Early-life sugar consumption and breastfeeding practices: a multicenter initiative in Latin America.

The aim of this multicenter study was to explore the early-life sugar consumption and dietary practices in Latin America as well as to investigate the association between breastfeeding duration and the age at which foods and beverages with added sugars are introduced. A cross-sectional study was conducted with 805 1- to 3-year-old children from 10 Latin American countries, as a complementary study to the Research Observatory for Dental Caries of the Latin American Region (OICAL). A Food Frequency Questionnaire previously tested in different countries was applied to children's mothers and data on breastfeeding and age at introduction of sugary foods and beverages was collected. Statistical analysis included the Kruskal-Wallis test and Poisson regression with robust variance, with the calculation of crude and adjusted mean ratios (MR) and 95% of confidence intervals (CI). The average age at introduction of sugary foods and beverages was 10.1 months (95%CI 9.7-10.4) and 9.6 (95%CI 9.2-9.9) months, respectively, with a significant variation between countries (p < 0.001). The average daily frequency of sugary foods-beverages was 3.3 times per day (95%CI 3.1-3.5) and varied significantly between countries (p = 0.004). Breastfeeding duration of over six months was associated with an increase in the age of introduction of sweet drinks (16%; MR 1.16; 95%CI 1.05-1.28) and foods (21%; MR 1.21; 95%CI 1.10-1.33). In conclusion, most children from vulnerable settings in Latin America start consuming sugary products in the first year of life and a high frequency of consumption was reported through early childhood. Additionally, breastfeeding contributes to a delay in the introduction of sugary products.

Early-life sugar consumption and breastfeeding practices: a multicenter initiative in Latin America

Abstract The aim of this multicenter study was to explore the early-life sugar consumption and dietary practices in Latin America as well as to investigate the association between breastfeeding duration and the age at which foods and beverages with added sugars are introduced. A cross-sectional study was conducted with 805 1- to 3-year-old children from 10 Latin American countries, as a complementary study to the Research Observatory for Dental Caries of the Latin American Region (OICAL). A Food Frequency Questionnaire previously tested in different countries was applied to children's mothers and data on breastfeeding and age at introduction of sugary foods and beverages was collected. Statistical analysis included the Kruskal-Wallis test and Poisson regression with robust variance, with the calculation of crude and adjusted mean ratios (MR) and 95% of confidence intervals (CI). The average age at introduction of sugary foods and beverages was 10.1 months (95%CI 9.7-10.4) and 9.6 (95%CI 9.2-9.9) months, respectively, with a significant variation between countries (p < 0.001). The average daily frequency of sugary foods-beverages was 3.3 times per day (95%CI 3.1-3.5) and varied significantly between countries (p = 0.004). Breastfeeding duration of over six months was associated with an increase in the age of introduction of sweet drinks (16%; MR 1.16; 95%CI 1.05-1.28) and foods (21%; MR 1.21; 95%CI 1.10-1.33). In conclusion, most children from vulnerable settings in Latin America start consuming sugary products in the first year of life and a high frequency of consumption was reported through early childhood. Additionally, breastfeeding contributes to a delay in the introduction of sugary products.

Impact on oral health-quality of life in infants: Multicenter study in Latin American countries.

To assess the impact of oral conditions on oral health-related quality of life (OHRQoL) in infants in ten Latin America countries (LAC). A cross-sectional study was conducted with 930 pairs of 1-to-3-year-old children/parents from 10 LAC, as a complementary study of the Research Observatory for Dental Caries of the Latin American Region. The scale ECOHIS, previously tested and valid in ten countries, was applied to parents/caregivers of children to measure OHRQoL. Statistical analysis included descriptive data analysis and one-way analysis of variance (ANOVA-One-Way) were performed to compare age groups with OHRQoL. Bootstrapping procedures (1000 re-samplings; 95%CI Bca) were performed. The mean scores of the 'Child Impact' section in the LAC was 4.0(±8.3), in the 'Family Impact' section was 2.0(±4.0), and in overall ECOHIS score was 6.0(±12.0). In the 'Child Impact' section, Argentina 10.0(+2.4) and Venezuela 17.8(±17.5) demonstrated mean scores higher than the LAC total data. In the 'Family Impact' section, the countries with higher mean scores were Argentina 4.9(±2.0), Ecuador 2.1(±3.1) and Venezuela 7.9(±7.8). In the overall ECOHIS score, Argentina 15.1 (±4.1) and Venezuela 25.7(±25.2) has higher mean scores than the values of LAC. There is an association between children's age and parents' report of impact on the OHRQoL (p<0.001). Three-year-olds had a higher mean when compared to one- and two-year-olds, both in the Impact on the Child and Impact on the Family (p<0.001) sections, as well as in the overall ECOHIS (p<0.001). In conclusion, there are differences in OHRQoL among Latin American countries, impacting older children more significantly.

