaron los datos de 736 expedientes. Las variables consideradas fueron: sexo, edad de ingreso, nacionalidad, estado civil, hijos, lugar y colegio de procedencia, y nota de examen de admisión. Los datos se recopilaron del Sistema de Aplicaciones Estudiantiles, los expedientes físicos y del Tribunal Supremo de Elecciones de Costa Rica. Se realizó estadística descriptiva, análisis bivariado y multivariado que se implementó a partir de dos modelos de regresión logística. El 98% de los estudiantes fueron costarricenses, el 68% mujeres, el 79% ingresó según la nota de admisión, el 43% ingresó con una edad de 18 años o menos, el 50% provenía de un colegio público, el 77% residía en la gran área Metropolitana y el 95% eran solteros y permanecieron sin hijos. La eficiencia terminal en promedio fue de 6%; el 46% de los estudiantes se han graduado con rezago, el 16% continúan matriculados y el 32% hizo abandono de los estudios. El sexo, la edad, la nota del examen de admisión y la maternidad son variables sociodemográficas que se asocian con la eficiencia terminal y el abandono. El promedio de la eficiencia terminal en las cohortes del 2007 al 2014 en la carrera de Odontología de la Facultad de Odontología UCR fue muy bajo, casi la mitad de los estudiantes se han graduado con rezago y cerca de un tercio hizo abandono de los estudios. La nota del examen de admisión parece ser un predictor en el comportamiento académico de los estudiantes: a mayor nota más posibilidades de graduarse y menos de abandonar la carrera.

Use of community resources as health assets for rehabilitation of people with Long COVID in northeastern Spain two years after the outbreak of the COVID-19 pandemic: qualitative study.

INTRODUCTION: The epidemiology of Post COVID Condition is not yet known. There are different treatment options, but they are not recommended or suitable for all those affected. For this reason and due to the lack of health treatment, many of these patients have tried to carry out their own rehabilitation through the use of community resources. OBJECTIVE: The objective of this study is to deepen into the understanding about the use of community resources as assets for health and rehabilitation by people with Long COVID and their utility. METHODOLOGY: A qualitative design was carried out with the participation of 35 Long COVID patients, of which 17 subjects were interviewed individually and 18 of them were part of two focus groups. The participating patients were recruited in November and December 2021 from the Primary Health Care centers and through the Association of Long COVID patients of Aragon. The research topics were the use of community resources, before and after their infection by COVID-19, rehabilitation through their use, as well as barriers and strengths for their employment. All analyses were performed iteratively using NVivo software. RESULTS: Long COVID patients who have used community resources for rehabilitation have seen an improvement in their physical and mental health. Most of them, specifically those affected, have used green spaces, public facilities, physical or cultural activities and associations. The main barriers identified have been the symptoms themselves and the fear of reinfection, with the main advantage of these activities being the perceived health benefits. CONCLUSION: The use of community resources seems to be beneficial in the recovery process of Long COVID patients, so it is necessary to continue delving into this topic and promote the formal use of the Recommendation of Health Assets from Primary healthcare.

The Impact of Social Media Use for News on Academic Performance in Underrepresented Undergraduate College Students.

Researchers have demonstrated that the relationship between social media use (SMU) and academic performance is mixed. This study extends those findings by examining how SMU for news predicts grade point average (GPA) for Hispanic, Black/African American, and White college students while controlling for gender. Students (N = 378) completed surveys where they reported how many times per week they used various social media platforms for news, whether or not they used those platforms to consume certain types of news, and demographic information. For Hispanic students, results indicated that using YouTube for entertainment news predicted lower GPAs, whereas using YouTube for news predicted higher GPAs. Black/African American students' use of Facebook for news predicted lower GPAs. SMU for news for White students did not predict GPA. Findings indicate that race/ethnicity should be considered when examining the relationship between SMU and academic performance and that minority students' GPAs are affected by their use of social media for news.

Patients satisfaction with dental service, school of dentistry, University of Costa Rica / Satisfacción de los usuarios del Servicio de Odontología, Universidad de Costa Rica

The objective of this research was to use the Dental Satisfaction Questionnaire to determine the level of patient's satisfaction who come to the School of Dentistry of the University of Costa Rica. The research was conducted with the entire population of patients who received dental care in the Undergraduate Student Clinics of the School of Dentistry between April and September 2021. A digital survey was generated with the questions of the DSQ and sociodemographic variables, which was sent by email. Descriptive statistics were performed to establish the absolute and relative frequency, as well as measures of central tendency and variability, according to the nature of the variables. The Kolmogorov-Smirnov test was used in the conformity assessment of the data for the normal distribution. The relationships between the scores obtained from the Dental Satisfaction Questionnaire and the sociodemographic variables were analyzed using the Mann-Whitney U Test and the Kruskal-Wallis Test. A response rate of 36% was obtained. 98.5% of the subjects were satisfied with the services received. There was a statistically significant difference between the frequency of visits and the dental satisfaction scale (p=0.001). The scoring by type of clinic with regards to access, pain management, cost and availability were statistically significant (p=0.001, p=0.014, p=0.001, p=0.001, respectively). The differences in the relationship between the age groups and access was significant (p=0.014); in addition to that between education level and cost (p=0.001). A large majority of patients who come to the services of the School of Dentistry UCR are satisfied with the service received.

