Necesidad de prótesis estomatológica, septiembre-diciembre, 2014

Introduction: in the analysis of the health area the necessity of dental prosthesis represented the principal health problem. Objective: to determine the necessity of dental prosthesis in patients older than 15 years from September to December 2014. Method: An observational - cross sectional - descriptive study was carried out in David Moreno Dominguez teaching polyclinic from Santa Rita, Jiguaní municipality, Granma province, in the period from September to December 2014. The universe was 9622 people older than 15 years and the sample of 1078 was established. A form created by the authors and validated by authorities in the subject was used; oral examinations were done in the patients´ houses; the data were taken and processed by descriptive statistics. The variables studied were dental prosthesis necessity, age, sex, type of needed denture and type of necessity. Results: the necessity of dental prosthesis in the studied health area was 75.60 %; Female sex and the group of age from 60 and older constituted of major necessity of dental prosthesis 80.92 % and 99.29 %; respectively, lower partial removable denture was the most needed 21.59 % and the felt necessity was predominant over the non-felt one 88.59 %. Conclusions: the necessity of dental prosthesis in the health area studied was elevated. Females and the group of age from 60 and older were in great need of denture. The lower partial removable denture was the most needed and the felt necessity rather than the non-felt one was predominant.Introducción: en el Análisis de la Situación de Salud del área la necesidad de prótesis estomatológica representó el principal problema de salud. Objetivo: determinar la necesidad de prótesis estomatológica en pacientes de 15 y más años desde septiembre a diciembre de 2014. Método: se realizó una investigación observacional descriptiva de corte transversal en el Policlínico David Moreno Domínguez de Santa Rita, municipio Jiguaní, Granma, desde septiembre a diciembre de 2014. El universo de estudio estuvo constituido por 9622 personas de 15 y más años de edad, a partir del cual se determinó una muestra de 1078 personas. Se utilizó un formulario creado por los autores y validado por un comité de expertos; se realizó examen bucal en el hogar de los pacientes; se vaciaron los datos y se procesaron mediante estadística descriptiva. Las variables estudiadas fueron: necesidad de prótesis estomatológica, edad, sexo, tipo de prótesis necesitada y tipo de necesidad. Resultados: la necesidad de prótesis estomatológica en el área de salud estudiada fue de un 75.60 %; el sexo femenino y el grupo de edad de 60 y más años constituyeron los de mayor necesidad de prótesis estomatológica, con 80.92 % y 99.29 % respectivamente; el tipo de prótesis estomatológica más necesitado resultó la parcial removible inferior con el 21.59 % y la necesidad sentida predominó sobre la no sentida, con el 88.59 %. Conclusiones: la necesidad de prótesis estomatológica en el área objeto de estudio resultó elevada. El sexo femenino y el grupo de 60 y más años fueron los más necesitados. La prótesis parcial removible inferior fue la más necesitada y la necesidad sentida predominó con respecto a la no sentida

Necesidad de prótesis estomatológica, septiembre- diciembre, 2014

RESUMEN Introducción: en el Análisis de la Situación de Salud del área la necesidad de prótesis estomatológica representó el principal problema de salud. Objetivo: determinar la necesidad de prótesis estomatológica en pacientes de 15 y más años desde septiembre a diciembre de 2014. Método: se realizó una investigación observacional descriptiva de corte transversal en el Policlínico David Moreno Domínguez de Santa Rita, municipio Jiguaní, Granma, desde septiembre a diciembre de 2014. El universo de estudio estuvo constituido por 9622 personas de 15 y más años de edad, a partir del cual se determinó una muestra de 1078 personas. Se utilizó un formulario creado por los autores y validado por un comité de expertos; se realizó examen bucal en el hogar de los pacientes; se vaciaron los datos y se procesaron mediante estadística descriptiva. Las variables estudiadas fueron: necesidad de prótesis estomatológica, edad, sexo, tipo de prótesis necesitada y tipo de necesidad. Resultados: la necesidad de prótesis estomatológica en el área de salud estudiada fue de un 75.60 %; el sexo femenino y el grupo de edad de 60 y más años constituyeron los de mayor necesidad de prótesis estomatológica, con 80.92 % y 99.29 % respectivamente; el tipo de prótesis estomatológica más necesitado resultó la parcial removible inferior con el 21.59 % y la necesidad sentida predominó sobre la no sentida, con el 88.59 %. Conclusiones: la necesidad de prótesis estomatológica en el área objeto de estudio resultó elevada. El sexo femenino y el grupo de 60 y más años fueron los más necesitados. La prótesis parcial removible inferior fue la más necesitada y la necesidad sentida predominó con respecto a la no sentida

Caracterización clínica y epidemiológica de los trastornos temporomandibulares.Policlínico ¨13 de Marzo¨ Bayamo