Impact on oral health-quality of life in infants: Multicenter study in Latin American countries

Abstract To assess the impact of oral conditions on oral health-related quality of life (OHRQoL) in infants in ten Latin America countries (LAC). A cross-sectional study was conducted with 930 pairs of 1-to-3-year-old children/parents from 10 LAC, as a complementary study of the Research Observatory for Dental Caries of the Latin American Region. The scale ECOHIS, previously tested and valid in ten countries, was applied to parents/caregivers of children to measure OHRQoL. Statistical analysis included descriptive data analysis and one-way analysis of variance (ANOVA-One-Way) were performed to compare age groups with OHRQoL. Bootstrapping procedures (1000 re-samplings; 95%CI Bca) were performed. The mean scores of the 'Child Impact' section in the LAC was 4.0(±8.3), in the 'Family Impact' section was 2.0(±4.0), and in overall ECOHIS score was 6.0(±12.0). In the 'Child Impact' section, Argentina 10.0(+2.4) and Venezuela 17.8(±17.5) demonstrated mean scores higher than the LAC total data. In the 'Family Impact' section, the countries with higher mean scores were Argentina 4.9(±2.0), Ecuador 2.1(±3.1) and Venezuela 7.9(±7.8). In the overall ECOHIS score, Argentina 15.1 (±4.1) and Venezuela 25.7(±25.2) has higher mean scores than the values of LAC. There is an association between children's age and parents' report of impact on the OHRQoL (p<0.001). Three-year-olds had a higher mean when compared to one- and two-year-olds, both in the Impact on the Child and Impact on the Family (p<0.001) sections, as well as in the overall ECOHIS (p<0.001). In conclusion, there are differences in OHRQoL among Latin American countries, impacting older children more significantly.

Resumo Avaliar o impacto das condições bucais na qualidade de vida relacionada à saúde bucal (QVRSB) em crianças de dez países da América Latina (AL). Foi realizado um estudo transversal com 930 pares de crianças/pais de 1 a 3 anos de 10 países da AL, como estudo complementar do Research Observatory for Dental Caries of the Latin American Region. A escala ECOHIS, previamente testada e validada em dez países, foi aplicada a pais/cuidadores de crianças para mensurar a QVRSB. A análise estatística incluiu análise descritiva de dados e análise de variância unidirecional (ANOVA-One-Way) para comparar grupos etários com QVRSB. Procedimentos de bootstrapping (1000 reamostragens; 95%IC Bca) foram realizados. A pontuação média da seção 'Impacto na Criança' na AL foi 4,0 (±8,3), na seção 'Impacto na Família' foi 2,0 (±4,0) e no escore total do ECOHIS foi 6,0 (±12,0). Na seção 'Impacto na Criança', Argentina 10,0(+2,4) e Venezuela 17,8(±17,5) demonstraram pontuações médias superiores aos dados totais da AL. Na seção 'Impacto na Família', os países com pontuações médias mais altas foram Argentina 4,9(±2,0), Equador 2,1(±3,1) e Venezuela 7,9(±7,8). No escore total do ECOHIS, Argentina 15,1 (±4,1) e Venezuela 25,7(±25,2) apresentaram escores médios superiores aos valores de AL. Houve associação entre a idade das crianças e o relato dos pais de impacto na QVRSB (p<0,001). As crianças de três anos tiveram média maior quando comparadas às de um e dois anos, tanto nas seções 'Impacto na Criança' e 'Impacto na Família' (p<0,001), quanto no escore total ECOHIS (p<0,001). Em conclusão, houveram diferenças na QVRSB entre os países da América Latina, impactando de forma mais significativa as crianças mais velhas.

Covid-19 y la odontología latinoamericana para pacientes con necesidades especiales / Covid-19 and latin american dentistry for patients with special needs / Covid-19 and dental care for patients with special needs in Latin America

Resumen La región de América Latina se ha convertido en la más afectada del mundo por la pandemia del COVID-19. Y personas con necesidades especiales, población ya vulnerable, están sufriendo un impacto significativo de la crisis actual. Dado que estas personas no pueden dejar de ser protegidas y cuidadas, un grupo de profesores de 10 países de América Latina se reunió para analizar la situación de la odontología para pacientes con necesidades especiales en la región. En todos los países, se evidenció que el confinamiento y las restricciones de desplazamiento están interrumpiendo el acceso a bienes y servicios esenciales para ellos. En cuanto a la odontología, la disposición general es posponer los procedimientos de rutina, a menos que sean clínicamente urgentes o de emergencia; adoptar estrictas medidas de protección personal y evitar o minimizar las intervenciones que puedan producir aerosoles. La atención odontológica remota, teleodontología, se considera como una herramienta fundamental en este momento, ya que permite evaluar la necesidad de atención presencial y ofrecer soporte, información y seguridad a los pacientes y familias. La pandemia nos ha demostrado, a todos, que impulsar la Promoción de la Salud es el verdadero camino, y que no debemos esperar a que se presenten condiciones que afecten la calidad de vida.

