Oral diseases and systemic conditions: correlation analyses from the Colombian national health records between 2016 and 2023.

Introduction: Prevalence of oral, metabolic, circulatory, and nutritional diseases has tended to increase globally. As these diseases have common contributing factors, such as unhealthy diets, evaluating their epidemiological trends and the relation between them is relevant. In Colombia, the Ministry of Health records the frequency of consultation for these diseases through the Integrated Social Protection Information System. It facilitates the evaluation of their epidemiological behavior at the population level. Aim: To analyze and correlate the burden of oral diseases (caries and periodontitis) with respect to nutritional, circulatory and metabolic pathologies, as well as their relationships with socioeconomic indices in Colombian regions from 2016 to 2023. Methods: This study analyzes retrospective data collected between 2016 and 2023 by the National Health Registry in Colombia (SISPRO) according to the ICD-10. Sociodemographic data and the number of disease consultations were extracted. The number of consultations for oral diseases was correlated with systemic pathologies, socioeconomic indices through the Spearman test. Associations were explored via multiple linear regressions. A Principal Component Analyses (PCA) was conducted to identify patterns between socioeconomic, oral and systemic disease variables, as well as to reduce the complexity of the analysis by creating clusters that capture the greatest possible variability in the data. Results: The average number of consultations per biennium was 24.550.435 being the highest number for 2018-2019. The highest percentage of consultations was related to extensive caries, followed by chronic gingivitis. Moreover, consultations for oral diseases were found to correlate with systemic pathologies. All socioeconomic indices were associated with caries and/or periodontal diseases. This study is the first in Colombia that uses national data on diagnoses assigned to medical and dental consultations. PCA revealed a clustering pattern of pathologies suggesting that they are highly associated one to each other. Conclusion: Correlations between consultations for oral and systemic diseases stratified by life cycle and socioeconomic indices highlight the importance of conducting epidemiological and public health characterizations and their associations. Identifying these factors is imperative in the prevention and management of both diseases.

Evidence for Molecular Mimicry between SARS-CoV-2 and Human Antigens: Implications for Autoimmunity in COVID-19.

As for other viral diseases, the mechanisms behind the apparent relationship between COVID-19 and autoimmunity are yet to be clearly defined. Molecular mimicry, the existence of sequence and/or conformational homology between viral and human antigens, could be an important contributing factor. Here, we review the accumulated evidence supporting the occurrence of mimicry between SARS-CoV-2 and human proteins. Both bioinformatic approaches and antibody cross-reactions have yielded a significant magnitude of mimicry events, far more common than expected to happen by chance. The clinical implication of this phenomenon is ample since many of the identified antigens may participate in COVID-19 pathophysiology or are targets of autoimmune diseases. Thus, autoimmunity related to COVID-19 may be partially explained by molecular mimicry and further research designed specifically to address this possibility is needed.

Prevalence of erosive tooth wear and associated risk factors in Colombian adolescents.

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.

Prevalence of erosive tooth wear and associated risk factors in Colombian adolescents

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.

Core Cariology Curriculum Framework in Spanish for Latin American dental schools: development and consensus.

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.

Tracing ΦX174 bacteriophage spreading during aerosol-generating procedures in a dental clinic.

OBJECTIVE: The aim of this study was to test the plausibility of using the ΦX174 bacteriophage as a tracer of viral aerosols spreading in a dental aerosol-generating procedure (AGP) model. METHODS: ΦX174 bacteriophage (~ 108 plaque-forming units (PFU)/mL) was added into instrument irrigation reservoirs and aerosolized during class-IV cavity preparations followed by composite fillings on natural upper-anterior teeth (n = 3) in a phantom head. Droplets/aerosols were sampled through a passive approach that consisted of Escherichia coli strain C600 cultures immersed in a LB top agar layer in Petri dishes (PDs) in a double-layer technique. In addition, an active approach consisted of E coli C600 on PDs sets mounted in a six-stage cascade Andersen impactor (AI) (simulating human inhalation). The AI was located at 30 cm from the mannequin during AGP and afterwards at 1.5 m. After collection PDs were incubated overnight (18 h at 37 °C) and bacterial lysis was quantified. RESULTS: The passive approach disclosed PFUs mainly concentrated over the dental practitioner, on the mannequin's chest and shoulder and up to 90 cm apart, facing the opposite side of the AGP's source (around the spittoon). The maximum aerosol spreading distance was 1.5 m in front of the mannequin's mouth. The active approach disclosed collection of PFUs corresponding to stages (and aerodynamic diameters) 5 (1.1-2.1 µm) and 6 (0.65-1.1 µm), mimicking access to the lower respiratory airways. CONCLUSION: The ΦX174 bacteriophage can be used as a traceable viral surrogate in simulated studies contributing to understand dental bioaerosol's behavior, its spreading, and its potential threat for upper and lower respiratory tract. CLINICAL RELEVANCE: The probability to find infectious virus during AGPs is high. This suggests the need to continue characterizing the spreading viral agents in different clinical settings through combination of passive and active approaches. In addition, subsequent identification and implementation of virus-related mitigation strategies is relevant to avoid occupational virus infections.

