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La Fluorosis Dental (FD) es un defecto del desarrollo del esmalte tipo hipomineralización atribuido a la exposición crónica y excesiva de fluoruro durante el período de amelogénesis. Clínicamente, en los casos más leves se pueden observar finas líneas blancas y opacas, mientras que en casos moderados y severos las líneas se pueden fundir y formar bandas más gruesas comprometiendo toda la superficie del diente pudiendo estar asociadas con pérdidas de estructura y cambios de color. El tratamiento de la FD puede incluir desde microabrasión, infiltración, aclaramiento y restauraciones con resina compuesta hasta carillas y coronas. El objetivo de este caso clínico fue asociar la técnica de microabrasión e infiltración como alterantiva de tratamiento estético para el manejo de la FD. Paciente de sexo femenino y 9 años que presentaba opacidades blancas en forma de bandas gruesas y pérdidas de estructura dental en los incisivos superiores permanentes (FD severa). Para el tratamiento se optó por realizar microabrasión con ácido clorhídrico, seguido de infiltración con resina de baja viscosidad, logrando un resultado estético favorable y estable a tres meses. Se concluye que la combinación de estas dos técnicas micro-invasivas es una estrategia viable y efectiva para enmascarar efectivamente opacidades producidas por la FD.

This study aimed to evaluate the association between the severity of hypomineralized second primary molars (HSPM), molar-incisor hypomineralization (MIH) and dental caries in children. 450 children between the ages of 6 and 7 years were included in this cross-sectional study. A calibrated examiner classified the enamel hypomineralizations and dental caries lesions using the MIH and HSPM and the Nyvad criteria, respectively. The primary outcome was the severity of MIH according to the severity of HSPM. Statistical analysis was performed using the generalized linear model and ordinal logistic regression. The prevalence of concomitant MIH and HSPM was 26% sex and age adjusted. Mild enamel defects were more frequent than severe enamel defects. An association was found between the severity of MIH and HSPM, both for mild defects (OR=87.54; 95%CI: 55.87, 137.17) and severe defects (OR=82.15; 95%CI: 45.72, 147.61). The severity of hypomineralization in permanent molars was associated with the activity of dental caries lesions (OR=29.85; 95%CI: 12.95, 68.83). To conclude, there is a strong association between the severity of HSPM and MIH, which is more significant in the presence of active dental caries lesions. Resumo O objetivo desse estudo foi avaliar a associação entre a severidade da Hipomineralização de Segundos Molares decíduos (HSMD), da Hipomineralização de Molares e Incisivos (HMI) e cárie dentária em crianças. Neste estudo transversal foram incluídas 450 crianças entre 6 e 7 anos de idade. Um examinador calibrado classificou as hipomineralizações e lesões de cárie dentária utilizando o índice da HMI/HMD e o critério Nyvad, respectivamente. O desfecho primário foi a severidade da HMI de acordo com a severidade da HSMD. As análises estatísticas foram realizas usando o modelo linear generalizado e regressão logística ordinal. A prevalencia concomitante da HMI e HMSD foi de 26 % ajustada por sexo e idade. Defeitos leves foram mais frequentes que os defeitos severos. Foi encontrada a associação entre a severidade da HMI e da HSMD para defeitos leves (OR=87.54; IC95%: 55.87, 137.17) e severos (OR=82.15; IC95%: 45.72, 147.61). A severidade da hipomineralização em molares permamentes foi associada a atividade da lesão de cárie dentária (OR=29.85; IC95%: 12.95, 68.83). Conclui-se que existe uma forte associação entre a severidade da HSMD e da HMI, a qual foi mais significante na presença lesões ativas de cárie.

Resumen Las vasculitis, patologias cuyo hallazgo principal es la afectacion de las paredes de los vasos sanguineos, se presentan de forma infrecuente en la poblacion pediatrica. En general, en ninos se clasifican de acuerdo con el consenso de la EULAR/PReS y en adultos, segun la Conferencia de Consenso de Chapel-Hill. Las vasculitis asociadas con ANCA (VAA) hacen parte de las vasculitis de pequenos vasos y estan representadas por la granulomatosis con poliangeitis (GPA), la granulomatosis eosinofilica con poliangeitis (EGPA) y la poliangeitis microscopica (PAM), entre otras. A nivel renal, los hallazgos histopatologicos representativos son la glomerulonefritis focal necrotizante con media luna, inflamacion intersticial variable, ausencia de complejos inmunes o pequenos depositos de inmunoglobulinas. Clinicamente las VAA pueden manifestarse con hematuria, proteinuria, hipertension arterial o glomerulonefritis rapidamente progresiva. La GPA puede afectar de forma severa el rinon en el 75% de los casos, mientras que, en la PAM, el compromiso renal (75-90%) puede ser rapido y severo con posibilidad de requerir terapia de reemplazo renal en mas de la mitad de los pacientes. Ademas, hasta el 25% de los casos puede tener hipertension arterial con una mortalidad a un ano de 85%. En la EGPA, el compromiso renal suele ser leve. Se presentan tres casos pediatricos de VAA con diferentes desenlaces renales, que incluyen necesidad de terapia de reemplazo renal con recuperacion de funcion renal, trasplante renal y muerte, seguidas en una institucion de IV nivel del suroccidente colombiano.

Introducción: El paso del adolescente con trasplante renal del servicio de pediatría al de adulto se relaciona con aumento en el rechazo y pérdida del injerto renal. La evidencia señala que un proceso de transición adecuado disminuye el riesgo de rechazo y mejora los desenlaces clínicos. Objetivo: Caracterizar socio demográficamente adolescentes con trasplante renal o en protocolo pre-trasplante previo a la implementación de un programa de transición. Métodos: Estudio cuantitativo, descriptivo de corte transversal. Se incluyeron los pacientes del servicio de nefrología pediátrica de la Fundación Valle del Lili entre 11-19 años, obteniendo 31 participantes con trasplante renal y 4 en protocolo pre-trasplante. Se realizó una prueba piloto de la encuesta sociodemográfica con un grupo diferente con salud similar salud, se ajustó y aplicó la encuesta a la población objeto. Resultados: 54% eran de sexo masculino, el promedio de edad 14,3 ± 2,3 años, 23% afrodescendientes, el 65% provenían del Valle del Cauca y el 35% de otros departamentos del suroccidente colombiano. El nivel socioeconómico fue bajo en el 65%. El 44% cursó primaria, 47% secundaria y 9% cursaba educación superior. La madre fue el cuidador principal en el 85% y el 63% de los cuidadores cursó algún grado de secundaria. La enfermedad renal de base fueron las malformaciones congénitas 57%, y el 89% calificó su estado de salud como bueno. Conclusiones: Este estudio generó una apropiación de conocimientos y cumplimiento del tratamiento en los adolescentes, dando paso a la segunda fase de evaluación del programa en un futuro estudio.

Introducción: Técnicas adhesivas contemporáneas permiten la rehabilitación conservadora y estética de dientes afectados por caries dental, trauma dentoalveolar y defectos del desarrollo del esmalte. Para el tratamiento restaurador de la hipomineralización de molares e incisivos (HMI) se ha recomendado el uso de restauraciones indirectas. Reporte de caso: Paciente sintomático de sexo femenino, 8 años, portadora de HMI severa y comportamiento levemente negativo. Los dientes 16, 36 y 46 presentaban opacidades demarcadas asociadas a dolor provocado. El tratamiento se enfocó en educar a la familia con respecto a la HMI, orientar el comportamiento, controlar la sintomatología y restaurar la función y estética de los dientes afectados por la HMI. Debido a la extensión, severidad y localización de los defectos en los dientes 16, 36 y 46, se optó por realizar restauraciones indirectas con resina compuesta. Luego de 12 meses la paciente presentaba comportamiento definitivamente positivo, no relataba sintomatología dolorosa, las restauraciones estaban sin cambio de color, bien adaptadas, con buena salud gingival y con adecuada anatomía oclusal, lisas y sin signos de lesiones de caries dental. Conclusión: En este caso de HMI severa, la restauración con resina indirecta fue una estrategia estética, conservadora, viable y efectiva durante un periodo de seguimiento de 12 meses.