El objetivo de esta investigación fue utilizar el cuestionario DSQ para determinar el nivel de satisfacción de los pacientes que acuden a la Facultad de Odontología de la UCR. La investigación se realizó con toda la población de pacientes que recibieron atención dental en las Clínicas de pregrado y grado de la Facultad de Odontología UCR entre abril y setiembre del 2021. Se generó una encuesta digital con las preguntas del cuestionario DSQ y variables sociodemográficas, la cual se envió por medio del correo electrónico. Se realizó estadística descriptiva estableciendo la frecuencia absoluta y relativa, así como medidas de tendencia central y variabilidad, según la naturaleza de las variables. La prueba de Kolmogorov-Smirnov fue utilizada en la evaluación de la conformidad de los datos para la distribución normal. Las relaciones entre las puntuaciones obtenidas del Cuestionario de Satisfacción Dental y las variables sociodemográficas se analizaron mediante las pruebas de Prueba U de Mann-Whitney y la Prueba de Kruskal-Wallis. Se obtuvo un índice de respuesta del 36%. El 98,5% de los sujetos estuvo satisfecho con los servicios recibidos. Hubo diferencia estadísticamente significativa entre la frecuencia de visitas y la escala de satisfacción dental (p=0,001). También hubo diferencia estadísticamente significativa entre las diferentes clínicas y el acceso, manejo del dolor, costo y disponibilidad (p=0,001, p=0,014, p=0,001, p=0,001, respectivamente). De igual forma, hubo diferencia significativa en los grupos de edad y el acceso (p=0,014) y entre el nivel educativo y el costo (p=0,001). Una gran mayoría de los pacientes que acuden a los servicios de la Facultad de Odontología UCR están satisfechos con el servicio recibido.

Sociodemographic and academic characteristics of the admission profile of students, faculty of dentistry, University of Costa Rica 2007-2014 / Características sociodemográficas y académicas del perfil de ingreso de estudiantes de la Facultad de Odontología de la Universidad de Costa Rica 2007-2014

The objective of this research was to determine some of the sociodemographic and academic characteristics of the students who entered the Dentistry career in the period 2007 to 2014. Data was collected from 673 student files. The variables considered were sex, admission age, marital status, children, nationality, place of origin, high school of origin, and admission exam score. The data was obtained from the database of the Student Applications System, the physical files, and the Supreme Electoral Tribunal of Costa Rica. Descriptive statistics were performed, establishing the absolute and relative frequency of the variables. The Mann-Whitney test was used to determine if there were statistically significant differences between the admission exam and the established sociodemographic variables (p<0,05, IC 95%). 68,4% of the students are female. The average age was 18.4 years (SD=2,41). 99,0% of the students are from Costa Rica. 99,3% were single and only 0,9% had children. The largest number of students entered through an admission exam (78.9%) and 50.7% studied at a public high school. Regarding the address, 77.9% of the subjects resided in the Greater Metropolitan Area. The average grade of the admission exam was 613,8 (SD=49,95). There was a statistically significant difference between the entrance exam grade and the different types of high schools of origin. The group of students who entered to train as Dentists at the University of Costa Rica from 2007 to 2014 was a population with an average age of entry of 18,4 years, Costa Rican, predominantly female, single, without children, from geographic areas within the Greater Metropolitan Area (GMA), graduated from public schools with an average admission exam grade of 612,2.

El objetivo de esta investigación fue determinar algunas de las características sociodemográficas y académicas de los estudiantes que ingresaron a la carrera de Odontología en el período 2007 al 2014. Se recopilaron los datos de 673 expedientes de los estudiantes. Las variables consideradas fueron: sexo, edad de ingreso, estado civil, hijos, nacionalidad, lugar de procedencia, colegio de procedencia y nota de examen de admisión. Los datos se obtuvieron de la base de datos del Sistema de Aplicaciones Estudiantiles (SAE), los expedientes físicos y del Tribunal Supremo de Elecciones de Costa Rica. Se realizó estadística descriptiva estableciendo la frecuencia absoluta y relativa de las variables. Se empleó el test de Mann Whitney para determinar si existían diferencias estadísticamente significativas entre el examen de admisión y las variables sociodemográficas establecidas (p<0,05, IC 95%). El 68,4% de los estudiantes pertenecen al sexo femenino. La edad promedio fue de 18,4 años (DS=2,41). El 99,0% de los discentes son de nacionalidad costarricense. El 99,3% eran solteros y sólo el 0,9% tenían hijos. La mayor cantidad de estudiantes ingresaron por examen de admisión (78,9%) y el 50,7% cursó sus estudios en un colegio público. Respecto al domicilio, el 77,9% de los sujetos residían en el Gran Área Metropolitana. El promedio de nota del examen de admisión fue de 613,8 (DS=49,95). Hubo una diferencia estadísticamente significativa entre la nota del examen de admisión y los diferentes tipos de colegios de procedencia. El grupo de estudiantes que ingresaron a formarse como Odontólogos en la Universidad de Costa Rica en el periodo de 2007 al 2014 fue una población con un promedio una edad de ingreso de 18,4 años predominantemente femenina, costarricense, soltera, sin hijos, proveniente de áreas geográficas dentro del Gran Área Metropolitana (GAM), egresadas de colegios públicos con un promedio de nota de examen de admisión de 612,2.

