Dental sealant knowledge, opinion, values and practice of Spanish dental hygienists.

OBJECTIVES: Dental sealants have proved to be an effective approach to prevent pit and fissure caries. This study examines the knowledge, opinion, values and practice (KOVP) of dental hygienists concerning sealant use in the southwest region of Andalusia, Spain. METHODS: Spanish dental hygienists (n = 400) volunteered to complete a 31-item, self-administered, pretested questionnaire to assess their knowledge, opinion, values and practice regarding pit and fissure sealants. Wilcoxon matched-pairs signed ranks test, the Friedman nonparametric repeated-measures anova and Spearman's correlation were used to analyse the data. RESULTS: The mean scores for knowledge, opinion, values and practice were 3.57 ± 0.41; 2.17 ± 0.42; 2.58 ± 0.77 and 3.56 ± 0.46, respectively. Knowledge differed by years of experience (P < 0.01) and place of work (P < 0.01); opinion differed by years of experience (P = 0.03) and sector (P < 0.01). Similarly, practice about sealants differed by years of experience (P < 0.01). Conversely, values around sealant placement did not statistically differ by sex, years of experience, practice sector or place of work. Statistically, significant correlations were found between knowledge, opinion and value, while it was found no significant correlation between practice and the other variables (P > 0.05). CONCLUSIONS: Most dental hygienists have sufficient knowledge about pit and fissure sealants. They also acknowledge the importance of use of dental sealants and have positive opinion/attitude about using sealants. Practice of dental sealants in clinics was found adequate. However, they were not following the specific guidelines and standardized procedures.

Polymorphism G1359A of the cannabinoid receptor gene (CNR1): allelic frequencies and influence on cardiovascular risk factors in a multicentre study of Castilla-Leon.

BACKGROUND: A polymorphism (1359 G/A) of the CNR1 gene was reported as a common polymorphism in Caucasian populations and was related to cardiovascular risk factors. The present study aimed to investigate the allelic distribution of polymorphism (G1359A) of the CB1 receptor gene in a geographical area of Spain (Community of Castilla y Leon) and to evaluate the influence of this polymorphism on obesity anthropometric parameters and cardiovascular risk factors in the fasted state in obese patients. METHODS: A population of 341 obese subjects was analysed. Tetrapolar electrical bioimpedance measurement, blood pressure measurement, a serial assessment of nutritional intake with 3 days of written food records and a biochemical analysis were all performed. RESULTS: One hundred and seventy-seven patients (51.9%) had the genotype G1359G (wild-type group) and 164 (48.1%) patients were A carriers: G1359A (136 patients; 39.9%) or A1359A (28 patients; 8.2%) (mutant type group). The Health Area of Palencia had a lower frequency of wild-type genotype and G allelic frequency than all the other Health Areas. Segovia and Burgos Areas had a higher frequency of wild-type genotype and G allelic frequency than the other Health Areas. High-density lipoprotein (HDL) cholesterol was higher in the mutant type group and blood tryglicerides were lower in the same group. CONCLUSIONS: In conclusion, the novel finding of the present study is the association of the mutant type group G1359A and A1359A with a better lipid profile (triglycerides and HDL cholesterol) than the wild-type group. The frequencies of this polymorphism are different among Health Areas of Castilla y Leon (Spain).

Directional solidification, thermo-mechanical and optical properties of (Mg(x)Ca(1-x))(3)Al(2)Si(3)O(12) glasses doped with Nd(3+) ions.

In this work glass rods of (Mg(x)Ca(1-x))(3)Al(2)Si(3)O(12) (x = 0, 0.5 and 1) doped with 1 wt% Nd(2)O(3) were produced by the laser floating zone technique. Thermo-mechanical and spectroscopic properties have been evaluated. The three glass samples present good thermo-mechanical properties, with similar hardness, toughness and glass transition temperatures. The spectroscopic characterization shows spectral shifts in absorption and emission spectra. These spectral shifts together with Judd-Ofelt intensity parameters and ionic packing ratio have been used to investigate the local structure surrounding the Nd(3+) ions and the covalency of the Nd-O bond. All obtained results agree and confirm the higher covalency of the Nd-O bond in the Ca(3)Al(2)Si(3)O(12) glass.