Introducción: la nefropatía por IgA (NIgA) es la enfermedad glomerular más común del mundo. En pediatría, la frecuencia de la enfermedad no está bien establecida y puede llevar a falla renal terminal a los 20 años entre el 20-30 % de los casos. Se ha descrito relación entre una tinción histológica C4d positiva y variables clínicas e histológicas de peor pronóstico renal. Objetivo: el objetivo del presente estudio es correlacionar la presencia diagnóstica de C4d en biopsias renales con variables clínicas e histológicas en pacientes con NIgA. Métodos: estudio observacional y retrospectivo. Se incluyeron entre los años 2011-2018 todos los pacientes pediátricos con diagnóstico histopatológico de NIgA que contaran con material de biopsia renal adecuado para la tinción de C4d. La variable resultado principal fue la tasa de filtración glomerular (TFG) al momento del diagnóstico y al último seguimiento. Resultados: catorce pacientes fueron incluidos en el estudio. Dos (14.2 %) tuvieron tinción positiva para C4d en la biopsia de diagnóstico, de los cuales, ninguno presentó deterioro de la función renal por TFG ni proteinuria moderada-severa durante el estudio. No se encontró relación entre una tinción para C4d positiva y variables histopatológicas de peor pronóstico (incluyendo hipercelularidad mesangial y fibrosis intersticial-atrofia tubular), de la clasificación de Oxford. Conclusión: dado el escaso tamaño de la muestra, nuestros hallazgos no fueron concordantes con la literatura en cuanto a la relación entre una tinción positiva para C4d y variables clínicas e histopatológicas de peor pronóstico renal.

Made available in DSpace on 2022-04-29T08:41:16Z (GMT). No. of bitstreams: 0 Previous issue date: 2022-01-01 OBJECTIVE: To assess the association between the frequency and severity of dental fluorosis (DF) and molar incisor hypomineralization (MIH) in a fluoridated salt region. STUDY DESIGN: In this retrospective cross-sectional study, we evaluated the buccal, occlusal/incisal, and palatal/lingual surfaces of first permanent molars and permanent incisors of 453 patients aged 13-16 years through intraoral standardized photographs. Two standardized examiners evaluated DF and MIH independently, utilizing the Thylstrup-Fejerskov (TF) index and the MIH index. The statistical analysis was performed using a generalized linear model and logistic regression adjusted for age, sex, and dental caries experience. RESULTS: The MIH frequency at the surface level was lower in the presence of DF (PR= 0.03; P= 0.00, 95% CI: 0.01-0.08). At the surface level, MIH severity was lower among those presenting mild DF (aOR= 0.02; 95% IC: 0.01-0.07). Regarding severe DF, we found no significant difference in MIH severity (P= 0.174). CONCLUSION: MIH frequency and severity tend to be lower in the presence of DF. Manuel Restrepo DDS MSc Ph.D. Professor. Basic and Clinical Research Group in Dentistry School of Dentistry CES University MSc Ph.D. Professor. School of Medicine CES University *** Aline Leite de Farias DDS MSc PhD student. Department of Pediatric Dentistry and Orthodontics São Paulo State University (Unesp) Araraquara School of Dentistry DDS MSc PhD. Postdoc student. São Paulo State University (Unesp) Araraquara School of Dentistry DDS MSc Ph.D. Professor. Department of Pediatric Dentistry and Orthodontics São Paulo State University (Unesp) Araraquara School of Dentistry *** Aline Leite de Farias DDS MSc PhD student. Department of Pediatric Dentistry and Orthodontics São Paulo State University (Unesp) Araraquara School of Dentistry DDS MSc PhD. Postdoc student. São Paulo State University (Unesp) Araraquara School of Dentistry DDS MSc Ph.D. Professor. Department of Pediatric Dentistry and Orthodontics São Paulo State University (Unesp) Araraquara School of Dentistry

La Hipomineralización de Molares e Incisivos (HMI) es un defecto de desarrollo del esmalte de origen multifactorial que afecta de uno a cuatro primeros molares permanentes y frecuentemente está asociada con incisivos permanentes. Clínicamente se caracteriza por presentar opacidades demarcadas de color blanco-crema y/o amarillo-café. En casos severos puede haber dolor, fracturas posteruptivas, lesiones de caries dental y/o restauraciones atípicas. Entre las opciones de tratamiento se encuentran restauraciones temporales con cemento de ionómero de vidrio, restauraciones en resina compuesta, coronas, restauraciones indirectas y exodoncia. El objetivo de este caso es analizar las consideraciones diagnósticas de la exodoncia de primeros molares permanentes severamente afectados por la HMI. Paciente de sexo femenino, 9 años de edad, patrón esquelético Clase I, maloclusión Clase I bilateral e HMI severa. Para el tratamiento se optó por realizar la exodoncia de los cuatro primeros molares permanentes bajo anestesia general. Luego de 10 meses, se observa que los segundos molares permanentes están clínicamente sanos y presentan inclinaciones y posiciones favorables para el cierre espontáneo del espacio. Se concluye que la exodoncia de primeros molares permanentes severamente afectados por la HMI es una estrategia que mejora el pronóstico del paciente y para realizarla, se requiere trabajar en conjunto con el ortodoncista para diagnosticar y planear individualmente cada caso.

Resumen Introduccion La nefritis lupica (NL) es una consecuencia del lupus eritematoso sistemico (LES). La biopsia renal es un potencial biomarcador de pronostico de funcion renal. Objetivo Correlacionar hallazgos histopatologicos y la funcion renal de los pacientes pediatricos con la NL. Materiales y metodos Estudio observacional retrospectivo. Se incluyeron pacientes pediatricos con diagnostico histopatologico de NL. Se excluyeron pacientes sin seguimiento por la institucion. Se evaluo la biopsia renal al diagnostico con la escala modificada de la International Society of Nephrology and the Renal Pathology Society (ISN/RPS). Se uso el indice kappa para determinar el nivel de acuerdo entre la falla renal (tasa de filtracion glomerular [TFG] Resultados Entre el 2011 y el 2018, 57 pacientes con NL fueron atendidos en la institucion, 40 cumplieron con los criterios de inclusion, 10 (25%) eran de sexo masculino. La mediana de edad de diagnostico de NL fue 12,9 anos (IQR 11,1 a 14,9). El tiempo de seguimiento fue de 2,3 anos (IQR 1,0 a 5,16). Al diagnostico, la cariorexis fue la caracteristica de la escala con mayor nivel de acuerdo con la falla renal (k = 0,1873, EE = 0,0759, p = 0,0068) y al ultimo seguimiento lo fue la esclerosis segmentaria global (k = 0,1481, EE = 0,078, p = 0,0287). No hubo diferencia en la TFG al ultimo seguimiento y presencia de proteinuria al diagnostico (p = 0,3936). Conclusion La biopsia renal puede ser insuficiente para evaluar la prediccion de la funcion renal. El tratamiento de pacientes con NL debe realizarse utilizando otros biomarcadores y signos clinicos. Deben hacerse estudios prospectivos que puedan confirmar esta hipotesis.

