Estudio epidemiológico de salud oral en población escolar del Estado Mexicano de Tabasco

ESTUDIO EPIDEMIOLÓGICO DE SALUD ORAL EN POBLACION ESCOLAR DEL ESTADO MEXICANO DE TABASCO Objetivos: Valorar el estado de salud oral de la población escolar del Estado de Tabasco, México, determinando los índices de caries dental y la prevalencia en escolares con cohortes de 6, 12 y 15 años, mediante el criterio ICDAS. Analizar la relación que existe entre los niveles de caries y el Índice Periodontal Comunitario con los diferentes estratos sociales y determinar la prevalencia de los Defectos de Desarrollo del Esmalte (DDE) y la Fluorosis en dicha población. Comparar la equivalencia entre los criterios diagnósticos de caries de la Organización Mundial de la Salud (OMS) y el Sistema Internacional para la Detección y Evaluación de la Caries (ICDAS), la influencia del factor socioeconómico y la tendencia epidemiológica de la caries dental en el Estado de Tabasco así como el acceso a los servicios odontológicos por parte de la población estudiada. Material y método: El estudio epidemiológico de salud oral en población escolar del Estado Mexicano de Tabasco se desarrolla dentro del marco de la 3ª. Encuesta Nacional de Caries y Fluorosis Dental 2010 en los Estados Unidos Mexicanos, aportando de manera novedosa la utilización de un criterio internacional para la detección y evaluación de la caries dental (ICDAS), que codifica los diferentes estadios de esta enfermedad desde su etapa inicial (desmineralización) hasta la lesión franca (cavitación). Este estudio es una encuesta epidemiológica, de corte transversal descriptivo y observacional. El universo del estudio está formado por la población escolar de 6, 12 y 15 años de edad, de los 17 municipios que conforman el Estado de Tabasco en México, y que cuentan con centros de Educación Primaria y Secundaria. Se ha realizado un muestreo estratificado y por conglomerados, considerando los municipios como estratos y las escuelas como conglomerados, por lo que cada estrato (municipio) cuenta con una serie de conglomerados (escuelas). Se obtuvo una muestra de 500 niños (n= 500) por cada grupo etario (6, 12 y 15 años), que fueron examinados en 54 centros escolares públicos y privados, 25 de ellos escuelas primarias y 29 secundarias. El número total de escolares explorados fueron 1.500, de los cuales 762 (50,9%) eran de sexo masculino y 738 (49,1%) femenino. Las exploraciones del estudio se llevaron a cabo con un único examinador estandarizado con el criterio ICDAS (Kappa 0,91) y certificado por la Organización ICDAS. El trabajo de campo se realizó entre octubre de 2011 y mayo de 2012. El material utilizado en las exploraciones fue el recomendado por el manual de encuestas de la OMS como son los espejos bucales planos # 5 (Single-sided) (HuFriedy®), sondas periodontales PCP 11.5 B (HuFriedy®), además del necesario para valorar las lesiones incipiente según el criterio ICDAS, una linterna tipo minero con luz LED blanca 1w (Nitrolite®) y peras de aire para el secado de las superficies dentales. En nuestra investigación se registraron diferentes variable como fueron: caries dental , estado periodontal, defectos de desarrollo del esmalte (hipoplasia), fluorosis dental, nivel socioeconómico (Estrato social), materiales de obturación incluidos selladores de fosas y fisuras, necesidad inmediata de asistencia y/o consulta, utilización de servicios de odontológicos y de que tipo. Los datos fueron analizados por el programa SPSS ® v 18.0 y se determinaron las medias e intervalos de confianza para las variables cuantitativas y proporciones para las variables categóricas. Se emplearon las pruebas T de Student y ANOVA para comparar medias y Chi cuadrado para las proporciones. Resultados y discusión: En la cohorte de 6 años el índice cod (ICDAS 1-6) fue de 3,52 y el cod (ICDAS 4-6) de 1,87, por otra parte en la cohorte de 12 y 15 obtuvimos con el índice CAOD (ICDAS 1-6) de 3,27 y 5,39, mientras que con el mismo índice con (ICDAS 4-6) obtenemos un ,83 y 1,78 respectivamente. En cuanto a la prevalencia de caries, que incluye todas las lesiones detectadas bajo el criterio ICDAS, en los niños de 6 años se sitúa en un 70,4%. En los escolares de 12 años, este porcentaje es muy similar alcanzando un 71,8%, y a los 15 años se obtiene la prevalencia más alta con un 84,8%. En el año 2001, el grupo etario de 12 años presentaba un ICAOD de 2,2 con una prevalencia del 68,9%. En el año 2011 el dato que se obtiene de este índice es de 1,28 con una prevalencia de 36,7%. La equivalencia entre los criterios diagnósticos de caries OMS e ICDAS se encuentra a partir del grado 5, es decir cuando solamente se considera caries severa (grados 5 y 6 de ICDAS). Entre un 23% y un 30% de los niños encuestados presentan una buena salud periodontal. A los 6 años la media de sextantes con sangrado gingival era de 2,86, y a los 12 y 15 años de 2,44 y 2,41 respectivamente. El valor medio del IPC, para las tres cohortes de edad se situó alrededor de 0,5. La prevalencia de Defectos de Desarrollo del Esmalte a los 6 años es de un 3,4%, aumentando hasta un 7,8% y un 13,6% a los 12 y 15 años respectivamente. El 98,4% de los escolares no presentaban ningún grado de fluorosis dental. En Tabasco los servicios odontológicos se encuentran infrautilizados. Sólo un 53,7% de los escolares entrevistados a los 6 años hacen uso de ellos. A los 12 y 15 años, este porcentaje se reduce hasta un 41,2% y un 42,1% respectivamente. El servicio público es utilizado con mayor frecuencia que la consulta odontológica privada. Conclusiones: Un bajo nivel socioeconómico se relaciona con un mayor índice de lesiones cariosas. Se observa una tendencia lineal entre la prevalencia de caries y la clase social, ya que ésta aumenta a medida que la clase social disminuye. La tendencia epidemiológica de la caries en el Estado de Tabasco en el periodo comprendido entre 2001 y 2011 es descendente. Un bajo nivel socioeconómico se relaciona con una mayor presencia de lesiones cariosas. Además, la peor condición