Osteomielite crônica aguda da maxila. Apresentação de um caso pediátrico

A nine-year old female patient presented with a history of trauma to the upper central incisors. She received treatment for apicoforming with calcium hydroxide for a prolonged period, who after root canal obturation presented acute inflammation of the upper lip and buccal vestibule. Treatment included antimicrobial therapy, extensive surgical debridement under general anesthesia, apicoectomy of both incisors, and direct visual obturation of the canals and apical sealing of the teeth with gutta-percha. The anatomopathologic diagnosis was acute chronic osteomyelitis of the maxilla. One and a half years later, clinical absence of inflammatory signs and adequate healing of the bone tissue were observed. It was concluded that, although reports concerning chronic osteomyelitis of the maxillary bone are rare events, this type of infection should be always present at the time of the differential diagnosis for evaluating pediatric patients with a history of dentoalveolar trauma and inflammatory processes in the maxillofacial region.Se presentó el caso de una paciente femenina de 9 años con historia de traumatismo a nivel de incisivos centrales superiores, por lo cual recibió tratamiento para apicoformación con hidróxido de calcio durante un periodo prolongado, que luego de realizarle la obturación de los conductos radiculares presentó un cuadro de inflamación aguda en labio superior y vestíbulo bucal. El tratamiento incluyó terapia antimicrobiana, desbridamiento quirúrgico amplio bajo anestesia general, apicectomía de ambos incisivos, obturación a visión directa de los conductos y sellado apical de los dientes con gutapercha. El diagnóstico anatomopatológico fue el de osteomielitis crónica agudizada del maxilar. Año y medio después se observó ausencia clínica de signos inflamatorios y adecuada cicatrización del tejido óseo. Se concluyó que, aunque los reportes de osteomielitis crónica del hueso maxilar son escasos, debe estar presente dentro del diagnóstico diferencial cuando se evalúan pacientes en edad pediátrica con historia de traumatismo dentoalveolar y procesos inflamatorios en la región maxilofacial.Apresentamos o caso de uma paciente feminina de 9 anos de idade com histórico de trauma nos incisivos centrais superiores, para a qual ela recebeu tratamento para apicoformação com hidróxido de cálcio por um período prolongado, que após a obturação do canal radicular apresentou inflamação aguda do lábio superior e vestíbulo vestibular. O tratamento incluiu terapia antimicrobiana, desbridamento cirúrgico extensivo sob anestesia geral, apicoectomia de ambos os incisivos, obturação visual direta dos canais e vedação apical dos dentes com guta-percha. O diagnóstico patológico foi uma osteomielite crônica aguda da maxila. Um ano e meio depois, houve uma ausência clínica de sinais inflamatórios e uma cicatrização adequada do tecido ósseo. Concluiu-se que, embora os relatos de osteomielite crônica do osso maxilar sejam escassos, ela deveria estar presente no diagnóstico diferencial ao avaliar pacientes pediátricos com histórico de trauma dentoalveolar e processos inflamatórios na região maxilofacial

Caracterización de terceros molares inferiores incluidos. Portoviejo 2017 -2019

Esta investigación tuvo como objetivo caracterizar los terceros molares inferiores incluidos, de los pacientes atendidos en una consulta privada de la ciudad de Portoviejo en el periodo de 2017 -2019. Se realizó un estudio descriptivo transversal que incluyó las variables: edad, sexo, criterios de referencia para la extracción quirúrgica, clasificación radiográfica de Winter, y de Gregory y Pell; y los criterios modificados de la escala de Parant para medir la dificultad operatoria. El universo fue de 134 pacientes, 62% fueron del sexo femenino, y el 70,2% tenía una edad comprendida entre 20 y 30 años. Se realizó la extracción quirúrgica de 228 molares, la pericoronaritis (41,0%) fue el principal criterio de referencia para la extracción, la radiografía panorámica mostró que la angulación mesioangular (46,15%), y la profundidad de inclusión, posición B (69,35%), fueron las más frecuentes; el 52,2% de las cirugías tuvieron una dificultad operatoria media. La caracterización clínica – radiológica de los terceros molares inferiores incluidos se corresponde con estudios internacionales, aunque se observó que la indicación profiláctica de la extracción quirúrgica en personas menores de 20 años fue baja, lo cual indica la necesidad de un cambio en los criterios sobre las indicaciones y momento de la extracció

