Efficacy of two behavioural management techniques during inferior alveolar nerve block administration in pre-school children: a randomised clinical trial.

PURPOSE: To evaluate and compare the efficacy of the hands-eyes-mouth distraction technique (HEM-DT) in reducing anxiety and pain levels and improving the behaviour of pre-school children during inferior alveolar nerve block (IANB) administration to that of the covering patient's vision technique (CPV-T). METHODS: This study included 52 children aged 3-5 years old with primary dentition, no history of receiving local anaesthesia, and whose treatments required an IANB. These children were randomly assigned into two groups: HEM-DT (G1; n = 26) and CPV-T (G2; n = 26). Anxiety and pain levels were assessed using the Facial Image Scale and the Wong-Baker Scale, respectively, while the patient's behaviour was evaluated using the Frankl Behaviour Scale. This study was divided into two sessions including the treatment session (administration of IANB) and the control session (7 days after anaesthesia). Chi-square test, the Mann-Whitney U test and Wilcoxon test were used for statistical analyses. RESULTS: The patients' anxiety levels did not increase 7 days after IANB in G1 (p value = 0.798); however, higher anxiety levels were observed in the G2 group (p value = 0.039). No significant differences in pain levels and behaviour were observed between the groups during administration of anaesthesia (p value > 0.005). CONCLUSION: HEM-DT and CPV-T showed efficacy in terms of pain and behaviour during IANB administration. Pre-school children in the HEM-DT group exhibited lower anxiety levels in the control session. TRIAL REGISTRATION NUMBER AND DATE OF REGISTRATION: ClinicalTrials.gov (NCT02591797). October 28, 2015.

Influencia de la saliva en la erosión dental en niños. Estudio transversal / Influence of saliva on dental erosion in children. A cross-sectional study

Introducción: La erosión dental es la pérdida patológica, crónica, localizada e indolora de los tejidos dentarios duros, producido por la acción química de ácidos, donde no está involucrada la acción de microorganismos. En los últimos años se ha observado un incremento significativo de la prevalencia de esta patología, especialmente en niños y adolescentes. El objetivo fue establecer la relación del flujo, el pH y la capacidad buffer de la saliva estimulada con el desarrollo de erosión dental en una muestra de 400 niños valencianos de edades comprendidas entre 6 y 14 años. Material y métodos: Se realizó un estudio transversal. Mediante una exploración clínica se determinó con el índice BEWE la presencia o no de erosión en cada paciente, así como la gravedad en caso de ser detectada. Además, se determinó el flujo de saliva estimulado, la capacidad buffer y el pH salival. Resultados: La prevalencia de erosión dental en la muestra estudiada fue del 22,3%. Se observó que los pacientes con un pH moderadamente ácido presentaron un mayor índice BEWE (p<0,001). Además, cuanto menor fue la capacidad buffer salival menor fue la gravedad de las lesiones erosivas presentes (p<0,001) en los pacientes. No se pudo establecer una relación positiva entre el flujo salival y el índice BEWE. Discusión: Una baja capacidad buffer, así como un pH moderadamente ácido salival parecen ser factores asociados positivamente con el desarrollo de lesiones erosivas. (AU)

Introduction: Dental erosion is the pathological, chronic, localized and painless loss of hard dental tissues, produced by the chemical action of acids, where the action of microorganisms is not involved. In recent years, a significant increase in the prevalence of this pathology has been observed, especially in children and adolescents. The objective was to establish the relationship between flow, pH and buffer capacity of stimulated saliva with the development of dental erosion in a sample of 400 Valencian children aged between 6 and 14 years. Material and methods: A cross-sectional study was carried out. A clinical examination was used to determine the presence or absence of erosion in each patient, as well as the severity of erosion, if detected. In addition, stimulated saliva flow, buffer capacity and salivary pH were determined. Results: The prevalence of dental erosion in the studied sample was 22.3%. It was observed that the patients with a moderately acid pH had a higher BEWE index (p <0.001). Furthermore, the lower the salivary buffer capacity was, the lower the severity of the erosive lesions present (p <0.001) in the patients. A positive relationship between salivary flow and BEWE index could not be established. Discussion: A low buffer capacity, as well as a moderately salivary acid pH seem to be factors positively associated with the development of erosive lesions. (AU)

Dental erosion. Etiologic factors in a sample of Valencian children and adolescents. Cross-sectional study.

