Orofacial manifestations of chorea-acanthocytosis: case presentation and literature review.

Chorea-acanthocytosis is a rare neurological disorder that produces involuntary body movements, along with a condition of misshapen red blood cells that is characterized by appearing in early adulthood. There are numerous orofacial manifestations linked to chorea-acanthocytosis that the dental practitioner must consider in early and late stages of the disease, such as chronic oral ulcerations, chronic mouth grinding, difficulty swallowing, and biting the lip and tongue, among others. This case, the first to the authors' knowledge to address the area of orofacial pain, provides general signs and symptoms of the disorder and management following a multidisciplinary approach. The life span of patients with this disorder is generally shortened, and correct management is essential to improve the quality of life.

Empathy and Personality Styles in Medical Students / Empatia y Estilos de Personalidad en Estudiantes de Medicina

Abstract This study established the relationship between empathy and personality styles in medical students, considering the differences by gender. The participants were 278 students of the medical career of the Universidad del Azuay, Ecuador. The evaluation involved the Jefferson empathy scale and the Millon Index of Personality Styles. Relationships between empathy and personality styles were examined using Pearson's correlation coefficient and Hierarchical Multiple Linear Regression analysis, for comparisons by gender and educational levels, with both Student's f-test and analysis of variance used respectively. Results indicated that the factor structure of the empathy scale is invariant between men and women, noticing gender differences in care with compassion and total empathy, with women presenting a higher mean. Differences are visible by educational level, where the general empathy in the first three years grows progressively, and then slightly decrease. Concluding, female students present an average score of total empathy greater than men, with differences of empathy according to educational level.

Resumen Esta investigación estableció la relación entre empatia y estilos de personalidad en estudiantes de medicina según género. Participaron 278 estudiantes de la carrera de medicina de la Universidad del Azuay, Ecuador. Se aplicó la escala de empatia de Jefferson y el índice de estilos de personalidad de Millon. Las relaciones entre empatia y estilos de personalidad se examinaron utilizando el coeficiente de correlación de Pearson y el análisis jerárquico de regresión lineal múltiple. Las comparaciones por género y niveles educativos se analizaron con la prueba f de Student y el análisis de varianza. La estructura factorial de escala de empatia no varia entre hombres y mujeres, sin embargo, se notaron diferencias de género en cuidado con compasión y empatia total, presentando las mujeres una media más alta. Existen diferencias por nivel educativo, se observó que la empatia general en los primeros tres años crece y luego disminuye. Finalmente, las estudiantes presentan una puntuación media de empatia total mayor que los hombres, con diferencias según el nivel educativo.

Empatía y Componentes de la Empatía en Estudiantes de Obstetricia / Empathy and Components of Empathy in Obstetrics Students

Introduction: Empathy with the patient is an important attribute that contributes to the success of treatment. This attribute must be object of teaching in the training stage of the student of the health sciences. Objective: To evaluate the levels of empathy and its components in students of the Obstetrics course at the University of Norbert Wiener, Peru. Material and Methods: Design: cross-sectional study. Participants: The sample was composed of 219 first-year to fifth-year students. Measurements: The Jefferson Empathy Scale, S version for students was applied. The internal reliability of the data was estimated using the general Cronbach's alpha, interclass correlation coefficient, Hotelling's T2, and Tukey non-additive test; the mean and standard deviation were estimated. A bi-factorial analysis of variance (ANOVA), model III was applied in the academic years, the genders and the interaction of these two factors. Results: The empathic level of obstetrics students has an average of 105,95 points, out of a maximum of 140, and it is higher (in absolute values) than other values observed in analogous measurements in Latin America. In general, there are no significant differences in empathy between academic years and genders, and in the components of empathy. Conclusions: The average level of empathy among obstetrics students at Wiener University shows relative little growth per year of study(AU)