The aim of this study was to determine the frequency and severity of dental fluorosis (DF) and the association between severity and risk factors. In a cross-sectional study, 8- to 12-year-old children, born in a Colombian district, were evaluated according to the Thylstrup and Fejerskov Index (TFI) by two calibrated examiners. Molar Incisor Hypomineralization (MIH) and dental caries (DC) were also evaluated. Ordinal logistic regression was applied (p0.05). Risk factors and lifestyle factors were collected using a questionnaire answered by parents. DF was detected in 76 (98.7%) of the children (average of 18.4 ±1.81 permanent teeth affected). Grade TF2 was the most frequently observed (34.8%); TF5 was observed in all age groups; TF6- TF7 were observed in 12-year-olds. No association was found between DF severity and DC (Odds Ratio (OR)=1.35; 95%CI: 0.56-3.26) or MIH (OR=1.39; 95%CI: 0.43-4.46). DF severity was significantly associated with use of an indoor wood stove for food preparation (OR = 9.34; 95%CI: 1.11-78.57) and use of a pea-sized volume of toothpaste (OR = 27.42; 95%CI: 1.57-477.36). Prevalence of DC was 38.1% and prevalence of MIH was 14.4%. In this population, the frequency of DF was high and severity was associated with use of an indoor wood stove for food preparation and toothpaste amount used during childhood.El objetivo de este estudio fue determinar la prevalencia y severidad de la Fluorosis Dental (FD) y la asociación de la severidad con factores de riesgo. Mediante un estudio transversal, niños (8-12 años-de-edad), nacidos en Ayapel (El Cedro-Colombia) fueron evaluados por 2 examinadores calibrados, según los criterios del índice de Thylstrup y Fejerskov (TFI) para FD. También se evaluaron la Hipomineralización molar-incisiva (HMI) y la caries dental (CD). Se aplicó un cuestionario de factores de riesgo y estilo de vida, a los padres/responsables de los niños. Se utilizó un modelo de regresión logística ordinal (p0.05). Se encontró FD en 76 (98.7%) niños (con una media de dientes permanentes afectados de 18.4 ±1.81). La severidad categoría TF2 fue la más observada (34.8%) en los dientes evaluados. Las lesiones que presentan pérdida estructural moderada TF 6-7, fueron evidenciadas en el grupo de edad de 12 años. No se encontró asociación entre la severidad y la CD (OR=1.35; IC95%:0.56-3.26) o con HIM (OR=1.39; IC95%:0.43-4.46). Se encontró una asociación significativa con la severidad de la FD en los niños que utilizaban fogón de leña-interno para la preparación de los alimentos (OR=9.34; IC95%:1.11-78.57) y utilizaban un volumen de crema dental del tamaño de una alverja- pequeña (OR=27.42; IC95%:1.57-477.36). la prevalencia de CD fue 38.1% y de HMI fue 14.4%. La frecuencia de la FD fue alta y la severidad mostró correlación con la utilización de fogón de leña interno para la preparación de los alimentos y la cantidad de crema-dental utilizada.

El síndrome de Dressler es un tipo de pericarditis desarrollada por una lesión aguda al miocardio o pericardio. Se presenta hasta la décima semana posterior al infarto. Es de mencionar que la lesión miocárdica previa al síndrome puede deberse a cardiotomía. Así, si bien el enfoque general es posinfarto, existen fuentes que se refieren al síndrome poscardiotomía. Su fisiopatología es incierta: puede deberse a una interacción entre el sistema de complemento y el tejido afectado. A la fecha no existen signos patognomónicos o criterios consensuados, lo que lo hace un fuerte reto para el clínico. Para el diagnóstico es necesario el antecedente de lesión miocárdica o pericárdica, junto con marcadores inflamatorios y alteraciones electrocardiográficas; las imágenes son útiles para descartar diferenciales y complicaciones. El tratamiento se realiza según la estabilidad hemodinámica y comorbilidades. Es necesario el conocimiento de este síndrome que, si bien suele ser autolimitado, tiene un alto número de recurrencias, lo cual afecta la calidad de vida de los pacientes.

This article reviews the indications, objectives and step by step process of the Modified Hall Technique in the management of primary and permanent molars affected by severe enamel hypomineralization. Scientific based biological principles are discussed in order to provide relevant clinical information for Pediatric and General dentists in order to provide support for the safe use the technique in clinical practice.

El Síndrome de Stevens-Johnson (SSJ) y la Necrólisis Epidérmica Tóxica (NET) son enfermedades que se encuentran dentro del espectro de las reacciones adversas cutáneas severas. Estas enfermedades comprometen cavidad oral entre el 25% y 50% de los casos. Se presenta el caso de un paciente de 10 años de edad que sufrió unataque agudo de SSJ a la edad de 6 años. Con implicación de la cavidad oral debido a las secuelas que presenta mucosa oral, raíces cortas y poco desarrolladas en todos los órganos dentario sin otra causa atribuible en su historial médico, diferente al SSJ. La edad a la que se presentó la enfermedad y el estadio de desarrollo dental señalan como causa probable el ataque agudo de SSJ, lo que permite concluir que durante su curso ocurrió un daño en la vaina epitelial de Hertwig, provocando apoptosis y, en consecuencia, un cese en el desarrollo radicular.

In compliance with Act of Congress 31/1992, Article 5, the Board of Directors of Banco de la República hereby submits to the Congress of the Republic of Colombia a detailed report on the measures that Banco de la República has taken in the emergency situation generated by Covid-19 and presents the macroeconomic results for 2020 and the outlook for 2021 for its consideration. Furthermore, the breakdown of the Foreign Reserves and their performance, the financial position of the Bank and its forecasts, and the Bank’s Cultural management are described. Sincerely, Leonardo Villar Gómez Governor

The aim of this study was to evaluate the prevalence evolution rate of MIH (molar-incisor hypomineralization) after a 6-year period in Araraquara/SP, Brazil. This population-based study evaluated MIH in 545 schoolchildren (6–12 years of age) and other associated alterations, dental caries and dental fluorosis (DF). A semistructured questionnaire was sent to the schoolchildren’s parents/guardians with the purpose of identifying the socioeconomic profile. Associations between MIH and the clinical characteristics were analyzed by the Poisson analysis of regression with robust variance, estimating the RPc (crude prevalence ratio) with CI 95%. The level of significance of 5% was adopted. The MIH prevalence in Araraquara/SP in 2016 was 14.3% (n = 78), and at this time, an increase of 2% was observed, in comparison with the data of the first prevalence study conducted in 2010 (12.3%). The mild degree compromise was the most prevalent diagnosis in the affected teeth (82.0%). Among children with MIH, the mean number of affected teeth was 2.78. Of the total number of children with MIH, 32.0% presented alterations in both first permanent molars and permanent incisors. There is no significant association between MIH and dental caries experience on permanent dentition (PRc = 1.141; CI 95% 0.709–1.835) or on primary dentition (PRc = 1.132; CI 95% 0.749–1.709). Children with MIH presented significantly less prevalence of dental fluorosis (PRc = 0.505; CI 95% 0.268–0.950). There is no association between MIH and monthly Brazilian minimal wage income (PRc = 1.130; CI 95% 0.655–1.949). It was concluded that the number of MIH cases had increased, revealing a greater need for defining the etiological factors and establishing a correct diagnosis to make it possible to institute early intervention.

Objective In previous studies, smaller renal volumes were reported in prematurely born infants, however, these renal volumes were not corrected for body surface area, the main determinant of renal size. Given the rapid growth of the renal cortex after premature birth, the authors hypothesized that corrected volumes would not differ from healthy controls. Methods Ambispective cohort study with prospective follow-up of prematurely born babies in a large specialized center and retrospectively recruited healthy control group. Children were assessed for renal length and renal volumes at age 5 by three independent ultrasonographers. Detailed anthropometry, blood pressure and renal function were also obtained. Age independent z-scores were calculated for all parameters and compared using descriptive statistics. Results Eighty-nine premature study participants (median 32 weeks gestational age) and 33 healthy controls (median 38 weeks gestational age) were studied. Study participants did not differ in age, sex, Afro-Colombian descent, height, blood pressure, serum creatinine, or new Schwartz eGFR. Premature study participants had a significantly lower weight (17.65 ± 2.93 kg) than controls (19.05 ± 2.81 kg, p = 0.0072) and lower body surface area. The right renal volumes were significantly smaller (39.4 vs 43.4 mL), but after correction for body surface area, the renal volume and renal length z-scores were identical for both kidneys (mean right kidney -0.707 vs -0.507; mean left kidney -0.498 vs -0.524, respectively). Conclusion Renal volumes need to be corrected to body surface area. After correction for body surface area, 5-year-old healthy and prematurely born children have comparable renal volumes.

