Glosario básico actualizado de términos odontológicos de endodoncia: Inglés- Español.

Dentistry as a branch of Medical Sciences is influenced by a great deal of scientific information written in English, compelling the dental professionals to be updated in English language for a better science understanding. One of the means and methods to fulfill such goal is through English terms glossaries in which in a very simple way provide the meaning of the most frequent and important words of a certain area of knowledge. This Glossary focused on Endodontics has been conceived mainly as a working and reference tool for dental students and post- graduated professionals. Some terms have been left out of the Glossary because of their similarity to the Spanish equivalent. However, others were included because of their special translation. It is not an attempt to give all the words and phrases related to Endodontics; the aim is only to offer a quick and an updated reference on the most common and indispensable terms in this field.La estomatología como rama de las ciencias médicas no escapa al impacto del desarrollo de la ciencia y la técnica donde se crean grandes volúmenes de información científica que en la mayor parte de los casos su divulgación y/o comunicación provienen de países de habla inglesa o se generan en ese idioma, siendo muy necesario para el profesional al permitirle comprender y comunicar mejor la ciencia. Son variados los medios y métodos que el profesional utiliza para apropiarse de dichos conocimientos, los glosarios de términos en inglés de una misma rama o de un mismo campo de estudio son una herramienta válida de trabajo en el aprendizaje y uso de los idiomas al permitir de forma rápida el significado de palabras desde el contexto apropiado. Este glosario se ha concebido como un instrumento de trabajo y de consulta para estudiantes y profesionales en el campo de la Odontología, específicamente en endodoncia, no se pretende exponer todos los vocablos y frases pertenecientes a esta rama sería imposible, se excluyen los términos cuya escritura semeje al español excepto aquellos que su significado no sea el mismo. Recopila términos frecuentes y actuales necesarios para la comprensión de textos en esa rama

Lesiones de la mucosa bucal asociadas al uso de prótesis estomatológica en desdentados totales

Fundamento: La salud bucal debe ser vista como componente de la calidad de vida. El uso de prótesis durante largos períodos de tiempo sin que sean cambiadas periódicamente, puede generar dolor e inestabilidad durante la masticación, factores que conjuntamente con otros, pueden provocar el desarrollo de lesiones en los tejidos que están en contacto con el aparato protésico. Objetivo: Caracterizar la población con lesiones en la mucosa bucal asociadas al uso de prótesis estomatológica que acudió a la consulta de clasificación de prótesis en la Clínica Estomatológica “Leonardo Fernández”. Métodos: se realizó un estudio observacional descriptivo transversal en el período comprendido entre octubre de 2014  hasta enero de 2015 en la Clínica Estomatológica “Leonardo Fernández” del municipio Cienfuegos, desarrollado en un universo constituido por 200 pacientes se seleccionó una muestra no probabilística a conveniencia  para conformar un grupo de estudio que presentara algún tipo de lesión para lo que se realizó el examen clínico  a cada paciente. Resultados fundamentales: la lesión de mayor prevalencia resultó la estomatitis subprótesis con un 83,33 %, la mayor cantidad de lesiones se registraron en el sexo femenino con un 74.07 %, la estomatitis subprótesis apareció con mayor frecuencia en pacientes que usaban prótesis de 11 a 20 años (35.56 %) y tanto las prótesis ajustadas (deterioradas) y las desajustadas causaron la misma cantidad de lesiones (50 %). Conclusión: El uso de prótesis estomatológica se encuentra indudablemente relacionado con la aparición de lesiones en la mucosa bucal

Characterization of patients with stomatitis subprosthesis

Foundation: sub-prothesis stomatitis is one of the most frequently diagnosed disturbances within oral pathology. Objective: To characterize patients carrying subprothesis stomatitis. Methods: A descriptive cross-sectional study was carried out on a sample of 37 patients belonging to the José Luis Chaviano Chavez University Polyclinic Clinic, Area I, from Cienfuegos, attended between September and December 2016. Sex, age, type of prosthesis, use, technical state of the prosthesis, harmful habits, degree and area of injury were analyzed. Results: female gender predominated, between the ages of 60 and 74 years. The most common type of prosthesis was the total one, poor oral hygiene prevailed as a harmful habit, most the patients used prostheses continuously, the II degree was of higher prevalence and the lesion was more frequently found in the middle zone; the highest percentage of patients had maladjusted dentures. Conclusions: in patients with stomatologic prosthetics, sub-prothesis stomatitis constitutes undoubtedly a lesion with multifactorial etiology

