Dental malocclusions in the anterior sextant, in a group of mexican patients between 3 and 14 years old / Frecuencia de maloclusiones dentarias en el sextante anterior, en un grupo de pacientes mexicanos entre 3 y 14 años

Aim: To evaluate the association between the frequency of malocclusions in the anterior sextant with dentition type, age, and sex. Material and methods: A descriptive, transversal and prospective study was carried out, in a convenience sample of 200 patients between 3 and 14 years old, of both sexes who attended the pediatric dentistry clinic of Dentistry Faculty from Autonomous University of Tlaxcala, Mexico. A dentist was standardized by a direct method (k=0.998, p=0.0001). Results: Crossbite and edge to edge bite were the most frequent (18% and 17% respectively), in no case the alterations in the previous sextant were related to sex, except altered overjet with age and dentition type (likelihood ratio=18,169, p=0.0001) (X2=18.820, p=0.0001). Conclusion: These observations highlight the importance of the diagnosis of possible alterations in the occlusion of the anterior sextant in both dentitions, in order to preventatively avoid major sequelae.

Objetivo: Evaluar la asociación entre la frecuencia de maloclusiones en el sextante anterior con el tipo de dentición, la edad y el sexo. Material y Métodos: Se llevó a cabo un estudio descriptivo, transversal, prolectivo en una muestra por conveniencia conformada por 200 pacientes entre 3 y 14 años, de ambos sexos atendidos en la clínica de odontopediatría de la Facultad de Odontología, de la Universidad Autónoma de Tlaxcala. Se estandarizó a una cirujana dentista a través del método directo (k=0,998, p=0,0001). Resultados: La mordida cruzada y borde a borde fueron las que se presentaron con mayor frecuencia (18% y 17% respectivamente), en ningún caso las alteraciones en el sextante anterior se relacionaron con el sexo, no así, el resalte alterado que se asoció con la edad y con el tipo de dentición (Razón de verosimilitudes=18.169, p=0.0001, X2=18.820, p=0.0001). Conclusión: El comportamiento observado permite reconocer la importancia del diagnóstico de las alteraciones en la oclusión del sextante anterior en ambas denticiones, con el propósito de actuar anticipadamente para evitar secuelas mayores.

Effect of health professional intervention on adherence to statin use according to the cause of patient non-adherence.

Background Non-adherence is a problem that particularly affects those with chronic diseases. Studying causes for not following the treatment is necessary to choose the best intervention to improve non-adherence. Objective Analyze how the intentionality of non-adherence modulates the effects of professional intervention in patients with hypercholesterolemia. Setting: Community pharmacies and primary care centres in Spain. Methods A 6-month randomized controlled trial was conducted in 46 community pharmacies and 50 primary care centres in Spain. Adherence to statin therapy was measured with the Morisky-Green-Levine test. Non-adherence was classified based on the intentionality. Results 746 Patients were recruited for the study (465 non-adherent and 281 adherent). Of those, 237 were randomly assigned to the intervention group and 228 to the non-intervention group. The 56.5% of non-adherent patients were classified as unintentional non-adherents and 43.5% as intentional non-adherents. More patients in the intervention group finished being adherent compared with the non-intervention group (+ 17.2% for intentional non-adherents and + 27.4% for unintentional non-adherence). The percentage of patients in the intervention group who completed the study as adherent was higher among those who previously had unintentional non-adherence (66.4%) compared to those with intentional non- adherence (55.3%) (p < 0.001). Conclusion Intervention provided to patients with unintentional non-adherence was more effective than intervention provided to patients with intentional non- adherence.

Tailored interventions by community pharmacists and general practitioners improve adherence to statins in a Spanish randomized controlled trial.

OBJECTIVE: To evaluate the impact of health professionals' intervention on adherence to statins, the influence on total cholesterol levels, and lifestyle patterns in patients with hypercholesterolemia and analyze the differences according to the center of recruitment. STUDY SETTING: Forty-six community pharmacies and 50 primary care centers of Spain. STUDY DESIGN: Randomized controlled trial design (n = 746). Patients were assigned into adherent (ADH) or nonadherent group depending on their initial adherence to statins. Nonadherent patients were randomly assigned to intervention (INT) or nonintervention (NOINT) group. Patients enrolled in the INT group received an intervention depending on the cause of nonadherence. Patients in the ADH and NOINT groups received usual care. Intention-to-treat (ITT) analysis was performed with multiple imputation to replace the missing data. DATA COLLECTION: Adherence, total cholesterol levels, and lifestyle behaviors. FINDINGS: The odds of becoming adherent during the 6 months was higher in the INT group compared to the NOINT group (OR = 1,49; 95% CI: 1.30-1.76; P < 0.001), especially in the community pharmacy group (OR = 2.34; 95% CI: 1.81-3.03; P < 0.001). Adherent patients showed lower values of total cholesterol compared with nonadherent patients at baseline (ADH: 200.3 mg/dL vs NOADH: 216.7 mg/dL; P < 0.001) and at the endpoint (ADH: 197.3 mg/dL vs NOADH: 212.2 mg/dL; P < 0.001). More patients enrolled in the INT group practices exercise at the end of the study (INT: +26.6 percent; P = 0.002), and a greater number of patients followed a diet to treat hypercholesterolemia (+30.2 percent; P < 0.001). CONCLUSIONS: The intervention performed by health professionals, especially by community pharmacists, improved adherence to statins by hypercholesterolemic patients, and this improvement in adherence was accompanied by a reduction in total cholesterol levels and a healthier lifestyle.

