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BACKGROUND AND OBJECTIVE: As elsewhere in the world, the prevalence of periodontitis in stages I-II is high in the Latin American population, this scenario emphasizes the need for identification of urgent needs for allocating adequate resources to provide diagnosis, prevention, and treatment of these diseases. The aim of this Delphi study was to predict the trends in periodontology/periodontics in the Latin American region by the year 2030. METHODS: A steering committee and an advisory group of experts in periodontology/periodontics were selected from 16 countries. An open questionnaire of 60 questions was validated and used following the Delphi methodology. RESULTS: Two hundred and twenty-five experts from Latin America answered the two rounds of the questionnaire. Moderate to strong consensus was reached on 45 questions (75%). The prediction was that the prevalence of gingivitis and periodontitis in stages I and II will be maintained, the importance of the link with systemic diseases will increase, and the impact of prevention and periodontal treatment will also increase, mainly in the private sector. There was a strong consensus that plastic and regenerative surgical procedures will increase, as well as the demand for training in the specialty of periodontology. CONCLUSIONS: The present study has provided relevant and useful information on predictions in periodontology/periodontics in Latin America, with important level of consensus among experts. It has been predicted that periodontitis will still be a highly prevalent disease, and its links with other medical conditions should demand more attention by health authorities to develop adequate prevention and management policies and strategies.

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Introduction: Sleep-disordered breathing (SDB) are highly prevalent in patients with heart failure (HF). The presence of obstructive sleep apnea syndrome (OSA) determines a worse prognosis in these patients. There are questionnaires aimed at evaluating the probability of OSA, although none have been validated in patients with HF. The primary objective of this study was to establish the prevalence of SDB in a cohort of patients with HF and reduced ejection fraction (HFrEF) from the Multidisciplinary HF Unit (UMIC). As a secondary objective, to evaluate the usefulness of the Stop-Bang, Berlin, and 2ABN3M questionnaires for TRS screening in these patients. Methodology: Cross-sectional, observational study, including the active cohort of the UMIC, over 18 years with HFrEF, clinically stable and informed consent. Patients with cognitive, neurological or hearing impairment with limitations when conducting the interview were excluded. Patients with other limiting or uncontrolled sleep disorders, continuous home oxygen therapy requirements, did not enter the study. Berlin, Stop-Bang, and 2ABN3M questionnaires were administered, classifying the population into high-risk, intermediate-risk, and low-risk groups of presenting SDB. All patients underwent outpatient respiratory polygraphy (RP). Descriptive statistics were used to characterize demographic variables, measures of central tendency and dispersion. SPSS statistical software was used. Results: 387 patients were included, 248 men (64.1%), mean age was 63.5 ± 0.6 years. The etiology of HF was ischemic in 41.6% of patients. The body mass index was 29.3 ± 0.3 kg/m2. LVEF was 34.2 ± 0.5, pro-BNP 1233.8 ± 137.6 pg/ml. The results of the questionnaires showed that 52.1% (198) presented a high risk of SDB according to the Berlin questionnaire. With Stop-Bang, 35.9% (139) were high risk, 42.1% (163) intermediate risk, and the remaining 22% (85) low risk. With the 2ABN3M score, 62% (240) were high risk. A total of 156 respiratory polygraphs (40.3% of the population) were performed. The cut-off point to define the presence of sleep apnea was considered to be an AHI >15. 58.3% (91) of the patients presented TRS. Of these, 95% presented obstructive apnea and 5% central apnea with periodic Cheyne-Stokes breathing. A high percentage (26%) presented AHI greater than 30. The sensitivity of the Berlin and Stop-Bang questionnaires was 75.8% and 91.2%, respectively, with a specificity of 53.8% and 24.6%. Regarding the 2ABN3M score, a sensitivity of 71.4% and a specificity of 44.6% were observed. Conclusions: The prevalence of sleep-disordered breathing in patients with HFrEF was high in our cohort and obstructive apnea predominated. Given the high sensitivity (91.2%) of the Stop-Bang questionnaire found in our study, it could be useful as a screening tool for TRS in this type of patient. The importance of investigating this pathology whose clinical presentation can be non-specific and remain underdiagnosed is highlighted.