Made available in DSpace on 2021-06-25T10:55:32Z (GMT). No. of bitstreams: 0 Previous issue date: 2021-01-01 Background: The second permanent molar plays an important role when considering extraction of first permanent molars severely affected by molar-incisor hypomineralization (MIH). Aim: To assess the association between MIH and enamel hypomineralization of the second permanent molars in terms of presence and severity. Design: In this retrospective cross-sectional study, permanent teeth were evaluated in 453 patients between the ages of 13 and 16 at a dental clinic, using intraoral photographs. A calibrated examiner classified enamel hypomineralization using the MIH index and dental caries experience using the DMFT and DMFS indices. Statistical analyses were performed using a linear generalized model and ordinal logistic regression. Results: The most commonly affected teeth by enamel hypomineralization were permanent molars, whereas incisors, premolars, and canines were less affected. The presence of severe defects in the first permanent molars was associated with mild defects in the second permanent molars (OR = 4.01; 95% CI: 2.50-7.77). Enamel hypomineralization was associated with increased caries experience (PR = 5.54; 95% CI: 3.81-9.06). Conclusion: Enamel hypomineralization mainly affects the first and second permanent molars. Mild defects in the second permanent molars tend to be more frequent in patients with severe MIH in the first permanent molars. The presence of enamel hypomineralization was associated with higher dental caries experience. Department of Morphology Genetics Orthodontics and Pediatric Dentistry Araraquara School of Dentistry São Paulo State University (Unesp) School of Medicine CES University Basic and Clinical Research Group in Dentistry School of Dentistry CES University Department of Morphology Genetics Orthodontics and Pediatric Dentistry Araraquara School of Dentistry São Paulo State University (Unesp)

Este trabajo es el resultado de la búsqueda, desde el rol de educadores musicales, de rutas pedagógicas situadas en una diversidad epistémica más allá de la tradición occidental y sus territorios de influencia colonial en Latinoamérica, Colombia y Antioquia, en particular. En nuestro contexto se han institucionalizado formas de educación musical derivadas del proyecto civilizatorio moderno, lo que ha determinado las estrategias de aprendizaje y sus modelos educativos para la música. En consecuencia, tanto la música centroeuropea de conservatorio como las músicas populares y tradicionales han quedado inmersas en las mismas lógicas de construcción y de producción simbólica. Así, en la educación superior prevalece una mirada universalizante y conservadora que concibe el asunto de la práctica musical, preferentemente en términos del objeto, es decir, de la obra, lo que coarta aspectos tan relevantes como las transacciones simbólicas, los imaginarios culturales, la identidad, las narrativas, la estesis y las matrices de realidad, así como las ontologías que soportan toda su construcción. Por tal razón, es necesario proponer una ruta diferente que explore la formación musical desde la dimensión del ser como eje central de la misma, con el objeto de reincorporar el cuerpo como elemento receptor de conocimiento que favorece la conexión entre los estados emocionales y la construcción del sentido musical en su práctica. Todo ello en relación con tres verbos que resultan fundamentales para este propósito: imaginar, configurar y propiciar experiencias vitales y diversas encaminadas a reforzar, ampliar y complementar las prácticas pedagógicas para la música, con otras herramientas, estrategias y recursos basados en la estesis.

Pediatric nephrologists use kidney length and kidney volume z-scores to longitudinally assess normal nephron endowment. However, most radiologists only report kidney length. Agreement between kidney length and kidney volume z-scores in children has been understudied. This study aims to assess agreement between kidney length and kidney volume z-scores in children. This novel cross-sectional cohort study prospectively followed prematurely born babies from a large specialized prematurity follow-up center. A healthy control group matched the cases by age and sex and was recruited from schools. Children were assessed for kidney length and kidney volumes at age 5 by three independent ultrasonographers. All measurements were performed in triplicate. Detailed anthropometry, blood pressure, and kidney function were also obtained. Age-independent z-scores were calculated for all parameters according to Scholbach and Weitzel and compared using descriptive statistics. We studied 89 premature patients (median 32 weeks gestational age) and 33 healthy controls (median 38 weeks gestational age). There were 732 determinations of kidney length, width, and thickness. The mean z-score of the right kidney length was 0.65 ± 0.08 (SEM) compared with 0.88 ± 0.08 of the left kidney length (p = 0.0003, two-sided paired t test). The squared correlation coefficient for kidney volume to kidney length was 0.32 (p < 0.0001). Bland and Altman analysis revealed considerable bias with − 1.36 ± 0.76 standard deviations and 95% limits of agreement from − 2.83 to − 0.16. Reporting only kidney length results in significant overestimation of age-independent z-scores. Based on our findings, consideration to measuring all kidney dimensions may be more appropriate.

We develop a superstructure framework for the design of biorefineries for ethanol upgrading into advanced biofuels to replace gasoline, jet fuel or diesel. The framework integrates catalysis, process synthesis, and fuel property modelling towards the design of biorefineries producing fuels with specified properties. The proposed framework is applied to identify strategies for the upgrading of ethanol into one or more fuels with specific properties. We discuss the trade-off between profit and biorefinery complexity, as well as the relation among fuel property constraints, the optimal upgrading strategy selected, and process economics. Finally, we show how to find the optimal biorefinery associated with a particular chemistry or catalyst. The results presented constitute the first systematic study of ethanol upgrading considering, simultaneously, fuel and process design.

La caries de la infancia temprana hace referencia a la presencia de una o más superficies cariadas, perdidas o restauradas en dientes deciduos en niños menores de 6 años de edad, siendo clasificada como severa cuando afecta a niños menores de 3 años. En dientes deciduos con gran destrucción coronal por caries dental, pero con integridad radicular, la rehabilitación puede ser compleja debido a la calidad y cantidad de estructura remanente. El objetivo de este caso, fue reportar la rehabilitación de cuatro incisivos deciduos severamente afectados por caries dental de la infancia temprana utilizando pernos en fibra de vidrio y restauraciones directas en resina compuesta. Paciente masculino de tres años de edad que presenta lesiones de caries dental activas y cavitadas y necrosis pulpar en los cuatro incisivos deciduos superiores. En la fase higiénica se realizaron actividades de educación, motivación en higiene y adecuación del medio bucal; en la fase restauradora se realizaron los tratamientos endodónticos, cementación de pernos en fibra de vidrio y restauraciones en resina compuesta con matrices anatómicas de celuloide y en la fase de mantenimiento se realizaron controles clínicos, radiográficos y actividades específicas de prevención. La rehabilitación con pernos de fibra de vidrio y resina compuesta logró reestablecer la forma, función y estética de los dientes del paciente.

Made available in DSpace on 2022-04-29T08:30:21Z (GMT). No. of bitstreams: 0 Previous issue date: 2022-03-01 Background: Currently, there is no consensus on the superiority of any material for the restorative treatment of molars affected by molar-incisor hypomineralization (MIH). Aim: To evaluate the survival of restorations with stainless-steel crown (SSC) or composite resin (CR) in first permanent molars affected by MIH for 24 months. Design: In this retrospective cohort study, 61 CR and 54 SSC restorations placed on molars affected by MIH of patients, aged between 7 and 10, that were treated and overseen at a university dental clinic in the period of 2017-2020 were evaluated. The primary outcome was the failure-free survival time. Parametric survival models were used for data censored by interval, and the comparison between SSC and CR was performed using the hazard ratio function with a 95% confidence interval. Results: The survival of SSC and CR restorations after 24 months was 94.4% and 49.2%, respectively. This difference was influenced by the presence of previous restoration (aHR = 3.4; 95% CI: 1.2-9.4) and cusp involvement (aHR = 4.0; 95% CI: 1.5-11.2). Conclusion: In molars with MIH and the need for restorative treatment, SSC had a significantly higher survival rate than CR over 24 months. Department of Morphology Genetics Orthodontics and Pediatric Dentistry Araraquara School of Dentistry São Paulo State University (Unesp), São Paulo School of Medicine CES University Basic and Clinical Research Group in Dentistry School of Dentistry CES University Department of Morphology Genetics Orthodontics and Pediatric Dentistry Araraquara School of Dentistry São Paulo State University (Unesp), São Paulo

Aim To evaluate whether renal length z-scores predict renal dysfunction in children with a solitary functioning kidney (SFK). Methods In a single-centre retrospective cohort of children with SFK, we correlated body mass index z-scores, extracellular volume and lean body mass to renal length z-scores. We grouped these z-scores to other markers of renal dysfunction (proteinuria, hypertension, extracellular volume and abnormal estimated glomerular function rate [eGFR]) and analysed renal length z-score with multivariate analysis, receiver-operated characteristics (ROC) plots and Youden's index to determine an appropriate cut-off. Results 111 children had a median follow-up 5.08 years, eGFR 80.8 mL/min/1.73 m2 , and age at last follow-up 7.4 (3.8-13.4 years). The median renal length z-scores of those without any renal dysfunction (n = 37, 25.1%) were greater (+3.66, interquartile range 3.02-4.47) than those with renal dysfunction (median 3.11, interquartile range 1.76-4.11, P = .0107, Mann-Whitney test). Using a cut-off of z-score of >+1.911, the odds ratio for having no renal dysfunction was 0.07 (95% CI 0.002-0.459, P = .0010). However, accuracy of the renal length z-score was poor (ROC curve 0.6488). Conclusion In this cohort of children with SKF, using the renal length z-score as a biomarker of renal dysfunction at 7 years of age is not recommended.