[Ventricular assist device as alternative to heart transplant in a hospitalized patient in an intensive care unit: clinical case]. / Asistencia ventricular definitiva como alternativa al trasplante cardíaco en un paciente ingresado en una unidad de cuidados intensivos: un caso clínico.

OBJECTIVE: To present and analyze a clinical case that addresses the care plan for a patient with permanent ventricular assist in an intensive care unit (ICU). CLINICAL CASE PRESENTATION: A 65-year-old man admitted to an ICU in a tertiary teaching hospital in September 2011 after receiving an implant of a permanent ventricular assist device (Heartmate II). DISCUSSION AND IMPLICATIONS FOR PRACTICE: The case analysis has been structured into 3 categories identified in the review of the literature: prevention of risks and complications, management of the device and health education. CONCLUSION: This study shows the importance of establishing a protocolized care plan for the patients who are carriers of permanent ventricular assist in the ICU. This would avoid postoperative complications, reduce costs and hospitalization time.

Postoperative management and nursing care after implantation of a total artificial heart: Scoping review.

INTRODUCTION: End-stage heart failure (HF) is a condition whose only successful long-term treatment, with a survival of more than 10 years, is heart transplantation. However, limited organ availability and the progressive increase in the number of patients with advanced HF have served as an impetus for the development of implantable mechanical assistive devices. AIM: To provide an overview of postoperative management and nursing care after the implementation of a Total Artificial Heart (TAH). METHODS: A scoping review was carried out by consulting the PUBMED, CINAHL, and COCHRANE databases. From all the documents located, information was extracted on the date of publication, country of publication, type of study, and results of interest to answer the research question. In addition, the degree of recommendation was identified. RESULTS: Twenty-three documents were included in the scoping review. Results were classified in relation to: 1) description of the CAT SynCardia®; 2) nursing care in the immediate postoperative period (management of the device and management of hematological, infectious, nephrological, nutritional complications, related to immobilization, sleep-rest disturbances, psychological disorders, and patient and family education); and 3) follow-up at home. CONCLUSIONS: The complexity of implantation of the TAH, the multiple related complications that can arise during this process, both in the immediate post-operative and late, require a standardised and multidisciplinary management. The absence of standardised protocols raises the need for future studies to measure the effectiveness of care in patients with TAH. A multidisciplinary approach is crucial. Nurses must acquire autonomy and involvement in decision-making and develop competencies to address the patient's and family's physiological and psychosocial needs.

Reduced sedation and increased ethanol consumption in knock-in mice expressing an ethanol insensitive alpha 2 subunit of the glycine receptor.

Previous studies have shown the presence of several subunits of the inhibitory glycine receptor (GlyR) in the reward system, specifically in medium spiny neurons (MSNs) of the nucleus Accumbens (nAc). It was suggested that GlyR α1 subunits regulate nAc excitability and ethanol consumption. However, little is known about the role of the α2 subunit in the adult brain since it is a subunit highly expressed during early brain development. In this study, we used genetically modified mice with a mutation (KR389-390AA) in the intracellular loop of the GlyR α2 subunit which results in a heteromeric α2ß receptor that is insensitive to ethanol. Using this mouse model denoted knock-in α2 (KI α2), our electrophysiological studies showed that neurons in the adult nAc expressed functional KI GlyRs that were rather insensitive to ethanol when compared with WT GlyRs. In behavioral tests, the KI α2 mice did not show any difference in basal motor coordination, locomotor activity, or conditioned place preference compared with WT littermate controls. In terms of ethanol response, KI α2 male mice recovered faster from the administration of ataxic and sedative doses of ethanol. Furthermore, KI α2 mice consumed higher amounts of ethanol in the first days of the drinking in the dark protocol, as compared with WT mice. These results show that the α2 subunit is important for the potentiation of GlyRs in the adult brain and this might result in reduced sedation and increased ethanol consumption.

Polymorphism Ala54Thr of fatty acid-binding protein 2: Allelic frequencies and influence on cardiovascular risk factors in a multicenter study of Castilla y Leon.