AIM: To establish the relationship between dental erosion prevalence in children aged 6-14 and all the aetiological factors that lead to the development of the lesions. MATERIALS AND METHODS: Study design: A correlational cross-sectional study of a sample of 400 Valencian children was conducted. First, a questionnaire was completed to analyse the patients' health status, their dietary and oral hygiene habits, the kind of school they attended and their parents' academic level. Then, a clinical exploration of the permanent dentition was done, calculating the BEWE index and the risk of erosion for each patient. RESULTS: The prevalence of dental erosion of the studied sample was 22.3%. A positive correlation was observed between the presence of dental erosion and the frequent intake of fruit juices, carbonated and isotonic drinks (p<0.05), presenting a higher correlation if the liquid was kept in the mouth before swallowing. Aetiological factors such as the use of inhalers in patients with asthma (p=0.006), frequency of vomiting and regurgitation (p<0.001), frequent swimmers (p<0.001) or a low socioeconomic status (p<0.05) were also positively associated to the development of erosive lesions. STATISTICS: A descriptive and inferential statistical analysis was performed, using the Mann-Whitney U and the Kruskal-Wallis tests in the latter. CONCLUSION: The results of this study suggest that the frequent intake of fruit juices, carbonated and isotonic drinks, the use of inhalers and belonging to a low socioeconomic level family are factors positively associated to the development of erosive lesions.

Programa de cribado poblacional de cáncer colorrectal en Aragón. Primeros resultados / Colorectal cancer screening programme in Aragon (Spain): preliminary results

Objetivo: Describir los primeros resultados del programa de cribado de cáncer colorrectal en Aragón para valorar su implantación. Métodos: Se recogen los datos del programa en el primer año de implantación (2014), basado en la realización de test de sangre oculta en heces inmunoquímico para personas de 60-69 años de edad. Se reportan los indicadores principales de la red nacional de cribado. Resultados: Población invitada tras exclusiones: 12.518 personas. Tasa de participación: 45,28% (intervalo de confianza del 95% [IC95%]: 44,41-46,15). Test inadecuados: 0,21% (IC95%: 0,12-0,37). Test positivos: 10,75% (IC95%: 9,97-11,58). Aceptación de colonoscopia: 95,07% (IC95%: 93,04-96,52). Colonoscopias completas: 97,58% (IC95%: 95,98-98,55). Tasas de detección de adenomas de alto riesgo: 14,7‰ (IC95%: 11.9-18.2); adenomas de bajo riesgo: 5,55‰ (IC95%: 3,9-7,8). Valor predictivo positivo (VVP) para cualquier adenoma: 58,55% (IC95%: 54,49-62,49); VVP para cáncer invasivo: 5,36% (IC95%: 3,8-7,51). Conclusión: El análisis de los indicadores muestra que el programa se está implantando de forma adecuada

Objective: To describe preliminary findings from the colorectal cancer screening programme in Aragon (Spain) to evaluate its implementation. Methods: We have collected data from the first year of the program (2014) based on faecal occult blood immunochemical (FOBTi) test in patients 60-69 years old. We report "indicators" defined by the "Red Nacional de Cribado". Results: Invited population after exclusions: 12,518. Program participation rate: 45.28% (95%CI: 44.41-46.15). Inadequate tests: 0.21% (95%CI: 0.12-0.37); positive FOBTi test 10.75% (95%CI: 9.97-11.58) and colonoscopy acceptance 95.07% (95%CI: 93.04-96.52). Colonoscopy was appropriate and complete in 97.58% (95%CI: 95.98-98.55) of cases. The high- and low-risk adenoma detection rates were 14.7‰ (95%CI: 11.9-18.2) and 5.55‰ (95%CI: 3.9-7.8) respectively. The positive predictive value for any adenoma was 58.55% (95%CI: 54.49-62.49) and for invasive cancer was 5.36% (95%CI: 3.8-7.51). Conclusion: The indicator analysis of the ongoing programme suggests the programme is being implemented correctly in our community

Disminución de la aparición de dehiscencia y otras complicaciones en el manejo de vías venosas periféricas en el posoperatorio de cirugía hepatobiliar y vascular mediante el uso de aerosol Nobecutan® / Decrerase of dehiscence and other complications in the use of peripheral venous lines in post-operative hepato-biliary and vascular surgery through the use of Nobecutan® aerosol

