Comparative study of the osteoblastic activity of two implant systems (Endopore versus Entegra) utilizing single photon emission computed tomography (SPECT): experimental study in pigs model / Estudio comparativo de la actividad osteoblástica de dos sistemas de implantes (Endopore versus Entegra) utilizando tomografía computarizada por emisión de fotones individuales: estudio experimental en modelos porcinos

Implantology has been an important component of dental management for over forty years, and during that period, many configurations of implant materials and methods have been developed. As empirical and clinical research yield new implant materials, there has been need to test and compare these materials to provide the most cost-effective and efficient implants. Evaluation of efficiency of implants has relied heavily on histological and radiological methods, but these one-dimensional measurement methods fail to evaluate the osteoblastic activity and osseointegration properties of putative implants. In this report, we describe the use of a quantitative single photon emission computed tomography (SPECT) as a tool for comparing the osseointegrating capabilities of two types of implants.

La implantología ha sido un componente importante del tratamiento odontológico durante más de cuarenta años, y durante ese período, se han desarrollado muchas configuraciones de materiales y métodos de implante. A medida que la investigación empírica y clínica proporciona nuevos materiales de implante, ha surgido la necesidad de probar y comparar estos materiales para lograr que los implantes sean lo más costo-efectivos y eficientes posible. La evaluación de la eficiencia de los implantes ha dependido considerablemente de los métodos histológicos y radiológicos, pero estos métodos de medición unidimensional no son útiles a la hora de evaluar la actividad osteoblástica y las propiedades osteointegradoras de los implantes putativos. En este reporte, describimos el uso de la tomografía computarizada por emisión de fotones individuales (SPECT) como herramienta para comparar las capacidades osteointegradoras de dos tipos de implantes.

Supporting cancer patients in Jamaica: a needs assessment survey / Apoyo a los pacientes de cáncer en Jamaica: una encuesta para la evaluación de las necesidades

OBJECTIVE: Global cancer incidence is rising rapidly, particularly in the developing world where a majority of people present with advanced disease. In the English-speaking Caribbean, there is very little published data on the needs of cancer patients, their caregivers or those of allied health professionals. The research team sought to redress this balance by undertaking a needs assessment survey in the South Eastern Health Region of Jamaica to identify unmet needs and to make recommendations for improved service delivery. METHODS: A mixed methods, cross-sectional study design was used involving formal and semi-formal interviews and focus group discussions. RESULTS: The study results indicated that there were significant barriers to accessing healthcare. These included prohibitive costs of diagnosis and treatment, a mistrust of, and poor communication with doctors, compounded by people's fears, belief in folk wisdom and lack of knowledge about cancer. Recommendations offered by the study participants focussed on a community-based model of support to address the multiple needs of people facing life-limiting illness and their caregivers. Healthcare practitioners recommended the development of specific policies, targeting, in particular, improved drug availability and palliative care education in order to guide development of appropriate services for the large numbers of cancer patients in need. CONCLUSION: A multiplicity of unmet needs was identified by cancer patients, their caregivers and allied health professionals. Recommendations by study participants and the authors echoed the guidelines as set out by the World Health Organization (WHO) in its 1990 Public Health Model for the integration of palliative care into existing healthcare systems.

OBJETIVO: La incidencia de cáncer global está aumentado rápidamente, particularmente en el mundo en vías de desarrollo, dónde un gran número de personas se presentan con la enfermedad en estado avanzado. En el Caribe angloparlante, se ha publicado muy poca información sobre las necesidades de los pacientes de cáncer, sus cuidadores o los profesionales de salud asociados. El equipo de investigación buscó restablecer el equilibrio emprendiendo un estudio de evaluación de las necesidades en la Región de Salud Suroriental de Jamaica, para identificar las necesidades no satisfechas y hacer recomendaciones encaminadas a mejorar la prestación de servicios. MÉTODOS: Se empleo un diseño de estudio transversal con métodos mixtos, contentivo de entrevistas formales y semi-formales así como discusiones de grupos focales. RESULTADOS: Los resultados del estudio indicaron que había barreras considerables para el acceso a la atención a la salud. Estas comprendían costos prohibitivos para el diagnóstico y el tratamiento, desconfianza y pobre comunicación con los doctores, agravada por los miedos de la gente, la creencia en la sabiduría popular, y la falta de conocimientos sobre el cáncer. Las recomendaciones ofrecidas por los participantes en el estudio se centran en un modelo basado en la comunidad. Este modelo permite abordar las múltiples necesidades de las personas que enfrentan enfermedades limitantes de la vida, así como las necesidades de sus cuidadores. Los practicantes de cuidados de la salud recomendaron el desarrollo de políticas específicas, encaminadas especialmente a mejorar la disponibilidad de medicamentos y educación de cuidados paliativos para guiar el desarrollo de servicios apropiados para el gran número de pacientes necesitados, enfermos de cáncer. CONCLUSIÓN: Se identificaron una multiplicidad de necesidades no satisfechas, por parte de los pacientes de cáncer, sus cuidadores y profesionales de salud asociados. Las recomendaciones hechas por los participantes en el estudio y los autores, siguieron al pie de la letra los lineamientos trazados por la Organización Mundial de la Salud (OMS) en su Modelo de Salud Pública de 1990 para la integración del cuidado paliativo en los sistemas de cuidado de salud existentes.