Diferencias en el abordaje de dos premolares inferiores con dens evaginatus: reporte de caso / Diferencas na abordagem de dois pré-molares inferiores com dens evaginatus: relato de caso / Differences in the approach of two lower premolars with dens evaginatus: case report

El dens evaginatus es una anomalía dentaria de forma que consiste en una elevación del esmalte en forma de cúspide o tubérculo que se ubica en el surco central o en la zona bucal de las cúspides de premolares o molares, así como en las superficies palatinas de dientes anteriores. La estructura interna del tubérculo está formada por una capa de esmalte que recubre un núcleo de dentina el cual contiene, en el 90% de los casos una evaginación de tejido pulpar. En este artículo se reporta el caso de un paciente de ascendencia asiática con dos premolares inferiores con dens evaginatus las cuales fueron abordadas de diferente forma: una premolar recibió tratamiento preventivo y mínimamente invasivo mientras que la otra premolar requirió un tratamiento pulpar

Dens evaginatus é uma anormalidade dentaria que consiste em uma elevação do esmalte em forma de cúspide ou tubérculo que se localiza no sulco central ou na zona bucal das cúspides de pré-molares ou molares, bem como nas superficies palatinas dos dentes anteriores. A estructura interna do tubérculo é formada por uma camada de esmalte que recobre um núcleo de dentina que contém, em 90% dos casos, uma evaginação de tecido pulpar. Neste artigo relata o caso de um paciente de ascendência asiática com duas pré-molares inferiores com dens evaginatus, que foram abordados de forma diferente: um pré-molar recebeu tratamento preventivo e minimamente invasivo enquanto a outra pré-molar necessitou de tratamento pulpar

Dens evaginatus is a dental abnormality consisting of a cusp- or tubercle-shaped elevation of the enamel that is in the central groove or in the buccal area of the cusps of premolars or molars, as well as on the palatal surfaces of teeth. The internal structure of the tubercle is formed by a layer of enamel that covers a core of dentin which contains, in 90% of cases, an evagination of pulp tissue. This article reports the case of a patient of Asian descent with two lower premolars with dens evaginatus, which were approached differently: one premolar received preventive and minimally invasive treatment while the other premolar required root canal treatment.

Patient satisfaction regarding biosecurity protocols in the face of COVID-19, Faculty of Dentistry, University of Costa Rica / Satisfacción de los pacientes respecto a los protocolos de bioseguridad ante el COVID-19, Facultad de Odontología, Universidad de Costa Rica

Abstract Biosecurity protocols are particularly important in dental practice. The aim of this research was to determine the level of patient satisfaction regarding biosecurity protocols used in the School of Dentistry of the University of Costa Rica, to avoid COVID-19 infections during dental care. A survey was sent by email to all patients who received dental consultations at the School of Dentistry between April and September 2021. They were asked about sociodemographic variables (sex, age range, approved educational level, and place of origin), as well as whether they considered safe the protocols used during the dental consultation to avoid COVID-19 infections. Descriptive statistics were performed proving the absolute and relative frequency of the socio-demographic variables and the satisfaction of patients with the protocols used. A Chi-square test was used to determine if there was a difference in patient satisfaction with biosecurity protocols to avoid COVID-19 infections during dental care and sociodemographic variables. 95.9% of the respondents considered the biosafety protocols used to be safe and there was no statistically significant difference between patient satisfaction with the protocols and sociodemographic variables. A large majority of patients who come to the UCR School of Dentistry are satisfied with the biosecurity protocols used to avoid COVID-19 infections during dental care.

Resumen Los protocolos de bioseguridad son muy importante en la consulta odontológica. El objetivo de esta investigación fue conocer el nivel de satisfacción de los pacientes respecto a los protocolos de bioseguridad utilizados en la Facultad de Odontología para evitar los contagios por COVID-19 durante la atención dental. Se envió una encuesta por medio del correo electrónico a todos los pacientes que recibieron consulta dental en la Facultad de Odontología entre abril y setiembre del 2021. Se les consultó sobre variables sociodemográficas (sexo, rango de edad, nivel educativo aprobado y lugar de procedencia), así como si consideraban seguros los protocolos empleados durante la consulta dental para evitar los contagios por COVID-19. Se realizó estadística descriptiva estableciendo la frecuencia absoluta y relativa de las variables sociodemográficas y la satisfacción de los pacientes con los protocolos empleados en la Facultad. Se utilizó la prueba de chi cuadrado para determinar si existía diferencia en la satisfacción de los pacientes respecto a los protocolos de bioseguridad para evitar los contagios por COVID-19 durante la atención dental y las variables sociodemográficos. El 95.9% de los encuestados consideró seguros los protocolos de bioseguridad empleados y no hubo diferencia estadísticamente significativa entre la satisfacción de los pacientes con los protocolos y las variables sociodemográficas. Una gran mayoría de los pacientes que acuden a la Facultad de Odontología UCR están satisfechos con los protocolos de bioseguridad empleados para evitar los contagios por COVID-19 durante la atención dental.