Commitment, perception and evidence-based practice training in Spanish nursing students: A multicentre cross-sectional study in 2020

Aims and objectives: To evaluate the commitment and level of self-perceived training in evidence-based practice among students of the Nursing degree of five Spanish universities. Background: In university Health Sciences degrees, evidence-based clinical practice can directly or indirectly impact the quality of care, the cost of the service provided and the safety of clinical practice. Design: Multicentre cross-sectional observational study according to STROBE guidelines. Methods: The evidence-based skills in Practice questionnaire (CACH-PBE, for its acronym in Spanish) and the Utrecht Work Engagement Student Scale (UWES-9S) were used. The study was performed in five Spanish universities (Alicante, Castilla La Mancha, Jaen, Huelva and Seville) from October to December 2020, with 755 participants (Nursing students). Results: A total mean score of 91.9 points (SD = 11.81) was observed for the CACH-PBE questionnaire and of 36.8 points (SD = 8.48 points) for the UWES-9S. In addition, the multivariate analysis predicted that variables such as sex, academia, university, intention to do a Master or Doctorate degree, the level of work engagement, and the previous training in evidence-based clinical practice were associated with a greater perception of evidence-based practice. Conclusion: The sample of Nursing degree students has intermediate-high levels of knowledge, skills and attitudes regarding evidence-based practice and work commitment, with differences observed between each of the universities. Relevance to clinical practice: Nursing students should develop from intermediate to high levels of knowledge, skills and attitudes regarding evidence-based practice and work commitment. There are various actions to promote EBP, such as the incorporation of a specific course covering the subject into the nursing curriculum, and the selection, for clinical practices, of care units that implemented evidence-based care

Etapas históricas do processo de formação na especialidade de estomatologia geral abrangente na província de Guantánamo

Introduction: throughout its history, the training of stomatologists in Cuba has been going through different study plans, but there is no doubt that the most radical changes are generated after the triumph of the Cuban Revolution, when there is a democratization of access to careers, the development of postgraduate education, especially the specialization and the gradual transition of the conception of the health disease process. Objective: to present the consolidation of the training process in the specialty of General Comprehensive Stomatology in Guantanamo province. Development: a historical analysis of the training process of the Specialty of General Comprehensive Stomatology in Guantánamo was carried out considering the relevance of this specialty in the dental care system in Cuba. The following indicators are taken into account: training model, form of entry into the training process, training scenario and stomatological care model. In the article the historical milestones were established that allowed to delimit three stages of the formative process in the specialty of Integral General Dentistry, the historical regularities and description of each stage and, finally, the historical tendency that prevailed in the process was raised. Conclusions: by comprehensively analyzing the stages of the training process in the specialty of EGI was established as a historical trend: the training process in the specialty of General Comprehensive Stomatology has gone from a biologicist and curative model, a fragmented care practice, and a selective entrance of the stomatologists, towards a biopsychosocial model, based on health promotion and disease prevention, but it has maintained in its study plans the traditional approach with the objectives as governing categories.Introducción: a lo largo de su historia la formación de estomatólogos en Cuba transita por diferentes planes de estudios pero no hay dudas que los cambios más radicales se generan a partir del triunfo de la Revolución Cubana, cuando se produce una democratización del acceso a la carrera, el desarrollo de la educación de posgrado, sobre todo de la especialización y el tránsito gradual de la concepción del proceso salud enfermedad. Objetivo: exponer la consolidación del proceso de formación en la especialidad de Estomatología General Integral en provincia Guantánamo. Desarrollo: se realizó un análisis histórico del proceso formativo de la Especialidad de Estomatología General Integral en Guantánamo considerando la relevancia que tiene esa especialidad en el sistema de atención estomatológica en Cuba. Se tienen en cuenta los siguientes indicadores: modelo formativo, forma de ingreso al proceso formativo, escenario de formación y modelo de atención estomatológica. Resultados: en el artículo se establecieron los hitos históricos que permitieron delimitar tres etapas del proceso formativo en la especialidad de Estomatología General Integral, las regularidades históricas y descripción de cada etapa y, finalmente, se planteó la tendencia histórica que prevaleció en el proceso. Conclusiones: al analizar de manera integral las etapas del proceso de formación en la especialidad de EGI se estableció como tendencia histórica: el proceso de formación en la especialidad de Estomatología General Integral ha transitado desde un modelo biologicista y curativo, de una práctica asistencial fragmentada, y un ingreso selectivo de los estomatólogos, hacia un modelo biopsicosocial, basado en la promoción de salud y la prevención de enfermedades, pero ha mantenido en sus planes de estudio el enfoque tradicional con los objetivos como categorías rectoras.Introdução: Ao longo de sua história a formação de odontologia em Cuba passa por currículos diferentes, mas não há dúvida de que as mudanças mais radicais são gerados a partir do triunfo da Revolução Cubana, quando um acesso democratização ocorre para a corrida , o desenvolvimento do ensino de pós-graduação, especialmente a especialização e a transição gradual da concepção do processo de doença em saúde. Objetivo: apresentar a consolidação do processo de formação na especialidade de Estomatologia Geral Geral na província de Guantánamo. Desenvolvimento: uma análise histórica do processo de formação da especialidade de estomatologia geral abrangente em Guantánamo foi realizada considerando a relevância desta especialidade no sistema de atendimento odontológico em Cuba. Os seguintes indicadores são levados em consideração: modelo de treinamento, forma de entrada no processo de treinamento, cenário de treinamento e modelo de atendimento estomatológico. No artigo, os marcos históricos que ajudaram a determinar três etapas do processo educativo na especialidade de Estomatologia Integral Geral resolvido, regularidades históricas e descrição de cada fase e, finalmente, a tendência histórica que prevaleceu no processo foi levantada. Conclusões: para analisar de forma abrangente os estágios de formação na especialidade de EGI foi estabelecida como uma tendência histórica: o processo de formação na especialidade de Integral Odontologia geral passou de biologicista e modelo curativo da prática do cuidado fragmentado, e uma entrada seletiva dos estomatologistas, em direção a um modelo biopsicossocial, baseado na promoção da saúde e na prevenção de doenças, mas manteve em seus planos de estudo a abordagem tradicional com os objetivos como categorias reguladoras

