Francisco Sánchez, filósofo y médico gallego, precursor de la Medicina Basada en la Evidencia / Francisco Sánchez, Galician philosopher and medical doctor, precursor of Evidence Based Medicine

November 16 marked the 400th anniversary of the death, in Toulouse, of Francisco Sánchez de Sousa, known as "the Skeptic" or "the Tudense" who was, without a doubt, the most prestigious doctor and philosopher in the history of Galicia. With a versatile, multifaceted and cosmopolitan spirit, he represents the living incarnation of the Renaissance prototype of universal man. From a medical point of view, it could be said that our protagonist was a precursor of Evidence-Based Medicine, since he advocated a direct examination of things and submitting the data from the experience to analysis and critical judgment. The medical work of Francisco Sánchez is collected in a very heterogeneous conglomerate, published posthumously under the generic title of Opera Medica. It consists of a compilation of philosophical texts and a collection of various medical writings that includes notes, monographs, conferences, speeches and even notes for teaching. (AU)

El 16 de noviembre se cumplieron 400 años de la muerte, en Toulouse, de Francisco Sánchez de Sousa, conocido por “el Escéptico” o “el Tudense” que fue, sin duda alguna, el médico y filósofo más prestigioso de la historia de Galicia. De espíritu versátil, polifacético y cosmopolita, representa la encarnación viva del prototipo renacentista de hombre universal. Desde el punto de vista médico se podría decir que nuestro protagonista fue un precursor de la Medicina Basada en la Evidencia ya que propugnaba un examen directo de las cosas y someter los datos de la experiencia al análisis y al juicio crítico. La obra médica de Francisco Sánchez está recogida en un conglomerado muy heterogéneo, publicado de forma póstuma con el título genérico de Opera Medica. Consiste en una recopilación de textos filosóficos y una colección de diversos escritos médicos que incluye apuntes, monografías, conferencias, discursos e incluso notas para impartir la docencia. (AU)

Outpatient atorvastatin use and severe COVID-19 outcomes: A population-based study.

Evidence of the effect of statins on patients with coronavirus disease (2019) COVID-19 is inconsistent. The aim of this study was to evaluate the association between chronic use of statins-both overall and by active ingredient-and severe outcomes of COVID-19 (risk of hospitalization and mortality), progression to severe outcomes, and susceptibility to the virus. We conducted a population-based case-control study with data from electronic records to assess the risk of (1) hospitalization: cases were patients admitted due to COVID-19 and controls were subjects without COVID-19; (2) mortality: cases were hospitalized patients who died due to COVID-19 and controls were subjects without COVID-19; (3) progression: cases were hospitalized COVID-19 subjects and controls were nonhospitalized COVID-19 patients; and (4) susceptibility: cases were patients with COVID-19 (both hospitalized and nonhospitalized) and controls were subjects without COVID-19. We collected data on 2821 hospitalized cases, 26 996 nonhospitalized cases, and 52 318 controls. Chronic use of atorvastatin was associated with a decreased risk of hospitalization (adjusted odds ratios [aOR] = 0.83; 95% confidence interval [CI]: 0.74-0.92) and mortality (aOR = 0.70; 95% CI: 0.53-0.93), attributable in part to a lower risk of susceptibility to the virus (aOR = 0.91; 95% CI: 0.86-0.96). Simvastatin was associated with a reduced risk of mortality (aOR = 0.59; 95% CI: 0.40-0.87). The wide degree of heterogeneity observed in the estimated odds ratios (ORs) of the different statins suggests that there is no class effect. The results of this real-world study suggest that chronic use of atorvastatin (and to a lesser degree, of simvastatin) is associated with a decrease in risk of severe COVID-19 outcomes.

[Ethics Committee experience during COVID-19 emergency. A brief report.] / Experiencia de un Comité de Ética de la Investigación durante la pandemia por COVID-19.

