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Accurate determination of the prevalence of erosive tooth wear (ETW) and associated risk factors in adolescents can inform clinical management guidelines. The aim of this analytical cross-sectional study was to estimate the prevalence, severity, and risk factors of ETW in adolescents aged 12-15 years in the municipality of Usaquén in Bogotá, Colombia. Two calibrated examiners clinically assessed ETW using Basic Erosive Wear Examination (BEWE) Index (range: 0-3). All tooth surfaces (excluding proximal) were scored to allow estimation of the Highest (0-3) and Total BEWE (sum of Highest BEWE score per sextant: 0-18) scores per patient. Sociodemographic characteristics, ETW risk factors, and caries severity (ICDAS-epi-merged) were evaluated, and their association with the presence of ETW (indicated by a Highest BEWE score of 2-3) was examined using preliminary analyses and logistic regression models. The study sample included 454 adolescents (mean age: 13.5±1.1 years; female: 61.7%), and the prevalence of ETW was 71.6%. The majority of participants exhibited a Highest BEWE score of 3 (58.0%) and a Total BEWE score ≤8 (84.3%). The preliminary analysis showed an association between the presence of ETW and age, caries, and brushing teeth before eating (p-value < 0.05). Risk factors for ETW included always brushing teeth before eating [adjusted Prevalence Ratio (PRa) 1.31, p-value=0.014], presence of extensive carious lesions (PRa 1.23, p-value = 0.024), male gender (PRa 1.14, p-value = 0.028), and age > 14 years (PRa 1.17, p-value = 0.009). Although ETW was highly prevalent, most Colombian adolescents exhibited low Total BEWE scores. ETW was associated with frequent fruit intake, age, toothbrushing habits, caries lesions, and sex.
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Caries Dental , Factores Socioeconómicos , Erosión de los Dientes , Humanos , Colombia/epidemiología , Adolescente , Femenino , Masculino , Estudios Transversales , Erosión de los Dientes/epidemiología , Erosión de los Dientes/etiología , Factores de Riesgo , Prevalencia , Niño , Caries Dental/epidemiología , Caries Dental/etiología , Índice de Severidad de la Enfermedad , Factores de Edad , Distribución por Sexo , Distribución por Edad , Factores Sexuales , Modelos LogísticosRESUMEN
Abstract Accurate determination of the prevalence of erosive tooth wear (ETW) and associated risk factors in adolescents can inform clinical management guidelines. The aim of this analytical cross-sectional study was to estimate the prevalence, severity, and risk factors of ETW in adolescents aged 12-15 years in the municipality of Usaquén in Bogotá, Colombia. Two calibrated examiners clinically assessed ETW using Basic Erosive Wear Examination (BEWE) Index (range: 0-3). All tooth surfaces (excluding proximal) were scored to allow estimation of the Highest (0-3) and Total BEWE (sum of Highest BEWE score per sextant: 0-18) scores per patient. Sociodemographic characteristics, ETW risk factors, and caries severity (ICDAS-epi-merged) were evaluated, and their association with the presence of ETW (indicated by a Highest BEWE score of 2-3) was examined using preliminary analyses and logistic regression models. The study sample included 454 adolescents (mean age: 13.5±1.1 years; female: 61.7%), and the prevalence of ETW was 71.6%. The majority of participants exhibited a Highest BEWE score of 3 (58.0%) and a Total BEWE score ≤8 (84.3%). The preliminary analysis showed an association between the presence of ETW and age, caries, and brushing teeth before eating (p-value < 0.05). Risk factors for ETW included always brushing teeth before eating [adjusted Prevalence Ratio (PRa) 1.31, p-value=0.014], presence of extensive carious lesions (PRa 1.23, p-value = 0.024), male gender (PRa 1.14, p-value = 0.028), and age > 14 years (PRa 1.17, p-value = 0.009). Although ETW was highly prevalent, most Colombian adolescents exhibited low Total BEWE scores. ETW was associated with frequent fruit intake, age, toothbrushing habits, caries lesions, and sex.
