The Rogdi knockout mouse is a model for Kohlschütter-Tönz syndrome.

Kohlschütter-Tönz syndrome (KTS) is a rare autosomal recessive disorder characterized by severe intellectual disability, early-onset epileptic seizures, and amelogenesis imperfecta. Here, we present a novel Rogdi mutant mouse deleting exons 6-11- a mutation found in KTS patients disabling ROGDI function. This Rogdi-/- mutant model recapitulates most KTS symptoms. Mutants displayed pentylenetetrazol-induced seizures, confirming epilepsy susceptibility. Spontaneous locomotion and circadian activity tests demonstrate Rogdi mutant hyperactivity mirroring patient spasticity. Object recognition impairment indicates memory deficits. Rogdi-/- mutant enamel was markedly less mature. Scanning electron microscopy confirmed its hypomineralized/hypomature crystallization, as well as its low mineral content. Transcriptomic RNA sequencing of postnatal day 5 lower incisors showed downregulated enamel matrix proteins Enam, Amelx, and Ambn. Enamel crystallization appears highly pH-dependent, cycling between an acidic and neutral pH during enamel maturation. Rogdi-/- teeth exhibit no signs of cyclic dental acidification. Additionally, expression changes in Wdr72, Slc9a3r2, and Atp6v0c were identified as potential contributors to these tooth acidification abnormalities. These proteins interact through the acidifying V-ATPase complex. Here, we present the Rogdi-/- mutant as a novel model to partially decipher KTS pathophysiology. Rogdi-/- mutant defects in acidification might explain the unusual combination of enamel and rare neurological disease symptoms.

Comment reconnaître et distinguer les anomalies de structure dentaire ?

Introduction: The precise diagnosis of dental structural anomalies is an essential step preceding our restorative and orthodontic therapies. Indeed, first of all, it is necessary to identify the type of structural anomaly and to determine if it is an isolated or a syndromic form: the dental anomaly could be included in a more complex clinical picture combining other clinical signs. Moreover, the establishment of the diagnosis will allow the practitioner to adapt his clinical protocol according to the observed dental structure anomaly. The choice of the bonding material, the type of preparation (no prep, prep less, complete eviction), and the application of a deproteinization protocol with sodium hypochlorite depend to the structural defect. Material and Method: The diagnosis of dental structural anomalies is based on several key points described in this article in order to facilitate the practitioner's diagnostic approach. Conclusion: The diagnosis of amelogenesis or dentinogenesis imperfecta should justify the search for other signs to determine whether the anomaly of tooth structure is isolated or syndromic.

Introduction: Le diagnostic précis des anomalies de structure dentaire est une étape primordiale et préalable à nos thérapeutiques restauratrices et orthodontiques. En effet, dans un premier temps, il conviendra d'identifier le type d'anomalie de structure et de déterminer si celle-ci est isolée ou syndromique, c'est-à-dire si elle s'intègre ou non dans un tableau clinique plus complexe regroupant d'autres signes cliniques. De plus, d'un point de vue thérapeutique, l'établissement du diagnostic permettra au praticien d'adapter son protocole clinique en fonction de l'anomalie observée : choix des matériaux de collage, fraisage sélectif, étape de déprotéinisation à l'hypochlorite de sodium. Matériel et méthode: Le diagnostic des anomalies de structure repose sur plusieurs points clés qui seront abordés au cours de cet article afin de faciliter la démarche diagnostique du praticien. Conclusion: Le diagnostic d'amélogenèses ou de dentinogenèses imparfaites doit justifier la recherche d'autres signes afin de déterminer le caractère isolé ou syndromique de l'anomalie de structure dentaire.

Damaged first permanent molar: how conservative can we be? / Première molaire permanente délabrée : jusqu'où peut-on être conservateur ?

Introduction: It is a fact reported in the literature that the first permanent molar is the most frequently decayed tooth. Our treatment choice is based mainly on two clinical criteria: the degree of coronal decay and the damage to the pulp tissue. In the absence of pulp tissue necrosis, the following therapeutic gradient: indirect pulp capping, direct pulp capping, partial pulpotomy, cameral pulpotomy should be implemented with the objective of maintaining pulp vitality regardless the degree of maturity of the molar. Discussion: In the case of pulp tissue necrosis, if the tooth is immature, stopping root construction and apical closure requires an apexification or endodontic regeneration technique. The prognosis of these necrotic teeth remains uncertain in the medium and long term (risk of fractures). This raises the question of the indication for avulsion of the first permanent molar (FPM). Objectives: The main objectives of this article are to present the means of conservation and their limits. Conclusion: The decision to retain a FPM is based on several criteria, including assessment of pulpal status (which remains problematic, especially on immature permanent teeth) and the feasibility of coronal restoration. The decision to retain or extract a FPM must be the subject of a multidisciplinary discussion between a paediatric dental surgeon and a specialist qualified in dentofacial orthopaedics.