Onchocerciasis control on the island of Bioko (Republic of Equatorial Guinea) by vector elimination: Environnemental impact assessment (EIA) part 2c macro invertebrate indicator species

A literature search has established that the freshwater macro-invertebrate fauna ofBioko is extremely poorly studied and that relatively few species of freshwater insects have been recorded from the island (Appendix 1). Nevertheless, it is apparent from this searc[ and from insects collected on the island during the present study, that the ocp identification manual to aquatic inseas from the Ivory coast @ejoux et al., lggl)and the standard recording form 5620 are adequate for family level recording of specimens collected on the island because all families known from Bioko are covered. There are genera of aquatic insects which are found on Bioko and are not covered, but this is unlikely to seriously distort estimates of community structurq for which they are designed. l'2' The impact of the inseaicide Temephos, used to eradicate Sirrulium dannowms.l. the vector of onchoceriasis, on chironomidae (non-biting midges) genera and odonata (dragonflies) species on three streams on Bioko has been investigated as part of an environmental impaa assessment. 1'3' Adult and larval odonata and larval Chironomidae were surveyed throu-ehout Bioko between 23 Marchand 9 April 1999 to establish the distribution ofthese groups and to indicate whether recolonisation oftreated strezmrs from untreated refugia would be possible to re-establish any non-target ta:ra that were eliminated following rhe Simuliumeradication progriunme.l'4' Treatment of all three trial sfeams with Temephos had an adverse effect on the chironomid fauna with an elimination of up 5u/o of thegenera at sites immediately downstream ofthe treaunent point. Insufficient nurnbers of odonata larvae were present in the samples to draw meaningful conclusions about the direa impact ofthe insecticide on the odonate fauna. However, if the insecticide causes a general reduction in abundance and biodiversity of aquatic macro- invertebrates, the odonate fauna could be expected to decline within a few weeks due to a shortage ofprey l'5 Twenty-five species of Odonata were recorded during the present survey, including six species not previously found in Bioko. The total number of odonata species now known from the island is 48 including one species (Trithemis hartwigt)and one subspecies (Chtorocypha cancellata insulua)that are cunently thought to be endernic. Trithemis hartwigr was not collected during the current survey but has previously only been recorded in the highland region around Moca. Chloruyplw cancellaninsalqwwas collected from several lowland streams during the present survey The dragonfly fauna has two elements, an upland element which includes species that occur above 1000 m only, and a lowland element including several species that do not occur above 500 m. Only three species occurred in both these faunistic elements, but there was a transitional fauna at 600 m that included a few species from each elernent. Much ofthe adult dragonfly fauna is probably seasonal in occurrence and so was not recorded during this brief survey. Certain Libellulidae probably migrate to Bioko from mainland Africa to breed in temporary pools during the wet se.$on. ffis migration us likely to be wind assisted. 1.9. Downstream recolonisation by Odonata of streams treated with inseAicide below 1000 m will not occur since upland strearns do not act as refugia for most ofthe lowland odonate fauna. However, if some permanently flowing lowland sffeams are left untreated these could act as refugia for the lowland fauna. Simultaneous inseaicide fieament of the lowland sections of all rivers on Bioko is likely to result in the elimination of a significant proportion ofthe dragonfly fauna on the island, although recolonisation by some species from the African mainland might be possible over time. The chironomid fauna appeared to be fairly uniform in lowland rivers but samples from the high altitude site included four tu