Niveles de ruido generados en procedimientos realizados en una facultad de odontología / Noise levels of dental equipment used in a dental school

Introducción: Los profesionales del área de odontología se ven expuestos a diferentes tipos de ruidos generados en el ambiente laboral producidos durante el ejercicio de su práctica clínica, originados, entre otros, por el instrumental y los aparatos rotatorios de uso diario. Estos niveles de ruido pueden variar de acuerdo a la especialidad clínica. Objetivo: Determinar el nivel de ruido producido durante los procedimientos odontológicos en las clínicas de una facultad de odontología. Material y Métodos: A partir de un estudio de corte transversal analítico y mediante muestreo no probabilístico a conveniencia se realizó el reconocimiento de las unidades en las especialidades odontológicas a evaluar. Se usó un sonómetro digital BENETECH GM1352, nivel de frecuencia A, rango 30-130 dB, exactitud más o menos 1,5 dB. Se utilizaron las pruebas U de Mann Whitney y Kruskal Wallis para determinar diferencias en los niveles de ruido entre las especialidades odontológicas. Resultados: La mediana del nivel de ruido medido en general fue de 75,94 dB (RIC 74,12 ­ 77,51), la especialidad clínica en la que mayor ruido se identificó fue la operatoria dental (mediana 77,34 y RIC 76,44 ­79,4 dB). Conclusiones: las áreas clínicas operatoria dental, rehabilitación, endodoncia y odontopediatría corresponden a las especialidades donde los niveles de ruido determinados se ajustan a los límites permitidos por la normatividad vigente en Colombia para el ruido medido en ambiente laboral.

Introduction: Dental professionals are exposed to different noise levels in their work environment during their clinical practice, mainly caused by dental instruments and rotary instruments used on a daily basis. Noise levels may vary according to the type of clinical specialty. Objective: To determine noise levels during dental procedures in dental school clinics. Materials and Methods: An analytical cross-sectional study was conducted by means of non-probability convenience sampling to determine dental specialties to be evaluated. BENETECH GM1352 30-130dB Digital Sound Level Meter with accuracy +/- 1.5 dB and A weighting was used for measurements. Mann-Whitney U and Kruskal-Wallis H tests were used to identify differences in noise levels among dental specialties. Results: Measured median noise level was 75.94 dB (RCI 74.21 -77.51), dental surgery was identified to have the highest noise among clinical specialties (median 77.34 and RCI 76.44 -79.4 dB). Conclusions: Dental surgery, oral rehabilitation, endodontics and pediatric dentistry were found to be the clinical specialties where noise exposure is within the limits established by Colombian regulations for noise in the workplace.

Introdução: Os profissionais da área da odontologia estão expostos a diferentes tipos de ruído gerado no ambiente de trabalho produzido durante o exercício da sua prática clínica, proveniente, entre outros, de instrumentos e aparelhos rotativos em uso diário. Estes níveis de ruído podem variar de acordo com a especialidade clínica. Objetivo: Determinar o nível de ruído produzido durante procedimentos odontológicos nas clínicas de uma escola de odontologia. Material e Métodos: Com base em um estudo analítico transversal e por meio de amostragem por conveniência não probabilística, foram levantadas as unidades das especialidades odontológicas a serem avaliadas. Foi utilizado um sonómetro digital BENETECH GM1352, nível de frequência A, faixa de medição 30-130 dB, precisão mais ou menos 1,5 dB. Os testes U de Mann Whitney e Kruskal Wallis foram usados para determinar as diferenças nos níveis de ruído entre as especialidades odontológicas. Resultados: O nível de ruído médio medido globalmente foi de 75,94 dB (RIC 74,12 - 77,51), sendo que a especialidade clínica em que foi identificado o maior ruído foi a cirurgia dentária (média 77,34 e RIC 76,44 -79,4 dB). Conclusões: as áreas clínicas de cirurgia dentária, reabilitação, endodontia e odontologia pediátrica correspondem às especialidades onde os níveis de ruído determinados estão de acordo com os limites permitidos pela regulamentação em vigor na Colômbia para o ruído medido no ambiente de trabalho.