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Abstract The aim of this study was to develop and achieve consensus on a cariology teaching framework for dental schools in Latin American Spanish-speaking countries. The Delphi process, with a ≥8 0% pre-defined participants' agreement, included three phases and a Coordinating Group. During the Preparation phase three panels of experts were selected and invited to participate: a) Regional academic/professional Dental Associations (Associations-Panel): n = 12; b) Regional Dental Schools (Dental-Schools-Panel): existing dental schools (n = 263) from the 19 Spanish-speaking regional countries; c) International academic/professional associations Peer Experts (Peer-Panel): n = 4. Based on consensus documents from Europe, Colombia, the Caribbean, USA, Chile and Spain, and updated scientific evidence, the Coordinating Group developed a baseline framework proposal of domains, main competencies (MC) and specific competencies (SC). The Consultation-Agreement and Consensus phases included three rounds of questionnaires with a step-wise sharing of the MC updated version of the consensus framework with the Dental-Schools-Panel and including SC with the Associations-Panel. Diverse communication strategies were used ( e.g ., independent google-form questionnaires and workshops). Consensus was reached after an on-site Associations-Panel workshop and secret voting, followed by an online meeting with the Peers-Panel. A total of 127 academic/professional institutions participated (Associations-Panel: 11, 91.6%; Dental-Schools-Panel: 112, 42.6%, all countries; Peers-Panel: 4, 100%). The baseline Cariology teaching framework of 5 domains, 10 MC and 92 SC underwent modifications after agreements for a final consensus framework consisting of 5 domains, 10 MC and 85 SC. A Core Cariology curriculum framework in Spanish for Latin American Dental Schools was successfully developed and agreed upon with regional dental academic and professional institutions.
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Abstract Roughness-tactile perception is part of activity assessment in initial-caries-lesions. Hypothesizing that a probe's design influences this examiner's assessment, four probes were designed. The aims of this study were to select the probe with highest inter-/intra-examiners' roughness-assessment agreement and to determine its diagnostic accuracy on artificial initial-caries lesions. A pilot study was conducted with trained dentists to select one controlled-pressure probe design (n = 4) by assessing roughness on known-roughness metal plaques with 5-point Likert scale. Diagnostic accuracy of roughness assessment was conducted with the selected controlled-pressure probe and the WHO-probe on sound and artificial initial-caries-lesion (n = 20) human enamel blocks. Intra-class correlation coefficients (ICCs) and quadratic weighted-Kappa scores were used to assess examiners' reproducibility and Multilevel Poisson models to determine diagnostic accuracy between both probes controlling for confounding variables. The probe design with the highest inter/intra-examiner's agreement (ICC = 0.96) was selected for subsequent analyses. Unadjusted sensitivity, specificity and accuracy values were for the controlled-pressure and the WHO probes: 71.1%,90.6%,81.2%, and 67.4%,84.6%,75.8%, respectively (p > 0.05). Examiner remained the most important factor influencing diagnostic accuracy. While this study did not show significantly higher diagnostic accuracy of the designed controlled-pressure vs. the WHO-probe when used by trained dentists, all over roughness-assessment accuracy and reproducibility were high.
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Resumen Introducción y objetivo: la severidad de la fluorosis dental refleja exposición a fluoruros durante el desarrollo del esmalte. Recientemente se han reportado asociaciones entre la exposición prenatal y postnatal a fluoruros y efectos negativos en el neurodesarrollo. El objetivo de este estudio fue describir y comparar la severidad y el patrón de distribución de la fluorosis en las denticiones primaria y permanente, como base para discutir la temporalidad de la exposición en niños viviendo en áreas endémicas en el departamento del Huila. Materiales y métodos: odontólogos entrenados diagnosticaron fluorosis en 840 niños (preescolares y escolares) de cuatro municipios usando el índice de Thylstrup & Fejerskov. Para estimar la prevalencia de las diferentes severidades, cada niño se clasifico de acuerdo con la severidad más alta en boca. La distribución de la prevalencia de severidades por grupo etario y tipo de dentición se reportan como tasas de prevalencia (%). Resultados: la prevalencia en preescolares y escolares fue de 97.2% y 99.9%, respectivamente y la fluorosis moderada la más prevalente (75.6% y 63.5%, respectivamente). En ambas denticiones, la fluorosis leve fue más prevalente en los dientes anteriores que en posteriores. Las severidades moderada y severa tuvieron mayor prevalencia en dientes posteriores que en anteriores. Conclusiones: el patrón de distribución de la severidad de la fluorosis sugiere exposición prenatal y postnatal a fluoruros, por encima de los niveles recomendados. Este estudio resalta la importancia de la alidación de la fluorosis del dental como un potencial biomarcador histórico de exposición a luoruros en momentos críticos para el neurodesarrollo.
Resumo Introdução e objetivo: a severidade da fluorose dentária reflete a exposição a fluoretos durante o desenvolvimento do esmalte. Recentemente, associações entre a exposição pré-natal e pós-natal ao fluoretos e efeitos negativos no desenvolvimento neurológico foram relatadas. O objetivo deste estudo é descrever e comparar o padrão de severidade e distribuição da fluorose na dentição decídua e permanente, como intuito para a discussão sobre a temporalidade da exposição em crianças moradoras em áreas endêmicas de fluorose no departamento de Huila, Colômbia. Materiais e métodos: Cirurgiões-dentistas treinados diagnosticaram fluorose em 840 crianças (pré-escolares e escolares) de quatro municípios, utilizando o índice de Thylstrup & Fejerskov. Para estimar a prevalência dos diferentes estágios de severidade, cada criança foi classificada de acordo com o escore mais severo da boca. A distribuição da prevalência de fluorose nos diferentes estágios de severidade por faixa etária e tipo de dentição é apresentada como taxa de prevalência (%). Resultados: a prevalência de fluorose em pré-escolares foi de 97,2% e em escolares de 99,9%. Fluorose moderada foi a mais prevalente (75,6% e 63,5%, respectivamente). Em ambas as dentições, a fluorose leve foi mais prevalente nos dentes anteriores do que nos posteriores. Porém, tanto fluorose moderada como severa foram mais prevalentes nos dentes posteriores do que nos anteriores. Conclusões: o padrão de distribuição da severidade da fluorose sugere uma exposição pré- e pós-natal a fluoretos acima de níveis recomendados. Este estudo salienta a importância da validação da fluorose dentária como um potencial biomarcador histórico da exposição ao fluoretos durante momentos críticos para o neurodesenvolvimento.
