[Kawasaki disease versus Multisystem Inflammatory Syndrome COVID-19 with Kawasaki disease phenotype. Single-center experience]. / Enfermedad de Kawasaki versus Síndrome Inflamatorio Multisistémico COVID 19 con fenotipo enfermedad de Kawasaki. Experiencia de un centro.

In pediatrics, a process called Pediatric Inflammatory Multisystem Syndrome (PIMS) associated with recent infection by SARS-CoV-2 virus has been observed. One of its variants presents similarities with Kawasaki disease (KD). OBJECTIVE: to compare the clinical presentation, laboratory testing, and evolution of KD with PIMS Kawasaki phenotype (PIMS-KD) in patients hospitalized before the pandemic, compared with the pandemic period. PATIENTS AND METHOD: Cross-sectional study in two groups of patients at the Hospital Exequiel González Cortés: typical KD (group 1) and PIMS-KD (group 2). Data on demographic, clinical, and biochemical details were collected, as well as echocardiogram, treatment, and evolution records. IgG and IgM serology for SARS-CoV-2 was performed in both groups. RESULTS: In the KD group and the PIMS-KD group, 20 and 33 patients were analyzed, respectively. There were differences in age, days of fever, count of leukocytes, lymphocytes, and platelets, erythrocyte sedimentation rate (ESR), and hospital stay. In 25% of the KD group, there were alterations in the echocardiogram and, in the PIMS-K group, all patients received corticosteroids and 25 patients received intravenous immunoglobulin (IVIG). In both groups, a favorable clinical evolution was observed, characterized by the absence of complications and mortality. CONCLUSIONS: Based on the data obtained in our study, the importance of the epidemiological link is emphasized as an essential factor in differentiating between both pathologies, highlighting the need to consider factors such as age, duration of fever, count of leukocytes, lymphocytes, and platelets, and degree of cardiac involvement, for a differential evaluation between patients with PIMS-KD versus KD.

Remodeling dental anatomy vs sham therapy for chronic temporomandibular disorders. A placebo-controlled randomized clinical trial.

BACKGROUND: Evidence regarding the etiology or effective treatments for chronic orofacial pain, the majority diagnosed as temporomandibular disorder (TMD), is limited. PURPOSE: To investigate whether occlusal equilibration therapy (ET) and decreasing the (higher) angle of the lateral guidance on the nonworking-side leads to a reduction in chronic TMDs intensity. METHODS: It was conducted a randomized, explanatory, single blind with blinded assessment, placebo-controlled trial with strong protection against bias involving patients with chronic TMDs. Participants were randomly assigned to receive equilibration therapy or sham therapy. ET in this study consisted of minimal invasive occlusal remodeling to obtain balanced occlusion with reduction of the steeper angle of lateral mandibular movement with respect to the Frankfort plane. The primary outcome was a change in the pain intensity score (on a 0-10 point scale, with 0 indicating no pain and 10 the worst possible pain) at month 6. Secondary outcomes include maximum unassisted mouth opening and psychological distress. RESULTS: A total of 77 participants underwent randomization, 39 of whom received ET and 38 sham therapy. The trial was stopped early for efficacy, according to preestablished rules when 67 participants (n = 34, n = 33, respectively) had completed the analysis. At month 6, the mean unadjusted pain intensity score was 2.1 in the ET and 3.6 in the sham therapy group (adjusted mean difference, -1.54; 95% confidence interval [CI] -0.5 to -2.6; P = 0.004; ANCOVA model). The mean increase in maximum unassisted mouth opening (main secondary outcome) was significantly higher in the real therapy group (adjusted mean difference 3.1 mm, 95% CI 0.5-5.7, p = 0.02). CONCLUSION: ET significantly reduced the intensity of facial pain associated with chronic TMDs and increased maximum unassisted mouth opening, as compared with sham therapy, over the course of 6 months. There were no serious adverse events. Funded by the Instituto de Salud Carlos III from the Ministry of Science and Innovation of the Government of Spain and European Regional Development Fund, Grant nº PI11/02507; "una manera de hacer Europa".