Gestational phthalate exposure and lung function during childhood: A prospective population-based study.

The potential effect of gestational exposure to phthalates on the lung function levels during childhood is unclear. Therefore, we examined this association at different ages (from 4 to 11 years) and over the whole childhood. Specifically, we measured 9 phthalate metabolites (MEP, MiBP, MnBP, MCMHP, MBzP, MEHHP, MEOHP, MECPP, MEHP) in the urine of 641 gestating women from the INMA study (Spain) and the forced vital capacity (FVC), forced expiratory volume in 1 s (FEV1) and FEV1/FVC in their offspring at ages 4, 7, 9 and 11. We used linear regression and mixed linear regression with a random intercept for subject to assess the association between phthalates and lung function at each study visit and for the overall childhood, respectively. We also assessed the phthalate metabolites mixture effect on lung function using a Weighted Quantile Sum (WQS) regression. We observed that the phthalate metabolites gestational levels were consistently associated with lower FVC and FEV1 at all ages, both when assessed individually and jointly as a mixture, although most associations were not statistically significant. Of note, a 10% increase in MiBP was related to lower FVC (-0.02 (-0.04, 0)) and FEV1 z-scores (-0.02 (-0.04, -0.01) at age 4. Similar significant reductions in FVC were observed at ages 4 and 7 associated with an increase in MEP and MnBP, respectively, and for FEV1 at age 4 associated with an increase in MBzP. WQS regression consistently identified MBzP as an important contributor to the phthalate mixture effect. We can conclude that the gestational exposure to phthalates was associated with children's lower FVC and FEV1, especially in early childhood, and in a statistically significant manner for MEP, MiBP, MBzP and MnBP. Given the ubiquity of phthalate exposure and its established endocrine disrupting effects in children, our findings support current regulations that limit phthalate exposure.

Association between phenols and thyroid hormones: The role of iodothyronine deiodinase genes.

Previous literature on prenatal phenol exposure and thyroid hormone (TH) alteration is conflicting, and the possible mechanisms of action involved remain unclear. We aimed to examine the association between prenatal phenol exposure and levels of maternal and neonatal THs, as well as the possible role of iodothyronine deiodinase (DIO) gene polymorphisms in this relation. We studied 387 Spanish mother-neonate pairs with measurements of maternal phenols, total triiodothyronine (TT3) and free thyroxine (FT4), maternal and neonatal thyroid-stimulating hormone (TSH), and maternal genotypes for single nucleotide polymorphisms in the DIO1(rs2235544) and DIO2(rs12885300) genes. We implemented multivariate linear and weighted quantile sum (WQS) regressions to examine the association between phenols and THs (including sex-stratified models for neonatal TSH) and investigated effect modification of genotypes in the maternal phenol-TH associations. In single exposure models, we found negative associations between maternal triclosan (TCS) and neonatal TSH (% change [95%CI]: -2.95 [-5.70, -0.11], per twofold phenol increase) - stronger for girls - and less clearly for maternal ethylparaben (EPB) and TSH (-2.27 [-4.55, 0.07]). In phenol mixture models, we found no association with THs. In the genetic interaction models, we found some evidence of effect modification of DIO gene polymorphisms with stronger negative associations between methylparaben (MPB), propylparaben (PPB), butylparaben (BPB) and TT3 as well as bisphenol A (BPA) and FT4 for DIO1(rs2235544)-CC. Stronger inverse associations for genotypes DIO2(rs12885300)-CC and DIO2(rs12885300)-CT and positive ones for DIO2(rs12885300)-TT were also reported for BPA and FT4. In conclusion, we found some evidence of an association between phenols and TSH during pregnancy and at birth in single exposure models, the latter being stronger for girls. Since no association was observed between maternal levels of phenols and TT3 or FT4, the possible role of the genetic background in these associations warrants further investigation.

The Tracking of Moist Habitats Allowed Aiphanes (Arecaceae) to Cover the Elevation Gradient of the Northern Andes.