Abstract Introduction and objective: dental fluorosis severity reflects fluoride exposure during dental enamel development. Recently, prenatal and postnatal exposure to fluoride has been associated with negative neurodevelopmental outcomes. The aim of this study was to describe and compare the severity and distribution pattern of dental fluorosis in the primary and permanent dentition, as a basis to discuss the timing and extent of fluoride exposure of children living in endemic areas of fluorosis in the department of Huila. Materials and methods: 840 children (preschoolers and schoolchildren) from four municipalities of the Huila Department were examined by trained dentists for dental fluorosis using the Thylstrup & Fejerskov Index. To estimate the prevalence of severities of fluorosis, each child was classified according to the most severe score. The distribution of the prevalence of enamel fluorosis severity by age-group and type of dentition were reported as prevalence rates (%). Results: Prevalence of dental fluorosis in preschoolers was of 97.2% and in schoolers of 99.9%. For both preschoolers and schoolers moderate fluorosis was the most prevalent (75.6% and 63.5%, respectively). For both primary and permanent teeth, mild fluorosis was more prevalent in anterior teeth than in posterior teeth. Moderate and severe fluorosis were more prevalent in posterior teeth than in anterior teeth. Conclusions: the distribution pattern of the severity of dental fluorosis suggests both prenatal and postnatal exposure to fluoride above recommended levels. This study raises the importance of the validation of dental fluorosis as a potential historical biomarker of fluoride exposure at moments that are critical for neurodevelopment.
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Background: Dietary exposure to mercury in women of childbearing age could result in neurological effects on the fetus. A health risk assessment of total mercury by fishery products intake has not been conducted in this population group in Bogota, Colombia. On the other hand, it has been suggested that selenium content on fishery products may have a protective effect against mercury toxicity. Nevertheless, selenium content on fish species marketed in Bogota has not been determined. Objective: Exposure risk to total mercury and selenium content on fishery products consumed by women of childbearing age from Bogota, Colombia, were assessed. Methods: Total mercury and selenium concentrations for products available at fish stores and supermarkets were determined. The exposure risk to total mercury was estimated considering the intake of these products by women of childbearing age group. Results: Total mercury highest concentrations were 0.8166 mg/kg in mota (Calophysusmacropterus), and 0.6275 mg/kg in catfish (Pseudoplatystoma tigrinum). On the other hand, the highest selenium concentration was 0.6471 mg/kg in nicuro (Pimelodus blochii). Finally, it was established that for women of childbearing age group, health risk of exposure to total mercury due to mota intake exceeded by 8.56-fold the reference dose. Conclusions:Mota intake considerably increases exposure risk to total mercury on women of childbearing age from Bogota, Colombia. The selenium levels established in the fishery products assessed, except for catfish and mota, are theoretically suggestive of a protective effect of selenium against mercury toxicity. Consequently, continuous total mercury concentrations monitoring is required to protect health of women of childbearing age and the general population from Bogota, Colombia
Antecedentes: La exposición dietética al mercurio en mujeres en edad fértil podría provocar efectos neurológicos en el feto. En Bogotá, Colombia no se han realizado evaluaciones de riesgo por la exposición al mercurio total debido a la ingesta de productos de la pesca en este grupo de la población. Por otro lado, ha sido sugerido que el contenido de selenio en los productos de la pesca podría tener un efecto protector frente a la toxicidad por mercurio, sin embargo, el contenido de selenio en las especies de peces comercializadas en Bogotá, Colombia no ha sido determinado. Objetivo: Evaluar el riesgo de exposición al mercurio total y el contenido de selenio en los productos de la pesca consumidos por las mujeres en edad fértil de Bogotá, Colombia. Métodos: Se determinaron las concentraciones de mercurio total y selenio en distintos productos de la pesca disponibles en pescaderías y supermercados. El riesgo de exposición a mercurio total se estimó considerando la ingesta de estos productos por parte de un grupo de mujeres en edad fértil. Resultados: Las concentraciones más altas de mercurio total fueron de 0.8166 mg/kg en mota (Calophysus macropterus) y 0.6275 mg/kg en bagre (Pseudoplatystoma tigrinum). Por otro lado, la concentración más alta de selenio fue de 0.6471 mg/kg en nicuro (Pimelodus