Theoretical method for a radiopacifier proportion calculation in MTA type cements.

This article deals with the problem of determining the proportion by weight of radiopacifying material needed to add to a cement clinker of mineral trioxide aggregated (CE) to comply with ISO 6876/2001 and ANSI-ADA 57 regulations for radiopacity. With this aim, CE was synthesized and mixed experimentally with 5, 10, 15, and 20 wt% of ZrO2 as radiopacifying material. Radiographic images were taken so that radiographic density was obtained and related to the mmAl scale by using an aluminum step wedge. From a theoretical point of view, absorbed intensity given by the Lambert-Beer law was calculated using mass attenuation coefficients (NIST database) for each chemical element included in each component of the cement samples. In this way, we predicted that by adding above 10 wt% of ZrO2 to the CE, the requirements stipulated by ISO 6876 for radiopacity were satisfied with discrepancies around 1 mmAl. This theoretical method gives an excellent approximation to determine the amount of radiopacifying material needed to meet the requirements stipulated by ISO.

Staring Spells: An Age-based Approach Toward Differential Diagnosis.

Evaluations to rule out epileptic vs nonepileptic staring spells may entail unnecessary evaluations that can be costly and time consuming. Our study aims to identify common etiologies for staring spells across 3 different pediatric age groups and to propose an age-based clinical guidance to help determine which patients warrant further workup. Methods: This was a single-center retrospective chart analysis of 1496 patients aged 0.0-17.9 years presenting with confirmed staring spell diagnosis from January 2011 to January 2021. The patients were divided into 3 groups based on their age: 0.0-2.9, 3.0-12.9, and 13.0-17.9 years. Patient information collected included demographics, clinical presentation, comorbidities, and final diagnosis. Multilevel likelihood ratios and a receiver operating characteristic curve were determined using 8 of the 11 clinical variables. A total of 1142 patients who met the inclusion criteria were included for the final analysis. The most common final diagnosis was attention-deficit hyperactivity disorder (ADHD) (35%), followed by normal behavior (33%). Generalized and focal epilepsy were diagnosed in 8% and 4% of the patients, respectively. In the 0.0-2.9-year age group, normal behavior was the final diagnosis in 72% patients. In the 3.0-12.9-year and 13.0-17.9-year age groups, ADHD was the most frequent final diagnosis in 46% and 60%, respectively. Overall, ADHD and normal behaviors remain the most common final diagnoses. Multilevel likelihood ratios can be used to develop an age-based guidance to differentiate between epileptic and nonepileptic staring spell diagnoses.

Association of polymorphisms rs2303729, rs10880, and rs1131620 of LTBP4 with sarcopenia in elderly patients with type 2 diabetes mellitus.

BACKGROUND: Latent TGFß binding protein 4 (LTBP4) modifies skeletal muscle function, and polymorphisms in this gene have been associated with a longer ambulation time in patients with Duchenne muscular dystrophy. However, no studies associate these polymorphisms with an acquired muscle condition. AIM: The study aims to determine whether three functional variants within the LTBP4 were associated with sarcopenia in patients with type 2 diabetes mellitus (T2DM). SUBJECTS AND METHODS: We performed an analysis with 144 elderly individuals with T2DM, including 101 without sarcopenia and 43 with sarcopenia. Polymorphism frequency was determined by real-time PCR allelic discrimination TaqMan assay. RESULTS: Under different genetic models, the univariant analysis did not show a significant association of any polymorphism with sarcopenia. But the multivariate model analysis showed that variant rs1131620 (OR 7.852, 95% CI 1.854-33.257, p = 0.005) was significantly associated with sarcopenia under a dominant model. Under the same analysis, the variants rs2303729 and rs10880 had a more discrete association (OR 3.537 95% CI 1.078-11.607, p = 0.037; OR 5.008, 95% CI 1.120-22.399, p = 0.035, respectively). CONCLUSIONS: Our study highlights the importance of studying LTBP4 polymorphisms associated with sarcopenia. These findings suggest that the rs1131620 polymorphism of the LTBP4 may be part of the observed sarcopenia process in patients with T2DM.

Differences in inflammatory markers between coronavirus disease 2019 and sepsis in hospitalised patients.