Resumo: A região da América Latina tem se tornado a mais afetada do mundo pela pandemia do COVID-19. E as pessoas com necessidades especiais, população já vulnerável, estão sofrendo um impacto significativo da crise atual. Uma vez que essas pessoas não podem deixar de ser protegidas e cuidadas, um grupo de professores de 10 países de América Latina se reuniu para analisar a situação da odontologia para pacientes com necessidades especiais na região. Em todos os países se verificaram que o confinamento e restrições de movimento estavam interrompendo o acesso a bens e serviços essenciais para eles. Para a odontologia, a orientação geral é adiar procedimentos de rotina, a menos que seja clinicamente urgente ou emergencial; adotar medidas rígidas de proteção individual e evitar ou minimizar intervenções que possam produzir aerossóis. O atendimento odontológico à distância, teleodontología, é considerada uma ferramenta fundamental neste momento, pois permite avaliar a necessidade de atendimento presencial e oferecer suporte, informação e segurança aos pacientes e famílias. A pandemia tem demostrado, para todos, que trabalhar na Promoção da Saúde é o verdadeiro caminho, e que não devemos esperar por condições que afetem a qualidade de vida.

Abstract Latin America has become the most affected region by the COVID-19 pandemic in the world. People with special needs-an already vulnerable population-are suffering terrible consequences on account of this crisis. These people need to be protected and cared for at all times. Therefore, a group of lecturers from ten Latin American countries came together to analyze the regional situation of dental care for patients with special needs. Every country shows evidence that lockdowns and movement restrictions interrupt these people's access to essential goods and services. The general course of action regarding dental care is to postpone routine procedures unless they are clinically urgent or an emergency, implement strict personal protection measures and avoid or minimize processes that may produce aerosols. Remote dental care is considered essential these days since it allows practitioners to assess the need for face-to-face care and offer support, information, and safety to patients and families. The pandemic has shown us all that supporting health promotion is the true path and that we should not wait until conditions that affect people's quality of life appear to act.

Maturation of cervical vertebrae and chronological age in children and adolescents.

In maxillary orthopedics and related areas, it is essential to determine patient growth peak in order to provide timely diagnosis and treatments. This requires the use of biological indicators that enable children and adolescents to be assigned to maturation stages. The aim of this study was to determine the correlation between cervical vertebrae maturation stages and chronological age in children and adolescents. In this study were evaluated 93 lateral cranium radiographs of 6- to 17-year-old patients who visited the Postgraduate Maxillary Orthopedics Clinic at the School of Dentistry at Universidad del Zulia. Two examiners made independent assessments of cervical vertebrae maturation stage using the method described by Baccetti et al. For each stage, descriptive statistics for chronological age were evaluated, classified according to sex. In addition, parametric and non-parametric tests were performed in which p <0.05 was considered significant. Mean age of the children and adolescents studied was 9.6 years, with standard deviation 2.5 years. The correlation coefficient (r= 0.771) certified a high positive correlation between bone maturation and chronological age. This correlation coefficient was highly positive for girls (r=0.858) and moderately positive for boys (r=0.688). The model obtained explains 59.4 % of the variation between bone maturation and chronological age, evidencing an average age increase of three years when maturation stage increases by approximately 1 year. The results suggest that although the degree of covariance between chronological age and maturation stages was highly positive in this study, chronological age does not allow bone maturation to be determined precisely, since it may be influenced by genetic and/or environmental factors.

En ortopedia maxilar y áreas afines resulta esencial determinar el pico de crecimiento de los pacientes para establecer diagnósticos y tratamientos oportunos para lo cual es necesario utilizar indicadores biológicos, que permiten ubicar a los niños y adolescentes en estadios de maduración. El objetivo de este estudio fue determinar la correlación de los estadios de maduración de las vértebras cervicales según la edad cronológica en niños y adolescentes. Se evaluaron 93 imágenes de radiografías lateral de cráneo, de pacientes entre 6 y 17 años de edad que asistieron a la clínica del Posgrado de Ortopedia Maxilar de la Facultad de Odontología de La Universidad del Zulia, dos examinadores estimaron de forma independiente el estadio de maduración de las vértebras cervicales, utilizando el método descrito por Baccetti et al. y para cada estadio se evaluaron los estadísticos descriptivos de la edad cronológica categorizando según sexo, además se realizaron pruebas paramétricas y no paramétricas donde un p <0,05 fue considerado como significativo. La edad media de los niños y adolescentes estudiados resultó de 9,6 años y una desviación típica de 2,5 años. El coeficiente de correlación (r=0,771) certificó una correlación positiva alta entre maduración ósea y edad cronológica, igual producto se obtuvo en el caso de las niños y adolescentes del sexo femenino (r=0,858), mientras los del sexo masculino obtuvieron una correlación positiva moderada (r= 0,688). El modelo obtenido explica el 59,4 % de la variación entre maduración ósea y edad cronológica, lo cual evidencia el aumento de la edad promedio en tres años, cuando el estadio de maduración aumenta 1 año aproximadamente. Los resultados registrados sugieren que, aunque el grado de covarianza entre edad cronológica y estadios de maduración en esta investigación fue positiva alta, la edad cronológica no permite determinar con exactitud la maduración ósea, pudiendo estar influenciada por factores genéticos y/o ambientales.