periodontal se asocia a los estratos socioeconómicos más desfavorecidos. El criterio diagnóstico ICDAS nos da información relevante sobre la presencia de caries en sus primeros estadios, y podría dar un nuevo enfoque de los programas de salud hacia la detección y tratamiento temprano de estas lesiones.Epidemiological study of oral health in Schoolchildren in the Mexican State of Tabasco Objectives: To evaluate the state of oral health in school children of the Mexican State of Tabasco, whilst defining the indices for dental caries and the prevalence in cohorts of 6, 12 and 15 years of age, through the use of ICDAS criteria. Also to analyse the relationship between the levels of caries and the community periodontal index with the various social classes and determine the prevalence of developmental defects of the enamel and fluorosis in said population. Compare the equivalence between the caries diagnostic criteria of the World Health Organisation (WHO) and the International Caries Detection and Assessment System (ICDAS), the influence of the socio-economic factor and the epidemiologic tendency for dental caries in the State of Tabasco as well as the access to dental services at studied population. Materials and methods: A descriptive observational cross-sectional epidemiology study of oral health was performed using cluster sampling in school children in the 17 municipalities that conform the Mexican state of Tabasco. This survey was developed within the 3rd National Dental Caries and Fluorosis 2010 Survey of Mexico, using for the very first time in this State an international criteria for the detection and evaluation of dental caries (ICDAS) as a new way to perform dental examinations, which outlines the different stages of disease from its initial stage (demineralization) to an advanced lesion (cavitation). The whole study was performed in school children of 6, 12 and 15 years of age, enrolled in primary and secondary educational centers. Considering each municipality as a stratum and each school as a conglomerate, so each stratum (municipality) had a series of conglomerates (schools). A sample of 500 children (n = 500) was obtained for each age group (6, 12 and 15 years), which were examined out of 54 public and private schools, 25 of them were primary schools and 29 secondary schools. The total number of students studied was 1,500, of which 762 (50.9%) were male and 738 (49.1%) female. A single standardized and certified ICDAS examiner, whose weighted kappa value for intra-examiner reproducibility was 0.91, performed dental examinations. Fieldwork was carried out between October 2011 and May 2012. The material used was that recommended by the WHO Oral health surveys, such as the single-sided (HuFriedy®) mouth mirrors, Periodontal probes PCP 11.5 B (HuFriedy®). Additionaly, to evaluate the incipient lesions according to the ICDAS criteria, a lamp with white LED light 1w (Nitrolite®) and air blowers for drying the dental surfaces were used. Different variables were recorded such as: dental caries, periodontal status, developmental defects of enamel (hypoplasia), dental fluorosis, filling materials including pits and fissure sealants, socioeconomic level (social class), the need for immediate treatment and / or consultation, the use of dental services and of which type. The data was analyzed by SPSS ® version 18.0 and the means and confidence intervals were determined for the quantitative variables and proportions for the categorical variables. Student’s t-test and ANOVA tests were conducted in order to compare means and Chi Square for proportions. Results and Discussion: In the 6-year cohort the dmf index (ICDAS 1-6) was 3.52 and the dmf (ICDAS 4-6) was 1.87, on the other hand in the cohort of 12 and 15 years old, we obtained a DMFT index (ICDAS 1-6) of 3.27 and 5.39, while with the (ICDAS 4-6) we obtained 0,83 and 1,78 respectively. Regarding the prevalence of caries, which includes all the lesions detected under the ICDAS criteria, in 6-year-old children it is 70.4%. In 12-year-old schoolchildren, this percentage is very similar reaching 71.8%, and at 15 years the highest prevalence is obtained with 84.8%. In 2001, the 12-year old age group had a DMFT Index of 2.2 with a prevalence of 68.9%. and in 2011 the data obtained from this index was 1.28 with a prevalence of 36.7%. The equivalence between the diagnostic criteria of WHO and ICDAS for caries is found at grade 5 and above, this means only at the point when caries are considered severe (grades 5 and 6 of ICDAS). Between 23% and 30% of the children surveyed have good periodontal health. At 6 years the mean of sextants with gingival bleeding was 2.86, and at 12 and 15 years was 2.44 and 2.41 respectively. The mean value of the Community Periodontal Index (CPI) in the three cohorts was around 0.5. The prevalence of Developmental Defects of Enamel (DDE) at 6 years was 3.4%, increasing to 7.8% and 13.6% at 12 and 15 years respectively. 98.4% of the students did not present any degree of dental fluorosis. In Tabasco dental services are underused. Only 53.7% of the students interviewed at age 6 use them. At age 12 and 15, this percentage falls to 41.2% and 42.1%, respectively. The dental public health service is used more frequently than private dental practices. Conclusions: Low socioeconomic status is associated with a higher index of carious lesions. There is a linear trend between the prevalence of caries and social class. As social class decreases, the prevalence of caries increases. The epidemiological trend of dental caries in the State of Tabasco in the period between 2001 and 2011 is descending. A low socioeconomic level is associated with a greater presence of carious lesions. In addition, a worse periodontal state is associated with the lowest socio-economic classes. The ICDAS diagnostic criteria gives us relevant information about the presence of caries in its early stages and could give a new approach to the health programs towards the early detection and treatment of these lesions