Introducción: La empatía con el paciente es un importante atributo que contribuye al éxito del tratamiento. Este atributo debe ser objeto de enseñanza en la etapa de formación del estudiante de ciencias de la salud. Objetivo: Evaluar los niveles de empatía y de sus componentes en estudiantes del curso de Obstetricia de la Universidad Norbert Wiener, Perú. Material y métodos: Diseño: estudio transversal; Participantes: la muestra fue de 219 estudiantes que estaban en el primer a quinto año de su carrera; Medidas: se aplicó la escala de empatía de Jefferson, versión S para estudiantes. La confiabilidad interna de los datos se estimó utilizando el alfa general de Cronbach, el coeficiente de correlación interclase, el T2 de Hotelling y la prueba no aditiva de Tukey, estimando las medias y la desviación estándar. Se aplicó un análisis bifactorial de varianza (ANOVA), modelo III entre los años académicos, entre los géneros y en la interacción de estos dos factores. Resultado: El nivel empático de los estudiantes de obstetricia examinados tiene un promedio de 105,95 puntos de un máximo de 140 y es mayor (en valores absolutos) a otros valores observados en mediciones análogas en América Latina. En general, no hay diferencias significativas entre los años académicos y entre los géneros en la empatía y en los componentes de la empatía. Conclusiones: El nivel promedio de empatía entre los estudiantes de obstetricia en la Universidad de Wiener muestra un crecimiento relativamente pequeño por año de estudio(AU)

Declinación en el género y la empatía en alumnos de la Facultad de Odontología de la Universidad Central (Ecuador): estudio transversal. Género y declinación empática: un estudio transversal / Decline in gender and empathy in students of the Faculty of Dentistry of the Central University (Ecuador): cross-sectional study. Gender and empathic decline: a cross-sectional study

Objetivo: Diagnosticar el comportamiento empático en general y de cada uno de sus componentes en los estudiantes de la Facultad de Odontología de la Universidad Central de Quito, Ecuador. Material y Métodos: Este trabajoes de tipo exploratorio y transversal. A los participantes se les aplicó la Escala de Empatía Médica de Jefferson sometida a criterio de jueces para verificar la validez cultural y de contenido y adaptarla para estudiantes de odontología.Se estimó el alpha de Cronbach, el coeficiente de correlación intraclase y T2 de Hotelling. Se estimaron la mediay desviación estandar. Se aplicó un análisis de varianza (ANOVA multivariado) bifactorial (modelo III) Se estimóel potencial total de crecimiento posible. Se utilizaron gráficos de cajas aritméticos simples y procesados con SPSS22.0. El nivel de significación fue de α ≤ 0,05 y ß ≥ 0,80. Resultados: Se encontraron bajos niveles de empatía enrelación a otras facultades de América Latina y un alto desarrollo relativo de los niveles del componente cuidado concompasión. Los componentes restantes se mantuvieron con valores de crecimiento bajos y, en algunos casos, negativos; no se cumple el modelo de erosión empática, y en general, no existen diferencias estadísticas entre los géneros.Conclusiones: El diagnóstico realizado permite crear las condiciones para construir una estrategia de intervenciónmás específica(AU)

Objective:To make a diagnosis of empathic behaviour as a whole and in each of its components in the students of Facultadde Odontologia de la Universidad Central de Quito, Ecuador. Materials and methods: This is an exploratory and crosssectional research. Jefferson Medical Empathy Scale was applied to the participants. It was submited to judges to verify thecultural and content validity and to adapt it to dentistry students. Cronbach's alpha, intraclass correlation coefficient andHotelling's T2 were estimated, as well as the mean and standard deviation. A bifactorial (model III) analysis of variance(multivariate ANOVA) was applied. Total possible growth potential was estimated. Simple and SSPSS22.0 processedarithmetic box graphs were used. The level of significance was α ≤ 0.05 and ß ≥ 0.90. Results:We found low levelsof empathy in comparison with other faculties from Latin America and a high relative development of the levels of thecompassionate component, with the remaining components with low, and in some cases negative growth values. The modelof empathic decline is not fulfilled and, generally, there are no statistical differences between genders. Conclusions: Theresults presented here may create conditions to build a more specific intervention strategy(AU)

Reconsidering the 'Decline' of Dental Student Empathy within the Course in Latin America.