The clinical and epidemiological characterization of the temporomandibular disorders in 87 patients older than 20 years of the health area of the Policlínico ¨ 13 de Marzo ¨, of the Bayamo municipality, who attended the General Dentistry Service in 2017, is shown. An observational research was carried out of the transversal descriptive type The variables were analyzed: degree of dysfunction, age group, sex, history and clinical manifestations. In the studied population the degree of moderate dysfunction predominated (72.41%), the most affected patients were between 40 to 49 years old (39.08%), of females (50.57%). Stress (54.02%), parafunctional habits (22.99%) and the need for prosthetic treatment (16.09%) were the main antecedents. 40.23% of patients had alterations in joint function, followed by muscle pain (25.29%) and limitations in the range of mandibular movement (13.79%).Se muestra la  Caracterización clínica y epidemiológicamente de los trastornos temporomandibulares en 87 pacientes mayores de 20 años del área de salud del  Policlínico ¨13 de Marzo ¨, del municipio Bayamo, que acudieron al servicio de Estomatología General  en el año 2017. Realizándose una investigación observacional del tipo descriptivo transversal Se analizaron las variables: grado de disfunción, grupo de edades, sexo, antecedentes y manifestaciones clínicas. En la población estudiada predominó el grado de disfunción moderado (72.41 %), los pacientes más afectados estaban entre los  40 a 49 años  (39.08%),  del  sexo femenino (50.57%). El estrés (54.02%), los hábitos parafuncionales  (22.99%) y la necesidad de tratamiento protésico (16.09%) fueron los principales antecedentes. El 40.23% de los pacientes tenían alteraciones de la función articular,  seguido del dolor muscular (25.29%) y las  limitaciones en el rango de los  movimiento mandibulares (13.79%)

Eficacia y seguridad de la tintura de manzanilla en el tratamiento de la gingivitis crónica edematosa

Gingivitis affects great part of the population if it is not controlled on time can produce loss of support tissue, mobility and tooth loss. It was carried out an experimental fase IIb, randomized, controlled, evaluated by thirds clinical trial study with the purpose of evaluating efficiency and safety of chamomile tincture at 20 % in treating edematous chronic gingivitis in the department of odontology of the university polyclinic David Moreno Dominguez from January to September 2015. One hundred twenty four patients participated which were randomized into two groups of treatment, one study group and a control group. Chamomile tincture was applied to group B (study group) and conventional treatment was applied to group A (control group). Information was processed using SPSS version 22, and it was applied chi-squared test to corroborate the hypothesis. Most of the patients of study group were cured before 19 days of treatment, and they need less than 10 applications of the medical. The treatment with chamomile tincture at 20 % was effective and safe as the conventional treatment.La gingivitis afecta a gran parte de la población, si no se controla a tiempo puede producir la pérdida de los tejidos de soporte, movilidad y pérdida de los dientes.Se realizó un estudio experimental tipo ensayo clínico, fase IIb, aleatorizado, controlado y con evaluación a ciegas por tercero con el objetivo de evaluar la eficacia y seguridad de la tintura de manzanilla al 20 % en el tratamiento de la gingivitis crónica edematosa en el departamento de estomatología del policlínico universitario David Moreno Domínguez desde enero hasta septiembre del 2015. Participaron 124 pacientes que se aleatorizaron en dos grupos de tratamiento, uno de estudio y otro de control. Al grupo B (estudio) se le aplicó tintura de manzanilla al 20 % y al grupo A (control) tratamiento convencional. La información fue procesada mediante el programa estadístico profesional SPSS 22 y se utilizó la prueba de chi-cuadrado para corroborar la hipótesis. La mayoría de los pacientes del grupo estudio fueron curados antes de los 19 días de tratamiento y necesitaron menos de 10 aplicaciones del medicamento. El tratamiento con tintura de manzanilla al 20 % fue tan eficaz y seguro como el tratamiento convencional

Impact of COVID-19 on cardiovascular testing in the United States versus the rest of the world