The topographic gradients of the Tropical Andes may have triggered species divergence by different mechanisms. Topography separates species' geographical ranges and offers climatic heterogeneity, which could potentially foster local adaptation to specific climatic conditions and result in narrowly distributed endemic species. Such a pattern is found in the Andean centered palm genus Aiphanes. To test the extent to which geographic barriers and climatic heterogeneity can explain distribution patterns in Aiphanes, we sampled 34 out of 36 currently recognized species in that genus and sequenced them by Sanger sequencing and/or sequence target capture sequencing. We generated Bayesian, likelihood, and species-tree phylogenies, with which we explored climatic trait evolution from current climatic occupation. We also estimated species distribution models to test the relative roles of geographical and climatic divergence in their evolution. We found that Aiphanes originated in the Miocene in Andean environments and possibly in mid-elevation habitats. Diversification is related to the occupation of the adjacent high and low elevation habitats tracking high annual precipitation and low precipitation seasonality (moist habitats). Different species in different clades repeatedly occupy all the different temperatures offered by the elevation gradient from 0 to 3,000 m in different geographically isolated areas. A pattern of conserved adaptation to moist environments is consistent among the clades. Our results stress the evolutionary roles of niche truncation of wide thermal tolerance by physical range fragmentation, coupled with water-related niche conservatism, to colonize the topographic gradient.

Conocimiento acerca del manejo inmediato del trauma dental en un grupo de docentes de preescolar y primaria en Costa Rica / Immediate management dental trauma knowledge of preschool and primary school teachers in Costa Rica

Objetivo. Determinar el grado de conocimiento en el manejo inmediato del trauma dental en los profesores de preescolar y primaria en la provincia de Cartago en Costa Rica. Métodos. Se realizó un estudio observacional de corte transversal en el que se aplicó una encuesta enviada vía correo electrónico a un grupo de docentes. Se incluyeron variables sociodemográficas y de conocimiento referente a la atención del trauma dental en niños/as. El total de instituciones participantes fue de 11 (6 públicas y 5 privadas). La encuesta fue respondida por 60 docentes de instituciones públicas y 141 de centros privados. Se creó un puntaje de conocimiento, asignando 1 punto para las respuestas correctas y 0 puntos para las respuestas incorrectas. Las puntuaciones mayores a 4 fueron consideradas como "conocimiento adecuado" acerca del trauma dental y su manejo. Se realizó una estadística descriptiva de las variables y la prueba de chi cuadrado para determinar si existía diferencia en el grado de conocimiento de los docentes respecto a la atención inmediata del trauma dental según las variables sociodemográficas. Resultados. Solo un 24% de los docentes obtuvo una puntuación superior a 4. Además, se encontró una relación estadísticamente significativa entre algunas variables: a mayor edad, mayor experiencia docente y haber sido testigo de situaciones de trauma dental, mayor es el conocimiento de los docentes en esta área. Conclusiones. Los docentes de preescolar y primaria del Circuito 1 de la provincia de Cartago poseen, en su mayoría, un bajo conocimiento para la atención inmediata del trauma dental

Objective. To determine the degree of knowledge in the immediate management of dental trauma in preschool and primary school teachers in the province of Cartago in Costa Rica. Methods. A cross-sectional observational study was performed. An electronic survey was sent via email to a group of teachers. Sociodemographic and knowledge variables regarding dental trauma care in children were included. Eleven schools participated in the study (6 public and 5 private). The survey was answered by 60 teachers from public institutions and 141 from private schools. A knowledge of score was created, assigning 1 point for correct answers and 0 points for incorrect answers Scores greater than 4 were considered as "adequate knowledge" about dental trauma and its management. Descriptive statistics of the variables and the chi-square tests were performed to determine if there was a difference in the degree of knowledge of the teachers regarding the immediate care of dental trauma according to the sociodemographic variables. Results. Only 24% of the teachers obtained a score higher than 4. In addition, a statistically significant relationship was found between some variables: the older they are, the more experienced they are in teaching, and having witnessed situations of dental trauma, the greater the knowledge of the teachers in this area. Conclusions. Preschool and primary teachers of Circuit 1 of the province of Cartago have, mostly, little knowledge for the immediate care of dental trauma.

Prevalence of neuromyelitis optica spectrum disorder in antioquia between 2016 and 2018.

BACKGROUND: There are few epidemiological studies published in the world evaluating the prevalence of Neuromyelitis Optica Spectrum Disorder (NMOSD). The true prevalence of the disease is not known and the studies carried out are based on the diagnostic criteria used prior to 2015. OBJECTIVE: To determine the prevalence of NMOSD in Antioquia, from January 2016 to December 2018. METHODS: The prevalence of NMOSD in Antioquia was determined using the Capture-Recapture Method. Eight centers in the Department of Antioquia for the care of patients with neurological diseases were included. The data was collected between 2016 and 2018. RESULTS: A total of 221 consultation histories, 169 patients with a diagnosis of NMOSD were identified. The prevalence was 4.03 cases/100,000 inhabitants (95% confidence interval (CI) 3.3-4.8) of whom (87.5%), were women and the predominant race was Mestizo (81.6%). The most frequent initial presentation was optic neuritis (ON) (50.9%). Most of the patients had motor or visual disability (86.4%) and the treatment most used was Rituximab (47.9%). CONCLUSION: The prevalence of NMOSD in Antioquia is one of the highest reported in the world, except for the French Antilles. More studies are required to know the prevalence of this disease in the Colombian population.

