Condiciones de salud bucodental en personas adultas mayores con enfermedad de Alzheimer: Scoping Review

Introducción: El aumento de la longevidad de las personas ha generado en la última etapa de vida la aparición de enfermedades de tipo multifactorial y relacionadas con el estilo de vida, aumentando la prevalencia de patologías mentales y enfermedades orales. Objetivo: Identificar las condiciones de salud oral en personas adultas mayores con enfermedad de Alzheimer. Métodos: Se planteó una revisión de la literatura tipo Scoping Review, determinando una estrategia de búsqueda para tres bases de datos (Pubmed, EbscoHost y LILACS). Fueron incluidos artículos con diseño de corte transversal, cohorte y casos y controles en idioma español, inglés y portugués entre 2011 y 2021. Se realizó la extracción y evaluación del riesgo de sesgo teniendo en cuenta los criterios de elegibilidad. Resultados: Se seleccionaron 32 artículos para revisión de texto completo y síntesis cualitativa de la información. Alemania y Estados Unidos presentan mayor cantidad de publicaciones, el sexo femenino predominó como población de estudio. Se observó menor frecuencia de cepillado, mayor cantidad de ausencias dentales en pacientes con demencia por Alzheimer y consecuentemente un mayor uso de prótesis en dicha población. Conclusiones: Es importante fortalecer la relación sistémico-oral de los adultos mayores mediante un manejo interdisciplinario entre el geriatra y el odontólogo.

Introduction. The increase in the longevity of individuals has led to the emergence of multifactorial diseases related to lifestyle during the later stages of life, thereby increasing the prevalence of mental disorders and oral diseases. Objective: To identify oral health conditions in older adults with Alzheimer's disease. Methods: A Scoping Review literature review was conducted, outlining a search strategy for three databases (Pubmed, EbscoHost, and LILACS). Articles with a cross-sectional, cohort, or case-control design published in Spanish, English, or Portuguese between 2011 and 2021 were included. Extraction and bias risk assessments were performed based on eligibility criteria. Results: Thirty-two articles were selected for full-text review and qualitative synthesis of information. Germany and the United States had the highest number of publications, with females predominating as the study population. A lower frequency of brushing, a higher number of missing teeth in Alzheimer's patients, and consequently higher use of prosthetics were observed in this population. Conclusions: It is essential to strengthening the systemic-oral relationship in older adults through interdisciplinary management involving geriatricians and dentists.

Introdução: O aumento da longevidade das pessoas tem gerado na última fase da vida o aparecimento de doenças multifatoriais e relacionadas ao estilo de vida, aumentando a prevalência de patologias mentais e doenças bucais. Objetivo: identificar as condições de saúde bucal em idosos com doença de Alzheimer. Métodos: foi realizada uma revisão de escopo da literatura, determinando uma estratégia de busca em três bancos de dados (Pubmed, EbscoHost e LILACS). Foram incluídos artigos com desenho transversal, de coorte e de caso-controle em espanhol, inglês e português entre 2011 e 2021. A extração e a avaliação do risco de viés foram realizadas levando-se em conta os critérios de elegibilidade. Resultados: Trinta e dois artigos foram selecionados para revisão do texto completo e síntese qualitativa das informações. A Alemanha e os Estados Unidos tiveram o maior número de publicações, e a população do estudo era predominantemente feminina. Observou-se menor frequência de escovação, maior número de ausencias odontológicas em pacientes com demência de Alzheimer e, consequentemente, maior uso de dentaduras nessa população. Conclusões: É importante fortalecer a relação sistêmico-oral dos idosos por meio do gerenciamento interdisciplinar entre o geriatra e o dentista.