Identificación de factores asociados a la pérdida de capacidad auditiva en estudiantes, docentes y auxiliares de odontología / Identification of factors associated with hearing loss in teaching, students and dental assistants

Introducción: La exposición continua al ruido en el ambiente laboral, generado durante la atención clínica, afecta la capacidad auditiva del personal del área de odontología. No obstante, hay otras características que pudieran estar asociadas a una mayor expresión de esta condición. Objetivo: Identificar factores asociados a capacidad auditiva en estudiantes, docentes y auxiliares de una facultad de odontología. Material y Métodos: Estudio analítico de corte transversal; se seleccionaron aleatoriamente los participantes y se excluyeron personas con diagnóstico clínico de pérdida auditiva hereditaria o previa al inicio del ejercicio profesional o estudiantil. Se realizaron mediciones del ruido en el ambiente laboral y valoraciones audiométricas. Se evaluó asociación entre capacidad auditiva y las variables independientes con Chi2 o Test Exacto de Fisher (significancia estadística p<0,05). Se propone un modelo predictivo para pérdida de capacidad auditiva. Resultados: 193 participantes fueron incluidos, el 35,8% presentaron disminución leve o moderada de su capacidad auditiva (37,2% estudiantes y 30% en docentes-auxiliares). No hubo diferencias entre estudiantes y docentes/auxiliares ni entre el oído derecho e izquierdo. Conclusión: Los años de experiencia clínica, el semestre cursado y el antecedente de tinnitus predicen la aparición de pérdida de capacidad auditiva (AU)

Introduction: Continuous exposure to noise in the work environment, generated during clinical care, affects the hearing capacity of dental staff. However, there are other characteristics that could be associated with a greater expression of this condition. Objective: Identify factors associated with hearing capacity in students, teachers and assistants of a dental school. Material and Methods: Analytical cross-sectional study; participants were randomly selected and people with a clinical diagnosis of hereditary hearing loss or prior to the start of professional or student practice were excluded. Noise measurements were made in the work environment and audiometric evaluations. The association between hearing capacity and the independent variables was evaluated with Chi2 or Fisher’s Exact Test (statistical significance p <0.05). A predictive model for hearing loss is proposed. Results: 193 participants were included, 35.8% had a slight or moderate decrease in their hearing capacity (37.2% students and 30% in teaching assistants). There were no differences between students and teachers / assistants or between the right and left ears. Conclusion: The years of clinical experience, the semester attended and the history of tinnitus predict the appearance of hearing loss (AU)

Evaluación de la capacidad auditiva en estudiantes de una facultad de odontología en Colombia / Avaliação da capacidade auditiva em estudantes de uma faculdade de dentistria na Colômbia / Assessment of hearing capacity in students of a faculty of dentistry in Colombia

Resumen Introducción y objetivo: La pérdida de capacidad auditiva por exposición a ruido en ambiente laboral es un problema de salud pública que se constituye en la tercera causa de incapacidad mundial por exposición laboral. En el área de odontología, personal en proceso de formación se ve expuesto al ruido del instrumental usado en los procedimientos clínicos lo que puede conducir a pérdida auditiva inducida por ruido. Evaluar la capacidad auditiva de estudiantes de una facultad de odontología en Colombia. Materiales y métodos: Se realizó un estudio observacional analítico de corte transversal, en estudiantes de odontología de sexto a décimo semestre; se hizo encuesta autodiligenciada y valoración clínica audiológica a todos los participantes. La base de datos se consolidó en Microsoft Excel y se analizó en el programa estadístico STATA 14.0. El análisis estadístico incluyó descripción de los datos usando media y desviación estándar (datos cuantitativos) y frecuencias absoluta y relativa (datos cualitativos) los cuales se acompañaron de intervalos de confianza del 95%. El análisis bivariado se realizó con test exacto de Fisher y prueba de Chi cuadrado así como prueba de t de Student y ANOVA. Resultados: Se evidenció una pérdida auditiva de 77,8% para el oído derecho y el 76,2% para el oído izquierdo. Conclusión: Los estudiantes de odontología presentaron alteración en su capacidad auditiva. La edad y el semestre académico se asocian con la pérdida de la capacidad auditiva.