La profesion docente constituye un desafio permanente para quienes la ejercemos, debido a que socialmente es una de las profesiones menos valoradas. Sin embargo, en ella recae la obligacion de formar los ciudadanos del futuro, en cualquiera de las epocas en las que se ejerza. Se presenta una aproximacion al deber ser del profesor universitario, teniendo en cuenta que se configura y re-configura en una labor de importancia, asociada a la calidad educativa. Se plantean no solo valores que se deben tener para este ejercicio, sino tambien los retos que el mundo actual en constante cambio le asigna, para la formacion integral de los futuros profesionales. Esta reflexion se realizo a partir de conversaciones academicas de algunos integrantes de la comunidad educativa de un area de la salud. Challenges of the university teacher: a role that is permanently re-configured The teaching profession constitutes a permanent challenge for those who exercise it, because socially it is one of the least valued professions. However, it is the obligation of training the citizens of the future, in any of the periods in which it is exercise. An approach to the duty of the university professor is present, taking into account that it is configure and reconfigure in a work of importance, associated with the educational quality. There are not only values that be taken for this exercise, but also the challenges that the constantly changing world assigns to it for the integral training of future professionals. This reflection was product from academic conversations of some members of the educational community of a health area. Keywords: Professor; university; pedagogics models; didactic; learning. Desafios do professor universitario: um papel que se reconfigura permanentemente A profissao docente constitui um desafio permanente para quem a exerce, pois socialmente e uma das profissoes menos valorizadas. No entanto, sobre ela recai a obrigacao de formar os cidadaos do futuro, em qualquer um dos periodos em que e exercida. Este trabalho apresenta uma abordagem do dever do professor universitario, tendo em vista que ele e configurado e e reconfigurado em um trabalho de importância associado a qualidade educacional. Nao sao apenas os valores que devem ser considerados para este exercicio, mas tambem os desafios que o mundo atual em constante mudanca lhe atribui para o treinamento integral de futuros profissionais. Este estudo/trabalho foi produzido a partir de reunioes de reflexao de alguns membros da comunidade educacional de uma area de saude. Palavras chave: Professor; universidade; modelos pedagogicos; didatica; aprendizagem.

Introduction X-linked hypophosphatemic rickets is part of a larger group of hereditary diseases characterized by renal phosphate loss, which causes growth disorders, rickets, and osteomalacia. These conditions are characterized by disorders in phosphate equilibrium, which is essential for bone formation. Case report A female patient presented with bone deformities of the inferior extremities, prominent joints, and loss of teeth. She received initial management with oral calcium and orthotics in inferior extremities, with poor clinical outcome. PHEX gene sequencing revealed a pathogenic variant c.1601C>T (p.Pro534Leu). Discussion XLHR is caused by mutations in the PHEX gene; to date, more than 460 mutations have been associated with the disease. Clinically, it is characterized by bowing of the lower extremities, decreased growth, musculoskeletal complaints, dental abscesses, and other clinical signs and symptoms of rickets.

Este artículo es producto del proyecto de investigación “Banco ampliado de sonidos digitales de los instrumentos musicales del folclor colombiano – P142113”, realizado por la Escuela Superior de Artes Débora Arango y el Instituto Tecnológico Metropolitano. Cuyo objetivo esencial fue la realización de un banco de sonidos virtuales de instrumentos y ritmos de las músicas tradicionales colombianas, el cual puede ser utilizado en diferentes plataformas digitales de producción musical por músicos y productores, en la generación de contenidos musicales. En este proyecto se registraron las cualidades técnicas y sonoras de la Flauta de Millo, las Gaitas, la Marimba de Chonta, el Acordeón, la Bandola y el Tiple. Para tal fin se utilizaron las técnicas más avanzadas en el proceso de captura. Como resultado se obtuvieron unos bancos de sonidos de alta calidad que pueden ser utilizados en cualquier software de producción musical. Al concluir la investigación, se encontró una ligera diferencia de afinación, en algunos instrumentos, respecto a los parámetros de afinación de la música occidental centroeuropea. Situación que genera cierta incompatibilidad con el temperamento de la música comercial. Este artículo pretende incentivar la discusión sobre las problemáticas relacionales que acontecen con estos instrumentos y su inserción en la música comercial.

Resumen Introducción: la nefropatía por inmunoglobulina A (NIgA) es la enfermedad glomerular más común en el mundo. En Colombia, el 11-22 % de las glomerulonefritis primarias en niños corresponden a NIgA y de estos casos, el 30 % progresa a enfermedad renal terminal. Objetivo: describir las características paraclínicas e histopatológicas de la NIgA, así como los resultados clínicos según tres tipos de tratamiento en pacientes pediátricos con esta enfermedad atendidos en un hospital de alta complejidad del suroccidente colombiano. Materiales y métodos: estudio retrospectivo realizado en pacientes pediátricos de entre 1 mes y 18 años de edad con diagnóstico de NIgA. Las variables categóricas se presentaron como proporciones y las continuas con medianas y rango intercuartílico. Se usó la prueba de Fisher para comparar los tres esquemas de tratamiento. Resultados: se incluyeron 58 pacientes pediátricos atendidos entre 1996 y 2013. La media de edad al inicio de síntomas fue 7,5±4,2 años y al momento de la biopsia renal, 10±3,8 años. El 77,6 % de los pacientes presentó hematuria microscópica y el 27,6 %, macroscópica. Además, el 81 % tuvo proteinuria, siendo severa el 29 %. Histológicamente, el 10 % se clasificó como grado I, el 62 % como grado II, el 21 % como grado III y el 7 % como grado IV. Tres pacientes requirieron diálisis y dos, trasplante renal. Los esquemas terapéuticos evaluados fueron: solo prednisona (n=20, 34,5 %), prednisona y mofetil micofenolato (MMF) (n=13, 22,4 %) y sin prednisona ni MMF (n=25, 43,1 %). La diferencia en la presencia de hematuria entre los grupos fue significativa (p>0,001), siendo más frecuente en el grupo sin prednisona ni MMF (68 %). No hubo diferencia entre los grupos de proteinuria, hipertensión arterial y valor de creatinina. La mediana de años entre la biopsia renal y el ultimo control fue de 4 años (RIC 1-7). La supervivencia de la función renal fue del 89,1 % a los 5 años. Conclusión: la NIgA amerita reconocimiento temprano y seguimiento estricto, ya que puede tener desenlaces ominosos como enfermedad renal crónica. Abstract Introduction: IgA nephropathy (IgAN) is the most common glomerular disease in the world, in Colombia belongs to 11-22 % of primary glomerulonephritis in pediatric patients. Of these, 30 % progress to chronic kidney disease. Materials and methods : It is a retrospective descriptive study. We used median and IRQ for continuous variables, and proportions for categorical variables, Fisher test to compare clinical outcomes. Results: Between 1996 to 2013 58 patients were diagnosed. The mean age at symptoms onset was 7.5 years (SD±4.2) and at the time of renal biopsy was 10 years (SD±3.8). At diagnosis, 77.6 % of the patients showed microscopic hematuria, 27.6 % gross hematuria and 81 % proteinuria, classified as severe in 29 %. Three patients required dialysis and two needed kidney transplant. Three groups with different therapeutic regimens were evaluated: first group only prednisone 34.5 % (n = 20), second group prednisone and mycophenolate mofetil (MMF) 22.4 % (n = 13) and third group without prednisone neither MMF 43.1 % (n = 25). The difference in the presence of hematuria among the groups was significant (p> 0.001), being more frequent in the group without prednisone neither MMF (68 %). There were no significant differences in proteinuria, hypertension or creatinine among the groups. The median of years between the renal biopsy and the last control was 4 years RI 1-7. At five years, the renal function survival probability (GFR >90 ml/min/1.73m2) was 89.1 %. Conclusion: IgAN needs early recognition and strict follow-up, since it may have ominous outcomes.