Introduction: C'est un fait rapporté dans la littérature : la première molaire permanente est la dent la plus fréquemment délabrée. Notre choix thérapeutique repose principalement sur deux critères cliniques : le degré de délabrement coronaire et l'atteinte du tissu pulpaire. En l'absence de nécrose du tissu pulpaire, le gradient thérapeutique suivant : coiffage pulpaire indirect, coiffage pulpaire direct, pulpotomie partielle, pulpotomie camérale doit être mis en œuvre avec pour objectif de maintenir la vitalité pulpaire quel que soit le degré de maturité de la molaire. Discussion: En cas de nécrose du tissu pulpaire, si la dent est immature, l'arrêt de l'édification radiculaire et de la fermeture apicale requiert une technique d'apexification ou de régénération endodontique. Or le pronostic de ces dents nécrosées reste incertain à moyen et long termes (risque de fractures). Se pose alors la question de l'indication d'avulsion de la première molaire permanente (PMP). Objectifs: Les principaux objectifs de cet article sont de présenter les moyens de conservation et leurs limites. Conclusion: La décision de conservation d'une PMP repose sur plusieurs critères dont l'évaluation du statut pulpaire (qui reste problématique, surtout sur dent permanente immature) et la faisabilité de la restauration coronaire. La décision de conserver ou d'extraire une PMP doit faire l'objet d'une discussion pluridisciplinaire entre chirurgien-dentiste pédiatrique et spécialiste qualifié en orthopédie dento-faciale.

Pulp regeneration: follow the guide / Régénération pulpaire : suivez le guide

Introduction: What if we changed our point of view? What if we approached endodontics from a biological perspective rather than a mechanistic one? What if, in the case of pulpal tissue necrosis, we were to consider an alternative to apexification therapies? Is pulp tissue regeneration now possible? Objective: Regenerative endodontic therapy (RET) aims to regenerate the pulp-dentin complex damaged by infection, trauma, or developmental anomaly of immature permanent teeth with necrotic pulp. The new intracanal tissue formation is expected to display pulp-like architecture and functions. There are two different based to tissue engineering approaches described to perform RET: cell-free CF-RET that attempt to induce host endogenous cells or stem cells to migrate into the root canal for regeneration or cell-based CB-RET which introduce exogenously prepared cells or stem cells into the canal for regeneration. Material and Method: CB-RET is the basis of current protocols recommended by the American Association of Endodontists (AAE) and the European Society of Endodontology (ESE) for the treatment of necrotic immature permanent teeth, with or without LIPOE. In this article, after defining the above-mentioned concepts, we will describe the ESE protocol and discuss the key steps for "getting started with endodontic regeneration". Conclusion: Each stage of the protocol must be carried out rigorously so as not to compromise the stages of the various biological processes involved. The practitioner has to stay informed of advances in knowledge resulting from research and new protocols to be published.

Introduction: Et si nous changions de point de vue ? Et si nous abordions l'endodontie d'un point de vue biologique et non mécanistique ? Et si, devant la nécrose du tissu pulpaire, nous envisagions une alternative aux thérapeutiques d'apexification ? La régénération du tissu pulpaire est-elle désormais possible ? Objectif: L'objectif des thérapeutiques régénératives endodontiques (regenerative endodontic therapy ou RET) est de récréer au sein du canal radiculaire un tissu semblable au complexe dentino-pulpaire tant sur le point de l'organisation cellulaire que sur le point fonctionnel. Deux concepts basés sur les principes de l'ingénierie tissulaire sont décrits : l'un basé sur la transplantation de cellules souches : le CB-RET (Cell-based RET) et l'autre basé sur le cell homing, c'est-à-dire sur le recrutement de cellules souches localisées à proximité de l'apex : le CF-RET (Cell-free RET). Matériel et méthode: Les protocoles actuels recommandés par l'Association Américaine des Endodontistes (American Association of Endodontists ou AAE) et la Société Européenne d'Endodontie (European Society of Endodontology ou ESE) dans le traitement des dents permanentes immatures nécrosées en présence ou non de lésion inflammatoire périapicale d'origine endodontique (LIPOE) sont basés sur le CF-RET. Dans cet article, après avoir défini les concepts cités précédemment, nous décrirons le protocole de l'ESE et discuterons des étapes clés pour « se mettre à la régénération endodontique ¼. Conclusion: Chaque étape du protocole doit être conduite avec rigueur afin de ne pas compromettre les étapes des différents processus biologiques engagés. Le praticien devra se tenir informé des avancées des connaissances issues des travaux de recherche et des nouveaux protocoles qui seront édités.

