Attitudes scale toward cancer-related cognitive changes - an initial Colombian validation.

OBJECTIVE: The aim of this study was to develop an initial valid tool to measure attitudes toward cancer-related cognitive changes. SUBJECTS AND METHODS: After revising the literature, three main dimensions were hypothesized. Eight judges were contacted to obtain content validity evidence. A robust Exploratory Factor Analysis (EFA) was performed via a parallel analysis with an Unweighted Least Squares (ULS) estimator and polychoric correlations. The results were crossed with sociodemographic variables to find possible statistical differences and estimate the size effect. Analysis was performed in the software Factor and the statistical package R. RESULTS: A sample of 374 participants was obtained, involving oncology patients, their caregivers, and people from the general community. A statistical fit was found in two dimensions: Awareness and Judgments [root mean squared error of approximation (RMSEA) = 0.042, standardized root mean square residual (SRMR) = 0.02, comparative fit index (CFI) = 0.99, Tucker-Lewis index (TLI) = 0.98] with a moderate correlation between them (r = 0.612). Optimal reliability indices were obtained for the total scale and its dimensions. No real statistical difference was found between sociodemographic variables; the interpretation norms were established via the quartiles. CONCLUSIONS: The first attempt to measure the construct of interest was developed with two primary validity evidence based on the content and its internal structure. This instrument could help strengthen the prevention of cancer-related cognitive changes. More research is needed to adhere more valid evidence to the scale.

Identifying self-report measures of emotion regulation and evaluating their psychometric properties: a protocol for a systematic review.

INTRODUCTION: Successful emotion regulation (ER) is critical for psychological health. Disturbances in this ability are associated with several psychiatric disorders. There are several self-report questionnaires to assess ER. However, there are no studies synthesising the evidence on their psychometric properties. We aim to identify all available instruments addressing ER in adolescents or adults and to critically appraise, compare and summarise the quality of their psychometric properties. For this, we will use COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) criteria. METHOD AND ANALYSIS: The search process to identify eligible studies will be conducted in April 2021 including the ProQuest, PubMed, Scopus and Web of Science databases with no restriction in terms of publication date. Eligibility criteria include peer-reviewed research articles written in English or Spanish by means of patient-reported outcome measures focused on ER among participants of 13 years or older. We will assess the quality of measures according to the COSMIN Risk of Bias Checklist. The psychometric properties will be assessed by the COSMIN updated criteria for good measurement. The available evidence will be addressed by the Grading of Recommendations, Assessment, Development and Evaluations approach. Our findings will be synthesised independently for each measure, including information on their sample, theoretical model and psychometric properties when possible. ETHICS AND DISSEMINATION: Ethical approval is not required, as this study does not involve any participants or collection of primary data. Results are expected to be published in a peer-reviewed journal in the field of youth mental health and presented at relevant meetings and conferences. PROSPERO REGISTRATION NUMBER: CRD42021249498.

Adaptaciones de la dispensación hospitalaria a pacientes con hemofilia durante la pandemia COVID-19 en España y su influencia en la adherencia / Adaptations of hospital dispensing to haemophilia patients during the COVID-19 pandemic in Spain and its influence on adherence

Introducción: El estado de alarma decretado por la pandemia del virus SARS COV-2 del 14 de marzo hasta el 21 de junio, ha supuesto un desafío para el área de pacientes externos de los Servicios de Farmacia. Nos centramos en los pacientes con hemofilia que se administran factores de la coagulación de forma crónica para prevenir hemorragias.Objetivos: Analizar durante este periodo el porcentaje de pacientes que han recogido su medicación, han mantenido la adherencia al tratamiento y las barreras encontradas para ello. Cuantificar el número y gravedad de episodios hemorrágicos (EH) sufridos y su relación con la pandemia. Analizar la prevalencia y gravedad de COVID en hemofílicos.Métodos: Uno objetivo, utilizando los registros del hospital y otro subjetivo, mediante encuesta oral durante la consulta de atención farmacéutica presencial o telemática.Resultados: El 80% de los pacientes retiraron medicación durante el periodo de estudio, un 30% en domicilio. El último mes las dispensaciones a domicilio se acompañaron de consulta telemática.Un 24% de pacientes disminuyó su adherencia respecto al 2019. Las principales causas fueron dificultad para acudir al hospital, y percepción de no necesitar tratamiento ante la inactividad.No se registraron más EH o ingresos por causas imputables a la pandemia.No hubo ningún enfermo COVID-19 grave y la incidencia de pacientes con síntomas leves fue similar a la población general.Conclusión: La mayoría de los pacientes con hemofilia pudieron acceder a su medicación. La adherencia se redujo. Los EH no aumentaron por causas atribuibles a la pandemia. La incidencia de COVID-19 fue similar a la población. (AU)