La Junta Directiva del Banco de la República, de conformidad con lo previsto en el artículo 5° de la Ley 31 de 1992, presenta a consideración del honorable Congreso de la República su Informe al Congreso en el cual se detallan las medidas que ha tomado el Banco de la República en el marco de la emergencia generada por el Covid-19 y se presentan los resultados macroeconómicos del primer semestre de 2021 y las perspectivas para lo que resta del año. Adicionalmente, se describe la composición de las reservas internacionales y su rendimiento, la situación financiera de la Entidad y sus proyecciones, y la evolución de los pagos en la economía colombiana.

Introduction and objective: The Dental Fluorosis (DF) is a development defect of enamel resulting from overexposure to fluoride and can aesthetically compromise the patient. This study aims to investigate the relationship between aesthetic perception and dental fluorosis (DF) in a low-income community with high DF prevalence. Materials and methods: A cross-sectional study was conducted with 171 Colombian schoolchildren aged 8 to 12 years living in low socioeconomic community (El Cedro, district of Ayapel, Córdoba, Colombia). After receiving authorization, the students were examined for DMFT and dmft indexes (WHO criteria), and for DF (TF index). The aesthetic perceptions were verified by the Child Perceptions Questionnaire About Tooth Appearance (CQATA). Data analysis was carried out using descriptive statistics, the chi-square test, the Student´s t-test, the one-way ANOVA test, and linear regression at a significance level of p ≤ 0.05. Results: The prevalence of DF in this sample was 84.8% (n=145). Only the presence of caries (DMFT/ deft≠ 0) had a significant impact on aesthetic perceptions. A significantly lower rate was found in girls for the report of pleasant color domain. The number of teeth affected by DF had a significant positive correlation with mean overall perception of dental health. Conclusion: The presence of mild DF in children with low socioeconomic status, from a population with a high prevalence of the condition, did not seem to have an impact on the report of pleasant color of teeth domain. Resumo Introdução e Objetivo: A fluorose dentária (FD) é um defeito de desenvolvimento do esmalte decorrente da sobre-exposição ao flúor e pode comprometer esteticamente o paciente. O presente estudo se propõe a investigar a relação entre percepção estética e fluorose dentária em uma comunidade de baixa renda com alta prevalência de FD. Materiais e métodos: Foi realizado um estudo transversal com 171 escolares colombianos de 8 a 12 anos de idade, moradores de uma comunidade de baixa renda (El Cedro, distrito de Ayapel, Córdoba, Colômbia). Após receber autorização, os estudantes foram examinados para os índices CPOD e ceod (OMS) e para o FD (TF index). As percepções estéticas foram verificadas pelo “Child Perception Questionaire about Teeth Appearence” (CQATA). A análise dos dados foi realizada por meio de estatística descritiva, teste do qui-quadrado, teste t de Student, teste ANOVA one-way e regressão linear em nível de significância de p ≤ 0,05. Resultados: A prevalência de FD nesta amostra foi de 84,8% (n = 145). Apenas a presença de cáries (CPOD/cpod≠0) teve um impacto significativo nas percepções estéticas. Uma taxa significativamente menor foi encontrada em meninas para o relato de domínio de cor agradável. O número de dentes afetados pela FD teve correlação positiva significativa com a percepção geral da saúde bucal. Conclusão: A presença de FD leve em crianças com baixo nível socioeconômico, de uma população com alta prevalência da doença, não parece ter impacto na satisfação com a coloração dos dentes. Resumen Introducción y objetivo: La fluorosis dental (FD) es un defecto en el desarrollo del esmalte como resultado de la sobreexposición al fluoruro y puede comprometer estéticamente al paciente. Este estudio tiene como objetivo investigar la relación entre la percepción estética y la fluorosis dental en una comunidad de bajos ingresos económicos y con alta prevalencia de FD. Materiales y métodos: Se realizó un estudio transversal con 171 escolares de 8 a 12 años que viven en una comunidad socioeconómica baja (El Cedro, distrito de Ayapel, Córdoba, Colombia). Los estudiantes fueron examinados para caries dentaria (índices DMFT y dmft (criterios de la OMS) y para el fluorosis dentaria (índice TF). La percepción estética se verifico con el cuestionario sobre percepciones de los niños sobre la apariencia de los dientes (CQATA). El análisis de los datos se realizó mediante estadísticas descriptivas y las pruebas de chi cuadrado, t de Student, ANOVA de una vía y la regresión lineal (p ≤ 0.05). Resultados: La prevalencia de FD fue de 84.8% (n = 145). Solo la presencia de caries (DMFT/deft ≠ 0) tuvo un impacto significativo en las percepciones estéticas. Se encontró una tasa significativamente más baja en las niñas para el informe acerca de color agradable. La cantidad de dientes afectados por FD tuvo una correlación positiva significativa con la percepción general de la salud dental. Conclusión: La presencia de FD leve en niños con bajo nivel socioeconómico, en una población con una alta prevalencia de este defecto de esmalte, no pareció tener tuvo un impacto en la aceptción aceptar la apariencia del color de los dientes.

Made available in DSpace on 2022-04-28T19:40:31Z (GMT). No. of bitstreams: 0 Previous issue date: 2021-07-01 Department of Morphology Genetics Orthodontics and Pediatric Dentistry São Paulo State University (Unesp) Universidad CES Child and Adolescent Oral Health Department Federal University of Minas Gerais Department of Morphology Genetics Orthodontics and Pediatric Dentistry São Paulo State University (Unesp)

Made available in DSpace on 2022-04-29T08:31:02Z (GMT). No. of bitstreams: 0 Previous issue date: 2021-12-01 Background: Dental fluorosis (DF) has been one of the most prevalent pediatric dental conditions associated with aesthetic concern and treatment needs. This study aimed to identify the longitudinal clinical change in the severity of DF in 8–12-year-old children and its association with gender, age, severity, and tooth type. Methods: This observational study assessed the dental aspects of the 92 Colombian children in 2015 (mean age at beginning 9.71 years ± 1.23) and 2018 (mean age 13.69 years ± 1.41), from an area with high DF prevalence. DF was recorded in all permanent teeth by two calibrated examiners using the Thylstrup and Fejerskov Index (TFI). DF severity change (maximum-TFI-score) was analyzed with descriptive analysis at the tooth level. Associated factors were evaluated with the generalized linear model, binomial family, and logarithmic link function. Results: TFI scores ranged between 1 (very mild) to 6 (severe), being score 2 (41.7%) the most prevalent. After three years, 29.6% of the teeth presented score reduction, 24.1%, increased and 46.3% did not change; the significant association was related to increasing of the basal TFI = 1 score (44.2%) (RR = 9.7; 95% CI 1.7–56.5; p = 0.01) and with canines, premolars and second-permanent-molars teeth group (RR = 3.3; 95% CI 1.9–5.6; p = 0.005). Conclusion: The present study based on clinical features about DF confirms the dynamic post-eruptive nature of this condition. After three years of follow-up, a considerable proportion of the teeth changed to a higher score. Furthermore, the canines, premolars, and second-permanent-molars showed a higher incidence of an increase in severity of TFI score. Department of Pediatric Dentistry and Orthodontics São Paulo State University (Unesp) Araraquara School of Dentistry, Rua Humaitá, 1680 Research Department School of Dentistry CES University School of Medicine CES University Department of Pediatric Dentistry and Orthodontics São Paulo State University (Unesp) Araraquara School of Dentistry, Rua Humaitá, 1680