BDNF and Cerebellar Ataxia.

Brain-derived neurotrophic factor (BDNF) has been proposed as a treatment for neurodegeneration, including diseases of the cerebellum, where BDNF levels or those of its main receptor, TrkB, are often diminished relative to controls, thereby serving as replacement therapy. Experimental evidence indicates that BDNF signaling countered cerebellar degeneration, sensorimotor deficits, or both, in transgenic ATXN1 mice mutated for ataxin-1, Cacna1a knock-in mice mutated for ataxin-6, mice injected with lentivectors encoding RNA sequences against human FXN into the cerebellar cortex, Kcnj6Wv (Weaver) mutant mice with granule cell degeneration, and rats with olivocerebellar transaction, similar to a BDNF-overexpressing transgenic line interbred with Cacng2stg mutant mice. In this regard, this study discusses whether BDNF is effective in cerebellar pathologies where BDNF levels are normal and whether it is effective in cases with combined cerebellar and basal ganglia damage.

Amelogenesis imperfecta: Next-generation sequencing sheds light on Witkop's classification.

Amelogenesis imperfecta (AI) is a heterogeneous group of genetic rare diseases disrupting enamel development (Smith et al., Front Physiol, 2017a, 8, 333). The clinical enamel phenotypes can be described as hypoplastic, hypomineralized or hypomature and serve as a basis, together with the mode of inheritance, to Witkop's classification (Witkop, J Oral Pathol, 1988, 17, 547-553). AI can be described in isolation or associated with others symptoms in syndromes. Its occurrence was estimated to range from 1/700 to 1/14,000. More than 70 genes have currently been identified as causative. Objectives: We analyzed using next-generation sequencing (NGS) a heterogeneous cohort of AI patients in order to determine the molecular etiology of AI and to improve diagnosis and disease management. Methods: Individuals presenting with so called "isolated" or syndromic AI were enrolled and examined at the Reference Centre for Rare Oral and Dental Diseases (O-Rares) using D4/phenodent protocol (www.phenodent.org). Families gave written informed consents for both phenotyping and molecular analysis and diagnosis using a dedicated NGS panel named GenoDENT. This panel explores currently simultaneously 567 genes. The study is registered under NCT01746121 and NCT02397824 (https://clinicaltrials.gov/). Results: GenoDENT obtained a 60% diagnostic rate. We reported genetics results for 221 persons divided between 115 AI index cases and their 106 associated relatives from a total of 111 families. From this index cohort, 73% were diagnosed with non-syndromic amelogenesis imperfecta and 27% with syndromic amelogenesis imperfecta. Each individual was classified according to the AI phenotype. Type I hypoplastic AI represented 61 individuals (53%), Type II hypomature AI affected 31 individuals (27%), Type III hypomineralized AI was diagnosed in 18 individuals (16%) and Type IV hypoplastic-hypomature AI with taurodontism concerned 5 individuals (4%). We validated the genetic diagnosis, with class 4 (likely pathogenic) or class 5 (pathogenic) variants, for 81% of the cohort, and identified candidate variants (variant of uncertain significance or VUS) for 19% of index cases. Among the 151 sequenced variants, 47 are newly reported and classified as class 4 or 5. The most frequently discovered genotypes were associated with MMP20 and FAM83H for isolated AI. FAM20A and LTBP3 genes were the most frequent genes identified for syndromic AI. Patients negative to the panel were resolved with exome sequencing elucidating for example the gene involved ie ACP4 or digenic inheritance. Conclusion: NGS GenoDENT panel is a validated and cost-efficient technique offering new perspectives to understand underlying molecular mechanisms of AI. Discovering variants in genes involved in syndromic AI (CNNM4, WDR72, FAM20A … ) transformed patient overall care. Unravelling the genetic basis of AI sheds light on Witkop's AI classification.

