Effect of Silver Nanoparticle-Added Pit and Fissure Sealant in the Prevention of Dental Caries in Children.

OBJECTIVE: The objective of this study was to evaluate the effects of pit and fissure sealant mixed with silver nanoparticles on dental caries, by means of monthly measurement of fluorescence with DIAGNOdent over six months. STUDY DESIGN: This study was divided in two phases: experimental and clinical. In the experimental phase, the adhesion and microleakage of the pit and fissure sealant experiment were evaluated. Two groups of 10 teeth, without serious carious lesions, were included. Conventional (group A) and silver nanoparticles (group B) were added to the pit and fissure sealant. For the clinical phase, a split-mouth study was performed on 40 children aged 6-10 years old with healthy, erupted permanent first molars. A conventional pit and fissure sealant or a silver nanoparticle-mixed sealant was randomly placed. Repeated measures analysis was performed. RESULTS: Conventional sealant presented an average microleakage of 30.6%, and the silver nanoparticle-mixed sealant showed 33.6% (P=NS). A three times greater reduction in fluorescence was found in the silver nanoparticles group compared to the conventional group (P<0.05). No sex- or age-based associations were found. CONCLUSIONS: The silver nanoparticle-mixed sealant reduced tooth demineralization significantly and likely increased remineralization, compared to the conventional sealant.

[Effect of Omega 3 fatty acids on body female obese composition]. / Efecto de la suplementación de omega 3 sobre IMC, ICC y composición corporal en mujeres obesas.

Evidence on the possible mechanisms for the use of Omega 3 fatty acids to mediate obesity requires clinical studies continue with specific methodologies. The aim was to assess the effect of omega-3 supplementation on Body Mass Index (BMI), Wais - Hip Index (WHI) and body composition of obese women using bioelectrical impedance. Subjects 60 premenopausal obese women (BMI > 30Kg/m2) were randomly assigned to 3 groups: Group 1) placebo, vitamin E (200 IU), group 2) 1 g of omega and group 3) 2 g of omega-3. All of them received a low calorie diet and moderate exercise. Weight, BMI, WHI, and fat distribution were measured at the beginning and every month for three months. The results show us Omega-3 supplementation significantly reduced weight, BMI, and total fat mass, compared to the control group, a dose-response effect. These effects depended on the time and amount of Omega 3 supplemented, when the degree of compliance of exercise, adherence to the diet and age were controlled. In conclusion the supplementation with omega-3 is an efficient method in the management of obesity in premenopausal women.

In vitro cytotoxicity of silver nanoparticles on human periodontal fibroblasts.

UNLABELLED: Silver nanoparticles (NNPs) are extensively used for all kinds of antimicrobial applications in medical research. Their efficacy has been demonstrated against Streptococcus mutans, which is associated with dental caries. However their cytotoxic effects on human periodontal tissue are not completely understood. OBJECTIVE: The aim of this study was to evaluate the possible toxic cellular effects of different concentrations and sizes of silver nanoparticles, less than 10 nm, 15-20 nm, and 80-100 nm, respectively, on human periodontal fibroblasts. STUDY DESIGN: Primary culture cells isolated from human periodontal tissue were exposed to 0-1,000 microM silver nanoparticles of each size for 24-, 72-, and 168-hour periods. Cytotoxicity was evaluated with a nonradioactive, soluble MTS/PMS assay. RESULTS: The results demonstrated that silver nanoparticles of less than 20 nm increased cytotoxicity in human periodontal fibroblasts in a dose- and time-dependent manner. CONCLUSION: The 80-100-nm-sized nanoparticles did not modify the viability of human primary culture cells.

Estimation and interrater reliability of pupillography by digital mobile app: Digital movil pupillography app validity.

OBJECTIVE: The examination of pupillary light reflexes is widely employed to evaluate the autonomic system's balance, ocular, and neurological conditions, typically evaluated by qualitative observation. To describe and evaluate the inter-rater reliability and agreement of pupillometric values obtained with a novel semi-automatic mobile pupillography app. METHODS: Two examiners and two graders perform the measurements with an android app which corrects the device-face distance, measure the maximum contraction of the pupil, and calculates its slope, in a hospital room setting with three levels of environmental light intensity: <100, 101 to 200, and 201 to 300 lux, at 200, 400, 600, 900, 1200, and 1500 milliseconds. RESULTS: Sixty healthy individuals, aged 18 to 45, were included; 85% had brown eyes. The reliability of the pupil/iris ratio had Ri = 70% to 88%, and bland Altman graphics show a uniform agreement. The pupillography curves show a similar slope at different light intensities, during the contraction phase. CONCLUSION: There were very good repeatability and inter-rater reproducibility of the measurements at average levels of illumination in examination rooms, even in dark-eyed people. This app provides a highly promising approach to pupillary measurements in clinical practice.