Made available in DSpace on 2021-06-25T11:01:55Z (GMT). No. of bitstreams: 0 Previous issue date: 2021-01-01 Aim: The aim of this study was to evaluate caries diagnosis and treatment decisions made by undergraduate dental students based on ICDAS or Nyvad criteria. Methods: Twelve students analyzed 90 digital photographs of permanent teeth at different clinical stages of carious lesion development and chose among different treatments in three different assessments: when there was no knowledge of the criteria (described as “No knowledge (N)”; when there was theoretical knowledge of the criteria (described as “Theoretical knowledge (T)” and when there was theoretical knowledge, clinical experience about dental caries and the criteria (described as “Theoretical and clinical knowledge (TC)”. For “T” and “TC” the students were randomized into two experimental groups – ICDAS or Nyvad (experimental units: 6 students/group). The reference standard was established cooperatively by two experienced researchers. Criteria performance was evaluated by sensitivity, specificity, AUC, and Kappa statistics. Treatment decision was described in percentage by contingency tables and Spearman’s correlation with the reference standard. Results: The first assessment demonstrated a high percentage of operative treatment even for initial enamel lesions based on ICDAS criteria and treatment was proposed for both active and inactive lesions, according to the Nyvad criteria. In the second assessment, the students continued recommending treatments for initial or inactive lesions, but less frequently. In the third assessment, treatment decisions presented greater cohesion in relation to the assigned classification criterion. The criteria presented no differences between them in terms of diagnostic in the third assessment. Conclusion: Clinical experience may improve caries detection and treatment decisions with the use of ICDAS and Nyvad criteria. Department of Morphology Genetics Orthodontic and Pediatric Dentistry Araraquara School of Dentistry São Paulo State University (UNESP) CES University Faculty of Dentistry Department of Morphology Genetics Orthodontic and Pediatric Dentistry Araraquara School of Dentistry São Paulo State University (UNESP)

Deciduous molar hypomineralization (DMH) is an enamel defect of systemic and multifactorial origin that affects the second deciduous molar. Currently, its treatment is based on guidelines for Molar Incisor Hypomineralization (MIH), a disturbance that affects permanent molars and may or may not be associated with permanent incisors. To date, there are no guidelines for DMH. Therefore, three different therapeutic approaches are presented to treat DMH, emphasizing the relevance of early diagnosis, differential diagnosis and treatment options, and tailored to take into account each patient's and parents' specific needs, as well as the involved tooth, severity of DMH, patients' symptoms and behaviour. CPD/Clinical Relevance: To understand the clinical implications of DMH since the diagnosis and delayed treatment of this enamel alteration could have important complications in both the primary and permanent dentition.

Este artículo analiza cómo la tenue participación de actores no estatales –como las barras populares–, dentro del “Plan Decenal de Seguridad Comodidad y Convivencia en el fútbol (2014-2024)”, afecta su proceso de implementación. A partir de la perspectiva de teórica anidada de Howlett y el debate de la gobernanza, se evidencia la fragilidad de la política en cuanto a su instrumentación (específicamente en términos de recursos y organización) y la ausencia de legitimidad y eficacia por la falta de inclusión, y concluye que el desarrollo de canales participativos de carácter interactivo coadyuva a la efectividad de la política. Se realiza un análisis comparativo entre Cali y Medellín.

Membrane separation processes are efficient and sustainable alternatives to energy intensive distillation operations. In gas separations, polymeric membranes dominate the landscape of industrial applications and many improvements in performance hinge on the ability to tailor the chemistry of polymeric materials. The basic goal in membrane separations is to control the solubility and diffusivity of the chemical compounds in order to tailor the relative magnitude of the fluxes of the chemical species across the membrane. In this paper, we introduce a fundamentally new separation device that uses an anisotropic polymeric membrane to guide molecular transport to specific spatial locations. Our proposed separation device enables to manipulate the flux direction of compounds, in addition to the flux magnitude, thus adding a new tool to separate chemical species. We report unprecedented selectivities for O2/N2 separation – up to two orders of magnitude larger than conventional membranes.

Background:Congenital anomalies of the kidney and urinary tract (CAKUT) are the leading cause of end stage renal disease in children. Diagnosis by genetic testing has proven challenging due to its genetic and phenotypic heterogeneity, as well as incomplete penetrance. We report a case on a 16-months old female with a history of renal cysts and a PAX2 mutation.Case presentation:The patient presented with a prenatal diagnosis of Potter sequence and a postnatal diagnosis of renal cysts. An ultrasound at 20 weeks gestation revealed right renal agenesis and possible left renal dysplasia. Post natal genetic analyses identified a novel mutation in PAX2.Conclusion:Cystic kidney disease is often underdiagnosed due to its variable expressivity and wide range of clinical manifestations; PAX2 genetic screening should be considered for all patients with CAKUT.

Made available in DSpace on 2021-06-25T11:14:08Z (GMT). No. of bitstreams: 0 Previous issue date: 2021-01-01. Added 1 bitstream(s) on 2021-07-15T15:24:14Z : No. of bitstreams: 1 S1806-83242021000100233.pdf: 574796 bytes, checksum: 82012df6c1f7c4984f787a9b73ee379b (MD5) The aim of this study was to investigate the segregation patterns of molar incisor hypomineralization (MIH) in families, given the evidence that its etiology is influenced by genetics. Clinically, MIH may be detected in parents and/or siblings of MIH-affected children. Our study included children with at least one first permanent molar affected by MIH (proband) and their first-degree relatives (parents and siblings). The participants were examined clinically to detect MIH, according to the European Academy of Paediatric Dentistry criteria (2003). A total of 101 nuclear families (391 individuals) were studied. Proband diagnosis was followed by MIH classification of the subject, his parents and siblings, as affected, unaffected, or unknown. Segregation analysis was performed using the multivariate logistic regression model of the Statistical Analysis for Genetic Epidemiology package, and segregation models (general transmission, environmental, major gene, dominant, codominant and recessive models). The Akaike information criterion (AIC) was used to evaluate the most parsimonious model. In all, 130 affected individuals, 165 unaffected individuals, and 96 unknown individuals were studied. Severe MIH was found in 50.7% of the cases. A segregation analysis performed for MIH revealed the following different models: environmental and dominance (p = 0.05), major gene (p = 0.04), codominant (p = 0.15) and recessive models (p = 0.03). According to the AIC values, the codominant model was the most parsimonious (AIC = 308.36). Our results suggest that the codominant model could be the most likely for inheriting MIH. This result strengthens the evidence that genetic factors, such as multifactorial complex defect, influence MIH. Universidade Estadual Paulista - UNESP school of Dentistry Department of Morphology Genetics Orthodontics and Pediatric Dentistry Universidade CES - Basic and Clinical Research Group in Dentistry School of Dentistry Universidade Federal do Paraná - UFPR School of Dentistry Department of Stomatology PR Universidade Estadual de Campinas - Unicamp School of Medicine Department of Medical Genetics and Genomic Medicine Universidade Estadual de Campinas - Unicamp School of Medical Science Department of Medical Genetics Universidade Estadual Paulista - UNESP school of Dentistry Department of Morphology Genetics Orthodontics and Pediatric Dentistry

The development of good governance practices is necessary for every type of institution. The mitigation of conflicts of interest and an appropriate balance of powers must be sought between governance actors to ensure organizations work toward the common purpose and avoid being held hostage by the interests of a particular individual or group of stakeholders. Higher Education Institutions (HEIs) in Colombia are nonprofit by law. The absence of shareholders, or owners in general, in these organizations imposes specific challenges in terms of mitigating conflicts of interest. Colombia’s Ministry of Education is aware of this, and together with other education sector government agencies, teachers, deans, and rectors of various institutions have in the past decade participated in discussions on the need to encourage good governance at the country’s HEIs. These discussions have led to concrete actions being implemented, but at the same time revealed the need for further work. In this chapter, we propose a course of action that Colombia, and indeed any country in Latin America and beyond, can follow in order to encourage the implementation of good governance practices in HEIs.