Maturation of cervical vertebrae and chronological age in children and adolescents

In maxillary orthopedics and related areas, it is essential to determine patient growth peak in order to provide timely diagnosis and treatments. This requires the use of biological indicators that enable children and adolescents to be assigned to maturation stages. The aim of this study was to determine the correlation between cervical vertebrae maturation stages and chronological age in children and adolescents. In this study were evaluated 93 lateral cranium radiographs of 6to 17yearold patients who visited the Postgraduate Maxillary Orthopedics Clinic at the School of Dentistry at Universidad del Zulia. Two examiners made independent assessments of cervical vertebrae maturation stage using the method described by Baccetti et al. For each stage, descriptive statistics for chronological age were evaluated, classified according to sex. In addition, parametric and nonparametric tests were performed in which p <0.05 was considered significant. Mean age of the children and adolescents studied was 9.6 years, with standard deviation 2.5 years. The correlation coefficient (r=0.771) certified a high positive correlation between bone maturation and chronological age. This correlation coefficient was highly positive for girls (r=0.858) and moderately positive for boys (r=0.688). The model obtained explains 59.4 % of the variation between bone maturation and chronological age, evidencing an average age increase of three years when maturation stage increases by approximately 1 year. The results suggest that although the degree of covariance between chronological age and matu ration stages was highly positive in this study, chronological age does not allow bone maturation to be determined precisely, since it may be influenced by genetic and/or environmental factors (AU)

En ortopedia maxilar y áreas afines resulta esencial determinar el pico de crecimiento de los pacientes para establecer diagnósticos y tratamientos oportunos para lo cual es necesario utilizar indicadores biológicos, que permiten ubicar a los niños y adolescentes en estadios de maduración. El objetivo de este estudio fue determinar la correlación de los estadios de maduración de las vértebras cervicales según la edad cronológica en niños y adolescentes. Se evaluaron 93 imágenes de radiografías lateral de cráneo, de pacientes entre 6 y 17 años de edad que asistieron a la clínica del Posgrado de Ortopedia Maxilar de la Facultad de Odontología de La Universidad del Zulia, dos examinadores estimaron de forma independiente el estadio de maduración de las vértebras cervicales, utilizando el método descrito por Baccetti et al. y para cada estadio se evaluaron los estadísticos descriptivos de la edad cronológica categorizando según sexo, además se realizaron pruebas paramétricas y no paramétricas donde un p <0,05 fue considerado como significativo. La edad media de los niños y adolescentes estudiados resultó de 9,6 años y una desviación típica de 2,5 años. El coeficiente de correlación (r=0,771) certificó una correlación positiva alta entre maduración ósea y edad cronológica, igual producto se obtuvo en el caso de las niños y adolescentes del sexo femenino (r=0,858), mientras los del sexo masculino obtuvieron una correlación positiva moderada (r= 0,688). El modelo obtenido explica el 59,4 % de la variación entre maduración ósea y edad cronológica, lo cual evidencia el aumento de la edad promedio en tres años, cuando el estadio de maduración aumenta 1 año aproximadamente. Los resultados registrados sugieren que, aunque el grado de covarianza entre edad cronológica y estadios de maduración en esta investigación fue positiva alta, la edad cronológica no permite determinar con exactitud la maduración ósea, pudiendo estar influenciada por factores genéticos y/o ambientales (AU)

CHIKUNGUNYA: Experiencia en la emergencia de adultos. Hospital III Nuestra Señora de la Chiquinquirá. Maracaibo, Venezuela. Septiembre-Diciembre 2014 / CHIKUNGUNYA: Experience in adults emergency. Hospital III Nuestra Señora de la Chiquinquirá. Maracaibo. Venezuela. September-December 2014

Se describe la experiencia en casos probables de chikungunya en la emergencia de adultos de un hospital de Maracaibo, Venezuela. Se reporta la morbilidad y mortalidad entre Septiembre a Diciembre 2014, así como el análisis y diagnóstico clínico de los casos agudos en una zona endémica para dengue.

This work reports experience in probable cases of chikungunya fever at adult emergency in a Maracaibo Hospital, Venezuela. It is describes morbidity and mortality between September to December 2014, as well as analysis and clinic diagnosis in acute and complicated cases in a endemic dengue fever zone.

Early Childhood Oral Health Impact Scale (ECOHIS). Translation and validation in Spanish language.

Health is currently recognized as lying in the individual process rooted in genes, personal habits, the social model and the understanding of the ideological standpoint from which it is viewed. The aim of this study was to validate the Early Childhood Oral Health Impact Scale (ECOHIS) for use in Latin American communities, in order to demonstrate its efficacy for determining the impact of dental condition on children under 5 years of age and their families. The ECOHIS explores two domains: impact on children (9 questions) and on families (4 questions). Validation in Spanish was done in four stages. Stage I included translation and back-translation of the questionnaire (English-Spanish-English). Stage II was a pilot test on families in Venezuela to test stability (test-retest) and make semantic adjustments. Stage III included validation of the questionnaire applied to a Venezuelan sample (n = 50) and two Argentine samples (A and B, made up of families with and without social risk, respectively; n = 95), and consisted of statistical analysis to check the questionnaire's internal consistency and discriminant capacity. In the final stage, parents were given feedback on the results and significance of each domain in the questionnaire. From the results of this study it may be concluded that the Spanish version of the ECOHIS was reliable and valid for administering to populations with homogeneous social risk, and that parents without social risk factors (AC/B) have significantly greater perception of the impact of oral health on the family's quality of life. The trends recorded suggest that (a) larger samples should be used, including variables for diagnosing social vulnerability or general risk, (b) the association with dental condition should be established by applying indicators to discriminate distinct cut-off points in the dental caries process and (c) it should be ascertained whether there are changes in perception of the impact on quality of life before and after dental treatments, including impact on general health condition.