La canalización de vías venosas periféricas, su vigilancia y mantenimiento las realizan enfermeras con fines diagnósticos o terapéuticos. En la unidad de cirugía se observó que era frecuente la aparición de flebitis, la extravasación o dehiscencia en el punto de punción. En aras de aumentar la calidad de los cuidados y la seguridad del paciente se buscaron nuevas pautas para prevenir o minimizar complicaciones utilizando el aerosol Nobecutan® como nueva técnica y material de fijación. Fue seleccionado por sus características: película adherente (ayuda a la fijación), elástica, transparente (permite la visualización del punto de inserción), permeable y que sella la zona. Mediante la realización de un estudio descriptivo transversal aleatorizado se pretendió abrir campo para la realización de nuevos estudios y la implementación de nuevos procedimientos. Los objetivos fueron: disminuir el número de cambios de catéter, evitar la dehiscencia, disminuir la flebitis, favorecer la sujeción y determinar la efectividad de Nobecutan® en prevención de complicaciones en la zona de inserción. Una vez obtenidos los datos, se elaboró una base de datos y se analizaron mediante el paquete estadístico SPSS versión 19.0 para Windows. Según los resultados obtenidos, y tras la discusión, se concluyó que la aplicación de Nobecutan® en la cura disminuyó de manera significativa la aparición de dehiscencia en el punto de inserción y el número de cambios de vía necesarios durante el ingreso. No se encontró influencia beneficiosa en la flebitis (AU)

Peripheral venous canalization, its surveillance and maintenance is realized by nurses with a diagnostic or therapeutic purpose. In the surgery unit was observed frequent appearances of phlebitis, extravasations or dehiscence in the point puncture. In order to increase the quality cares and patient safety, it was searched for new guidelines for preventing or minimizing applications using Nobecutan® aerosol as a new technical and material to fix. It was selected by its characteristics: adhesive layer (helps to fix), elastic, transparent (allows to visualize insertion point), permeable and sealing material. It was intended to open up a new field to realize new studies and to implement new procedures by means of a randomized cross-sectorial descriptive study. The objectives were: reduce catheter changes, avoid dehiscence, reduce phlebitis, get a better fixation and determine Nobecutan® effectiveness to prevent complications. With obtained data, a data base was designed and analyzed by statistical software SPSS version 19.0 for Windows. According to obtained results and after discussion, it was concluded to apply Nobecutan® to decrease dehiscence in the insertion point and the numbers of intravenous lines changes during admittance. It wasn't found beneficial influence to phlebitis (AU)

[DECREASE OF DEHISCENCE AND OTHER COMPLICATIONS IN THE USE OF PERIPHERAL VENOUS LINES IN POST-OPERATIVE HEPATO-BILIARY AND VASCULAR SURGERY THROUGH THE USE OF NOBECUTAN® AEROSOL]. / Disminución de la aparición de dehiscencia y otras complicaciones en el manejo de vías venosas periféricas en el posoperatorio de cirugía hepatobiliar y vascular mediante el uso de aerosol Nobecutan®.

Peripheral venous canalization, its surveillance and maintenance is realized by nurses with a diagnostic or therapeutic purpose. In the surgery unit was observed frequent appearances of phlebitis, extravasations or dehiscence in the point puncture. In order to increase the quality cares and patient safety, it was searched for new guidelines for preventing or minimizing applications using Nobecutan® aerosol as a new technical and material to fix. It was selected by its characteristics: adhesive layer (helps to fix), elastic, transparent (allows to visualize insertion point), permeable and sealing material. It was intended to open up a new field to realize new studies and to implement new procedures by means of a randomized cross-sectorial descriptive study. The objectives were: reduce catheter changes, avoid dehiscence, reduce phlebitis, get a better fixation and determine Nobecutan® effectiveness to prevent complications. With obtained data, a data base was designed and analyzed by statistical software SPSS version 19.0 for Windows. According to obtained results and after discussion, it was concluded to apply Nobecutan® to decrease dehiscence in the insertion point and the numbers of intravenous lines changes during admittance. It wasn't found beneficial influence to phlebitis.

