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1.
Int J Eat Disord ; 54(12): 2155-2166, 2021 12.
Artigo em Inglês | MEDLINE | ID: mdl-34704615

RESUMO

OBJECTIVE: To evaluate body composition, nutritional status through food selectivity and degree of inadequate intake, and mealtime behavior in children with autism spectrum disorder (ASD) compared to neurotypical children. METHOD: A cross-sectional case-control study was carried out in 144 children (N = 55 with ASD; N = 91 with neurotypical children) between 6 and 18 years of age. Body composition, nutritional intake, food consumption frequency (FFQ), and mealtime behavior were evaluated. RESULTS: Results showed a greater presence of children with a low weight (18.4% ASD vs. 3.20% comparison group) and obesity (16.3% ASD vs. 8.6% comparison group) in the ASD group for body mass index (BMI) categories (p = .003; number needed to take [NNT] = 8.07). The presence of obesity in ASD children compared to the comparison group was even higher when considering the fat component (47.5% ASD vs. 19.4% comparison group, p = .002; NNT = 10.3). ASD children had greater intake inadequacy (50% ASD vs. 22% comparison group, p = .014; NNT = 3.58), high food selectivity by FFQ (60.6% ASD vs. 37.9% comparison group, p < .037; NNT = 4.41), and more eating problems (food rejection, limited variety, disruptive behavior), compared to neurotypical children (p = .001). CONCLUSION: Children with ASD showed an unbalanced body composition toward both underweight and obesity, a greater degree of inadequate intake, high food selectivity as indicated by their consumption frequency, and more disturbed eating behavior than children with neurotypical development. We suggest monitoring nutritional inadequacies and implementing nutritional strategies to expand the variety of foods children with ASD consume.


Assuntos
Transtorno do Espectro Autista , Comportamento Problema , Transtorno do Espectro Autista/complicações , Estudos de Casos e Controles , Criança , Estudos Transversais , Comportamento Alimentar , Humanos , Refeições
2.
Eur J Dent Educ ; 25(2): 238-245, 2021 May.
Artigo em Inglês | MEDLINE | ID: mdl-32813319

RESUMO

BACKGROUND AND AIMS: A study was made to evaluate knowledge of dental trauma among first-year dental students at the start of the career; assess the knowledge gained immediately after a lecture intervention; and evaluate persisting knowledge on an annual basis until the fourth year of the career. MATERIAL AND METHODS: The study involved 29 volunteers from the first year of dentistry (School of Dentistry, Madrid Complutense University, Madrid, Spain). All the participants completed a previously validated questionnaire including questions referred to the management of dental trauma at the site of the accident, and other related aspects. This was followed by a brief lecture on the subject, and then the same questionnaire was administered again. Completion of the original questionnaire was subsequently repeated on an annual basis up until the fourth year of the career. Repeated measures analysis was used to assess the evolution of student knowledge. RESULTS: Knowledge of the subject was seen to be lacking at the start of the career, but increased significantly as a result of the lecture intervention (P < .001). Over the subsequent courses, although the notions referred to dental trauma were seen to decrease with respect to the first evaluation, they remained high. All of the participants agreed on the need for informative campaigns referred to dental trauma targeted to students in the first courses of the health sciences. CONCLUSIONS: It is necessary to impart knowledge on the prevention and immediate management of dental traumatisms in order to improve their prognosis. This learning is especially relevant to students in the first courses of the health sciences.


Assuntos
Educação em Odontologia , Estudantes de Odontologia , Seguimentos , Humanos , Espanha , Inquéritos e Questionários
3.
J Clin Pediatr Dent ; 42(5): 344-348, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-29763349