Gold nanoparticles: current and upcoming biomedical applications in sensing, drug, and gene delivery.

Gold nanoparticles (AuNPs) present unique physicochemical characteristics, low cytotoxicity, chemical stability, size/morphology tunability, surface functionalization capability, and optical properties which can be exploited for detection applications (colorimetry, surface-enhanced Raman scattering, and photoluminescence). The current challenge for AuNPs is incorporating these properties in developing more sensible and selective sensing methods and multifunctional platforms capable of controlled and precise drug or gene delivery. This review briefly highlights the recent progress of AuNPs in biomedicine as bio-sensors and targeted nano vehicles.

Metodología de una encuesta por internet para hombres que tienen sexo con hombres en México.

OBJETIVO: Describir el diseño, implementación y el perfil de los participantes de la Encuesta de Sexo Entre Hombres (ES Entre Hombres). Material y métodos. ES Entre Hombres es una encuesta en línea no probabilística aplicada a nivel nacional a hombres de 18 años o más, que tienen sexo con hombres (HSH) y que usan internet. La población de estudio se reclutó a través de publicidad en diversos sitios de encuentro en línea y los cuestionarios se autoaplicaron con SurveyGizmo. RESULTADOS: Durante 11 semanas se registró un total de 15 875 autoaplicaciones elegibles y completas de las 32 entidades del país. La mayoría de los participantes fueron jóvenes (<29 años; 65.7%) y personas que acceden a internet diariamente (94.3%). Conclusión. Las encuestas realizadas por internet para poblaciones como los HSH representan un método costoefectivo de estudio poblacional, ya que tienen el potencial de ahorrar recursos y alcanzar muestras grandes, lo que a la vez facilita la cobertura geográfica a un bajo costo.

Metodología de una encuesta por internet para hombres que tienen sexo con hombres en México / Methodology of an internet survey for men who have sex with men in Mexico

Resumen: Objetivo: Describir el diseño, implementación y el perfil de los participantes de la Encuesta de Sexo Entre Hombres (ES Entre Hombres). Material y métodos: ES Entre Hombres es una encuesta en línea no probabilística aplicada a nivel nacional a hombres de 18 años o más, que tienen sexo con hombres (HSH) y que usan internet. La población de estudio se reclutó a través de publicidad en diversos sitios de encuentro en línea y los cuestionarios se autoaplicaron con SurveyGizmo. Resultados: Durante 11 semanas se registró un total de 15 875 autoaplicaciones elegibles y completas de las 32 entidades del país. La mayoría de los participantes fueron jóvenes (<29 años; 65.7%) y personas que acceden a internet diariamente (94.3%). Conclusión: Las encuestas realizadas por internet para poblaciones como los HSH representan un método costoefectivo de estudio poblacional, ya que tienen el potencial de ahorrar recursos y alcanzar muestras grandes, lo que a la vez facilita la cobertura geográfica a un bajo costo.

Abstract: Objective: To describe the design, implementation and profile of participants in the Sex Between Men Survey (ES entre Hombres). Materials and methods: ES entre Hombres is an online non-probabilistic survey applied at a national level to men 18 years of age or older, who have sex with men (MSM) and who use the internet. The target population was recruited through advertising on various online meeting sites and the questionnaires were self-administered using SurveyGizmo. Results: During 11 weeks a total of 15 875 eligible participants completed a self-applied questionnaire in 32 Mexican states. Most of the participants were young people (<29 years old; 65.7%) and people who access the internet daily (94.3%). Conclusion: Internet surveys for populations such as MSM represent a cost-effective method for population-based studies, since they have the potential to save resources and reach large samples sizes, providing geographic coverage at a low cost.

Sc(III)-Based metal-organic frameworks.

Scandium(III) ions can form robust metal-organic frameworks (MOFs) with relative ease of synthesis. However, their use in MOF construction remains scarce compared to the vast collection of MOFs using other ions. This highlight features the chronological development of Sc(III)-MOFs, which attest to the ability of Sc(III) ions to afford materials that combine exceptional stability with catalytic or photo-physical attributes.