Background: Inflammatory markers are pivotal for the diagnosis of coronavirus disease 2019 (COVID-19) and sepsis. This study compared markers between hospitalised patients with COVID-19 and those with bacterial sepsis. Methods: This retrospective single-centre cohort study included 50 patients with COVID-19 clinical stages II and III and 24 patients with bacterial sepsis. Both groups were treated according to the country's official standards. Leukocytes, C-reactive protein (CRP), ferritin, and D-dimer were registered at the time of patient's admission and 24, 48, and 72 h after initiating intrahospital treatment. Results: Upon admission, marker levels were high, with a significant decrease at 72 h after antibiotic therapy in the sepsis group. The leukocyte count was higher in deceased patients with sepsis. The mean ferritin levels were 1105 mcg/dl for COVID-19 and 525 mcg/dL for sepsis. Higher ferritin levels in COVID-19 (P = 0.001) seemed to be a predictor of higher mortality. Upon admission, the median D-dimer level was 0.68 mg/L for COVID-19 and 3 mg/L for patients with sepsis, whether recovered or deceased. As D-dimer, procalcitonin levels were higher in patients with sepsis (P = 0.001). CRP levels were equally elevated in both entities but higher in deceased patients with COVID-19. Conclusion: Ferritin was the main inflammatory marker for COVID-19, and leukocytes, procalcitonin, and D-dimer were the main markers of sepsis. Markers that were most affected in deceased patients were CRP for COVID-19 and leukocyte for sepsis. The therapeutic implications of these differences require further study.

Use and effectiveness of propolis on chronic periodontitis: a systematic review / Uso y efectividad del propóleo en periodontitis crónica: una revisión sistemática

Abstract The aim of this study was to determine the effect of propolis on non- surgical periodontal therapy in patients with chronic periodontitis (CP) as it appears in the recent literature. Propolis is a natural and biocompatible resinous substance that has shown, by means of several scientific studies, to possess medicinal properties such as antimicrobial, healing, anesthetic, anti-inflammatory, and analgesic, among others. There are several studies that have reported the use of propolis as a non- surgical treatment of CP, its comparison with other antimicrobials, and the improvement of clinical and microbiological parameters with scaling and root planing (SRP). A bibliographic search was conducted in the PubMed, Google Scholar, Web of Science, and Science Direct databases up to 2021. The results showed that there are very few reports focused on clinical studies; however, according to the analyzed data, propolis could be a good adjuvant for the treatment of patients with chronic periodontitis compared to the conventional treatment (SRP).

Resumen El objetivo de este estudio fue determinar el efecto del propóleo sobre la terapia periodontal no quirúrgica en pacientes con periodontitis crónica (PC) en la literatura reciente. El propóleo es una sustancia resinosa natural y biocompatible que ha sido demostrado a través de varios estudios científicos que posee propiedades medicinales como antimicrobianas, cicatrizantes, anestésicas, antiinflamatorias, analgésicas, entre otras. Existen varios estudios que han reportado el uso del propóleo como tratamiento no quirúrgico de la PC y su comparación con otros antimicrobianos y la mejora de los parámetros clínicos y microbiológicos con el raspado y alisado radicular (SRP). Se realizó una búsqueda bibliográfica en las bases de datos directas de PubMed, Google Scholar, Web of Science y Science hasta el 2021. Los resultados muestran que existen muy pocos reportes enfocados a estudios clínicos, sin embargo, según los datos analizados, el propóleo podría ser un buen adyuvante para el tratamiento de pacientes con periodontitis crónica en comparación con el tratamiento convencional (SRP).

Bilateral Ptosis, Zosteriform Rash and Flaccid Bladder in a 10-Year-old boy.

We present a case report of a 10-year-old completely immunized boy presenting with a 2-week history of bilateral eyelid drooping, fatigue followed by bladder and bowel paralysis. This was followed by the appearance of a vesicular painful and itchy rash which directed further diagnosis and treatment as it was consistent with a varicella reactivation rash. This case is a very important addition to the current body of literature on varicella-related neurological complications. It outlines that varicella reactivation can present in completely vaccinated, immunocompetent young children as a neurological syndrome affecting the autonomic nervous system primarily and the rash can occur a few weeks later after presentation of the neurological symptoms.

New diagnostic and therapeutic modalities in neuromuscular disorders in children.