Caracterización de pacientes portadores de estomatitis subprótesis

Fundamento: la estomatitis subprótesis es una de las alteraciones que con más frecuencia se diagnostica dentro de la patología bucal. Objetivo: Caracterizar pacientes portadores de estomatitis subprótesis.Métodos: estudio descriptivo transversal sobre una muestra de 37 pacientes pertenecientes a la Clínica Estomatológica del Policlínico Universitario José Luis Chaviano Chávez, Área I, de Cienfuegos atendidos entre septiembre y diciembre de 2016. Se analizaron: sexo, edad, tipo de prótesis, hábito de uso, estado técnico de la prótesis, hábitos perjudiciales, grado y zona de la lesión.Resultados: predominó el sexo femenino, las edades entre 60 y 74 años. El tipo de prótesis más común fue la total, prevaleció como hábito perjudicial la higiene bucal deficiente; la mayor cantidad usaba continuamente las prótesis, el grado de mayor prevalencia resultó el II y la lesión se encontró con más frecuencia en la zona media; el mayor porcentaje de pacientes portaba prótesis desajustadas. Conclusiones: en los pacientes portadores de prótesis estomatológicas, la estomatitis subprótesis constituye indudablemente una lesión de etiología multifactorial.</p

Instrument for the evaluation of education at work in the Comprehensive Attention to the Population subject

Background: in the current context of higher medical education, it is necessary to develop a participatory evaluation methodology in the various practical-clinical teaching scenarios of the training process that allows overcoming the traditional forms that have historically been based on the identification of knowledge and skills.Objective: to propose an instrument to evaluate the students` learning in the education at work of the Comprehensive Attention to the Population subject, that is taught in the fifth year of the Stomatology career.Methods: pedagogical research developed at the Cienfuegos University of Medical Sciences. Theoretical methods were used: analytical-synthetic and inductive-deductive and empirical: documentary analysis, interviews with teachers of the subject and participatory techniques. The proposed instrument was evaluated according to the criteria of specialists.Results: a rubric was made in correspondence with the system of main skills to be mastered declared in the program of the subject. For each nucleus, a score was established according to the level of execution or its domain. It allows hetero-evaluation, co-evaluation and self-evaluation, by providing the student with the possibility of recognizing their progress, achievements and difficulties, analyzing their individual and group situation in said educational process and developing a critical and reflective attitude about their educational process.Conclusions: the rubric is, undoubtedly, one of the instruments with the greatest potential for learning, it enables the evaluation of the objectives` degree of fulfillment.</p

Ciencia, Tecnología y Salud en la Atención de los Adolescentes

El Centro de Investigación en Ciencias Médicas (CICMED) de la Universidad Autónoma del Estado de México, institución que se distingue por su preocupación en el desarrollo de proyectos de investigación, actividades académicas y de vinculación encaminadas a la detección y tratamiento de aquellos problemas que aquejan a los adolescentes, se ha distinguido por la promoción de la salud del adolescente, además de un trabajo intenso a través de redes de investigación con otras instituciones con lo cual se han enriquecido nuestros proyectos de investigación, permitiendo establecer convenios con instituciones tanto nacionales como internacionales. Los temas que se tratan en este libro, han dado lugar a una gran cantidad de reflexiones, mitos, estrategias y propuestas para la cuidado del adolescente, motivo por el cual se invitó tanto a docentes como a investigadores a participar en este libro y poder mostrar lo que se está haciendo actualmente en relación con la atención de la salud del adolescente desde diferentes perspectivas temáticas, con el propósito de difundir ampliamente los hallazgos que como investigadores se han encontrado a través del trabajo clínico y de campo, aportar información relevante para la prevención y tratamiento de la problemática más frecuente en el adolescente y abrir un espacio de intercambio y actualización, basado en el trabajo interdisciplinario para entender mejor y ampliar la visión de los diferentes factores que inciden en la salud integral del adolescente. El adolescente concebido como la persona que está en la transición de la niñez a la vida adulta, ha existido siempre. Sin embargo, la adolescencia entendida como un proceso bio-psico-social con entidad propia y, en consecuencia, con características necesidades y problemas específicos, es una realidad que apenas ha comenzado a tenerse en cuenta recientemente. La adolescencia es el período de tiempo en el que se producen los cambios desde la inmadurez propia del niño a la madurez propia del adulto. Entendiendo al individuo maduro como: aquel que es capaz de orientar su propia vida según el sentido de la existencia, con criterios propios. Desde el punto de vista intelectual o mental, el individuo maduro es aquel que es capaz de juzgar con independencia y objetividad, con sentido crítico. Desde la vertiente afectiva, posee autocontrol de las emociones y es capaz de aceptar los fracasos sin grandes conmociones interiores. Desde el aspecto social, está dispuesto a colaborar en las tareas colectivas, es tolerante con los demás y es capaz de asumir su propia responsabilidad. Esta etapa de la vida de los seres humanos es importante ya que depende del desarrollo armónico de ésta, obliga al futuro adulto en su mundo globalizado lleno de exigencias y riesgos, que los profesionales de la salud reconsideren su actuar con estas personas, dado que hoy en día no hay especialistas o posgraduados que atiendan de manera específica a los adolescentes. En este sentido la Universidad Autónoma del Estado de México, a través del Centro de Investigación en Ciencias Médica adquiere la responsabilidad y el compromiso de motivar a padres, educadores, profesionales de la salud y a los mismos adolescentes para que se conviertan en promotores de la salud física y mental que bajo la misma meta en la escuela y el hogar promuevan una conducta saludable. Por lo que brindamos nuestro agradecimiento a los autores por su valiosa participación y confianza al dejar en nuestras manos su trabajo profesional, comprometido y entusiasta, con el propósito de aportar a la sociedad una perspectiva general sobre el adolescente y sus trastornos para ubicarnos después en un contexto de salud integral

