Removal of a migrated dental implant from a maxillary sinus through an intraoral approach : a case report

The replacement of maxillary posterior teeth often challenges the clinician due to bone resorption after dental exodontia and low bone quality. Currently, attempts are being made to shorten treatment times by placing implants simultaneously to sinus lif

Sentiment Analysis on Twitter: Role of Healthcare Professionals in the Global Conversation during the AstraZeneca Vaccine Suspension

The vaccines against COVID-19 arrived in Spain at the end of 2020 along with vaccination campaigns which were not free of controversy. The debate was fueled by the adverse effects following the administration of the AstraZeneca-Oxford (AZ) vaccine in some European countries, eventually leading to its temporary suspension as a precautionary measure. In the present study, we analyze the healthcare professionals’ conversations, sentiment, polarity, and intensity on social media during two periods in 2021: the one closest to the suspension of the AZ vaccine and the same time frame 30 days later. We also analyzed whether there were differences between Spain and the rest of the world. Results: The negative sentiment ratio was higher (U = 87; p = 0.048) in Spain in March (Med = 0.396), as well as the daily intensity (U = 86; p = 0.044; Med = 0.440). The opposite happened with polarity (U = 86; p = 0.044), which was higher in the rest of the world (Med = −0.264). Conclusions: There was a general increase in messages and interactions between March and April. In Spain, there was a higher incidence of negative messages and intensity compared to the rest of the world during the March period that disappeared in April. Finally, it was found that the dissemination of messages linked to negative emotions towards vaccines against COVID-19 from healthcare professionals contributed to a negative approach to primary prevention campaigns in the middle of the pandemicThis research was funded by Fundación Banco Santander and Fundación Alfonso X el Sabio, grant number 1012031. Partial funding for open access charge: Universidad de Málag

Is Penicillin Allergy a Risk Factor for Early Dental Implant Failure? A Systematic Review

The prescription of preventive antibiotics in dental implant treatments reduces the incidence of early failures. This study has focused mainly on the influence of amoxicillin, which is contraindicated in penicillin-allergic patients. The present systematic review aimed to determine whether penicillin-allergic patients have a higher risk of implant failure compared to non-allergic patients. An electronic search was performed on Medline and Web of Science using the following MeSH terms: (penicillin allergy OR clindamycin OR erythromycin OR azithromycin OR metronidazole) AND (dental implant OR dental implant failure OR dental implant complications). The criteria employed were those described in the PRISMA® Declaration. Only five articles were included that analyzed the failure rates of implants placed in penicillin-allergic patients who were prescribed clindamycin compared to non-allergic patients who were prescribed amoxicillin. With the limitations of this study, it is not possible to state that penicillin allergy per se constitutes a risk factor for early dental implant failure as most of the studies included self-reported allergic patients. Clindamycin has been associated with a significantly elevated risk of failure and an up to six times increased risk of infection. Immediate implants also have a 5.7 to 10 times higher risk of failure

Implementación de un centro especializado en el cuidado y desarrollo infantil en la ciudad de Chiclayo “Baby Club & Garden”