OBJECTIVE: The health crisis caused by COVID-19 required the prompt launch of research in order to generate scientific evidence pertaining to the new disease oriented to control its devastating effects and continuous spread. Therefore, it was essential to adapt the work flow of Research Ethics Committees, to prioritize and to accelerate the evaluation of projects related to this disease. METHODS: This work analyses the evaluation conducted by our Regional Ethics Committees during the initial period of the health emergency (between 13th March and 28th May 2020). RESULTS: 81 research projects were evaluated, 73 of them of regional scope (62 single-centre), 4 national and 4 international. 57 projects obtained a favourable opinion, 4 were withdrawn by the sponsors, 6 did not require ethics approval and 14 did not respond to the clarifications requested up to the date of the study's closure. CONCLUSIONS: The most important research procedures to be analysed in this context are those related to the methodology and informed consent process. It is also essential to address aspects related to the privacy of personal data, and to take into account the workload of the researchers. As an improvement proposal, we think that greater collaboration between the different research teams should be encourage to obtain more robust results.

OBJETIVO: La crisis sanitaria motivada por la COVID-19 hace necesaria la puesta en marcha, con celeridad, de investigaciones encaminadas a generar evidencias científicas que incidan en el control de sus devastadores efectos. Por ello, fue necesario realizar ajustes en la dinámica de trabajo de los Comités de Ética de la Investigación, así como priorizar y agilizar la evaluación de los proyectos relacionados con dicha enfermedad. Este trabajo pretendió analizar la actividad la actividad evaluadora del Comité de Ética de la Investigación con Medicamentos de Galicia (CEIm-G) durante dicho período de emergencia sanitaria. METODOS: Se evaluaron 81 proyectos de investigación, 73 de ellos de ámbito autonómico (62 unicéntricos), 4 nacionales y 4 internacionales. RESULTADOS: En 57 proyectos el dictamen fue favorable, 4 fueron retirados por los promotores, en 6 no procedía dictamen y 14 no respondieron a las aclaraciones solicitadas hasta la fecha del cierre del estudio. CONCLUSIONES: Las causas más frecuentes de solicitud de aclaraciones están relacionadas con la metodología y, a continuación, con la hoja de información al paciente y el consentimiento informado. También es imprescindible abordar los aspectos relacionados con la intimidad de los datos personales y las muestras, e igualmente tener en cuenta la carga de trabajo de los investigadores. Como propuesta de mejora, consideramos que se debe incidir en una mayor coordinación entre los diferentes equipos de investigación para tratar de obtener resultados más robustos.

Aportes sobre el editorial: «Importancia de los Comités de Ética en la Investigación en Medicina de Familia» / Contributions on the editorial: "Importance of Research Ethics Committees in Family Medicine"

No disponible

Family nurses, oral hygiene, and educational implications: a cross-sectional study.

OBJECTIVE: To describe family nurses self-reported oral hygiene practices and to compare them with those of their potential patients in a public, free, and universal primary healthcare system. MATERIAL AND METHODS: Cross-sectional study using an anonymous questionnaire applied to randomly selected participants and their family nurses. RESULTS: A total of 1,394 people entered the study (1,326 laypersons, 66 nurses). Not all nurses reported to brush their teeth daily. Daily interdental cleaning scored percentages lower than mouthwashes. Devices like oral irrigators or tongue scrappers were not used by family nurses. CONCLUSIONS: Nurses' oral self-care routines are similar to those of university graduates, with poor reported interdental cleaning. Oral health promotion activities may contribute to nurse's oral health and could have a positive effect on their patients.

Regular dental attendance and periodontal health knowledge: A cross-sectional survey.

OBJECTIVES: To explore dental clinics' performance on periodontal education by comparing knowledge about periodontal health of regular and inconsistent dental attenders. SUBJECTS AND METHODS: A population-based study with a cross-sectional design was performed in Galicia (Northwestern Spain). Participants were randomly selected from 16 different areas and a questionnaire applied face-to-face. The survey included items on socio-demographic features, habits and routines, periodontal status and periodontal health knowledge. Participants were grouped according to the median of overall knowledge, and a logistic regression analysis was performed to explore the relationship between good periodontal knowledge and frequency of dental visits. RESULTS: A total of 8,206 individuals were invited to enter the study, and 3,553 of them accepted the invitation (43.3%). Most participants (59.3%; n = 1,945) fit within the regular dental attenders' group. Younger women holding a university degree and visiting their dentist regularly elicited higher knowledge about periodontal health. Regular use of dental services increased the chances of being in the higher knowledge group (OR: 1.67; 95% CI: 1.40-2.00). CONCLUSIONS: Reported regular dental attendance is related to periodontal health knowledge. Specific interventions for promoting tailored patient education on periodontal topics during routine dental visits may have a positive effect on laypersons' knowledge about periodontal health.