Early childhood oral health impact scale (ECOHIS): translation and validation in Spanish language

En la actualidad, se reconoce que la salud está en el proceso individual enraizado en los genes, los hábitos personalísimos, el modelo social y la comprensión de la ideología de la cual depende en realidad el ángulo desde el cual se la examina. El objetivode este estudio fue validar el Early Childhood Oral Health Impact Scale (ECOHIS) en comunidades latinoamericanas, a fin de demostrar su eficacia para determinar el impacto que el estado dentario produce sobre los niños menores de 5 años y su familia. El ECOHIS explora dos dominios: elimpacto sobre el niño (9 preguntas) y sobre la familia (4 preguntas). Para la validación en el idioma español se desarrollaron cuatro etapas. La etapa I: incluyó la traducción reversa del cuestionario (ingleìs-español.ingles). La etapa II consistió en la prueba piloto realizada en familias venezolanas para comprobar la estabilidad (test-retest) y realizar el ajuste semántico. La etapaIII incluyó la validación del cuestionario aplicado en una muestra venezolana (n=50) y en dos muestras argentinas (AC/A y AC/B, constituidas por familias con y sin riesgo social, respectivamente;n=95). En la última etapa se realizó la devolución de la información a los padres acerca de los resultados y del significado de cada uno de los dominios del cuestionario. Los resultados obtenidos en el presente estudio permiten concluir que la versión en español del ECOHIS resulto confiable y válida para su aplicación en poblaciones con riesgo social homogéneo y que los padres sin factores de riesgo social (AC/B) muestran una percepción significativamente mayor del impacto que el estado bucodental determina sobre la calidad de vida de la familia. Las tendencias registradas permiten recomendar la conveniencia de (a) ampliar el tamaño de las muestras aplicadas en este estudio, incorporando variables que instalen el diagnóstico de factores de vulnerabilidad social o de riesgo generales (b) establecer laasociación existente con el estado dentario.

Efectos de los aparatos ortopédicos en el crecimiento y desarrollo del sistema estomatognático en niños con hendidura unilateral del labio y paladar: una revisión sistemática / Effect of bracing on the growth and development of the stomatognathic system in children with unilateral cleft lip and palate: a systematic review

Evaluar el efecto de los aparatos ortopédicos en el crecimiento y desarrollo del sistema estomatognático en niños con hendidura unilateral de labio y paladar. La búsqueda electrónica abarcó las bases de datos: Medline y Registro Cochrane Central de Ensayos Controlados. Ensayos clínicos aleatorios controlados (ECA) de intervenciones con aparatología ortopédica en niños con hendidura unilateral de labio y paladar (HULP), quienes recibieron el tratamiento ortopédico entre los 0 y 5 años de edad; que evaluaban como medida de resultado el crecimiento y desarrollo maxilar y mandibular, la morfología facial y nasal y la oclusión dentaria. Recopilación y análisis: Independientemente se evaluó un estudio con tres 3 reporte de resultados, se excluyeron 68 porque no cumplían con los criterios de inclusión. En el estudio se comparó la utilización de la placa Hotz versus ausencia de placa; valorándose la dimensión maxilar, la prevención del colapso de los segmentos alveolares y la oclusión en la dentición primaria. Este estudio muestra una evidencia débil acerca de que se produce inicialmente disminución de la anchura anterior del arco, no previene el colapso de los segmentos alveolares y no mejora la oclusión dentaria. No se hallo diferencia significativa entre el grupo que utilizó placa Hotz y los que no, en lo referente a la prevención del colapso de los segmentos alveolares, la oclusión y dimensión maxilar. No se hallaron pruebas para evaluar otros aparatos

Evaluate the effect of orthopedic appliances on estomathognatic system`growth and development, in children with unilateral cleft lip and palate. Search Strategies: The search included electronic databases: MEDLINE y Cochrane Central Register of Controlled Trials. Randomized controlled trials (RCTs) of orthopedics appliances interventions in children with unilateral cleft lip and palate, who's received orthopedic treatment between 0 and 5 years of age; evaluating as a result jaw and maxilar´s growth and development, nose and facial morphology and dental occlusion. Regardless assessed a study with three duplicated publications, 68 were excluded because they did not meet criteria for inclusion. In the study with 3 duplicate publications were compared using the plate Hotz versus absence of plate; valued dimension jaw, preventing the collapse of the alveolar segments and occlusion in the primary teeth, respectively. There is a weak evidence about that initially occurs a declining of the anterior width of the arc, does not prevent the collapse of the alveolar segments and does not improve dental occlusion. No significant differences were found between the group that used Hotz plate and those without, in terms of preventing the collapse of the alveolar segments, occlusion and jaw dimension. We found no evidence to evaluate other appliances

Alteraciones maxilofaciales en histiocitosis de células de Langerhans: reporte de un caso / Maxillofacial abnormalities in Langerhans cell histiocytosis: a case report