SO2 Capture Using Porous Organic Cages.

We report the first experimental investigation of porous organic cages (POCs) for the demanding challenge of SO2 capture. Three structurally related N-containing cage molecular materials were studied. An imine-functionalized POC (CC3) showed modest and reversible SO2 capture, while a secondary-amine POC (RCC3) exhibited high but irreversible SO2 capture. A tertiary amine POC (6FT-RCC3) demonstrated very high SO2 capture (13.78 mmol g-1 ; 16.4 SO2 molecules per cage) combined with excellent reversibility for at least 50 adsorption-desorption cycles. The adsorption behavior was investigated by FTIR spectroscopy, 13 C CP-MAS NMR experiments, and computational calculations.

Effects of corticosterone injections in mid-to-late mouse postnatal development on adult motor activity and coordination.

Glucocorticoids are involved in the developing brain but, in excessive amounts, may depress its growth and cause psychomotor development disorders. To test the long-term vulnerability of motor structures such as the cerebellum to supraphysiological corticosterone (CORT), the hormone was subcutaneously delivered at a dose of 20 mg/kg from postnatal day (P) 8 to P29 in C57BL/6 male mice evaluated for sensorimotor functions at P15, P22, P29, and 3 months. Relative to placebo, CORT increased motor activity in the open-field at P29 and 3 months as well as facilitating rotorod acquisition and visuomotor control necessary for swimming towards a visible goal without affecting spatial learning in the Morris water maze. CORT caused lobule-specific effects on cerebellar morphology by decreasing granule cell layer thickness in simplex lobule but increasing molecular and granule cell layer thickness in crus 2. The functional impact of these changes is indicated by significant correlations found between cerebellar size and activity levels or proficiency on the rotorod test of motor coordination.

Long-term Adverse Effects of Acute Myeloid Leukemia Treatment on Odontogenesis in a Child.

BACKGROUND: Several studies showed that cancer therapies during tooth development are associated with dental abnormalities, including enamel defects, arrested tooth development, microdontic teeth, and agenesis. STUDY DESIGN: We describe the case of a nine-year-old boy treated for acute myeloid leukemia at 15 months of age, who presents several dental abnormalities resulting from anticancer treatment. RESULTS: The patient was included and treated according to the ELAM 02 French protocol. Six years after allogenic hematopoietic stem cell transplantation, the intraoral and radiographic examination highlighted the agenesis of the second permanent molars and three of the four second premolars, microdontia of the first premolars, root stunting of the central incisors and first premolars, rootlessness of the first permanent molars, and enamel defects localized at the permanent incisors and canines. As a first step to reduce enamel defects, restorations with resin composite (Tetric EvoCeram® A2, Ivoclar Vivadent) were performed under a dental dam. Orthodontic treatment was contraindicated due to arrested tooth development, short roots, and a risk of resorption is considered too important. CONCLUSION: The young age at diagnosis (<5 years of age) and intensive chemotherapy (especially myeloablative conditioning with high doses of cyclophosphamide and Busulfan) could explain the severity of the dental abnormalities. This case illustrates the importance of systematically scheduling a dental follow-up in parallel with the onco-hematologic follow-up allowing the clinicians to prevent, detect, and propose early intervention for dental late effects. HOW TO CITE THIS ARTICLE: Hernandez M, Pochon C, et al. Long-term Adverse Effects of Acute Myeloid Leukemia Treatment on Odontogenesis in a Child. Int J Clin Pediatr Dent 2019;12(3):243-246.

New copolymers as hosts of ribosomal RNA.

Functionalized copolymers were synthesized and are proposed as hosts of RNA. The copolymers are based on carboxymethyl cellulose and poly-(ethylene glycol)-OH. These copolymers were functionalized with two amino acids, either lysine or histidine, through amide bond formation. The functionalized copolymer was then used to adsorb ribosomal RNA. The RNA loading was based on the nature of the amino acid functionalization of the copolymer. The array of RNA-copolymers was observed to be soft sphere-like, where the density of spheres was a function of the molecular weight of the carboxymethyl cellulose and the nature of the amino acid. Such RNA-copolymer systems are very sensitive to changes in pH.

Annual Injection of Zoledronic Acid Improves Bone Status in Children with Cerebral Palsy and Rett Syndrome.