Age and sequence of emergence of permanent teeth in a population of Costa Rican school children / Edad y secuencia de erupción de la dentición permanente en una población de niños escolares en Costa Rica

ABSTRACT: The aim of this study was to determine the average age and sequence of eruption of permanent dentition in the school population of the province of Cartago, Costa Rica. Methods: A cross-sectional observational study included children between the ages of 5 and 12 from public and private schools. Clinical examination was performed, and the presence or absence of permanent teeth recorded. Statistical analysis: An estimation of means of eruption was used through binary variables, building the probabilities of the presence of a dental piece through a logistic regression. Results: 833 children were examined: 433 (51.90%) girls and 400 (48.10%) boys. The permanent teeth erupt first in the female sex; however, this difference is not statistically significant. The maxilla eruption sequence for girls was 6-1-2-4-3-5-7 on both sides; for boys, the sequence of eruption was 6-1-2-4-5-3-7 for the right side and 6-1-2-4-3-5-7 for the left side. In the jaw, the sequence in boys was 6-1- 2-3-4-5-7, and in girls, 1-6-2-3-4-5-7. Conclusions: For the first time, at the Central American Level, the pattern of permanent dentition eruption could be established. The age of permanent dental eruption does not vary according to sex in this population.

RESUMEN: El objetivo de este estudio fue determinar la edad promedio y la secuencia de erupción de la dentición permanente en la población escolar de la provincia de Cartago, Costa Rica. Metodología: se realizó un estudio transversal que incluyó niños con edades comprendidas entre los 5 y 12 años provenientes de escuelas públicas y privadas. Se realizó un examen clínico y se registró la presencia o ausencia de dientes permanentes. Análisis estadístico: se utilizó una estimación de las medias de erupción a través de variables binarias, construyendo las probabilidades de la presencia de una pieza dental por medio de una regresión logística. Resultados: se examinaron 833 sujetos: 433 (51,90%) niñas y 400 (48,10%) niños. Los dientes permanentes erupcionaron primero en el sexo femenino, sin embargo, esa diferencia no fue estadísticamente significativa. La secuencia de erupción maxilar para las niñas fue 6-1-2-4-3-5-7 en ambos lados; para los niños la secuencia fue 6-1-2-4-5-3-7 para el lado derecho y 6-1-2-4-3-5-7 para el lado izquierdo. En la mandíbula, la secuencia en los niños fue de 6-1-2-3-4-5-7-, y en las niñas fue de 1-6-2-3-4-5-7. Conclusiones: por primera vez a nivel de Centroamérica se pudo establecer el patrón de erupción de la dentición permanente. La edad de erupción dental permanente no varía según el sexo en esta población.

Corrective Treatment of Ectopic Eruption of Permanent First Molars: Case Report / Tratamiento correctivo de erupción ectópica de primeros molares permanentes: Reporte de casos

ABSTRACT: Ectopic eruption of a tooth is the process in which a tooth emerges in an abnormal position. The first permanent molar is the tooth that most frequently presents ectopic eruption, mostly because it is retained below the distal contour of the second temporary molar. The ectopic eruption may be reversible or irreversible, the latter of which requires corrective treatment to achieve correct eruption of the permanent molar in the arch. Treatments can be minimally invasive, such as the use of interproximal wedging, or more invasive orthodontic devices, such as brass wire, k-loops, Halterman devices, or wedging springs. The aim of this case report is to present two clinical cases where the ectopic eruption of permanent first molars is corrected using elastic separators. Conclusion:The elastic separators could be used successfully in cases of moderate or severe ectopic eruptions, not only in mild cases, as reported in most of the literature. The use of this technique does not require great cooperation from the patient, and it is low in cost.

RESUMEN: La erupción ectópica de un diente es el proceso por el cual el diente emerge en una posición anormal. La primera molar permanente es el diente que más frecuentemente presenta erupción ectópica, ya que, en su proceso de erupción, queda retenida debajo del contorno distal de la segunda molar temporal. La erupción ectópica puede ser reversible o irreversible, si es irreversible requiere tratamiento correctivo para lograr que la molar permanente erupciones correctamente en el arco. Los tratamientos pueden ser poco invasivos como el uso de separados elásticos o más invasivos con aparatos ortodóncicos tales como brass wire, k-loop, Halterman o wedging spring. El objetivo del presente artículo es presentar dos casos clínicos donde se corrige la erupción ectópica de primeros molares permanentes utilizando separadores elásticos. Conclusión: los separadores elásticos pueden usarse con éxito en casos de erupciones ectópicas moderadas o severas, no sólo en casos leves como reporta la mayoría de la literatura. El uso de esta técnica no requiere gran cooperación por parte del paciente y es de bajo costo económico.

[Degree of satisfaction of dental students regarding the use of educational games during the COVID-19 pandemic]. / Grado de satisfacción de estudiantes de odontología respecto al empleo de juegos didácticos en tiempos de pandemia por COVID-19.

