Assuntos

RESUMO

Interprofessional training in health is scarce in Mexico. Partners in Health (CES in Spanish), is the branch of an international civil society organization that provides health services to poor and rural populations. CES runs a set of ten health centers in Chiapas, Mexico, in partnership with the local Ministry of Health. A key component of the provision strategy is to train healthcare providers, mainly medical and nursing students in their final year of training, to create healthcare teams that work together while fostering their individual capacities. CES offers a diploma on Global Health and Social Medicine, where medical and nursing students -also called pasantes- interact to discuss jointly the effects of global and social determinants of health in local communities, as well as specific clinical topics. A qualitative study including interviews and nonparticipant observations was undertaken to identify initial achievements and challenges of the experience. CES has achieved important benefits related to teamwork as well as clinical capacities of individuals as healthcare providers. However, challenges have emerged: differences in social origin, personal development expectations, professional identity and institutional roles hinder team cohesion. Consequently, CES has introduced adjustments to reduce the negative impact of these differences. Although the training model needs further development, the possibility of transferring some of its good practices to non-CES scenarios should be seriously considered by health authorities.

Assuntos

Assuntos

RESUMO

The Madín Dam is a reservoir located in the municipalities of Naucalpan and Atizapán, in the metropolitan area adjacent to Mexico City. The reservoir supplies drinking water to nearby communities and provides an area for various recreational activities, including kayaking, sailing and carp fishing. Over time, the number of specimens of common carp has notably diminished in the reservoir, which receives direct domestic drainage from two towns as well as numerous neighborhoods along the Tlalnepantla River. Diverse studies have demonstrated that the pollutants in the water of the reservoir produce oxidative stress, genotoxicity and cytotoxicity in juvenile Cyprinus carpio, possibly explaining the reduction in the population of this species; however, it is necessary to assess whether these effects may also be occurring directly in the embryos. Hence, surface water samples were taken at five sites and pharmaceutical drugs, personal care products (especially sunscreens), organophosphate and organochlorine pesticides, and other persistent organic pollutants (e.g., polychlorinated biphenyls and polycyclic aromatic hydrocarbons) were identified. Embryos of C. carpio were exposed to the water samples to evaluate embryolethality, modifications in embryonic development, lipoperoxidation, the quantity of hydroperoxide and oxidized proteins, and antioxidant enzyme activity (superoxide dismutase, catalase and glutathione peroxidase). It was found that the polluted water of the Madín Dam gave rise to embryolethality, embryotoxicity, congenital abnormalities, and oxidative stress on the common carp embryos.

Assuntos

RESUMO

OBJECTIVE: The aim of this systematic review was to evaluate the most appropriate hydrogel scaffold type (natural, synthetic or hybrid) to be applied with stem cells for dental pulp regeneration. The findings should help clinicians make an informed choice about the appropriate scaffold to be applied for this approach. DESIGN: Three electronic databases were searched (Medline, Web of Science and Scopus). The review was conducted based on the Preferred Reporting Items for Systematic Reviews and Meta-analysis (PRISMA). RESULTS: From 4990 potentially relevant studies initially identified, 18 papers fulfilled the eligibility criteria and were considered for this review. Natural scaffolds were applied in most studies. Collagen was the most studied scaffold. In 5 of 10 studies, only growth factors were added to the constructs. Even without growth factors, these scaffolds containing stem cells were able to support the formation of dentin. The synthetic scaffolds were the least studied. Only 4 studies were selected, and in 3 of them, the same scaffold (Puramatrix) was evaluated. Puramatrix by itself was unable to form dental pulp when dental pulp stem cells were not present. Synthetic and hybrid hydrogels were unable to attract stem cells from the host. The presence of growth factors in these constructs seems to be of relevance since dental pulp tissue formation was achieved only when the hybrid scaffold was applied with growth factors. CONCLUSION: All types of hydrogel-based scaffolds, when containing mesenchymal stem cells, are able to form connective tissue with different degrees of similarity to dental pulp. However, current data is too heterogeneous to compare and identify the advantages of any specific scaffold.

Assuntos

RESUMO

AIM: To assess the fracture incidence of instruments from single-file reciprocating systems when used by students in an endodontic graduate programme. METHODOLOGY: Dental records and periapical radiographs of patients treated by students on an endodontic graduate programme using reciprocating systems were assessed. Data on tooth type, number of treated root canals, number of fractured instruments, fragment size, angle, radius, arc length and position of root canal curvature where fractures occurred were tabulated for analysis. The risk of fracture was calculated for each group of teeth, root canal and root thirds, whilst the incidence of fractures reported for the reciprocating systems was compared using the chi-squared test at 5% significance level. RESULTS: Overall, 2056 root canals (826 teeth) from 810 patients were included. The incidence of fractured files from single-file reciprocating systems in relation to a number of instrumented canals was 0.92%. Fracture rates of 0.84% and 0.93% were found in 830 and 1226 root canals instrumented with WaveOne and Reciproc systems, respectively. No significant differences were observed between the systems. The highest fracture rate was 52.6% in the mesiobuccal root of mandibular molars. The central angle, radius and arc length of the curvature of root canals where the instruments fractured ranged from 58° to 84°, from 1.7 to 7.2 mm and from 2.4 to 7.6 mm, respectively. CONCLUSION: The use of WaveOne and Reciproc single-file reciprocating systems in an endodontic graduate programme was associated with a low incidence of instrument fractures.