blochii). Finalmente, se estableció que el riesgo de exposición a mercurio total, debido a la ingesta de mota, excedió en 8.56 veces la dosis de referencia en el grupo de mujeres en edad fértil. Conclusiones: La ingesta de mota aumenta el riesgo de exposición al mercurio total en las mujeres en edad fértil de Bogotá, Colombia. Por otro lado, los niveles de selenio identificados en los productos evaluados, excepto en bagre y mota, teóricamente sugieren un posible efecto protector del selenio contra la toxicidad por mercurio. Considerando lo indicado, es necesario realizar un monitoreo continuo de las concentraciones de mercurio total en los productos de la pesca, con el fin de proteger la salud de las mujeres en edad fértil y de la población general de Bogotá, Colombia
Asunto(s)
Humanos , Medición de Riesgo , Selenio , Mujeres , Fertilidad , MercurioRESUMEN
Background: in Colombia the consumption of fresh green mango (also known as mango "biche") is quite popular, and is consumed with lemon juice, salt, and honey. However, its high humidity content and high water activity makes of mango a highly perishable fruit, thus requiring processing alternatives. Osmotic dehydration (OD) is an interesting alternative for the conservation of mango. In OD, binary solutions (Solute + water) and ternary solutions (2 Solutes + water), have been traditionally used, however, more water removal can be achieved using ternary solutions, which leads to the improved organoleptic properties of dehydrated products. Objetives: to evaluate the kinetic water loss (WL), solutes gain (SG), weight reduction (WR), water activity (aw), and volume (Shrinking Coefficient, SC)) in green mango (Mangifera indica L. Filipino variety) osmotically dehydrated (OD). Additionally, to calculate water and solutes diffusivity (Def) for each treatment. Methods: green mango samples, with maturity scale zero, were used. Ternary solutions of sucrose at 40% and NaCl at 3, 6 and 9% were used for OD. The binary solution of sucrose with water as control treatment, was used. In the osmotic process samples were taken out at different times of OD (15, 30, 60, 90, 180, 240, and 300 min). Results: the findings show that at a higher concentration of NaCl, the dehydration kinetics was more rapid, aw and SC were smaller and water and solutes Def were higher. The samples dehydrated with the greatest solutes concentration (40 - 9%) reached the highest WL, SG, and WR with 89.52, 13.10, and 46.68%, respectively. Coefficients Defw and Defs showed a magnitude order of 10-10 m2/s, which is within the interval of dehydrated foods. Conclusions: this research showed that binary (sucrose + water) and ternary (NaCl + sucrose + water) solutions, are suitable for dehydrating green mango, however, the ternary solutions were more effective.
Antecedentes: en Colombia el consumo de mango verde fresco (también conocido como mango "biche") es popular, y se consume con zumo de limón, sal y miel. Sin embargo, su alto contenido de humedad y alta actividad de agua hace que el mango sea un fruto altamente perecedero, por lo que requiere alternativas de procesamiento. La deshidratación osmótica (OD) es una interesante alternative para la conservación de mango. En OD se utilizan tradicionalmente soluciones binarias (solute + agua) y soluciones ternarias (2 solutos + agua), sin embargo, puede removerse mayor cantidad de agua utilizando soluciones ternarias, las cuales permiten mejorar las propiedades organolépticas de productos deshidratados. Objetivos: evaluar las cinéticas de pérdida de agua (WL), ganancia de solutos (SG), reducción de peso (WR), actividad de agua (aw) y volumen (coeficiente de encogimiento, SC) en muestras de mango verde (Mangifera indica L. Variedad filipino) deshidratadas osmóticamente (OD). Adicionalmente, calcular la difusividad (Def) del agua y de solutos, en los distintos tratamientos. Métodos: se usaron mangos verdes con escala de madurez cero. En la OD se usaron soluciones ternarias compuestas por sacarosa (40%) y NaCl al 3, 6 y 9%. Como tratamiento control se usó una solución binaria de sacarosa más agua. En el proceso osmótico las muestras fueron tomadas a diferentes tiempos de OD (15, 30, 60, 90, 180, 240, and 300 min). Resultados: los resultados mostraron que al incrementar la concentración de NaCl, las WL fueron más rápidas, la aw y el SC fueron menores y las de agua y solutos mayores. Las muestras deshidratadas con la máxima concentración de solutos (40-9%), alcanzaron las mayores WL, SG y WR con valores de 59.82, 13.10 y 46.68%, respectivamente. Los coeficientes Defw and Defs mostraron orden de magnitude de 10-10 m2/s, valor que se encuentra en el intervalo para alimentos deshidratados. Conclusiones: esta investigación mostró que soluciones binarias (sacarosa + agua) y ternarias (NaCl + sacarosa + agua) son adecuadas para deshidratar mango verde, sin embargo, las soluciones ternarias fueron más efectivas.
