Chemical Composition, Knoop Hardness, Surface Roughness, and Adhesion Aspects of Additively Manufactured Dental Interim Materials.

PURPOSE: To measure the chemical composition, Knoop hardness, surface roughness, and composite bond strength of additive manufactured (AM) and conventional interim materials. MATERIAL AND METHODS: Disks were prepared using conventionally (CNV group) and additively manufactured (AM group) materials: CNV-1 (Protemp 4; 3M ESPE), CNV-2 (Anaxdent new outline dentin; Anaxdent), AM-1 (FreePrint temp; Detax), AM-2 (E-Dent 400 C&B MFH; Envisiontec), AM-3 (NextDent C&B MFH; 3D Systems), and AM-4 (Med620 VEROGlaze; Stratasys). Each group was subdivided into 3 subgroups (n = 20) for analyzing Knoop hardness (KHN), chemical composition, superficial roughness (Ra), and composite shear bond strength. The first subgroup was exposed to a microhardness test. Subsequently, EDAX analysis was selected to analyze the chemical composition. The second subgroup was selected to measure the superficial roughness (Ra) using a contact profilometer. The third subgroup was used to measured composite shear bond strength using a universal testing apparatus. A digital microscope was used to analyze the fracture mode. The Shapiro-Wilk test showed normally distributed data. One-way ANOVA and post hoc Sidak tests were selected (α = 0.05). RESULTS: Major variances in chemical composition were observed among the specimens. Significant differences in Knoop hardness (p < 0.001) and surface roughness (p < 0.001) were detected. The AM-4 (13.45 ± 2.93 KHN), the CNV-2 (13.35 ± 5.84 KHN), the AM-2 (13.03 ± 3.29 KHN), and the AM-1 (12.55 ± 2.93 KHN) groups obtained the highest Knoop hardness values, followed by the AM-3 and the CNV-1 groups (p < 0.05). The AM-1 group (1.88 ± 1.11 Ra) obtained the highest surface roughness values among the groups, followed by the AM-3 group (0.90 ± 0.14 Ra) (p < 0.05). However, no significant differences in shear bond strength values were found between the groups ranging from 23.18 ± 8.88 MPa to 33.29 ± 9.17 MPa (p = 0.061). All the groups showed a cohesive mode of failure. CONCLUSIONS: The AM interim materials tested had significant chemical composition variations compared to conventional materials. For the mechanical properties evaluated, the AM materials obtained appropriate mechanical properties for use as an interim dental restoration. However, further studies are required to evaluate more extensively its mechanical properties and verify their applicability in the oral cavity, clinical behavior, and biocompatibility.

Design and Implementation of a Pressure Monitoring System Based on IoT for Water Supply Networks.

Increasing the efficiency of water supply networks is essential in arid and semi-arid regions to ensure the supply of drinking water to the inhabitants. The cost of renovating these systems is high. However, customized management models can facilitate the maintenance and rehabilitation of hydraulic infrastructures by optimizing the use of resources. The implementation of current Internet of Things (IoT) monitoring systems allows decisions to be based on objective data. In water supply systems, IoT helps to monitor the key elements to improve system efficiency. To implement IoT in a water distribution system requires sensors that are suitable for measuring the main hydraulic variables, a communication system that is adaptable to the water service companies and a friendly system for data analysis and visualization. A smart pressure monitoring and alert system was developed using low-cost hardware and open-source software. An Arduino family microcontroller transfers pressure gauge signals using Sigfox communication, a low-power wide-area network (LPWAN). The IoT ThingSpeak platform is used for data analysis and visualization. Additionally, the system can send alarms via SMS/email in real time using the If This, Then That (IFTTT) web service when anomalous pressure data are detected. The pressure monitoring system was successfully implemented in a real water distribution network in Spain. It was able to detect both breakdowns and leaks in real time.