Experiencia de un comité de ética de la investigación durante la pandemia por COVID-19 / Ethics Committee experience during COVID-19 emergency. A brief report

OBJETIVO: La crisis sanitaria motivada por la COVID-19 hace necesaria la puesta en marcha, con celeridad, de investigaciones encaminadas a generar evidencias científicas que incidan en el control de sus devastadores efectos. Por ello, fue necesario realizar ajustes en la dinámica de trabajo de los Comités de Ética de la Investigación, así como priorizar y agilizar la evaluación de los proyectos relacionados con dicha enfermedad. Este trabajo pretendió analizar la actividad la actividad evaluadora del Comité de Ética de la Investigación con Medicamentos de Galicia (CEIm-G) durante dicho período de emergencia sanitaria. MÉTODOS: Se evaluaron 81 proyectos de investigación, 73 de ellos de ámbito autonómico (62 unicéntricos), 4 nacionales y 4 internacionales. RESULTADOS: En 57 proyectos el dictamen fue favorable, 4 fueron retirados por los promotores, en 6 no procedía dictamen y 14 no respondieron a las aclaraciones solicitadas hasta la fecha del cierre del estudio. CONCLUSIONES: Las causas más frecuentes de solicitud de aclaraciones están relacionadas con la metodología y, a continuación, con la hoja de información al paciente y el consentimiento informado. También es imprescindible abordar los aspectos relacionados con la intimidad de los datos personales y las muestras, e igualmente tener en cuenta la carga de trabajo de los investigadores. Como propuesta de mejora, consideramos que se debe incidir en una mayor coordinación entre los diferentes equipos de investigación para tratar de obtener resultados más robustos

OBJECTIVE: The health crisis caused by COVID-19 required the prompt launch of research in order to generate scientific evidence pertaining to the new disease oriented to control its devastating effects and continuous spread. Therefore, it was essential to adapt the work flow of Research Ethics Committees, to prioritize and to accelerate the evaluation of projects related to this disease. METHODS: This work analyses the evaluation conducted by our Regional Ethics Committees during the initial period of the health emergency (between 13th March and 28th May 2020). RESULTS: 81 research projects were evaluated, 73 of them of regional scope (62 single-centre), 4 national and 4 international. 57 projects obtained a favourable opinion, 4 were withdrawn by the sponsors, 6 did not require ethics approval and 14 did not respond to the clarifications requested up to the date of the study's closure. CONCLUSIONS: The most important research procedures to be analysed in this context are those related to the methodology and informed consent process. It is also essential to address aspects related to the privacy of personal data, and to take into account the workload of the researchers. As an improvement proposal, we think that greater collaboration between the different research teams should be encourage to obtain more robust results

Error humano, seguridad del paciente y formación en medicina / Human error, patient safety and medical training

A pesar de que se tiene la expectativa de que los médicos deben de tener una fiabilidad diagnóstica y terapéutica del 100%, lo cierto es que la condición humana está ligada al error en cualquier actividad y el ejercicio práctico de la medicina no es la excepción, ya que, por naturaleza, es una ciencia imperfecta, y la expectativa de la perfección no es ni realista ni posible. Esto no quiere decir que no se pueda hacer nada para disminuir la frecuencia y mitigar las consecuencias de los errores médicos. La complejidad de las organizaciones sanitarias y de los procesos de salud ha llevado a considerar que, para garantizar la calidad de los cuidados y la seguridad de los pacientes, son necesarios nuevos modelos de entrenamiento de los profesionales sanitarios. En la situación actual, la seguridad del paciente es uno de los nuevos desafíos que debe afrontar la educación médica tanto en el pregrado como en el posgrado. Esto pasa por incorporar la cultura de la seguridad del paciente a los planes de formación de los médicos residentes en particular y de otras profesiones sanitarias en general. El presente artículo es una revisión sobre este tema

Despite of the expectation that physicians must have a diagnostic and therapeutic reliability of 100%, the truth is that the human condition is linked to error in any activity and the practical exercise of medicine is no exception, as it is by nature imperfect science, and the expectation of perfection is neither realistic nor possible. This does not mean that nothing can be done to decrease the frequency and mitigate the consequences of medical errors. The complexity of health organizations and health processes has led us to consider that, in order to guarantee the quality of care and patient safety, new models of training of health professionals are needed. In the current situation, patient safety is one of the new challenges facing medical education in undergraduate and posgraduate courses. This involves incorporating the culture of patient safety into the training plans of resident physicians in particular and other health professions in general. This article is a review on this topic

Periodontal awareness and what it actually means: A cross-sectional study.