La Histiocitosis de células de Langerhans conocida anteriormente como Histiocitosis X, es un término aplicado a un grupo de desórdenes poco comunes del sistema fagocítico mononuclear, caracterizado por una acumulación clonal y proliferación anormal de células de Langerhans derivadas de la medula ósea. El propósito de esta investigación es reportar las alteraciones maxilo-faciales en un paciente con diagnostico de Histiocitosis de Células de Langerhans. Se presenta el caso de un varón de tres años de edad con diagnostico de Histiocitosis de Células de Langerhans con afección ósea multifocal y otros sitios especiales, con antecedentes de otitis media supurativa recurrente, diabetes insípida, dermatitis seborreica y lesiones hipercrómicas en miembros inferiores. La exploración extraoral evidenció lesiones eritematosas y descamativas en piel de cara y cuero cabelludo; intraoralmente se observó movilidad en dientes posteriores de ambos maxilares acompañada de recesión gingival, caries dental y erupción prematura del 26. Radiograficamente presentó lesiones osteolíticas en alas mayores de esfenoides, techo orbitario izquierdo, pared orbitaria externa derecha, arco cigomático, peñasco del temporal y zonas posteriores de ambos maxilares, además de agenesia de los gérmenes dentarios del 35 y 45. Adicionalmente al tratamiento sistémico de quimioterapia se realizó control de la infección dentobacteriana y tratamiento quirúrgico de las zonas maxilares afectadas. Se concluye que los maxilares al igual que los huesos del cráneo deben ser evaluados en pacientes con diagnóstico de Histiocitocis de Células de Langerhans, ya que estos sitios pueden ser los únicos huesos afectados como sucedió en el caso estudiado

Langerhans Cell Histiocytosis, known earlier as Histiocytosis X is a term applied to a group of rare disorders of the reticuloendothelial system, characterized by an abnormal proliferation of Langerhans cells derived from bone marrow. The purpose of this research is to report the maxillofacial alterations of a patient with diagnostic of Langerhans Cell Histiocytosis. A three-year old male patient with diagnostic of Langerhans Cell Histiocytosis with multifocal bone involvement and special sites of disease is presented. He had a previous history of exophtalmus, recurrent suppurative otitis media, diabetes insipidus, seborrheic dermatitis and hyperchromic lesions in lower members. The extraoral exam showed erythematosus and desquamative lesions in face skin and the scalp, intraorally back teeth mobility of both maxilars was found together with gingival recession, dental caries and premature eruption of 26. Radiographically, he presented osteolitic lesions in the sphenoid major wings, left orbital roof, right external orbital wall, zygomatic arch, temporal bone and back areas of both maxilars, besides dental germ agenesia of 35 and 45. In addition to the systemic chemiotherapy treatment, a control of the dentobacterial infection and surgical treatment of the affected maxillary areas was made. The conclusion is that maxilars as well as the skull bones must be evaluated in patients with a diagnostic of Langerhans cell Histiocytocis, because this could be the only bone involvement to be found as it happened in this case

Alteraciones maxilofaciales en histiocitosis de células de langerhans: reporte de un caso / Maxillofacial abnormalities in Langerhans cell histiocytosis: a case report

La Histiocitosis de células de Langerhans conocida anteriormente como Histiocitosis X, es un término aplicado a un grupo de desórdenes poco comunes del sistema fagocítico mononuclear,  caracterizado por una acumulación clonal y proliferación anormal de células de Langerhans derivadas de la medula ósea. El propósito de esta investigación es reportar las alteraciones maxilo-faciales en un paciente con diagnostico de Histiocitosis de Células de Langerhans. Se presenta el caso de un varón de tres años de edad con diagnostico de Histiocitosis de Células de Langerhans con afección ósea multifocal y otros sitios especiales, con antecedentes de otitis media supurativa recurrente, diabetes insípida, dermatitis seborreica y lesiones hipercrómicas en miembros inferiores. La exploración extraoral evidenció lesiones eritematosas y descamativas en piel de cara y cuero cabelludo; intraoralmente se observó movilidad en dientes posteriores de ambos maxilares acompañada de recesión gingival, caries dental y erupción prematura del 26. Radiograficamente presentó lesiones osteolíticas en alas mayores de esfenoides, techo orbitario izquierdo, pared orbitaria externa derecha, arco cigomático, peñasco del temporal y zonas posteriores de ambos maxilares, además de agenesia de los gérmenes dentarios del 35 y 45. Adicionalmente al tratamiento sistémico de quimioterapia se realizó control de la infección dentobacteriana y tratamiento quirúrgico de las zonas maxilares afectadas. Se concluye que los maxilares al igual que los huesos del cráneo deben ser evaluados en pacientes con diagnóstico de Histiocitocis de Células de Langerhans, ya que estos sitios pueden ser los únicos huesos afectados como sucedió en el caso estudiado