Abstract Introduction and objective: Loss of hearing ability due to exposure to noise in the workplace is a public health problem that constitutes the third cause of disability worldwide due to occupational exposure. In the dental area, personnel are exposed to the noise of the instruments used in clinical procedures, which can lead to noise-induced hearing loss. To evaluate the hearing capacity of students from a dental school in Colombia. Materials and methods: An analytical cross-sectional study was carried out in dental students from sixth to tenth semester; the participants' information was obtained through a self-filled survey and clinical audiological evaluation. The database was consolidated in Microsoft Excel and exported to the STATA 14.0 program where the information was processed. The analysis plan included description of the data using mean and standard deviation (quantitative data) and absolute and relative frequencies (qualitative data) which are accompanied by 95% confidence intervals. Bivariate analysis was performed with Fisher's exact test and Chi square test, as well as Student's t-test and ANOVA. Results: A hearing loss of 77.8% was evident for the right ear and 76.2% for the left ear. Conclusion: Dental students presented alteration in their hearing ability. Age and academic semester are associated with loss of hearing ability.

Resumo Introdução e objetivo: A perda da capacidade auditiva devido à exposição ao ruído no local de trabalho é um problema de saúde pública que é a terceira principal causa de incapacidade no mundo devido à exposição ocupacional. Na área de odontologia, o pessoal é exposto ao ruído dos instrumentos utilizados nos procedimentos clínicos, o que pode levar à perda auditiva induzida por ruído. avaliar a capacidade auditiva de estudantes de uma escola de odontologia na Colômbia. Materiais e métodos: Um estudo transversal analítico foi realizado em estudantes de odontologia do sexto ao décimo semestre; as informações dos participantes foram obtidas por meio de inquérito auto-preenchido e avaliação audiológica clínica. O banco de dados foi consolidado no Microsoft Excel® e exportado para o programa STATA 14.0, onde as informações foram processadas. O plano de análise incluiu a descrição dos dados usando média e desvio padrão (dados quantitativos) e frequências absolutas e relativas (dados qualitativos) acompanhadas por intervalos de confiança de 95%. A análise bivariada foi realizada com o teste exato de Fisher e qui-quadrado, bem como o teste t de Student e ANOVA. Resultados: Perda auditiva de na orelha direita foi 77,8% na orelha direita e 76,2% na orelha esquerda. Conclusão: Os estudantes de odontologia apresentaram alteração na capacidade auditiva. A idade e o semestre acadêmico estão associados à perda da capacidade auditiva.

Reproducibilidad en el diagnóstico imagenológico de periodontitis apical a partir de CBCT / Reproducibility of apical periodontitis diagnosis using CBCT imaging

Objetivo: evaluar la reproducibilidad en el diagnóstico imagenológico de Periodontitis Apical en dientes del maxilar superior, a partir de 60 CBCT tomadas en una institución clínica de Bucaramanga, Colombia. Métodos: el estudio fue realizado por dos obser-vadores, previamente calibrados, de CBCT del maxilar superior que contenían dientes permanentes con ápice cerrado, correspondientes a adultos mayores de 18 años de edad. La presencia o ausencia de periodontitis apical se analizó utilizando el índice CBCT PAI. La información registrada fue relacionada con variables de interés. Resultados:la reproducibilidad entre los evaluadores fue sustancial o perfecta. La prevalencia de periodontitis apical encontrada fue del 21,6%; en los dientes con tratamiento de en-dodoncia fue del 12,4% y en los dientes sin tratamiento endodóntico fue de un 9,2%. Conclusiones: la tomografía CBCT proporciona al clínico información que permite una mayor claridad en la fase de diagnóstico. Los dientes con la mayor prevalencia de PA fueron el primer molar y el primer premolar superior izquierdo, respectivamente.