OBJECTIVES: To assess periodontal awareness among laypersons, to characterize the very aware of periodontitis and to disclose whether high awareness implies sufficient periodontal knowledge. SUBJECTS AND METHODS: Cross-sectional study on laypersons randomly selected by quota sampling from March 2015 to June 2016. The questionnaire of periodontal awareness included aspects of aetiology, risk factors, signs and symptoms, related risks, prevention, treatment and related attitudes. It was applied by 12 interviewers in the community in each four province capitals, in a sort of pathfinder survey method. RESULTS: A 43.3% response rate was obtained, and 3,553 people entered the study. "Very aware": 19.4%. "Aware": 42.7%. "Not aware": 37.9%. Age, oral self-care and educational achievements characterized those "very aware." Any additional degree beyond compulsory education halves the chances for being "not periodontally aware." Very aware people likely to have periodontitis were elder, less educated, with a smoking history and less knowledge of the disease. Gaps of knowledge among the "very aware" were identified in all aspects except for "prevention" and "treatment.". CONCLUSIONS: Very periodontally aware people were in their late 40-60 s, followed sound oral care routines and held a degree but elicited insufficient knowledge about aetiology, signs-symptoms, related risks or periodontal risk factors.

Primary care physicians and nurses: Targets for basic periodontal education.

BACKGROUND: Early diagnosis may improve patients' quality of life and reduce the lifelong social and financial burden inherent to treatment. Growing evidence supports the importance of a healthy periodontium in systemic health. Diagnosis depends on the patient and the healthcare professional. As many patients seek physicians' advice first, this study aims at assessing periodontal knowledge in a general population and their primary care physicians and nurses. METHODS: This is a cross-sectional study using an anonymous questionnaire applied to randomly selected laypersons (March to June 2016), and to physicians and nurses at their workplaces (October to December 2016) in Ourense, Spain. Sample size for the general population was determined by quota sampling. RESULTS: A total of 1,469 people entered the study. All healthcare workers and 624 (47.1%) laypersons were familiar with periodontitis. Bacterial etiology of periodontitis was recognized by 25 (4%) laypersons, 23 (34.3%) physicians, and 11 (16.6%) nurses. The following periodontal problems were experienced: 1) gingival redness: laypersons 14.4%, physicians 16.4%, and nurses 21.2%; 2) gingival bleeding: laypersons 22.2%, physicians 50.7%, and nurses 50%; 3) tooth mobility: laypersons 34.9%, physicians 7.4%, and nurses 6%; and 4) bleeding while toothbrushing: laypersons 44.3%, physicians 8.9%, and nurses 15.1%. More than a third of laypersons (37%) think periodontitis is related to other health problems, together with 53% of physicians and 47% of nurses. CONCLUSIONS: Our results show a low degree of periodontal knowledge both amongst the public and their primary care physicians and nurses and unveil unreliable targets (primary healthcare workers) for educational interventions to improve early diagnosis and treatment of periodontal disorders.

La cultura de seguridad del paciente en los médicos internos residentes de Medicina Familiar y Comunitaria de Galicia / Patient safety culture in Family practice residents of Galicia