Introdução: Os distúrbios respiratórios do sono (DRS) são altamente prevalentes em pacientes com insuficiência cardíaca (IC). A presença da síndrome da apneia obstrutiva do sono (SAOS) determina pior prognóstico nesses pacientes. Existem questionários destinados a avaliar a probabilidade de AOS, porém nenhum foi validado em pacientes com IC. O objetivo primário deste estudo foi estabelecer a prevalência de DRS em uma coorte de pacientes com IC e fração de ejeção reduzida (ICFEr) da Unidade Multidisciplinar de IC (UMIC). Como objetivo secundário, avaliar a utilidade dos questionários Stop-Bang, Berlin e 2ABN3M para triagem de SRT nesses pacientes. Metodologia: Estudo transversal, observacional, inclui a coorte ativa da UMIC, maiores de 18 anos com ICFEr, clinicamente estável e consentimento informado. Foram excluídos pacientes com deficiência cognitiva, neurológica ou auditiva com limitações na realização da entrevista. Pacientes com outros distúrbios do sono limitantes ou descontrolados, requisitos de oxigenoterapia domiciliar contínua, não entraram no estudo. Os questionários Berlin, Stop-Bang e 2ABN3M foram aplicados, classificando a população em grupos de alto risco, risco intermediário e baixo risco de apresentar DRS. Todos os pacientes foram submetidos à poligrafia respiratória (PR) ambulatorial. A estatística descritiva foi utilizada para caracterizar as variáveis ​​demográficas, medidas de tendência central e dispersão. Foi utilizado o software estatístico SPSS. Resultados: foram incluídos 387 pacientes, 248 homens (64,1%), com idade média de 63,5 ± 0,6 anos. A etiologia da IC foi isquêmica em 41,6% dos pacientes. O índice de massa corporal foi de 29,3 ± 0,3 kg/m2. FEVE foi de 34,2 ± 0,5, pro-BNP 1233,8 ± 137,6 pg/ml. Os resultados dos questionários mostraram que 52,1% (198) apresentaram alto risco de DRS de acordo com o questionário de Berlim. Com Stop-Bang, 35,9% (139) eram de alto risco, 42,1% (163) de risco intermediário e os restantes 22% (85) de baixo risco. Com a pontuação 2ABN3M, 62% (240) eram de alto risco. Foram realizados 156 polígrafos respiratórios (40,3% da população). O ponto de corte para definir a presença de apneia do sono foi considerado um IAH >15. 58,3% (91) dos pacientes apresentaram SRT. Destes, 95% apresentavam apnéia obstrutiva e 5% apnéia central com respiração Cheyne-Stokes periódica. Uma alta porcentagem (26%) apresentou IAH maior que 30. A sensibilidade dos questionários Berlin e Stop-Bang foi de 75,8% e 91,2%, respectivamente, com especificidade de 53,8% e 24,6%. Em relação ao escore 2ABN3M, observou-se sensibilidade de 71,4% e especificidade de 44,6%. Conclusões: A prevalência de distúrbios respiratórios do sono em pacientes com ICFEr foi alta em nossa coorte, com predominância de apneias obstrutivas. Dada a alta sensibilidade (91,2%) do questionário Stop-Bang encontrado em nosso estudo, ele pode ser útil como uma ferramenta de triagem para ERT nesse tipo de paciente. Ressalta-se a importância da investigação dessa patologia cuja apresentação clínica pode ser inespecífica e permanecer subdiagnosticada.