In vivo study of different methods for diagnosing pit and fissure caries

Background: In recent years the early detection of such caries has gained importance, since it may avoid unnecessary dental tissue damage and allow minimally invasive dental treatment. A study is made of 5 systems for diagnosing caries: traditional visual and tactile methods, DIAGNOdent, VistaProof and CarieScan. Material and Methods: A prospective study was made in the Department of Stomatology, Dental Pathology and Therapeutics Teaching unit of the University of Valencia (Valencia, Spain), involving the analysis of 32 teeth (molars or premolars of both arches scheduled for filling or for use as posts in dental bridges) in 28 patients. The following caries diagnostic methods were applied: visual, tactile, DIAGNOdent (KAvo, Biberach, Germany), VistaProof (Dürr Dental AG, Bietigheim-Bissingen, Germany) and CarieScan (IDMoS Dental Systems, Dundee, Scotland, United Kingdom). Fissurotomy was subsequently performed for histological validation. Results: Visual inspection showed an area under the receiver operating characteristic curve (AUC-ROC) of 0.75, with a sensitivity and specificity of 0.75. Tactile diagnosis in turn showed AUC = 0.714, with maximum sensitivity (100%) and a specificity of 42.9%. DIAGNOdent (cutoff point 22.5) and VistaProof (cutoff point 1.1) showed AUC = 0.969, while CarieScan (cutoff point 21.5) presented AUC = 0.973. These latter three methods all had a sensitivity of over 92%. The specificity of DIAGNOdent was maximum, while that of CarieScan and VistaProof was 75%. Conclusions: The emergent methods in the diagnosis of caries (DIAGNOdent, VistaProof and CarieScan) yielded similar results, and in all cases proved superior to the traditional visual and tactile methods. DIAGNOdent was seen to be the most effective technique, followed by CarieScan and VistaProof

Creación de recursos educativos mediante enriquecimiento de contenidos

Actualmente existen numerosos sitios web que ofrecen acceso libre a sus contenidos a través de APIS web para crear servicios de valor añadido. En este proyecto se plantea generar recursos educativos para las asignaturas utilizando estas APIS