OBJETIVO: Determinar la percepción que tienen los médicos residentes de Medicina Familiar y Comunitaria (MFyC) sobre las diferentes dimensiones de la seguridad del paciente para identificar posibles áreas de mejora. DISEÑO: Estudio transversal descriptivo por encuesta.Emplazamiento: Las 7 unidades docentes de MFyC de Galicia. PARTICIPANTES: Se incluyó a 182 médicos residentes de MFyC que contestaron el cuestionario Medical Office Survey on Patient Safety Culture. Mediciones: Se eligió el cuestionario Medical Office Survey on Patient Safety Culture porque está traducido, validado y adaptado al modelo de atención primaria español. Los resultados se agruparon en las 12 dimensiones que evalúa dicho cuestionario. Las variables del estudio fueron las dimensiones del cuestionario y las variables sociodemográficas/laborales de los profesionales: edad, sexo, año de residencia y unidades docentes de MFyC. RESULTADOS: Las dimensiones «Aprendizaje organizacional» y «Trabajo en equipo» se consideraron áreas fuertes. En cambio, las dimensiones «Aspectos relacionados con la seguridad del paciente y la calidad», «Intercambio de información con otros dispositivos asistenciales» y «Ritmo y carga de trabajo» se consideraron áreas con un importante potencial de mejora. Los residentes de primer año obtuvieron los mejores resultados y los de cuarto, los peores. CONCLUSIONES: Los resultados nos indican posiblemente la necesidad de incluir durante el proceso docente conocimientos básicos entre los profesionales en formación con el objetivo de incrementar y consolidar la frágil cultura de seguridad del paciente que se describe en este estudio

OBJECTIVE: To determine the views held by Family practice (FP) residents on the different dimensions of patient safety, in order to identify potential areas for improvement. DESIGN: A cross-sectional study. LOCATION: Seven FP of Galicia teaching units. PARTICIPANTS: 182 FP residents who completed the Medical Office Survey on Patient Safety Culture questionnaire. Measurements: The Medical Office Survey on Patient Safety Culture questionnaire was chosen because it is translated, validated, and adapted to the Spanish model of Primary Care. The results were grouped into 12 composites assessed by the mentioned questionnaire. The study variables were the socio-demographic dimensions of the questionnaire, as well as occupational/professional variables: age, gender, year of residence, and teaching unit of FP of Galicia. RESULTS: The «Organisational learning» and «Teamwork» items were considered strong areas. However, the «Patient safety and quality issues", «Information exchange with other settings», and «Work pressure and pace» items were considered areas with significant potential for improvement. First-year residents obtained the best results and the fourth-year ones the worst. CONCLUSIONS: The results may indicate the need to include basic knowledge on patient safety in the teaching process of FP residents in order to increase and consolidate the fragile patient safety culture described in this study

[Patient safety culture in Family practice residents of Galicia]. / La cultura de seguridad del paciente en los médicos internos residentes de Medicina Familiar y Comunitaria de Galicia.

OBJECTIVE: To determine the views held by Family practice (FP) residents on the different dimensions of patient safety, in order to identify potential areas for improvement. DESIGN: A cross-sectional study. LOCATION: Seven FP of Galicia teaching units. PARTICIPANTS: 182 FP residents who completed the Medical Office Survey on Patient Safety Culture questionnaire. MEASUREMENTS: The Medical Office Survey on Patient Safety Culture questionnaire was chosen because it is translated, validated, and adapted to the Spanish model of Primary Care. The results were grouped into 12 composites assessed by the mentioned questionnaire. The study variables were the socio-demographic dimensions of the questionnaire, as well as occupational/professional variables: age, gender, year of residence, and teaching unit of FP of Galicia. RESULTS: The "Organisational learning" and "Teamwork" items were considered strong areas. However, the "Patient safety and quality issues", "Information exchange with other settings", and "Work pressure and pace" items were considered areas with significant potential for improvement. First-year residents obtained the best results and the fourth-year ones the worst. CONCLUSIONS: The results may indicate the need to include basic knowledge on patient safety in the teaching process of FP residents in order to increase and consolidate the fragile patient safety culture described in this study.