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Humanos , Mangifera , Sacarosa , Cloruro de Sodio , Conservación de AlimentosRESUMEN
The aim of this study was to assess whether caries risk, nutritional status, access to dental care and sociobehavioral factors are associated to two caries experience outcome variables using the Epidemiologic International Caries Detection and Assessment System (ICDASepi), which includes initial enamel caries lesions: 1The presence of ICDASepi caries experience (dmfICDASepi ≥ 1), and 2Having an ICDASepi caries experience (dmftICDASepi) higher than national figures for the same age. The sample included 316 eightto 71monthold children from the municipality of Anapoima, Colombia. Assessments included: prevalence and mean of caries experience using the ICDASepi system without compressed airdrying of teeth surfaces (dmfICDASepi), caries risk and nutritional status. Caregivers completed an elevenitem questionnaire assessing oral healthrelated social determinants, practices and quality of life (OHRQoL), and children's access to dental care. Data were analysed using the Wilcoxonranksum test, the test, the Fisherexact test, and bivariatelinear and nonconditioned logisticmultivariate regression models. Prevalence and mean number of teeth with dmftICDASepi were 65.2% and 3.5±4.13, respectively. Nutritional status outside the normal status, lower educational level of caregivers and age were significantly associated with dmfICDASepi≥ 1. OHRQoL, access barriers to miss and to attend dental care, operativetreatment or emergency being the reason to attend dental care, high caries risk, and age were significantly associated with a higherthannational dmftICDASepi. The significant associations found between early childhood caries experience and other variables represent oralhealth inequalities in early childhood in Anapoima, Colombia (AU)
El objetivo de este estudio fue evaluar en la primera infancia la asociación entre el riesgo de caries, el estado nutricional, el acceso a la consulta odontológica y los factores sociocomporta mentales y dos variables de desenlace de experiencia de caries usando el Sistema epidemiológico Internacional de Detección y Valoración de Caries (ICDASepi), que incluye lesiones de caries en el esmalte: 1La presencia de experiencia de caries ICDASepi (ceodICDASepi ≥ 1) y, 2Tener una experiencia de caries ICDASepi (ceodICDASepi) mayor que los datos nacionales correspondientes para la misma edad.La muestra fue de 316 niños del municipio de Anapoima, Colombia, de 8 a 71 meses de edad. Las valoraciones incluyeron: prevalencia y promedio de experiencia de caries usando el sistema ICDASepi sin secado de las superficies de los dientes con aire comprimido (dmfICDASepi) ; riesgo de caries y estado nutricional. Los cuidadores respondieron un cuestionario de once ítems que valoraba en relación con salud oral, determinantes sociales, prácticas y calidad de vida y, el acceso de los niños a la consulta odontológica. Los datos fueron analizados con la prueba de suma de rangos de Wilcoxon, la prueba de χ2, la prueba exacta de Fisher y, modelos de regresión logística multivariada tipos bivariantelineal y no condicionada. La prevalencia de experiencia de caries (ceodICDASepi) fue de 65.18% y el promedio de dientes con ceodICDASepi de 3.5 ± 4.13. El estado nutricional por fuera de rangos de normalidad, el bajo nivel educativo de los cuidadores y la edad se asociaron significativamente con ceoICDASepi ≥ 1. Se encontró asociación estadísticamente significativa entre tener un ceodICDASepi mayor que el promedio nacional y, calidad de vida relacionada con salud oral, barreras de acceso para perder y asistir a consulta odontológica, tratamiento operatorio o urgencia como motivo de consulta odontológica, alto riesgo de caries y edad. Las asociaciones estadísticamente significativas encontradas en este estudio entre la experiencia de caries de infancia temprana y demás variables representan inequidades en salud oral en la primera infancia en Anapoima, Colombia (AU)
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Humanos , Masculino , Femenino , Lactante , Preescolar , Índice CPO , Estado Nutricional , Factores de Riesgo , Atención Dental para Niños , Caries Dental , Susceptibilidad a Caries Dentarias , Calidad de Vida , Factores Socioeconómicos , Estudios Transversales , Interpretación Estadística de Datos , Encuestas y Cuestionarios , Factores de Edad , Colombia , Accesibilidad a los Servicios de SaludRESUMEN
ABSTRACT. Objective: identify social determinants of health in families of preschoolers from Anapoima, Cundinamarca, and their relationship with prevalence of caries experience. Methods: in the framework of the Alliance for a Caries-Free Future - Colombia Chapter (Alianza por un Futuro Libre de Caries-Capítulo Colombia, AFLC-CC), the prevalence of caries experience in preschool children from Anapoima, Cundinamarca, was assessed using the International Caries Detection and Assessment System (ICDAS) and the dmft (decayed, missing, filled teeth) index, characterizing their families and homes. Descriptive analysis was done, using X2 to explore associations between dmft and ICDAS with socioeconomic and infrastructure conditions, as well as health practices in families. Results: 120 kindergarten children from the municipality of Anapoima were assessed and their homes were visited. The prevalence of caries experience (dmft) was 33.3% (average: 1.3 ± 2.5); when initial lesions were included, the prevalence reached 46.7% (4.3 ± 7.0). There was a relationship between the presence of caries and type of oral health problems referred to by parents, kin relationship with caregiver, visits to the oral health service, and availability of a space for the toothbrush (p < 0.05). Conclusions: the assessed children showed low caries experience compared to national benchmarks, which can be explained by the intermediate determinants identified in their family environments, with economic, infrastructure and family structure conditions favorable to health practices. It is necessary to better understand the relationship between social determinants and oral health from a structural point of view and to strengthen health strategies, in order to achieve caries-free populations.
