Knowledge, Perceptions, and Practices on Risks and Disasters Among Medical Students. A Multicenter Cross-Sectional Study in 9 Latin American and Caribbean Countries.

Purpose: The objective of this study was to describe the level of knowledge, perceptions, and practices in relation to risks and disasters in medical schools in Latin America and the Caribbean. Participants and Methods: Multicenter, observational, analytical, non-probabilistic convenience sample study with 2546 medical students in 9 countries of Latin America and the Caribbean. An online survey was conducted between October 2020 and November 2020, using an instrument validated in each country to assess knowledge, perceptions, and practices regarding risk and disaster prevention measures. Frequencies, percentages, mean and standard deviation (SD) were used for descriptive analysis. Differences resulting from the relationship between the variables studied and the level of knowledge were obtained using the Chi-square test. P-value <0.05 was accepted as statistically significant for all analyses. Results: The highest proportion of responses came from women, third-semester students, and those studying in public universities. Students from Colombia and Honduras had the highest percentage of high levels of knowledge about disasters, while Peruvian students had the highest percentage of low levels of knowledge. Women and students from public universities showed a higher proportion of high levels of knowledge. 52.7% considered that they live in a country with a medium risk of natural disasters, while 91.2% said that Latin American and Caribbean countries are not prepared to face natural disasters. Only 43.6% believe they are prepared to help in the event of a natural disaster. Conclusion: Most of medical students from Latin America and Latin America and the Caribbean have high and medium level of knowledge in risks and disasters. However, the implementation of disaster training programs for medical students has the potential to improve the preparedness, knowledge, and skills that are important for medical personnel to improve their self-confidence, and their ability to respond, resulting in more effective systems.

Effect of warming anesthetic on pain perception during dental injection: a split-mouth randomized clinical trial.

BACKGROUND: The purpose of this study is to determine the effectiveness of warming anesthesia on the control of the pain produced during the administration of dental anesthesia injection and to analyze the role of Transient Receptor Potential Vanilloid-1 nociceptor channels in this effect. PATIENTS AND METHODS: A double-blind, split-mouth randomized clinical trial was designed. Seventy-two volunteer students (22.1±2.45 years old; 51 men) from the School of Dentistry at the Universidad Austral de Chile (Valdivia, Chile) participated. They were each administered 0.9 mL of lidocaine HCl 2% with epinephrine 1:100,000 (Alphacaine®) using two injections in the buccal vestibule at the level of the upper lateral incisor teeth. Anesthesia was administered in a hemiarch at 42°C (107.6°F) and after 1 week, anesthesia was administered by randomized sequence on the contralateral side at room temperature (21°C-69.8°F) at a standardized speed. The intensity of pain perceived during the injection was compared using a 100 mm visual analog scale (VAS; Wilcoxon test p<0.05). RESULTS: The use of anesthesia at room temperature produced an average VAS for pain of 35.3±16.71 mm and anesthesia at 42°C produced VAS for pain of 15±14.67 mm (p<0.001). CONCLUSION: The use of anesthesia at 42°C significantly reduced the pain during the injection of anesthesia compared to its use at room temperature during maxillary injections. The physiological mechanism of the temperature on pain reduction could be due to a synergic action on the permeabilization of the Transient Receptor Potential Vanilloid-1 channels, allowing the passage of anesthetic inside the nociceptors.

Expression and the Peculiar Enzymatic Behavior of the Trypanosoma cruzi NTH1 DNA Glycosylase.

Trypanosoma cruzi, the etiological agent of Chagas' disease, presents three cellular forms (trypomastigotes, epimastigotes and amastigotes), all of which are submitted to oxidative species in its hosts. However, T. cruzi is able to resist oxidative stress suggesting a high efficiency of its DNA repair machinery.The Base Excision Repair (BER) pathway is one of the main DNA repair mechanisms in other eukaryotes and in T. cruzi as well. DNA glycosylases are enzymes involved in the recognition of oxidative DNA damage and in the removal of oxidized bases, constituting the first step of the BER pathway. Here, we describe the presence and activity of TcNTH1, a nuclear T. cruzi DNA glycosylase. Surprisingly, purified recombinant TcNTH1 does not remove the thymine glycol base, but catalyzes the cleavage of a probe showing an AP site. The same activity was found in epimastigote and trypomastigote homogenates suggesting that the BER pathway is not involved in thymine glycol DNA repair. TcNTH1 DNA-binding properties assayed in silico are in agreement with the absence of a thymine glycol removing function of that parasite enzyme. Over expression of TcNTH1 decrease parasite viability when transfected epimastigotes are submitted to a sustained production of H2O2.Therefore, TcNTH1 is the only known NTH1 orthologous unable to eliminate thymine glycol derivatives but that recognizes and cuts an AP site, most probably by a beta-elimination mechanism. We cannot discard that TcNTH1 presents DNA glycosylase activity on other DNA base lesions. Accordingly, a different DNA repair mechanism should be expected leading to eliminate thymine glycol from oxidized parasite DNA. Furthermore, TcNTH1 may play a role in the AP site recognition and processing.