Osteoporosis is a common complication of cerebral palsy and Rett's syndrome. It is responsible for multiple fractures, bone pain, and impaired quality of life. In case of Rett's syndrome, a specific dysfunction of osteoblasts causes bone fragility. We observed the effects of annual zoledronic acid (ZA) infusion in a cohort of children with cerebral palsy and Rett's syndrome. 27 children under 18 years (19 with cerebral palsy and 8 girls with Rett syndrome confirmed by MCEP2 mutation) were treated with an annual injection of 0.1 mg/kg (max 4 mg) of ZA. Calcium and vitamin D were combined in all patients from the first injection of ZA. Dental examination was performed before treatment. Data were analyzed retrospectively. Bone mineral density was measured at diagnosis and yearly thereafter. Bone mass density (BMD) is decreased in patient with cerebral palsy and RS. One year after injection of ZA, we observe an increase of Lumbar spine BMD from - 2.99 to - 2.14 SD (p < 0.0001) and femoral BMD from - 4.26 to - 3.32 SD (p < 0.001) In the subgroup of patient with Rett syndrome, we also observe an increase from - 3.27 to 2.50 SD (p = 0.018) of Lumbar spine BMD. No fractures have been observed in our cohort since the first infusion. Side effects (flu-like syndrome and hypocalcemia) were more common in younger patients and after the first infusion. No serious complications were noticed. This study confirms the efficacy and the safety of an annual injection of ZA to improve bone status in children with cerebral palsy and Rett syndrome. No severe adverse effects were observed.

Use of new targeted cancer therapies in children: effects on dental development and risk of jaw osteonecrosis: a review.

New targeted cancer therapies such as bisphosphonates, denosumab, and bevacizumab are routinely used in adult for the past decades. Their introduction into pediatric medicine is more recent that means there is a paucity of data on long-term effects on dental development and on the risk of osteonecrosis of jaw. This study aimed to outline adverse effects of new targeted cancer therapies on oral cavity including dental abnormalities observed in pediatric population treated with these molecules and the risk of osteonecrosis of the jaw (ONJ). The impact of bisphosphonates and denosumab on bone remodeling (inhibition of osteoclasts) could interfere with teeth exfoliation and eruption processes, causing a tooth eruption delay. This hypothesis was confirmed, bisphosphonate-treated rats presented tooth eruption delay, and bisphosphonate therapy was associated with a mean delay of 1.67 years in tooth eruption in children with osteogenesis imperfecta. Another study showed that the inhibition of RANK/RANKL by denosumab was associated with a lack of tooth eruption in animals. Several animal studies reported that bisphosphonate could also induce dental abnormalities including defective amelogenesis and dentinogenesis in rats, but there is no evidence of such effects in children; only one case of enamel hypoplasia in a child treated for idiopathic arterial calcification with bisphosphate was reported. To date, there has been no reported case of ONJ in children treated with bisphosphonates, denosumab, or bevacizumab.

Hydrotalcite-quinolinate composites as catalysts in a coupling reaction.

Samples of layered double hydroxides were prepared by a sol-gel procedure. Quinolinate Al(C9H6NO)3 units were added during the synthesis, leading to composite quinolinate hydrotalcite-like compounds. The amount of quinolinate was varied, showing that the number of organic building blocks determines the physicochemical properties of materials, which differ significantly from those commonly reported for hydrotalcites without any quinolinate. The order of layers, specific surface area and coordination of aluminium were the parameters most significantly influenced by the presence of the quinolinate as a part of the brucite-like layers. The composite quinolinate-hydrotalcite materials were tested to catalyse the Kabachnik-Fields reaction.Graphical abstractAdding of quinolinate Al(C9H6NO)3 to hydrotalcite-like compounds creates disorder in the stack of brucite-like layers, leading to a significant modification of structural, textural and catalytic properties. The presence of quinolinate inhibits the enchainment of octahedral blocks in hydrotalcite but develop specific surface areas as high as 600 m2g-1.