Introduction: The state of alarm decreed by the SARS COV-2 virus pandemic from March 14th to June 21st, has meant a challenge for the outpatient area of the pharmacy services. We focus on hemophilia patients who are chronically administered clotting factors to prevent bleeding.Objectives: To analyse during this period the percentage of patients who have collected their medication, maintained adherence to treatment and the barriers encountered in doing so. To quantify the number and severity of haemorrhagic episodes (HD) suffered and their relationship with the pandemic. Analyse the prevalence and severity of COVID in haemophiliacs.Methods: One objective, using hospital records, and one subjective, using an oral survey during the face-to-face or telematic pharmaceutical care consultation.Results: 80% of patients withdrew medication during the study period, 30% at home. In the last month, home deliveries were accompanied by telematic consultation.24% of patients decreased their adherence with respect to 2019. The main causes were difficulty in going to hospital, and perception of not needing treatment in the face of inactivity.There were no more HD or admissions for reasons attributable to the pandemic.There were no serious COVID-19 patients and the incidence of patients with mild symptoms was similar to the general population.Conclusion: Most haemophilia patients were able to access their medication. Adherence was reduced. HD did not increase due to causes attributable to the pandemic. The incidence of COVID-19 was similar to the population. (AU)

Adhesion between zirconia and resin cement: A critical evaluation of testing methodologies.

This study aimed to analyze different methodologies (tensile, microtensile, shear, microshear, and interfacial toughness) for evaluation of the bond strength between zirconia (Y-TZP) and resin cement. Zirconia ceramic blocks (VITA in-Ceram® YZ, VITA Zahnfabrik, Germany) were obtained, substrate surfaces were air-abraded with aluminum oxide (50 µm) for 10 s (2 bar pressure, distance: 10 mm, angle: 90°). Then, the specimens were washed with distilled water, dried, and coated with Clearfil Ceramic Primer that was actively applied with a microbrush for 20 s. The specimens were then cemented with resin cement under a load of 750 g, followed by photo-polymerization (40 s on each surface). After cementation, the specimens were aged in thermocycling (8000 cycles, 5-55 °C, 30 s for each bath) and subjected to tensile, microtensile, shear, microshear or interfacial toughness tests. All specimens were inspected for failure modes. The microtensile test showed the highest bond value (18.29 N/mm2). The microshear tests showed the highest coefficient of variation (0.59) and highest number of pre-test failures. The interfacial energy to fracture test showed that as the shear stress increased its interaction in the adhesive interface, the coefficient of variation also increased. The bond strength of Y-TZP showed different results according to the methodology, as well as its interfacial energy to fracture varied according to the angulation/type of stress specimen was submitted. The lower the shear stress at the adhesive interface of the mixed tests (interfacial energy to fracture), the lower was the variability of the test.

Failure probability and stress distribution of milled porcelain-zirconia crowns with bioinspired/traditional design and graded interface.

