Assessing the burden of osteoarthritis in Latin America: a rapid evidence assessment.

This rapid evidence assessment (REA) was conducted to explore the burden of weight-bearing joint osteoarthritis in the developing countries of Latin America. REA methodology used a standardized search strategy to identify observational studies published from 2010 to 23 April 2020 that reported outcomes pertaining to the epidemiology and humanistic or economic burden of weight-bearing osteoarthritis. Relevant data from each included study were used to populate bespoke data extraction tables and qualitatively analyzed. Thirteen publications were identified that reported on knee and hip osteoarthritis in the Latin American region. Overall prevalence of physician-diagnosed symptomatic knee osteoarthritis in adults ranged from 1.55% in Peru to 7.4% in Ecuador. Total prevalence of grade ≥ 2 radiographic knee osteoarthritis was 22% among those ≥ 39 years of age in Brazil and 25.5% among those ≥ 40 years of age in Mexico. The prevalence of symptomatic/radiographic knee osteoarthritis was 7.1% in people ≥ 18 years of age in Mexico and 17.6% among those ≥ 40 years of age. Prevalence of hip osteoarthritis was similar to or slightly lower than knee osteoarthritis. The limited data available indicates weight-bearing osteoarthritis negatively affects quality of life and that the economic burden may vary between countries with different healthcare systems. The limited evidence found in the published literature suggests the burden of osteoarthritis in Latin America is substantial. Our analysis identified several evidence gaps, particularly for health-related quality of life and socioeconomic outcomes. Further research is of particular importance in areas where government-subsidized healthcare and resources are scarce.

Anestesia en odontopediatría fuera de quirófano / Anesthesia in pediatric dentistry outside the operating room

Introducción: La anestesia fuera del quirófano crece constantemente, sobre todo en odontopediatria. Objetivo: Lograr una técnica anestésica segura en el consultorio del odontólogo, con participación activa de los padres y en forma ambulatoria. Material y método: Trabajo descriptivo sobre 50 pacientes ASA I y II de ambos sexos, con edades entre los 4 y los 15 años. Se realizó inducción inhalatoria con sevofluorano combinado con midazolam más fentanilo. Se mantuvo la ventilación espontánea con bigotera o máscara nasal. Resultados: Se lograron cortos tiempos de inducción y despertar, y estabilidad hemodinámica y respiratoria; los criterios de alta fueron adecuados y no se presentaron complicaciones de importancia. Discusión: Son requisitos indispensables el cuidado estricto de la vía aérea, las indicaciones precisas, el manejo interdisciplinario y los equipos y medicamentos de reanimación cardiopulmonar. Conclusión: La técnica anestésica utilizada fue segura y sin complicaciones; permitió realizar el 100 por ciento de los procedimientos, demostrando ser una alternativa válida y viable.

Introduction: Anesthesia outside the operating room is constantly becoming more frequent, particularly in pediatric dentistry. Objective: To achieve a safe anesthesia technique in the dentist’s office in ambulatory form with the active participation of the parents. Material and method: Descriptive paper regarding 50 ASA I y II patients of both sexes, aged between 4 and 15 years. Induction by inhalation was carried out with sevofluorane combined with midazolam plus fentanyl. Spontaneous ventilation with nasal cannula or mask. Results: Short induction and awakening times were achieved, as well as hemodynamic and respiratory stability; release criteria were adequate and no important complications appeared. Discussion: Indispensable requisites are: strict care of the airway, precise indications, interdisciplinary management and CPR teams and drugs. Conclusion: The anesthesia technique used was safe and without complications; it allowed carrying out 100 percent of the procedures and proved to be a valid and viable option.

Introdução: A anestesia fora da sala de cirurgia cresce de forma constante, principalmente em odontopediatria. Objetivo: Desenvolver uma técnica anestésica segura no consultório do odontologista, com a participação ativa dos pais da criança e de forma ambulatorial. Material e método: Trabalho descritivo sobre 50 pacientes ASA I e II de ambos os sexos, com idades entre 4 e 15 anos. Foi realizada indução inalatória com sevofluorano combinado com midazolam mais fentanilo. Manteve-se a ventilação espontânea utilizando bigodeira ou máscara nasal. Resultados: Foram conseguidos tempos curtos de indução e de acordar, e estabilidade hemodinâmica e respiratória; os critérios de alta foram adequados e não se apresentaram complicações importantes. Discussão: São requisitos essenciais o cuidado rigoroso da via aérea, as indicações precisas, o manejo interdisciplinar e o equipamento e os medicamentos de reanimação cardiopulmonar. Conclusão: A técnica anestésica utilizada é segura e livre de complicações; possibilitou realizar todos os procedimentos, provando ser uma alternativa válida e viável.