Objectives: This study sought to quantify and compare the decline in volumes of cardiovascular procedures between the United States and non-US institutions during the early phase of the coronavirus disease-2019 (COVID-19) pandemic. Background: The COVID-19 pandemic has disrupted the care of many non-COVID-19 illnesses. Reductions in diagnostic cardiovascular testing around the world have led to concerns over the implications of reduced testing for cardiovascular disease (CVD) morbidity and mortality. Methods: Data were submitted to the INCAPS-COVID (International Atomic Energy Agency Non-Invasive Cardiology Protocols Study of COVID-19), a multinational registry comprising 909 institutions in 108 countries (including 155 facilities in 40 U.S. states), assessing the impact of the COVID-19 pandemic on volumes of diagnostic cardiovascular procedures. Data were obtained for April 2020 and compared with volumes of baseline procedures from March 2019. We compared laboratory characteristics, practices, and procedure volumes between U.S. and non-U.S. facilities and between U.S. geographic regions and identified factors associated with volume reduction in the United States. Results: Reductions in the volumes of procedures in the United States were similar to those in non-U.S. facilities (68% vs. 63%, respectively; p = 0.237), although U.S. facilities reported greater reductions in invasive coronary angiography (69% vs. 53%, respectively; p < 0.001). Significantly more U.S. facilities reported increased use of telehealth and patient screening measures than non-U.S. facilities, such as temperature checks, symptom screenings, and COVID-19 testing. Reductions in volumes of procedures differed between U.S. regions, with larger declines observed in the Northeast (76%) and Midwest (74%) than in the South (62%) and West (44%). Prevalence of COVID-19, staff redeployments, outpatient centers, and urban centers were associated with greater reductions in volume in U.S. facilities in a multivariable analysis. Conclusions: We observed marked reductions in U.S. cardiovascular testing in the early phase of the pandemic and significant variability between U.S. regions. The association between reductions of volumes and COVID-19 prevalence in the United States highlighted the need for proactive efforts to maintain access to cardiovascular testing in areas most affected by outbreaks of COVID-19 infection

Guidelines for the use and interpretation of assays for monitoring autophagy (3rd edition)

In 2008 we published the first set of guidelines for standardizing research in autophagy. Since then, research on this topic has continued to accelerate, and many new scientists have entered the field. Our knowledge base and relevant new technologies have also been expanding. Accordingly, it is important to update these guidelines for monitoring autophagy in different organisms. Various reviews have described the range of assays that have been used for this purpose. Nevertheless, there continues to be confusion regarding acceptable methods to measure autophagy, especially in multicellular eukaryotes. For example, a key point that needs to be emphasized is that there is a difference between measurements that monitor the numbers or volume of autophagic elements (e.g., autophagosomes or autolysosomes) at any stage of the autophagic process versus those that measure fl ux through the autophagy pathway (i.e., the complete process including the amount and rate of cargo sequestered and degraded). In particular, a block in macroautophagy that results in autophagosome accumulation must be differentiated from stimuli that increase autophagic activity, defi ned as increased autophagy induction coupled with increased delivery to, and degradation within, lysosomes (inmost higher eukaryotes and some protists such as Dictyostelium ) or the vacuole (in plants and fungi). In other words, it is especially important that investigators new to the fi eld understand that the appearance of more autophagosomes does not necessarily equate with more autophagy. In fact, in many cases, autophagosomes accumulate because of a block in trafficking to lysosomes without a concomitant change in autophagosome biogenesis, whereas an increase in autolysosomes may reflect a reduction in degradative activity. It is worth emphasizing here that lysosomal digestion is a stage of autophagy and evaluating its competence is a crucial part of the evaluation of autophagic flux, or complete autophagy. Here, we present a set of guidelines for the selection and interpretation of methods for use by investigators who aim to examine macroautophagy and related processes, as well as for reviewers who need to provide realistic and reasonable critiques of papers that are focused on these processes. These guidelines are not meant to be a formulaic set of rules, because the appropriate assays depend in part on the question being asked and the system being used. In addition, we emphasize that no individual assay is guaranteed to be the most appropriate one in every situation, and we strongly recommend the use of multiple assays to monitor autophagy. Along these lines, because of the potential for pleiotropic effects due to blocking autophagy through genetic manipulation it is imperative to delete or knock down more than one autophagy-related gene. In addition, some individual Atg proteins, or groups of proteins, are involved in other cellular pathways so not all Atg proteins can be used as a specific marker for an autophagic process. In these guidelines, we consider these various methods of assessing autophagy and what information can, or cannot, be obtained from them. Finally, by discussing the merits and limits of particular autophagy assays, we hope to encourage technical innovation in the field

Risk profiles and one-year outcomes of patients with newly diagnosed atrial fibrillation in India: Insights from the GARFIELD-AF Registry.