Factores de riesgo de eventos coronarios agudos. Importancia del factor psicosocial. Área terapia intensiva municipal / Risk factors of acute coronary episodes. Importance of psychosocial factor in the Municipal Intensive Care Area

Introducción: los eventos coronarios agudos se encuentran en la actualidad entre las primeras causas de muerte en el mundo, incluyendo Cuba. Objetivo: determinar los factores de riesgo que influyeron en la aparición de eventos coronarios agudos, particularizando en el factor psicosocial en pacientes atendidos en el Área de Terapia Intensiva Municipal de Los Palacios durante el año 2009. Material y método: investigación aplicada, de casos y controles. Muestra: grupo estudio (pacientes mayores de 15 años atendidos en el área de terapea intensiva municipal que hayan sobrevivido a un evento coronario agudo) y grupo control (2 personas que no hayan sufrido un evento coronario agudo por cada una del grupo estudio, y que vivan en el mismo consejo popular). Se estudiaron factores de riesgo tradicionales y factores psicosociales (depresión, stress y ansiedad). Se utilizaron medidas de resúmenes para datos cualitativos, chi cuadrado, probabilidad exacta de Fisher (para asociación de variables en tablas de 2 x 2) y Mann-Whitney. Resultados: el incremento de la edad, el hábito de fumar y la hipertensión arterial resultaron muy significativos como predisponentes para desarrollar eventos coronarios agudos (p < 0.001 y p < 0.005) respectivamente, siendo el 100% de los pacientes del grupo estudio hipertensos; mientras que la depresión, ansiedad y stress aunque presentes en ambos grupos no resultaron importantes por sí solas para la ocurrencia de dichos eventos. Conclusiones: en la ocurrencia de eventos coronarios agudos en el municipio Los Palacios durante el año 2009 influyeron los factores de riesgo: edad, hábito de fumar e hipertensión arterial, mientras que la presencia del factor psicosocial no resultó importante como factor desencadenante de estos eventos.

Introduction: currently acute coronary episodes are found among the first causes of death in the world, including Cuba. Objective: to determine the risk factors influencing on the onset of acute coronary episodes, emphasizing on psychosocial factors in patients attending to the Municipal Intensive Care Area in Los Palacios municipality during 2009. Material and method: a case-control applied research. Sample: study group (patients older than 15 years old admitted to the Municipal Intensive Care who survived acute coronary episodes) and a control group (2 healthy people per one person included in the study group living in the same Popular Council). Traditional risk factors as well as psychosocial factors (depression, stress, and anxiety) were studied. Measures of summing up qualitative data, chi-square test, Fisher's exact probability (to the association of variables in tables of 2x2) and Mann-Whitney U test were used. Results: the increase of age, smoking and hypertension resulted significant as predisposing factors to develop acute coronary episodes (p < 0.001 and p <0.005) respectively, where 100% of the patients included into the study group suffered from hypertension; whereas depression, anxiety and stress, though present in both groups, resulted not so important per se to the occurrence of these episodes. Conclusions: during 2009 the risk factors influencing on the occurrence of acute coronary episodes in Los Palacios municipality were: age, smoking and hypertension, while the presence of psychosocial factors resulted not as important to trigger these episodes.

El tabaquismo en los profesionales de la salud en el municipio Habana Vieja / Smoking present in health professionals working in Habana Vieja municipality

Los médicos y otros profesionales de la salud constituyen una importante fuente de influencia para lograr cambios positivos en la prevalencia de tabaquismo en la comunidad. Identificar la prevalencia, percepción del riesgo y factores favorecedores del tabaquismo en profesionales de la salud. Estudio observacional, descriptivo realizado en 731 profesionales del municipio Habana Vieja en el año 2007. Se aplicó una entrevista y guía de observación en la que se midieron variables epidemiológicas relacionadas con la prevalencia y la percepción del riesgo de fumar y de ser fumador pasivo, así como los factores favorecedores al tabaquismo. El 36,4 por ciento de los profesionales fumaban, de ellos 91,7 por ciento son enfermeros y médicos. Se demostró una percepción distorsionada y una marcada despersonalización del riesgo de fumar. La presencia de amigos, compañeros de trabajo y parejas fumadores, resultaron factores favorecedores del tabaquismo, al igual que la permisibilidad de fumar en los centros de salud, 60,6 por ciento. El rol de los profesionales de la salud en la prevención y control del tabaquismo se encuentra limitado por la condición de ser fumadores y la baja percepción de riesgo. La elevada prevalencia de fumadores entre los profesionales de la salud y el escenario favorecedor al tabaquismo del municipio Habana Vieja, constituye un aspecto negativo para la prevención y control del tabaquismo en la comunidad, que no resulta coherente con la importancia que le confiere la salud pública a la participación comprometida de los profesionales sanitarios y no aprovecha las potencialidades que ofrece la atención primaria en el contexto cubano en la prevención y control del nocivo hábito de fumar.