A combined micro-Raman, X-ray absorption and magnetic study to follow the glycerol-assisted growth of epsilon-iron oxide sol-gel coatings

[EN] Epsilon iron oxide (ε-FeO) coatings on Si(100) substrates are obtained by an easy one-pot sol-gel recipe assisted by glycerol in an acid medium. Glycerol, given its small dimensions, enables the formation of ε-FeO nanoparticles with a size of a few nanometers and the highest purity is reached in coatings after a densification treatment at 960 °C. The structural and compositional evolution up to 1200 °C is studied by confocal Raman microscopy and X-ray absorption spectroscopy techniques, correlating the existing magnetic properties. We report a novel characterization method, which allows monitoring the evolution of the precursor micelles as well as the intermediate and final phases formed. Furthermore, the inherent industrial technology transfer of the sol-gel process is also demonstrated with the ε-FeO polymorph, impelling its application in the coatings form.This work has been supported by the Ministerio de Ciencia e Innovación (MCINN, Spain) through the projects PIE: 2021-60-E-030, PIE: 2010-6-OE-013, PID2019-104717RB-I00 (2020–2022), MAT2017-86540-C4-1-R, RTI2018-095856-B-C21 (2019–2021), RTI2018-097895-B-C43 and RTI2018-095303-A-C52. The authors are grateful to The ESRF (France), MCINN and Consejo Superior de Investigaciones Científicas (CSIC, Spain) for the provision of synchrotron radiation facilities and to the BM25-SpLine Staff for their valuable help. A.S.and A.M.-N acknowledge financial support from Comunidad de Madrid (Spain) for an “Atracción de Talento Investigador” Contract 2017-t2/IND5395 and 2018-T1/IND-10360, respectivel

Further progress in the study of epsilon iron oxide in archaeological baked clays

[EN] The occurrence of ε-FeO in archaeological samples that have been subjected to high temperatures is gradually being detected by the use of micrometric structural characterization techniques. This work provides new information by revealing that the ε-FeO is formed as a response to temperature, the aggregation state and the position within the baked clay with respect to the nearest heat source. In addition, depending mainly on the atmospheric environment, the temperature reached by the combustion structure, the distance from the heating source and the particle aggregation, other iron oxide magnetic phases are produced. In the baked clay studied here, hematite is found over the whole range of samples studied but its magnetic contribution is negligible. Magnetite is observed at the sample surface, probably due to local atmospheric environment closest to the combustion source. Maghemite is found at all depths up to 6 cm below the sample surface. ε-FeO has a limited distribution, found within 2–3 cm of the sample surface. Furthermore, the viability of this compound as a palaeofield marker has been evaluated in both archaeological and synthetic samples. The results indicate that ε-FeO is able to register the direction of the magnetic field. Linear palaeointensity plots have been obtained in synthetic samples, although the value of the palaeofield could be, sometimes, overestimated.The authors also acknowledge the financial support from the Spanish Ministry of Science, Innovation and Universities under the projects RTI2018-095856-B-C21, CGL2017-87015-P, CGL2017-92285-EXP, CGL2017-92285-EXP/BTE, MAT2017-86540-C4-1-R, MAT2017-87072-C4-2-P and RTI2018-095303-A-C52, from Comunidad de Madrid NANOFRONTMAG S2013/MIT-2850 and NANOMAGCOST S2018/NMT-4321, and from the European Commission under H2020 frame by AMPHIBIAN Project ID: 720853. APO thanks the Ministry of Economy, Industry and Competitiveness (PTA Contract).Peer reviewe

Recommendations for the Treatment of Anti-Melanoma Differentiation-Associated Gene 5-positive Dermatomyositis-Associated Rapidly Progressive Interstitial Lung Disease