Bioactive compounds as an alternative for the sugarcane industry: Towards an integrative approach.

Here, a comprehensive review of sugarcane industrialization and its relationship with bioactive compounds (BCs) detected in various products and by-products generated during its processing is presented. Furthermore, it is discussed how these compounds have revealed important antioxidant, antineoplastic, antidiabetic, and antimicrobial activities. From this bibliographic research highlights the significance of two types of BCs of natural origin (phenolic compounds (PCs) and terpenoids) and a group of compounds synthesized during industrial transformation processes (Maillard reaction products (MRPs)). It was found that most of the studies about the BCs from sugarcane have been conducted by identifying, isolating, and analyzing ones or a few compounds at a specific period, this being a conventional approach. However, given the complexity of the synthesis processes of all these BCs and the biological activities they can manifest in a specific biological context, novel approaches are needed to address these analyses holistically. To overcome this challenge, integrating massive and multiscale methods, such as omics sciences, seems necessary to enrich these studies. This work is intended to contribute to the state of the art that could support future research about the exploration, characterization, or evaluation of different bioactive molecules from sugarcane and its derivatives.

Core Cariology Curriculum Framework in Spanish for Latin American dental schools: development and consensus

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.

Tactile perception of roughness to assess activity in artificial initial caries lesions with a novel force-controlled probe.

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.

Association of Midgut Bacteria and Their Metabolic Pathways with Zika Infection and Insecticide Resistance in Colombian Aedes aegypti Populations.

INTRODUCTION: Aedes aegypti is the vector of several arboviruses such as dengue, Zika, and chikungunya. In 2015-16, Zika virus (ZIKV) had an outbreak in South America associated with prenatal microcephaly and Guillain-Barré syndrome. This mosquito's viral transmission is influenced by microbiota abundance and diversity and its interactions with the vector. The conditions of cocirculation of these three arboviruses, failure in vector control due to insecticide resistance, limitations in dengue management during the COVID-19 pandemic, and lack of effective treatment or vaccines make it necessary to identify changes in mosquito midgut bacterial composition and predict its functions through the infection. Its study is fundamental because it generates knowledge for surveillance of transmission and the risk of outbreaks of these diseases at the local level. METHODS: Midgut bacterial compositions of females of Colombian Ae. aegypti populations were analyzed using DADA2 Pipeline, and their functions were predicted with PICRUSt2 analysis. These analyses were done under the condition of natural ZIKV infection and resistance to lambda-cyhalothrin, alone and in combination. One-step RT-PCR determined the percentage of ZIKV-infected females. We also measured the susceptibility to the pyrethroid lambda-cyhalothrin and evaluated the presence of the V1016I mutation in the sodium channel gene. RESULTS: We found high ZIKV infection rates in Ae. aegypti females from Colombian rural municipalities with deficient water supply, such as Honda with 63.6%. In the face of natural infection with an arbovirus such as Zika, the diversity between an infective and non-infective form was significantly different. Bacteria associated with a state of infection with ZIKV and lambda-cyhalothrin resistance were detected, such as the genus Bacteroides, which was related to functions of pathogenicity, antimicrobial resistance, and bioremediation of insecticides. We hypothesize that it is a vehicle for virus entry, as it is in human intestinal infections. On the other hand, Bello, the only mosquito population classified as susceptible to lambda-cyhalothrin, was associated with bacteria related to mucin degradation functions in the intestine, belonging to the Lachnospiraceae family, with the genus Dorea being increased in ZIKV-infected females. The Serratia genus presented significantly decreased functions related to phenazine production, potentially associated with infection control, and control mechanism functions for host defense and quorum sensing. Additionally, Pseudomonas was the genus principally associated with functions of the degradation of insecticides related to tryptophan metabolism, ABC transporters with a two-component system, efflux pumps, and alginate synthesis. CONCLUSIONS: Microbiota composition may be modulated by ZIKV infection and insecticide resistance in Ae. aegypti Colombian populations. The condition of resistance to lambda-cyhalothrin could be inducing a phenome of dysbiosis in field Ae. aegypti affecting the transmission of arboviruses.