Objetive: To determine the degree of student satisfaction regarding the use of didactic games in Infantile Odontology I at the School of Dentistry of the Costa Rica University. Methods: This was a descriptive study with a qualitative approach. Five didactic games were created using the Educaplay application and were implemented alternately: evaluation of cariogenic risk, general pathology of children, early childhood cries, dental remineralization and anatomy of temporal pieces. At the end of the course, a survey was sent by institutional mail to the 52 students to assess the use of the games. Results: 38 students answered the survey, with 97.4% considering the didactic games useful or very useful in the lessons. Furthermore, 65.8% indicated that the games had greatly helped to improve learning and 71.1% stated that the classes in which the game was applied were more dynamic. In addition, 92.1% of the respondents would like this dynamic to be implemented in other courses. Conclusions: The students of Infantile Odontology I reported a high degree of satisfaction regarding the use of didactic games during the lessons, describing that the games maintain motivation.

Paramolares bilaterales maxilares no erupcionados y su abordaje quirúrgico: reporte de un caso inusua / Paramolares bilaterais superiores não erupcionados e sua abordagem cirúrgica: relato de caso incomun / Non-erupted maxillary bilateral paramolars and their surgical approach: unusual case report

El término dientes supernumerarios se refiere al exceso en el número normal de dientes ya sea en la dentición primaria como en la permanente, pueden presentarse de forma única o múltiple, unilateral o bilateral, tanto en maxilar como en mandíbula. Un paramolar es un molar supernumerario generalmente rudimentario ubicado en posición vestibular o palatino de uno de los molares o en el espacio interproximal al segundo y tercer molar. Su prevalencia es menor al 0,20%, se presentan más en hombres que en mujeres y generalmente se encuentran erupcionados. En el presente artículo se reporta el caso inusual de una paciente femenina con paramolares maxilares bilaterales no erupcionados los cuales fueron removidos quirúrgicamente sin complicaciones

A O termo dentes supranumerário se refere ao excesso no número normal de dentes, seja na dentição decídua ou permanente, podendo ocorrer de forma única ou múltipla, unilateral ou bilateral, tanto na maxila quanto na mandíbula. Um paramolar é um molar supranumerário geralmente rudimentar localizado na posição vestibular ou palatina de um dos molares ou no espaço interproximal do segundo e terceiro molares. Sua prevalência e inferior a 0,20%, ocorrem mais em homens do que em mulheres e geralmente surgem. Neste artigo, relatamos o caso incomum de uma paciente do sexo feminino com paramolares superiores bilaterais não erupcionados, que foram removidos cirurgicamente sem complicações

The term supernumerary teeth refer to the excess in the normal number of teeth, either in the temporary or in the permanent dentition, it can appear in a single or multiple forms, unilateral or bilateral, both in the maxilla and in the mandible. A paramolar is a generally rudimentary supernumerary molar located in the vestibular or palatal position of one of the molars or in the space interproximal to the second and third molars. Prevalence is less than 0,2%, they are more frequent in men than in women and are generally erupted. This article reports the unusual case of a female patient with unerupted bilateral maxillary paramolars which were surgically removed without complications

Frecuencia de anomalías dentales de número en niños costarricenses atendidos en la Facultad de Odontología de la Universidad de Costa Rica / Frequency of Teeth Number Anomalies in Costa Rican Children at the Faculty of Dentistry University of Costa Rica

Resumen 16. Las anomalías dentales pueden producir alteraciones de forma, número, tamaño y estructura dental, afectando la función y la estética. El objetivo del presente estudio es determinar la frecuencia y localización de anomalías dentales de número en niños sanos costarricenses entre los 6 y 12 años. Se realizó un estudio observacional y retrospectivo con 157 radiografías panorámicas de los expedientes de los pacientes de la Clínica de Odontopediatría y Ortodoncia de la Universidad de Costa Rica entre los años 2015-2017; las anomalías que se observaron fueron hiperdoncias e hipodoncias. Los datos fueron analizados utilizando la prueba de Fisher con un nivel de significancia del 5%. Se encontró un 8.3% de anomalías de número, 4.5% fueron hiperdoncias y 3.8% hipodoncias, ambas anomalías se presentaron tanto de forma única como doble o múltiple. No se encontró diferencia estadísticamente significativa según el género. Las hiperdoncias fueron más comunes en maxila y las hipodoncias en mandíbula. Los dientes supernumerarios más frecuentes fueron los mesiodens y las ausencias más recurrentes fueron los segundos premolares inferiores.

Abstract 20. Dental anomalies can produce alterations in dental shape, number, size, and structure, affecting function and aesthetics. The objective of this study is to determine the frequency and location of teeth number anomalies in healthy Costa Rican children between 6 and 12 years old. An observational and retrospective study was carried out with 157 panoramic radiographs of the patients of the pediatric dentistry and orthodontics clinic of the University of Costa Rica between the years 2015-2017. Hyperdontias and hypodontias were the anomalies observed. Data were analyzed using a Fisher exact test with a significance level of 5% . The results showed that the overall frequency of dental anomalies was 8.3%, 4.5% were hyperdontias and 3.8% hypodontias. Double or multiple hyperdontia and hypodontia were also found. The difference between sex was not significant (p= 0.145). Supernumeraries were more frequent in maxilla and hypodontias in mandible. Mesiodens was the most frequently found supernumerary teeth. Mandibular second premolars were the most commonly missing teeth.