RESUMO

AIM: Molar-incisor hypomineralization is a disturbance in dental development that involves first permanent molars as well as permanent incisors with a prevalence that ranges from 2.5% to 40%. The objective of this study was to investigate the etiology of molar-incisor hypomineralization among school children from two randomly selected towns in the province of Barcelona, Spain. STUDY DESIGN: A cross-sectional study was conducted with 705 children ranging in age from six years-old to 14 years and 11 months-old. Full mouth examinations were carried out in accordance with the European Academy of Paediatric Dentistry criteria for the diagnosis of molar-incisor hypomineralization, from April to July 2016. RESULTS: A total of 56 cases of molar-incisor hypomineralization were found in 22 (39.3%) boys and 34 (60.7%) girls. MIH was significantly more prevalent among those who had atopic dermatitis (OR=90.9; 33.4-247.1 CI 95%), food allergies (OR=104.2; 12.2-887.5 CI 95%), bronchitis/asthma (OR=5.3; 2.7-10.1 CI 95%), varicella (OR=96.3; 41.9-221.1 CI 95%), otitis media (OR=12.2; 6.3-23.5 CI 95%), pneumonia (OR=276.7; 35.1-2183.7 CI 95%), and febrile syndrome (OR=7.8; 4.1-14.8 CI 95%). CONCLUSIONS: The present research reveals for the first time a statistically significant relationship between atopic dermatitis and food allergies with the presence of molar-incisor hypomineralization.


Assuntos
Hipoplasia do Esmalte Dentário/epidemiologia , Dermatite Atópica/epidemiologia , Hipersensibilidade Alimentar/epidemiologia , Adolescente , Criança , Estudos Transversais , Feminino , Humanos , Masculino , Espanha/epidemiologia
4.
J Oral Microbiol ; 12(1): 1766166, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32595912

RESUMO

Objective: An insufficient mineralization (hypomineralization) in the teeth during the maturation stage of amelogenesis cause defects in 3-44% of children. Here, we describe for the first time the microbiota associated with these defects and compared it to healthy teeth within the same subjects. Methods: Supragingival dental plaque was sampled from healthy and affected teeth from 25 children with molar-incisor hypomineralization (MIH). Total DNA was extracted and the 16S rRNA gene was sequenced by Illumina sequencing in order to describe the bacterial composition. Results: We detected a higher bacterial diversity in MIH samples, suggesting better bacterial adhesion or higher number of niches in those surfaces. We found the genera Catonella, Fusobacterium, Campylobacter, Tannerella, Centipeda, Streptobacillus, Alloprevotella and Selenomonas associated with hypomineralized teeth, whereas Rothia and Lautropia were associated with healthy sites. Conclusion: The higher protein content of MIH-affected teeth could favour colonization by proteolytic microorganisms. The over-representation of bacteria associated with endodontic infections and periodontal pathologies suggests that, in addition to promote caries development, MIH could increase the risk of other oral diseases.

5.
Med Oral Patol Oral Cir Bucal ; 11(2): E188-205, 2006 Mar 01.
Artigo em Inglês, Espanhol | MEDLINE | ID: mdl-16505802

RESUMO

The goal of antibiotic prophylaxis in Odontology is to prevent the onset of infections through the entranceway provided by the therapeutic action, therefore it is indicated providing there is a considerable risk of infection, either because of the characteristics of the operation itself or the patient s local or general condition. Nonetheless, clinical trials with antibiotics in dental pathologies have had scant regard for the required methodological criteria and, in addition, are not sufficiently numerous. This text presents the results of an expert conference comprising the Presidents of the most representative Scientific Societies in Spain who have analyzed the existing literature and have drawn on their valuable professional experience. It describes the technical circumstances, analyzes the biological and pharmacological foundations and their application to the most representative medical situations. It is concluded that antibiotic prophylaxis in Odontology has certain well-founded, precise indications and offers the international scientific community a practical protocol for action.


Assuntos
Antibioticoprofilaxia , Procedimentos Cirúrgicos Bucais , Infecções Bacterianas/prevenção & controle , Humanos , Doenças da Boca/cirurgia , Procedimentos Cirúrgicos Bucais/efeitos adversos , Complicações Pós-Operatórias/prevenção & controle
6.
Am J Dent ; 18(3): 151-4, 2005 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-16158803

RESUMO

PURPOSE: To evaluate the results of using mineral trioxide aggregate (MTA) in pulpotomy procedures in primary teeth. METHODS: Seven patients were selected and a total of 20 molars and two canines were treated with pulpotomy procedures using MTA instead of formocresol. RESULTS: After 6 months, 55% of the molars and 100% of the canines treated showed radiographic signs of dentin bridge formation. Also, 6 months after treatment, 60% of the molars showed root canal calcification (obliteration). Color change of the crown of the canines treated was noticeable. No clinical or radiographic signs of pathology was observed.