BACKGROUND: A transition of guanin to alanin at codon 54 of the fatty acid-binding protein 2 gene (FABP2) results in an amino acid substitution (Ala54 to Thr54). This polymorphism was associated with some cardiovascular risk factors. OBJECTIVE: The aim of our study was to investigate the influence of the Thr54 polymorphism in the FABP2 gene on obesity anthropometric parameters and cardiovascular risk factors in the fasted state in obese subjects and the allelic distribution of this polymorphism in a geographic area of Spain. DESIGN: A population of 264 obese subjects was analyzed in a cross-sectional study from all health centers of Castilla y Leon (Spain). A nutritional and biochemical evaluation was performed. The statistical analysis was performed for the combined Ala54/Thr54 and Thr54/Thr54 genotype as a dominant model. RESULTS: The mean age was 41.1 ± 13.1 years and the mean BMI 36.5 ± 5.9, with 94 males (35.6%) and 170 females (74.4%). One hundred and fifty-three subjects (58%) had the genotype Ala54/Ala54 (wild-type group) and 111 (42%) participants had the genotype Ala54/Thr54 (n = 92, 34.8%) or Thr54/Thr54 (n = 19, 7.2%) (mutant-type group). The health area of Valladolid had a lower frequency of wild-type genotype and Ala54 allelic frequency than all the other health areas of Castilla y Leon. C-reactive protein was higher in the mutant-type than the wild-type group (3.4 ± 5.6 vs. 7.9 ± 10.4 mg/dl; p < 0.05). CONCLUSION: The finding of this study is the association of the Thr54/Ala54 and Thr54/Thr54 FABP2 phenotypes with higher levels of C-reactive protein without relation to insulin resistance. Frequencies of this polymorphism are different among health areas of Castilla y Leon.

Polymorphism Trp64Arg of beta 3 adrenoreceptor gene: allelic frequencies and influence on insulin resistance in a multicenter study of Castilla-León.

BACKGROUND AND OBJECTIVE: The genetic variant (Trp64Arg) is a missense mutation located within the beta3 adrenoreceptor (Beta3AR). The aim of our study was to investigate the influence of Trp64Arg polymorphism in the Beta3AR gene on insulin resistance in obese patients and the allelic distribution of this polymorphismin a geographic area of Spain. DESIGN: A population of 264 obese patients was analyzed. A bioimpedance, blood pressure, an assessment of nutritional intake, and biochemical parameters were measured. The beta 3 adrenoreceptor gene polymorphism(Trp64Arg) was genotyped. RESULTS: Two hundred and twenty six patients (77 males/149 females) (85.6%) had the genotype Trp64/Trp64 (wild type group) with and average age of 41.12 +/- 13.1 years and 38 patients (16 males/22 females) Trp64/Arg64 (14.4%) (mutant type group) with an average age of 40.5 +/- 12.7 years. High frequencies of Arg64 allele were observed in Salamanca and Valladolid. In the mutant type group, HOMA (3.75 +/- 2.77 vs 5.27 +/- 5.4; p < 0.05) was higher than wild type group. CONCLUSION: The finding of this study is the association of the Trp64/Arg64 Beta3AR with higher levels of HOMA. Frequencies of this polymorphism are different among geographic areas.

The effect of partial substitution of Ni by Mg on the structural, magnetic and spectroscopic properties of the double perovskite Sr2NiTeO6.

