Valoración del riesgo médico en la consulta dental mediante la encuesta EMRRH

Fundamento: debido a que cada vez hay una población de mayor edad y debido a las nuevas técnicas médicas y odontológicas, el número de complicaciones médicas durante el tratamiento dental tiende a aumentar. Para evitar estas complicaciones, debe realizarse una historia clínica apropiada a todos los pacientes. La búsqueda de un cuestionario apropiado, que cubra adecuadamente todas las posibilidades, es por tanto necesario. Material y método: en este trabajo se utilizó la encuesta EMRRH, propuesta por un grupo de investigadores europeos, para estudiar la prevalencia de los antecedentes médicos en una población que acude a la consulta dental solicitando tratamiento. Resultados: un total de 716 pacientes fueron registrados, de estos, 219 pacientes tenían algún antecedente médico de interés. Existían diferencias estadísticamente significativas entre la edad media de la población con y sin antecedentes médicos (p<0'0005). En segundo lugar, del 30'6% de la población con antecedentes médicos (N=219), diferenciamos aquellos pacientes que podían tener un riesgo bajo, medio y alto de complicaciones a la hora del tratamiento dental. Se obtuvo que el 17'31% de los pacientes fueron clasificados como riesgo ASA II; el 9'49% como ASA III, y el 2'51% como ASA IV. Dentro de las patologías, la de mayor frecuencia fue la hipertensión (13'8%), seguida de las alergias medicamentosas (8'37%), palpitaciones (7'82%), patología respiratoria (5'16%) y diabetes (4'3%). Conclusión: de todo esto podemos deducir la gran importancia de la realización de una detallada historia clínica, ya que podríamos alterar gravemente la salud del paciente con nuestro tratamiento dental.Object: Due to the fact that the population is getting older and to new medical and dental techniques, the number of medical complications during treatment is tending to increase. In order to avoid these complications a correct clinical history should be obtained of all these patients. The search for a suitable questionnaire which would be able to take into account all these factors is therefore necessary. Material and Method: In this study we have used the questionnaire EMRRH which has been proposed by a group of European investigators, in order to study the prevalence of past medical problems in a population that attends a dental clinic for treatment. Results: A total number of 716 patients were registered. Of these, 219 had a medical history that was of some interest to us. There were significant differences between the average age of the population with or without former medical problems (p<0´0005). Secondly, out of the 30´6% of the population with medical problems (N=219), we separated into groups those patients who would have a low, medium or high risk of complications when submitted to dental treatment. 17´31% of the patients were classified as risk ASA II; 949´% as ASA III, and 2´51% as ASA IV. Among the diverse pathologies the highest percentage was hypertension (13´8%), followed by allergies to different drugs (8´37%), palpitations (7´82%), respiratory pathologies (5´16%) and diabetes (4´3%). Conclusion: We can see the obvious need for a detailed medical history to be taken because of the existing prevalence of these above pathologies taking into account that without one we could seriously harm the patient´s health with our dental treatment

Osteocalcin in serum, saliva and gingival crevicular fluid : their relation with periodontal treatment outcome in postmenopausal women

Antecedentes. Los niveles de osteocalcina se han propuesto como marcador de la inhibición de la formación ósea. El propósito de este trabajo es determinar las concentraciones de osteocalcina en plasma, saliva y fluido crevicular correlacionándolo con el resultado del tratamiento periodontal en mujeres postmenopáusicas. Pacientes y métodos. El estudio se realizó en treinta y nueve mujeres postmenopáusicas (57.8 ±8.5 años de edad). El examen periodontal incluyó el control de placa, el sangrado al sondaje, la profundidad de sondaje (PS) y la pérdida de inserción (CAL). Se determinaron los niveles de osteocalcina en suero, saliva y fluido crevicular. A continuación se llevó a cabo el tratamiento periodontal. Pasados seis meses tras la primera cita se llevó a cabo un segundo examen periodontal. Resultados. Las medias de la PS y del CAL disminuyeron significativamente en el segundo examen periodontal en el grupo de mujeres con osteocalcina en suero < 10 ng/ml (15.8± 15.8% y 15.3± 21.2%, respectivamente; p < 0.05). La PS media disminuyó significativamente en el segundo exámen en los grupos con concentraciones de osteocalcina en saliva < 3 ng/ml (17.1± 15.9%; p < 0.05) y 3 ? 7 ng/ml (16.2 ± 18.1%; p < 0.05). Conclusiones. Los niveles bajos de osteocalcina en suero se asocian significativamente a un mayor porcentaje de disminución de la PS y del CAL tras el tratamiento periodontal en mujeres postmenopáusicas. Las bajas concentraciones de osteocalcina en saliva se asociaron significativamente a un mayor porcentaje de disminución de la PS