Assuntos
Compostos de Alumínio/uso terapêutico , Compostos de Cálcio/uso terapêutico , Dentina Secundária/efeitos dos fármacos , Óxidos/uso terapêutico , Pulpotomia/métodos , Materiais Restauradores do Canal Radicular/uso terapêutico , Silicatos/uso terapêutico , Compostos de Alumínio/farmacologia , Compostos de Cálcio/farmacologia , Criança , Pré-Escolar , Dentina Secundária/metabolismo , Combinação de Medicamentos , Feminino , Seguimentos , Humanos , Masculino , Óxidos/farmacologia , Materiais Restauradores do Canal Radicular/farmacologia , Silicatos/farmacologia , Dente Decíduo
7.
Nutr Hosp ; 28(4): 1065-76, 2013.
Artigo em Inglês | MEDLINE | ID: mdl-23889623

RESUMO

OBJECTIVE: To evaluate nutritional status and dietary habits after implementation of a nutritional education program in professional handball players. RESEARCH METHODS AND PROCEDURES: Longitudinal study of 14 handball players evaluated with 72-h recall, a questionnaire on food consumption and anthropometric measures during 4 months. The intervention consisted of a nutrition education program. RESULTS: Energy intake was consistently below the recommended allowances. Macronutrient intakes as a percentage of total energy intake were below the recommended allowances for carbohydrates, and above recommended allowances for fats. Nutritional education was followed by a significant increase (p < 0.01) in total energy and macronutrient intakes, with no significant changes in macronutrient or micronutrient intakes after adjustment for energy intake. DISCUSSION: The imbalance in nutrient intake in handball players suggests that detailed re-analysis is needed to determine specific recommendations for this population. Nutritional education with continuous follow-up to monitor athletes' dietary habits may lead them to adopt appropriate nutritional habits to optimize dietary intakes. The lack of specific recommendations for micronutrient intakes in athletes leads to confusion regarding appropriate intakes; biochemical tests that yield normal values (albeit approaching cut-off values for deficiency) may disguise deficient status for some nutrients when strenuous exercise is involved. CONCLUSION: In-depth studies with nutrition education programs that include long-term follow-up are advisable to avoid deficiencies that can lead to irreversible damage in competitive athletes.


Objetivos: Evaluar el estado nutricional y los hábitos dietéticos en respuesta a la aplicación de un programa de educación nutricional en jugadores profesionales de balonmano. Sujetos y metodología: Estudio longitudinal realizado a una muestra de 14 jugadores pertenecientes a un equipo de balonmano de alto rendimiento, a los que se les evaluó mediante recordatorio de 72 horas, un cuestionario de frecuencia de consumo, medidas antropométricas a lo largo de 4 meses, y a los que se les aplicó un programa de educación nutricional al inicio del estudio. Los valores de ingesta y de frecuencia de consumo fueron comparados con las recomendaciones de macronutrientes existentes para deportistas y micronutrientes para población sana, respectivamente, y con la pirámide de alimentos para población sana española. Resultados: La ingesta de energía de los deportistas se situó por debajo de las recomendaciones a lo largo de todo el estudio. La ingesta de macronutrientes respecto a la energía ingerida, se situó por debajo de las recomendaciones para la ingesta de carbohidratos y por encima de las recomendaciones para la ingesta de grasa, mostrada en los resultados obtenidos de frecuencia de consumo de alimentos. La educación nutricional produjo un incremento significativo (p < 0,01) en la ingesta de energía y macronutrientes tras su aplicación. A pesar de ello, no se produjeron cambios significativos en la ingesta de macronutrientes y micronutrientes al ajustar por energía ingerida. Los niveles bioquímicos se encontraron dentro de los rangos de normalidad durante todo el estudio. Discusión: El desequilibrio en la ingesta de nutrientes presente en los jugadores de balonmano hace necesario realizar un ajuste nutricional completo para poder establecer recomendaciones específicas para este tipo de población. La aplicación de un programa de educación nutricional monitorizada de manera continuada mediante seguimiento en los deportistas, puede tener como consecuencia la instauración de hábitos nutricionales adecuados que lleve a una optimización en la ingesta. La ausencia de recomendaciones específicas de micronutrientes en el deporte, provoca una cierta confusión a la hora de establecer una ingesta adecuada de micronutrientes, ya que en muchos casos demuestran normalidad en los niveles bioquímicos, aunque muy cercanos a la deficiencia, pudiendo comprometer el estatus de algún nutriente en situaciones de ejercicio extremo. Conclusión: Sería aconsejable realizar estudios exhaustivos de valoración del estatus nutricional que planteen la instauración de programas de educación nutricional a largo plazo, con el fin de evitar carencias que deriven en daños irreversibles en el deportista de competición.


