Interferometric microscopy study of the surface roughness of Portland cement under the action of different irrigants

Objectives: Some investigations suggested common Portland cement (PC) as a substitute material for MTA for endodontic use; both MTA and PC have a similar composition. The aim of this study was to determine the surface roughness of common PC before and after the exposition to different endodontic irrigating solutions: 10% and 20% citric acid, 17% ethylenediaminetetraacetic (EDTA) and 5% sodium hypochlorite. Study Design: Fifty PC samples in the form of cubes were prepared. PC was mixed with distilled water (powder/ liquid ratio 3:1 by weight). The samples were immersed for one minute in 10% and 20% citric acid, 17% EDTA and 5% sodium hypochlorite. After gold coating, PC samples were examined using the New View 100 Zygo interferometric microscope. It was used to examine and register the surface roughness and the profile of two different areas of each sample. Analysis of variance (ANOVA) was carried out, and as the requirements were not met, use was made of the Kruskal-Wallis test for analysis of the results obtained, followed by contrasts using Tukey's contrast tests. Results: Sodium hypochlorite at a concentration of 5% significantly reduced the surface roughness of PC, while 20% citric acid significantly increased surface roughness. The other evaluated citric acid concentration (10%) slightly increased the surface roughness of PC, though statistical significance was not reached. EDTA at a concentration of 17% failed to modify PC surface roughness. Irrigation with 5% sodium hypochlorite and 20% citric acid lowered and raised the roughness values, respectively. Conclusions: The surface texture of PC is modified as the result of treatment with different irrigating solutions commonly used in endodontics, depending on their chemical composition and concentration

Abordaje integrativo del insomnio en atención primaria: medidas no farmacológicas y fitoterapia frente al tratamiento convencional

ResumenIntroducciónEl insomnio es un trastorno del sueño que imposibilita iniciarlo o mantenerlo. En algún momento de la vida, hasta un 50% de adultos lo padecen ante situaciones estresantes.ObjetivoEvaluar el impacto de medidas higiénicas del sueño, técnicas de relajación y fitoterapia para abordar el insomnio, comparado con medidas habituales (tratamiento farmacológico).MetodologíaEstudio experimental, retrospectivo, sin asignación aleatorizada. Revisión de pacientes diagnosticados de insomnio (2008-2010).Los pacientes de grupo intervención (GI) recibieron abordaje integrativo (medidas higiénicas, técnicas de relajación y fitoterapia), y los del grupo control (GC), tratamiento convencional.Se compararon resultados de uso de recursos (media mensual de visitas pre y posdiagnóstico), tipo de tratamiento farmacológico prescrito y dosis total.Evaluación de la calidad del sueño a los 18-24meses (test de Epworth).ResultadosSe incluyeron 48 pacientes en GI y 47 en GC (70% mujeres, media de edad 46años (DE: 14,3).La media mensual de visitas prediagnóstico fue 0,54(DE: 0,42) en GI y 0,53 (DE: 0,53) en GC (p=0,88). La media posterior fue 0,36 (DE: 0,24) y 0,65(DE: 0,46), respectivamente (p<0,0001), observándose reducción estadísticamente significativa en GI.Recibieron alguna benzodiacepina el 52,5% de los pacientes GI y el 93,6% de los del GC (p<0,0001). En GC se prescribió más alprazolam y lorazepam, con dosis acumuladas superiores.En la evaluación posterior no presentaban insomnio el 17% de los pacientes del GI y el 5% del GC. Presentaban insomnio severo el 13% de los pacientes del GC y ninguno del GI (p<0,0001).ConclusionesEl abordaje integrativo del insomnio puede ser resolutivo, disminuyendo las visitas y los efectos secundarios y la dependencia a benzodiacepinas.AbstractIntroductionInsomnia is a sleep disorder in which there is an inability to fall asleep or to stay asleep. At some point in life, 50% of adults suffer from it, usually in stress situations.AimTo evaluate the impact of sleep hygiene measures, relaxations techniques, and herbal medicine to deal with insomnia, compared with standard measures (drug treatment).MethodologyAn experimental, retrospective, non-randomized study was conducted by means of a review of patients diagnosed with insomnia (2008-2010).Patients in the intervention group (IG) received an integrative approach (hygiene measures, relaxation techniques, and herbal medicine) and a control group (CG) with conventional treatment.A comparison was made of the resources used in the two groups (average monthly visits pre- and post-diagnosis), type of prescribed drug therapy and total dose.Sleep quality was evaluated at 18-24months (Epworth test).ResultsA total of 48 patients were included in the IG and 47 in the CG (70% women, mean age 46years (SD: 14.3).Average monthly visit pre-diagnosis was 0.54 (SD: 0.42) in the IG and 0.53 (SD: 0.53) in the CG (P=.88). Post-diagnosis it was 0.36 (SD: 0.24) and 0.65 (SD: 0.46), respectively (P<.0001), with a statistically significant reduction being observed in the IG.More than half (52.5%) of the IG patients and 93.6% in the CG had received a benzodiazepine (P<.0001). Alprazolam and lorazepam were the most prescribed in the CG and with higher cumulative dose.In the subsequent evaluation, 17% of patients in the IG and 5% in CG did not have insomnia. Severe insomnia was present in 13% of patients in the IG and none in CG (P<.0001).ConclusionsThe integrative approach to insomnia may be worthwhile as it reduces resource use and side effects, as well as dependence to benzodiazepines