OBJECTIVE: To evaluate the failure probability and stress distribution of traditional and bioinspired porcelain-zirconia milled crowns, with and without silica infiltration (graded zirconia). METHODS: Traditional crown design had a zirconia infrastructure veneered with porcelain; Bioinspired, had a porcelain infrastructure with translucent-zirconia veneer; Graded and Graded Bioinspired crowns had their zirconia layer infiltrated by silica (n = 25). The cameo surface of each crown (porcelain or zirconia) was glazed. The restoration layers were fused by a vitreous connector and the crowns were adhesively cemented to dies. The specimens were then mechanically cycled in a sliding machine using 100 N load at 4 Hz. The specimens were tested until 2 × 106 cycles, and every 0.5 × 106 cycles the crowns were evaluated under stereomicroscopy for the presence of failures. The stress distribution was inspected with Finite Element Analyses. RESULTS: The predominant failure modes for the Traditional and Graded crowns were delamination and cracking, respectively. The Weibull parameters beta and eta were, respectively: Traditional 1.30 and 2.3 × 106 cycles, and Graded 1.95 and 2.3 × 106 cycles. Thus, the Traditional and Graded crowns presented greater susceptibility to failure due to fatigue, while the Bioinspired and Graded Bioinspired crowns showed no fatigue effect using 100N load, showing beta = 1 and eta of approximately 17 × 106 cycles. Also, through finite element analyses, it was verified that the Bioinspired and Graded Bioinspired crowns presented the best stress distribution on both crowns and dental structures. SIGNIFICANCE: Bioinspired and Graded Bioinspired crowns had the lowest failure probability and better stress distribution and may be considered robust long lasting restorations.

Silica infiltration in partially stabilized zirconia: Effect of hydrothermal aging on mechanical properties.

It aimed to evaluate if silica infiltration might influence the hydrothermal degradation of zirconia by determining: the phases formed, hardness, microstructure, and flexural strength of a 3Y-TZP. Yttria partially stabilized zirconia discs (1.2 mm thickness x 13 mm diameter) (InCeram YZ, Vita Zanhfabrik) were produced and assigned into 6 groups, considering 2 factors: silica infiltration in 2 levels (as-sintered or infiltration) and hydrothermal aging (LTD-Low Temperature Degradation) in 3 levels (baseline, aging at 132 °C for 35 h or 140 h). All the groups were subjected to the biaxial flexural test (n = 30), and Vickers hardness (n = 42). Weibull analysis was performed to determine the Weibull moduli (m) and characteristic strenghts (σ0). The specimens were characterized by scanning electron microscopy (SEM) to evaluate microstructure and X-ray diffraction (XRD) for phases percentages determination. For as-sintered condition: there was saturation of the amount of monoclinic zirconia after 35 h of hydrothermal aging, with 66% of monoclinic zirconia formed on the surface. LTD generated a progressive reduction in hardness over time; flexural strength was increased by the 35-h treatment (baseline: 974 MPa; 35 h: 1161.5 MPa), but, the 140 °C treatment was deleterious (698.5 MPa). On the other hand, the infiltrated specimens had an increase in the amount of cubic zirconia on the surface and showed 26% (35h) and 31% (140h) of monoclinic zirconia after the hydrothermal aging ; the strength was kept unaltered after LTD-35 h (935.9 MPa) and an increase was observed after LTD-140 h (1033.6 MPa); the hardness values had no statistically significant changes during the process. Thus, one can concludes that the silica infiltration can prevent the decrease in the mechanical properties due to the LTD on partially stabilized zirconia materials.

Efficacy and safety of bortezomib in refractory lupus nephritis: a single-center experience.