Evaluación de la vía aérea mediante laringoscopia indirecta en pacientes con hipertrofia de la amígdala lingual / Airway evaluation by indirect laryngoscopy in patients with lingual tonsillar hypertrophy

Introducción y objetivos: Se desconoce la prevalencia de la amígdala lingual hipertrófica, pero se cree que su presencia está asociada con la vía aérea difícil. Para investigarlo se realizó a los pacientes una laringoscopia indirecta en el preoperatorio y se diagnosticó esta enfermedad. Después, bajo anestesia general y laringoscopia directa estudiamos su relación con la dificultad de visión de la laringe, intubación y ventilación. Métodos: A 300 pacientes que iban a ser sometidos a anestesia general, además de realizarles en el preoperatorio los predictores demográficos y de vía aérea difícil (prueba de Mallampati, apertura bucal, distancia tiromentoniana, flexoextensión cervical y grosor del cuello), se les practicó una laringoscopia indirecta con el laringoscopio rígido de 70° y se comprobó la frecuencia de aparición de la amígdala lingual hipertrófica. Después, bajo anestesia general y laringoscopia directa verificamos si existía dificultad de visión e intubación de la laringe y de ventilación. Exploramos la relación de las 3 variables anteriores con esta enfermedad mediante la prueba de Fisher. También, se investigó la asociación de predictores demográficos y de vía aérea difícil incluyendo la laringoscopia indirecta, con la presencia de esta afección. Resultados: La prevalencia de amígdala lingual hipertrófica fue del 2%. No se encontró relación entre la aparición de esta entidad y la dificultad de visión de la laringe, intubación y ventilación. Solo la laringoscopia indirecta previno la aparición de esta enfermedad. Conclusiones: La amígdala lingual hipertrófica es una entidad relativamente frecuente. Su presencia no se asocia habitualmente con la vía aérea difícil (AU)

Introduction and objectives: Prevalence of the lingual tonsillar hypertrophy is unknown but it is believed that its presence is associated with the difficult airway. To investigate this, indirect laryngoscopy was performed on patients in the preoperative evaluation and this pathology was diagnosed. The relationship with difficulty of viewing the larynx, intubation and ventilation, under general anaesthesia and using direct laryngoscopy, was then studied. Methods: We performed the demographic variable checks and tests for predicting difficult intubation (mouth opening, thyromental distance, cervical flexion-extension, neck thickness, and Mallampati test), in the preoperative step on 300 patients who were going to be submitted to general anaesthesia. We then performed indirect laryngoscopy on them using a 70° rigid laryngoscope to ascertain the frequency of appearance of lingual tonsillar hypertrophy. Next, under general anaesthesia, we carried out direct laryngoscopy to verify whether there was difficulty in viewing the larynx and intubation and ventilation. We then investigated the association of demographic predictors of difficult intubation, including indirect laryngoscopy, with the presence of this condition. Results: Prevalence of lingual tonsillar hypertrophy was 2%. No relationship between the appearance of this entity and the difficulty of viewing the larynx, intubation and ventilation was found. Only indirect laryngoscopy was linked to the appearance of this pathology. Conclusions: Lingual tonsillar hypertrophy is a relatively frequent disorder, whose presence is not usually associated with difficult airway (AU)

Airway evaluation by indirect laryngoscopy in patients with lingual tonsillar hypertrophy.

INTRODUCTION AND OBJECTIVES: Prevalence of the lingual tonsillar hypertrophy is unknown but it is believed that its presence is associated with the difficult airway. To investigate this, indirect laryngoscopy was performed on patients in the preoperative evaluation and this pathology was diagnosed. The relationship with difficulty of viewing the larynx, intubation and ventilation, under general anaesthesia and using direct laryngoscopy, was then studied. METHODS: We performed the demographic variable checks and tests for predicting difficult intubation (mouth opening, thyromental distance, cervical flexion-extension, neck thickness and Mallampati test), in the preoperative step on 300 patients who were going to be submitted to general anaesthesia. We then performed indirect laryngoscopy on them using a 70° rigid laryngoscope to ascertain the frequency of appearance of lingual tonsillar hypertrophy. Next, under general anaesthesia, we carried out direct laryngoscopy to verify whether there was difficulty in viewing the larynx and intubation and ventilation. We then investigated the association of demographic predictors of difficult intubation, including indirect laryngoscopy, with the presence of this condition. RESULTS: Prevalence of lingual tonsillar hypertrophy was 2%. No relationship between the appearance of this entity and the difficulty of viewing the larynx, intubation and ventilation was found. Only indirect laryngoscopy was linked to the appearance of this pathology. CONCLUSIONS: Lingual tonsillar hypertrophy is a relatively frequent disorder, whose presence is not usually associated with difficult airway.