Description of thyroid disorders the year before conception: a population-based study

ObjectiveThis study aimed to monitoring the prevalence of previously identified thyroid disorders and hypothyroidism monitoring before pregnancy.Material and methodsA retrospective cross-sectional study of women whose pregnancies occurred between 2014 and 2016 was conducted, including 120,763 pregnancies in Catalonia (Spain). The presence of thyroid disorders in women was based on disease diagnostic codes and/or prescription of levothyroxine or antithyroid drugs. To evaluate the thyroid disorder diagnosis and monitoring, thyrotropin (TSH), free T4 (FT4), antiperoxidase antibody (TPOAb), and anti-TSH receptor antibody (TRAb) records were gathered and categorised according to the reference values of each laboratory.ResultsThe prevalence of recorded thyroid disorders before the last menstrual period was 5.09% for hypothyroidism and 0.64% for hyperthyroidism,showing a significant increase with age. A thyroid monitoring test was not performed in the year before the last menstrual period in approximately 40% of women with a known thyroid disorder. Amongst the women with hypothyroidism who underwent a TSH test, 31.75% showed an above-normal result. Amongst women previously unknown to have thyroid disorders, 3.12% had elevated TSH levels and 0.73% had low TSH levels.ConclusionA high percentage of Catalan women with a known thyroid disorder were not properly monitored during the year before pregnancy. Amongst those monitored, more than one-third had TSH values outside the reference range. Therefore, it is important to evaluate women with thyroid disorders during pre-pregnancy visits

Equitat en salut: el cas del biaix de genere

Equitat en salut; Equity in Health; Equidad en saludL’equitat en salut ens ha de preocupar si considerem que tots els éssers humans són moralment iguals i que, per tant, mereixen el mateix respecte a la seva vida i dignitat. Però també és rellevant des d’una visió més utilitarista, atès que uns nivells pitjors de salut dels individus comprometen el benestar social i econòmic global de les comunitats. Així, doncs, l’aspiració a l’equitat no és només una qüestió d’altruisme o de bones intencions, sinó una obligació moral i una qüestió de dret

