Oral Squamous Cell Carcinoma Lipid Evaluation in Gingiva Tissue Stored in TRIzol via Shotgun Lipidomics and MALDI Mass Spectrometry Imaging.

Oral squamous cell carcinoma (OSCC) is the prevalent type of oral cavity cancer, requiring precise, accurate, and affordable diagnosis to identify the disease in early stages, Comprehending the differences in lipid profiles between healthy and cancerous tissues encompasses great relevance in identifying biomarker candidates and enhancing the odds of successful cancer treatment. Therefore, the present study evaluates the analytical performance of simultaneous mRNA and lipid extraction in gingiva tissue from healthy patients and patients diagnosed with OSCC preserved in TRIzol reagent. The data was analyzed by partial least-squares discriminant analysis (PLS-DA) and confirmed via matrix-assisted laser desorption/ionization mass spectrometry imaging (MALDI-MSI). The lipid extraction in TRIzol solution was linear in a range from 330 to 2000 ng mL-1, r2 > 0.99, intra and interday precision and accuracy <15%, and absolute recovery values ranging from 90 to 110%. The most important lipids for tumor classification were evaluated by MALDI-MSI, revealing that the lipids responsible for distinguishing the OSCC group are more prevalent in the cancerous tissue in contrast to the healthy group. The results exhibit the possibilities to do transcriptomic and lipidomic analyses in the same sample and point out important candidates related to the presence of OSCC.

Desorption electrospray ionization and matrix-assisted laser desorption/ionization as imaging approaches for biological samples analysis.

The imaging of biological tissues can offer valuable information about the sample composition, which improves the understanding of analyte distribution in such complex samples. Different approaches using mass spectrometry imaging (MSI), also known as imaging mass spectrometry (IMS), enabled the visualization of the distribution of numerous metabolites, drugs, lipids, and glycans in biological samples. The high sensitivity and multiple analyte evaluation/visualization in a single sample provided by MSI methods lead to various advantages and overcome drawbacks of classical microscopy techniques. In this context, the application of MSI methods, such as desorption electrospray ionization-MSI (DESI-MSI) and matrix-assisted laser desorption/ionization-MSI (MALDI-MSI), has significantly contributed to this field. This review discusses the evaluation of exogenous and endogenous molecules in biological samples using DESI and MALDI imaging. It offers rare technical insights not commonly found in the literature (scanning speed and geometric parameters), making it a comprehensive guide for applying these techniques step-by-step. Furthermore, we provide an in-depth discussion of recent research findings on using these methods to study biological tissues.

Protocol For A Perioperative Approach To Patients With Coronary Stents Undergoing Non Cardiac Surgery.

Patients undergoing angioplasty and stent insertion require double prophylactic anti-aggregation or monotherapy. This is a challenging procedure with a high risk of morbidity and coronary mortality. The aim of this protocol is to provide guidelines for a presurgical approach to patients with a coronary stent who will be undergoing non-coronary surgery. This protocol highlights potential complications that may occur, namely those related with the cardiac stent and the evaluation of cardiac risk, and notes the thrombotic and hemorrhagic risks associated with the surgical procedure and the decision algorithms for both elective surgery and urgent surgery involving the suspension and re-introduction of antiplatelet therapy. Our main goal is to outline an optimized approach to these cases in order to improve cardiac outcomes and to minimize the risk of complications.

An Agile and Accurate Approach for N-Nitrosamines Detection and Quantification in Medicines by DART-MS.

N-nitrosamines (NAs) are prevalent mutagenic impurities in various consumer products. Their discovery in valsartan-containing medicines in 2018 prompted global regulatory agencies to set guidelines on their presence and permissible levels in pharmaceuticals. In order to determine the NAs content in medicines, efficient and sensitive analytical methods have been developed based on mass spectrometry techniques. Direct analysis in real time-mass spectrometry (DART-MS) has emerged as a prominent ambient ionization technique for pharmaceutical analysis due to its high-throughput capability, simplicity, and minimal sample preparation requirements. Thus, in this study DART-MS was evaluated for the screening and quantification of NAs in medicines. DART-MS analyses were conducted in positive ion mode, for both direct tablet analysis and solution analysis. The analytical performance was evaluated regarding linearity, precision, accuracy, limits of detection, and quantification. The DART-MS proved to be suitable for the determination of NAs in medicines, whether through direct tablet analysis or solution analysis. The analytical performance demonstrated linearity in the range from 1.00 to 200.00 ng mL-1, limits of quantification about 1.00 ng mL-1, precision and accuracy lower than 15%, and no significant matrix effect for six drug-related NAs. In conclusion, the DART-MS technique demonstrated to be an alternative method to determine NAs in medicines, aligning with the principles of green chemistry.