Effects of xylitol chewing gum on salivary flow rate, pH, buffering capacity and presence of Streptococcus mutans in saliva.

AIM: The first studies on the use of chewing gum in dentistry were done in the 1970s. The Turku Sugar Studies, carried out between 1970 and 1973, showed the excellent anticaries properties of xylitol chewing gums. Since then, many dentists, particularly in Scandinavian countries, have studied the role of chewing xylitol-sweetened chewing gums as another preventive strategy in the control of dental caries. OBJECTIVE: To compare variations in salivary flow rate, pH, buffering capacity, and levels of Streptococcus mutans in baseline conditions and after chewing paraffin pellets or xylitol chewing gum in children between the ages of 6 and 12 years who eat lunch in a school canteen. MATERIALS AND METHODS: The study sample consisted of 90 children divided into 2 study groups, and a control group. The children ate lunch at the canteen of the Escultor Ortells state school in the town of Vila-real (Castellón, Spain). The baseline data recorded in the first phase of the study were compared with the data recorded in the second phase, after 15 minutes of chewing xylitol- sweetened chewing gums or paraffin pellets, depending on the study group. Salivary flow rate was measured by collecting the stimulated saliva in a graduated beaker. Levels of pH were measured using a Cyberscan pH 110 pH meter (Eutech Instruments). CRT buffer strips and the CRT bacteria test (Ivoclar-Vivadent) were used to measure buffering capacity and levels of S. mutans, respectively. RESULTS: The data obtained after sample collection were compared by means of a 1-way analysis of variance using the StatGraphics Plus statistical software package, version 5.0. Statistically significant differences were found (p<.05) when pH, buffering capacity and levels of S. mutans were compared between the 3 groups. Comparison of salivary flow rates revealed no statistically significant differences (p>.05), though salivary flow rates were higher in the groups where gum was chewed. CONCLUSION: The effect of chewing is essential to the stimulation of salivary flow and the resulting recovery of pH levels and reduction of levels of S. mutans in saliva.

Chemical modification of jute fibers for the production of green-composites.

Natural fiber reinforced composites is an emerging area in polymer science. Fibers derived from annual plants are considered a potential substitute for non-renewable synthetic fibers like glass and carbon fibers. The hydrophilic nature of natural fibers affects negatively its adhesion to hydrophobic polymeric matrices. To improve the compatibility between both components a surface modification has been proposed. The aim of the study is the chemical modification of jute fibers using a fatty acid derivate (oleoyl chloride) to confer hydrophobicity and resistance to biofibers. This reaction was applied in swelling and non-swelling solvents, pyridine and dichloromethane, respectively. The formation of ester groups, resulting from the reaction of oleoyl chloride with hydroxyl group of cellulose were studied by elemental analysis (EA) and Fourier Transform infrared spectroscopy (FTIR). The characterization methods applied has proved the chemical interaction between the cellulosic material and the coupling agent. The extent of the reactions evaluated by elemental analysis was calculated using two ratios. Finally electron microscopy was applied to evaluate the surface changes of cellulose fibers after modification process.

[Cerebral venous thrombosis associated to subacute De Quervain's thyroiditis in a carrier for the G20210A mutation of the prothrombin gene]. / Trombosis venosa cerebral asociada a tiroiditis subaguda de De Quervain en una paciente con la mutación G20210A del gen de la protrombina.

INTRODUCTION: Recently, thyrotoxicosis has been described as a risk factor for cerebral venous thrombosis (CVT) in some reported cases. We present a case of CVT associated to a subacute De Quervain's thyroiditis in a young female who was an heterozygous carrier for the G20210A mutation of the prothrombin gene. CASE REPORT: A 42-year-old female with irrelevant past medical history developed a thrombosis of the superior sagital and right transverse sinus in the initial phase of a subacute thyroiditis. Diagnosis was made by thyroid radioactive iodine uptake, and cerebral computerized tomography scan, magnetic resonance imaging, and magnetic resonance angiography. Treatment with aspirin and corticosteroids was started until thyroid function was normalized. When CVT diagnosis was made, the patient was treated with anticoagulation. Two months later, magnetic resonance imaging showed resolution of the CVT. The patient was diagnosed as an heterozygous carrier for the G20210A mutation of the prothrombin gene by genetic studies. CONCLUSIONS: Subacute thyroiditis might act as a risk factor for CVT, increasing the thrombotic risk in the presence of other acquired or hereditary prothrombotic factors, such as the G20210A mutation of the prothrombin gene in our patient.