Balance as bias, resolute on the retreat? Updates & analyses of newspaper coverage in the United States, United Kingdom, New Zealand, Australia and Canada over the past 15 years

Through this research, we systematically updated and expanded understanding of how the print media represent evidence of human contributions to climate change. We built on previous research that examined how the journalistic norm of balanced reporting contributed to informationally biased print media coverage in the United States (U.S.) context. We conducted a content analysis of coverage across 4856 newspaper articles over 15 years (2005&ndash;2019) and expanded previous research beyond U.S. borders by analyzing 17 sources in five countries: the United Kingdom (U.K.), Australia, New Zealand, Canada, and the U.S. We found that across all the years of analysis, 90% of the sample accurately represented climate change. In addition, our data suggests that scientifically accurate coverage of climate change is improving over time. We also found that media coverage was significantly less accurate in 2010 and significantly more accurate in 2015, in comparison to the sample average. Additionally, Canada&rsquo;s National Post, Australia&rsquo;s Daily Telegraph and Sunday Telegraph, and the U.K.&rsquo;s Daily Mail and Mail on Sunday (all historically conservative outlets) had significantly less accurate coverage of climate change over this time period than their counterparts.</p

FAUST X: Formaldehyde in the Protobinary System [BHB2007] 11: Small Scale Deuteration

Context. Deuterium in H-bearing species is enhanced during the early stages of star formation, however, only a small number of high spatial resolution deuteration studies exist towards protostellar objects, leaving the small-scale structures unrevealed and understudied. Aims. We aim to constrain the deuterium fractionation ratios in a Class 0/I protostellar object in formaldehyde (H2CO), which has abundant deuterated isotopologues in this environment. Methods. We observed the Class 0/I protobinary system [BHB2007] 11, whose emission components are embedded in circumstellar disks that have radii of 2-3 au, using ALMA within the context of the Large Program FAUST. The system is surrounded by a complex filamentary structure connecting to the larger circumbinary disk. In this work we present the first study of formaldehyde D-fractionation towards this source with detections of H2CO 3(0,3)-2(0,2), combined with HDCO 4(2,2)-3(2,1), HDCO 4(1,4)-3(1,3) and D2CO 4(0,4)-3(0,3). These observations enable multiple velocity components associated with the methanol hotspots also uncovered by FAUST data, as well as the external envelope, to be resolved. In addition, based on the kinematics seen in the observations of the H2CO emission, we propose the presence of a second large scale outflow. Results. HDCO and D2CO are only found in the central regions of the core while H2CO is found more ubiquitously. From radiative transfer modelling, the column densities ranges found for H2CO, HDCO and D2CO are (3-8)x10$^{14}$ cm$^{-2}$, (0.8-2.9)x10$^{13}$ cm$^{-2}$ and (2.6-4.3)x10$^{12}$ cm$^{-2}$, respectively, yielding an average D/H ratio of 0.01-0.04. Following the results of kinematic modelling, the second large scale feature is inconsistent with a streamer-like nature and we thus tentatively conclude that the feature is an asymmetric molecular outflow launched by a wide-angle disk wind.Comment: 17 pages, 15 figure

Star formation in Perseus: II. SEDs, classification and lifetimes

Working with the submillimetre continuum map of the Perseus molecular cloud (Hatchell et al. 2005), we aimed to determine the evolutionary stage of each submm core in Perseus, and investigate the lifetimes of these phases. We compile spectral energy distributions (SEDs) from 2MASS, Spitzer IRAC, Michelle, IRAS, SCUBA and Bolocam data. Sources are classified starless/protostellar on the basis of infrared and/or outflow detections and Class I/Class 0 on the basis of Tbol, Lbol/Lsmm and F_{3.6}/F_{850}. In order to investigate the dependence of these evolutionary indicators on mass, we construct radiative transfer models of Class 0 sources. Of the submm cores, 56/103 (54%) are confirmed protostars on the basis of infrared emission or molecular outflows. Of these, 22 are classified Class 1 on the basis of three evolutionary indicators, 34 are Class 0, and the remaining 47 are assumed starless. Perseus contains a much greater fraction of Class 0 sources than either Taurus or Rho Oph. Comparing the protostellar with the T Tauri population, the lifetime of the protostellar phase in Perseus is 0.25-0.67 Myr (95% confidence limits). The relative lifetime of the Class 0 and Class 1 phases are similar. We find that for the same source geometry but different masses, evolutionary indicators such as Tbol vary their value. It is therefore not always appropriate to use a fixed threshold to separate Class 0 and Class I sources. More modelling is required to determine the observational characteristics of the Class 0/Class I boundary over a range of masses.Comment: A&A accepted. 35 pages, 24 figures. Version with original figures available at http://www.astro.ex.ac.uk/people/hatchell/publications.htm