Actitudes hacia la sexualidad en adolescentes de bachillerato de la ciudad de Querétaro, México / Attitudes toward sexuality among high school adolescents in Queretaro city, Mexico

INTRODUCCIÓN. La sexualidad forma parte de cada etapa de la vida del ser humano, no obstante, en la adolescencia existe una pérdida de orientación, presión social por parte de sus iguales e información no precisa, lo que conduce a un inicio temprano de la vida sexual y consecuencias no deseadas. OBJETIVO. Determinar la actitud en adolescentes de bachillerato, hacia la sexualidad. METODOLOGÍA. Estudio transversal, descriptivo, realizado en el Colegio de Bachilleres del Estado de Querétaro, Plantel 1. El instrumento se denomina "Actitudes hacia el sexo", diseñado y validado en población queretana en 2017. RESULTADOS. Se aplicaron 264 instrumentos en jóvenes con edades de 15 a 16 años. Con respecto a las actitudes hacia el sexo, 32,6% no saben por qué tendrían sexo. Indican que les acarrearía mala reputación o pérdida de respeto hacia su persona si tuvieran relaciones sexuales, el 19,7% y 18,9%, respectivamente. Podrían sentirse culpables después de hacer el acto sexual el 22,3%. Tienen curiosidad de vivir la experiencia el 23,5%. Han iniciado con la práctica de relaciones sexuales el 38,6% aproximadamente a los 15 años, la mayoría. 6,1% ha tenido relaciones sin uso de un método de barrera y bajo el efecto del alcohol. CONCLUSIONES. La información obtenida refleja la necesidad de trabajar con los estudiantes en valores, inteligencia emocional, violencia, perspectivas de género, que favorezcan una visión clara de la sexualidad y una apropiada toma de decisiones.

INTRODUCTION. Sexuality is part of every stage of human life, however in adolescence the loss of orientation, social pressure from peers, and inaccurate information often leads to an early onset of sexual life and unwanted consequences. OBJECTIVE. To determine the attitude of high school adolescents towards sexuality. METHODOLOGY. Cross-sectional, descriptive study, conducted at High School Colegio de Bachilleres del Estado de Querétaro, Plantel 1. An instrument called "Attitudes towards sex" was designed and validated in the Queretano population in 2017. RESULTS. 264 instruments were administered to adolescents aged 15 to 16 years. With respect to attitudes towards sex, 32.6% did not know why they tend to have sex. Respondents were concerned that sex could result in a bad reputation (19.7%) or loss of their own self-respect (18.9%). Students could also feel guilty after sex (22.3%). 23.5% had curiosity about have sex. 28.6% of the teenagers surveyed started their sexual life at an average of 15 years; most of them have had sex without the use of a condom and under the influence of alcohol. CONCLUSIONS. The information obtained shows the necessity to work with the values, emotional intelligence, violence, and gender perspectives of adolescent students to help them develop a better perspective about sexuality and make appropriate decisions.

OpenModelica-based virtual simulator for the cardiovascular and respiratory physiology of a neonate.

There is a lack of medical simulation tools that can be understood and used, at the same time, by researchers, teachers, clinicians and students. Regarding this issue, in this work we report a virtual simulator (developed in OpenModelica) that allow to experiment with the fundamental variables of the cardiovascular and respiratory system of a neonate. We extended a long-tested lumped parameter model that represents the cardiovascular and respiratory physiology of a neonate. From this model, we implemented a physiological simulator using Modelica. The fidelity and versatility of the reported simulator were evaluated by simulating seven physiological scenarios: two of them representing a healthy infant (newborn and 6-months old) and five representing newborns affected by different heart diseases. The simulator properly and consistently represented the quantitative and qualitative behaviour of the seven physiological scenarios when compared with existing clinical data. Results allow us to consider the simulator reported here as a reliable tool for researching, training and learning. The advanced modelling features of Modelica and the friendly graphical user interface of OpenModelica make the simulator suitable to be used by a broad community of users. Furthermore, it can be easily extended to simulate many clinical scenarios.

Production of a rich-carotenoid colorant from pumpkin peels using oil-in-water emulsion followed by spray drying.

Peels and seeds are byproducts generated during the processing of fruits and vegetables that have been cut off or rejected in the food industry. Pumpkin peels are an example of products that provide valuable nutritional aspects but that have low commercial value. This work aimed at recovering carotenoids from pumpkin peels to produce valuable powders. The pumpkin peel flour was obtained from convective drying and milling processes. Liquid-solid extraction produced the ethanol raw extract with a high carotenoid content. Carotenoid extract and Arabic gum suspensions were mixed in proportions of 1:2, 1:3, or 1:4 w/w. Emulsions produced via Ultra-Turrax (UT) and Ultra-Turrax plus high pressure (UTHP) were evaluated and spray dried. The particles carotenoid concentrations varied from 159.1 to 304.6 µg/g and from 104.3 to 346.2 µg/g for samples primarily produced via UT and UTHP, respectively. UTHP 1:3 particles showed the lowest degradation of carotenoids during 90 days of storage, with a retention index of 79%. The homogenization and spray drying techniques were proven to be suitable steps to preserve the carotenoids recovered from the byproduct studied. Microparticles can be used as a natural dye with potential use in food, pharmaceuticals, and cosmetics.