La laringoscopia indirecta mediante endoscopio rígido de 70º como valor predictivo de la dificultad de visión de la laringe / Indirect laryngoscopy with rigid 70-degree laryngoscope as a predictor of difficult direct laryngoscopy

Introducción y objetivos: Los predictores comúnmente utilizados para prever la vía aérea difícil poseen poca capacidad para pronosticarla. Nuestro objetivo es investigar la potencia de la laringoscopia indirecta con el laringoscopio rígido de 70° como predictor de dificultad de visión de la laringe con la laringoscopia directa. Métodos: Se efectuó una laringoscopia indirecta con el laringoscopio rígido en el preoperatorio a 300 pacientes. Según la visión obtenida fueron clasificados en 4 grados: 1 (cuerdas vocales visibles), 2 (comisura posterior visible), 3 (visión solo de epiglotis) y 4 (ninguna estructura glótica visible). EL 3 y el 4 eran considerados predictores de dificultad de visión de la laringe. Después, bajo anestesia general, practicamos a los pacientes la laringoscopia directa con el laringoscopio de Macintosh. Valoramos como positivo el encontrar un Cormack-Lehane III-IV. Se registraron otros predictores clínicos comunes. Se elaboró un modelo de regresión logística con fines predictivos utilizando las variables relevantes. Investigamos también los predictores de la dificultad de visión de la laringe con la laringoscopia indirecta. Resultados: El modelo encontrado y sus coeficientes para confeccionarlo fueron: f(x)=-10,097+5,145 laringoscopia indirecta (3-4)+3,489 retrognatia +2,548 apertura boca <3,5cm+1,911 distancia tiromentoniana <6,5cm+1,352 roncopatía+ (0,151*cm grosor cuello). Proporciona un resultado correcto en el 94,3% de los casos. En el caso de la laringoscopia indirecta el modelo hallado era: f(x)=-2,641+0,920 roncopatía+0,875 movilidad cervical. Conclusiones: La laringoscopia indirecta fue la variable independiente con más poder predictivo (mayor coeficiente). La roncopatía es un predictor común entre los modelos de ambas laringoscopias(AU)

Introduction and objectives: The commonly-used predictors for difficult airway management are not very accurate. We investigate the power of indirect laryngoscopy with the rigid 70-degree laryngoscope as a predictor of difficult visualisation of the larynx with direct laryngoscopy. Methods: We performed preoperative indirect laryngoscopy with the rigid laryngoscope on 300 patients. The vision obtained was classified into four grades: 1 (vocal cords visible), 2 (posterior commissure visible), 3 (epiglottis visible) and 4 (no glottic structure visible). Grades 3 and 4 were considered predictors of difficult larynx visualisation. Next, direct laryngoscopy with the Macintosh laryngoscope was carried out on the patients under general anaesthesia. Positive value was defined as a Cormack and Lehane III and IV. Other common clinical predictors were also analysed. A logistic regression model using the relevant variables was elaborated. We also investigated predictors of difficult visualisation of the larynx with indirect laryngoscopy. Results: The model found and the coefficients for preparing it were: f(x)= -10.097+5.145 indirect laryngoscopy (3-4)+3.489 retrognathia +2.548 mouth opening <3.5cm +1.911 thyromental distance <6.5cm +1.352 snorer+(0.151 * cm neck thickness). This model provided a correct result in 94.3% of cases. In the case of indirect laryngoscopy, the model found was: f (x)=-2.641+0.920 snorer+0.875 cervical mobility. Conclusions: Indirect laryngoscopy was the independent variable with the greatest predictive power. Snoring is a common predictor in both laryngoscopy models(AU)

Indirect laryngoscopy with rigid 70-degree laryngoscope as a predictor of difficult direct laryngoscopy.