RESUMEN Objetivo: identificar determinantes sociales de salud, en el ámbito familiar, en preescolares de Anapoima, Cundinamarca, y su relación con la prevalencia de experiencia de caries. Métodos: en el marco de la Alianza por un Futuro Libre de Caries-Capítulo Colombia (AFLC-CC), se valoró la prevalencia de experiencia de caries en niños preescolares de Anapoima, Cundinamarca, usando el Sistema Internacional de Detección y Valoración de Caries (ICDAS) y el índice ceod (cariados, extraídos y obturados, por diente), y se caracterizaron sus familias y viviendas. Se hizo análisis descriptivo y usando 2 se exploraron asociaciones entre ceod e ICDAS y condiciones socioeconómicas, de infraestructura y prácticas de salud en las familias. Resultados: se valoraron 120 niños de jardines infantiles del municipio de Anapoima y se visitaron sus hogares. La prevalencia de experiencia de caries (ceod) fue de 33,3% (promedio: 1,3 ± 2,5); al incluir lesiones iniciales, fue de 46,7% (4,3 ± 7,0). Se encontró relación entre presencia de caries y tipo de problemas de salud bucal referidos por los padres, relación filial con el cuidador, asistencia al servicio de salud bucal y disponibilidad de un espacio para el cepillo (p < 0,05). Conclusiones: los niños valorados presentaron baja experiencia de caries, en comparación con referentes nacionales, lo cual se explica por los determinantes intermedios identificados en su ámbito familiar, en los que se evidencian condiciones económicas, de infraestructura y de conformación familiar favorables para las prácticas de salud. Es necesario profundizar en la comprensión de la relación entre determinantes sociales y salud bucal desde la esfera estructural y fortalecer las estrategias en salud, con miras a lograr poblaciones libres de caries.
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Determinantes Sociales de la Salud , Familia , Preescolar , Caries DentalRESUMEN
Abstract A caries-epidemiological study using the ICDASepi-merged system was conducted in Colombian young children. This study aimed at associating the time needed for the clinical examination of caries and caries risk in 1 to 5-year-old children according to age and caries risk, and to assess behavior and child pain self-perception during examination according to age. After IRB approval and given parents/caregivers' informed consent, seven trained examiners assessed 1 to 5-year olds in kindergartens under local field conditions. ICDASepi-merged caries experience (depiMEmf) was assessed as follows: Initial-depi (ICDAS 1/2 without air-drying); Moderate-dM (ICDAS 3,4); Extensive-dE (ICDAS 5,6) lesions; due-to-caries fillings-f and missing-m surfaces/teeth. Caries risk was assessed with Cariogram®. Child's behavior (Frankl-Behavior-Rating-Scale) and self-perceived pain (Visual-Analogue-Scale-of-Faces) during examination were evaluated. Clinical examination time was recorded with a stopwatch. A total of 592 children participated (1-yr.: n=31; 2-yrs.: n=96; 3-yrs.: n=155; 4-yrs.: n=209, 5-yrs.: n=101). The depiMEmfs prevalence was of 79.9% and the mean 8.4±10.4. Most were high-caries-risk children (68.9%). The majority (58.9%) showed ≥ positive-behavior and ≤ light-pain self-perception (88.4%). Mean clinical examination time was around 3.5 minutes (216.9±133.9 seconds). For 5-yr. olds it corresponded to 4 minutes (240.4±145.0 seconds) vs. 2 minutes (122.8±80.1 seconds) for 1-yr. olds (Kruskal-Wallis; p=0.00). For high- and low-caries risk children it was around 4.3 minutes (255.7±118.5 seconds) and 3.3 minutes (201.3±129.4 seconds), respectively (ANOVA; p=0.01). This study demonstrates using the ICDAS system in young children is feasible, taking less than 4 minutes for the clinical examination without children behavior/pain self-perception issues.