Oral manifestations in pediatric patients receiving chemotherapy for acute lymphoblastic leukemia.

The purpose of this study was to determine the prevalence of oral manifestations in pediatric patients with acute lymphoblastic leukemia (ALL) receiving chemotherapy, and to evaluate the significance of independent risk factors (oral health, gender, age, time and type of treatment, and phase of chemotherapy). A cross-sectional study was made in 49 children with ALL between 2 and 14 years of age. To describe oral manifestations, a clinical diagnosis was made and the following criteria were applied: the OHI-S index to describe oral health and the IMPA index to describe periodontal conditions and to differentiate gingivitis from periodontitis. The prevalence of oral manifestations was: gingivitis, 91.84%; caries, 81.63%; mucositis, 38.77%; periodontitis, 16.32%; cheilitis, 18.36%; recurrent herpes, 12.24%; and primary herpetic gingivostomatitis, 2.04%. Other oral manifestations were: dry lips, mucosal pallor, mucosal petechiae, ecchymoses, and induced ulcers. The prevalence of oral candidiasis was 6.12%. It was observed that high risk ALL and poor oral hygiene were important risk factors for the development of candidiasis and gingivitis. The type of leukemia, gender and phase of chemotherapy were apparently associated with the presence of candidiasis, gingivitis, and periodontitis, and they could be considered risk factors for the development of oral manifestations.

In vitro determination of the chromatic effect of a silver nanoparticles solution linked to the gantrez S-97 copolymer on tooth enamel.

Silver nanoparticles (NNPs), alone or in combination with the bioadhesive Gantrez S-97, have demonstrated their efficacy against Streptococcus mutans; however, it is not known if this combination changes the color of teeth. The aim of this work was to measure the color changes occurring after the use of a Gantrez-NNP combination on enamel tooth blocks. Two study groups were randomly formed: enamel blocks brushed with (a) the Gantrez-NNP combination and (b) conventional toothpaste, for 1 minute once daily for 4 weeks, then rinsed with distilled water and placed in thymol solution. Color changes in the enamel blocks were measured using a Minolta colorimeter CR300. Analysis of mixed models was performed with R 2.10.1 at a 95% confidence level, using the nonlinear mixed effects (NLME) package. The results showed that there were no color changes over time, only a high luminosity equal in both groups. Our study showed that the use of the Gantrez-NNP combination is safe with respect to dental esthetics in the control of S. mutans.

Bactericidal capacity of silver nanoparticles associated with Gantrez S-97 on Streptococcus mutans.

UNLABELLED: Dental caries is a worldwide public health problem. S mutans plays an important role in the etiology of caries. There have been studies that showed the antimicrobial properties of silver nanoparticles are an effective agent to diminish S. mutans. The objective of this study was to evaluate the bactericidal and bacteriostatic effects of silver nanoparticles in addition to the Gantrez S-27 copolymer, on S mutans. METHOD: We performed an in vitro experimental study using the liquid microdilution method in order to find the minimum inhibitory concentrations (MICs) and the minimum bactericidal concentrations (MBCs) with the subcultures obtained. The mixture was obtained by preparing 98 microg/mL of silver nanoparticles (10(3)mol) with Gantrez S-27 2%, in distilled water The readings were performed 24 hours after incubation and on 3 consecutive days. The results showed an average MTC of 6.12 microg /mL and MBC of 6.12 microg /mL. CONCLUSION: The addition of Gantrez 2% to silver nanoparticles does not alter its antimicrobial effect.

The antimicrobial sensitivity of Streptococcus mutans to nanoparticles of silver, zinc oxide, and gold.

Dental caries is a worldwide public health problem for which Streptococcus mutans has been identified as the possible infectious etiology. In recent years nanotechnology has permitted the development of new properties of materials. The objective of this study was to compare the bactericidal and bacteriostatic effects of nanoparticles of silver, zinc oxide, and gold on S. mutans. We used the liquid dilution method to find the minimum inhibitory concentrations (MICs) and with subcultures obtained the minimum bactericidal concentrations (MBCs). For silver the results showed an average MIC of 4.86 +/- 2.71 microg/mL and MBC of 6.25 microg/mL; for zinc the MIC was 500 +/- 306.18 muicrog/mL and MBC of 500 microg/mL; the gold nanoparticles demonstrated an effect only at an initial concentration of 197 mug/mL. We established a higher antimicrobial effect against S. mutans of silver nanoparticles at lower concentrations than gold or zinc, which would allow achieving important clinical effects with a reduced toxicity.