INTRODUCTION: The controversy over the presence of empathic decline within the course in students of medicine, dentistry and health sciences in general, has not fully been studied. This controversy could be partially solved if massive studies of empathy levels are made in similar cultural, social and economic contexts. MATERIAL AND METHODS: Empathy levels within the course were studied in eighteen dental schools from six countries in Latin America (2013). The mean of the empathy levels were used to study the behavior between first and fifth academic years. The values of empathy levels within the course were observed by applying the Jefferson Scale of Physician Empathy, the Spanish version. All these studies were cross-sectional. The value of means observed, were subjected to regression studies and further adjustment curves were obtained and the coefficient of determination were calculated. RESULTS: Six different models of behavior were observed, which found that five of them suffer empathic decline within the course, but with different final results: in some the decline persists until the fifth academic year and in others, this decline 'recovers' persistently until the fifth academic year. The sixth model is characterized by a constant and persistent increase of levels of empathy within the course until the last academic year. DISCUSSION: There are six different models for the behavior of means of levels of empathy within the course evaluated by a common methodology in eighteen dental schools from six countries of Latin America. These findings support the existence of variability of empathic response and a comprehensive approach is needed to find the causes that give rise to this variability. CONCLUSION: In dental students of Latin America, there is variability in the behavior of the distribution in means between the academic years of the dentistry schools examined in this study.

Introdução: A controvérsia sobre o declínio da empatia relativamente ao curso em estudantes de Medicina, Odontologia e Ciências da Saúde em geral ainda não foi completamente elucidada. Esta controvérsia poderia ser parcialmente solucionada se fossem realizados estudos significativos sobre os níveis de empatia em contextos culturais, sociais e económicos similares. Material e Métodos: Foram estudados os níveis de empatia com o curso em dezoito escolas de Odontologia de seis países na América Latina (2013). As médias dos níveis de empatia foram usadas para estudar o comportamento entre académicos do primeiro e quinto anos. Os valores de níveis de empatia para com o curso foram observados aplicando a versão em espanhol da escala Jefferson de Empatia Médica. Todos estes estudos foram transversais. O valor das médias observadas sujeito a tratamento estatístico de regressão, obtendo-se as subsequentes curvas de ajustes e calculado o coeficiente de determinação. Resultados: Foram observados seis diferentes modelos de comportamento, sendo que em cinco deles se verificou declínio da empatia, com diferentes resultados finais: em alguns, o declínio persistiu até o quinto ano académico e, em outros, o declínio 'recuperou-se' persistentemente até ao quinto ano académico. O sexto modelo caracterizou-se por um constante e persistente aumento nos níveis de empatia com o curso até o último ano académico. Discussão: Existem seis modelos diferentes para o comportamento das médias dos níveis de empatia para com o curso, avaliados por uma metodologia comum em dezoito escolas de Odontologia de seis países na América Latina. Estes resultados suportam a existência de variabilidade de resposta empática, sendo necessária uma abordagem compreensiva para encontrar as suas causas. Conclusão: Em estudantes de Odontologia da América Latina verifica-se variabilidade no comportamento da distribuição de meios entre os anos acadêmicos das escolas de odontologia examinadas neste trabalho.

Coronoid hyperplasia in a pediatric patient: case report and review of the literature.

Coronoid hyperplasia is a rare entity of unknown etiology due to increased and persistent bone growth that has been associated with trauma, inflammation, hormonal influence and hypervascularization. A case of coronoid hyperplasia in a pediatric patient with restriction in mandibular movements and an absence of painful symptoms initially misdiagnosed as a functional temporomandibularjoint (TMJ) abnormality is presented. Causative factors and management strategies are emphasized to enhance the recognition and understanding of mandibular hypomobilities.

Burning mouth syndrome: a challenge for dental practitioners and patients.

A retrospective study was conducted on patients with burning mouth syndrome (BMS) to assess demographics, onset characteristics, temporal behavior (frequency), duration, and progression of oral burning symptoms. Additionally, treatments provided by health practitioners prior to a definitive diagnosis of BMS were analyzed with an overview of current management strategies. The records of 49 adult patients diagnosed with BMS were reviewed. Descriptive statistics and a Pearson correlation with a statistical significance at p < 0.05 were utilized to analyze the data. The majority of patients were mid-life white women who reported a sudden onset of constant oral burning symptoms that increased in intensity. On average, patients reported oral burning symptoms for 41 months (standard deviation = 73.5, range = 2-360 months, median = 20 months), and 38 of the patients received/trialed 71 various interventions (mean = 1.9) prior to receiving a definitive diagnosis for their oral burning symptoms. This study sample shared many characteristics with those reported previously in the literature. The authors found that patients frequently reported delays in receiving a definitive diagnosis with an array of various trialed interventions. For this reason, the authors provide this overview of current management strategies in order to assist dental practitioners in providing appropriate interventions for patients with BMS.