Langerhans Cell Histiocytosis, known earlier as Histiocytosis X is a term applied to a group of rare disorders of the reticuloendothelial system, characterized  by an abnormal proliferation of Langerhans cells derived from bone marrow. The purpose of this research is to report the maxillofacial alterations of a patient with diagnostic of Langerhans Cell Histiocytosis. A three-year old male patient with diagnostic of Langerhans Cell Histiocytosis with multifocal bone involvement and special sites of disease is presented. He had a previous history of exophtalmus, recurrent suppurative otitis media, diabetes insipidus, seborrheic dermatitis and hyperchromic lesions in lower members. The extraoral exam showed erythematosus and desquamative lesions in face skin and the scalp, intraorally back teeth mobility of both maxilars was found together with gingival recession, dental caries and premature eruption of 26. Radiographically, he presented osteolitic lesions in the sphenoid major wings, left orbital roof, right external orbital wall, zygomatic arch, temporal bone and back areas of both maxilars, besides dental germ agenesia of 35 and 45. In addition to the systemic chemiotherapy treatment, a control of the dentobacterial infection and surgical treatment of the affected maxillary areas was made. The conclusion is that maxilars as well as the skull bones must be evaluated in patients with a diagnostic of Langerhans cell Histiocytocis, because this could be the only bone involvement to be found as it happened in this case

Barniz de fluoruro y clorhexidina en el control de la caries dental: presentación de un protocolo / Fluoride and chlorhexidine varnish in dental caries control: presentation of a protocol

Presentar un protocolo profilactico combinado para el uso del barniz de flúor y clorhexidina en el control de las caries dental, diseñado sobre la base de las condiciones de riesgo a la enfermedad y el estado de salud bucal de los individuos, de fácil aplicación en la práctica clínica. En este trabajo se propone un protocolo profiláctico para el uso de barniz de flúor y clorhexidina con una frecuencia que depende de la fase de tratamiento, edad, estado de erupción y condiciones de higiene bucal del paciente. La combinación de clorhexidina y fluoruros tópicos, pueden tener un efecto cariostático aumentado, comparado con el efecto que pueda lograr se con el tratamiento separado e independiente de cada uno de estos agentes. No obstante, es necesario realizar ensayos clínicos que comprueben la efectividad de este protocolo.

Oral Candidiasis in children and adolescents with cancer. Identification of Candida spp.

UNLABELLED: Oral candidiasis represents a serious problem for children with cancer. The mortality rate of this infection has increased due to fungal septicemia, associated with a primary buccal infection. OBJECTIVE: Identify the Candida spp. in buccal lesions of patients with cancer, establish the predominant species and correlate them to age and sex of the patient, clinical presentation, type of neoplasic disease and cytostatic therapy received. STUDY DESIGN: 62 patients, between 0-16 years, were investigated in a cross sectional study. SAMPLE INCLUSION CRITERIA: Patients with malignant neoplasic disease that were receiving cytostatic treatment and had suspicious lesions of oral candidiasis. Patients with antifungal therapy, active caries, calculus or intraoral appliances were excluded. A clinical evaluation was carried out. The lesion sample was taken and studied by direct exam and culture in CHROMagar-Candida and Sabouraud-Dextrose Agar with chloramphenicol. The identification of the isolated yeast was done by the filamentation test, carbohydrate fermentation and assimilation. RESULTS: Most of the cases (69.35%) were positive to oral candidiasis, C. albicans was the most frequent species found, followed by C. parapsilosis (14.89%), C. tropicalis (12.77%), C. krusei (4.26%), C. glabrata (2.13%) and C. lusitaniae (2.13%). In some cases more than one specie were isolated (9.30%). The most frequent location of the lesion was in the tongue (72.70%). The pseudomembranous candidiasis was the most frequent clinical presentation found (78.71%). There were not significant statistically differences with regard to sex and age of the patient, type of neoplasic disease and cytostatic agent received. CONCLUSION: The results suggest that oral candidiasis is a frequent complication in the pediatric oncological population, being C. albicans the main etiological agent, however, there is an important participation of other Candida species.

Mucositis oral y estado nutricional en pacientes pediátricos con leucemia / Oral mucositis and nutritional levels in pediatric patients with leukemia

El propósito de este estudio fue describir el comportamiento de la mucositis oral según el estado nutricional de pacientes pediátricos con Leucemia. Se realizó un estudio descriptivo en 17 pacientes con Leucemia Linfoblástica Aguda LLA (edad media= 10,05 ± 4,7 años); hospitalizados para recibir 3 g/m² de metotrexate. Se excluyeron pacientes con enfermedades cardiovasculares, renales, hepáticas, tiroideas, diabetes, problemas gastrointestinales, procesos infecciosos e inflamatorios, lesiones en mucosa bucal, caries activas y procesos pulpares irreversibles. Los pacientes fueron divididos en dos grupos según los valores de albúmina sérica. Sin desnutrición proteica (SDP) albúmina > 3.5 g/dl y con desnutrición proteica (CDP) albúmina < 3.5 g/dl. La mucositis oral fue registrada según el índice de la OMS. No se observaron diferencias significativas en la prevalencia y severidad de la mucositis oral entre los pacientes SDP y aquellos CDP, la mucositis apareció en 15 de 17 pacientes, siendo el grado 1 el más frecuente, no se registraron grados 3 y 4; esta complicación no prolongó la estancia hospitalaria, ni el reingreso del paciente. Este estudio no encontró diferencias significativas en el comportamiento de mucositis oral en pacientes con CDP y SDP.

Capacity buffer of the saliva in children and adolescents with cancer: Variations induced by the administration of metotrexate or cyclophosphamide.