BACKGROUND AND OBJECTIVES: Resistant lupus nephritis (LN) has been associated with the persistence of long-lived plasma cells. Preliminary studies identified bortezomib as a potential treatment option for patients with refractory LN. The aim of this study was to analyze the efficacy and safety of bortezomib in the treatment of severe refractory LN. METHODS: This retrospective study included 12 female patients diagnosed for the first time with class IV or IV/V LN with acute or rapidly progressive kidney injury (n = 11) and/or severe nephrotic syndrome (n = 1) who showed resistance to induction therapy with cyclophosphamide, steroids, mycophenolate, and rituximab, and were treated with either intravenous or subcutaneous bortezomib plus intravenous dexamethasone. RESULTS: All patients with acute or rapidly progressive kidney injury showed a significant reduction in both biochemical and immunological activity after a mean of 6 (minimum 5, maximum 7) weekly cycles of bortezomib regimen, with a significant increase in C3 levels and a significant decrease of anti-ds DNA antibody titers, Systemic Lupus Erythematosus Disease Activity Index score, serum creatinine, and proteinuria. One patient (8.3%) achieved a complete response, and 10 patients (83.4%) achieved a partial response. During follow-up, all these patients maintained partial responses under treatment with mycophenolate and low-dose glucocorticoids. The patient with refractory nephrotic syndrome showed a partial response but relapsed 11 months after the end of bortezomib treatment and was resistant to treatment. A significant decrease in serum IgG levels after initiation of bortezomib treatment was observed in all patients, five of them (41.6%) showed hypogammaglobulinemia (<500 mg/dl), but no patient suffered from opportunistic infections; in only two patients (16.6%) hypogammaglobulinemia persisted at the end of follow-up. Two patients (16.6%) suffered from sensory neuropathy, which led to bortezomib treatment discontinuation. CONCLUSIONS: Bortezomib may be an effective option for refractory LN, but close monitoring must be performed for possible adverse events such as peripheral neuropathy and hypogammaglobulinemia.

The efficacy of a medication review programme conducted in an emergency department.

Background Older age and inappropriate prescribing is related to a greater rate of emergency department visits and hospitalisations. Objective To assess the efficacy of an interprofessional collaboration programme in which a review of the medication of older patients seen in the emergency observation unit was carried out. Setting Emergency departments at four Spanish hospitals. Method Randomised, controlled study. Patients over 65 years of age presenting to the emergency department were randomised to a control or an intervention group. In the intervention group, a pharmacist reviewed the patients' chronic medication and identified any potentially inappropriate prescriptions based on the STOPP/START criteria. Each case was discussed with the emergency specialist and a recommendation to modify the treatment was sent to the general practitioner. Main outcome measure Rate of emergency visits and hospital admissions. Results The adjusted rate ratio of emergency visits and hospital admissions was 0.808 (95% CI 0.617 to 1.059) at 3 months, 0.888 (95% CI 0.696 to 1.134) at 6 months and 0.954 (95% CI 0.772 to 1.179) at 12 months. There was a statistically significant reduction at 3 months in two of the hospitals that participated in the study [adjusted rate ratio at 3 months was 0.452 (95% CI 0.222 to 0.923) in hospital 3 and 0.567 (95% CI 0.328 to 0.983) in hospital 4]. Conclusion Overall, the intervention did not reduce the number of emergency visits and hospital admissions. However, a significant effect was observed in centres were a high acceptance rate of treatment recommendations was achieved.

Silica-Based Infiltrations for Enhanced Zirconia-Resin Interface Toughness.

Novel silica-based infiltrations on the surface of zirconia have the potential to improve their bondability, allowing for the etching/silane adhesive bonding technique. Nonetheless, adhesively bonded joints are subject to mixed tensile and shear stresses when the restoration is in occlusal service. Thus, we aimed to investigate the effect of 2 novel silica-based infiltrations on the interfacial toughness of adhesively bonded zirconia using the Brazil nut method, which allows for controlled types of stresses to be applied at the interfaces. In total, 150 3Y-TZP (In-Ceram YZ; Vita) Brazil nuts were machined and randomly assigned to 3 groups: C, control (air abraded); SG, sol-gel silica infiltration; and GI, glass infiltration. SG specimens were immersed twice in silicic acid for 20 min and dried (100°C, 1 h). GI specimens were presintered (1,400°C, 1 h) before a glass powder slurry was applied to the intaglio surface. All specimens were then sintered (1,530°C, 2 h). Following adhesive bonding (Panavia F 2.0, Kuraray) and water storage (37°C) for 10 d, the Brazil nuts were subdivided into groups baseline and aged (40,000 thermal cycles between 5°C and 55°C, with a dwell time of 30 s). The Brazil nuts were subjected to axial-loading tests using various inclinations (precrack angle with load direction): Θ = 0°, 5°, 10°, 15°, or 25°, which define the stress type at the interface, from pure tension (0°) to increasing levels of shear. Under pure tension (0°), GI yielded superior interfacial fracture energy, SG and C were similar, and aging had no effect. Under predominantly shear stresses (25°), aging significantly decreased interfacial fracture energy of C and SG, while GI remained stable and was superior. The glass infiltration of the zirconia intaglio surface increases its adhesive bonding interfacial toughness. The sol-gel silica infiltration method requires improvement to obtain a homogeneous surface infiltration and an enhanced bond strength.