Consumo de drogas en estudiantes de enfermería / Drug abuse in nursing students

OBJETIVO: Conocer los patrones de consumo de sustancias adictivas de los estudiantes de la Escuela Universitaria de Enfermería de Lugo. MÉTODO: Estudio observacional, descriptivo y transversal realizado en las aulas a través de un cuestionario en el mes de abril de 2015. RESULTADOS: La participación del alumnado fue del 61,5% (185), de los que el 83,2% correspondían al sexo femenino. La sustancia adictiva de consumo más precoz fue el tabaco (15 años). Consumieron cigarrillos en el último mes un 36,2% de los estudiantes y alcohol el 89,9% (un 58,4% del total se emborracharon). Un 2,2% utilizaron, en ese período, tranquilizantes/hipnóticos. La droga ilegal de mayor uso fue el cannabis (17,8%) y a continuación la cocaína (2,2%). Existe una asociación significativa entre el consumo de drogas ilegales y ser varón, fumar tabaco o beber alcohol, vivir solo o con amigos (no con la familia), tener un mal rendimiento académico y practicar botellón. No hubo diferencias con la práctica deportiva ni con la lectura. Se estudió también el policonsumo: el 16,2% manifestó haber utilizado simultáneamente alcohol y cannabis y un 4,9% alcohol y cocaína. CONCLUSIONES: Los patrones de consumo son similares, y algunos incluso mayores, que los de la población general en ese grupo de edad. De ahí que se consideren necesarias, en el ámbito universitario, medidas específicas para prevenir la adicción a sustancias en este colectivo

OBJECTIVE: To determine the patterns of substance abuse of students attending the Lugo School of Nursing. Method: Observational, descriptive and cross-sectional study in the classroom carried out by survey research in April 2015. RESULTS: 61.5% of students participated (185), 83.2% of whom were females. The first addictive substance consumed by participants was tobacco (at 15 years old). In the last month cigarettes were consumed by 36.2% of students, while alcohol was consumed by 89.9% (58.4% of the total got drunk).2.2% were consuming tranquilizers/hypnotics in the same time period. The most widely used illegal drug was cannabis (17.8%) and then cocaine (2.2%). There is a significant correlation between illegal drug consumption and being male, smoking cigarettes or drinking alcohol, living alone or with friends (not family), have poor academic performance and public drinking (botellón). There were no association between illegal drugs and sports or reading. Polydrug use was also studied: a 16.2% declared to have consumed alcohol and cannabis simultaneously, and a 4.9% alcohol and cocaine. CONCLUSIONS: Consumption patterns are similar compared to the general population in that age group, with some of them being higher. Therefore, it is necessary to take measures in order to prevent substance abuse at the university level

[Drug abuse in nursing students]. / Consumo de drogas en estudiantes de enfermería.

OBJECTIVE: To determine the patterns of substance abuse of students attending the Lugo School of Nursing. METHOD: Observational, descriptive and cross-sectional study in the classroom carried out by survey research in April 2015. RESULTS: 61.5% of students participated (185), 83.2% of whom were females. The first addictive substance consumed by participants was tobacco (at 15 years old). In the last month cigarettes were consumed by 36.2% of students, while alcohol was consumed by 89.9% (58.4% of the total got drunk). 2.2% were consuming tranquilizers/hypnotics in the same time period. The most widely used illegal drug was cannabis (17.8%) and then cocaine (2.2%). There is a significant correlation between illegal drug consumption and being male, smoking cigarettes or drinking alcohol, living alone or with friends (not family), have poor academic performance and public drinking (botellón). There were no association between illegal drugs and sports or reading. Polydrug use was also studied: a 16.2% declared to have consumed alcohol and cannabis simultaneously, and a 4.9% alcohol and cocaine. CONCLUSIONS: Consumption patterns are similar compared to the general population in that age group, with some of them being higher. Therefore, it is necessary to take measures in order to prevent substance abuse at the university level.

Periodontitis Awareness Amongst the General Public: A Critical Systematic Review to Identify Gaps of Knowledge.

BACKGROUND: Poor awareness of periodontal diseases and their consequences has been reported as the most frequent reason for periodontal treatment failure on a community basis. This study aims to identify the most relevant gaps of knowledge about periodontal diseases among the general public and to disclose whether these gaps are culturally consistent. METHODS: Systematic searches were conducted of the EMBASE, PubMed, and SciELO databases (1998 to November 2014). The search strategy was "periodontitis OR periodontal disease" and "knowledge OR awareness" as keywords and free text. Papers were included if they reported on community-based, quantitative studies undertaken on adult individuals. RESULTS: A total of 2,330 references were identified (1,567 single papers), and six papers were finally selected. Raw data were grouped into nine dimensions of periodontal knowledge: 1) awareness; 2) etiology; 3) associated risks; 4) signs and symptoms; 5) risk factors; 6) treatment; 7) general knowledge; 8) prevention; and 9) attitudes. This classification recognized disease awareness (80%), etiology (75%), and periodontal-related risks (71.43%) as the most important knowledge deficits among the general public. These findings were confirmed by weighted data analysis. CONCLUSIONS: The number of available community-based investigations on periodontal knowledge is scarce and restricted to areas with a very high level of human development. Gaps of knowledge exist in every geographic area, with the most relevant issues of low awareness and poor knowledge about the etiology of periodontal diseases and their relation with systemic disorders. These results highlight the need for local, community-based investigations about periodontal knowledge and barriers hampering early diagnosis, as well as for adequate educational interventions focused on these issues.