El presente proyecto se enfoca en el crecimiento humano de las familias que apuntan a una calidad de vida más elevada,que les permita consolidarse dentro de la sociedad en la que viven. La propuesta del proyecto es la implementación de un centro especializado en el cuidado y desarrollo infantil, para niños de 3 a 36 meses de edad, basado en la aplicación de la metodología Montessori y haciendo uso de la tecnología acorde a los tiempos modernos. La metodología Montessori fomenta en el infante actitudes autónomas mediante el ejercicio de prueba-ensayo, la cual gestiona en el niño la construcción y descubrimiento de sus propias formas de aprendizaje, fortaleciendo su personalidad y autoestima. El otro componente es la tecnología, que mediante un aplicativo multiplataforma le permite al padre y/o apoderado, involucrarse en tiempo real con el desarrollo y crecimiento de su hijo, afianzando la cultura de confianza y transparencia en la relación servicio/cliente. La propuesta de valor se basa en una metodología dinámica y tecnológica, haciendo posible el desarrollo integral del infante e impulsando sus habilidades blandas para una relación más asertiva con el mundo, cumpliendo con la expectativa del padre y/o apoderado.Asociados al proyecto, se encuentran una gama de profesionales altamente calificados, con conocimientos modernos, acordes a las exigencias actuales y, sobre todo,con una vocación de servicio que los destaque por encima de otras propuestas conocidas en la Región Lambayeque. El nombre comercial que se ha considerado es Baby Club & Garden, un nombre amigable y de rápida recordación. Los términos empleados son una invitación a una comunidad de familias que anhela crecer y desarrollarse para enfrentar con éxito la vida. El distintivo del logo es la silueta de un bebé en actitud de incorporarse hacia adelante, lo que denota espíritu de superación, que va acorde al propósito del proyecto. El slogan “CRECE” es una invitación directa para contribuir con el crecimiento de la familia; el motivo vital de un padre y/o apoderado, es la de proteger y asegurar un mejor futuro para su hijo, y este proyecto lo logra, posibilitándole,a su vez, acceder a una vida más plena, personal y profesionalmente. Baby Club & Garden es una promesa de crecimiento para la familia moderna.El centro está ubicado en la Provincia de Chiclayo, Distrito de Chiclayo, en la Av. Libertad N° 573 –Urb. Santa Victoria. Aledaña al cercado de la ciudad, Baby Club & Garden, cuenta con una interesante ubicación, en donde existe una importante actividad comercial, donde han prosperado en los últimos años importantes negocios de servicios como clínicas, restaurantes, veterinarias, bancos, hoteles, aseguradoras, entre otros, lo que favorece y asegura el tránsito de potenciales clientes, situándola en una zona idónea para el negocio. A nivel infraestructura, Baby Club & Garden, cuenta con un diseño arquitectónico únicoen la región, dotado de una personalidad diferente, capaz de transmitir una atmósfera de innovación y vanguardia, lo que asegura un marcado liderazgo en el rubro.Para darse a conocer y en aras de ampliar su comunidad, Baby Club & Garden, apela a una estrategia de marketing (On y Off Line) alineada a los hábitos de consumo de su potencial cliente, haciendo uso de piezas publicitarias con un mensaje directo y potente, y con unidad de campaña que le de orden y asertividad a su poder de comunicación.El 2022 será el año de retorno a la presencialidad de los servicios que aún no se han reactivado o que lo han hecho parcialmente. Consciente de que el proceso de vacunación es un factor preponderante para la normalización de las actividades comerciales, Baby Club & Garden, se prepara para abrir sus puertas cumpliendo con todos los protocolos de bioseguridad vigentes y alineados a los estándares de salud pública que dicta el estado peruano.El ideal del proyecto es convertirse en una organización sostenible y sustentable, que posibilite el desarrollo integral de las familias en Chiclayo. Baby Club & Garden, crece.Escuela de Postgrad

CSVS, a crowdsourcing database of the Spanish population genetic variability

The knowledge of the genetic variability of the local population is of utmost importance in personalized medicine and has been revealed as a critical factor for the discovery of new disease variants. Here, we present the Collaborative Spanish Variability Server (CSVS), which currently contains more than 2000 genomes and exomes of unrelated Spanish individuals. This database has been generated in a collaborative crowdsourcing effort collecting sequencing data produced by local genomic projects and for other purposes. Sequences have been grouped by ICD10 upper categories. A web interface allows querying the database removing one or more ICD10 categories. In this way, aggregated counts of allele frequencies of the pseudo-control Spanish population can be obtained for diseases belonging to the category removed. Interestingly, in addition to pseudo-control studies, some population studies can be made, as, for example, prevalence of pharmacogenomic variants, etc. In addition, this genomic data has been used to define the first Spanish Genome Reference Panel (SGRP1.0) for imputation. This is the first local repository of variability entirely produced by a crowdsourcing effort and constitutes an example for future initiatives to characterize local variabilityworldwide. CSVS is also part of the GA4GH Beacon network.Spanish Ministry of Economy and Competitiveness SAF2017-88908-R PT17/0009/0006 PI19/00321 CIBERER ACCI-06/07/0036 PI14-948 PI171659Regional Government of Madrid, RAREGenomicsCM B2017/BMD3721 B2017/BMD-3721European Union (EU)European Union (EU) 676559University Chair UAM-IIS-FJD of Genomic MedicineRamon Areces Foundatio

Psychometric characteristics of the Spanish version of instruments to measure neck pain disability