Assuntos
Educação em Saúde , Estado Nutricional , Esportes/fisiologia , Antropometria , Análise Química do Sangue , Índice de Massa Corporal , Ingestão de Energia/fisiologia , Comportamento Alimentar , Feminino , Promoção da Saúde , Humanos , Masculino , Inquéritos e Questionários , Adulto Jovem
8.
Enferm Infecc Microbiol Clin ; 26(10): 621-8, 2008 Dec.
Artigo em Espanhol | MEDLINE | ID: mdl-19100192

RESUMO

INTRODUCTION: The objective of this study was to evaluate the efficacy of the most commonly used antimicrobial treatments in odontogenic infections in children and adolescents on the basis of pharmacokinetic/ pharmacodynamic (PK/PD) criteria. METHODS: Unbound drug plasma concentration-time curves were simulated with mean population pharmacokinetic parameters of amoxicillin, co-amoxiclav, cefuroxime axetil, spiramycin, clindamycin, azithromycin, and metronidazole. For drugs showing time-dependent antibacterial killing, the time above MIC90 of the pathogens studied was calculated (T>MIC). For drugs with concentration-dependent bactericidal activity, the area under the concentration-time curve (AUC)/MIC90 ratio was calculated. RESULTS: Adequate efficacy indexes (T>MIC>40%) against all the microorganisms examined with the exception of Veillonella spp. were obtained with co-amoxiclav (80 mg/kg/day). Clindamycin (40 mg/kg/day) obtained adequate PK/PD indexes except for Lactobacillus, Actinobacillus actinomycetemcomitans, penicillin-resistant Peptostreptococcus, and Eikenella corrodens. High-dose amoxicillin yielded unsatisfactory results against many bacterial species. Azithromycin and metronidazole showed inadequate efficacy indexes against the majority of pathogens studied (AUC/MIC90<25). CONCLUSION: When antibiotic therapy is needed for odontogenic infections in children and adolescents, the most active empirical therapeutic choice is co-amoxiclav with high doses of amoxicillin. Clindamycin can be used as an alternative option. These results should be confirmed in clinical trials, in which the PK/PD approach could be useful for the design and assessment of results.


Assuntos
Antibacterianos/uso terapêutico , Gengivite/tratamento farmacológico , Periodontite/tratamento farmacológico , Pulpite/tratamento farmacológico , Adolescente , Combinação Amoxicilina e Clavulanato de Potássio/sangue , Combinação Amoxicilina e Clavulanato de Potássio/farmacocinética , Combinação Amoxicilina e Clavulanato de Potássio/farmacologia , Combinação Amoxicilina e Clavulanato de Potássio/uso terapêutico , Antibacterianos/sangue , Antibacterianos/farmacocinética , Antibacterianos/farmacologia , Criança , Pré-Escolar , Cárie Dentária/prevenção & controle , Relação Dose-Resposta a Droga , Feminino , Gengivite/sangue , Bactérias Gram-Negativas/efeitos dos fármacos , Bactérias Gram-Positivas/efeitos dos fármacos , Humanos , Masculino , Testes de Sensibilidade Microbiana , Periodontite/sangue , Pulpite/sangue , Resultado do Tratamento
9.
Nutr. hosp ; 28(4): 1065-1076, jul.-ago. 2013. ilus, tab
Artigo em Inglês | IBECS (Espanha) | ID: ibc-120300

