Project to prepare a teaching book for teaching Maxillofacial Surgery to Dentistry students

En la actividad odontológica, resulta imprescindible el conocimiento de la anatomía maxilofacial y las principales técnicas de diagnóstico, planificación y tratamiento quirúrgico de las patologías bucodentales. La enseñanza de Cirugía Maxilofacial en alumnos de Odontología comprende la impartición de clases magistrales en las que se exponen los conocimientos que el alumno debe adquirir, seminarios en los que se actualizan los conocimientos científicos actuales, prácticas en las que el alumno adquiere la habilidad manual para desarrollar en un futuro su actividad, y trabajos de revisión o búsqueda bibliográfica en los que el alumno debe aprender a seleccionar la información que le resulte de utilidad, organizarla y exponerla. Sin embargo, las herramientas docentes actuales de la Cirugía Maxilofacial en la Facultad de Odontología no incluyen un libro propio sobre los contenidos anteriormente mencionados. La actualización de los contenidos programados y los recursos disponibles, elaborando una literatura de referencia debe permitir al alumno adquirir los conocimientos y competencias necesarias para realizar su actividad profesional de forma razonada, responsable y eficaz. La comprobación de la adquisición de conocimientos se realizará mediante una autoevaluación disponible en el libro. Finalmente, mediante la simulación de situaciones clínicas para las que el alumno debe estar capacitado en base al conocimiento adquirido en la literatura de referencia el alumno será capaz de asimilar los conocimientos necesarios para la práctica odontológica.Depto. de Especialidades Clínicas OdontológicasFac. de OdontologíaFALSEsubmittedPagado por el auto

Complex Care Needs in Multiple Chronic Conditions: Population Prevalence and Characterization in Primary Care. A Study Protocol

Background: Chronicity, and particularly complex care needs for people with chronic diseases is one of the main challenges of health systems. Objective: To determine the population prevalence of people with chronic diseases and complex care needs and to characterize these needs considering features of health and social complexity in Primary Care. Design: Cross-sectional population-based study. Scope: Patients who have one or more chronic health conditions from three Primary Care urban centres of a reference population of 43.647 inhabitants older than 14 years old. Methodology: Data will be obtained from the review of electronical medical records. Complexity will be defined by: 1) the independent clinical judgment of primary care physicians and nurses and 2) the aid of three complexity domains (clinical and social). Patients with advanced chronic disease and limited life prognosis will be also described. Conclusions: This research protocol intends to describe and analyse complex care needs from a primary care professional perspective in order to improve knowledge of complexity beyond multimorbidity and previous consumption of health resources. Knowing about health and social complexity with a more robust empirical basis could help for a better integration of social and health policies and a more proactive and differentiated care approach in this most vulnerable population

Switching TNF antagonists in patients with chronic arthritis: An observational study of 488 patients over a four-year period

The objective of this work is to analyze the survival of infliximab, etanercept and adalimumab in patients who have switched among tumor necrosis factor (TNF) antagonists for the treatment of chronic arthritis. BIOBADASER is a national registry of patients with different forms of chronic arthritis who are treated with biologics. Using this registry, we have analyzed patient switching of TNF antagonists. The cumulative discontinuation rate was calculated using the actuarial method. The log-rank test was used to compare survival curves, and Cox regression models were used to assess independent factors associated with discontinuing medication. Between February 2000 and September 2004, 4,706 patients were registered in BIOBADASER, of whom 68% had rheumatoid arthritis, 11% ankylosing spondylitis, 10% psoriatic arthritis, and 11% other forms of chronic arthritis. One- and two-year drug survival rates of the TNF antagonist were 0.83 and 0.75, respectively. There were 488 patients treated with more than one TNF antagonist. In this situation, survival of the second TNF antagonist decreased to 0.68 and 0.60 at 1 and 2 years, respectively. Survival was better in patients replacing the first TNF antagonist because of adverse events (hazard ratio (HR) for discontinuation 0.55 (95% confidence interval (CI), 0.34-0.84)), and worse in patients older than 60 years (HR 1.10 (95% CI 0.97-2.49)) or who were treated with infliximab (HR 3.22 (95% CI 2.13-4.87)). In summary, in patients who require continuous therapy and have failed to respond to a TNF antagonist, replacement with a different TNF antagonist may be of use under certain situations. This issue will deserve continuous reassessment with the arrival of new medications. © 2006 Gomez-Reino and Loreto Carmona; licensee BioMed Central Ltd