Pediatric neuromuscular disorders are a diverse group of conditions that affect how muscle and nerve function. They involve the motor neurons, nerves, neuromuscular junction and muscles. Pathology of any of these regions leads to the inability to perform voluntary movements. Over time, the natural progression of most of these disorders is followed by significant disability, and at the most extreme, almost complete paralysis and death secondary to complications. Diagnostic measures for pediatric neuromuscular disorders, like that of most medical conditions, relies heavily on clinical presentation, history and a detailed physical examination. Primary additional diagnostic measures have included serum creatine kinase (CK) levels, electromyography (EMG), nerve conduction studies (NCS) and muscle or nerve biopsies, which has historically been the gold standard. In the last several decades less invasive testing has become more common such as muscle magnetic resonance imaging (MRI) and genetic testing.  The advances of molecular genetics, such as next generation sequencing (NGS) which includes whole-exome sequencing (WES) and whole-genome sequencing (WGS), enable clinicians to pinpoint more accurately exact gene mutations. The advent of genetic testing enhances personalized medicine. The field of pediatric neuromuscular disorders is also undergoing a remarkable evolution in therapeutic modalities including novel targeted therapies such as exon skipping/inclusion and gene replacement therapies. This is a review of the initial approach to suspected neuromuscular disorders in children as well as up to date diagnostic and therapeutic modalities for the most common pediatric neuromuscular disorders. As the world enters the new decade, there are encouraging therapeutic results. However, there remain key challenges to these modalities including limitations in its applicability, optimization for delivery of gene replacement therapies and in its effectiveness.

Acute Cerebellitis and Atypical Posterior Reversible Encephalopathy Syndrome Associated with Methadone Intoxication.

We report a case of a 9-year-old boy who presented with altered mental status and ataxia following 3 days of vomiting. Shortly after arrival to our emergency department, he declined and required intubation. The following day, he recovered and was successfully extubated. He was found to be positive for methadone on his urine drug screen. Brain imaging demonstrated a pattern of acute cerebellitis. Following extubation, the patient returned to his normal mental status; however, he began to have consistently elevated blood pressure and bradycardia and subsequent brain imaging showed supratentorial changes that were related to atypical posterior reversible encephalopathy syndrome. Through medical management including high-dose steroids and antihypertensive medications, the patient's blood pressure normalized, and he was eventually discharged home without further complications.

Is it possible to improve early childhood development with a video-feedback intervention directed at the mother-father-child triad?

Relationships with primary caregivers provide the context for early childhood development, and evaluating those relationships during the early years can detect difficulties that may influence future mental health. Video feedback is a valuable intervention tool in early childhood, both for family relationships and child development. An intervention was implemented using this technique, focused on mother-father-child triads that were experiencing difficulties in social-emotional development. Participants were 80 mother-fatherinfant triads (experimental group, EG=40, control group, CG=40), with children between 1 and 3 years old. Socio-emotional difficulties decreased significantly in the children who received the intervention (Wilks λ=0.930, F (1, 78)=5.907; P=.017). There was also an increase in psychomotor development in communication (Wilks λ=0.948, F (1, 78) =4.284; P=.042) and fine motor skills (Wilks λ=0.875, F (1, 78)=11.185; P=.001) in children in the EG compared with children in the CG.

[Psychometric properties of a spanish version of the Beck depression inventory IA]. / Propiedades psicométricas del inventario de depresión de Beck IA para la población chilena.

BACKGROUND: According to the Chilean National Health Survey (2009-2010), 17% of people aged 15 years or more have depressive symptoms. Thus, freely-available, easily-administered, and highly sensitive screening tests for depression are needed in clinical and research settings. AIM: To evaluate the psychometric properties of a Spanish version of the Beck Depression Inventory (BDI-IA) in adult Chilean population. MATERIAL AND METHODS: The inventory was applied to a sample of 1.105 adults aged between 18 to 73 years (94% women). Ninety nine participants were outpatients receiving treatment for affective disorders, 932 were parents and/or guardians of students enrolled in schools and 73 were university students (sample with no known depressive disorder). To perform data analysis, two groups from the random combination of both samples were generated. RESULTS: The inventory showed an appropriate degree of internal consistency (Cronbach alpha = .92). An exploratory factor analysis suggested a one-factor solution. This solution was reinforced with a confirmatory factor analysis, which displayed an adequate goodness of fit. The cutoff score, based on the Youden Index, was 13/14 points. It was able to discriminate between depressed and non-depressed participants. CONCLUSIONS: These results indicate that the BDI-IA is an appropriate instrument to assess depressive symptoms in Chilean adults.

Propiedades psicométricas del inventario de depresión de Beck IA para la población chilena / Psychometric properties of a spanish version of the Beck depression inventory IA

Background: According to the Chilean National Health Survey (2009-2010), 17% of people aged 15 years or more have depressive symptoms. Thus, freely-available, easily-administered, and highly sensitive screening tests for depression are needed in clinical and research settings. Aim: To evaluate the psychometric properties of a Spanish version of the Beck Depression Inventory (BDI-IA) in adult Chilean population. Material and Methods: The inventory was applied to a sample of 1.105 adults aged between 18 to 73 years (94% women). Ninety nine participants were outpatients receiving treatment for affective disorders, 932 were parents and/or guardians of students enrolled in schools and 73 were university students (sample with no known depressive disorder). To perform data analysis, two groups from the random combination of both samples were generated. Results: The inventory showed an appropriate degree of internal consistency (Cronbach alpha = .92). An exploratory factor analysis suggested a one-factor solution. This solution was reinforced with a confirmatory factor analysis, which displayed an adequate goodness of fit. The cutoff score, based on the Youden Index, was 13/14 points. It was able to discriminate between depressed and non-depressed participants. Conclusions: These results indicate that the BDI-IA is an appropriate instrument to assess depressive symptoms in Chilean adults.