Objective: To evaluate the reproducibility in the imaging diagnosis of apical periodontitis (PA) in upper jaw teeth from 60 cone beam computerized axial tomography (CBCT) taken at a clinical institution in an intermediate city in Colombia.Methods: The study was conducted by two previously calibrated observers from CBCT of the upper jaw containing permanent teeth with closed apex corresponding to adults over 18 years of age. The presence or absence of apical periodontitis was analyzed using the CBCT PAI index. The recorded information was related to variables of interest. Results: Reproducibility among testers was substantial or perfect. The prevalence of PA found was 21.6%, in teeth with endodontic treatment 12.4% and in teeth without endodontic treatment 9.2%. Conclusions: CBCT tomography provides the clinician with information that allows for greater clarity in the diagnostic phase. The teeth with the highest prevalence of PA were the first molar and first upper left premolar respectively.

Nifurtimox versus benznidazole or placebo for asymptomatic Trypanosoma cruzi infection (Equivalence of Usual Interventions for Trypanosomiasis - EQUITY): study protocol for a randomised controlled trial.

BACKGROUND: Either benznidazole (BZN) or nifurtimox (NFX) is recommended as equivalent to treat Trypanosoma cruzi infection. Nonetheless, supportive data from randomised trials is limited to individuals treated with BZN in southern cone countries of Latin America. METHODS: The goal of this randomised, concealed, blind, parallel-group trial is to inform the trypanocidal efficacy and safety of NFX and its equivalence to BZN among individuals with T. cruzi positive serology (TC+). Eligible individuals are TC+, 20-65 years old, with no apparent symptoms/signs or uncontrolled risk factors for cardiomyopathy and at negligible risk of re-infection. Consenting individuals (adherent to a 10-day placebo run-in phase) receive a 120-day BID blinded treatment with NFX, BZN or matching placebo (2:2:1 ratio). The four active medication arms include (1) a randomly allocated sequence of 60-day, conventional-dose (60CD) regimes (BZN 300 mg/day or NFX 480 mg/day, ratio 1:1), followed or preceded by a 60-day placebo treatment, or (2) 120-day half-dose (120HD) regimes (BZN 150 mg/day or NFX 240 mg/day, ratio 1:1). The primary efficacy outcome is the proportion of participants testing positive at least once for up to three polymerase chain reaction (PCR) assays (1 + PCR) 12-18 months after randomisation. A composite safety outcome includes moderate to severe adverse reactions, consistent blood marker abnormalities or treatment abandons. The trial outside Colombia (expected to recruit at least 60% of participants) is pragmatic; it may be open-label and not include all treatment groups, but it must adhere to the randomisation and data administration system and guarantee a blinded efficacy outcome evaluation. Our main comparisons include NFX groups with placebo (for superiority), NFX versus BZN groups and 60CD versus 120HD groups (for non-inferiority) and testing for the agent-dose and group-region interactions. Assuming a 1 + PCR ≥ 75% in the placebo group, up to 25% among BZN-treated and an absolute difference of up to ≥ 25% with NFX to claim its trypanocidal effect, 60-80 participants per group (at least 300 from Colombia) are needed to test our hypotheses (80-90% power; one-sided alpha level 1%). DISCUSSION: The EQUITY trial will inform the trypanocidal effect and equivalence of nitroderivative agents NFX and BZN, particularly outside southern cone countries. Its results may challenge current recommendations and inform choices for these agents. TRIAL REGISTRATION: ClinicalTrials.gov, NCT02369978 . Registered on 24 February 2015.

Human Trypanosomiasis in the Eastern Plains of Colombia: New Transmission Scenario.

Characteristics of Trypanosoma cruzi infection were studied in a rural area of the eastern plains of Colombia. Using enzyme-linked immunosorbent assay and indirect fluorescent-antibody tests, the infection was determined in 11.6% of the inhabitants of 142 dwellings. During 6 months of community surveillance, in 42.3% dwellings, 609 triatomines were collected (597 Rhodnius prolixus and seven, three, one, and one of Panstrongylus geniculatus, Psammolestes arturi, Eratyrus mucronatus, and Triatoma maculata, respectively). Rhodnius prolixus was found in 80% peridomiciliary Attalea butyracea palms examined with baited traps, and its infection with T. cruzi was 30% and 38.5% in dwellings and palms, respectively. Trypanosoma cruzi was isolated in five of 35 triatomines and in one of 24 dogs. The blood of domestic and wild animals was identified in triatomines collected in the intradomicile and in palms. These results support the extension of the wild cycle of T. cruzi to human dwellings and the characterization of a new scenario for transmission in Colombia.

