FR 28. Productive and reproductive survey in a ranch in flooded savannas ecosystem

To assess the reproductive and productive stage of a dual purpose herd (meat-milk) in bad drained savanna plains, Guárico State, Venezuela, one farm (206 ha) were monitored, with 70 zebu cows, fed with diet based on mainly native forage shrubs and crop residues (corn and bean). The calving data, and the milk yields (kg) were registered each 15 days, to evaluate the effect of delivery month (1...4 and 7 ... 12) and number of calving (NP) (two and more than two) on calving interval (IEP).NP resulted significant (P<.01); however cows calving during the dry months had a shorter IEP. The cows with two calved (VDP) showed longer IEP than those of more two calved (MDP) (585 vs 433 days). Furthermore, effect of calving month (MP), lactation month (ML) and NP on milk production (PL) were studied. The average of PL/cow/day was 2.03 ± 0.9 kg. MP and ML had significant effect (P<.01) on PL. The cows had calved earlier (January, February and March) had higher level of PL. Cows (VDP) produced less milk than the other one MDP.PL increased during the first two months of lactation to reduce gradually until the wean to 10 months

Transitioning Children with Autism from Individualized Dental Care to Traditional Dental Settings

Objectives: The objective of this study is to examine characteristics associated with the retention of patients at Nova Southeastern University (NSU) dental clinics. Background: Although children with Autism Spectrum Disorder (ASD) develop strong bonds with their pediatric dental provider, as they age, transition to other providers is necessary. Low rates of successful transition, coupled with the need for long term care, highlights the importance of understanding the transition process. Methods: A retrospective chart review of patients with an ASD diagnosis was conducted. Data such as demographics, insurance status, and household income were collected. A logistic regression analysis was conducted to examine patient factors associated with transition to an NSU clinic. Results: Data were collected for 101 children (89.1% male & 10.9% female) required to transition between 2015-2019; Medicaid was the most frequently reported insurance type (68%). In terms of transitions, 42% of patients transitioned to an NSU clinic, 5.9% sought care privately, and the remaining were lost to follow up. Regression analysis indicated that insurance type was significantly associated with transition to NSU. Children with Medicaid were 7 times more likely to transition to an NSU clinic than to seek private care (OR= 7.156; [CI: 2.931, 17.472]; p=0.000). Conclusion: Results demonstrate that insurance may play a major role in a family’s decision to seek care at a facility. Since many studies have shown that Medicaid acceptance is low among private dental care providers, these findings suggest that this may be a major barrier in finding facilities to transition children with ASD. Grants: Funded by Nova Southeastern University, College of Dental Medicine, Health Professions Division and the Health Resources and Services Administration Grant Number D88HP20126

Evaluation of a special needs curriculum: Using outcomes for ongoing program modification and development

Introduction Oral health care is the number one unmet health need among children with special health care needs (SHCN), specifically Autism Spectrum Disorder (ASD). Children with ASD are at increased risk for oral diseases; however, socio-behavioral problems make it difficult for dental professionals to provide interventions. Specialized training in the treatment and management of these children is necessary for dentists to deliver needed dental care. Purpose A didactic curriculum and clinical rotation was developed within a special needs dental clinic under the supervision of a specialty care dentist to educate and train dental residents in skills and knowledge to treat children with ASDs. The purpose of this presentation is to illustrate how an evaluation plan is used to monitor program outcomes and effectiveness necessary to determine if curriculum modifications are needed. Innovation This is an ever-evolving program providing needed education to dental residents working with SHCN. Outcomes Program evaluation is based on the following outcomes: resident and parent satisfaction, resident mean pre and posttest scores from didactic trainings, and feedback from didactic training surveys. The residents engage in the learning process through providing feedback from each didactic training session including suggestions for their additional training needs for each topic. During clinical rotations residents have the opportunity to perform procedures and utilize skills obtained within didactic trainings under the supervision the pediatric dentist. Within this context the pediatric dentist are active engaged in the learning process. Outcomes are discussed at annual stakeholder meetings to improve the effectiveness of the curriculum on residents’ knowledge of treating and managing children with ASDs; residents’ opinions and level of satisfaction with the didactic and clinical components of the curriculum; and parental satisfaction with treatment. Discussion This project serves as an interdisciplinary model for the development and use of an evaluation plan to examine outcomes and facilitate ongoing program modification and improvement