OBJECTIVE: To determine the variations in the levels of capacity buffer of the saliva in children and adolescents with cancer that receiving Metotrexate or cyclophosphamide. MATERIALS AND METHODS: A clinical, random-controlled assay was carried out. The sample was composed by 24 children, ages between 2 and 16 years, with diagnostic of Leukemia and Lymphomas attending to The Autonomous Service of University Hospital of Maracaibo and Hospital of Pediatric Specialties. Two groups were conformed to which a sample of saliva was taken before and after the chemotherapy; twelve patients were randomly placed in the G1: patient receiving Metotrexate and twelve in the G2: patient receiving cyclophosphamide. In order to determine the capacity buffer, the CRT Buffer IVOCLAR VIVADENT was used. RESULTS: The capacity salivary buffer did not show significant differences before and after the administration of the cytostatic agents studied. CONCLUSIONS: In this study, the Metotrexate or cyclophosphamide administration does not modify the salivary buffer capacity in pediatric patient with cancer.

Metodología estratégica para la participación de los padres en los cuidados de la salud bucal de niños preescolares / A strategic methodology for the participation of parents in oral health care in pre-school children

Evaluar la efectividad de una metodología estratégica para la participación de los padres en los cuidados de la salud bucal de niños preescolares. Muestra constituida por 32 padres y sus niños, provenientes de un preescolar público del municipio Maracaibo, estado Zulia. Venezuela. Se establecieron las condiciones bucales de los preescolares antes y después de la aplicación del método, determinando caries inicial y manifiesta, índice de placa e índice gingival. Se utilizó el Método Altadir de Planificación Popular para impulsar la participación de los padres, propiciándose la discución sobre la salud bucal, se partió de la selección de un problema, para identificar sus causas, nudos críticos, actores relevantes y se diseñaron operaciones y acciones para enfrentarlo. Las caries manifiesta, sin tratar, se reportó en un 53.3 por ciento de los niños ante de la aplicación del método, disminuyendo a un 15.6 por ciento (P<0.05) posterior a su aplicación. El índice gingival e índice de placa se redujo de 0.65 a 0.37 (P<0.05) y de 1.12 a 0.59 (P<0.05) respectivamente. Después de la aplicación de la metodología se produjeron cambios significativos en las condiciones de salud bucal de los niños preescolares, resultando factible y viable la aplicación de la misma en otros contextos y adecuándola a cada realidad.

Gingivitis and anti-neutrophil cytoplasmic antibodies in children and adolescents suffering from Leukemia.

INTRODUCTION: Systemic sickness can originate and proliferate alterations in the periodontium. The presence of Anti-neutrophil Cytoplasmic Antibodies (ANCA) in patients suffering destructive periodontal disease and systemic illness has been widely proven. OBJECTIVE: To determine the existent relation between gingivitis and ANCA in children and adolescents suffering from leukemia. These patients were examined at the Autonomous Services of the University Hospital in Maracaibo, Venezuela, and at the Hospital of Pediatrics Foundation in Zulia State, Venezuela. MATERIALS AND METHODS: 40 patients ranging from 6 to 16 years of age were included in a controlled study. 20 patients suffering from acute leukemia constituted an experimental group, and 20 more patients without apparent systemic sickness who formed a control group. All 40 patients underwent clinical evaluation, and periodontal tissue radiographic evaluation and assessment of ANCA through an enzyme-linked immunoasorbent assay (ELISA); this was done using an IMMCO Diagnostic commercial kit. RESULTS: No Significant differences in the gingivitis average index, plaque and bone loss between the experimental and the control group were evidenced. A significant correlation between gingivitis and ANCA was not evidenced either. Nevertheless, 7 out of 20 patients of the experimental group turned out to be ANCA positive. In contrast, no positive cases were reported in the control group. (p < 0.05 Fisher Test). CONCLUSION: The results of this study suggest that the presence of ANCA is probably related to ongoing immune alterations in patients suffering from leukemia but not related to gingivitis.

Mucositis oral inducida por metotrexate en pacientes pediátricos con leucemia / Oral mucositis induced by methotrexate in children suffering from leukemia

El metotrexate, principal agente citostático en la terapia de niños con Leucemia Linfoblástica Aguda (LLA), es considerado un agente estomatotóxico. Describir la aparición de mucositis oral inducida por 2 g/m² de metotrexate en pacientes pediátricos con LLA. Utilizando el índice de mucositis oral de la Organización Mundial de la Salud, se evaluaron 16 pacientes con LLA entre 4 y 14 años de edad, desde el primero al séptimo día de administrado el metotrexate. Un total de 62.5 por ciento de los pacientes desarrolló mucositis grados I y II. En el 75 por ciento de los casos, las lesiones eritematosas y ulcerosas aparecieron entre el segundo y tercer día. Los sitios de inicio de mayor frecuencia correspondieron a la lengua y a la mucosa de carrillo. Ningún paciente refirió dolor bucal y dificultades en la alimentación. La aparición de mucositis no mostró diferencias significativas según grupos de edades ni fases de tratamiento. En este estudio, la mucositis oral inducida por 2 g/m² de metotrexate, apareció con mayor frecuencia entre el segundo y tercer día, en ausencia de síntomas. Un examen bucal durante este momento permitirá el inicio de una terapia que pudiera reducir la duración y evolución de la mucositis oral.