RESUMO

Objective: To evaluate nutritional status and dietary habits after implementation of a nutritional education program in professional handball players. Research methods and procedures: Longitudinal study of 14 handball players evaluated with 72-h recall, a questionnaire on food consumption and anthropometric measures during 4 months. The intervention consisted of a nutrition education program. Results: Energy intake was consistently below the recommended allowances. Macronutrient intakes as a percentage of total energy intake were below the recommended allowances for carbohydrates, and above recommended allowances for fats. Nutritional education was followed by a significant increase (p < 0.01) in total energy and macronutrient intakes, with no significant changes in macronutrient or micronutrient intakes after adjustment for energy intake. Discussion: The imbalance in nutrient intake in handball players suggests that detailed reanalysis is needed to determine specific recommendations for this population. Nutritional education with continuous follow-up to monitor athletes' dietary habits may lead them to adopt appropriate nutritional habits to optimize dietary intakes. The lack of specific recommendations for micronutrient intakes in athletes leads to confusion regarding appropriate intakes; biochemical tests that yield normal values (albeit approaching cut-off values for deficiency) may disguise deficient status for some nutrients when strenuous exercise is involved. Conclusion: In-depth studies with nutrition education programs that include long-term follow-up are advisable to avoid deficiencies that can lead to irreversible damage in competitive athletes (AU)


Objetivos: Evaluar el estado nutricional y los hábitos dietéticos en respuesta a la aplicación de un programa de educación nutricional en jugadores profesionales de balonmano. Sujetos y metodología: Estudio longitudinal realizado a una muestra de 14 jugadores pertenecientes a un equipo de balonmano de alto rendimiento, a los que se les evaluó mediante recordatorio de 72 horas, un cuestionario de frecuencia de consumo, medidas antropométricas a lo largo de 4 meses, y a los que se les aplicó un programa de educación nutricional al inicio del estudio. Los valores de ingesta y de frecuencia de consumo fueron comparados con las recomendaciones de macronutrientes existentes para deportistas y micronutrientes para población sana, respectivamente, y con la pirámide de alimentos para población sana española. Resultados: La ingesta de energía de los deportistas se situó por debajo de las recomendaciones a lo largo de todo el estudio. La ingesta de macronutrientes respecto a la energía ingerida, se situó por debajo de las recomendaciones para la ingesta de carbohidratos y por encima de las recomendaciones para la ingesta de grasa, mostrada en los resultados obtenidos de frecuencia de consumo de alimentos. La educación nutricional produjo un incremento significativo (p < 0,01) en la ingesta de energía y macronutrientes tras su aplicación. A pesar de ello, no se produjeron cambios significativos en la ingesta de macronutrientes y micronutrientes al ajustar por energía ingerida. Los niveles bioquímicos se encontraron dentro de los rangos de normalidad durante todo el estudio. Discusión: El desequilibrio en la ingesta de nutrientes presente en los jugadores de balonmano hace necesario realizar un ajuste nutricional completo para poder establecer recomendaciones específicas para este tipo de población. La aplicación de un programa de educación nutricional monitorizada de manera continuada mediante seguimiento en los deportistas, puede tener como consecuencia la instauración de hábitos nutricionales adecuados que lleve a una optimización en la ingesta. La ausencia de recomendaciones específicas de micronutrientes en el deporte, provoca una cierta confusión a la hora de establecer una ingesta adecuada de micronutrientes, ya que en muchos casos demuestran normalidad en los niveles bioquímicos, aunque muy cercanos a la deficiencia, pudiendo comprometer el estatus de algún nutriente en situaciones de ejercicio extremo. Conclusión: Sería aconsejable realizar estudios exhaustivos de valoración del estatus nutricional que planteen la instauración de programas de educación nutricional a largo plazo, con el fin de evitar carencias que deriven en daños irreversibles en el deportista de competición (AU)