Assuntos

Assuntos

RESUMO

Madín Reservoir provides a substantial amount of drinking water to two municipalities close to Mexico City metropolitan area. However, it receives untreated wastewater discharges from domestic sources in the towns of Nuevo Madín and others, as well as diverse pollutants which are hauled by the Río Tlalnepantla from its upper reaches, so that the xenobiotics in the reservoir are highly diverse in terms of type and quantity. Previous studies showed that MR is contaminated with xenobiotics such as Al, Hg and Fe, as well as NSAIDs, at concentrations exceeding the limits established for aquatic life protection. These pollutants have been shown to induce oxidative stress on Cyprinus carpio and may therefore also damage the genetic material of exposed organisms, eliciting cytotoxicity as well. The present study aimed to determine the genotoxicity and cytotoxicity induced on blood, liver and gill of C. carpio by the pollutants present in MR water. Specimens were exposed to water from five sampling sites and the following biomarkers were evaluated: DNA damage by comet assay, frequency of micronuclei, apoptosis by TUNEL assay and caspase-3 activity. Significant increases relative to the control group (P < 0.05) were found with all biomarkers in all tissues evaluated, with the level of damage differing between sampling sites. In conclusion, pollutants present in MR water are genotoxic and cytotoxic to C. carpio, and this sentinel species, coupled with the biomarkers evaluated herein, is a reliable tool for assessing the health risk to wildlife posed by exposure to pollutants in freshwater bodies.

Assuntos

RESUMO

Introduction: Kinesiotape (Kt) is a therapeutic technique producing somatosensory stimulation when placed on the skin, and has shown improvement in dynamic activities in neuropediatric field; however, there are limited studies on its effect during gait. Objective: To assess the effect of KT in children with spastic hemiparetic cerebral palsy (CP) during gait, when applied on tibialis anterior muscle of the affected side. Method: Study carried out with 9 children with spastic hemiparetic cerebral palsy and Gross Motor Function Classification System (GMFCS) I & II, between 4 and 10 years old, male and female, at Instituto teletón Antofagasta. Gait was recorded in video in 3 instances: before Kt, immediately after application of Kt, and 5 days post application. Recordings were assessed using the Edinburgh Visual Gait Score (EVGS) and range of motion (RoM) of the ankle during gait. Results: None of the subjects showed significant improvement in RoM of the ankle during gait or in the EVGS. Conclusion: Kt did not change ROM of the ankle during gait in the studied cases, nor as an immediate effect or 5 days after application. only 2 out of 9 children showed a 1 point improvement during the swing phase during EVGS. It is suggested to consider other exclusion criteria and extend the duration of Kt therapy.

El vendaje neuromuscular (VN) es una herramienta terapéutica que estimula el nivel somatosensitivo al ubicarlo sobre la piel, que ha demostrado mejoras en actividades dinámicas en el ámbito neuroinfantil; sin embargo, existen escasos estudios sobre su efecto durante la marcha. Objetivo: Evaluar el efecto del VN sobre la marcha de niños con parálisis cerebral (PC) hemiparética espástica, aplicado en músculo tibial anterior del lado afectado. Método: Estudio de 9 niños con PC y Gross Motor Function Classification System (GMFCS) I y II tipo hemiparesia espástica entre 4 y 10 años de edad, de ambos sexos en el Instituto Teletón Antofagasta. Se filmó marcha en 3 instancias: antes del VN, inmediato con VN y a los 5 días post aplicación. Las grabaciones fueron valoradas con la Edinburgh Visual Gait Score (EVGS) y rango de movimiento (RoM) de tobillo durante la marcha. Resultados: Ninguno de los 9 niños presentó mejoría significativa en su ROM del tobillo durante la marcha ni en la EVGS. Conclusión: El vendaje neuromuscular no produjo cambios del RoM del tobillo durante la marcha en los casos presentados, ni como efecto inmediato ni a los 5 días post aplicación. Sólo 2 de 9 mejoraron en 1 punto durante la fase de balanceo en la EVGS. Se sugiere considerar otros criterios de exclusión y ampliar el tiempo de aplicación del VN.

Assuntos