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INTRODUCTION: One of the major difficulties with respect to molar incisor hypomineralization (MIH) is its classification and differentiation from other enamel development defects (EDDs). The aim of this study was to evaluate diagnostic accuracy in dental students to classify MIH as well as its differentiation from other EDDs by combining conventional theoretical classes and e-learning-assisted pre-clinical practices. METHODS: In this one-group pre-test and post-test study, 59 second-year students assessed 115 validated photographs using the MIH Index on the Moodle learning platform. This index assesses the clinical features and extent of MIH, differentiating it from other EDDs. Students received automatic feedback after the pre-test. Two weeks later, students re-evaluated the same photographs. Both pairwise accuracy and overall diagnostic accuracy were estimated and compared for pre- and post-testing, with the area under the curve AUC, along with 95% confidence intervals (95% CI). RESULTS: The lowest diagnostic accuracy was for the ability to discriminate between white or cream-coloured demarcated opacities and hypomineralization-type defect that is not MIH. The overall pre-test accuracy was AUC = 0.83 and increased significantly post-test to AUC = 0.99 (p < .001). The overall accuracy to discriminate the extent of the lesion also increased significantly post-test (p < .001). CONCLUSION: Diagnostic skills to classify MIH can be developed by combining conventional theoretical classes and e-learning-assisted pre-clinical practices.

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PURPOSE: To evaluate the feasibility of developing visual diagnostic skills for detecting and assessing dental caries using e-learning assisted practice in preclinical dental education. METHODS: A one-group before and after the study was conducted. After a theoretical lesson on cariology, 53 inexperienced second-year preclinical students assessed 78 clinical photographs using the Nyvad criteria; they received automated feedback upon completion of the test. After a week, all students reassessed the same set of photographs, which were randomly reordered. Differential diagnostic accuracy was analyzed category-pairwise, and overall accuracy measures were based on the receiver operator curve. Diagnostic accuracy in both attempts was evaluated and compared through estimation and pooling of individual student accuracies. RESULTS: Pooled category-pairwise accuracy was lower for discriminating Sound surface from Non-cavitated-active caries, and for discriminating inactive caries (surface discontinuity) from intact surface inactive caries and Cavitated-active caries. Pooled overall accuracy, after the theoretical lesson, was 0.79 (95% confidence interval [CI] 0.77-0.81), and it increased to 0.99 (95% CI 0.98-0.99) after feedback. Between-student variability in accuracy was reduced from I2  = 0.66 to 0.55. CONCLUSION: E-learning assisted practice is a feasible alternative to start developing visual diagnostic skills for detecting and assessing dental caries using the Nyvad criteria from preclinical dental education in cariology. However, further studies are required to evaluate its effectiveness in improving real-world practice knowledge and skills.

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Aim: The aim of this study was to evaluate caries diagnosis and treatment decisions made by undergraduate dental students based on ICDAS or Nyvad criteria. Methods: Twelve students analyzed 90 digital photographs of permanent teeth at different clinical stages of carious lesion development and chose among different treatments in three different assessments: when there was no knowledge of the criteria (described as "No knowledge (N)"; when there was theoretical knowledge of the criteria (described as "Theoretical knowledge (T)" and when there was theoretical knowledge, clinical experience about dental caries and the criteria (described as "Theoretical and clinical knowledge (TC)". For "T" and "TC" the students were randomized into two experimental groups ­ ICDAS or Nyvad (experimental units: 6 students/group). The reference standard was established cooperatively by two experienced researchers. Criteria performance was evaluated by sensitivity, specificity, AUC, and Kappa statistics. Treatment decision was described in percentage by contingency tables and Spearman's correlation with the reference standard. Results: The first assessment demonstrated a high percentage of operative treatment even for initial enamel lesions based on ICDAS criteria and treatment was proposed for both active and inactive lesions, according to the Nyvad criteria. In the second assessment, the students continued recommending treatments for initial or inactive lesions, but less frequently. In the third assessment, treatment decisions presented greater cohesion in relation to the assigned classification criterion. The criteria presented no differences between them in terms of diagnostic in the third assessment. Conclusion: Clinical experience may improve caries detection and treatment decisions with the use of ICDAS and Nyvad criteria