Linking traits and personal constructs: an exploratory study throughout levels of personality

This article presents a preliminary study of links between personal constructs and traits. The conceptual framework for this study is the domains of personality model postulated by McAdams (1995) and McAdams & Pals (2006), and we tried to find concomitances between variables of two different levels, the dispositional level and the identity level. A repertory grid and the NEOFFI inventory were distributed to a total of 273 individuals, 146 representing the general population, and 137 having pathologies. By applying an exploratory design ex post facto in which Pearson’s correlations and ANOVAs were used, we found associations between the content of the constructs used and the traits. The neuroticism trait was most closely related to the content of the constructs. There were also clear associations between construct structure and scores on traits. Neurotic subjects were more rigid, whereas agreeable and conscientious subjects were more complex. However, the type of sample (normal or pathological) is a basic modulator of the relationships between constructs and traits

A pilot study on post-thawing quality of Iberian red deer spermatozoa (epididymal and electroejaculated) depending on glycerol concentration and extender osmolality

P. 1165-1172The optimization of cryopreservation extenders is a fundamental issue for adequately performing germplasm banking on wild species. We have tested two glycerol concentrations (4 and 8%), and three extender osmolalities (320, 380 and 430 mOsm/kg; before adding cryoprotectants), for cryopreservation of epididymal and ejaculated sperm samples from Iberian red deer. All the extenders were based on Tes–Tris and fructose (for osmolality adjustment), and complemented with 20% egg yolk. Epididymal and ejaculated sperm samples were obtained from the cauda epididymis (post-mortem) and using electroejaculation, respectively. Samples were diluted 1:1 with each extender and equilibrated for 2 h at 5 °C. Then, they were diluted down to 100 × 106 sperm/mL and frozen at −20 °C/min. Post-thawed samples were assessed for motility (CASA), HOS test, proportion of swollen (osmotically challenged) cells in the untreated sample, viability and acrosomal status. For epididymal samples, 8% glycerol rendered a slightly higher proportion of intact acrosomes on viable spermatozoa than 4%; regarding extender osmolality, 380 and 430 mOsm/kg rendered higher motility results, and the 430 mOsm/kg yielded the lowest proportion of swollen spermatozoa. For ejaculated samples, 4% glycerol yielded more viable spermatozoa than 8%; for extender osmolality, 320 mOsm/kg rendered the highest percentages of progressively motile and viable spermatozoa, although 380 mOsm/kg extender was not significantly different. These results show that sample source influences extender suitability, and that extenders should be isoosmotic or rather slightly hyperosmotic. Future studies should test multiple glycerol concentrations and extender osmolalities in order to adjust them to these kinds of sample.S