Color Stability of Resin Cements Exposed to Aging.

The aim of this study was to evaluate the color stability of light-cured and dual-cured resin cements after artificial accelerated aging. Ten specimens (6-mm diameter and 2-mm thickness) for each of five resin cements were prepared: GC (dual-cured cement, GCem), Vb (light-cured cement, Variolink II only the base), Vbc (dual-cured cement, Variolink II base with catalyst), VV (light-cured cement, Variolink Veneer), and FR (flowable resin composite, light cured). The samples were polished and stored in an accelerated artificial aging machine for 308 hours (160 klx), with cycles of 120 minutes under light and 60 minutes in the dark. All aging was carried out in distilled water at 37°C and light irradiation at 765 W/m2. The samples were evaluated in a spectrophotometer before and after aging, and results were calculated according to CIEDE2000. The data were statistically analyzed (one-way analysis of variance and Tukey test, 95% confidence). The results of ΔE00 were statistically significant for the type of cement (p<0.001), with differences among tested groups. Variolink II (base only and base + catalyst) and the flowable resin were the cements with the lowest color variations after the artificial accelerated aging. Considering the values ΔE00 of acceptability and perceptibility, none of the tested cements showed acceptable values.

Dual T1/ T2 Nanoscale Coordination Polymers as Novel Contrast Agents for MRI: A Preclinical Study for Brain Tumor.

In the last years, extensive attention has been paid on designing and developing functional imaging contrast agents for providing accurate noninvasive evaluation of pathology in vivo. However, the issue of false-positives or ambiguous imaging and the lack of a robust strategy for simultaneous dual-mode imaging remain to be fully addressed. One effective strategy for improving it is to rationally design magnetic resonance imaging (MRI) contrast agents (CAs) with intrinsic T1/ T2 dual-mode imaging features. In this work, the development and characterization of one-pot synthesized nanostructured coordination polymers (NCPs) which exhibit dual mode T1/ T2 MRI contrast behavior is described. The resulting material comprises the combination of different paramagnetic ions (Fe3+, Gd3+, Mn2+) with selected organic ligands able to induce the polymerization process and nanostructure stabilization. Among them, the Fe-based NCPs showed the best features in terms of colloidal stability, low toxicity, and dual T1/ T2 MRI contrast performance overcoming the main drawbacks of reported CAs. The dual-mode CA capability was evaluated by different means: in vitro phantoms, ex vivo and in vivo MRI, using a preclinical model of murine glioblastoma. Interestingly, the in vivo MRI of Fe-NCPs show T1 and T2 high contrast potential, allowing simultaneous recording of positive and negative contrast images in a very short period of time while being safer for the mouse. Moreover, the biodistribution assays reveals the persistence of the nanoparticles in the tumor and subsequent gradual clearance denoting their biodegradability. After a comparative study with commercial CAs, the results suggest these nanoplatforms as promising candidates for the development of dual-mode MRI CAs with clear advantages.

Social exclusion of the adolescent with overweight: study of sociocentric social networks in the classroom.