BACKGROUND: The Global Anticoagulant Registry in the FIELD-Atrial Fibrillation (GARFIELD-AF) is an ongoing prospective noninterventional registry, which is providing important information on the baseline characteristics, treatment patterns, and 1-year outcomes in patients with newly diagnosed non-valvular atrial fibrillation (NVAF). This report describes data from Indian patients recruited in this registry. METHODS AND RESULTS: A total of 52,014 patients with newly diagnosed AF were enrolled globally; of these, 1388 patients were recruited from 26 sites within India (2012-2016). In India, the mean age was 65.8 years at diagnosis of NVAF. Hypertension was the most prevalent risk factor for AF, present in 68.5% of patients from India and in 76.3% of patients globally (P < 0.001). Diabetes and coronary artery disease (CAD) were prevalent in 36.2% and 28.1% of patients as compared with global prevalence of 22.2% and 21.6%, respectively (P < 0.001 for both). Antiplatelet therapy was the most common antithrombotic treatment in India. With increasing stroke risk, however, patients were more likely to receive oral anticoagulant therapy [mainly vitamin K antagonist (VKA)], but average international normalized ratio (INR) was lower among Indian patients [median INR value 1.6 (interquartile range {IQR}: 1.3-2.3) versus 2.3 (IQR 1.8-2.8) (P < 0.001)]. Compared with other countries, patients from India had markedly higher rates of all-cause mortality [7.68 per 100 person-years (95% confidence interval 6.32-9.35) vs 4.34 (4.16-4.53), P < 0.0001], while rates of stroke/systemic embolism and major bleeding were lower after 1 year of follow-up. CONCLUSION: Compared to previously published registries from India, the GARFIELD-AF registry describes clinical profiles and outcomes in Indian patients with AF of a different etiology. The registry data show that compared to the rest of the world, Indian AF patients are younger in age and have more diabetes and CAD. Patients with a higher stroke risk are more likely to receive anticoagulation therapy with VKA but are underdosed compared with the global average in the GARFIELD-AF. CLINICAL TRIAL REGISTRATION-URL: http://www.clinicaltrials.gov. Unique identifier: NCT01090362

Reducing the environmental impact of surgery on a global scale: systematic review and co-prioritization with healthcare workers in 132 countries

Abstract Background Healthcare cannot achieve net-zero carbon without addressing operating theatres. The aim of this study was to prioritize feasible interventions to reduce the environmental impact of operating theatres. Methods This study adopted a four-phase Delphi consensus co-prioritization methodology. In phase 1, a systematic review of published interventions and global consultation of perioperative healthcare professionals were used to longlist interventions. In phase 2, iterative thematic analysis consolidated comparable interventions into a shortlist. In phase 3, the shortlist was co-prioritized based on patient and clinician views on acceptability, feasibility, and safety. In phase 4, ranked lists of interventions were presented by their relevance to high-income countries and low–middle-income countries. Results In phase 1, 43 interventions were identified, which had low uptake in practice according to 3042 professionals globally. In phase 2, a shortlist of 15 intervention domains was generated. In phase 3, interventions were deemed acceptable for more than 90 per cent of patients except for reducing general anaesthesia (84 per cent) and re-sterilization of ‘single-use’ consumables (86 per cent). In phase 4, the top three shortlisted interventions for high-income countries were: introducing recycling; reducing use of anaesthetic gases; and appropriate clinical waste processing. In phase 4, the top three shortlisted interventions for low–middle-income countries were: introducing reusable surgical devices; reducing use of consumables; and reducing the use of general anaesthesia. Conclusion This is a step toward environmentally sustainable operating environments with actionable interventions applicable to both high– and low–middle–income countries

Nurses' perceptions of aids and obstacles to the provision of optimal end of life care in ICU

Contains fulltext : 172380.pdf (publisher's version ) (Open Access

Reducing the environmental impact of surgery on a global scale: systematic review and co-prioritization with healthcare workers in 132 countries

Background Healthcare cannot achieve net-zero carbon without addressing operating theatres. The aim of this study was to prioritize feasible interventions to reduce the environmental impact of operating theatres. Methods This study adopted a four-phase Delphi consensus co-prioritization methodology. In phase 1, a systematic review of published interventions and global consultation of perioperative healthcare professionals were used to longlist interventions. In phase 2, iterative thematic analysis consolidated comparable interventions into a shortlist. In phase 3, the shortlist was co-prioritized based on patient and clinician views on acceptability, feasibility, and safety. In phase 4, ranked lists of interventions were presented by their relevance to high-income countries and low–middle-income countries. Results In phase 1, 43 interventions were identified, which had low uptake in practice according to 3042 professionals globally. In phase 2, a shortlist of 15 intervention domains was generated. In phase 3, interventions were deemed acceptable for more than 90 per cent of patients except for reducing general anaesthesia (84 per cent) and re-sterilization of ‘single-use’ consumables (86 per cent). In phase 4, the top three shortlisted interventions for high-income countries were: introducing recycling; reducing use of anaesthetic gases; and appropriate clinical waste processing. In phase 4, the top three shortlisted interventions for low–middle-income countries were: introducing reusable surgical devices; reducing use of consumables; and reducing the use of general anaesthesia. Conclusion This is a step toward environmentally sustainable operating environments with actionable interventions applicable to both high– and low–middle–income countries