Comparison of three conscious sedation regimens for pediatric dental patients.

The aim of this study was to compare the clinical success of three conscious sedation regimens for pediatric dental patients. A clinical trial was performed wherein dental treatment was administered to pediatric patients ASA I and II under conscious sedation.. Fifty-four children were divided into three groups of 18 patients each, randomly assigned Group A received hydroxyzine (2 mg/kg 2 h before treatment and a subsequent dose of 1 mg/kg 20 min before treatment) orally; group B received 0.50 mg/kg midazolam mixed with 1.5 mg/kg hydroxyzine 20 min before treatment orally; group C received chloral hydrate, 50 mg/kg mixed with 1.5 mg/kg hydroxyzine 20 min before treatment orally. The Ohio State Behavioral Rating Scale (OSBRS) showed statistically significant differences between groups B and C with respect to group A. The regimens of midazolam or chloral hydrate mixed with hydroxyzine represent excellent choices for conscious sedation regimens for pediatric dental patients.

[Comparative clinical study of dexamethasone vs. nebulized salbutamol in acute bronchiolitis]. / Uso de dexametasona y salbutamol nebulizados en bronquiolitis aguda. Estudio clínico comparativo.

OBJECTIVE: Asess the efficacy of nebulized salbutamol and dexamethasone compared with nebulized salbutamol, in patients with bronchiolitis. MATERIAL AND METHODS: A blinded clinical trial was performed with 49 patients between 1-18 months diagnosed with bronchiolitis with three days or less of disease evolution. Participant's parents signed an informed consent and patients did not receive prior medication. Patients were randomly assigned to two groups: nebulized salbutamol or salbutamol plus dexamethasone, which they received every four hours during twenty-four hours. We measured heart and respiratory rate; respiratory distress index, oxygen saturation, and Silverman Andersen scores. RESULTS: No significant differences were found between groups for treatment response; but the frequency of hospital release at 24 hrs was significant among groups; 75 vs 96 % respectively (p = 0.04). CONCLUSIONS: The administration of salbutamol plus dexamethasone is more effective in the control of respiratory distress in children with bronchiolitis compared with the use of salbutamol alone.

[Effectiveness of supervised aerobic exercise in alternating weekdays associated with glycosylated hemoglobin levels among type 2 sedentary diabetic patients]. / Efectividad del ejercicio aeróbico supervisado en el nivel de hemoglobina glucosilada en pacientes diabéticos de tipo 2 sedentarios.

OBJECTIVE: [corrected] Determine the extent to which levels of glycosylated hemoglobin levels among type 2 sedentary diabetic patients change when performing aerobic exercises two or three times a week. SETTING: Mexican Institute Social Security, Family Medicine Unit, primary care level. STUDY DESIGN: Controlled clinical trial. METHODS AND SUBJETS: Two groups of 25 participants carried out a comprehensive exercise routine 2 or 3 times per week in alternate days. Measurements were done at baseline, 8 and 16 weeks. HbA1c, aerobic capacity, BMI and compliance were assesed. OUTCOME: There was no significant difference in HbA1c between the two study groups, however both groups showed lower levels of HbA1c when comparing their baseline and follow up levels (p < 0.001). No significant association was found between Hb1Ac, aerobic capacity or BMI. Compliance was higher among the group exercising 2 days. CONCLUSION: Moderate aerobic exercise was well tolerated showing a significant decrease on HbA1c even among the 2 day group.

[Efficacy of modified auriculotherapy for post-operative pain control in patients subjected to laparoscopic cholecystectomy]. / Eficacia de la auriculoterapia modificada como tratamiento para el control del dolor postoperatorio en pacientes intervenidos mediante colecistectomía laparoscópica.