In this report, the structural, magnetic and spectroscopic properties of the freeze-drying synthesized Sr2Ni1-xMgxTeO6 (x = 0.0, 0.1, 0.2, 0.3 and 0.5) oxides are analyzed by means of X-ray powder diffraction (XRPD) and neutron powder diffraction (NPD), electron paramagnetic resonance, diffuse reflectance and magnetic susceptibility. The XRPD and NPD data analysis using the mode-crystallography approach have revealed that at room temperature (RT), all the compositions are monoclinically distorted with the space group I2/m. The high and low temperature analyses have shown that these materials suffer a series of three structural phase transitions. The EPR results have shown that the spectra of all the compositions are centred at g≈ 2.28, indicating a slightly distorted octahedral environment of Ni(2+), which is in agreement with the crystal structure analysis. The increase of the Mg(2+) content in Sr2Ni1-xMgxTeO6, provokes a decrease of the dipolar interaction effects and thus, the resonance becomes narrower. This resonance does not completely disappear which leads to the idea that the long-range magnetic order is not completely established when x≥ 0.3. The substitution of the Ni(2+) (S = 1) ions by Mg(2+) (S = 0) ions, also induces a weakening of the antiferromagnetic interactions, which is reflected in the diminishing of the absolute value of θ and the Néel temperature TN. The magnetic structure determination revealed the existence of an antiferromagnetic coupling for x- and z-spin components of the nickel atoms.

The healthcare system and the provision of oral healthcare in European Union member states. Part 2: Spain.

Spain is the second largest EU Member State with an area of 504,645 km(2) and is the fifth most populated one with a total of 46.5 million inhabitants. The number of dentists working in Spain has grown rapidly in the last 20 years. In December 2014, there were 33,346 practising dentists with a ratio of one dentist for every 1394 inhabitants. Oral health of children has improved; with a fall in the national mean DMFT index (decayed, missing and filled permanent teeth) among 12-year-olds, from 4.20 in 1984 to 1.12 in 2010. The percentage of the population that has visited a dentist within the last three months has risen from 13.5% (1987) to 16.9% (2011-2012). Forty-three percent of the Spanish population visited a dentist in the last year in 2009. The Spanish National Health System (SNS) provides comprehensive cover for general health, but very little oral healthcare for adults. Only emergency care and oral surgery (dental extractions) for adults are provided in publicly funded clinics. The vast majority of oral health care is provided in the private sector and over 90% of dental professionals work in the private sector. Nevertherless, children aged 7-15 years are covered (with some restrictions) by publicly funded oral healthcare with different care models, depending on the local health authority, and some of them are funded by a capitation system which was introduced 25 years ago.

Structural phase transitions and magnetic and spectroscopic properties of the double perovskites Sr2Co1-xMgxTeO6 (x = 0.1, 0.2 and 0.5).

The structural and magnetic properties of a series of ordered double perovskites with the formula Sr(2)Co(1-x)Mg(x)TeO(6) (x = 0.1, 0.2 and 0.5) are investigated by X-ray diffraction, low temperature neutron diffraction, electron paramagnetic resonance and magnetic susceptibility. The progressive substitution of the paramagnetic Co(2+) high spin ion by the diamagnetic Mg(2+), of about the same size, induces changes in the room temperature crystal structure, from a distorted P2(1)/n phase for the undoped Sr(2)CoTeO(6) oxide to the I4/m of the end member (Sr(2)MgTeO(6)). These perovskites experience structural transitions on heating, the temperature at which the transitions occur being smaller as x increases. The novel approach of mode-crystallography is used for the analysis. All oxides show antiferromagnetic exchange interactions between Co(2+) ions but the long range antiferromagnetic order is not achieved for the phase with x = 0.5. The low temperature neutron diffraction data have been evaluated using a full symmetry analysis. Results are consistent with an unquenched orbital contribution of a high spin Co(2+) ion.

Family resemblance for anthropometric traits. II. Assessment of maternal occupational and age effects.

The present study was based on a cross-sectional sample of 1326 subjects (197 fathers, 466 mothers, 307 sons and 356 daughters) belonging to 488 nuclear families from the province of Biscay (Basque Country, Spain), with the purpose of estimating the degree of familial resemblance, for several anthropometric traits, by analysing the correlation coefficients between parent-offspring pairs. Height, weight, biacromial and bicrystal breadths, humerus and femur biepicondylar breadths, arm, waist and hip circumferences, biceps, triceps, subscapular, suprailiac, abdominal, thigh and calf skinfolds were taken from each individual. BMI, WHR and the sum of the seven skinfolds was computed. The mother's occupation and the age of offspring were taken into account, since the combination of all these factors might have an effect on familial resemblance. The mothers were classified into housewife (HM) and working mothers (WM). The offspring were divided into prepuberal, puberal and postpuberal subgroups. Standardised residuals were used to compute father-offspring (FO) and mother-offspring (MO) relations through correlation coefficients computed by maximum likelihood. The results confirm the influence of age on the correlations, since FO correlations revealed an increasing trend in HM's children for weight and another six variables as they grew older. On the other hand, the weight change tends to decrease with age in FO correlations within the WM group. Depending on mother's occupation and children's age, the global trend in the sample results in higher correlations in the second group (WM) than in the first one (HM) for the whole age range, but specially in FO correlations before puberty, where four variables (weight, bicrystal breadth, triceps and subscapular skinfolds) yield statistically significant differences.