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Introducción: las expectativas de autoeficacia son un predictor importante del éxito académico en todos los niveles formativos, incluyendo las carreras de la salud. El diagnóstico temprano de los niveles de autoeficacia de los alumnos y una oportuna intervención puede ser una estrategia útil para favorecer los procesos formativos. Esto hace necesario contar con instrumentos psicométricamente adecuados que permitan su evaluación en los estudiantes. Objetivo: evaluar la estructura factorial y la consistencia interna de la Escala de Autoeficacia Percibida Específica de Situaciones Académicas de Palenzuela en estudiantes de Fonoaudiología de Chile. Métodos: esta escala se aplicó a 282 estudiantes elegidos por muestreo no probabilístico por cuotas.Se realizó un análisis factorial exploratorio y se evaluó la confiabilidad con alfa de Cronbach. Resultados: presentaban entre 19 y 33 años de edad y 84,59 % eran mujeres. Se identificó una estructura unifactorial. Su consistencia interna fue adecuada según un alfa de Cronbach de 0,87. Conclusiones: existe evidencia psicométrica de la validez de constructo de la escala como medida unifactorial de autoeficacia académica en estudiantes de Fonoaudiología de Chile; además, muestra una adecuada confiabilidad(AU)

Introduction: Self-efficacy expectations are an important predictor for academic success at all levels of education, including the health-related majors. Early diagnosis of students' self-efficacy levels and timely intervention can be a useful strategy to favor the training processes. This makes it necessary to have psychometrically adequate instruments that allow students to evaluate themselves. Objective: To evaluate the factorial structure and internal consistency of the Scale of Specific Perceived Self-efficacy of Academic Situations of Palenzuela in Phonoaudiology students in Chile. Methods: This scale was applied to 282 students chosen by non-probabilistic sampling by rates. They were at ages between 19 and 33 years and 84.59% were women. An exploratory factorial analysis was performed and reliability was evaluated with Cronbach's alpha. Results: A unifactorial structure was identified. Its internal consistency was adequate according to Cronbach alpha of 0.87. Conclusions: There is psychometric evidence on the validity of the scale construction as a unifactorial measure of academic self-efficacy in Phonoaudiology students in Chile. In addition, it shows an adequate reliability(AU)

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OBJECTIVE: To evaluate, prospectively, the influence of examiner's experience in interpreting and applying the caries detection systems ICDAS (IC) and Nyvad (NY). MATERIAL AND METHODS: Twelve second-year undergraduate dental students (UG) and 12 postgraduates (PG) MSc level analysed and codified 77 clinical dental caries photographs at three different moments: initially, without any training; after one week of receiving training through a theoretical class; and after two years. Reproducibility and correlation was evaluated; sensitivity, specificity and area under ROC curve (AUC) were dichotomized according to the presence of cavitation (IC) and in relation to disease activity (NY). RESULTS: IC presented good kappa values for the first two evaluations. Both criteria resulted in good Spearman's correlation after two years (IC = UG: 0.89; PG: 0.93/NY = UG: 0.81; PG: 0.82). Sensitivity, specificity and AUC were statistically higher in the third evaluation by UG for Nyvad. CONCLUSIONS: ICDAS criteria seem to be instinctively understood by students without clinical experience. Nyvad's concepts performed better after two years where the students deepened their theoretical knowledge and experienced clinical practice, collaborating with the identification of activity signs.

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INTRODUCCIÓN: la enfermedad cerebrovascular en la actualidad es uno de los problemas de salud más importantes, no solo en Cuba, sino en los países desarrollados del mundo. Ocupa el segundo lugar como causa de discapacidad permanente en el adulto y muerte, solo es superada por las enfermedades cardiovasculares y el cáncer, lo que determina su relevancia médica, económica y social por el costo en la rehabilitación y los cuidados que requieren los pacientes con importantes daños neurológicos. OBJETIVO: caracterizar los factores de riesgos prevalecientes en los pacientes ingresados por enfermedad cerebrovascular. MÉTODOS: estudio descriptivo y longitudinal en una muestra de 144 pacientes ingresados por enfermedad cerebrovascular en el servicio de urgencias del Hospital Clinicoquirúrgico Docente "Dr. Octavio de la Concepción y de la Pedraja" entre enero y diciembre de 2012. Se aplicó una encuesta que exploró diferentes variables y los datos obtenidos se codificaron manualmente. RESULTADOS: el tipo de enfermedad cerebrovascular que prevaleció fue la hemorragia subaracnoidea, seguida por la hemorragia cerebral. Los factores de riesgo modificables que se identificaron con mayor frecuencia fueron la hipertensión arterial y la diabetes mellitus. Se constató insuficiente control de los factores de riesgo en la atención primaria de salud. CONCLUSIONES: los factores de riesgo mayormente asociados a la enfermedad cerebrovascular fueron la hipertensión arterial y la edad avanzada, seguidos por el tabaquismo y la diabetes mellitus, en correspondencia con un control deficiente de estas enfermedades.