Urinary tract injuries during treatment of patients with morbidly adherent placenta.

INTRODUCTION: Urinary tract injuries (UTI) are a frequent complication of morbidly adherent placenta (MAP) management. In this study, we aim to characterize the type of UTI that occurs and to define if their incidence varies after establishing a fixed interdisciplinary group for the protocolized management of patients with MAP. METHODOLOGY: All patients with confirmed MAP attended between 2011 and 2019 in our institution, were included. We analyzed the effect of a change in the surgical protocol including rigid ureteral catheters, vesicouterine dissection before hysterotomy and interdisciplinary planning, in the bladder or ureteral injuries incidence. RESULTS: The study included 65 women. UTI was identified in 27.7% of patients and was associated with a greater volume of blood loss, transfusion requirement, hospital stay, and the need for additional surgeries. There was a high frequency of UTI in patients without protocolized management. The use of rigid ureteral catheters and retrovesical dissection before hysterotomy were associated with a less ureteral injury. CONCLUSIONS: Developing expertise among the members of the surgical team is essential to improve results. Using rigid ureteral catheters, performing retrovesical dissection before hysterotomy, and performing less extensive surgeries in selected patients are associated with a low frequency of ureteral injuries.

Advances in biopolymeric active films incorporated with emulsified lipophilic compounds: a review.

The attention towards active films has increased due to consumer demand for high-quality foods without chemical additives. Active biopolymer-based films have shown great potential for active films by impacting food safety, acting as the carriers of various natural antioxidant and antimicrobial compounds, and decreasing environmental pollution from petrol-derived packaging materials. However, there is a wide range of challenges concerning the different characteristics of biopolymers and plasticizers, often hygroscopic/hydrophilic, compared to numerous lipophilic bioactive compounds. Therefore, recent studies have focused on applying oil-in-water emulsion-based systems to enhance the lipophilic bioactive compounds' dispersibility into the film matrix, improving their performance. It is worth emphasizing that resulting complex systems give rise to new challenges such as (i) dispersion technology of the bioactive compounds with minimum adverse effects on its bioactivities, (ii) interactions between different components of the active films, giving rise to new physicochemical properties, and (iii) the change of the diffusion properties of bioactive compounds into the active films, resulting in different release properties. These challenges are profound and critically discussed in this review, as well as the encapsulation techniques employed in preparing emulsions loaded with lipophilic bioactive compounds for the active film development. An outlook of future directions in the research, development, and application of these active films are given.

Differences in the physical demands between handball and beach handball players / Diferenças nas exigências físicas entre jogadores de handebol e handebol de praia

Abstract Handball is one of the most practiced team sports worldwide that consists of different modalities, with the aim of reaching as many users as possible. One of the modalities with increasing interest in the last years is Beach Handball, as it takes the advantage of the absence of competitive calendar in the standardized modality so that users continue practicing. A comparative analysis was performed between standard handball (indoor) and beach handball athletes in order to determine the demands of both modalities and determine if they are similar. The competition was evaluated by analyzing external load variables: number of steps, jumps, impacts and Player load. The selected sample was composed of U-16 players from both modalities. Each player was equipped with WIMUTM inertial device. The results showed that the standard modality requires greater physical demands than the beach modality. For this reason, the physical demands of the different modalities require different training processes to obtain the best possible results in the competition.