Asymmetry of dental or joint anatomy or impaired chewing function contribute to chronic temporomandibular joint disorders.

INTRODUCTION: The etiologies of most chronic temporomandibular joint disorders are unknown. However, an association between habitual chewing on a particular side and chronic temporomandibular joint disorders has been reported. The aim of this study was to investigate the differences between sides (affected vs unaffected) of biodynamic factors (including lateral dental guidance determined by dental anatomy) or condylar path angles (determined by temporomandibular joint morphology) and chewing function (physiological alternate chewing vs single habitual chewing side). The study scope was to investigate possible etiological factors to improve the understanding of temporomandibular joint disorders. The null hypothesis was that no difference would be found between sides that are or are not affected by chronic temporomandibular joint disorders in chewing function or in levels of dental or temporomandibular joint remodeling. METHODS: This cross-sectional, double-blind study involved 24 adults with substantial, chronic, unilateral symptoms diagnosed as temporomandibular joint disorders. Chewing function, temporomandibular joint remodeling (using axiography) and dental anatomy (lateral guidance angles using kinesiography) were assessed. RESULTS: Habitual chewing on one particular side was observed in 17 of 24 participants; significantly more (n=15) chewed on the affected side than on the unaffected side (P=0.002 in a two-tailed Fisher's exact test; risk estimate=4.5; 95% CI 1.326-15.277). The condylar path (CP) angle was steeper on the affected side than on the unaffected side (mean (standard deviation)=50.52° (9.98°) versus 45.50° (7.98°); P=0.002 in a two-tailed t-test). The lateral guidance (LG) angles were flatter on the affected side in all 24 participants. CONCLUSION: Our results suggest that habitual chewing on one side may be associated with increasing condylar path, with flattening lateral guidance angles, and also with chronic temporomandibular joint disorder on the habitual chewing side.

Jaw biodynamic data for 24 patients with chronic unilateral temporomandibular disorder.

This study assessed 24 adult patients, suffering from severe chronic unilateral pain diagnosed as temporomandibular joint (TMJ) disorder (TMD). The full dentate patients had normal occlusion and had never received an occlusal therapy, i.e., were with natural dental evolution/maturation. The following functional and dynamic factors were assessed: (1) chewing function; (2) TMJ remodeling or the condylar path (CP); and (3) lateral jaw motion or lateral guidance (LG). CPs were assessed using conventional axiography, and LG was assessed by K7 jaw tracking. Seventeen (71%) of the 24 (100%) patients consistently showed a habitual chewing side. The mean (standard deviation [SD]) of the CP angles was 47.90 (9.24) degrees. The mean (SD) of the LG angles was 42.95 (11.78) degrees. Data collection emerged from the conception of a new TMD paradigm where the affected side could be the habitual chewing side, the side with flatter lateral jaw motion or the side with an increased CP angle. These data may lead to improved diagnosis, therapy plans and evolution in TMD patients.

[Role-playing in the teaching-learning process of the nursing degree. Assessment of graduate (profesionals)]. / Role-playing en el proceso de enseñanza-aprendizaje. Evaluación de los egresados (profesionales) de la licenciatura de enfermería.

OBJECTIVES: To assess role-playing as a methodology in the teaching-learning process for the Nursing Degree. To identify the attitude of alumni (professionals) towards role-playing after entering the job market. INTRODUCTION: One of the worst fears of students is facing real situations that they will have to face soon, when they become professionals. Role-playing is a tool that allows the students act out real situations and reduce their concerns. PARTICIPANTS AND CONTEXT: Five alumni (nurses) from the Nursing School of the University of Alicante. Academic years 2006-2007 and 2007-2008. METHODOLOGY: The reflexive nature of qualitative research is based on symbolic interactionism. COLLECTION OF DATA-SUMMARIES: The subject category chosen is role-playing and it is sorted into subcategories and codes. CONCLUSIONS: Findings from the analysis of the summaries have allowed us to see what actually happens when using role-playing as a teaching-learning tool in nursing, and what the consequences are for professionals, once they finish their studies.