BACKGROUND: The high frequency of post-operative pain in the patients after laparoscopic cholecystectomy has led to the need to use multiple analgesic therapies. These include auriculotherapy, although not very good results have been obtained with the traditional techniques. OBJECTIVE: To evaluate the effectiveness of modified auriculotherapy for post-operative pain control in laparoscopic cholecystectomy patients. MATERIAL AND METHODS: Double-blind controlled clinical trial. Experimental group: Different points ear puncture with xylocaine without needles vs. placebo group. Post-operative visual analogue scale (VAS) at 6, 12, 18, 24, 36, and 48h and rescue doses of analgesics, were measured in both groups. RESULTS: At 6h post-operative, 87% of the auriculotherapy group had a VAS of<4 vs. 48% of placebo group (p = 0.004), and 96 vs. 74% (p = 0.008) at 18hours. At 24, 36 and 48h after surgery there were no differences, and as all of the patients in both groups had a VAS<4, they were discharged to the hospital. CONCLUSIONS: Modified auriculotherapy was better to the conventional analgesics for post-operative pain control in patients subjected to laparoscopic cholecystectomy.

Clinical comparison of pain perception rates between computerized local anesthesia and conventional syringe in pediatric patients.

The purpose of this study was to evaluate pain perception rates in pediatric patients by comparing computerized injection device and traditional injection procedure. In a clinical trial, by using a crossover design, sixty-four patients were randomly assigned to receive, in consecutive sessions, dental anesthetic techniques with either traditional or computerized device. Visual Analogue Scale qualification and heart rate monitoring as physiologic indicator of pain response were used for the evaluation. Results showed that traditional syringe injections were more painful than computerized injection device (p < 0.001). Results suggested that computerized injection device reduces pain perception compared to the traditional syringe during the dental anesthetic management.

[Risk factors for students desertion from the UASLP School of Medicine, México]. / Factores de riesgo para la deserción de estudiantes en la Facultad de Medicina de la Universidad auTónoma de San Luís Potosí (UASLP), México.

OBJECTIVE: To obtain the profile of students that deserted from the Faculty of Medicine of the Autonomous University of San Luis Potosi, México. DESIGN: Cases and controls nested in a cohort. METHODS: All students that voluntarily deserted between 1992 and 2002 were consulted. Each student was compared in an aleatory form with a regular student and a proper questionnaire was applied. RESULTS: The significantly associated factors to abandon the Faculty of Medicine were: high school of origin (OR=2.43), extra-ordinary exam (OR=3.13), and lack of vocation (OR=2.41). CONCLUSION: The subjacent factors for not deserting from the Faculty of Medicine were: study habits, capacity for sustained effort, and tolerance to frustration.

[Prognostic value of pre-B immunophenotype in early treatment response among acute pediatric lymphoblast leukemia patients]. / Valor pronóstico del inmunofenotipo en la respuesta temprana de la leucemia aguda linfoblástica pre-B en niños.

OBJECTIVE: To determine the prognostic value of preB immunophenotype and its variants on early treatment response among of acute pediatric lymphoblast leukemia. PATIENTS AND METHODS: A case-control study nested in a cohort was carried out with male and female patients 15 years and younger with recently diagnosed pre-B lymphoblast leukemia. A panel of B, T, monoclonal antibodies of the myelo-monocytic and megakaryocytic cell type was used. Response was assessed by bone marrow aspiration 14 days post treatment. RESULTS: 54 patients were included. The median age was 7 years (2 months - 14 years) median leukocyte count was 13,450/mm3 (1200-986,000/mm3). We identified 29 cases with late pre-B immune phenotype, 19 cases with common pre B and 6 cases with early preB immunophenotype. Eleven, patients also displayed myeloid antigens. A significant association (p=0.034) was found between early treatment response and the presence of myeloid antigens. No association was found between the pre-B immunophenotype, age and leukocyte count with early treatment response (p=0.264). CONCLUSIONS: We need to pay special emphasis on early treatment response in children with lymphoblast leukemia as our study did not corroborate the common finding that clinical factors and immune phenotype can be predictive factors.

[Effect of metabolic control in type I diabetes patients and its association with periodontal disease]. / Efecto del control metabólico en pacientes diabéticos tipo 1 y su asociación con enfermedad periodontal.

OBJECTIVE: To compare the frequency of periodontal disease in type 1 diabetes mellitus patients with and without metabolic control, having a control group of healthy patients. MATERIAL AND METHODS: A prolective cross sectional study with simple random sampling was carried out; patients were divided in three groups: A). Forty healthy subjects, B). Twenty diabetic patients with metabolic control, and C). Twenty diabetic patients without metabolic control. The diabetic subjects were evaluated with glycosylated hemoglobin (GHb) to determine the glucose control; clinical periodontal evaluations were performed for all teeth in each subject and following indexes were included: Plaque, gingival, mobility, probing depth, attachment level, bleeding on probing, and marginal bone loss. RESULTS: The imbalance of glucose of subjects with diabetes mellitus type 1 was associated with more frequency of periodontal disease (p < 0.05). CONCLUSION: The population of type 1 diabetes mellitus with imbalance of glucose showed association with periodontal disease.