Resumo O handebol é um dos esportes coletivos mais praticados em todo o mundo, que consiste em diferentes modalidades, com o objetivo de atingir o maior número possível de usuários. Uma das modalidades em expansão nos últimos anos é o Handebol de Praia, pois aproveita a ausência de calendário competitivo na modalidade padronizada para que os usuários continuem praticando. Uma análise comparativa foi realizada entre atletas de handebol padronizado (na pista) e handebol de praia, a fim de determinar as demandas de ambas as modalidades e determinar se essas demandas são semelhantes. A competição foi avaliada através da análise das variáveis externas de carga: número de etapas, saltos, impactos e Player Load. A mostra selecionada foram jogadores de ambas as disciplinas na categoria cadete. Cada jogador foi equipado com um dispositivo inercial WIMUTM. Os resultados mostraram que a modalidade padronizada exige dos atletas maior demanda física que a modalidade de praia. Por esse motivo, os requisitos físicos de ambas as modalidades exigem diferentes processos de treinamento para obter os melhores resultados possíveis na competição.

Production and characterization of films based on blends of chitosan from blue crab (Callinectes sapidus) waste and pectin from Orange (Citrus sinensis Osbeck) peel.

The objective of this study was to develop and characterize films based on blends of chitosan and pectin, produced in laboratory scale, from industrial wastes. The chitosan was obtained by termoalcaline deacetylation of chitin, extracted from blue crab (Callinectes sapidus) waste and characterized according to degree of deacetylation (DD) and viscosimetric molecular weight (Mw); and pectin was extracted by conventional heating, from orange (Citrus sinensis Osbeck) peel and characterized according to degree of esterification (DE) and molecular weight (Mw). The Ch:P based films were prepared by the casting method in different Ch:P ratios [0: 100, 25:75, 50:50, 75:25 and 100:0], and compared to two controls [0:100 and 100:0], of commercial pectin and chitosan. Glycerol was used as a plasticizer at concentrations of 0.2g/g macromolecules. The addition of high concentrations of pectin in the formulations resulted in films with high solubility and an increase in moisture. No significant difference (P>0.05) in the degree of swelling (DS) and water vapor permeability (WVP) of the films was observed. Ch:P blend films were less stiff and therefore more elastic and flexible than films based on only one biopolymer. The control films presented better results in terms of color, being brighter and less opaque than other film formulations. These data suggest that chitosan or pectin obtained from agro-industrial waste is a potential matrix to produce biodegradable films for future food applications.

Giant canine with dentine anomalies in oculo-facio-cardio-dental syndrome.

Radiculomegaly affecting incisors, canines or premolars is a rare radiological finding (Maden et al., 2010) but is pathognomomic of a rare x-linked dominant syndrome called oculo-facio-cardio-dental syndrome (OFCDS). As this syndrome includes cardiac malformations and can lead to blindness due to congenital glaucoma, oral and maxillofacial surgeons should be aware of the somatic anomalies potentially associated with radiculomegaly. We report a typical case of OFCDS and provide the first description of the microscopic dental anomalies associated with this syndrome.

Prognostic factors in Fournier gangrene.

BACKGROUND: Fournier gangrene is a necrotizing fasciitis, arising in the genital and perineal area. This entity is still associated with a high mortality rate despite improvements in antibiotic and surgical treatment. METHODS: This is a retrospective study of all the patients diagnosed and surgically treated for Fournier gangrene at General University Hospital Ramon y Cajal between 1988 and 2008. Possible prognostic factors that could have any influence on the evolution of Fournier gangrene were analyzed. RESULTS: Seventy patients were analyzed, 62 males (88.6%) and 8 females (11.4%) with a mean age of 57.9 ± 13.5 years. Most frequent clinical manifestations were perineal pain (82.9%) and fever (60%). Physical examination revealed edema (91.4%), erythema (88.6%) and perineal skin necrosis (60%). All the patients underwent surgical debridement of necrotic tissue. In 54.3% reoperations were necessary for new surgical debridements. Medical complications rate was 27.1% and mortality one 22.9%. Ethylism, coexistence of neoplasms, presence of skin necrosis, myonecrosis, abdominal wall affection, number of debrided areas, reoperations, concentration of creatinine in serum>1.4 mg/dL, and hemoglobin <10 g/dL, and platelet count <150 × 10(9)/L in whole blood are associated with higher mortality rates. CONCLUSION: Identification of prognostic factors may help to determine high-risk patients in order to establish an optimal treatment, according to severity of the infection and general status.

First Colombian multicentric newborn screening for congenital toxoplasmosis.