Comparative study of dental enamel loss after debonding braces by analytical scanning electron microscopy (SEM).

Clinical procedures when shear forces are applied to brackets suggest adhesion forces between 2.8 and 10.0 MPa as appropriate. In this study dental enamel was evaluated by scanning electron microscopy (SEM) before and after removing the brackets. Thirty bicuspids (previous prophylaxis) with metallic brackets (Roth Inovation 0.022 GAC), Transbond Plus SEP 3M Unitek adhesive and Transbond XT 3M resin were used. The samples were preserved to 37°C during 24 hr and submited to tangential forces with the Instron Universal machine 1.0 mm/min speed load strength resistance debonding. Also the Adhesive Remanent Index (ARI) test was made, evaluating the bracket base and the bicuspid surface. All the bracket SEM images were processed with AutoCAD to determine the enamel detached area. The average value was 6.86 MPa (SD ± 3.2 MPa). ARI value 1= 63.3%, value 2= 20%, value 3= 13.3% and 33% presented value 0. All those samples with dental enamel loss, presented different situations as fractures, ledges, horizontal, and vertical loss in some cases, and some scratch lines. There is no association between the debonding resistance and enamel presence. Less than half of the remanent adhesive on the dental enamel was present in most of the samples when the ARI test was applied. When the resin area increases, the debonding resistance also increases, and when the enamel loss increases, the resin free metallic area of the bracket base decreases in the debonding.

Risk Factors for Failed Newborn Otoacoustic Emissions Hearing Screen.

Objective To identify any socioeconomic, demographic, neonatal, and perinatal factors that may be associated with failing the otoacoustic emissions (OAE) newborn hearing screen. Study Design A retrospective chart review was performed looking at hearing screens performed on 1272 newborn infants by OAE testing. Socioeconomic, demographic, neonatal, and perinatal factors were reviewed to determine association with failing the OAE newborn hearing screen. Results Our results demonstrate that Hispanic race was significantly associated with failing the newborn OAE hearing screen with an odds ratio of 2.54 (CI = 1.56-4.14, P = .0002). Family history of hearing loss was also significantly associated with failing the newborn hearing screen. Newborns with a family history of hearing loss were 13 times more likely to fail the newborn screen (odds ratio = 13.63, CI = 4.09-45.43, P < .0001). Conclusions Hispanic race and family history of hearing loss are statistically significant risk factors for failing the newborn OAE hearing screen.

Intervención grupal para reducir la sintomatología depresiva y promover la sensibilidad materna en embarazadas chilenas / Group intervention for reducing depressive symptoms and promoting maternal sensitivity in pregnant Chilean women

La sintomatología depresiva es frecuente en el embarazo y repercute en el posparto y en el vínculo madre-bebé. Se reportan los resultados de una intervención grupal de 5 sesiones para reducir la sintomatología depresiva y promover una adecuada sensibilidad materna. Participaron 134 embarazadas con antecedentes de depresión (grupo experimental = 88 y grupo control = 46). Se evaluó sintomatología depresiva (Inventario para la Depresión de Beck), resolución de problemas sociales (Inventario de Resolución de Problemas Sociales Abreviado), sensibilidad materna, cooperatividad infantil y riesgo vincular (Índice Experimental de Relación Niño-Adulto) en ambos grupos. Se observó una reducción significativa de la sintomatología depresiva, así como un incremento de las habilidades para la resolución de problemas sociales en el grupo intervenido. Este grupo muestra también puntajes significativamente mayores en sensibilidad materna y cooperatividad infantil, así como menores frecuencias de riesgo vincular en la evaluación postintervención. Se discute la relevancia de desarrollar estrategias de intervención durante el embarazo, considerando su impacto en la sensibilidad materna, en la calidad de las interacciones madre-bebé y en las habilidades de las madres para resolver problemas.