Evaluación in vitro de la dureza superficial en amalgamas y coronas de acero cromado / Avaliação in vitro da dureza superficial em amálgamas e coroas de aço / In vitro evaluation of micro-hardness of amalgam and stainless-steel crowns

Introducción: la elección del material restaurador es uno de los puntos críticos cuando se va a restaurar un diente temporal. Tradicionalmente, la corona de acero cromado ha sido empleada en dientes con extensa destrucción coronal o posterior a un tratamiento pulpar; no obstante, la amalgama también ha sido muy utilizada. Existen estudios que miden el porcentaje de éxito a nivel clínico de dichos materiales, sin embargo, no hay investigaciones que midan y comparen las propiedades físicas. Objetivo: evaluar la dureza superficial en amalgamas y coronas de acero cromado. Materiales y método: se confeccionaron 15 cuerpos de prueba de amalgama SDI tipo GS80, y 15 cuerpos de prueba con un trozo de corona de acero cromado marca 3M. Los cuerpos de prueba se elaboraron en dos tiempos diferentes, unos fueron alma-1. DDS, Especialista en Odontopediatría. Profesora de Odontopediatría, Facultad de Odontología, Universidad de Costa Rica, San José, Costa Rica. 2. DDS, MSc. Profesora, Facultada de Odontología, ULACIT Universidad Latinoamericana de Ciencia y Tecnología, San José, Costa Rica. cenados por 4 años y los otros por 3 días al 100% de humedad relativa. A cada cuerpo de prueba se le hicieron 2 indentaciones con el microdurómetro Micromet 2001 para determinar la dureza superficial. Los resultados obtenidos fueron evaluados por el test ANOVA (p≤0,05) Resultados: se comprobó que la media de la dureza superficial de la corona de acero cromado es significativamente mayor que la media de la amalgama (p=0,000). La dureza superficial de la amalgama aumenta de forma significativa con el tiempo de almacenamiento (p=0,000). Conclusiones: el material que presentó mayor dureza superficial fue la corona de acero cromado. Los valores de microdureza de la amalgama son tiempo-dependientes, no así los valores registrados con las coronas de acero cromado.

Introdução: a seleção do material restaurador é um ponto crítico no momento da restauração de dentes decíduos.Tradicionalmente, a coroa de aço tem sido utilizada em dentes com muita destruição coronária ou após tratamento endodôntico, porém o amálgama pode também ser utilizado nesses casos. Existem estudos que determinam a porcentagem de sucesso a nível clínico desses materiais, no entanto, poucas pesquisas medem e comparam as propriedades físicas. Objetivo: avaliar a dureza superficial em amálgamas dentais e coroas de aço. Materiais e método: foram elaborados 15 corpos de prova de amálgama SDI tipo GS80, e 15 corpos de prova com um fragmento de coroa de aço marca 3M. A fabricação dos corpos de prova ocorreu em dois tempos distintos, sendo alguns armazenados por 4 anos e outros por 3 dias a 100% de umidade relativa. A dureza superficial foi determinada a partir de duas endentações feitas com o microdurômetro Micromet 2001 em cada corpo de prova. Os resultados foram avaliados com o teste de ANOVA (p≤0,05). Resultados: a média da dureza superficial da coroa de aço foi significativamente maior que a média da dureza do amálgama (p=0,000). A dureza superficial do amálgama aumenta significativamente conforme o tempo de armazenamento (p=0,000). Conclusões: a coroa de aço foi o material que apresentou maior dureza superficial. Os valores da microdureza do amálgama são tempo-dependentes, diferentemente dos valores da coroa de aço.

Introduction: the choice of the restorative material is critical for the restoration of primary teeth. Traditionally, stainless-steel crowns have been used in teeth with extensive crown destruction or after pulp treatment; however amalgam can be used too. There are studies that have measured the clinical success of these materials; however, there are no reports that have measured and compared the physical properties between them. Aim: evaluate the micro-hardness of dental amalgam and stainless steel crown. Method and materials: test objects of SDI amalgam type GS80 (15) and 3M stainless-steel crown (15) were made in two different times, some were stored for 4 years and the others for 3 days at 100% relative humidity. Two indentations were made to each test object with the Micromet 2001 microdurometer to determine the micro-hardness. The results obtained were evaluated by the ANOVA test (p≤0.05). Results: the average of the microhardness stainless steel crown was significantly higher than the average of the amalgam (p=0.000). The micro-hardness of the amalgam increases significantly with the storage time (p=0.000). Conclusions: the stainless-steel crown was the material with the highest micro-hardness. The micro-hardness values of the amalgam are time-dependent.