Differential Hatching, Development, Oviposition, and Longevity Patterns among Colombian Aedes aegypti Populations.

Dengue, Zika, and chikungunya are arboviral diseases for which there are no effective therapies or vaccines. The only way to avoid their transmission is by controlling the vector Aedes aegypti, but insecticide resistance limits this strategy. To generate relevant information for surveillance and control mechanisms, we determined life cycle parameters, including longevity, fecundity, and mortality, of Colombian Ae. aegypti populations from four different geographical regions: Neiva, Bello, Itagüí, and Riohacha. When reared at 28 °C, Bello had the shortest development time, and Riohacha had the longest. Each mosquito population had its own characteristic fecundity pattern during four gonotrophic cycles. The survival curves of each population were significantly different, with Riohacha having the longest survival in both males and females and Bello the shortest. High mortality was observed in mosquitoes from Neiva in the egg stage and for Bello in the pupae stage. Finally, when mosquitoes from Neiva and Bello were reared at 35 °C, development times and mortality were severely affected. In conclusion, each population has a unique development pattern with an innate trace in their biological characteristics that confers vulnerability in specific stages of development.

Effectiveness of the ICCMS caries management system for children: a 3-year multicentre randomised controlled trial.

OBJECTIVE: This 3-year multicentre randomised controlled trial compared, in 6-7-year-old Colombian children, the effectiveness of the ICCMS (International Caries Classification and Management System) with a conventional caries-management system (CCMS) in terms of individual caries-risk, caries lesions, and secondarily, oral-health-related knowledge/attitudes/practices, and number of appointments. MATERIAL AND METHODS: With ethical approval, 240 6-7-year olds from six Colombian clinics were recruited. Trained examiners conducted the following baseline/follow-up assessments: Caries risk (Cariogram-ICCMS); caries severity/activity staging (ICDAS-merged combined radiographic/visual); sealants/fillings/missing teeth, and oral-health-related knowledge, attitudes and practices. Children received their randomly allocated (ICCMS/CCMS) care from dental practitioners. Outcomes: caries-risk control (children); caries-progression control (tooth surfaces); oral-health-related knowledge/attitudes/practices improvement (parents/children), and appointments' number (children). Descriptive and non-parametric/parametric bivariate analyses were performed. RESULTS: Three-year-follow-up: n = 187 (77.9%; ICCMS: n = 92; CCMS: n = 95) disclosed a baseline-to-3-year overall high-caries-risk children decrease (ICCMS: 60.9-0%, p < .001; CCMS: 54.7-5.3%, p < .001) (p > .05). ICCMS versus CCMS showed: fewer tooth-surface caries progression (6.2% vs 7.1%, p = .010) and fewer active-caries lesions (49.8% vs. 59.1%, p < .05); higher proportion of children with ≥2/day fluoride-toothpaste tooth-brushing practice (p < .05); similar mean number of appointments (10.9 ± 5.9 vs. 10.0 ± 3.8, p = .15). CONCLUSION: Both caries-management systems showed similar effectiveness in caries-risk control, with ICCMS more effectively controlling tooth-surface caries progression and improving toothbrushing practices.

Tactile perception of roughness to assess activity in artificial initial caries lesions with a novel force-controlled probe

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.

Patrón de distribución de severidad de fluorosis: ¿qué nos dice sobre exposición local a fluoruros? / Padrão de distribuição de severidade da fluorose: Que nos diz sobre exposição local ao fluoretos? / Distribution pattern of enamel fluorosis severity: What is it telling us about local fluoride exposure?

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.