[Ascaris lumbricoides-caused risk factors for intestinal occlusion and subocclusion]. / Factores de riesgo para oclusión y suboclusión intestinal por Ascaris lumbricoides.

OBJECTIVES: Our objective was to determine risk factors and mortality for partial and complete bowel obstruction caused by Ascaris lumbricoides as well as diagnostic validity of eosinophilia in peripheral blood. MATERIAL AND METHODS: We studied 50 patients with partial or complete bowel obstruction and expulsion of Ascaris lumbricoides by mouth or anus, as well as 50 patients as controls; no patient had a negative coproparasitoscopic study. The period of study was from January 1995-December 2001 at the General Hospital of Ciudad Valles, San Luis Potosí State, Mexico. RESULTS: Cases with partial bowel obstruction had average age of 3.1 years against 10.13 years for those with complete obstruction (p = 0.029). Females accounted for 55% and males 43%, respectively. We do not find a relationship among nutritional status, gestational order in the family, and place of excreta deposition in this study group. In the case of eosinophilia, best point of section found was three or more eosinophils with sensitivity of 34% but specificity of 100%; mortality was 2%. CONCLUSIONS: We do not find a statistical difference between partial and complete bowel obstruction for different variables studied with the exception of age. To find 3% or more of eosinophils in peripheral blood strongly suggests the etiology of the obstruction as Ascaris lumbricoides at prevalence sites of this parasite.

Amoebic toxic colitis: analysis of factors related to mortality.

BACKGROUND: Toxic or fulminant colitis due to Entamoeba histolytica infrequently presents but is very serious. Unfortunately, there are numerous contradictory factors related to mortality. METHODS: We analyzed several cases of E. histolytica infection to determine the factors related to mortality. We included patients >15 years of age who were histopathologically diagnosed with amoebic toxic colitis and treated from January 2000 through December 2006. We evaluated demographic, clinical, laboratorial, surgical, and histopathological characteristics. RESULTS: We examined 24 patients and recorded 12 deaths (50%). Twenty patients underwent surgery within a mean time of 24 hours (range: 8-120 hours). Tenesmus and intestinal perforation were determined to be statistically significant (P<0·05) by univariate analysis. Three models of logistic regression were able to determine three statistically significant factors that affected mortality: (1) tenesmus and a lymphocyte count <1·5×10(3) cell/µl; 2) depth of invasion beyond the mucosa and a lymphocyte count <1·5×10(3) cell/µl; 3) time spent with symptoms and perforation. CONCLUSIONS: The mortality rate determined in this study is similar to previously reported series. A low lymphocyte count, significant depth of invasion, and intestinal perforation were determined to be the factors related to increased mortality, while tenesmus and limited amount of time spent with symptoms were associated with survival. Quick diagnosis and appropriate treatment are important factors that reduce mortality.

Prognostic indications of the failure to treat amoebic liver abscesses.

OBJECTIVES: To identify the variables that predict the failure to treat amoebic liver abscesses. METHODS: We prospectively carried out a case-control study on a cohort of patients who had been diagnosed with amoebic liver abscesses using clinical, ultrasonic, and serologic methods. Patients with pyogenic abscesses, negative ELISA tests for amoebiasis, immunosuppression status, or previous abdominal surgery were excluded. All patients received metronidazole, and those who demonstrated 4 days of unfavorable clinical responses received percutaneous or surgical draining of the abscess. Demographic, laboratory, and ultrasonographic characteristics were assessed as prognostic indications of failure. RESULTS: Of 40 patients with amoebic liver abscess, 24 (mean age: 36·7±11·2 years) responded to medical treatment and 16 (41·8±11·6 years) required drainage, including 14 patients who underwent percutaneous drainage and two patients who required surgery. The albumin level, abscess volume, abscess diameter, and alkaline phosphatase level were all statistically significant (P<0·05) on the bivariate analysis. The highest (>99%) sensitivity and negative predictive value were observed for an abscess volume >500 ml and diameter >10 cm, while the best specificity and positive predictive value were achieved with the combination of low serum albumin level, high alkaline phosphatase level, and large abscess volume or diameter. CONCLUSIONS: The prognostic indications of the failure to treat amoebic liver abscesses include low albumin, high alkaline phosphatase, and large abscess volume or diameter. The combination of these variables is a useful and easy tool for determining appropriate therapy.