Effectiveness of an intervention for improving drug prescription in primary care patients with multimorbidity and polypharmacy:Study protocol of a cluster randomized clinical trial (Multi-PAP project)

This study was funded by the Fondo de Investigaciones Sanitarias ISCIII (Grant Numbers PI15/00276, PI15/00572, PI15/00996), REDISSEC (Project Numbers RD12/0001/0012, RD16/0001/0005), and the European Regional Development Fund ("A way to build Europe").Background: Multimorbidity is associated with negative effects both on people's health and on healthcare systems. A key problem linked to multimorbidity is polypharmacy, which in turn is associated with increased risk of partly preventable adverse effects, including mortality. The Ariadne principles describe a model of care based on a thorough assessment of diseases, treatments (and potential interactions), clinical status, context and preferences of patients with multimorbidity, with the aim of prioritizing and sharing realistic treatment goals that guide an individualized management. The aim of this study is to evaluate the effectiveness of a complex intervention that implements the Ariadne principles in a population of young-old patients with multimorbidity and polypharmacy. The intervention seeks to improve the appropriateness of prescribing in primary care (PC), as measured by the medication appropriateness index (MAI) score at 6 and 12months, as compared with usual care. Methods/Design: Design:pragmatic cluster randomized clinical trial. Unit of randomization: family physician (FP). Unit of analysis: patient. Scope: PC health centres in three autonomous communities: Aragon, Madrid, and Andalusia (Spain). Population: patients aged 65-74years with multimorbidity (≥3 chronic diseases) and polypharmacy (≥5 drugs prescribed in ≥3months). Sample size: n=400 (200 per study arm). Intervention: complex intervention based on the implementation of the Ariadne principles with two components: (1) FP training and (2) FP-patient interview. Outcomes: MAI score, health services use, quality of life (Euroqol 5D-5L), pharmacotherapy and adherence to treatment (Morisky-Green, Haynes-Sackett), and clinical and socio-demographic variables. Statistical analysis: primary outcome is the difference in MAI score between T0 and T1 and corresponding 95% confidence interval. Adjustment for confounding factors will be performed by multilevel analysis. All analyses will be carried out in accordance with the intention-to-treat principle. Discussion: It is essential to provide evidence concerning interventions on PC patients with polypharmacy and multimorbidity, conducted in the context of routine clinical practice, and involving young-old patients with significant potential for preventing negative health outcomes. Trial registration: Clinicaltrials.gov, NCT02866799Publisher PDFPeer reviewe

The evolution of the ventilatory ratio is a prognostic factor in mechanically ventilated COVID-19 ARDS patients

Background: Mortality due to COVID-19 is high, especially in patients requiring mechanical ventilation. The purpose of the study is to investigate associations between mortality and variables measured during the first three days of mechanical ventilation in patients with COVID-19 intubated at ICU admission. Methods: Multicenter, observational, cohort study includes consecutive patients with COVID-19 admitted to 44 Spanish ICUs between February 25 and July 31, 2020, who required intubation at ICU admission and mechanical ventilation for more than three days. We collected demographic and clinical data prior to admission; information about clinical evolution at days 1 and 3 of mechanical ventilation; and outcomes. Results: Of the 2,095 patients with COVID-19 admitted to the ICU, 1,118 (53.3%) were intubated at day 1 and remained under mechanical ventilation at day three. From days 1 to 3, PaO2/FiO2 increased from 115.6 [80.0-171.2] to 180.0 [135.4-227.9] mmHg and the ventilatory ratio from 1.73 [1.33-2.25] to 1.96 [1.61-2.40]. In-hospital mortality was 38.7%. A higher increase between ICU admission and day 3 in the ventilatory ratio (OR 1.04 [CI 1.01-1.07], p = 0.030) and creatinine levels (OR 1.05 [CI 1.01-1.09], p = 0.005) and a lower increase in platelet counts (OR 0.96 [CI 0.93-1.00], p = 0.037) were independently associated with a higher risk of death. No association between mortality and the PaO2/FiO2 variation was observed (OR 0.99 [CI 0.95 to 1.02], p = 0.47). Conclusions: Higher ventilatory ratio and its increase at day 3 is associated with mortality in patients with COVID-19 receiving mechanical ventilation at ICU admission. No association was found in the PaO2/FiO2 variation