Resumo Um estudo epidemiológico de cárie usando o sistema ICDAS foi realizado em crianças pequenas colombianas. O objetivo deste estudo foi associar o tempo necessário para o exame clínico da cárie e o risco de cárie em crianças de 1 a 5 anos de acordo com a idade e o risco de cárie e avaliar a autopercepção do comportamento e da dor na criança durante o exame, de acordo com a idade. Após a aprovação do comitê de ética e do consentimento informado dos pais/responsáveis, sete examinadores treinados avaliaram crianças de 1 a 5 anos em creches em condições locais de campo. A experiência de cárie do ICDAS (depiMEmf) foi avaliada da seguinte forma: Epi-depi inicial (ICDAS 1/2 sem secagem ao ar); Moderado-dM (ICDAS 3,4); lesões extensas de dE (ICDAS 5,6); restaurações devido a cárie -f e superfícies/dentes ausentes-m. O risco de cárie foi avaliado com Cariogram®. O comportamento de crianças (Frankl-Behavior-Rating-Scale) e a autopercepção de dor (Escala Visual-Analógica-de-Rostos) durante o exame foram avaliados. O tempo de exame clínico foi registrado com um cronômetro. 592 crianças participaram (1 ano: n = 31; 2 anos: n = 96; 3 anos: n = 155; 4 anos: n = 209, 5 anos: n = 101 ). A prevalência do depiMEmfs foi de 79,9% e a média de 8,4 ± 10,4. A maioria era de crianças com alto risco de cárie (68,9%). A maioria (58,9%) apresentou ≥ comportamento positivo e ≤ autopercepção de dor leve (88,4%). O tempo médio de exame clínico foi em torno de 3,5 min (216,9 ± 133,9 s). Para crianças de 5 anos, correspondeu a 4 min (240,4 ± 145,0 s) vs. 2 min (122,8 ± 80,1 s) para crianças de 1 ano de idade (Kruskal-Wallis; p = 0,00). Para crianças com alto e baixo risco de cárie, foi em torno de 4,3 min (255,7 ± 118,5 s) e 3,3 min (201,3 ± 129,4 s), respectivamente (ANOVA; p = 0,01). Este estudo demonstra que a utilização do sistema ICDAS em crianças pequenas é viável, levando menos de 4 min para o exame clínico sem problemas de autopercepção de comportamento/ dor em crianças.
Asunto(s)
Humanos , Lactante , Preescolar , Caries Dental/diagnóstico , Dolor/etiología , Conducta Infantil , Prevalencia , Factores de Riesgo , Colombia/epidemiología , Caries Dental/complicaciones , Caries Dental/epidemiologíaRESUMEN
El objetivo fue determinar la evidencia existente acerca de la efectividad de intervenciones tempranas sobre el desarrollo motor de niños con alto riesgo de desarrollar una parálisis cerebral. Método: Se realizó una búsqueda literaria en bases de datos y revistas relevantes para el tema (CINAHL, The Cochrane Library, EMBASE, PEDro y PubMed). Los criterios de selección consideran a recién nacidos muy prematuros (<32 semanas de gestación) y/o con extremo bajo peso al nacer (<1.500 g), recién nacidos con encefalopatías neonatales y recién nacidos (prematuros o de término) que presentan resonancia magnética anormal y/o ultrasonido craneal anormal y/o la evaluación de movimientos generales alterada. Las calidades metodológicas de los estudios se evalúan con la escala PEDro y el nivel de evidencia con la clasificación del centro basado en la Evidencia de Oxford. Resultados: Se analizaron 9 estudios, comprendiendo 687 lactantes menores de 18 meses, quienes reflejan una gran variedad respecto al tipo y frecuencia de intervenciones y las herramientas de evaluación utilizadas. Los componentes terapéuticos asociados a efectos beneficiosos son: la participación de los padres en las intervenciones y la estimulación a la producción del movimiento por parte del bebé durante las actividades de la vida diaria. Discusión: Se evidencia que programas de intervención temprana que incluyen a cuidadores para promover el desarrollo motor y cognitivo, parecen tener más efectos beneficiosos en el largo plazo. Se requiere más investigación sobre este tema, y mejoras metodológicas para resultados más consistentes y así establecer el nivel de eficacia de los programas de intervención temprana.