Exploring salivary lipid profile changes in COVID-19 patients: Insights from mass spectrometry analysis.

The most common COVID-19 testing relies on the use of nasopharyngeal swabs. However, this sampling step is very uncomfortable and is one of the biggest challenges regarding population testing. In the present study, the use of saliva as an alternative sample for COVID-19 diagnosis was investigated. Therefore, high-resolution mass spectrometry analysis and chemometric approaches were applied to salivary lipid extracts. Two data organizations were used: classical MS data and pseudo-MS image datasets. The latter transformed MS data into pseudo-images, simplifying data interpretation. Classification models achieved high accuracy, with pseudo-MS image data performing exceptionally well. PLS-DA with OPSDA successfully separated COVID-19 and healthy groups, serving as a potential diagnostic tool. The most important lipids for COVID-19 classification were elucidated and include sphingolipids, ceramides, phospholipids, and glycerolipids. These lipids play a crucial role in viral replication and the inflammatory response. While pseudo-MS image data excelled in classification, it lacked the ability to annotate important variables, which was performed using classical MS data. These findings have the potential to improve clinical diagnosis using rapid, non-invasive testing methods and accurate high-volume results.

Bisphenol determination in UHT milk and packaging by paper spray ionization mass spectrometry.

This study evaluates the use of paper spray ionization mass spectrometry (PSI-MS) for rapid determination of bisphenol A (BPA) and bisphenol S (BPS) in UHT milk and milk packaging. The packages were analyzed by cutting the cartons into triangular shapes and submitting them to PSI-MS analysis. The milk samples were subjected to a simple liquid-liquid extraction and the supernatant was deposited onto a triangular paper that was subsequently used for PSI-MS analysis. In milk, BPS and BPA levels ranged from 60.0 to 150.8 ng mL-1. The LOD and LOQ values were 1.5 and 4.8 ng mL-1 for BPA, and 4.8 and 16.0 ng mL-1 for BPS, respectively. Linearity was R2 > 0.98 for both compounds. Precision values were below 20%, and recoveries close to 100%. The PSI-MS can be used as a simple, rapid, and accurate methodology to determine bisphenols in milk and milk packaging.

Sedation, analgesia, and delirium management in Portugal: a survey and point prevalence study. / Abordagem da sedação, da analgesia e do delirium em Portugal: inquérito nacional e estudo de prevalência.

OBJECTIVE: To establish current Portuguese critical care practices regarding analgesia, sedation, and delirium based on a comparison between the activities reported and daily clinical practice. METHODS: A national survey was conducted among physicians invited to report their practice toward analgesia, sedation, and delirium in intensive care units. A point prevalence study was performed to analyze daily practices. RESULTS: A total of 117 physicians answered the survey, and 192 patients were included in the point prevalence study. Survey and point prevalence studies reflect a high sedation assessment (92%; 88.5%), with the Richmond Agitated Sedation Scale being the most reported and used scale (41.7%; 58.2%) and propofol being the most reported and used medication (91.4%; 58.6%). Midazolam prescribing was reported by 68.4% of responders, but a point prevalence study revealed a use of 27.6%.Although 46.4% of responders reported oversedation, this was actually documented in 32% of the patients. The survey reports the daily assessment of pain (92%) using standardized scales (71%). The same was identified in the point prevalence study, with 91.1% of analgesia assessment mainly with the Behavioral Pain Scale. In the survey, opioids were reported as the first analgesic. In clinical practice, acetaminophen was the first option (34.6%), followed by opioids. Delirium assessment was reported by 70% of physicians but was performed in less than 10% of the patients. CONCLUSION: The results from the survey did not accurately reflect the common practices in Portuguese intensive care units, as reported in the point prevalence study. Efforts should be made specifically to avoid oversedation and to promote delirium assessment.