Clustering COVID-19 ARDS patients through the first days of ICU admission. An analysis of the CIBERESUCICOVID Cohort

Background Acute respiratory distress syndrome (ARDS) can be classified into sub-phenotypes according to different inflammatory/clinical status. Prognostic enrichment was achieved by grouping patients into hypoinflammatory or hyperinflammatory sub-phenotypes, even though the time of analysis may change the classification according to treatment response or disease evolution. We aimed to evaluate when patients can be clustered in more than 1 group, and how they may change the clustering of patients using data of baseline or day 3, and the prognosis of patients according to their evolution by changing or not the cluster.Methods Multicenter, observational prospective, and retrospective study of patients admitted due to ARDS related to COVID-19 infection in Spain. Patients were grouped according to a clustering mixed-type data algorithm (k-prototypes) using continuous and categorical readily available variables at baseline and day 3.Results Of 6205 patients, 3743 (60%) were included in the study. According to silhouette analysis, patients were grouped in two clusters. At baseline, 1402 (37%) patients were included in cluster 1 and 2341(63%) in cluster 2. On day 3, 1557(42%) patients were included in cluster 1 and 2086 (57%) in cluster 2. The patients included in cluster 2 were older and more frequently hypertensive and had a higher prevalence of shock, organ dysfunction, inflammatory biomarkers, and worst respiratory indexes at both time points. The 90-day mortality was higher in cluster 2 at both clustering processes (43.8% [n = 1025] versus 27.3% [n = 383] at baseline, and 49% [n = 1023] versus 20.6% [n = 321] on day 3). Four hundred and fifty-eight (33%) patients clustered in the first group were clustered in the second group on day 3. In contrast, 638 (27%) patients clustered in the second group were clustered in the first group on day 3.Conclusions During the first days, patients can be clustered into two groups and the process of clustering patients may change as they continue to evolve. This means that despite a vast majority of patients remaining in the same cluster, a minority reaching 33% of patients analyzed may be re-categorized into different clusters based on their progress. Such changes can significantly impact their prognosis

Role of age and comorbidities in mortality of patients with infective endocarditis

[Purpose]: The aim of this study was to analyse the characteristics of patients with IE in three groups of age and to assess the ability of age and the Charlson Comorbidity Index (CCI) to predict mortality. [Methods]: Prospective cohort study of all patients with IE included in the GAMES Spanish database between 2008 and 2015.Patients were stratified into three age groups:<65 years,65 to 80 years,and ≥ 80 years.The area under the receiver-operating characteristic (AUROC) curve was calculated to quantify the diagnostic accuracy of the CCI to predict mortality risk. [Results]: A total of 3120 patients with IE (1327 < 65 years;1291 65-80 years;502 ≥ 80 years) were enrolled.Fever and heart failure were the most common presentations of IE, with no differences among age groups.Patients ≥80 years who underwent surgery were significantly lower compared with other age groups (14.3%,65 years; 20.5%,65-79 years; 31.3%,≥80 years). In-hospital mortality was lower in the <65-year group (20.3%,<65 years;30.1%,65-79 years;34.7%,≥80 years;p < 0.001) as well as 1-year mortality (3.2%, <65 years; 5.5%, 65-80 years;7.6%,≥80 years; p = 0.003).Independent predictors of mortality were age ≥ 80 years (hazard ratio [HR]:2.78;95% confidence interval [CI]:2.32–3.34), CCI ≥ 3 (HR:1.62; 95% CI:1.39–1.88),and non-performed surgery (HR:1.64;95% CI:11.16–1.58).When the three age groups were compared,the AUROC curve for CCI was significantly larger for patients aged <65 years(p < 0.001) for both in-hospital and 1-year mortality. [Conclusion]: There were no differences in the clinical presentation of IE between the groups. Age ≥ 80 years, high comorbidity (measured by CCI),and non-performance of surgery were independent predictors of mortality in patients with IE.CCI could help to identify those patients with IE and surgical indication who present a lower risk of in-hospital and 1-year mortality after surgery, especially in the <65-year group