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Safflower cultivation is of great socioeconomic importance worldwide. Production is intended for the extraction of oil from the seeds. In 2021 Mexico ranked fifth in world production with approximately 52,553.28 tons (SIAP, 2021). In April 2022, in the north-central zone of Sinaloa, Mexico, diseased plants were reported in fields planted with safflower. Symptoms included chlorotic plants, necrosis and rot in vascular bundles, dwarfed plants and reflexed plants bent towards the ground. The disease caused estimated losses of 15% of seed production, with respect to the production obtained from the previous year in the safflower fields surveyed. Twenty-five plants with symptoms were sampled to isolate the pathogen. Plants were cut at the base of the stem near the roots and roots cut into 5 mm2 pieces. Tissue samples were superficially disinfected by immersing in 70% alcohol for 10 sec, 2% sodium hypochlorite for 1 min, washed in sterile water, and placed on potato dextrose agar (PDA) at 28 ºC for 7 days in the dark. Twelve monosporic isolates derived from the PDA culture were morphologically characterized. Abundant white aerial mycelium and small pink to dark violet pigments in the center of the culture were observed. From 10-day-old cultures grown on carnation leaf agar medium microconidia and macroconidia were produced. Microconidia were hyaline, had zero to two septa, and were oval or ellipsoidal, 4.6 to 14 x 1.8 to 4.2 µm (n = 40). The macroconidia were hyaline, were slightly curved with three to five septa, and measured from 26 to 69 x 3 to 6.1 µm (n = 40). No chlamydospores were observed. According to the morphological characteristics, the isolates were identified as Fusarium verticillioides (Leslie and Summerell, 2006). DNA was extracted from one isolate and the Translation Elongation Factor 1-α (EF1) gene was amplified and sequenced (O'Donnell et al. 2010). The sequence obtained from isolate FV3CARCULSIN with 645 base pairs was submitted to NCBI GenBank with accession number OQ262963. The BLAST search revealed 100% similarity with F. verticillioides isolate 13 (KM598773) (Lizárraga et al. 2015). Identification in FUSARIUM ID resulted in a 99.85% similarity with isolate F. verticillioides CBS 131389 (MN534047) (Yilmaz et al. 2021). A phylogenetic tree, made with sequences of the EF1 gene, revealed that FV3CARCULSIN was most closely related to F. verticillioides (100% bootstrap). Pathogenicity tests were carried out on safflower plants (cv. Oleico) grown in sterile vermiculite. Plants were inoculated with a conidial suspension (1 × 105 conidia/ml) obtained from FV3CARCULSIN grown on PDA for 7 days. A total of 45 plants were inoculated by drenching the roots with 20 ml of inoculum when the plants were 20 days old. Fifteen plants served as negative controls without inoculation. Plants were kept for 60 days in greenhouse conditions; however, after 45 days the plants began to die. The assay was conducted twice. Rotting and necrosis was observed in the roots of the plants. The pathogen was reisolated from the tissue of all the plants with symptoms and identified as F. verticillioides using morphological characteristics and EF1 sequences, completing Koch's postulates. No symptoms were observed in control plants after 60 days. This is the first report of root rot in safflower caused by F. verticillioides in Mexico. The fungus has been reported in maize (Figueroa et al. 2010), but it is unknown if it could be the same pathogen of safflower. Identification of the pathogen is important for implementing management methods to reduce yield losses and for additional studies on the impact of the disease on oil quality extracted from safflower seeds.

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Objetivo: Conocer la ocurrencia de periodontitis a partir de un cuestionario de auto-reporte en una población de diabéticos en Montevideo, Uruguay. Materiales y métodos: Fueron invitados los participantes del 1er Encuentro de Diabetes en Uruguay, con diagnóstico de diabetes según auto-reporte, con al menos 18 años de edad y que firmaron el consentimiento informado. En todos los casos, fue aplicado un cuestionario con ocho preguntas previamente validadas al español de forma de estimar la ocurrencia de la Periodontits además de identificar indicadores asociados. Resultados: Un total de 37 personas respondieron el cuestionario suministrado, en su mayoría correspondientes al sexo femenino y de 45 años de edad promedio. La ocurrencia de periodontits fue del 68% de los encuestados, no existiendo diferencias significativas para el tipo de diabetes y las franjas etarias consideradas. Sin embargo las personas que presentaban periodontits tuvieron menos dientes naturales (según auto-reporte) al ser comparados con quienes no tenían periodontitis (27.5 vs. 20.4, p=0.01). Conclusiones: Los resultados del estudio permiten apreciar una condición oral deficitaria en aquellos diabéticos con periodontitis auto-reportada debido a la ocurrencia elevada de la misma así como la menor cantidad de dientes naturales.

Objective: To determine the occurrence of periodontitis from a self-report questionnaire in a population of diabetics in Montevideo, Uruguay. Materials and methods: Participants of the 1st Diabetes Meeting in Uruguay, with a diagnosis of diabetes according to self-report, with at least 18 years of age and signed the informed consent, were invited. In all cases, a questionnaire with eight questions previously validated in Spanish was applied in order to estimate the occurrence of Periodontits in addition to identifying associated indicators. Results: A total of 37 people answered the supplied questionnaire, mostly corresponding to the female sex and an average age of 45 years. The occurrence of periodontitis was 68%, with no significant differences for the type of diabetes and the age groups considered. However, people with periodontitis had fewer natural teeth (according to self-report) when compared to those who did not have periodontitis (27.5 vs. 20.4, p = 0.01). Conclusions: The results of the study allow us to appreciate a poor oral condition in those diabetics with self-reported periodontitis due to its high occurrence as well as the lower number of natural teeth.