INTRODUCTION: cerebrovascular diseases are presently one of the most important health problems not only in Cuba but in the developed countries as well. It holds the second place in the list of causes of permanent disability and of death in adults, just preceded by cancer and cardiovascular diseases, which determines its medical, economic and social relevance due to the cost of rehabilitation and of care that patients having significant neurological damage require. OBJECTIVE: to characterize the prevailing risk factors in hospitalized patients with cerebrovascular disease. METHODS: longitudinal and descriptive study of a sample of 144 patients with cerebrovascular disease, who were admitted to the emergency service of "Dr Octavio de la Concepcion y de la Pedraja" teaching, clinical and surgical hospital from January through December, 2012. A survey was conducted to explore different variables and the collected data were manually coded. RESULTS: the predominant type of cerebrovascular disease was subararachnoid hemorrhage followed by brain hemorrhage. The most frequently modifiable risk factors were blood hypertension and diabetes mellitus. It was observed that the control of risk factors was poor at the primary health care setting. CONCLUSIONS: the risk factors mainly associated to cerebrovascular disease were blood hypertension and advanced age, followed by tabaquismo and diabetes mellitus, in correspondence with a deficient control of these illnesses.

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El propósito del presente artículo es disertar sobre el problema de la formación del estudiante de odontología, la cual debería ser integral-integradora, orientada a crear un concepto unificado en la mente del futuro profesional, donde todas las enfermedades que tienen origen en relación con la bio-película dental puedan ser analizadas y comprendidas como distintas manifestaciones en cuya etiología existen factores comunes que permiten definirlas como enfermedades multifactoriales, complejas, con un importante componente social. En este artículo se presenta la experiencia de más de treinta años, de la Universidad CES, en la enseñanza de las enfermedades de origen dento-bacteriano, caries dental y enfermedades del periodonto, haciendo un comparativo con las propuestas de la enseñanza de la cariología por competencias desarrollada en la comunidad europea y que se ha propuesto en Colombia.

The purpose of this article is to discuss in detail the problems related to teaching dental students, in a holistic manner oriented at developing a unified concept of diseases of dento-bacterial origin in order to properly analyze and understand dental caries and periodontal diseases, both sharing etiological factors which allow clinicians and researchers to define them as a complex, multifactorial disease with a very strong social component. In this article, the authors present thirty years of experience at the College of Dentistry, Universidad CES, Medellin, teaching dental caries and periodontal diseases in a comprehensive manner, comparing their methodology with the model proposed by the European Community and the ACFF (Alliance for a caries free future) in Colombia, based on the development of competences.

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In this work we examined the correlation between long-term glial resilience and slow epileptogenesis using the pilocarpine-insult rat model. We assessed, quantitatively and morphometrically, glial fibrillary acidic protein (GFAP) expression and cell densities in hippocampus in a dose-response manner 2, 4 and 8 weeks after the pilocarpine insult. GFAP changes were correlated with observations on microglial activation. We used a commonly applied epileptogenic pilocarpine dose (380mg/kg) and its fractions of 1/10, 1/4 and 1/2. GFAP expression evaluated at 2 weeks revealed dose-dependent cytoskeletal hypertrophy and loss of GFAP+ cell densities in hippocampus. At 4-week timepoint, recoveries of the above mentioned parameters were observed in all groups, except for the full dose group in which the astrocytic hypertrophy reached the highest level, while its density dropped to the lowest level. Strong and localized microgliosis revealed by CD11b immunoreactivity was observed in hilus in the full dose group at 2- and 4-, persisting at 8-week timepoints. Through changing pattern analysis, we conclude that the loss of astroglial resilience is likely to be a determining factor for spontaneous recurrent seizure onset.

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