Violencia doméstica: preguntar para detectar

ResumenObjetivosEvaluar si preguntas clave permiten detectar la violencia doméstica (VD) y conocer la prevalencia de ésta en atención primaria (AP) y en atención a la mujer (AM).DiseñoEstudio de intervención con asignación aleatorizada.EmplazamientoConsultas de AP y de AM (Sant Boi de Llobregat, Barcelona).ParticipantesSelección sistemática aleatorizada de mujeres en AP (se excluyó a las que se conocía que se las maltrataba) y de mujeres que acudían por primera vez al Servicio de AM. Se seleccionaron controles emparejados por edad. Se entrevistaron 400 mujeres.IntervencionesSe realizó anamnesis y un cuestionario. En el grupo control (GC) había una pregunta referente a VD, en el grupo intervención (GI) se incluían 6 preguntas clave: relación de sus padres, los de la pareja, si la pareja había sufrido maltrato, relación con su pareja, si se consentían las relaciones sexuales y si la pareja se enfadaba cuando no quería tenerlas. Ante VD se preguntaba el tipo, características y duración.ResultadosSe detectaron 101 (25,3%) casos de violencia, 58 (29,4%) en el GI y 43 (21,2%) en el GC (OR [odds ratio] = 1,55; intervalo de confianza (IC): 0,96 a 2,51; p = 0,06). En AM se detectó el 32,7 y el 17,5% (OR = 2,3; IC: 1,2 a 4,5; p = 0,007) y en AP el 25,3 y el 25,8% (OR = 0,97; IC del 95%: 0,47 a 2,02; p = 0,5), respectivamente.Las mujeres presentaban características diferentes según la procedencia (AM frente a AP), pero similares entre el GI y el GC, excepto en cuanto a la discapacidad psíquica, que era más frecuente en el GI.Presentaba enfermedad psiquiátrica el 23,5%, el 15% de las no maltratadas y el 44% de las maltratadas (de éstas, en el 68% la enfermedad era posterior al maltrato).ConclusionesEl maltrato es un problema de salud pública. Cuando la mujer acude por primera vez es necesario utilizar preguntas indirectas para facilitar la comunicación; si la mujer y el profesional ya se conocen basta una sola pregunta para detectarlo.AbstractAimsTo assess whether key questions can detect domestic violence (DV), and find out the prevalence in primary care (PC) and women's care (WC).DesignIntervention Study with random assignment.LocationPC and WC clinics (Sant Boi de Llobregat Barcelona).ParticipantsSystematic random selection of women in PC (not know if battered) and women who came for the first time to the WC service. Age-matched controls were selected. A total of 400 women were interviewed.InterventionsAnamnesis was performed and a questionnaire filled in. In the control group (CG) there was one question concerning DV, in the intervention group (IG) there were 6 key questions: relationship of their parents, partner's parents, if the partner had suffered abuse, relationship with her partner, if sexual relations were consensual or got angry if they were not. When DV was detected, asked about type, features and duration.ResultsA total of 101(25.3%) cases of violence were detected, 58(29.4%) in IG and 43(21.2%) in CG (odds ratio (OR)=1.55, confidence interval (CI): 0.96–2.51, P=0.06). WC rates were 32.7% and 17.5% (OR: 2.3, CI: 1.2–4.5, P:0.007) and PC 25.3% and 25.8% (OR: 0.97, CI: 0.47–2.02, P=0.5), respectively.Different characteristics were observed depending on whether they were from PC or WC, but were similar between IG and CG, except mental disability, more common in IG.23.5% suffered from a psychiatric disorder, 15% in non-battered and 44% in the battered, in 68% of these the disorder appeared after the abuse.ConclusionsAbuse is a Public Health problem. When women visit for the first time it is necessary to use indirect questions to make communication easier, if the woman and the professional know each other, a single question is enough to detect it

Equitat en salut: el cas del biaix de genere

Equitat en salut; Equity in Health; Equidad en saludL’equitat en salut ens ha de preocupar si considerem que tots els éssers humans són moralment iguals i que, per tant, mereixen el mateix respecte a la seva vida i dignitat. Però també és rellevant des d’una visió més utilitarista, atès que uns nivells pitjors de salut dels individus comprometen el benestar social i econòmic global de les comunitats. Així, doncs, l’aspiració a l’equitat no és només una qüestió d’altruisme o de bones intencions, sinó una obligació moral i una qüestió de dret

Table_1_Description of thyroid disorders the year before conception: a population-based study.docx

ObjectiveThis study aimed to monitoring the prevalence of previously identified thyroid disorders and hypothyroidism monitoring before pregnancy.Material and methodsA retrospective cross-sectional study of women whose pregnancies occurred between 2014 and 2016 was conducted, including 120,763 pregnancies in Catalonia (Spain). The presence of thyroid disorders in women was based on disease diagnostic codes and/or prescription of levothyroxine or antithyroid drugs. To evaluate the thyroid disorder diagnosis and monitoring, thyrotropin (TSH), free T4 (FT4), antiperoxidase antibody (TPOAb), and anti-TSH receptor antibody (TRAb) records were gathered and categorised according to the reference values of each laboratory.ResultsThe prevalence of recorded thyroid disorders before the last menstrual period was 5.09% for hypothyroidism and 0.64% for hyperthyroidism,showing a significant increase with age. A thyroid monitoring test was not performed in the year before the last menstrual period in approximately 40% of women with a known thyroid disorder. Amongst the women with hypothyroidism who underwent a TSH test, 31.75% showed an above-normal result. Amongst women previously unknown to have thyroid disorders, 3.12% had elevated TSH levels and 0.73% had low TSH levels.ConclusionA high percentage of Catalan women with a known thyroid disorder were not properly monitored during the year before pregnancy. Amongst those monitored, more than one-third had TSH values outside the reference range. Therefore, it is important to evaluate women with thyroid disorders during pre-pregnancy visits.</p