Assuntos
Humanos , Masculino , Adulto Jovem , Educação Alimentar e Nutricional , Esportes , Avaliação Nutricional , Estado Nutricional , Avaliação de Eficácia-Efetividade de Intervenções , Desempenho Atlético/fisiologia , Suplementos Nutricionais
10.
Dent Traumatol ; 19(3): 165-9, 2003 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-12752539

RESUMO

- A case of severe crown fracture and luxation in the upper permanent incisors of a 9-year-old boy is reported. The treatment of one of the injured teeth included apexification with calcium hydroxide and endodontic treatment with gutta-percha obturation. The other incisor was also treated with calcium hydroxide, but as there was no apical stop after 3 years of treatment, it was decided to use a new root-end filling material: mineral trioxide aggregate (MTA). At follow-up 12 months later, the tooth was asymptomatic and radiographically showed the initial repair of the radiolucent apical lesion.


Assuntos
Compostos de Alumínio/farmacologia , Compostos de Cálcio/farmacologia , Incisivo/lesões , Óxidos/farmacologia , Obturação Retrógrada/métodos , Materiais Restauradores do Canal Radicular/farmacologia , Silicatos/farmacologia , Ápice Dentário/efeitos dos fármacos , Dente não Vital/terapia , Criança , Combinação de Medicamentos , Humanos , Masculino , Abscesso Periapical/etiologia , Abscesso Periapical/terapia , Retratamento , Ápice Dentário/fisiopatologia , Traumatismos Dentários/complicações , Dente não Vital/complicações
11.
Med. oral patol. oral cir. bucal (Internet) ; 11(2): E188-E205, mar.-abr. 2006. tab
Artigo em Es | IBECS (Espanha) | ID: ibc-045805

RESUMO

La profilaxis antibiótica en Odontología tiene como objetivo prevenir la aparición de infección a partir de la puerta de entrada que produce la actuación terapéutica, por lo que se encuentra indicada siempre que exista un riesgo importante de infección, ya sea por las características mismas de la operación o por las condiciones locales o generales del paciente. Sin embargo, los ensayos clínicos con antibióticos en patologías dentarias responden poco a los criterios metodológicos requeridos, y además no son lo suficientemente numerosos. Se presentan los resultados de una conferencia de expertos integrada por los Presidentes de Sociedades científicas españolas más representativas que han analizado la bibliografía existente y han aportado sus valiosas experiencias profesionales. Se describen las circunstancias técnicas, se analizan los fundamentos biológicos y farmacológicos y se aplican a las situaciones médicas más representativas. Se concluye que la profilaxis antibiótica en Odontología cuenta con indicaciones bien fundamentadas y precisas, ofreciendo a la comunidad científica internacional un protocolo práctico de actuación


The goal of antibiotic prophylaxis in Odontology is to prevent the onset of infections through the entranceway provided by the therapeutic action, therefore it is indicated providing there is a considerable risk of infection, either because of the characteristics of the operation itself or the patient’s local or general condition. Nonetheless, clinical trials with antibiotics in dental pathologies have had scant regard for the required methodological criteria and, in addition, are not sufficiently numerous. This text presents the results of an expert conference comprising the Presidents of the most representative Scientific Societies in Spain who have analyzed the existing literature and have drawn on their valuable professional experience. It describes the technical circumstances, analyzes the biological and pharmacological foundations and their application to the most representative medical situations. It is concluded that antibiotic prophylaxis in Odontology has certain well-founded, precise indications and offers the international scientific community a practical protocol for action


Assuntos
Humanos , Antibioticoprofilaxia , Procedimentos Cirúrgicos Bucais/efeitos adversos , Conferências de Consenso como Assunto , Infecções Bacterianas/prevenção & controle , Doenças da Boca/cirurgia , Complicações Pós-Operatórias/prevenção & controle
12.
Acta odontol. venez ; 40(3): 17-22, dic. 2002.
Artigo em Espanhol | LILACS | ID: lil-355235