COVID-19, salud mental y enfermedades psiquiátricas: revisión de la literatura en PubMed, durante los primeros meses de pandemia / COVID-19, mental health and mental disorders: review of the literature published in PubMed, during the first months of the pandemic

La literatura ha estudiado los efectos de anteriores epidemias en la salud mental de la población. En el contexto de la actual pandemia COVID-19, resulta de interés estudiar lo publicado referente a esta temática, considerando que, a diferencia de epidemias recientes, la actual se ha presentado a nivel mundial, con mayores cifras de contagio y mortalidad, con períodos de restricciones sociales más prolongados, alterando diversas dimensiones en la vida de la población. Las distintas implicaciones de la pandemia COVID-19 en la salud mental y las enfermedades psiquiátricas se recopilaron, de forma general, mediante la literatura publicada en PubMed durante los primeros meses de pandemia. La literatura evidencia que la actual pandemia ha influido negativamente en diversas dimensiones de la salud mental de la población general y específicas. Otras implicaciones revisadas son: abuso de alcohol y drogas, reacciones de duelo, agravamiento de trastornos mentales previos, y el rol e importancia de las redes sociales, servicios de salud mental y telepsiquiatría, entre otros.

The literature has studied the effects of previous epidemics on the mental health of the population. In the context of the current COVID-19 pandemic, it is of interest to study what has been published regarding this issue, considering that unlike recent epidemics, the current one has occurred worldwide, with higher numbers of contagion and mortality, with periods of longer social restrictions, altering various dimensions in the life of the population. The different implications of the COVID-19 pandemic with mental health and psychiatric diseases were collected in a general form, using the literature published in PubMed during the first months of the pandemic. The literature shows that the current pandemic has negatively influenced various dimensions of mental health in the general and specific population. Other implications reviewed are: alcohol and drugs, grief, patients with previous mental disorders, social networks, mental health services, telepsychiatry, among others.

Effect of warming anaesthetic solutions on pain during dental injection: a randomized clinical trial / Efecto del calentamiento del anestésico sobre el dolor durante la inyección dental: ensayo clínico aleatorio

To determine the effectiveness of warming anesthetic solutions on pain produced during the administration of anesthesia in maxillary dental infiltration technique. Material and Methods: A double-blind cross-over clinical study was designed. Fifty-six volunteer students (mean age 23.1+/-2.71 years) of the Dental School at Universidad Austral de Chile (Valdivia, Chile) participated in the study. Subjects were given 0.9ml of 2 percent lidocaine with 1:100.000 epinephrine (Alphacaine®; Nova DFL - Brazil) by two punctions at buccal vestibule of lateral incisor. Warm anesthesia at 42°C(107.6°F) was administered in a hemi-arch; and after one week anesthesia at room temperature (21°C; 69.8°F) and at a standardized speed was administered at the contralateral side. The intensity of pain felt during injection was registered and compared using visual analog scale (VAS) of 100mm (Wilcoxon test p<0.05). Results: The use of anesthesia at room temperature caused a VAS-pain intensity of 34.2+/-16.6mm, and anesthesia at 42°C a VAS-pain intensity of 15.7+/-17.4mm (p<0.0001). Conclusion: The use of anesthesia at42°C resulted in a significantly lower pain intensity perception during injection compared with the use of anesthesia at room temperature during maxillary infiltration technique...

Determinar la efectividad del calentamiento de anestesia en la reducción del dolor producidodurante la administración de anestesia dental en técnica infiltrativa maxilar. Material y método: Se diseñó un estudio clínico doble ciego de brazos cruzados.Participaron cincuenta y seis estudiantes voluntarios (23.1+/-2.71 años) de la Escuela de Odontología de la Universidad Austral de Chile (Valdivia, Chile). Se les administró 0.9ml de lidocaína 2 por ciento con epinefrina 1:100.000 (Alphacaine®; Nova DFL - Brasil) mediante 2 punciones en el fondo de vestíbulo a nivel del incisivo lateral superior. En una hemi-arcada se administró anestesia a 42ºC (107.6°F) y luego de una semana se les administró anestesia en el lado contralateral a temperatura ambiente (21ºC; 69.8°F) con una velocidad estandarizada. Se comparó laintensidad de dolor percibida durante la inyección mediante escala visual análoga (EVA) de 100mm (pruebade Wilcoxon p<0.05). Resultados: El uso de anestesia a temperatura ambiente provocó un dolor promedio EVAde 34.2+/-16.6mm y la anestesia a 42°C un dolor promedio EVA 15.7+/-17.4mm (p<0.0001). Conclusión: El uso de anestesia a 42ºC generó una percepción de dolor significativamente menor durante la inyección del anestésico en comparación a su uso con temperatura ambiente en la técnica infiltrativa maxilar...