Roleplaying en el proceso de enseñanza-aprendizaje de enfermería: valoración de los profesores / Role-playing in the teaching process in nursing: evaluation by professors

El objetivo de este estudio es evaluar el roleplaying como herramienta metodológica en el proceso de enseñanza-aprendizaje de pregrado en enfermería, identificando las actitudes de los profesores ante el role playing, y analizando los comentarios de estos después de su utilización en el aula. Investigación de naturaleza reflexiva y enfoque cualitativo basado en la interacción simbólica. La recolección de datos se realizó durante los años académicos 2006-2007 y 2007-2008, a dos profesores de la asignatura del tercer año en la Escuela de Enfermería "X". Los resultados muestran el roleplaying como categoría temática seleccionada y permiten la clasificación en subcategorías y códigos. El análisis de los datos permitió identificar lo que realmente sucede con el roleplaying como herramienta metodológica en el proceso de enseñanza-aprendizaje de enfermería, por qué y cuáles son sus consecuencias.

Using role playing in the integration of knowledge in the teaching-learning process in nursing: assessment of students / Utilización del role playing en la integración de conocimientos en el proceso de enseñanza-aprendizaje de enfermería: valoración de los estudiantes / Usando role playing na integração do conhecimento no processo ensino-aprendizagem em enfermagem: avaliação dos alunos

To assess role-playing as a methodology in the teaching-learning process for the Nursing Degree. To identify the attitude of nursing students towards role-playing. To analyze the response of students to their teaching-learning process after role-playing. Relationship is one of the main functions of nursing care in all fields, as it contributes to developing and coping with the various stimuli of life through therapeutic communication, which helps nurses know their role and how to behave according to the situation. Third-year students from the Nursing School of the "X". Academic years 2006-2007 and 2007-2008. The reflexive nature of qualitative research is based on Symbolic Interactionism. The subject category chosen is role-playing and it is sorted into the subcategories and codes. Findings from the analysis of the summaries have allowed us to see what actually happens when using role-playing as a teaching-learning tool in nursing, why and what the consequences are.

Evaluar el role-playing como metodología en el proceso de enseñanza-aprendizaje en la enseñanza del Grado de Enfermería. Identificar la actitud de los estudiantes de enfermería ante el role-playing. Analizar la respuesta de los estudiantes después de realizar el role-playing en su proceso de enseñanza-aprendizaje. La relación de ayuda es una de las funciones principales de los cuidados de enfermería, en todos los ámbitos con el fin de que se pueda desarrollar y hacer frente a los diversos estímulos de la vida a través de la comunicación terapéutica, que permite a las enfermeras ver su rol con las personas como un marco para "saber estar" en la relación de ayuda. Estudiantes de tercer año de la Escuela de Enfermería de la "X". Año académico 2006-2007 y 2007-2008. El carácter reflexivo de la investigación cualitativa está fundamentado en el Interaccionismo Simbólico. La categoría temática seleccionada, es la de role-playing que permite una clasificación de subcategorías y códigos. Los resultados del análisis de las síntesis nos han permitido identificar lo que sucede realmente con la utilización del role-playing como herramienta de enseñanza-aprendizaje en enfermería, por qué y cuáles son las consecuencias.

Avaliar o role-playing como metodologia no proceso ensino-aprendizagem no ensino de graduação de enfermagem. Identificar as atitudes dos estudantes de enfermagem relacionadas ao role-playing. Analisar a resposta dos alunos no proceso ensino-aprendizagem após realizarem o role-playing. a relação de ajuda é uma das principaisfunções dos cuidados de enfermagem, em todas as dimensões e, através da comunicação terapêutica busca o desenvolvimento das pessoas para enfrentar os diversos estímulos da vida. A comunicação terapêutica permite às enfermeiras reconhecerem seu papel, como um marco para "saber estar" na relação de ajuda. Estudantes de terceiro ano da Escola de Enfermagem "X" nos períodos letivos de 2006-2007 e 2007-2008. A natureza reflexiva desta pesquisa qualitativa baseia-se no interacionismo simbólico. A categoria temática selecionada foi o role-playing, que permitiuuma classificação em subcategorias e códigos. Os resultados permitiram identificar o que realmente acontece com o uso do role-playing como uma ferramenta de ensino e aprendizagem em enfermagem, porquê e quais suas consequências.