OBJETIVO: Determinar as práticas atuais de cuidados intensivos em Portugal quanto à analgesia, à sedação e ao delirium, com base em uma comparação entre as atividades relatadas e a prática clínica diária. MÉTODOS: Inquérito nacional em que os médicos foram convidados a relatar sua prática em relação à analgesia, à sedação e ao delirium em unidades de terapia intensiva. Para analisar a prática diária, realizou-se um estudo de prevalência pontual. RESULTADOS: Responderam ao inquérito 117 médicos, e 192 pacientes foram incluídos no estudo de prevalência pontual. O inquérito e o estudo de prevalência mostraram uma avaliação generalizada do nível de sedação (92%; 88,5%). A Escala de Agitação e Sedação de Richmond foi a mais reportada e utilizada (41,7%; 58,2%), e o propofol foi o medicamento mais reportado e utilizado (91,4%; 58,6%). A prescrição de midazolam foi relatada por 68,4% dos respondentes, mas o estudo de prevalência pontual revelou a sua utilização em 27,6%.Embora 46,4% dos respondentes tenham relatado excesso de sedação, na realidade foi documentado em 32% dos pacientes. O inquérito relatou avaliação diária de dor (92%) com uso de escalas padronizadas (71%). Identificou-se resultado semelhante no estudo de prevalência pontual, com 91,1% de avaliação da analgesia feita principalmente com a Escala Comportamental de Dor. No inquérito, os opioides foram relatados como analgésicos de primeira linha. Na prática clínica, o paracetamol foi a primeira opção (34,6%), seguido de opioides. A avaliação do delirium foi relatada por 70% dos médicos, embora tenha sido realizada em menos de 10% dos pacientes. CONCLUSÃO: Os resultados do inquérito não refletiram com precisão as práticas habituais nas unidades de terapia intensiva portuguesas, tal como relatado no estudo de prevalência pontual. Devem ser feitos esforços principalmente para evitar o excesso de sedação e promover a avaliação do delirium.

A fast and direct determination of bisphenol S in thermal paper samples using paper spray ionization mass spectrometry.

Concerns about human health regarding the large use of bisphenol A in thermal papers have led to its replacement by bisphenol S. Analyses of bisphenols require several sample pretreatment steps, which are laborious, expensive, and time-consuming. A paper spray ionization mass spectrometry (PSI-MS) was developed to detect and quantify bisphenol S in three different brands of thermal papers commercially available. Parameters such as paper size, and paper position relative to the mass spectrometer inlet were evaluated. The analyses were performed in selected ion monitoring mode on a linear ion trap mass spectrometer. The developed method presented absolute recovery values ranging from 92.2 to 109.04%, accuracy values from -1.2 to 9.0%, and inter assay precision from 1.8 to 5.6% and enabled LOD as low as 5 ng g-1. The concentration of bisphenol S in all of the three brands of BPA-free thermal papers evaluated ranged from 1.36 to 6.77 µg g-1, and the concentrarion of BPA ranged from 6.56 to 16.4 µg g-1 in all samples of thermal paper evaluated. The PSI-MS method described here was comparable to the conventional ones, such as liquid chromatography coupled with mass spectrometry and gas chromatography coupled with mass spectrometry described in the literature. The present study proved to be practical, fast, and efficient for the direct determination of bisphenol S in thermal papers. Furthermore, the methodology here described showed to be a promising alternative to replace the classical methods for determination of bisphenol S, due to its simplicity, and no needing of any sample pretreatment.

Polypyrrole monolithic extraction phase: From conventional to miniaturized sample preparation techniques.

Monolithic polymers are described as continuous and highly porous materials. They have been gaining popularity as an effective extracting phase for some sample preparation methods, due to their variety of functionalities, such as wide pH range tolerance, good permeability, and its ability to allow changes into their surface. Polypyrrole represents an interesting alternative for the modification in extraction phases due to its well related ability to perform multiple interactions, such as acid-base, π - π, ion exchange, interactions with hydrophobic affinities or polar functional groups. Among the different sample preparation techniques, solid-phase extraction (SPE) is one of the most popular and used; a miniaturized version of SPE is the disposable pipette extraction (DPX). DPX is a recent miniaturized extraction technique that usually employing silica-based sorbents inside a pipette tip (5 or 1 mL). The present study proposes the development of a monolithic extraction phase composed by styrene divinylbenzene (1:1) modified with polypyrrole for SPE and DPX techniques. The efficiency of the material was evaluated in face of the extraction of different samples and analytes, triazine herbicides in water and dexamethasone in synthetic synovial liquid by conventional and miniaturized solid-phase extraction techniques. The extractions performed by SPE and DPX presented absolute recovery values ranging from 74.8 to 105.0%, inter-day precision ranging from 0.6 to 14.0%, and limit of quantification of 0.5 and 5.0 ng.mL-1, respectively. The DPX miniaturized method exhibited results equivalent to the methods reported in the literature for extraction of dexamethasone in synovial fluid samples. Moreover, this technique proved to be quicker and cheaper than SPE, and produced fewer residual volumes, supporting the preference for green chemistry. Monolithic polymers modified with polypyrrole presented to be a feasible alternative extraction phase for miniaturized sample preparation techniques.