Objectives: The study aimed to develop evidence-based recommendations for the treatment of rapidly progressive interstitial lung disease (RPILD) associated with the anti-Melanoma Differentiation-Associated Gene 5-positive dermatomyositis (DM) syndrome. Methods: The task force comprised an expert panel of specialists in rheumatology, intensive care medicine, pulmonology, immunology, and internal medicine. The study was carried out in two phases: identifying key areas in the management of DM-RPILD syndrome and developing a set of recommendations based on a review of the available scientific evidence. Four specific questions focused on different treatment options were identified. Relevant publications in English, Spanish or French up to April 2018 were searched systematically for each topic using PubMed (MEDLINE), EMBASE, and Cochrane Library (Wiley Online). The experts used evidence obtained from these studies to develop recommendations. Results: A total of 134 studies met eligibility criteria and formed the evidentiary basis for the recommendations regarding immunosuppressive therapy and complementary treatments. Overall, there was general agreement on the initial use of combined immunosuppressive therapy. Combination of high-dose glucocorticoids and calcineurin antagonists with or without cyclophosphamide is the first choice. In the case of calcineurin antagonist contraindication or treatment failure, switching or adding other immunosuppressants may be individualized. Plasmapheresis, polymyxin B hemoperfusion and/or intravenous immunoglobulins may be used as rescue options. ECMO should be considered in life-threatening situations while waiting for a clinical response or as a bridge to lung transplant. Conclusions: Thirteen recommendations regarding the treatment of the anti-MDA5 positive DM-RPILD were developed using research-based evidence and expert opinion.This project was supported by Spanish Rheumatology Society and Spanish Society of Internal Medicine (GEAS, Study Group on Autoimmune Diseases)

Pancreatic metastases from renal cell carcinoma. Postoperative outcome after surgical treatment in a Spanish multicenter study (PANMEKID)

Background: Renal Cell Carcinoma (RCC) occasionally spreads to the pancreas. The purpose of our study is to evaluate the short and long-term results of a multicenter series in order to determine the effect of surgical treatment on the prognosis of these patients. Methods: Multicenter retrospective study of patients undergoing surgery for RCC pancreatic metastases, from January 2010 to May 2020. Variables related to the primary tumor, demographics, clinical characteristics of metastasis, location in the pancreas, type of pancreatic resection performed and data on short and long-term evolution after pancreatic resection were collected. Results: The study included 116 patients. The mean time between nephrectomy and pancreatic metastases' resection was 87.35 months (ICR: 1.51-332.55). Distal pancreatectomy was the most performed technique employed (50 %). Postoperative morbidity was observed in 60.9 % of cases (Clavien-Dindo greater than IIIa in 14 %). The median follow-up time was 43 months (13-78). Overall survival (OS) rates at 1, 3, and 5 years were 96 %, 88 %, and 83 %, respectively. The disease-free survival (DFS) rate at 1, 3, and 5 years was 73 %, 49 %, and 35 %, respectively. Significant prognostic factors of relapse were a disease free interval of less than 10 years (2.05 [1.13-3.72], p 0.02) and a history of previous extrapancreatic metastasis (2.44 [1.22-4.86], p 0.01). Conclusions: Pancreatic resection if metastatic RCC is found in the pancreas is warranted to achieve higher overall survival and disease-free survival, even if extrapancreatic metastases were previously removed. The existence of intrapancreatic multifocal compromise does not always warrant the performance of a total pancreatectomy in order to improve survival

Izaña Atmospheric Research Center. Activity Report 2015-2016

This report is a summary of the many activities at the Izaña Atmospheric Research Center to the broader community. The combination of operational activities, research and development in state-of-the-art measurement techniques, calibration and validation and international cooperation encompass the vision of WMO to provide world leadership in expertise and international cooperation in weather, climate, hydrology and related environmental issues

Morbid liver manifestations are intrinsically bound to metabolic syndrome and nutrient intake based on a machine-learning cluster analysis

Metabolic syndrome (MetS) is one of the most important medical problems around the world. Identification of patient ' s singular characteristic could help to reduce the clinical impact and facilitate individualized management. This study aimed to categorize MetS patients using phenotypical and clinical variables habitually collected during health check-ups of individuals considered to have high cardiovascular risk. The selected markers to categorize MetS participants included anthropometric variables as well as clinical data, biochemical parameters and prescribed pharmacological treatment. An exploratory factor analysis was carried out with a subsequent hierarchical cluster analysis using the z-scores from factor analysis. The first step identified three different factors. The first was determined by hypercholesterolemia and associated treatments, the second factor exhibited glycemic disorders and accompanying treatments and the third factor was characterized by hepatic enzymes. Subsequently four clusters of patients were identified, where cluster 1 was characterized by glucose disorders and treatments, cluster 2 presented mild MetS, cluster 3 presented exacerbated levels of hepatic enzymes and cluster 4 highlighted cholesterol and its associated treatments Interestingly, the liver status related cluster was characterized by higher protein consumption and cluster 4 with low polyunsaturated fatty acid intake. This research emphasized the potential clinical relevance of hepatic impairments in addition to MetS traditional characterization for precision and personalized management of MetS patients