Guidelines for occlusion strategy in implant-borne prostheses. A review.

Medium- or long-term failure of endosseous dental implants after osseointegration, when it has occurred, has been associated in the great majority of cases with occlusal overload. Overload depends ultimately on the number and location of occlusal contacts, which to a great extent are under the clinician's control. Much of our current understanding of occlusal contacts in this context is based on concepts derived from non-implant-borne prosthetics and has not been rigorously tested. The present article reviews occlussal contact designs and offers occlusion strategy guidelines for the main types of implant-borne prostheses.

Midline shift and lateral guidance angle in adults with unilateral posterior crossbite.

INTRODUCTION: Unilateral posterior crossbite is a malocclusion that, if not corrected during infancy, typically causes permanent asymmetry. Our aims in this study were to evaluate various occlusal parameters in a group of adults with uncorrected unilateral posterior crossbite and to compare findings with those obtained in a group of normal subjects. METHODS: Midline shift at maximum intercuspation, midline shift at maximum aperture, and lateral guidance angle in the frontal plane were assessed in 25 adults (ages, 17-26 years; mean, 19.6 years) with crossbites. RESULTS: Midline shift at maximum intercuspation was zero (ie, centric midline) in 36% of the crossbite subjects; the remaining subjects had a shift toward the crossbite side. Midline shift at maximum aperture had no association with crossbite side. Lateral guidance angle was lower on the crossbite side than on the noncrossbite side. No parameter studied showed significant differences with respect to the normal subjects. CONCLUSIONS: Adults with unilateral posterior crossbite have adaptations that compensate for the crossbite and maintain normal function.

Unilateral posterior crossbite and mastication.

OBJECTIVE: This study was designed to characterize masticatory-cycle morphology, and distance of the contact glide in the closing masticatory stroke, in adult subjects with uncorrected unilateral posterior crossbite (UPXB), comparing the results obtained with those obtained in a parallel group of normal subjects. STUDY DESIGN: Mandibular movements (masticatory movements and laterality movements with dental contact) were registered using a gnathograph (MK-6I Diagnostic System) during unilateral chewing of a piece of gum. Traces were recorded on the crossbite and non-crossbite sides in the crossbite group, and likewise on both sides in the non-crossbite group. RESULTS: Mean contact glide distance on the crossbite side in the UPXB group was significantly lower than in the control group (p<0.001), and mean contact glide distance on the non-crossbite side in the UPXB group was significantly lower than in the control group (p=0.042). Cycle morphology was abnormal during chewing on the crossbite side, with the frequency distribution of cycle types differing significantly from that for the noncrossbite side and that for the control group (p<0.001). CONCLUSIONS: Patients with crossbite showed alterations in both contact glide distances and masticatory cycle morphology. These alterations are probably adaptive responses allowing maintenance of adequate masticatory function despite the crossbite.

[Intrepid: Second nursing cycle. First step, first desire in European Spain]. / Intrepidos. 2 ciclo de enfermería. Primer paso, primer anhelo en la España Europea.

When we started to write this article for ROL the first question which confronted us was first step? Why? The beginning of second cycle studies in 1998 did not correspond to any European desire, but rather consolidated a real desire which Spanish Nursing had: attain the highest possible academic title through growth inside the nursing discipline itself, having as an objective to place nursing in equal conditions as the majority of titles in the Spanish university system. This meant it was necessary to carry out research and investigation inside one's own scientific field, develop future professionals, administrate under equal conditions, and specifically consolidate a way deserving of one who bears responsibility over health care.