BACKGROUND: Multiple studies have shown the social consequences of suffering overweight, with social exclusion or isolation as some of the most important. In order to study the social patterns among adolescents, we have set as objectives to analyse the position of the individual within their network from a sociocentric perspective, comparing the relational pattern of the adolescents suffering from overweight with those who are normal weight. METHOD: This was a cross-sectional descriptive study using logistic regression and social network analysis. We analysed the contact patterns of 235 adolescents in 11 social networks, classifying contact into three levels of intensity: minimum, intermediate and maximum (friendship). The WHO reference was used for the variable of overweight. RESULTS: The prevalence of overweight was 30.2% (25.5% overweight and 4.7% obesity). An analysis of the relational patterns of individuals with overweight showed that at the minimum contact level, they established fewer relationships and less closeness (odds ratio [OR]: 2.32; confidence interval [CI] 95%: 1.17-4.66; p-value: 0.016). This effect was more marked in female adolescents. At intermediate contact level, they had few relationships and low prestige (OR: 3.29; CI: 95%; 1.03-10.51; p-value: 0.045, OR: 3.18; CI: 95%; 1.00-10.04; p-value: 0.049, respectively). At maximum contact level (friendship), female adolescents related little with other adolescents (OR: 3.78; CI: 95%; 1.07-13.32; p-value: 0.038). CONCLUSIONS: Adolescents with overweight take up peripheral positions within their social network, choosing by themselves not to establish contact with others. Social network analysis is crucial to detect adolescents with overweight at risk of exclusion and help alleviate psychological and social deficits.

First-time detection of porcine reproductive and respiratory syndrome virus (PRRSV) infection in Uruguay.

Within the last two decades, several high-impact viruses have emerged in the global swine population, including porcine reproductive and respiratory syndrome virus (PRRSV). In Uruguay, the more recent serological survey for PRRSV and other notifiable diseases such as Aujeszky's disease virus (ADV) and classical swine fever virus (CSFV) dated from year 2000. The main purpose of this study was to update our information on the infection status of PRRSV, ADV and CSFV in Uruguayan pig herds, in order to keep informed about the epidemiological situation of these notifiable infections in the country. For serological testing, a total of 524 swine serum samples collected during the period 2014-2016 were assayed by commercial ELISAs. Our results revealed the (unexpected) presence of PRRSV antibodies in Uruguayan domestic swine herds and confirmed the absence of ADV and CSFV antibodies in all of the assessed samples. Following such initial finding, PRRSV antibodies were further investigated in 23 retrospective samples collected during 2010-2014. Thirteen of these 23 samples resulted seropositive. Subsequently, a molecular detection approach in frozen serum samples was implemented to confirm PRRSV infection, and viral RNA was identified by reverse transcription-nested polymerase chain reaction (RT-nPCR). Fourteen of 86 evaluated 2014-2016 samples resulted positive for viral RNA, while molecular analysis of four retrospective samples also revealed the presence of PRRSV type 2. Viral isolation of selected samples was carried out in porcine alveolar macrophages (PAM) and MARC 145 simian kidney cells, and the virus identity was confirmed by cytopathic effect (CPE) and immunofluorescence assay (IFA) using specific monoclonal antibodies for PRRSV nucleocapsid. Data reported here evidence for the first time the circulation of PRRSV type 2 in Uruguay, and retrospective serology results suggest that the virus has been infecting pigs in this country at least since 2011.

Pharmacokinetics of Polymersomes Composed of Poly(Butadiene-Ethylene Oxide); Healthy versus Tumor-Bearing Mice.