[EN] Background. The NDI, COM and NPQ are evaluation instruments for disability due to NP. There was no Spanish version of NDI or COM for which psychometric characteristics were known. The objectives of this study were to translate and culturally adapt the Spanish version of the Neck Disability Index Questionnaire (NDI), and the Core Outcome Measure (COM), to validate its use in Spanish speaking patients with non-specific neck pain (NP), and to compare their psychometric characteristics with those of the Spanish version of the Northwick Pain Questionnaire (NPQ). Methods. Translation/re-translation of the English versions of the NDI and the COM was done blindly and independently by a multidisciplinary team. The study was done in 9 primary care Centers and 12 specialty services from 9 regions in Spain, with 221 acute, subacute and chronic patients who visited their physician for NP: 54 in the pilot phase and 167 in the validation phase. Neck pain (VAS), referred pain (VAS), disability (NDI, COM and NPQ), catastrophizing (CSQ) and quality of life (SF-12) were measured on their first visit and 14 days later. Patients' self-assessment was used as the external criterion for pain and disability. In the pilot phase, patients' understanding of each item in the NDI and COM was assessed, and on day 1 test-retest reliability was estimated by giving a second NDI and COM in which the name of the questionnaires and the order of the items had been changed. Results. Comprehensibility of NDI and COM were good. Minutes needed to fill out the questionnaires [median, (P25, P75)]: NDI. 4 (2.2, 10.0), COM: 2.1 (1.0, 4.9). Reliability: [ICC, (95%CI)]: NDI: 0.88 (0.80, 0.93). COM: 0.85 (0.75,0.91). Sensitivity to change: Effect size for patients having worsened, not changed and improved between days 1 and 15, according to the external criterion for disability: NDI: -0.24, 0.15, 0.66; NPQ: -0.14, 0.06, 0.67; COM: 0.05, 0.19, 0.92. Validity: Results of NDI, NPQ and COM were consistent with the external criterion for disability, whereas only those from NDI were consistent with the one for pain. Correlations with VAS, CSQ and SF-12 were similar for NDI and NPQ (absolute values between 0.36 and 0.50 on day 1, between 0.38 and 0.70 on day 15), and slightly lower for COM (between 0.36 and 0.48 on day 1, and between 0.33 and 0.61 on day 15). Correlation between NDI and NPQ: r = 0.84 on day 1, r = 0.91 on day 15. Correlation between COM and NPQ: r = 0.63 on day 1, r = 0.71 on day 15. Conclusion. Although most psychometric characteristics of NDI, NPQ and COM are similar, those from the latter one are worse and its use may lead to patients' evolution seeming more positive than it actually is. NDI seems to be the best instrument for measuring NP-related disability, since its results are the most consistent with patient's assessment of their own clinical status and evolution. It takes two more minutes to answer the NDI than to answer the COM, but it can be reliably filled out by the patient without assistanceS

Psychometric characteristics of the Spanish version of instruments to measure neck pain disability