Total mercury exposure risk and selenium content measuring on fishery products consumed by women of childbearing age from Bogota, Colombia / Riesgo de exposición a mercurio total y medición del contenido de selenio en productos de la pesca consumidos por mujeres en edad fértil de Bogotá, Colombia

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

CariesCare International adapted for the pandemic in children: Caries OUT multicentre single-group interventional study protocol.

BACKGROUND: Comprehensive caries care has shown effectiveness in controlling caries progression and improving health outcomes by controlling caries risk, preventing initial-caries lesions progression, and patient satisfaction. To date, the caries-progression control effectiveness of the patient-centred risk-based CariesCare International (CCI) system, derived from ICCMS™ for the practice (2019), remains unproven. With the onset of the COVID-19 pandemic a previously planned multi-centre RCT shifted to this "Caries OUT" study, aiming to assess in a single-intervention group in children, the caries-control effectiveness of CCI adapted for the pandemic with non-aerosols generating procedures (non-AGP) and reducing in-office time. METHODS: In this 1-year multi-centre single-group interventional trial the adapted-CCI effectiveness will be assessed in one single group in terms of tooth-surface level caries progression control, and secondarily, individual-level caries progression control, children's oral-health behaviour change, parents' and dentists' process acceptability, and costs exploration. A sample size of 258 3-5 and 6-8 years old patients was calculated after removing half from the previous RCT, allowing for a 25% dropout, including generally health children (27 per centre). The single-group intervention will be the adapted-CCI 4D-cycle caries care, with non-AGP and reduced in-office appointments' time. A trained examiner per centre will conduct examinations at baseline, at 5-5.5 months (3 months after basic management), 8.5 and 12 months, assessing the child's CCI caries risk and oral-health behaviour, visually staging and assessing caries-lesions severity and activity without air-drying (ICDAS-merged Epi); fillings/sealants; missing/dental-sepsis teeth, and tooth symptoms, synthetizing together with parent and external-trained dental practitioner (DP) the patient- and tooth-surface level diagnoses and personalised care plan. DP will deliver the adapted-CCI caries care. Parents' and dentists' process acceptability will be assessed via Treatment-Evaluation-Inventory questionnaires, and costs in terms of number of appointments and activities. Twenty-one centres in 13 countries will participate. DISCUSSION: The results of Caries OUT adapted for the pandemic will provide clinical data that could help support shifting the caries care in children towards individualised oral-health behaviour improvement and tooth-preserving care, improving health outcomes, and explore if the caries progression can be controlled during the pandemic by conducting non-AGP and reducing in-office time. TRIAL REGISTRATION: Retrospectively-registered-ClinicalTrials.gov-NCT04666597-07/12/2020: https://register.clinicaltrials.gov/prs/app/action/SelectProtocol?sid=S000AGM4&selectaction=Edit&uid=U00019IE&ts=2&cx=uwje3h . Protocol-version 2: 27/01/2021.

The Midgut Microbiota of Colombian Aedes aegypti Populations with Different Levels of Resistance to the Insecticide Lambda-cyhalothrin.

Insecticide resistance in Aedes aegypti populations is a problem that hinders vector control and dengue prevention programs. In this study, we determined the susceptibility of Ae. aegypti populations from six Colombian regions to the pyrethroid lambda-cyhalothrin and evaluated the presence of the V1016I mutation in the sodium channel gene, which has been broadly involved in the resistance to this insecticide. The diversity of the gut microbiota of these mosquito populations was also analyzed. Only mosquitoes from Bello were susceptible to lambda-cyhalothrin and presented a lower allelic frequency of the V1016I mutation. Remarkably, there was not an important change in allelic frequencies among populations with different resistance ratios, indicating that other factors or mechanisms contributed to the resistant phenotype. Treatment of mosquitoes with antibiotics led us to hypothesize that the intestinal microbiota could contribute to the resistance to lambda-cyhalothrin. Beta diversity analysis showed significant differences in the species of bacteria present between susceptible and resistant populations. We identified 14 OTUs of bacteria that were unique in resistant mosquitoes. We propose that kdr mutations are important in the development of resistance to lambda-cyhalothrin at low insecticide concentrations but insect symbionts could play an essential role in the metabolization of pyrethroid insecticides at higher concentrations, contributing to the resistant phenotype in Ae. aegypti.