RESUMEN
INTRODUCTION: Osteogenesis imperfecta (OI) is a congenital disease comprising a heterogeneous group of inherited connective tissue disorders. The main treatment in children is bisphosphonate therapy. Previous animal studies have shown that bisphosphonates delay tooth eruption. The aim of this study is to determine whether patients with OI treated with pamidronate and/or zoledronic acid have a delayed eruption age compared to a control group of healthy children. METHODS: An ambispective longitudinal cohort study evaluating the age of eruption of the first stage mixed dentition in a group of children with OI (n = 37) all treated with intravenous bisphosphonates compared with a group of healthy children (n = 89). Within the study group, the correlation (Pearson correlation test) between the type of medication administered (pamidronate and/or zoledronic acid) and the chronology of tooth eruption is established, as well as the relationship between the amount of cumulative dose received and tooth eruption. RESULTS: The age of eruption of the study group was significantly delayed compared to the age of eruption of the control group for molars and lateral incisors (p < 0.05). Patients who received higher cumulative doses had a delayed eruption age compared to those with lower cumulative doses (p < 0.05). There is a high positive correlation between age of delayed tooth eruption and Zoledronic acid administration. CONCLUSION: Patients with OI have a delayed eruption of the 1st stage mixed dentition compared to a control group of healthy children. This delayed eruption is directly related to the cumulative dose of bisphosphonates and the administration of zoledronic ac.
Asunto(s)
Conservadores de la Densidad Ósea , Osteogénesis Imperfecta , Niño , Animales , Humanos , Pamidronato/uso terapéutico , Ácido Zoledrónico/uso terapéutico , Osteogénesis Imperfecta/complicaciones , Osteogénesis Imperfecta/tratamiento farmacológico , Erupción Dental , Conservadores de la Densidad Ósea/efectos adversos , Estudios Longitudinales , Difosfonatos/efectos adversos , Densidad ÓseaRESUMEN
Eight years after the enactment of the National Mental Health Law (26.657), we consider it necessary to build spaces for debate on the potentialities and challenges in its practical implementation. This research addresses the mental health practices in the general public hospitals of the city of Rosario and Gran Rosario, Argentina, from the workers' perspective. Through a qualitative and exploratory / descriptive approach, semi-structured interviews were conducted with 23 mental health workers (nurses, psychiatrists, psychologists, social workers and therapeutic companions). The analysis of the results allowed to stablish that the sanction of the law legitimized and strengthened already existing conceptions and practices, making possible its extension and the creation of new devices. Political, management, building, training and human resources limitations were analyzed. The scarcity of substitute devices to the psychiatric hospital, in addition to previously mentioned limitations, points to the importance of a Mental Health Plan, with clear resources, objectives and guidelines that may enable changes in the paradigm of care.