Depressive symptoms are frequently observed during pregnancy, and these affect the mother and her relationship with her baby during the post-partum period. Results are reported on a 5-session group intervention for reducing depressive symptoms and promoting maternal sensitivity. The participants included 134 pregnant women with a history of depression (experimental group = 46 and control group = 88). Depressive symptoms (Beck Depression Inventory), social problem-solving strategies (Social Problem-Solving Inventory-Revised), maternal sensitivity, infant cooperativeness and bonding risk (Child-Adult Relatinoship Experimental Index) were assessed in both groups. The group intervened showed a significant reduction of depressive symptoms and an improvement of social problem-solving strategies. This group also shows significantly higher scores in maternal sensitivity, and infant cooperativeness, as well as lower frequencies of bonding risk in the post-intervention assessment. The importance of considering intervention strategies during pregnancy, including its impact on maternal sensitivity, the quality of mother-baby interactions and the problem-solving abilities of the mothers, is discussed.

[Evaluation of dental treatment impact in a northwestern Mexican school children population]. / Evaluación del impacto del tratamiento odontológico en una población escolar del noroeste de México.

OBJECTIVE: To evaluate through functional teeth index, the impact in schoolchildren in communities with and without dental community support. MATERIAL AND METHODS: A cross-sectional study was carried out in communities with dental care provided by dental clinics of Sinaloa State University. The study sample was 2,083 schoolchildren. We used the criteria proposed by WHO for the index of decayed, missing-teeth (DMFT) for permanent dentition, index for prima- ry teeth (dmft) and the rate of functional teeth (RFT). For bivariate analysis, the nonparametric tests Pearson f and Mann-Whitney U were used. RESULTS: The comparisons of DMFT (0.20) and RFT (13.95) of children with and DMFT (0.43) and RFT (14.82) of children without community dental support showed statistical significant difference (p < 0.05). There was a statistically significant difference in DMFT and RFT between samples with and without community dental support (p < 0.05). The age showed a statistically significant difference between the DMFT and dmft (p < 0.05). Primary dentition required more dental care than permanent dentition. There was access for dental treatment, but it is not used for the population. CONCLUSIONS: The RFT provided precise information than DMFT, mainly due to register the changes of actions focused to recover the teeth function in the oral cavity.

[Predicting risk of caries in schoolchildren from northwestern Mexico: longitudinal study]. / Predicción de riesgo de caries en escolares del noroeste de México: estudio longitudinal.

OBJECTIVE: To analyze the caries risk through the Bratthall's Cariogram (BC) and the frequency of dental caries in a Mexican northwest children population for 12 months period. MATERIAL AND METHODS: A cohort of 583 scholar children between 6 and 10 years old from Sinaloa state was involved for 12 months period (2007-2008). The Bratthall's Cariogram was used to predict caries risk and the. WHO's criteria were used to obtain the caries index. The caries risk association with clinical variables was analyzed by logistic regression analysis and Sperman's Rho rank correlation test was used to evaluate the correlation between DMFT index and BC. RESULTS: The caries risk increased with respect to age (p < 0.05), the CB identified correctly children for high risk (85%) and low risk (65%) caries for a 12 months period. The baseline values of BC showed a positive correlation with DMFT index (0.86 and p = 0.0001); the diagnostic test evaluation showed the following values: positive predictive value of 87%, negative predictive value of 63%, sensitivity of 93% and specificity of 63%. CONCLUSIONS: The caries risk increased with the age in the studied population. The Bratthall's Cariogram is a useful screening test to evaluate the risk for dental caries at individual and population levels.

Phase composition of ProRoot mineral trioxide aggregate by X-ray powder diffraction.

INTRODUCTION: Composition and crystalline phases of the endodontic material mineral trioxide aggregate (MTA) is of fundamental importance for understanding its physical and chemical properties. This research was done to determine the composition of crystalline phases for ProRoot MTA. METHODS: For phase identification, powder of ProRoot MTA was analyzed by x-ray diffraction (XRD), comparing the MTA peaks with the data contained in the Powder Diffraction File of the International Centre for Diffraction Data (ICDD). To help the task of identifying a phase, chemical analysis by energy-dispersive spectrometry (EDS) and particle-induced x-ray emission (PIXE) were applied. Quantitative phase analysis was performed by applying Rietveld refinement to the XRD data. RESULTS: ProRoot MTA is composed of bismuth oxide (19.8%), tricalcium silicate (51.9%), dicalcium silicate (23.2%), calcium dialuminate (3.8%), and calcium sulfate dehydrated (1.3%). The trace elements detected were Fe, Ni, Cu, and Sr. CONCLUSIONS: Rietveld refinement was able to analyze the composition of ProRoot MTA, which is based basically on a mixture of Portland cement (with smaller quantities of calcium dialuminate and calcium sulfate dehydrated) and bismuth oxide for radiopacity.