RESUMO

Dentro del marco que caracteriza al maltrato y al abuso fÝsico, el odontólogo tiene la posibilidad de ver a Ústos con mßs frecuencia que el mÚdico de cabecera, pediatra u otros profesionales de la salud, pues, como se sabe, los tutores que maltratan a los niños no suelen llevarlos al mismo mÚdico o al mismo centro de salud mßs de una vez para no ser descubiertos. Al trastorno que se desarrolla despuÚs del abuso sexual y del maltrato fÝsico de lo conoce con el nombre de estrÚs postraumßtico. Hemos querido evaluar la bibliografÝa de los últimos 10 años referente al tema del maltrato y manejo de los niños vÝctimas de este fenómeno en el ßrea dental y psiquißtrica, para resaltar la importancia que tiene el perfil psicológico del paciente en el momento de aplicar una tÚcnica de manejo de conducta durante la consulta odontológica. Si bien desde la primera consulta en odontopediatrÝa se deben suponer una voluntad y preocupación especiales por parte del profesional, en el caso del niño vÝctima del maltrato se debe ademßs fomentar la confianza


Assuntos
Humanos , Masculino , Feminino , Criança , Assistência Odontológica para Crianças/métodos , Comportamento Infantil , Maus-Tratos Infantis/terapia , Abuso Sexual na Infância , Maus-Tratos Infantis/diagnóstico , Maus-Tratos Infantis/estatística & dados numéricos , Maus-Tratos Infantis/psicologia , Pediatria , Transtornos de Estresse Pós-Traumáticos/diagnóstico , Transtornos de Estresse Pós-Traumáticos/psicologia , Transtornos de Estresse Pós-Traumáticos/terapia
13.
Cient. dent. (Ed. impr.) ; 6(3): 181-202, sept.-dic. 2009. tab
Artigo em Espanhol | IBECS (Espanha) | ID: ibc-79585

RESUMO

La profilaxis antibiótica en Odontología tiene como objetivo prevenir la aparición de infección a partir de la puerta de entrada que produce la actuación terapéutica, por lo que se encuentra indicada siempre que exista un riesgo importante de infección, ya sea por las características mismas de la operación o por las condiciones locales o generales del paciente. Sin embargo, los ensayos clínicos con antibióticos en patologías dentarias responden poco a los criterios metodológicos requeridos, y además no son lo suficientemente numerosos. Se presentan los resultados de una conferencia de expertos integrada por los Presidentes de Sociedades científicas españolas más representativas que han analizado la bibliografía existente y han aportado sus valiosas experiencias profesionales. Se describen las circunstancias técnicas, se analizan los fundamentos biológicos y farmacológicos y se aplican a las situaciones médicas más representativas. Se concluye quela profilaxis antibiótica en Odontología cuenta con indicaciones bien fundamentadas y precisas, ofreciendo a la comunidad científica internacional un protocolo práctico de actuación (AU)


The goal of antibiotic prophylaxis in Odontology is to prevent the onset of infections through the entranceway provided by the therapeutic action, therefore it is indicated providing there is a considerable risk of infection, either because of the characteristics of the operation itself or the patient’s local or general condition. Nonetheless, clinical trials with antibiotics in dental pathologies have had scant regard for the required methodological criteria and, in addition, are not sufficiently numerous. This text presents the results of an expert conference comprising the Presidents of the most representative Scientific Societies in Spain who have analyzed the existing literature and have drawn on their valuable professional experience. It describes the technical circumstances, analyzes the biological and pharmacological foundations and their application to the most representative medical situations. It is concluded that antibiotic prophylaxis in Odontology has certain well-founded, precise indications and offers the international scientific community a practical protocol for action (AU)


Assuntos
Humanos , Antibioticoprofilaxia/métodos , Profilaxia Dentária/métodos , Sociedades Odontológicas , Espanha
14.
Enferm. infecc. microbiol. clín. (Ed. impr.) ; 26(10): 621-628, dic. 2008. tab
Artigo em Espanhol | IBECS (Espanha) | ID: ibc-60486