Subcutaneous ICD implantation.

An 18-year-old patient, with hypertrophic cardiomyopathy and an implantable cardioverter defibrillator for 6 years, was admitted with inappropriate shocks as a consequence of a lead fracture (Sprint Quattro, Medtronic). The device was explanted and replaced with a new subcutaneous defibrillator (Cameron SQ-RX), without complications. This was the first time that a subcutaneous cardioverter defibrillator had been used in the Iberian Peninsula. The new implantable defibrillator, with subcutaneous lead and generator, can lower the risk of complications, including lead fracture or infection. Furthermore, this device has good rhythm diagnostic performance and therapeutic efficacy. Following the case report, we present a brief review of the new defibrillator with subcutaneous implantation.

Atrial fibrillation ablation using simultaneous multielectrode application of radiofrequeney energy.

Despite technological advances in equipment for ablation of atrial fibrillation (AF), conventional pulmonary vein (PV) isolation with point-by-point radiofrequency application encircling the PV ostia remains a complex procedure requiring a high degree of operator skill and experience. Novel multielectrode catheters have been developed that deliver duty-cycled bipolar and unipolar radiofrequency energy, designed for PV electrical isolation and for ablation of complex fractionated electrograms in the left atrium. Initial studies suggest good results, reducing procedure time and with safety and efficacy equivalent to the conventional method. We describe the first four cases of AF ablation in our center using this method, with acute success in two patients: one with paroxysmal AF and the other with chronic AF.

[Circumferential pulmonary vein isolation with the cryoballoon technique]. / Isolamento circunferencial das veias pulmonares com a técnica do criobalão.

We present a clinical case on cryoballoon ablation of paroxysmal atrial fibrillation. This is a report of the first case performed at our center using this new technology.

Lab-made solid phase microextraction phases for off line extraction and direct mass spectrometry analysis: Evaluating the extraction parameters.

The analyses of drugs and metabolites in complex matrices have been widely studied in recent years. However, due to high levels endogenous compounds and matrix complexity, these analyses require a sample pre-treatment step. To this aim, two lab-made extractive phases were integrated to probe electrospray ionization mass spectrometry (PESI-MS) technique for direct analysis of illicit drugs in biological fluids and phorbol esters in Jatropha curcas extract. The polypyrrole (PPy) phase was electropolymerized onto a platinum wire surface by cyclic voltammetry. The molecularly imprinted polymer (MIP) was synthesized and adhered onto a stainless-steel needle with epoxy resin. The PPy-PESI-MS method showed to be linear in a concentration range from 1 to 500 µg L-1, with accuracy values between -2.1 and 14%, and precision values between 0.8 and 10.8%. The MIP-PESI-MS method showed to be linear in a concentration range from 0.9 to 30 mg L-1, with accuracy values between -1.6 and -15.3%, and precision values between 4.1 and 13.5%.

Abordagem da sedação, da analgesia e do delirium em Portugal: inquérito nacional e estudo de prevalência / Sedation, analgesia, and delirium management in Portugal: a survey and point prevalence study