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RESUMEN: La enfermedad periodontal se clasifica en dos grandes grupos principales: gingivitis y periodontitis, desencadenadas por una alteración de la microbiota oral, que causa un aumento de microorganismos patógenos con respecto a los beneficiosos. Estos, en interacción con el hospedero y con los factores de riesgo del paciente, definirán una presentación clínica específica. Una de las estrategias que se propone como alternativa frente al uso de antibióticos y como coadyuvante del raspado y alisado radicular (RAR) para tratar las periodontitis, es la administración de probióticos. Los probióticos son denominados como microorganismos vivos que al ser administrados en cantidades adecuadas son capaces de ejercer una acción benéfica sobre la salud del hospedador. Por tanto, el objetivo de este trabajo fue describir el beneficio de los probióticos en la prevención y tratamiento de las principales enfermedades periodontales. Para ello, se realizó una búsqueda desde Enero del 2010 a Mayo del 2020 en Pubmed, Web of Science, SciELO, Science Direct y el Portal Timbó. Obteniéndose como resultado que los probióticos son capaces de reducir los parámetros clínicos y microbiológicos de dichas enfermedades y que pueden ser un valioso complemento en su prevención y tratamiento.

ABSTRACT: Periodontal disease is classified into two main groups: gingivitis and periodontitis, triggered by an alteration of the oral microbiota, which causes an increase in pathogenic microorganisms with respect to the beneficial ones. In interaction with the host and with the risk factors of the patient. They will define a specific clinical presentation. One of the strategies proposed as an alternative to the use of antibiotics and as an adjunct to scraping and root planning (RAR) to treat periodontitis, is the administration of probiotics. Probiotics are living microorganisms that, when administered in adequate amounts, are capable of exerting a beneficial action on the health of the host. Therefore, the objective of this work was to describe the benefit of probiotics in the prevention and treatment of the main periodontal diseases. For this, a search was carried out between 2010 and 2020 in PubMed, Web of Science, SciELO, Science Direct and the Timbó Portal. The results obtained showed that probiotics are capable of reducing the clinical and microbiological parameters of these diseases and that they can be a valuable complement in their prevention and treatment.

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Hepatoportoenterostomy remains the cornerstone of treatment for biliary atresia. Current employed techniques include laparoscopy and open surgery. This study aims to determine if either method provides an advantage. Following PRISMA guidelines, a systematic review was conducted. Nineteen studies were included. Mean operative time 34.98 (95% CI 20.10, 49.85; p ≤ 0.00001) was longer in laparoscopic while bleeding volumes - 16.63 (95% CI - 23.39, - 9.86; p ≤ 0.00001) as well as the time to normal diet - 2.42 (95% CI - 4.51, - 0.32; p = 0.02) were lower in the laparoscopic group. No differences were observed in mean length of stay - 0.83. Similar complication, transfusions, postoperative cholangitis 0.97, and transplant free survival rates 1.00 (0.63, 1.60; p = 0.99) were seen between groups. Laparoscopic portoenterostomy provides advantages on operative time and bleeding as well as to normal diet when compared to open procedures. Both procedures showed no differences in length of stay, complications, cholangitis, and importantly, native liver survival. Level of evidence: III.

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Resumen Objetivos: Identificar los aspectos psicosociales de la enfermedad periodontal y su incidencia en la calidad de vida de las personas que la padecen. Métodos: Se realizó un estudio mixto cuanti-cualitativo en pacientes de la facultad de odontología UdelaR. Los instrumentos utilizados fueron: entrevista (semiestructurada) con base en la teoría fundamentada y la aplicación del cuestionario OHIP-14 (Oral Health Impact Profile) que mide el grado de afectación en la calidad de vida (modelo teórico de Locker). Resultado: Se identifican los factores psicosociales que presenta esta población, así como la afectación emocional y a nivel social que provoca el diagnóstico de enfermedad periodontal. Los resultados muestran una afectación en la calidad de vida de la población de 1,46 en una escala de 0-4, donde 4 es la máxima afectación. Las participantes femeninas mostraron mayor nivel de afectación en la calidad de vida (1,54) en comparación con los hombres (1,36). A mayor grado de instrucción más afectación en la calidad de vida. Conclusiones: Existe una limitación en el enfoque biomédico en la atención de pacientes odontológicos, y por tanto la necesidad de realizar un abordaje integral en pacientes con enfermedad periodontal. Los profesionales odontólogos deben tener un enfoque biopsicosocial en la atención debido a la complejidad que presenta la enfermedad periodontal.

Resumo Objetivos: Identificar os aspectos psicossociais da doença periodontal e sua incidência na qualidade de vida das pessoas que sofrem com a doença. Métodos: Foi realizado um estudo quantitativo e qualitativo misto. Os instrumentos utilizados foram: entrevista (semiestruturada), fundamentada na teoria fundamentada em dados, e aplicação do questionário OHIP-14 (Perfil de Impacto na Saúde Oral), que mede o grau de comprometimento da qualidade de vida (modelo teórico de Locker). Resultado: são identificados os fatores psicossociais que essa população apresenta, bem como a afetação emocional e social que causa o diagnóstico de doença periodontal. Os resultados mostram uma afetação na qualidade de vida da população de 1,46 em uma escala de 0-4, onde 4 é a afetação máxima. As participantes do sexo feminino apresentaram maior nível de comprometimento da qualidade de vida (1,54) em comparação aos homens (1,36). Quanto maior o grau de escolaridade, mais a qualidade de vida será afetada. Conclusões: A limitação da abordagem biomédica no cuidado de pacientes odontológicos e a necessidade de realizar uma abordagem abrangente em pacientes com doença periodontal são evidentes. Os profissionais de odontologia devem ter uma abordagem biopsicossocial ao atendimento devido à complexidade da doença periodontal.