RESUMO

INTRODUCCIÓN. El objetivo de este estudio es evaluar la eficacia de los tratamientos más utilizados en infecciones odontogénicas en niños y adolescentes aplicando criterios farmacocinéticos/farmacodinámicos (PK/PD).MÉTODOS. Se han simulado las curvas de concentración plasmática libre-tiempo a partir de parámetros farmacocinéticos medios de amoxicilina, amoxicilina-ácido clavulánico, cefuroxima axetilo, espiramicina, clindamicina, azitromicina y metronidazol. Para los antibióticos con actividad dependiente del tiempo, se ha calculado el tiempo durante el cual las concentraciones permanecen por encima de la concentración inhibitoria mínima (CIM90)de los microorganismos (T > CIM). Para los antimicrobianos con actividad dependiente de la concentración, se ha calculado el cociente entre el área bajo la curva y la CIM90 (ABC/CIM90).RESULTADOS. Con amoxicilina-ácido clavulánico(80 mg/kg/día) se han obtenido índices de eficacia adecuados frente a los microorganismos estudiados(T > CIM > 40%), excepto para Veillonella spp. Clindamicina (40 mg/kg/día) también ha presentado índices PK/PD adecuados frente a la mayoría de los patógenos, excepto Lactobacillus, Actinobacillus actinomycetemcomitans, Peptostreptococcus resistente a penicilina y Eikenellacorrodens. Con dosis altas de amoxicilina los resultados nohan sido satisfactorios frente a varias especies bacterianas. Con azitromicina y metronidazol no se han alcanzado valores adecuados frente a la mayoría de patógenos (ABC/CIM90 < 25).CONCLUSIÓN. El tratamiento empírico más adecuado en infecciones odontogénicas en niños y adolescentes esamoxicilina-ácido clavulánico en altas dosis de amoxicilina, aunque se puede utilizar como alternativa clindamicina. Sería conveniente confirmar estos resultados mediante ensayos clínicos, para cuyo diseño y evaluación podría serde gran utilidad la aplicación de estudios PK/PD(AU)


INTRODUCTION. The objective of this study was to evaluate the efficacy of the most commonly used antimicrobial treatments in odontogenic infections in children and adolescents on the basis of pharmacokinetic/pharmacodynamic (PK/PD) criteria. METHODS. Unbound drug plasma concentration-time curves were simulated with mean population pharmacokinetic parameters of amoxicillin, co-amoxiclav, cefuroxime axetil, spiramycin, clindamycin, azithromycin, and metronidazole. For drugs showing time-dependent antibacterial killing, the time above MIC90 of the pathogens studied was calculated (T > MIC). For drugs with concentration dependent bactericidal activity, the area under the concentration-time curve (AUC)/MIC90 ratio was calculated. RESULTS. Adequate efficacy indexes (T > MIC > 40%) against all the microorganisms examined with the exception of Veillonella spp. were obtained with co-amoxiclav(80 mg/kg/day). Clindamycin (40 mg/kg/day) obtained ad equate PK/PD indexes except for Lactobacillus, Actinobacillus actinomy cetemcomitans, penicillin-resistant Peptostreptococcus, and Eikenella corrodens. High-dose amoxicillin yielded unsatisfactory results against many bacterial species. Azithromycin and metronidazole showed inadequate efficacy indexes against the majority of pathogens studied (AUC/MIC90 < 25).CONCLUSION. When antibiotic therapy is needed for odontogenic infections in children and adolescents, the most active empirical therapeutic choice is co-amoxiclav with high doses of amoxicillin. Clindamycin can be used as an alternative option. These results should be confirmed inclinical trials, in which the PK/PD approach could be useful for the design and assessment of results (AU)


Assuntos
Humanos , Masculino , Feminino , Criança , Adolescente , Doenças da Boca/tratamento farmacológico , Antibacterianos/farmacocinética , Infecção Focal Dentária/tratamento farmacológico , Combinação Amoxicilina e Clavulanato de Potássio/farmacocinética , Amoxicilina/farmacocinética , Clindamicina/farmacocinética
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