Physicians and other health professionals represent an important source of influence to make positive changes in smoking prevalence in a community. To identify prevalence, risk perception and predisposing factors for smoking in health professionals. Methods A descriptive observational study was performed on 731 health professionals working in Habana Vieja municipality in 2007. An interview and an observation guide were used to measure epidemiological variables related to prevalence and perception of the risk of smoking and of being passive smoker as well as the predisposing factors for smoking. Of the total amount, 36,4 percent of these professionals smoked, 91,7 percent of them were doctors and nurses. There were distorted perception and marked depersonalization of the risk of smoking. The relationship with smoking friends, workmates and partners were favoring factors for smoking and also permissibility to smoking in health centers in 60,6 percent. The role of health professionals in the prevention and control of smoking is restricted because of their condition of smokers and low risk perception. High prevalence of smokers in health professionals and the favoring setting for smoking in Habana Vieja municipality constitute a negative aspect in the prevention and control of smoking in the community. This is in contradiction with the importance that public health attaches to the committed involvement of health professionals in this field and does not take advantage of the potentialities of the primary health care level under the Cuban conditions for the prevention and control of the harmful habit of smoking.

Legislación para el control del tabaquismo en Cuba / Smoking control legislation in Cuba

La población cubana se encuentra protegida mediante una legislación nacional, el Acuerdo 5570 de 2005 del Comité Ejecutivo del Consejo de Ministros, que permite controlar la venta de cigarrillos a menores y regular la prohibición de fumar en lugares públicos cerrados, en instituciones de salud y educación. Caracterizar el cumplimiento de las regulaciones y prohibiciones de fumar definidas en el mencionado acuerdo. Estudio observacional descriptivo. El universo fue el municipio Habana del Este, de Ciudad de La Habana, se realizó un muestreo por conglomerado monoetápico de cada localidad. La información primaria se obtuvo mediante guías de observación estructuradas y entrevistas. Los datos se procesaron de forma computarizada y los resultados se expresaron en porcentajes. Se encontró que en el 13,8 por ciento de los lugares de expendio, se vendió cigarrillos a menores de 18 años y fueron las cafeterias donde único de produjo violación de lo establecido a pesar de ser los lugares más señalizados. El 45,9 por ciento de los lugares con prohibición de fumar se encontraban señalizados pero en ellos se localizó un alto porcentaje de personas asistentes fumando. Los dependientes estaban fumando durante la atención al público en el 41 por ciento de los lugares de expendio, el 85,7 por ciento de los trabajadores de centros de salud fumaban durante el ejercicio de su profesión, el mayor porcentaje encontrado; no siendo así en los trabajadores de centros educacionales. Los directivos desconocen la existencia de señalización en sus propias entidades. La aplicación y cumplimiento de las regulaciones de venta y prohibiciones de fumar en lugares públicos como está establecido en el Acuerdo 5570 de 2005 en el municipio Habana del Este en el año 2007 es insuficiente, los principales factores determinantes son la falta de exigencia y control.

The Resolution 5570 of 2005 passed by the Executive Commission of the Council of Ministers protects the Cuban population through the control of selling cigarettes to children and of forbidding smoking in closed public places and in health and educational institutions, and plays a role in promoting healthy lifestyles. To characterize the enforcement of the regulations and of the ban on smoking defined in the Resolution no. 5570 of the Executive Commission of the Council of Ministers. Methods An observational descriptive study. The universe of study was Habana del Este municipality in the City of Havana province where one-stage cluster sampling was conducted. Primary data were collected from structured observational guides and interviews. Data was computer-processed and the results were given as percentages. Signs indicating the ban on selling cigarettes to children were seen in 44,8 percent points of sale but they were less frequent in bars and restaurants (66.7 percent). 13.8 percent of these placed did not abide by the legislation. Signs were seen in 45.9 percent of no smoking places but in 48.6 of them, there were people who smoked, including 41.4 percent of the staff at work; the healthcare personnel accounted for the highest percentage. Managers ignored the placing of such signs in their entities. The enforcement of and compliance with regulations on cigarette sale control and ban on smoking in closed public places as established by Resolution 5570 of 2005 was poor in Habana del Este municipality in 2007; and in this regard, the main determining factors were lack of control and exigency.