[Occlusion of patent ductus using the Rashkind system. Initial experience]. / Oclusão de canal arterial persistente mediante utilização do sistema de Rashkind. Experiência inicial.

Three patients were submitted to the Rashkind device technique for closure of a patent ductus arteriosus. The percutaneous transvenous technique was employed in every cases. A 12 mm prosthesis was utilized in one case and 17 mm prostheses in the other two cases. In the first case, after temporary occlusion of the ductus arteriosus, the prostheses was removed due to the technical impossibility of evaluation of the proximal umbrella position. In the second and third cases, the prostheses were duly liberated in the proper position, thus occluding the defects. This technique does not require general anesthesia, is indicated in patients over 6 kgs of body weight, and is a therapeutic alternative to the habitual surgical procedure.

[Mammary-coronary anastomosis: a new technique of approach through the brachial route for angiographic study and angioplasty]. / Anastomose mamária-coronária: nova técnica de abordagem por via braquial para estudo angiográfico e angioplastia.

PURPOSE: A new technique of mammary artery catheterization, by a brachial artery approach, utilizing a pre-molded conventional Sones catheter is described. METHODS: In a series of 300 patients, 308 procedures were performed. Three hundred internal mammary-coronary anastomosis were studied. In eight cases angioplasty were performed, five in the anterior descending artery and three in the internal mammary artery itself, with recanalization of one of the three cases. The approach was through the brachial artery homolateral to the anastomosed mammary artery. After the conventional coronarographic and bypass studies were performed, the catheter was withdrawn and pre-molded, forming a closed loop of approximately 10 mm in its distal extremity. The loop was introduced through the arteriotomy reaching the origin of the vertebral artery. The internal mammary artery was then catheterized utilizing rotation and traction movements. In the percutaneous transluminal coronary angioplasty (PTCA) procedures, the Sones catheter was replaced by a Myler right coronary catheter with a 260 cm metallic wire. RESULTS: In the 308 procedures, the internal mammary artery was catheterized in 305 instances (99.03%). In the remaining three cases selective catheterization of the internal mammary artery was not possible. In these three cases there was extreme tortuosity of the subclavian artery. The only complication observed in this series was thrombosis of the brachial artery in two cases (90.65%). In the eight patients submitted to PTCA the existing lesions were successfully dilated. CONCLUSION: Catheterization of the internal mammary artery through a brachial approach utilizing a pre-molded Sones catheter was an efficient procedure, with low incidence of complications. This approach could be the elective technique in the services that habitually utilize the brachial artery approach. It could be also an alternative for those utilizing the Judkins technique, whenever the internal mammary artery catheterization is impossible due to the anatomic characteristics of the patient.

Osificación heterotópica de cadera asociada a pancreatitis aguda severa: reporte de un caso / Hip heterotopic ossification associated with severe acute pancreatitis: a case report