RESUMO Objetivo: Determinar as práticas atuais de cuidados intensivos em Portugal quanto à analgesia, à sedação e ao delirium, com base em uma comparação entre as atividades relatadas e a prática clínica diária. Métodos: Inquérito nacional em que os médicos foram convidados a relatar sua prática em relação à analgesia, à sedação e ao delirium em unidades de terapia intensiva. Para analisar a prática diária, realizou-se um estudo de prevalência pontual. Resultados: Responderam ao inquérito 117 médicos, e 192 pacientes foram incluídos no estudo de prevalência pontual. O inquérito e o estudo de prevalência mostraram uma avaliação generalizada do nível de sedação (92%; 88,5%). A Escala de Agitação e Sedação de Richmond foi a mais reportada e utilizada (41,7%; 58,2%), e o propofol foi o medicamento mais reportado e utilizado (91,4%; 58,6%). A prescrição de midazolam foi relatada por 68,4% dos respondentes, mas o estudo de prevalência pontual revelou a sua utilização em 27,6%. Embora 46,4% dos respondentes tenham relatado excesso de sedação, na realidade foi documentado em 32% dos pacientes. O inquérito relatou avaliação diária de dor (92%) com uso de escalas padronizadas (71%). Identificou-se resultado semelhante no estudo de prevalência pontual, com 91,1% de avaliação da analgesia feita principalmente com a Escala Comportamental de Dor. No inquérito, os opioides foram relatados como analgésicos de primeira linha. Na prática clínica, o paracetamol foi a primeira opção (34,6%), seguido de opioides. A avaliação do delirium foi relatada por 70% dos médicos, embora tenha sido realizada em menos de 10% dos pacientes. Conclusão: Os resultados do inquérito não refletiram com precisão as práticas habituais nas unidades de terapia intensiva portuguesas, tal como relatado no estudo de prevalência pontual. Devem ser feitos esforços principalmente para evitar o excesso de sedação e promover a avaliação do delirium.

ABSTRACT Objective: To establish current Portuguese critical care practices regarding analgesia, sedation, and delirium based on a comparison between the activities reported and daily clinical practice. Methods: A national survey was conducted among physicians invited to report their practice toward analgesia, sedation, and delirium in intensive care units. A point prevalence study was performed to analyze daily practices. Results: A total of 117 physicians answered the survey, and 192 patients were included in the point prevalence study. Survey and point prevalence studies reflect a high sedation assessment (92%; 88.5%), with the Richmond Agitated Sedation Scale being the most reported and used scale (41.7%; 58.2%) and propofol being the most reported and used medication (91.4%; 58.6%). Midazolam prescribing was reported by 68.4% of responders, but a point prevalence study revealed a use of 27.6%. Although 46.4% of responders reported oversedation, this was actually documented in 32% of the patients. The survey reports the daily assessment of pain (92%) using standardized scales (71%). The same was identified in the point prevalence study, with 91.1% of analgesia assessment mainly with the Behavioral Pain Scale. In the survey, opioids were reported as the first analgesic. In clinical practice, acetaminophen was the first option (34.6%), followed by opioids. Delirium assessment was reported by 70% of physicians but was performed in less than 10% of the patients. Conclusion: The results from the survey did not accurately reflect the common practices in Portuguese intensive care units, as reported in the point prevalence study. Efforts should be made specifically to avoid oversedation and to promote delirium assessment.

Efectividad de antimicrobianos como coadyuvantes del raspado y alisado radicular en el tratamiento de la periodontitis del adulto

Fundamento: existen escasos estudios que evalúen la aplicación subgingival de antimicrobianos en el tratamiento de la periodontitis del adulto. Objetivo: evaluar la efectividad de antimicrobianos como coadyuvantes del raspado y alisado radicular en el tratamiento de la periodontitis leve y moderada del adulto. Métodos: estudio cuasiexperimental de intervención terapéutica, realizado en la Clínica Estomatológica de Santiago de Cuba, entre noviembre 2018 y septiembre 2021, sobre 144 pacientes con diagnóstico de periodontitis crónica leve y moderada. Mediante el método probabilístico aleatorio simple, se conformaron tres grupos con 48 integrantes, de forma voluntaria. El grupo control tratado con el raspado y alisado radicular y dos grupos de estudio en que, además, se aplicó una concentración subgingival de tetraciclina y azitromicina, respectivamente. Los pacientes fueron examinados y evaluados a los siete días, al mes y tres meses. Se empleó el análisis de varianza ANOVA para evaluar la igualdad de medias y la prueba ji-cuadrado para la efectividad de curación con un 95 % de confiabilidad. Resultados: hubo reducción de profundidad de sondaje y mayor ganancia de inserción clínica en los tres grupos, pero a favor de los grupos de estudio. Todas las terapias fueron efectivas, pero obtuvo mayor curación el grupo dos (RAR + Tetraciclina) con 97,9 %. Conclusiones: las aplicaciones subgingivales de tetraciclina y azitromicina resultaron efectivas como coadyuvantes del raspado y alisado radicular en el tratamiento de la periodontitis leve y moderada del adulto; con la tetraciclina se logró mayor mejoramiento de parámetros clínicos, disminución de profundidad de sondaje, ganancia de inserción clínica y menor tiempo de curación.