Vesicles composed of block copolymers (i.e., polymersomes) are one of the most versatile nano-carriers for medical purposes due to their tuneable physicochemical properties and the possibility to encapsulate simultaneously hydrophobic and hydrophilic substances, allowing, for instance, the combination of therapy and imaging. In cancer treatment, these vesicles need to remain long enough in the blood stream to be sufficiently taken up by tumors. Here, we have investigated the biodistribution and the pharmacokinetics of polymersomes, composed of poly(butadiene-b-ethylene oxide) having dimensions around 80 nm. The polymersomes have been radiolabeled with ¹¹¹In via the so-called active loading method achieving a loading efficiency of 92.9 ± 0.9% with radionuclide retention in mouse serum of more than 95% at 24 h. The optimized ¹¹¹In containing polymersomes have been intravenously administered in healthy and tumor bearing mice for pharmacokinetic determination using microSPECT (Single Photon Emission Computed Tomography). In healthy mice these polymersomes have been found to exhibit relatively long blood circulation (> 6 h), low liver uptake (6 ± 1.5%ID/g, 48 h p.i.) and elevated spleen uptake (188 ± 30%ID/g). The blood circulation in tumor bearing mice is dramatically reduced (< 1.5 h) most likely due to elevated splenic filtration, clearly indicating the importance of in vivo studies in diseased mice. Finally, the polymersomes have been injected subcutaneously in tumor bearing mice revealing retention of 77% in the mice, primarily accumulated at the site of injection, up to 48 hours after administration.

A new silica-infiltrated Y-TZP obtained by the sol-gel method.

OBJECTIVE: The aim of this study was to evaluate silica infiltration into dental zirconia (VITA In-Ceram 2000 YZ, Vita Zahnfabrik) and its effects on zirconia's surface characteristics, structural homogeneity and bonding to a resin cement. METHODS: Infiltration was performed by immersion of the pre-sintered zirconia specimens in silica sols for five days (ZIn). Negative (pure zirconia specimens, ZCon-) and positive controls (specimens kept in water for 5 days, ZCon+) were also performed. After sintering, the groups were evaluated by X-ray diffraction (XRD), grazing angle X-ray diffraction (DRXR), scanning electron microscopy (SEM), contact angle measurements, optical profilometry, biaxial flexural test and shear bonding test. Weibull analysis was used to determine the Weibull modulus (m) and characteristic strength (σ0) of all groups. RESULTS: There were no major changes in strength for the infiltrated group, and homogeneity (m) was also increased. A layer of ZrSiO4 was formed on the surface. The bond strength to resin cement was improved after zirconia infiltration, acid conditioning and the use of an MDP primer. CONCLUSION: The sol-gel method is an efficient and simple method to increase the homogeneity of zirconia. Infiltration also improved bonding to resin cement. CLINICAL SIGNIFICANCE: The performance of a zirconia infiltrated by silica gel improved in at least two ways: structural homogeneity and bonding to resin cement. The infiltration is simple to perform and can be easily managed in a prosthesis laboratory.

Résistances aux hormones stéroïdes : physiologie et pathologie: Pathophysiology of Steroid Resistance Syndrome.

Steroid resistance syndrome (mineralocorticoids, glucocorticoids, estrogens, androgens) is a rare clinical disorder, androgen insensitivity syndrome being the most commonly described. Resistance syndromes are characterized by elevated steroid hormone levels, secondary to an impaired signal transduction and a lack of negative feedback, without any specific clinical signs of steroid excess. In most cases, steroid hormone resistance is generally caused by steroid receptor mutations. Several nonsense and missense mutations or deletions have already been described for all steroid receptors, except for the progesterone receptor. The number of reported mutations is extremely variable, depending on the steroid receptor, ranging from 3 for the estrogen receptor to more than 500 for the androgen receptor. Loss of function of others factors implicated on the steroid hormone signaling pathway, such as molecular chaperones or coactivators, might also be involved in the pathogenesis of steroid resistance. Therapy is essentially symptomatic, there is currently no pharmacological strategy enabling restoration of the impaired hormone signaling pathway. Identification of steroid resistance syndrome and their characterization should allow a better understanding of underlying molecular defects, opening new avenues for the development of novel alternative options for the disease management.

The impact of vitamin D on the innate immune response to uropathogenic Escherichia coli during pregnancy.