Made available in DSpace on 2021-06-25T11:03:17Z (GMT). No. of bitstreams: 0 Previous issue date: 2021-01-01 Objectives. To analyze changes in the dental fluorosis (DF) incidence according to a birth cohort and explore current exposure to DF in a case series. Methods. Repeated cross-sectional study of two periods: 2015 and 2018. Two standardized examiners registered DF using the Thylstrup-Fejerskov index in permanent teeth of children aged 7-18 years. Period and birth cohort frequencies were estimated by a generalized linear model, binomial family, and logarithmic link function. Period estimates are presented as prevalence ratios (PR) and birth cohort estimates as cumulative incidence ratios (RR); 95% confidence intervals and P values are reported. In a subsample of 37 volunteers (12.29 ± 2.63 years), the fluoride (F) concentration in toenails was measured using the HMDS diffusion method and an ion-specific electrode. Other samples from the local environment such as food, soil, and coal were also collected. Results. In 274 children, we found that nonsignificant increases between periods (PR = 1.17; 95% CI: 0.89-1.55) were not explained by birth cohort effects. A total of 37.8% of the subsample had a toenail F concentration ≥2 μg F/g. The salty snacks and seasoning had the highest F concentrations among local environmental samples. Conclusion. In this population with a high DF frequency according to birth cohort and the evaluated period, the study of soil, coal, and food samples indicated a continued F exposure. F concentration found in the toenails shows a moderate F exposure; nearly a third of the children and adolescents exceeded the adopted threshold of 2 μg F/g. It is important to monitor and explore changes in exposure in highly affected population. Graduate Program in Dental Science São Paulo State University (UNESP) School of Dentistry School of Dentistry CES University School of Medicine CES University Department of Biological Sciences University of São Paulo (USP) Bauru School of Dentistry Department of Morphology and Orthodontics and Pediatric Dentistry São Paulo State University (UNESP) School of Dentistry Graduate Program in Dental Science São Paulo State University (UNESP) School of Dentistry Department of Morphology and Orthodontics and Pediatric Dentistry São Paulo State University (UNESP) School of Dentistry

BackgroundAcute kidney injury is frequent in critically ill children; however, it varies in causality and epidemiology according to the level of patient care complexity. A multicenter prospective cohort study was conducted in four medium-complexity pediatric intensive care units from the Colombian southeast aimed to estimate the clinical prognosis of patients with diagnosis of acute kidney injury.MethodsWe included children >28 days and ResultsPrevalence at admission of acute kidney injury was 5.2% (95%CI 4.3% to 6.2%). It was found that 71% of the patients had their maximum KDIGO on day one; an increment in the maximum stage of acute kidney injury increased the pediatric intensive care unit stay. Patients with maximum KDIGO 3 were associated with greater use of mechanical ventilation (47%), compared with maximum KDIGO 2 (37%) and maximum KDIGO 1 (16%). Eight patients with maximum KDIGO 2 and 14 with maximum KDIGO 3 required renal replacement therapy. Mortality was at 11.8% (95%CI 6.4% to 19.4%).ConclusionAcute kidney injury, established and classified according to KDIGO as severe and its maximum stage, was associated with worse clinical outcomes; early therapeutic efforts should focus on preventing the progression to severe stages.

Emissão de Raios-X Induzidos por Prótons. Fluorescência de Raios-X. PIXE. XRF. Quantificação Elementar. Quantificação do Hidrogênio. Among various analytical techniques, X-Ray Fluorescence (XRF) and Particle-Induced X-Ray Emission (PIXE) allow a highly sensitive, multi-elementary analysis, traditionally used in areas dealing with thin films, mineral, geological, archaeological and biological samples, etc. PIXE and XRF techniques allow quantifying the elemental composition of a sample measuring their characteristic X-rays. In thick homogeneous samples, the determination of the elemental mass concentrations requires prior knowledge of several parameters involved in the interaction of radiation with matter, such as the proton stopping power in the sample for PIXE and the X-ray mass absorption coefficients for both PIXE and XRF, which in turn depend on the elemental concentrations of the sample. In this work we will review and evaluate different methods for determining the mass concentrations that have been developed over the years, obtaining good accuracy in most cases, especially with geological and mineral samples. In samples with low-Z elements, like H, B, C, N, O and/or F, not detected in PIXE nor XRF, the methods to determine elemental concentrations do not have the same level of accuracy, except for major elements. Knowing the concentrations of these major elements, we can extract information of the undetected elements in the samples. We suggest a method for determining the concentrations of trace elements based on the knowledge of at least two major elements, constructing an equivalent sample-matrix constituted by hydrogen, carbon and oxygen with the same X-ray mass absorption coefficients and proton stopping power of the original sample-matrix made of hydrogen, carbon, nitrogen and oxygen, which are the major elements in biological and organic samples. Hence, the trace elements of the sample can be fully analyzed with an accuracy better than 1%. In PIXE analysis, under certain conditions, numerical calculations on thick and homogeneous samples show that on common materials, it is possible to retrieve the hydrogen amount in the sample with acceptable accuracy. The calculation of the uncertainties indicates that the method of determining hydrogen is quite sensitive to instrumental uncertainties, stressing the need for more precise PIXE measurements. A generalization of the method is also considered for all kinds of low-Z sample-matrix, not only biological or organic, having accuracies lower than 10%. Other applications and limitations are also discussed.

Introduction: The transition to youth in children and adolescents with chronic kidney disease (CKD) brings many changes that nursing professionals must incorporate in care protocols for health promotion and prevention of kidney disease. Objective: To deepen, in people on dialysis therapy, the meaning of have lived the transition childhood, adolescence, youth with CKD. Methodology: Qualitative study, following Grounded Theory in data. Nine participants aged between 18 and 24 years. The data collection was carried out through in-depth interviews and under the criteria of credibility, auditability and transferability. Findings: Through codification data, theoretical sampling and the constant comparative method, emerged three categories: 1) Childhood: Stage of normality, without recognition of latent kidney disease, 2) Adolescence: an awakening stage when a health issue is confirmed, uncertainty about the life project and final acceptance of dialysis therapy as a way of survival and 3) Youth: transplantation, a hope for a life change. Conclusion: The transition from childhood to youth in people with CKD, is a journey that begins in childhood, in disregard of the health problem; continues into adolescence with uncertainty for the construction of a life project given the dependence on dialysis therapy; and finally, in youth, with entry into kidney transplant program, it is transformed into a hope for a life change.

Proporcionar a los profesionales de la salud, conocimientos básicos en la detección, abordaje y seguimiento de las anomalías congénitas del riñón y de la vía urinaria. Materiales y métodos: Revisión no sistemática de la literatura, se accedió a las bases de datos PubMed, LILACS, Science Direct, Tripdatabase, Cochrane Library, Biblioteca Virtual en Salud y revistas de nefrología pediá- trica. Se incluyeron publicaciones de los últimos 25 años. Se utilizaron los términos MeSH “Congenital Anomalies of the Kidney and Urinary Tract, Hydronephrosis, risk factors, prenatal diagnosis, congenital abnormalities”. Resultados: Se han identificado dos importantes factores de riesgo para desarrollar estas patologías, el primero la Diabetes pregestacional, es decir“, aquella diabetes conocida previamente a la gestación, bien diabetes mellitus tipo 1 (DM1), diabetes mellitus tipo 2 (DM2) o intolerancia a los carbohidratos”, en segundo lugar el bajo o tardío consumo de micronutrientes de la gestación. Conclusiones: La diabetes mellitus pregestacional y el bajo consumo de micronutrientes antes o durante la gestación, se ven relacionado con el desarrollo de las anomalías renales y de la vía urinaria en el feto, aunque no las explican en la mayoría de casos.