The goal was to determine the evidence on the effectiveness of early interventions on motor development in children at high risk of developing cerebral palsy. Method: A literature search was conducted in databases and journals relevant to the topic (CINAHL, The Cochrane Library, EMBASE, PEDro and PubMed). Selection criteria considered very preterm infants (<32 weeks gestation) and/or with extremely low birth weight (<1,500 g), infants with neonatal encephalopathy and newborns (preterm or term) that have abnormal MRI and/ or abnormal cranial ultrasound and / or evaluation of altered general movements. Methodological quality of the studies was assessed with the PEDro scale and level of evidence with the classification based center for Evidence of Oxford scale. Results: 9 studies were analyzed, comprising 687 infants under 18 months, which reflect a variety regarding the type and frequency of interventions and evaluation tools used. The therapeutic benefits associated components are: the involvement of parents in interventions and stimulation to production of movement by the baby during activities of daily living. Discussion: It is evident, that early intervention programs which include caregivers to promote motor and cognitive development seem to have more beneficial effects in the long run. More research on this subject, and methodological improvements for more consistent results is required, to establish the level of effectiveness of early intervention programs.
Asunto(s)
Humanos , Niño , Intervención Médica Temprana , Parálisis Cerebral/prevención & control , RiesgoRESUMEN
Introducción: Los ácaros Demodex folliculorum y Demodex brevis son ectoparásitos habituales en la unidad folículo-sebácea de los humanos, fundamentalmente en adultos. En niños inmunocompetentes su presencia es rara. El objetivo de nuestro estudio es describir y caracterizar la demodicidosis en niños. Material y métodos: Se seleccionaron pacientes menores de 15 años con manifestaciones clínicas sugerentes de demodicidosis. El diagnóstico se efectuó mediante la cuantificación de Demodex sp con KOH 30% bajo microscopía de luz. Resultados: Se reclutaron 17 casos, 16 pacientes de sexo femenino, todos con lesiones faciales características. Sólo en 3 pacientes hubo inmunosupresión concomitante. Todos los casos respondieron al tratamiento con permetrina 5% tópica. Conclusión: La demodicidosis infantil puede presentarse en pacientes inmunocompetentes, su diagnóstico requiere un alto índice de sospecha. Se observa una excelente respuesta con permetrina 5% tópica.
Introduction: The mites Demodex folliculorum and Demodex brevis are common ectoparasites in the follicle-sebaceous unit of humans, principally in adults. In immunocompetent children their presence is rare. The aim of our study is to describe and characterize the demodicidosis in children. Materials and methods: Patients under 15 years old with clinical manifestations suggestive of demodicidosis were selected. Diagnosis was made by quantification of Demodex sp with KOH 30% under light microscopy. Results: We found 17 cases, 16 females, all with typical facial lesions. Only 3 patients presented concomitant immunosuppression. All cases responded to topical 5% permethrin treatment. Conclusion: Infantile demodicidosis can occur in immunocompetents patients, and it diagnosis requires a high index of suspicion. An excellent response with topical 5% permethrin is observed.
Asunto(s)
Humanos , Adolescente , Lactante , Preescolar , Niño , Infestaciones por Ácaros , Ácaros , Infestaciones Ectoparasitarias , PermetrinaRESUMEN
Introducción. El glifosato es un herbicida de amplio espectro, no selectivo, utilizado para eliminar malezas indeseables en ambientes agrícolas y forestales. La acción herbicida corresponde a la inhibición de la biosíntesis de aminoácidos aromáticos en las plantas. Al no ser este mecanismo compartido por los seres humanos es considerado como de bajo riesgo para la salud de los mismos. Sin embargo, investigaciones recientes indican que puede alterar otros procesos celulares en animales lo que puede presentar un factor de riesgo a nivel ambiental y de salud en las zonas donde se emplea este herbicida. Objetivo. El objetivo del presente estudio fue evaluar la citotoxicidad y la genotoxicidad del glifosato en células humanas normales (GM38) y en células humanas de fibrosarcoma (HT1080). Materiales y métodos. La citotoxicidad aguda y crónica se determinó al exponer las células en cultivo a diferentes concentraciones de glifosato, y se analizó la viabilidad celular con cristal violeta y colorante de exclusión azul de tripano, respectivamente. La genotoxicidad se determinó por medio del ensayo del cometa y los datos se analizaron usando la prueba de Dunnet. Resultados. En la citotoxicidad crónica las células GM38 y las HT1080 presentaron un efecto dependiente de la dosis después del tratamiento con glifosato en concentraciones de 5,2 a 8,5 mM y 0,9 a 3,0 mM, respectivamente. En la citotoxicidad aguda, las células GM38 y las HT1080 expuestas a un rango de concentraciones de 4,0 a 7,0 mM, 4,5 a 5,75 mM y 4,0 a 7,0 mM, respectivamente, presentaron una viabilidad mayor al 80 por ciento. Se evidenció daño en el ADN después del tratamiento con glifosato en concentraciones de 4,0 a 6,5 mM para las células GM38 y de 4,75 a 5,75 mM para las células HT1080. Conclusiones. Se sugiere que el mecanismo de acción del glifosato no se limita únicamente a las plantas sino que puede alterar la estructura del ADN en otros tipos de células como son las de los mamíferos