Urinary tract infections are highly common during pregnancy, and can cause serious complications for the mother and baby. Vitamin D, predominantly obtained from the sunlight, is known to have an effect on the urothelium, with immunomodulatory capacity against Escherichia coli infection. However, its influence at this site remains to be further explored. This study therefore investigated its impact during pregnancy in a population of women who have the possibility of adequate year-round sun exposure. Serum from pregnant Ugandan women (n = 32) in each trimester of pregnancy, from women after delivery (n = 29) and from never-pregnant controls (n = 25) was collected. 25-Hydroxyvitamin D (25-OHD), cathelicidin LL-37, human ß-defensin 2, interleukin (IL)-8 and soluble CD14 serum concentrations were measured by chemiluminescence immunoassay or ELISA. The ability of serum to inhibit E. coli growth was tested. The immunomodulatory capacities of these serum samples and 1,25-dihydroxyvitamin D3 were investigated in urothelial cells. Increases in 25-OHD and LL-37 levels were observed as pregnancy progressed, peaking in the third trimester. Serum 25-OHD levels were higher in multigravidae than in primigravidae, and correlated positively with maternal age. IL-8 levels were lower in the third trimester than in the first trimester, increased after delivery, but remained below those of never-pregnant women. Similarly, soluble CD14 concentrations increased after delivery. As gestation advanced, serum had an increased capacity to inhibit E. coli growth. In vitro, it modulated the IL-8 response to infection in a vitamin D concentration-dependent manner. Our findings demonstrate that increasing vitamin D levels as pregnancy advances modulate the innate immune system towards a protective response to infection.

Inlays made from a hybrid material: adaptation and bond strengths.

The aim of this study was to evaluate the internal fit, marginal adaptation, and bond strengths of inlays made of computer-aided design/computer-aided manufacturing feldspathic ceramic and polymer-infiltrated ceramic. Twenty molars were randomly selected and prepared to receive inlays that were milled from both materials. Before cementation, internal fit was achieved using the replica technique by molding the internal surface with addition silicone and measuring the cement thicknesses of the pulpal and axial walls. Marginal adaptation was measured on the occlusal and proximal margins of the replica. The inlays were then cemented using resin cement (Panavia F2.0) and subjected to two million thermomechanical cycles in water (200 N load and 3.8-Hz frequency). The restored teeth were then cut into beams, using a lathe, for microtensile testing. The contact angles, marginal integrity, and surface patterns after etching were also observed. Statistical analysis was performed using two-way repeated measures analysis of variance (p<0.05), the Tukey test for internal fit and marginal adaptation, and the Student t-test for bond strength. The failure types (adhesive or cohesive) were classified on each fractured beam. The results showed that the misfit of the pulpal walls (p=0.0002) and the marginal adaptation (p=0.0001) of the feldspathic ceramic were significantly higher when compared to those of the polymer-infiltrated ceramic, while the bond strength values of the former were higher when compared to those of the latter. The contact angle of the polymer-infiltrated ceramic was also higher. In the present study, the hybrid ceramic presented improved internal and marginal adaptation, but the bond strengths were higher for the feldspathic ceramic.

[Satisfaction of relatives of the patients admitted to an intensive careunit: Perceptions of relatives and professionals]. / Satisfacción de los familiares de los pacientes ingresados en una unidad de cuidados intensivos: percepción de los familiares y los profesionales

OBJECTIVES: To estimate the satisfaction of relatives of critical care patients with regard to the environment, relationship with professionals and visitation and compare it to the perception of professionals. METHODOLOGY: A descriptive study in two phases. In the first phase validated telephone survey within 15 days of discharge to the relatives of the patients was performed. In the second phase, the same modified questionnaire was self-administered to the professionals. The same variables were studied in both populations. RESULTS: We interviewed 78 family members and 44 professionals. 95% of professionals vs 67% of the families claimed not to know the name of the nurses (P < .001). Over 70% of professionals and families agreed that the visit protocol is correct and that the information was adequate income. 70% of professionals felt that the information received at admission is not understood by the family although 97% of households claimed to have understood themselves. Statistically significant differences were observed in relation to the location of the unit assessment, the waiting, the aspects of information and comfort, always being the professionals who felt greater dissatisfaction (P < .05). CONCLUSIONS: The perceptions of relatives and professionals were mostly uneven, making it necessary to continue exploring the differences through qualitative and participatory methodologies.