Background: there are few studies that evaluate the subgingival application of antimicrobials in adult periodontitis. Objective: to evaluate the effectiveness of antimicrobials as contributing for scaling and root planing in the treatment of mild and moderate periodontitis in adults. Methods: quasi-experimental study of therapeutic intervention, carried out at the Santiago de Cuba Stomatological Clinic, between November 2018 and September 2021, on 144 patients diagnosed with mild and moderate chronic periodontitis. Using the simple random probabilistic method, three groups with 48 members were formed voluntarily. The control group treated with scaling and root planing and two study groups in which, in addition, a subgingival concentration of tetracycline and azithromycin, respectively, was applied. The patients were examined and evaluated at seven days, one month and three months. ANOVA analysis of variance was used to evaluate the equality of means and the chi-square test for the effectiveness of healing with 95% reliability. Results: there was a reduction in probing depth and greater gain in clinical attachment in the three groups, but in favor of the study groups. All therapies were effective, but group two (RAR + Tetracycline) obtained a greater cure with 97.9%. Conclusions: subgingival applications of tetracycline and azithromycin were effective as adjuvants for scaling and root planing in mild and moderate periodontitis in adults; Tetracycline achieved greater improvement in clinical parameters, decreased probing depth, gain in clinical attachment, and shorter healing time.

Desarrollo de la periodontología en Santiago de Cuba / Development of periodontology in Santiago de Cuba

Se realizó una investigación de carácter histórico con el fin de exponer brevemente el desarrollo de la periodontología en Santiago de Cuba desde 1974 hasta la actualidad. Esta especialidad se ha venido fomentando de forma paulatina y hoy día cuenta con profesionales preparados integralmente para brindar una atención estomatológica especializada de calidad; también se vincula a la actividad docente-asistencial, con un claustro de 14 profesores altamente calificados. Puede afirmarse, entonces, que la formación del capital humano se ha cumplimentado por años -de acuerdo a la demanda poblacional y a los requerimientos del Sistema Nacional de Salud-, pues se ha contribuido, en gran medida, al perfeccionamiento y la preparación de estos especialistas con vistas a preservar, durante el presente y en el futuro, la salud periodontal de la población santiaguera.

An investigation of historical character aimed at briefly exposing the development of periodontology was carried out in Santiago de Cuba from 1974 to the present time. This specialty has been encouraging gradually and nowadays it has integrally prepared professionals to offer a specialized stomatological care with quality; it is also linked to the teaching-assistance activity, with a staff of 14 highly qualified professors. It can be affirmed then, that the human capital training has been fulfilled per years -according to the populational demand and the requirements of the National Health System-, because it has been contributed, in such an extent, to the improvement and preparation of these specialists aiming at preserving, during present and future times, the periodontal health of people from Santiago de Cuba.

Enfermedades perimplantarias: realidades y consecuencias / Peri-implantar diseases: realities and consequences

Introducción: La utilización de implantes dentales como método para reemplazar dientes perdidos ha demostrado ser un tratamiento con una tasa de éxito superior a 89 % en periodos de observación entre 10-15 años; no obstante, el número de implantes continúa incrementándose y, con ello, la prevalencia de enfermedades perimplantarias. Objetivo: Profundizar los conocimientos sobre la enfermedad perimplantaria y los tratamientos existentes. Desarrollo: Como resultado del avance en la rehabilitación, el uso de implantes dentales ha tomado un gran auge en los últimos años y, en particular, en la provincia de Santiago de Cuba; sin embargo, con el uso de esta técnica también se han incremento las complicaciones y los fracasos por múltiples razones. Conclusiones: La enfermedad perimplantaria representa un problema de salud con incidencia creciente, que requiere de un enfoque multidisciplinario, lo que depende de varios principios biológicos que es preciso respetar, tales como el diagnóstico, el plan terapéutico, la ejecución cuidadosa del proceder, el seguimiento posoperatorio y la carga apropiada del implante, que son factores importantes para lograr el resultado deseado.