Taking stock: provider prescribing practices in the presence and absence of ACT stock

BACKGROUND: Globally, the monitoring of prompt and effective treatment for malaria with artemisinin combination therapy (ACT) is conducted largely through household surveys. This measure; however, provides no information on case management processes at the health facility level. The aim of this review was to assess evidence from health facility surveys on malaria prescribing practices using ACT, in the presence and absence of ACT stock, at time and place where treatment was sought. METHODS: A systematic search of published literature was conducted. Findings were collated and data extracted on proportion of patients prescribed ACT and alternative anti-malarials in the presence and absence of ACT stock. RESULTS: Of the 14 studies identified in which ACT prescription for uncomplicated malaria in the public sector was evaluated, just six, from three countries (Kenya, Uganda and Zambia), reported this in the context of ACT stock. Comparing facilities with ACT stock to facilities without stock (i) ACT prescribing was significantly higher in all six studies, increasing by a range of 21.3% in children < 5 yrs weighing ≥ 5 kg (p < 0.001; Kenya 2006) to 51.7% in children ≥ 10 kg (p < 0.001; Zambia 2006); (ii) SP prescribing decreased significantly in five studies, by a range of 14.4% (p < 0.001; Kenya 2006), to 46.3% (p < 0.001; Zambia 2006); (iii) Where quinine was a reported alternative, prescriptions decreased in five of the six studies by 0.1% (p = 1.0, Kenya 2010) to 10.2% (p < 0.001; Zambia 2006). At facilities with no ACT stock on the survey day, the proportion of febrile patients prescribed ACT was < 10% in five of the nine target groups included in the six studies, with the proportion prescribed ACT ranging from 0 to 28.4% (Uganda 2007). CONCLUSIONS: Prescriber practices vary based on ACT availability. Although ACT prescriptions increased and alternative anti-malarials prescriptions decreased in the presence of ACT stock, ACT was prescribed in the absence, and alternative anti-malarials were prescribed in the presence of, ACT. Presence of stock alone does not ensure that treatment guidelines are followed. More health facility surveys, together with qualitative research, are needed to understand the role of ACT stock-outs on provider prescribing behaviours and preferences

Host choice and multiple blood feeding behaviour of malaria vectors and other anophelines in Mwea rice scheme, Kenya

<p>Abstract</p> <p>Background</p> <p>Studies were conducted between April 2004 and February 2006 to determine the blood-feeding pattern of <it>Anopheles </it>mosquitoes in Mwea Kenya.</p> <p>Methods</p> <p>Samples were collected indoors by pyrethrum spay catch and outdoors by Centers for Disease Control light traps and processed for blood meal analysis by an Enzyme-linked Immunosorbent Assay.</p> <p>Results</p> <p>A total of 3,333 blood-fed <it>Anopheles </it>mosquitoes representing four <it>Anopheles </it>species were collected and 2,796 of the samples were assayed, with <it>Anopheles arabiensis </it>comprising 76.2% (n = 2,542) followed in decreasing order by <it>Anopheles coustani </it>8.9% (n = 297), <it>Anopheles pharoensis </it>8.2% (n = 272) and <it>Anopheles funestus </it>6.7% (n = 222). All mosquito species had a high preference for bovine (range 56.3–71.4%) over human (range 1.1–23.9%) or goat (0.1–2.2%) blood meals. Some individuals from all the four species were found to contain mixed blood meals. The bovine blood index (BBI) for <it>An. arabiensis </it>was significantly higher for populations collected indoors (71.8%), than populations collected outdoors (41.3%), but the human blood index (HBI) did not differ significantly between the two populations. In contrast, BBI for indoor collected <it>An. funestus </it>(51.4%) was significantly lower than for outdoor collected populations (78.0%) and the HBI was significantly higher indoors (28.7%) than outdoors (2.4%). Anthropophily of <it>An. funestus </it>was lowest within the rice scheme, moderate in unplanned rice agro-ecosystem, and highest within the non-irrigated agro-ecosystem. Anthropophily of <it>An. arabiensis </it>was significantly higher in the non-irrigated agro-ecosystem than in the other agro-ecosystems.</p> <p>Conclusion</p> <p>These findings suggest that rice cultivation has an effect on host choice by <it>Anopheles </it>mosquitoes. The study further indicate that zooprophylaxis may be a potential strategy for malaria control, but there is need to assess how domestic animals may influence arboviruses epidemiology before adapting the strategy.</p

Modelling the Impact of Artemisinin Combination Therapy and Long-Acting Treatments on Malaria Transmission Intensity

Lucy Okell and colleagues predict the impact on transmission outcomes of ACT as first-line treatment for uncomplicated malaria in six areas of varying transmission intensity in Tanzania