[Heterozygous family hypercholesterolemia: study of use of statins under clinical practice conditions]. / Hipercolesterolemia familiar heterocigota: estudio de utilización de estatinas en condiciones de práctica clínica.

OBJECTIVES: To compare the use profile of statins in patients with clinical diagnosis of heterozygous family hypercholesterolaemia (HFH) and the use profile of the general population treated with statins. DESIGN. Retrospective, observational study. SETTING: Galician Health Service, Spain. PARTICIPANTS: Patients under 65 years old treated with statins. MAIN MEASUREMENTS: In patients with HFH: number of patients, age, gender, statins used and defined daily dose per patient and day (DDD/patient/day). Variables in the rest of the population treated with statins: number of patients, statins used and DDD/patient/day. RESULTS: In a sample of 331 under-65 patients with HFH, 185 were men (55.86%) and 146 women (44.14%). Their average age was 44.56 years old (95% CI, 43.33-45.80), without statistically significant differences between men and women. Relevant differences in the daily mean consumption (DDD/patient/day) of statins between the studied sample and the rest of the under-65 population treated with statins were found (3.03 DDD/patient/day [95% CI, 2.70-3.36] vs 1.33 DDD/patient/day [95% CI, 1.16-1.40]; P< .001). These differences were caused by atorvastatin: 70% of HFH patients were being treated with atorvastatin (versus 37.6% of the rest of the population treated with statins). Differences in daily mean consumption of atorvastatin between HFH and the rest of the statin-treated population were also found (3.58 DDD/patient/day [95% CI, 3.15-4.02] vs 1.64 DDD/patient/day [95% CI, 1.37-1.90]; P< .001). CONCLUSIONS: The DDD/patient/day of statins in HFH patients is double that of the rest of the population treated with statins. The different pattern of use of atorvastatin in HFH is the main reason for these results.

Hipercolesterolemia familiar heterocigota: estudio de utilización de estatinas en condiciones de práctica clínica / Heterozygous family hypercholesterolemia: study of use of statins under clinical practice conditions

Objetivo. Comparar el perfil de utilización de las estatinas en pacientes con hipercolesterolemia familiar heterocigota (HFH) frente al del resto de la población tratada con estatinas. Diseño. Estudio observacional, retrospectivo. Emplazamiento. Servicio Gallego de Salud. Participantes. Pacientes < 65 años tratados con estatinas. Mediciones principales. Variables en los pacientes HFH: número de casos, edad, sexo, estatinas utilizadas y dosis diaria definida consumida por paciente y día (DDD/paciente/día). Variables en el resto de la población tratada con estatinas: número de pacientes, estatinas utilizadas y DDD/paciente/día. Resultados. De 331 pacientes < 65 años con HFH, 185 eran varones (55,86%) y 146 mujeres (44,14%). La edad media fue 44,56 años (intervalo de confianza [IC] del 95%, 43,33-45,80), sin diferencias estadísticamente significativas entre sexos. Se encontraron importantes diferencias en el consumo medio de estatinas entre la población HFH y el resto de población < 65 años tratada con estatinas (3,03 DDD/paciente/día; IC del 95%, 2,70-3,36 frente a 1,33 DDD/paciente/día; IC del 95%, 1,16-1,40; p < 0,001). Estas diferencias están causadas por la atorvastatina: el 70% de los pacientes con HFH estaba tratado con atorvastatina (frente al 37,6% del resto de la población tratada con estatinas). También se evidencia la diferencia de consumo medio de atorvastatina entre HFH y el resto de la población tratada con estatinas (3,58 DDD/paciente/día; IC del 95%, 3,15-4,02 frente a 1,64 DDD/paciente/día; IC del 95%, 1,37-1,90; p < 0,001). Conclusión. En la HFH, la DDD/paciente/día de estatinas duplica la del resto de población tratada con estatinas. El diferente patrón de utilización de la atorvastatina en la HFH es la principal causa de estos resultados