Taste change associated with a dental procedure: case report and review of literature.

Loss or alteration of taste is a rare phenomenon that may be idiopathic or may be caused by head trauma, medication use or systemic and local factors including various invasive dental procedures resulting in nerve damage. We present an unusual case of generalized taste change following an oral surgical procedure. The case is presented to enhance understanding of taste disorders and their relation to a localized traumatic event. Causative factors and management strategies are also reviewed. Taste change, encompassing loss (ageusia) or alteration (dysgeusia) of taste, is a rare phenomenon that may be idiopathic or may result from head trauma; endocrine, metabolic, sinus, autoimmune and salivary gland disorders; medication use; cancer treatment (radiation or chemotherapy); viral, bacterial and fungal infections; certain oral conditions; or peripheral nerve damage due to invasive procedures including dental interventions. Some factors thought to be responsible for nerve injuries associated with dental procedures are proximity of the chorda tympani nerve to the surgical site, retraction of the lingual flap, extraction of unerupted teeth especially third mandibular molars, and experience of the operator. Nerve damage may also be a result of local anesthetic injection due to direct needle trauma causing hemorrhage within the epineurium or a neurotoxic effect of the anesthetic. The sensation of taste is mediated by three cranial nerves: facial (VII), glossopharyngeal (IX) and vagus (X). The trigeminal nerve (V) provides general sensory innervation to a region that overlaps the areas served by these other cranial nerves (Table 1). Because of their anatomic proximity, the possibility exists for iatrogenic injury to the chorda tympani, lingual nerve or both during surgical procedures in the posterior mandible. This may result in irreversible gustatory deficits and somatosensory dysfunction. The purpose of this article is to review the possible causes and management of taste disorders. An unusual case of generalized taste change following an oral surgical procedure is presented to enhance understanding of taste disorders and their possible relation to a localized traumatic event.

Parotid gland squamous cell carcinoma invading the temporomandibular joint.

BACKGROUND: Tumor invasion of the temporomandibular joint from the parotid gland is rare. Practitioners should be able to differentiate tumor involvement from temporomandibular disorders (TMDs). CASE DESCRIPTION: . The authors present case reports of two patients with parotid gland masses accompanied by pain, dysfunction and other symptoms not consistent with musculoskeletal disorders. In both cases, clinicians initially reached an incorrect diagnosis and treated the masses as if they were TMDs, which delayed a definitive diagnosis and provision of appropriate treatment. CONCLUSIONS: Dentists must take a thorough patient history, perform a detailed clinical examination and request proper radiographic imaging, when necessary, to render an accurate diagnosis and avoid mistreatment. Dentists who treat TMDs must recognize the possibility that a head or neck malignancy may manifest with symptoms and signs that mimic TMDs. If dentists are in doubt about a diagnosis, referral to the appropriate specialist should be considered. CLINICAL IMPLICATIONS: A thorough history, a comprehensive clinical examination and an understanding of salivary gland disorders should facilitate an accurate initial diagnosis, allowing delivery of the appropriate and necessary medical treatment.

Budesonide for local therapy of complex oral mucosal immune-mediated inflammatory diseases: case reports.

Local immunosuppressive therapies without systemic effects represent a therapeutic advantage in management of immune/inflammatory oral mucosal conditions. Topical budesonide rinses were prescribed to patients with mucosal disease that was resistant to other intervention without side effects. A case of paraneoplastic pemphigus and a patient with oral graft-versus-host disease that had not responded to standard approaches to management were successfully managed with budesonide rinse application. The cases presented represent mucosal conditions that were successfully managed with topical application of budesonide with reduced risk of systemic effects.

Taste change associated with a dental procedure: case report and review of the literature.

Loss or alteration of taste is a rare phenomenon that may be idiopathic or may be caused by head trauma, medication use or systemic and local factors including various invasive dental procedures resulting in nerve damage. We present an unusual case of generalized taste change following an oral surgical procedure. The case is presented to enhance understanding of taste disorders and their relation to a localized traumatic event. Causative factors and management strategies are also reviewed.