Trombosis venosa cerebral asociada a tiroiditis subaguda de De Quervain en una paciente con la mutación G20210A del gen de la protrombina / Cerebral venous thrombosis associated to subacute De Quervain's thyroiditis in a carrier for the g20210a mutation of the prothrombin gene

Introducción. Recientemente se ha descrito la tirotoxicosis como factor desencadenante de trombosis venosa cerebral (TVC) en diversos casos aislados. Se describe un caso de TVC asociada a tiroiditis subaguda de De Quervain en una mujer heterocigota para la mutación G20210A del gen de la protrombina. Caso clínico. Mujer de 42 años, sin antecedentes personales de interés, que durante la fase inicial de una tiroiditis subaguda desarrolló una trombosis del seno longitudinal superior y el seno transverso derecho. El diagnóstico por imagen se hizo mediante gammagrafía tiroidea, así como tomografía axial computarizada, resonancia magnética y angiorresonancia cerebral. Se inició el tratamiento con ácido acetilsalicílico y posteriormente esteroides orales, hasta normalizarse la función tiroidea. Una vez diagnosticada la TVC se instauró un tratamiento anticoagulante, con resolución de la TVC por resonancia magnética a los dos meses. El estudio genético demostró que era heterocigota para la mutación G20210A del gen de la protrombina. Conclusiones. La tiroiditis subaguda podría actuar como factor desencadenante de TVC, y aumentar el riesgo de TVC cuando se asocia a otros factores protrombóticos adquiridos o hereditarios, como, en nuestro caso, la mutación G20210A del gen de la protrombina (AU)

Introduction. Recently, thyrotoxicosis has been described as a risk factor for cerebral venous thrombosis (CVT) in some reported cases. We present a case of CVT associated to a subacute De Quervain’s thyroiditis in a young female who was an heterozygous carrier for the G20210A mutation of the prothrombin gene. Case report. A 42-year-old female with irrelevant past medical history developed a thrombosis of the superior sagital and right transverse sinus in the initial phase of a subacute thyroiditis. Diagnosis was made by thyroid radioactive iodine uptake, and cerebral computerized tomography scan, magnetic resonance imaging, and magnetic resonance angiography. Treatment with aspirin and corticosteroids was started until thyroid function was normalized. When CVT diagnosis was made, the patient was treated with anticoagulation. Two months later, magnetic resonance imaging showed resolution of the CVT. The patient was diagnosed as an heterozygous carrier for the G20210A mutation of the prothrombin gene by genetic studies. Conclusions. Subacute thyroiditis might act as a risk factor for CVT, increasing the thrombotic risk in the presence of other acquired or hereditary prothrombotic factors, such as the G20210A mutation of the prothrombin gene in our patient (AU)

[Work absenteeism because of musculosceletal injuries]. / Absentismo laboral por lesiones musculoesqueléticas.

The rate of occupational accidents with sick-leave has increased in the Valencian Community in the last few years. More specifically, a great part of the Temporary Occupational Leave (TOV) produced in the hospitalary field are a consequence of lesions related to the skeleton and muscle system. We consider that this absentism is theoretically avoidable and it is due to working conditions which can and must be modified. From this point of view, Health Education has a very important role in the prevention of these pathologies when it is focused to the health staff, and taught together with knowledge of pedagogy and a basic knowledge of ergonomy.

[Cold thyroid nodules: study of 163 cases (author's transl)]. / Nódulos fríos tiroideos: a propósito de 163 casos.

A group of 163 patients with cold thyroid nodules was studied. Of these, 131 underwent surgery with thyroid neoplasms being found in 33 cases (22.13%). No statistically significant differences were seen in frequency of neoplastic cold thyroid nodules between males and females; in time of evolution between neoplastic and non-neoplastic cold thyroid nodules; or in mean age of the groups with neoplastic and non-neoplastic cold nodules. On the other hand, there were significant differences between the mean age of patients with different types of thyroid neoplasms. In conclusion, as at present no diagnostic technique allowing a clear differentiation between neoplastic and non-neoplastic cold thyroid nodules is available for preoperative use, surgical intervention is desirable in cases of this type.