Isopropyl quinoxaline-7-carboxylate 1,4-di-N-oxide derivatives induce regulated necrosis-like cell death on Leishmania (Leishmania) mexicana.

Leishmaniasis is a neglected tropical disease caused by the parasite of the genus Leishmania. About 13 million people are infected worldwide, and it is estimated that 350 million are at risk of infection. Clinical manifestations depend on the parasite species and factors related to the host such as the immune system, nutrition, housing, and financial resources. Available treatments have severe side effects; therefore, research currently focuses on finding more active and less toxic compounds. Quinoxalines have been described as promising alternatives. In this context, 17 isopropyl quinoxaline-7-carboxylate 1,4-di-N-oxide derivatives were evaluated as potential leishmanicidal agents. Their effect on the cell metabolism of Leishmania mexicana promastigotes and their cytotoxic effects on the J774.A1 cell line and on erythrocytes were evaluated, and their selectivity index was calculated. Compounds T-069 (IC50 = 1.49 µg/mL), T-070 (IC50 = 1.71 µg/mL), T-072 (IC50 = 6.62 µg/mL), T-073 (IC50 = 1.25 µg/mL), T-085 (IC50 = 0.74 µg/mL), and T-116 (IC50 = 0.88 µg/mL) were the most active against L. mexicana promastigotes and their mechanism of action was characterized by flow cytometry and microscopy. Compound T-073, the most selective quinoxaline derivative, induced cell membrane damage, phosphatidylserine exposition, reactive oxygen species production, disruption of the mitochondrion membrane potential, and DNA fragmentation, all in a dose-dependent manner, indicating the induction of regulated necrosis. Light and transmission electron microscopy showed the drastic morphological changes induced and the mitochondrion as the most sensitive organelle in response to T-073. This study describes the mechanism by which active isopropyl quinoxaline-7-carboxylate 1,4-di-N-oxide quinoxalines affect the parasite.

Smart multi-level tool for remote patient monitoring based on a wireless sensor network and mobile augmented reality.

Technological innovations in the field of disease prevention and maintenance of patient health have enabled the evolution of fields such as monitoring systems. One of the main advances is the development of real-time monitors that use intelligent and wireless communication technology. In this paper, a system is presented for the remote monitoring of the body temperature and heart rate of a patient by means of a wireless sensor network (WSN) and mobile augmented reality (MAR). The combination of a WSN and MAR provides a novel alternative to remotely measure body temperature and heart rate in real time during patient care. The system is composed of (1) hardware such as Arduino microcontrollers (in the patient nodes), personal computers (for the nurse server), smartphones (for the mobile nurse monitor and the virtual patient file) and sensors (to measure body temperature and heart rate), (2) a network layer using WiFly technology, and (3) software such as LabView, Android SDK, and DroidAR. The results obtained from tests show that the system can perform effectively within a range of 20 m and requires ten minutes to stabilize the temperature sensor to detect hyperthermia, hypothermia or normal body temperature conditions. Additionally, the heart rate sensor can detect conditions of tachycardia and bradycardia.

Aplicación de la agenda de calidad en una consulta de atención primaria / Application of the quality agenda in primary care consultations

Introducción: La presión asistencial elevada es un problema que preocupa a los médicos de atención primaria (AP). Se puede optimizar la utilización de las consultas mediante la aplicación de estrategias dirigidas al usuario, los profesionales y la organización. Entre ellas está la gestión de la consulta. Objetivo: Mejorar la dinámica de una consulta de medicina de familia mediante la racionalización de la demanda, mejora de la accesibilidad y satisfacción del usuario. Material y método: Se establece un plan de intervención consistente en: organización de la cita, evaluación de la actividad asistencial antes y después de la intervención, de la satisfacción de los usuarios con la medida adoptada y de la atención recibida. Resultados: Con la gestión de la agenda de consulta, disminuye la consulta a demanda, aumenta la concertada (la presión asistencial se mantiene) y el usuario percibe que disminuye el tiempo de espera. Conclusiones: Se racionaliza la actividad asistencial y se consigue una adecuada satisfacción del usuario, al mejorar su acceso al sistema

Introduction: Heavy caseload is a significant concern to primary care physicians. The use of consultations can be reduced through the application of strategies directed at the user, the health professional and the organization. One of these strategies is consultation management. Objective: To improve the dynamics of family medicine consultations through demand rationalization, improved accessibility and user satisfaction. Material and method: An intervention plan was implemented. The intervention consisted of appointment organization, evaluation of caseload before and after the intervention, the degree of user satisfaction with the adopted measures, and evaluation with the care received. Results: Consultation management decreased demand and increased scheduled consultations (activity was maintained constant), while users perceived a decrease in waiting time. Conclusions: Healthcare activity can be rationalized through appropriate consultation management. Moreover, improved accessibility to the system leads to good user satisfaction