Epidemiology, risk factors and genotypes of HBV in HIV-infected patients in the northeast region of Colombia: high prevalence of occult hepatitis B and F3 subgenotype dominance.

INTRODUCTION: Chronic hepatitis B virus (HBV) infection is an increasing cause of morbidity and mortality in human immunodeficiency virus (HIV)-infected individuals. HIV-positive patients are commonly co-infected with HBV due to shared routes of transmission. OBJECTIVES: Our aim was to determine the risk factors, prevalence, genotypes, and mutations of the Surface S gene of HBV, and occult hepatitis B infection (OBI) among patients infected with HIV in a northeastern Colombian city. METHODS: A cross-sectional study was conducted with 275 HIV-positive patients attending an outpatient clinic in Bucaramanga, Colombia during 2009-2010. Blood samples were collected and screened for serological markers of HBV (anti-HBs, anti-HBc and HBsAg) through ELISA assay. Regardless of their serological profile, all samples were tested for the HBV S gene by nested-PCR and HBV genotypes were determined by phylogenetic inference. Clinical records were used to examine demographic, clinical, virological, immunological and antiretroviral therapy (ART) variables of HIV infection. RESULTS: Participants were on average 37±11 years old and 65.1% male. The prevalence of HIV-HBV coinfection was 12% (95%CI 8.4-16.4) of which 3.3% had active HBV infection and 8.7% OBI. The prevalence of HIV-HBV coinfection was associated with AIDS stage and ART treatment. Sequence analysis identified genotype F, subgenotype F3 in 93.8% of patients and genotype A in 6.2% of patients. A C149R mutation, which may have resulted from failure in HBsAg detection, was found in one patient with OBI. CONCLUSIONS: The present study found a high prevalence of HIV-HBV coinfection with an incidence of OBI 2.6-fold higher compared to active HBV infection. These findings suggest including HBV DNA testing to detect OBI in addition to screening for HBV serological markers in HIV patients.

Marcadores serológicos y moleculares de infección por el virus de la hepatitis B en estudiantes universitarios colombianos / Serological and molecular markers for Hepatitis B virus in university students

Introducción: Reportes de la OMS demuestran que la carga de infección por el virus de la hepatitis B (VHB) varía de acuerdo con la región geográfica y el grupo de riesgo. Propósito: Determinar la prevalencia de infección por el VHB y el estatus de vacunación en estudiantes universitarios de Bucaramanga. Metodología: Estudio descriptivo de corte transversal realizado en el 2010. Se incluyeron 1.298 estudiantes de cinco universidades. Se identificaron marcadores serológicos de infección para el VHB por ELISA y el genoma viral se detectó mediante PCR anidado. Resultados: Se estableció infección activa en 0,15%, confirmada por PCR; infección resuelta a 0,60%; 1,1% anti-HBc aislado, 30,2% vacunados y 67,9% susceptibles. No se evidenció hepatitis B oculta. Conclusiones: La baja prevalencia de infección por el virus de la hepatitis B reportada en el presente estudio contrasta con el patrón epidemiológico intermedio descrito en la región. Se encontró una baja cobertura de vacunación y ausencia de hepatitis B oculta en los estudiantes universitarios.

Introduction: Reports from the World Health Organization (WHO) show that the prevalence of hepatitis B virus (HBV) infections varies by geographical region and risk group. Purpose: The purpose of this study was to determine the prevalence of HBV infections, as well as the vaccination status, among university students from Bucaramanga. Methodology: This was a cross sectional study conducted in 2010 which included 1298 students from five universities. Serological markers for HBV infection were detected using ELISA. Viral genomes were detected with nested polymerase chain reaction (PCR). Results: Active infections were established in 0.15% of the study population, and this finding was confirmed by PCR. Resolved infections were identified in 0.60% of the population. Isolated anti-HBc antibodies were found, 30.2% of vaccinated individuals. 67.9% of the study population was susceptible. No occult HBV was detected. Conclusions: The low prevalence of HBV infections reported in this study contrasts with the intermediate epidemiological pattern described in the region. We found poor vaccination coverage and absence of occult hepatitis B among these university students.