Introduction: The use of dental implant as method to replace lost teeth has demonstrated to be a treatment with a success rate higher than 89 % in periods of observation between 10-15 years; nevertheless, the number of implants is still increasing and, with it, the prevalence of peri-implantar diseases. Objective: To deepen the knowledge on the peri-implantar disease and the existing treatments. Development: As a result of the advance in rehabilitation, the use of dental implants has taken a great boom in the last years and, in particular, in the province of Santiago de Cuba; however, with the use of this technique the complications and failures have also increased due to multiple reasons. Conclusions: The peri-implantar disease represents a health problem with growing incidence that requires a multidisciplinary approach, what depends on several biological principles that is necessary to respect, such as the diagnosis, the therapeutic plan, the careful implementation of the procedure, the postoperative follow up and the appropriate load of the implant that are important factors to achieve the result desired.

Evolución histórica del proceso enseñanza aprendizaje en Atención integral a la Familia II / Historic Evolution of the process teaching learning in integral Attention to the Family II / Evolução histórica do processo ensino-aprendizagem na Atenção Integral à Família II

RESUMEN Introducción: el proceso de enseñanza aprendizaje de la asignatura Atención Integral a la Familia II sufrió trasformaciones en los diferentes planes de estudio por los que transitó la carrera de estomatología. Objetivo: ilustrar la evolución histórica de la asignatura Atención Integral a la Familia II en la carrera de estomatología, a través de la enseñanza problémica y la educación en el trabajo como vía de adquirir y desarrollar los modos de actuación en estudiantes del cuarto año. Métodos: durante el curso 2018- 2019, en la Facultad de Estomatología de Granma se realizó una investigación educativa con enfoque histórico sobre el tema, utilizando como método teórico el histórico-lógico, inducción- deducción y analítico-sintético. Resultados: se determinaron las regularidades y tendencias a través del diagnóstico fáctico y de las diferentes etapas declaradas en la evolución histórica del proceso de enseñanza aprendizaje en esta asignatura. Conclusiones: existe variabilidad en la utilización del método y en la forma de enseñanza desde el objeto de la profesión, con insuficiente sistematización teórico- práctica según planes de estudio, lo que mantiene el carácter tradicionalista del proceso de enseñanza-aprendizaje y limita la actuación profesional independiente en el futuro estomatólogo.

ABSTRACT Introduction: the teaching-learning process of the Comprehensive Family Care II subject underwent transformations in the different study plans through which the stomatology career passed. Objective: to illustrate the historical evolution of the Comprehensive Family Care II course in stomatology, through problem teaching and education at work as a way of acquiring and developing modes of action in fourth-year students. Methods: during the 2018-2019 academic year, at the Faculty of Stomatology of Granma an educational research with a historical approach was carried out on the subject, using historical-logical, induction-deduction and analytical-synthetic as theoretical methods. Results: the regularities and trends were determined through the factual diagnosis and the different stages declared in the historical evolution of the teaching-learning process in this subject. Conclusions: there is variability in the use of the method and in the way of teaching from the object of the profession, with insufficient theoretical-practical systematization according to study plans, which maintains the traditionalist nature of the teaching-learning process and limits professional performance independent in the future stomatologist.

RESUMO Introdução: o processo ensino-aprendizagem da disciplina Atenção Integral à Família II passou por transformações nos diferentes planos de estudos pelos quais passou a carreira em Estomatologia. Objetivo: ilustrar a evolução histórica do curso de Atendimento Integral à Família II em Estomatologia, através do problema de ensino e educação no trabalho como forma de adquirir e desenvolver modos de atuação em alunos do quarto ano.: Durante o ano letivo 2018-2019, em Na Faculdade de Estomatologia do Granma foi realizada uma pesquisa educacional com abordagem histórica sobre o assunto, utilizando como métodos teóricos histórico-lógico, indução-dedução e analítico-sintético. Resultados: as regularidades e tendências foram determinadas através do diagnóstico factual e das diferentes etapas declaradas na evolução histórica do processo de ensino-aprendizagem nesta disciplina. Conclusões: há variabilidade na utilização do método e na forma de ensino a partir do objeto da profissão, com insuficiente sistematização teórico-prática de acordo com os planos de estudos, o que mantém o caráter tradicionalista do processo ensino-aprendizagem e limita a atuação profissional independente no futuro estomatologista.

