Integrando Sonrisas

El estado de salud bucal de los niños con discapacidad, que concurren a la Fundación Florecer (Florencia, Prov. De Santa Fe),   presenta una perspectiva desoladora.  Se cree que la atención odontológica a personas con discapacidad, requiere preparación especial y equipo adicional. Quizás sí, pero no para orientar, educar a los padres y enseñar estrategias con alto componente preventivo de enfermedades bucales futuras. Impulsando actividades que determinen patrones de conductas favorables, considerando a todas las personas como sujetos con derechos y deberes. Entre esas actividades, se realizan talleres sobre prevención y cuidados de la salud, general y bucal. Se organizan grupos de trabajo, uno de promoción y educación para la salud con las familias y otro de atención clínica odontológica no convencional. Se efectúan  evaluaciones de proceso, las cuales son transversales a todas las actividades y al finalizar cada jornada, con encuestas ad hoc sobre las actividades realizadas. La salud bucal es parte de la salud general, y como tal debe expresarse al considerar las necesidades de las personas, es decir, involucra al paciente como una unidad armónica, íntimamente unido a su familia o a quien se ocupa de él, además adaptado a su ambiente geográfico, social, cultural, y económico. El abandono, la falta de planificación y el desinterés son la constante habitual. Las personas con discapacidad en nuestro país se ven forzados a sufrir una pésima higiene bucodental, debido a la falta de instrucción adecuada por el profesional. Asimismo se producen odontalgias recidivantes, dado la presencia de restos alimenticios adheridos a mucosas y dientes. Debido al  predominio de dietas blandas, cariogénicas, ricas en hidratos de carbono y con un alto contenido de sacarosa. Se debe considerar que el desconocimiento de los problemas bucodentales de los pacientes con discapacidad, asociado a sus propias reacciones emocionales y las de sus familiares, patologías, así como las actitudes del profesional, van a crear con toda seguridad la mayor barrera para acceder a su atención. Además hay que agregar a estos factores la coexistencia de inconvenientes psicosociales que agravan el cuadro general de salud de estos pacientes y de su comprensión para que la profesión odontológica pueda plantearse el problema e idear soluciones a la medida de estas necesidades, que no son las mismas en todos los pacientes según diferentes características, situación y tipo de discapacidad. Es necesario que todos los niveles de los sistemas de salud existentes sean más inclusivos y accesibles, sin discriminar,  y generando ajustes razonables que incluyan a todos.    

Life Quality Impairment Caused by Hookworm-Related Cutaneous Larva Migrans in Resource-Poor Communities in Manaus, Brazil

Hookworm-related cutaneous larva migrans (CLM) is a parasitic skin disease common in developing countries with hot climates. In resource-poor settings, CLM is associated with considerable morbidity. The disease is caused by animal hookworm larvae that penetrate the skin and migrate aimlessly in the epidermis as they cannot penetrate the basal membrane. Particularly in the rainy season, the intensity of infection is high with up to 40 larval tracks in an affected individual. Tracks are very itchy and are surrounded by a significant inflammation of the skin. Bacterial superinfection is common and intensifies the inflammation. The psychosocial consequences caused by CLM have never been investigated. We showed that CLM causes skin disease-associated life quality impairment in 91 patients with CLM. Skin disease-associated life quality was significantly impaired. The degree of impairment correlated to the intensity of infection and the number of body areas affected. After treatment with ivermectin, life quality was rapidly restored

Documenting the Recovery of Vascular Services in European Centres Following the Initial COVID-19 Pandemic Peak: Results from a Multicentre Collaborative Study

Objective: To document the recovery of vascular services in Europe following the first COVID-19 pandemic peak. Methods: An online structured vascular service survey with repeated data entry between 23 March and 9 August 2020 was carried out. Unit level data were collected using repeated questionnaires addressing modifications to vascular services during the first peak (March – May 2020, “period 1”), and then again between May and June (“period 2”) and June and July 2020 (“period 3”). The duration of each period was similar. From 2 June, as reductions in cases began to be reported, centres were first asked if they were in a region still affected by rising cases, or if they had passed the peak of the first wave. These centres were asked additional questions about adaptations made to their standard pathways to permit elective surgery to resume. Results: The impact of the pandemic continued to be felt well after countries’ first peak was thought to have passed in 2020. Aneurysm screening had not returned to normal in 21.7% of centres. Carotid surgery was still offered on a case by case basis in 33.8% of centres, and only 52.9% of centres had returned to their normal aneurysm threshold for surgery. Half of centres (49.4%) believed their management of lower limb ischaemia continued to be negatively affected by the pandemic. Reduced operating theatre capacity continued in 45.5% of centres. Twenty per cent of responding centres documented a backlog of at least 20 aortic repairs. At least one negative swab and 14 days of isolation were the most common strategies used for permitting safe elective surgery to recommence. Conclusion: Centres reported a broad return of services approaching pre-pandemic “normal” by July 2020. Many introduced protocols to manage peri-operative COVID-19 risk. Backlogs in cases were reported for all major vascular surgeries

High prevalence of

A helminthological survey of the intestinal parasites in stray dogs was conducted in urban and suburban area of Tacuarembó, Uruguay, during winter time. Eighty stray dogs captured in the city were necropsied. Seventy nine dogs (98.8 %) were positive for helminth infection. Seventy seven (96.3 %) were parasitized by hookworms. Two species of hookworms were found: Ancylostoma caninum 96.3 % and A. braziliense 49.4 %. This is the first report of the prevalence of A. braziliense in Uruguay. Considering that incidences of human cutaneous larva migrans caused by the migration of hookworms larvae were restricted mainly to the northen part of Uruguay and that only A. caninum were reported to be prevalent in the southen part, it is supposed that A. braziliense is the primary causative agent of human cutaneous larva migrans in Uruguay

Consequences of both coxsackievirus B4 and type 1 diabetes on female non-obese diabetic mouse kidneys

Despite the 2019 Executive Order on Advancing American Kidney Health Initiative, kidney disease has moved up in rank from the 9th to the 8th leading cause of death in the United States. A recent push in the field of nephrology has been to identify molecular markers and/or molecular profiles involved in kidney disease process or injury that can help identify the cause of injury and predict patient outcomes. While these studies have had moderate success, they have not yet considered that many of the health conditions that cause kidney disease (diabetes, hypertension, etc.) can also be caused by environmental factors (such as viruses), which in and of themselves can cause kidney disease. Thus, the goal of this study was to identify molecular and phenotypic profiles that can differentiate kidney injury caused by diabetes (a health condition resulting in kidney disease) and coxsackievirus B4 (CVB4) exposure (which can cause diabetes and/or kidney disease), both alone and together. Non-obese diabetic (NOD) mice were used for this study due to their susceptibility to both type 1 diabetes (T1D)-and CVB4-mediated kidney injury, in order to glean a better understanding of how hyperglycemia and viral exposure, when occurring on their own and in combination, may alter the kidneys’ molecular and phenotypic profiles. While no changes in kidney function were observed, molecular biomarkers of kidney injury were significantly up-and downregulated based on T1D and CVB4 exposure, both alone and together, but not in a predictable pattern. By combining individual biomarkers with function and phenotypic measurements (i.e., urinary albumin creatinine ratio, serum creatinine, kidney weight, and body weight), we were able to perform an unbiased separation of injury group based on the type of injury. This study provides evidence that unique kidney injury profiles within a kidney disease health condition are identifiable, and will help us to identify the causes of kidney injury in the future