Objectives. To compare the use profile of statins in patients with clinical diagnosis of heterozygous family hypercholesterolaemia (HFH) and the use profile of the general population treated with statins. Design. Retrospective, observational study. Setting. Galician Health Service, Spain. Participants. Patients under 65 years old treated with statins. Main measurements. In patients with HFH: number of patients, age, gender, statins used and defined daily dose per patient and day (DDD/patient/day). Variables in the rest of the population treated with statins: number of patients, statins used and DDD/patient/day. Results. In a sample of 331 under-65 patients with HFH, 185 were men (55.86%) and 146 women (44.14%). Their average age was 44.56 years old (95% CI, 43.33-45.80), without statistically significant differences between men and women. Relevant differences in the daily mean consumption (DDD/patient/day) of statins between the studied sample and the rest of the under-65 population treated with statins were found (3.03 DDD/patient/day [95% CI, 2.70-3.36] vs 1.33 DDD/patient/day [95% CI, 1.16-1.40]; P<.001). These differences were caused by atorvastatin: 70% of HFH patients were being treated with atorvastatin (versus 37.6% of the rest of the population treated with statins). Differences in daily mean consumption of atorvastatin between HFH and the rest of the statin-treated population were also found (3.58 DDD/patient/day [95% CI, 3.15-4.02] vs 1.64 DDD/patient/day [95% CI, 1.37-1.90]; P<.001). Conclusions. The DDD/patient/day of statins in HFH patients is double that of the rest of the population treated with statins. The different pattern of use of atorvastatin in HFH is the main reason for these results

Los trastornos musculoesqueléticos en los odontoestomatólogos / Musculoskeletal disorders in dental professionals

Los profesionales de la Odontoestomatología sufren una incidencia alta de problemas en el aparato locomotor que, en ocasiones, pueden limitar su rendimiento laboral. Existen múltiples controversias relativas a los mecanismos y factores de riesgo implicados en estas molestias. Se analizan, además, las principales formas de prevención

Dental professionals suffer a high incidence of problems related to their locomotive apparatus which, in certain cases, can limit their working performance. There are multiple and controversial explanations regarding the mechanisms and risk factors associated to these disorders. We also analyze the most important preventive measures

[Use of acetylcholinesterase inhibitors and memantine in Alzheimer-type dementia]. / Utilización de los inhibidores de la acetilcolinesterasa y la memantina para el tratamiento clinico de la demencia tipo Alzheimer.

BACKGROUND: The therapeutic options to treat Alzheimer-type dementia (ATD) in recent years, have made it increasingly necessary to become familiar with the employment pattern of these new medicinal products. METHODS: A cross-sectional observational study of the population with ATD treated with acetylcholinesterase inhibitors and/or memantine in the Gallician Health Service. Databases were compiled with the demographic variables and use data during April 2005 of the medicinal products studied. RESULTS: Of the 5110 patients with ATD, 70.47% were women. The mean age of the women was 80.12 and of the men was 78.61 years old, with standard deviations of 6.66 and 7.03, respectively. The female sex was one of the factors associated with presenting ATD to pharmacological treatment (OR: 1.932 [CI 95%: 1.819-2.052]). The medication used most was donepezyl (44.46% of patients). Significant differences were found in that memantine was used to treat more patients in the group of patients < or =64 years (19.7% in < or =64 years vs. 14% in >64 years [p < 0.05]), and donepezyl was preferentially used in patients > or =95 years (75% in > or =95 years vs. 46.9% in <95 years [p < 0.03]). No significant differences were observed in the use of anti-dementia therapy, expressed in DDD/patient/day between the sexes, age groups, or in the age groups separated according to sex. CONCLUSIONS: The use of memantine (in monotherapy or in combination) is more frequent in patients under 64 years old. Female sex was found to be a factor associated with presenting ATD to pharmacological treatment.