Insuficiencia cardiaca en atención primaria: actitudes, conocimientos y autocuidado

Resumen: Objetivo: Conocer actitudes, conocimientos y prácticas en autocuidado en pacientes con insuficiencia cardiaca (IC) atendidos en atención primaria, e identificar factores asociados a mayor autocuidado. Diseño: Estudio transversal multicéntrico. Emplazamiento: Atención primaria. Participantes: Individuos mayores de 18 años con diagnóstico activo de IC a 1 de diciembre de 2011 en 10 centros de salud del Área Metropolitana de Barcelona. Medidas principales: Se realizó entrevista y revisión de historia clínica para obtención de datos sociodemográficos, clínicos y tests de actitudes (Self-efficacy Managing Chronic Disease Scale), conocimientos (Patient Knowledge Questionnaire), autocuidado (European Heart Failure Self-care Behaviour Scale), grado autonomía (Barthel) y cribado ansiedad-depresión (test Goldberg). Se analizaron las variables asociadas a autocuidado mediante modelo de regresión lineal múltiple de efectos mixtos jerarquizado por centros. Resultados: n = 295 individuos (77,6%), edad media 75,6 años (DE: 11), 56,6% mujeres, 62% sin estudios primarios. Se obtuvo una media global de autocuidado de 28,65 (DE: 8,22) puntos. Un 25% de los pacientes presentaron puntuaciones inferiores a 21 puntos. En el modelo multivariante final (n = 282; R2 condicional = 0,3382), un mayor autocuidado se relacionó con mejores conocimientos sobre la IC (coeficiente −1,37; intervalo de confianza 95%: −1,85 a −0,90) y el diagnóstico de cardiopatía isquémica (−2,41; −4,36: −0,46). Conclusiones: El grado de prácticas en autocuidado es moderado. La asociación de mejor autocuidado y mayor nivel de conocimientos sobre la IC, potencialmente modificables, subraya la oportunidad de implementar estrategias para su mejora adaptadas a las características diferenciales de los pacientes con IC atendidos de atención primaria. Abstract: Objective: To determine the attitudes, knowledge, and self-care practices in patients with heart failure (HF) in Primary Care, as well as to identify factors associated with better self-care. Design: Cross-sectional and multicentre study. Setting: Primary Care. Participants: Subjects over 18 years old with HF diagnosis, attended in 10 Primary Health Care Centres in the Metropolitan Area of Barcelona. Main measurements: Self-care was measured using the European Heart Failure Self-Care Behaviour Scale. Sociodemographic and clinical characteristics, tests on attitudes (Self-efficacy Managing Chronic Disease Scale), knowledge (Patient Knowledge Questionnaire), level of autonomy (Barthel), and anxiety and depression screening (Goldberg Test), were also gathered in an interview. A multivariate mixed model stratified by centre was used to analyse the adjusted association of covariates with self-care. Results: A total of 295 subjects (77.6%) agreed to participate, with a mean age of 75.6 years (SD: 11), 56.6% women, and 62% with no primary education. The mean self-care score was 28.65 (SD: 8.22), with 25% of patients scoring lower than 21 points. In the final stratified multivariate model (n = 282; R2 conditional = 0.3382), better self-care was associated with higher knowledge (coefficient, 95% confidence interval: −1.37; −1.85 to −0.90), and coronary heart disease diagnosis (−2.41; −4.36: −0.46). Conclusion: Self-care was moderate. The correlation of better self-care with higher knowledge highlights the opportunity to implement strategies to improve self-care, which should consider the characteristics of heart failure patients attended in Primary Care. Palabras clave: Insuficiencia cardiaca, Autocuidado, Actitudes, Conocimientos, Atención primaria, Keywords: Heart failure, Self-care, Self-efficacy, Knowledge, Primary car