INTRODUCTION AND OBJECTIVES: The commonly-used predictors for difficult airway management are not very accurate. We investigate the power of indirect laryngoscopy with the rigid 70-degree laryngoscope as a predictor of difficult visualisation of the larynx with direct laryngoscopy. METHODS: We performed preoperative indirect laryngoscopy with the rigid laryngoscope on 300 patients. The vision obtained was classified into four grades: 1 (vocal cords visible), 2 (posterior commissure visible), 3 (epiglottis visible) and 4 (no glottic structure visible). Grades 3 and 4 were considered predictors of difficult larynx visualisation. Next, direct laryngoscopy with the Macintosh laryngoscope was carried out on the patients under general anaesthesia. Positive value was defined as a Cormack and Lehane III and IV. Other common clinical predictors were also analysed. A logistic regression model using the relevant variables was elaborated. We also investigated predictors of difficult visualisation of the larynx with indirect laryngoscopy. RESULTS: The model found and the coefficients for preparing it were: f(x)= -10.097+5.145 indirect laryngoscopy (3-4)+3.489 retrognathia+2.548 mouth opening <3.5 cm+1.911 thyromental distance <6.5 cm+.352 snorer+(0.151 cm neck thickness). This model provided a correct result in 94.3% of cases. In the case of indirect laryngoscopy, the model found was: f(x)=-2.641+0.920 snorer+0.875 cervical mobility. CONCLUSIONS: Indirect laryngoscopy was the independent variable with the greatest predictive power. Snoring is a common predictor in both laryngoscopy models.

Correlation between glucose and bupivacaine levels in cerebrospinal fluid after spinal anesthesia: glycorrhachia as predictor for duration of sensory block.

BACKGROUND: Prediction of the duration of motor block after injection of a local anesthetic into cerebrospinal fluid (CSF) would be a very useful tool in clinical practice. However, previous attempts have not shown conclusive results. In this work, glycorrhachia is demonstrated to be an adequate predictive parameter after spinal anesthesia using 0.5% hyperbaric bupivacaine. METHODS: Two mL of local anesthetic through a continuous spinal catheter was administered to 40 patients. CSF was sampled at different time intervals from the onset of infusion to motor recovery. CSF bupivacaine concentrations were measured using chromatography. An automated analyzer was used for determining glycorrhachia in the same samples. RESULTS: For all patients, good correlation (r(2)>0.95, p<0.05) was obtained. From these results, it was possible to develop a general model which establishes the relationship between CSF glucose and bupivacaine concentrations (R(2)=0.987, p<0.05). Motor block is reached when CSF glucose concentration is about 245 mg/dL (13.5 mmol/L), which corresponds to 35 microg/mL of bupivacaine. CONCLUSIONS: Glycorrhachia measured during surgical intervention in patients undergoing spinal anesthesia with hyperbaric bupivacaine provides a mechanism for predicting the duration of motor block in a rapid and simple manner.

Historia Clínica Electrónica como elemento central en las soluciones de TI en la salud / The Electronic Medical Record as a central element of IT solutions in the health sector

La presencia de los Sistemas de Información en centros sanitarios se ha extendido notablemente en los últimos años, alcanzando una situación en la que podemos decir que cubre las necesidades existentes. Las nuevas tecnologías implican herramientas útiles para los profesionales sanitarios, si bien deben demostrar su validez y contribución a la mejora de la actividad sanitaria. El presente artículo repasa qué cualidades debe tener un sistema de Historia Clínica Electrónica para ser válido, eficaz y eficiente (AU)

The presence of Information Systems in health centres has extended considerably over the last few years, reaching a situation where we can say that it covers the existing needs. The new technologies are useful tools for health professionals, although they need to demonstrate their validity and contribution to improving activity in the health sector. This article reviews what qualities an Electronic Medical Record should have to be valid, efficient and effective (AU)