Background: The NDI, COM and NPQ are evaluation instruments for disability due to NP. There was no Spanish version of NDI or COM for which psychometric characteristics were known. The objectives of this study were to translate and culturally adapt the Spanish version of the Neck Disability Index Questionnaire (NDI), and the Core Outcome Measure (COM), to validate its use in Spanish speaking patients with non-specific neck pain (NP), and to compare their psychometric characteristics with those of the Spanish version of the Northwick Pain Questionnaire (NPQ). Methods: Translation/re-translation of the English versions of the NDI and the COM was done blindly and independently by a multidisciplinary team. The study was done in 9 primary care Centers and 12 specialty services from 9 regions in Spain, with 221 acute, subacute and chronic patients who visited their physician for NP: 54 in the pilot phase and 167 in the validation phase. Neck pain (VAS), referred pain (VAS), disability (NDI, COM and NPQ), catastrophizing (CSQ) and quality of life (SF-12) were measured on their first visit and 14 days later. Patients' self-assessment was used as the external criterion for pain and disability. In the pilot phase, patients' understanding of each item in the NDI and COM was assessed, and on day 1 test-retest reliability was estimated by giving a second NDI and COM in which the name of the questionnaires and the order of the items had been changed. Results: Comprehensibility of NDI and COM were good. Minutes needed to fill out the questionnaires [median, (P25, P75)]: NDI. 4 (2.2, 10.0), COM: 2.1 (1.0, 4.9). Reliability: [ICC, (95%CI)]: NDI: 0.88 (0.80, 0.93). COM: 0.85 (0.75,0.91). Sensitivity to change: Effect size for patients having worsened, not changed and improved between days 1 and 15, according to the external criterion for disability: NDI: -0.24, 0.15, 0.66; NPQ: -0.14, 0.06, 0.67; COM: 0.05, 0.19, 0.92. Validity: Results of NDI, NPQ and COM were consistent with the external criterion for disability, whereas only those from NDI were consistent with the one for pain. Correlations with VAS, CSQ and SF-12 were similar for NDI and NPQ (absolute values between 0.36 and 0.50 on day 1, between 0.38 and 0.70 on day 15), and slightly lower for COM (between 0.36 and 0.48 on day 1, and between 0.33 and 0.61 on day 15). Correlation between NDI and NPQ: r = 0.84 on day 1, r = 0.91 on day 15. Correlation between COM and NPQ: r = 0.63 on day 1, r = 0.71 on day 15. Conclusion: Although most psychometric characteristics of NDI, NPQ and COM are similar, those from the latter one are worse and its use may lead to patients' evolution seeming more positive than it actually is. NDI seems to be the best instrument for measuring NP-related disability, since its results are the most consistent with patient's assessment of their own clinical status and evolution. It takes two more minutes to answer the NDI than to answer the COM, but it can be reliably filled out by the patient without assistance

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

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

Estudio tecno-económico del bioproceso de producción de ácido adípico

El ácido adípico o hexanodioico es un ácido orgánico de cadena lineal y seis átomos de carbono. Desde una perspectiva industrial, es el ácido dicarboxílico más importante, con una producción de 2,5 millones de toneladas/año. Su aplicación principal es la producción de nylon 6,6, cuya demanda está creciendo actualmente, especialmente debido a las fibras y resinas de nylon por su uso en la industria de la automoción y del calzado. Otras aplicaciones incluyen su uso en pinturas y recubrimientos, poliuretanos, aditivos plastificantes, lubricantes de bajo punto de fusión, adsorbentes y resinas sintéticas. Casi la totalidad del ácido adípico comercial se produce a partir de ciclohexano, a través de un proceso que consiste en dos oxidaciones sucesivas. Este proceso tiene bajo rendimiento y los efluentes generados resultan muy perjudiciales para el medio ambiente, ya que se genera óxido nitroso, un gas de efecto invernadero, 300 veces más perjudicial que el dióxido de carbono. Por consiguiente, se están realizando proyectos de investigación con objeto de desarrollar un método alternativo y limpio basado en una producción por microorganismos. El principal objetivo de este proyecto es estudiar la viabilidad técnica, económico-social y medioambiental, de una planta industrial de producción de ácido adípico por vía biológica. Para ello, se comparará el proceso biológico con el convencional, empleando el simulador de procesos Aspen Plus, en el que se realizará el diseño de las dos plantas, con el objetivo de comparar los costes energéticos, costes de las materias primas, costes globales de operación y efluentes de los procesos. El proceso convencional consiste en la oxidación de ciclohexano a una mezcla de ciclohexanol y ciclohexanona, y posteriormente oxidar esta mezcla con ácido nítrico para obtener el ácido adípico. Se genera óxido nitroso como subproducto. El proceso biológico emplea para la síntesis del ácido, bacterias que han sido modificadas genéticamente para que generen el ácido adípico como producto de su metabolismo y lo excreten al medio. Así pues, el proceso requiere como materias primas lo necesario para garantizar el buen crecimiento de los microorganismos, esto es, oxígeno y una fuente de alimento, sacarosa. El equipo más importante del proceso es el reactor biológico, donde las bacterias, a través de una reacción de fermentación, convierten glucosa y fructosa en ácido adípico. En la actualidad varias empresas tratan de conseguir un sistema eficiente de bioproducción de ácido adípico, empleando diferentes métodos, en función de la materia prima que les resulta más provechosa, bien sean azúcares, ácidos grasos o alcoholes vegetales. Tras la evaluación de ambos procesos quedará patente el interés del proceso biológico, tanto desde el punto de vista medioambiental, como por el económico