AIMS: To determine the incidence of congenital toxoplasmosis in Colombian newborns from 19 hospital or maternal child health services from seven different cities of five natural geographic regions (Caribbean, Central, Andean, Amazonia and Eastern). MATERIALS AND METHODS: We collected 15,333 samples from umbilical cord blood between the period of March 2009 to May 2010 in 19 different hospitals and maternal-child health services from seven different cities. We applied an IgM ELISA assay (Vircell, Spain) to determine the frequency of IgM anti Toxoplasma. The results in blood cord samples were confirmed either by western blot and repeated ELISA IgM assay. In a sub-sample of 1,613 children that were negative by the anti-Toxoplasma IgM assay, the frequency of specific anti-Toxoplasma IgA by the ISAGA assay was determined. All children with positive samples by IgM, IgA, clinical diagnosis or treatment during pregnancy were recalled for confirmatory tests after day 10 of life. RESULTS: 61 positive samples for specific IgM (0.39%) and 9 positives for IgA (0.5%) were found. 143 questionnaires were positive for a clinical diagnosis or treatment for toxoplasmosis during pregnancy. 109 out of the 218 children that had some of the criteria for postnatal confirmatory tests were followed. Congenital toxoplasmosis infection was confirmed in 15 children: 7 were symptomatic, and three of them died before the first month of life (20% of lethality). A significant correlation was found between a high incidence of markers for congenital toxoplasmosis and higher mean annual rainfall for the city. CONCLUSIONS: Incidence for congenital toxoplasmosis is significantly different between hospitals or maternal child health services from different cities in Colombia. Mean annual rainfall was correlated with incidence of congenital toxoplasmosis.

Objeción de conciencia y la antropologÍa filosófica / Objeção de consciência e antropologia filosófica / Conscientious objection and philosophical anthropology

Se parte de la necesidad ineludible que tiene el ser humano de elegir entre dos o más realidades para optar por una de ellas con el fin de llevar a cabo cualquier acto voluntario por baladí o trascendental que sea. El afán de reducir o suprimir el derecho a la objeción de conciencia es la culminación de una política de desconocimiento a la dignidad intrínseca de la persona humana —todo ser humano es persona— que trata de imponer la obediencia a normas del Estado, normas dictadas por cualquier organismo oficial para asegurar la obediencia a una “ley” antes que a la conciencia, y obligar así a constituirse en criminal o cómplice en asuntos como el aborto, la eutanasia, etc.

The paper begins with the human being’s unavoidable need to choose between two or more realities and to opt for one of them in order to carry out any voluntary act, regardless of how trivial or momentous it might be. The rush to reduce or abolish the right of conscientious objection is the culmination of a policy that ignores the intrinsic dignity of the human being. Every human being is a person. This policy tries to impose adherence to the rules or norms of the State, which are dictated by any official agency to ensure observance of the “law” above and beyond conscience, thereby obliging a person to become a criminal or an accomplice in matters such as abortion, euthanasia and the like.

Ela começa com o imperativo de os seres humanos de escolher entre duas ou mais realidades para optar por um delas a fim de realizar um ato voluntário, sim importar que seja trivial ou transcendental. O esforço para reduzir ou suprimir o direito à objeção de consciência é o culminar de uma política de desrespeito pela dignidade inerente à pessoa humana – cada ser humano é uma pessoa que pretende impor a obediência às regras do Estado, estabelecidas por qualquer organismo oficial para garantir a obediência a uma “lei” e não à consciência. Assim, o ser humano constitui-se em criminal ou cúmplice em questões como aborto, eutanásia, etc.

Suicidio y logoterapia / Suicide and Logotherapy

Esta reflexión se orienta hacia una comprensión más profunda del suicidio, en particular y de la muerte, en general. Para ello, se realiza un análisis tanto de la muerte como del suicidio desde una perspectiva antropológica, bioética y logoterapéutica; en éste, se resalta el valor y la dignidad de la vida humana, señalando la importancia que tiene el sentido de la vida como aspecto fundamental para afrontar las crisis existenciales y para enfrentar el suicidio.

This reflection is geared towards a deeper understanding of suicide, in particular and death, in general. For this, an analysis of both death and suicide is carried out from an anthropological, bioethical and logotherapeutic perspective; in it, the value and dignity of human life is highlighted, pointing out the importance of the meaning of life as a fundamental aspect to face existential crises and to face suicide.