Elevated D-Dimer and acute pulmonary embolism in COVID-19 patients

Introduction. It has been determined that patients with SARS-CoV-2 infection and severe pneumonia with elevated D-dimer values can develop acute pulmonary thromboembolism (APE) as a complication, being one  of the causes related to mortality in this group of patients. Methods. A retrospective analysis of 12 patients diagnosed with SARS-CoV-2 infection with high clinical suspicion of APE confirmed by computed tomography pulmonary angiopgraphy (CTPA) was performed and  the described findings are described. Results. 12 patients with diagnosis of severe pneumonia, elevated D-dimer 9.2 μg / ml (1.4 - ˃20 μg / mL) and confirmation of SARS-CoV-2 infection through real-time reverse transcription polymerasa chain reaction (RT- PCR). APEs were observed mainly in segmental arteries (75%) and main arteries (25%). Pneumonia with  patched areas of bilateral ground glass opacities was observed in 100% of the sample as a typical finding of  SARS-CoV-2 infection. Conclusion. SARS-CoV-2 infection is related to elevation of D-dimer and APE. The CTPA determines the  diagnosis, severity and timely management (anticoagulation) of patients with APE. Therefore CTPA should be  considered in all patients with elevated D-dimer or clinical worsening.  Introducción. Se ha determinado que los pacientes con infección por SARS-CoV-2 y neumonía severa con  valores elevados de dímero-D, pueden desarrollar tromboembolismo pulmonar agudo (TEP) como  complicación, siendo una de las causas relacionada con la mortalidad en este grupo de pacientes. Material y métodos. Se realizó un análisis retrospectivo de 12 pacientes con diagnóstico de infección por  SARS-CoV-2 con alta sospecha clínica de APE confirmado por angio tomografia computarizada (AngioTC) y se  describen los hallazgos descritos. Resultados. 12 pacientes con diagnóstico de neumonía severa, dímero-D elevado 9,2 μg/ml (1,4 - ˃20 μg/ml)  y confirmación de infección de SARS-CoV-2 a través de reacción en cadena de polimerasa reversa (RT-PCR).  Se objetivaron TEP principalmente en arterias segmentarias (75%) y arterias principales (25%). En el 100% de  la muestra se objetivó neumonía con áreas parcheadas de vidrio deslustrado bilaterales como hallazgo típico de infección por SARS-CoV-2. Conclusión. La infección por SARS-CoV-2 está relacionada con elevación del dímero-D y con TEP. La angioTC  determina el diagnóstico, severidad y manejo oportuno (anticoagulación) de los pacientes con TEP. Por tanto el angioTC debe ser considerado en todos los pacientes con dímero-D elevado o empeoramiento clínico.

Parents of Children With Autism Spectrum Disorder and Their Attitude Towards Silver Diamine Fluride as a Different Treatment Modality for Carious Lesions

Objective. The purpose of this study is to evaluate attitudes towards Silver Diamine Fluoride (SDF) for carious lesions among parents of patients receiving dental care at Mailman Segal Center for Human Development (MSC) in lieu of alternative treatment approaches. Background. Children with Autism Spectrum Disorder (ASD) face numerous barriers to accessing and receiving quality healthcare. Dental care in particular has been found to be an unmet healthcare need among children with ASD due to poor perceived behavior, and lack of trained dental professionals. Methods. Parents (N=49) of children with ASD being treated at MSC were given information about the uses of SDF. SDF acceptance was measured by mean scale scores on the 20 item SDF feasibility questionnaire; scores for each item range from 0 (low) to 3 (high); higher scores indicate higher levels of SDF acceptance. Results. Most patients were male N=43 (87.8%), visited the dentist at least once a year N=36 (73.4%), and 22.4% (N=11) had a cavity filled. Dental management techniques included oral sedation (N=12, 24.5%) physical restraint (N=10, 18.4%), general anesthesia (N=9, 18.3%), and nitrous oxide (N=4, 8.2%). Mean level of SDF feasibility was moderate (1.3, SD=0.69). SDF was most acceptable for use on baby back teeth (1.90), back teeth if child could not complete filling (1.84), and on back teeth if general anesthesia was required (1.65). Conclusion. Results indicate that parents have moderate levels of SDF acceptance. Moreover, our findings suggest that parents are more comfortable using SDF on back teeth in order to avoid use of general anesthesia. Grants. This study is funded by a grant from the Health Professions Division

Twenty-four month clinical evaluation of fissure sealants on partially erupted permanent first molars: glass inonomer versus resin-based sealant

BACKGROUND: Glass ionomer sealants are an alternative to resin-based sealants, especially for use in partially erupted permanent molars. The authors conducted a study to compare the retention, marginal staining and cariostatic properties of a glass ionomer sealant with those of a resin-based sealant during a 24-month period. METHODS: We included in this study 39 patients aged 5 through 9 years who had bilateral partially erupted first permanent molars. One of us (S.B.) placed a resin-based sealant (Delton Plus FS+, Dentsply Professional, York, Pa.) (group D) on a partially erupted first molar in one quadrant of the maxilla or mandible and a glass ionomer sealant (GC Fuji Triage White, GC America, Alsip, Ill.) (group T) in the other quadrant. Two masked and calibrated investigators (S.A.A., J.C.) evaluated the sealants for retention, marginal staining and carious lesions at three, six, 12 and 24 months. The authors used a multinomial regression for statistical analysis (P \u3c .05). RESULTS: The recall rate was 69.2 percent at 24 months. Two sealants from group D and three from group T were lost completely. Complete retention rates at 24 months were 40.7 and 44.4 percent for groups D and T, respectively. The authors found no statistically significant difference in retention rates between groups at each recall examination (P \u3e .05). For marginal staining, sealants in the resin-based group exhibited statistically higher marginal staining than did sealants in the glass ionomer group (P \u3c .05). Although the authors detected no caries in teeth in group T, teeth in group D in which the sealant was lost completely experienced demineralization. CONCLUSIONS: Resin-based and glass ionomer sealants exhibited similar retention rates at 24 months. However, marginal staining was lower in the glass ionomer group, and the authors found no caries in teeth in this group. Consequently, glass ionomer sealants may be a better choice when salivary contamination is expected. CLINICAL IMPLICATIONS: Sealing during tooth eruption presents a particular challenge owing to difficulty in isolating the tooth. Glass ionomers may be a better material for sealing partially erupted molars