La osificación heterotópica (OH), es la formación anormal de hueso maduro dentro de tejidos blandos extra esqueléticos donde normalmente no existe tejido óseo. Varias formas de OH han sido descritas de acuerdo a su presentación clínica, localización y ocurrencia progresiva o aislada. Su presentación en pacientes sometidos a inmovilización prolongada en el contexto de coma farmacológicamente inducido, en ausencia de lesiones del sistema nervioso central, es poco habitual. Presentamos el caso de una paciente de 40 años, sexo femenino, sin antecedentes mórbidos, que presenta episodio de pancreatitis aguda grave, manejada en UCI. Producto de lo anterior, requiere coma farmacológicamente inducido por 3 meses y hospitalizaciones reiteradas y prolongadas durante los 10 meses siguientes. Durante 3 años desde la resolución de su cuadro inicial evoluciona con alteración progresiva de la marcha y rigidez de la extremidad inferior derecha, sin eventos traumáticos durante ese período. Se objetiva mediante radiografía y TAC foco de OH coxofemoral derecha. Se resuelve de forma quirúrgica y biopsia de pieza operatoria confirma el diagnóstico. La paciente logra buena recuperación posterior. NIVEL DE EVIDENCIA: IV

Heterotopic ossification (HO) is the abnormal formation of mature bone within extraskeletal soft tissues where bone does not exist. Various presentation of HO have been described according to the clinical settings and location of the lesions, and progressive or isolated occurrence. A rare form of presentation occurs in induced coma patients with long-term immobilization and without central nervous system injuries. We present the case of a 40 years old female patient, without previous morbidity, who develop a severe acute pancreatitis. The patient requires an intensive care unit management (ICU) and a 3-month pharmacology induced coma and reiterative and prolonged hospitalizations during the next 8 months. During 3 years after resolution of her base disease, patient develops a progressive step claudication and a hip rigidity in adduction and external rotation. A coxofemoral HO focus is confirmed by radiology and CT. A surgical treatment of HO was performed, and the initial diagnose confirmed by anatomic pathology after biopsy of the injury. Patient had a favorable outcome.

Eritema discromicum perstans (EDP) o dermatosis cenicienta: revisión a propósito de dos casos / Erythema discromicum perstans (EDP) or cystic dermatosis: review of two cases

El eritema discromicum perstans (EDP) o Dermatosis cenicienta es una entidad clínica poco común, de curso crónico e irreversible. Se presenta como máculas hiperpigmentadas color gris-ceniza, de tamaño y forma variable, distribuidas en cara, tronco, y extremidades. En Chile existen pocos casos reportados. La etiología es actualmente desconocida. Los hallazgos histopatológicos no son específicos de EDP, por lo que el diagnóstico es clínico e histopatológico. Aunque se han reportado múltiples opciones de tratamiento, ninguno ha demostrado ser efectivo de manera consistente. Presentamos dos casos de EDP y una revisión de los principales aspectos clínicos, epidemiológicos e histopatológicos de esta entidad.

Erythema dyschromicum perstans (EDP) or cinderella Dermatosis is an uncommon clinical entity, of chronic and irreversible course. Clinically it appears as hyper pigmented gray-ashy macules, of variable size and shape, distributed on face, trunk, and extremities. There are few cases reported on Chile. Etiology is currently unknown. The histopathological features are not characteristic of EDP, so the diagnosis is based upon clinical findings plus histopathology. Although there are several treatment options, none of them have been demonstrated to be consistently effective. We present two cases of EDP and a review of the clinical, epidemiological, and histopathological features of this entity.

Fístula odontogénica: revisión de la literatura a propósito de un caso / Odontogenic sinus: a case report and literature review

Las fístulas odontogénicas son canalizaciones anormales originadas a partir de procesos infecciosos de los ápices radiculares, las cuales puede adoptar distintas morfologías en piel. Se presenta el caso de hombre de 40 años, con una lesión en mejilla derecha de 2 años de evolución. El estado de las piezas dentarias, a la inspección, era deficiente. Debido a la sospecha clínica, se solicitó una ecografía de partes blandas que fue compatible con una fístula odontogénica. Estas lesiones, muchas veces son subdiagnosticadas, lo cual limita y retrasa el tratamiento adecuado.

Odontogenic cutaneous sinus are abnormal tracts originated from infectious processes of the root canal, which can show different morphologies on the skin. We present a 40 year old man, who had a lesion on his right cheek of 2 years of duration. The tooth pieces were compromised. Due to the clinical suspicion, a soft tissue ultrasound was requested which result was consistent with odontogenic cutaneous sinus. These injuries are often underdiagnosed, limiting and delaying a proper treatment.