Relationship between the Duration of the Second Stage of Labour and Neonatal Morbidity

(1) Background: To assess the relationship between the duration of the second stage of labour and the neonatal morbidity risk; (2) Methods: An observational, analytical, retrospective cohort study was performed at the “Mancha-Centro” Hospital (Spain) during the 2013–2016 period. Data were collected from 3863 women who gave a vaginal birth. The studied neonatal morbidity variables were umbilical cord arterial pH, 5-min Apgar score, need for advanced neonatal resuscitation, and a composite neonatal morbidity variable on which the multivariate analysis was done. A univariate analysis was used for the potential risk factors and a multivariate analysis with binary logistic regression to control for possible confounding factors; (3) Results: The univariate analysis showed a statistically significant relationship between the duration of the second stage of labour and a high risk of advanced neonatal resuscitation and composite neonatal morbidity in multiparous women. However, after performing the multivariate analysis for the variable “composite neonatal morbidity”, we observed no relationship with the duration of the second stage of labour in either nulliparous or multiparous women; (4) Conclusions: The duration of the second stage of labour was not related to an increased risk of neonatal morbidity in our study population

El aporte de Fernando Silva a la Literatura nicaragüense mediante el análisis del cuento “El Aruño” de la obra” Cuentos de Tierra y Agua

El propósito de este trabajo es identificar el aporte de la narrativa de Fernando Silva mediante el análisis del cuento “El Aruño” de la obra “Cuentos De Tierra y Agua”, así también reconocer el valor autóctono de su aporte en la literatura nicaragüense. En el desarrollo del trabajo se abordan los antecedentes de la narrativa nicaragüense y sus características, generalidades del cuento (definición, características, estructura y clasificación), aspectos de la obra “Cuentos De Tierra y Agua” tales como: contexto, lista de los cuentos que la conforman y la temática general. Posteriormente, se presenta un análisis literario del cuento “El aruño” que pertenece a esta obra, con el objetivo de identificar y valorar el aporte de Fernando Silva para la literatura nicaragüense. Para la elaboración de dicho trabajo se tomó como base la recopilación de documentos en internet (tesis, monografías de maestrías y doctorados) los cuales, fueron de gran relevancia con un contenido enriquecido, propicio para fundamentar la temática. Además, se acudió a libros u obras literarias que brindaron información significativa. De igual manera se consultaron revistas, ensayos, entrevistas y videos que aportaron al escrito y posteriormente al desarrollo de ideas críticas y reflexivas para realizar el trabajo investigativo. Se logró determinar el aporte significativo de Fernando Silva a la literatura. Es sumamente importante mencionar que, Fernando Silva, es el único autor que se preocupó por plasmar en sus escritos el regionalismo y el valor autóctono del nicaragüense desde su propio ser

Sperm parameters on Iberian red deer: Electroejaculation and post-mortem collection

P. 216-226Artificial reproductive technologies (ART) for cervids have improved, but a need remains for the collection of basic data. We studied two models of sperm collection in Iberian red deer, post-mortem (PM) in a wild population (179 samples) and by electroejaculation (EE) in a farmed population (37 samples), recording: testicular and epididymal weight, testicular diameter, sperm quantity, pH and osmolality and spermatozoa quality (motility by CASA, abnormal forms, cytoplasmic droplets, viability and acrosomal status). We tested the relationship of these parameters with stag age and compared the two models (PM and EE; medians showed). Genitalia parameters were linearly related to stag age (testicular diameter: 31.5–50.5 mm for 2–9 years). Total number of spermatozoa collected were PM: 2.5 × 109 and EE: 3.6 × 109 (P > 0.05), increasing with age only for PM. We found a positive relationship between testicular size and spermatozoa collected for PM. Osmolality and pH were PM: 6.28 and 378 mOsm/kg; EE: 7.63 and 309 mOsm/kg (P < 0.05). The pH increased with age only for EE. Percentage of motile spermatozoa was similar for PM and EE, but motility quality was lower for PM. Abnormal forms, proximal and distal droplets were lower for EE (22%, 1.3%, 1.5% vs. PM: 23%, 4.3%, 83%). Viability was similar (74%) and intact acrosomes were higher for EE (97% vs. 89%). Both PM and EE samples could be used for germplasm banking. This study contributes with new data on red deer spermatology and for the development of ART in cervids.S