Abstract Objectives: To identify the psychosocial factors of periodontal disease and their impact on the quality of life of patients. Methods: A mixed quantitative and qualitative study was conducted at the School of Dentistry, UdelaR. The instruments used were a semi-structured interview based on grounded theory and the application of the OHIP-14 (Oral Health Impact Profile) questionnaire that measures the degree of impairment of quality of life (Locker's theoretical model). Results: This population's psychosocial factors are identified, as well as the emotional and social effects of periodontal disease diagnosis. The results show a 1.46 impact on people's quality of life on a scale of 0-4, where 4 is the maximum impact. Women showed a higher level of impairment in quality of life (1.54) than men (1.36). The higher the educational level, the more the quality of life is affected. Conclusions The limitations of the biomedical approach to dental patient care and the need for a comprehensive approach in periodontal disease patients are clear. Dental professionals need a biopsychosocial care approach given the complexity of periodontal disease.

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Fusarium wilt is one of the main limiting factors for tomato production in Mexico. One thousand and fifty isolates were obtained from vascular tissues tomato plants showing wilt and yellowing symptoms in Sinaloa, Mexico. The pathogenic isolates were evaluated through phylogenetic analysis of the TEF-1α gene and ITS region, morphological markers and pathogenicity tests. Within the 15 pathogenic Fusarium isolates, 7 were identified as F. oxysporum and 8 as F. falciforme. Phylogenetic analysis of Fusarium oxysporum f. sp. lycopersici and Fusarium falciforme isolates confirmed that both populations are constituted by distinct phylogenetic lineages. The isolates showed differences in aggressiveness; F. falciforme was the most aggressive. Isolates of both complexes triggered similar aerial symptoms of yellowing and darkening of the vascular tissues in tomato plants. But only F. falciforme isolates triggered necrosis in the plant crowns. Morphological markers allowed differentiating isolates from distinct complexes but not differentiating between lineages.

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Objetivos: analizar comparativamente la prevalencia de ciertos patógenos periodontales en cuadros de periodontitis agresiva y crónica según la clasificación vigente al momento de los estudios, en 101 pacientes uruguayos. Métodos: Este análisis se basa en los trabajos de detección de patógenos periodontales en pacientes con periodontitis crónica y agresiva en Uruguay mediante metodología convencional y molecular 1,2. Ambos trabajos analizaron los mismos microorganismos y utilizaron las mismas técnicas de recuperación y análisis. Se estudiaron Aggregatibacter actinomycetemcomitans, Porphyromonas gingivalis, Tannerella forsythia, Prevotella intermedia y Fusobacterium nucleatum. Resultados: En los cuadros crónicos destacó F. nucleatum, T. forsythia y P.gingivalis. En los agresivos F. nucleatum y P. intermedia, y dentro de éstos en los generalizados una mayor proporción de P. gingivalis y T. forsythia y de A. actinomycetemcomitans en los localizados. Conclusiones: Se pudo constatar que se mantienen los patrones documentados en la bibliografía en Uruguay.3,4

Objectives: To compare the prevalence of certain periodontal pathogens in aggressive and chronic periodontitis in 101 Uruguayan patients according to the valid classification at the time the studies were conducted. Methods: This analysis is based on studies conducted to detect periodontal pathogens in patients with chronic and aggressive periodontitis in Uruguay using conventional and molecular methods. Both studies analyzed the same microorganisms and used the same recovery and analysis techniques. Aggregatibacter actinomycetemcomitans, Porphyromonas gingivalis, Tannerella forsythia, Prevotella intermedia and Fusobacterium nucleatum were studied. Results: A higher prevalence of F. nucleatum, T. forsythia and P. gingivalis was detected in chronic cases, whereas higher rates of F. nucleatum and P. intermedia were observed in aggressive ones. Within the last one, a higher proportion of P. gingivalis and T. forsythia was detected in the generalized cases and A. actinomycetemcomitans in the localized ones. Conclusions: The patterns detected are in line with those included in the literature for our country

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