Nivel de conocimientos sobre la COVID-19 en pacientes con urgencias estomatológicas / Knowledge level concerning COVID-19 in patients with dental emergencies / Nível de conhecimento sobre COVID-19 em pacientes com emergências odontológicas

RESUMEN Introducción: Los conocimientos sobre COVID-19 que posean los pacientes aquejados por urgencias estomatológicas son de vital importancia, ya que pueden infectarse y contagiar al personal de salud. Objetivo: Describir el nivel de conocimientos sobre COVID-19 en pacientes atendidos en la consulta de Urgencias de la Clínica Estomatológica Provincial "Mártires del Moncada" de Santiago de Cuba. Método: Se realizó un estudio descriptivo transversal entre marzo y junio de 2020, con un universo de 180 pacientes seleccionados mediante un muestreo probabilístico aleatorio simple, de ambos sexos y mayores de 18 años, que dieron su consentimiento para participar en la investigación. Se excluyeron aquellos con síndrome respiratorio agudo evidente. Se evaluaron la edad, sexo, urgencias estomatológicas y nivel de conocimientos. Se empleó la prueba Chi-cuadrado, con un grado de significación α=0,05, para determinar la asociación entre nivel de conocimientos, la edad y el sexo. Resultados: Las odontalgias y los abscesos dentoalveolares agudos fueron las afecciones estomatológicas predominantes, el nivel de conocimientos sobre COVID-19 predominante en los pacientes atendidos por urgencias estomatológicas fue bueno. Conclusiones: A pesar de que los pacientes afectados por urgencias estomatológicas poseen conocimientos buenos sobre la COVID-19, el desconocimiento o incumplimiento de algunas de las medidas de prevención y control de esta infección, puede contribuir a la transmisión de esta enfermedad hacia el personal de salud que los asiste, al ignoran su potencial de contagio.

ABSTRACT Introduction: Knowledge concerning COVID-19 among patients with dental emergencies, it is of high importance since they can become infected and infect health care personnel. Objective: To describe the level of knowledge concerning COVID-19 in patients who were attended at the Clínica Estomatológica Provincial "Mártires del Moncada" in Santiago de Cuba. Method: A descriptive cross-sectional study was conducted between March and June 2020. A total of 180 patients, in both sex and older than 18 and who gave their consent to be part of this research, were selected by a probability simple random sampling. Those with obvious acute respiratory syndrome were excluded. Age, sex, dental emergencies and knowledge level were assessed. The Chi-square test was used (alpha level of 0.05) to determine the association between knowledge Level, age, and sex. Results: Odontalgia and acute dentoalveolar abscesses were the predominant dental conditions, and the level of knowledge concerning COVID-19 in patients with dental emergencies attended at the clinic was good. Conclusions: Despite the good knowledge concerning COVID-19 showed by the patients affected with dental conditions, the lack of knowledge or non-compliance of measurements for the prevention and control of this infection may be the start point to spread the COVID-19 to the health personnel in service.

RESUMO Introdução: O conhecimento sobre a COVID-19 que os pacientes em situação de emergência odontológica possuem é de vital importância, pois podem infectar e infectar o pessoal de saúde. Objetivo: Descrever o nível de conhecimento sobre o COVID-19 em pacientes atendidos no Pronto-Socorro da Clínica Provincial de Estomatologia "Mártires del Moncada" de Santiago de Cuba. Método: Estudo transversal descritivo realizado entre março e junho de 2020, com um universo de 180 pacientes selecionados por amostragem probabilística aleatória simples, de ambos os sexos e maiores de 18 anos. Foram avaliados idade, sexo, emergências odontológica e nível de conhecimento. Foi utilizado o teste Qui-quadrado, com grau de significância α=0,05, para verificar a associação entre nível de conhecimento, idade e sexo. Resultados: Odontalgias e abscessos dentoalveolares agudos foram as condições estomatológicas predominantes, o nível de conhecimento predominante sobre a COVID-19 nos pacientes atendidos nas emergências odontológicas foi bom. Conclusões: Apesar de os pacientes acometidos por emergências odontológicas possuírem bons conhecimentos sobre a COVID-19, o desconhecimento ou não cumprimento de algumas das medidas de prevenção e controle desta infecção, pode contribuir para a transmissão desta doença aos profissionais de saúde que auxilia-os, ignorando seu potencial de contágio.