Efficacy of an aloe vera, chamomile, and thyme cosmetic cream for the prophylaxis and treatment of mild dermatitis induced by radiation therapy in breast cancer patients (the Alantel study).

Objectives: Radiation-induced dermatitis (RD) is one of the most common toxicities in radiation therapy (RT) patients. Corticosteroids, immunosuppressants, and natural products (NPs) have been used as treatment. The objective was to evaluate the efficacy of a NPs-based cream (Alantel®) to reduce the incidence of RD in women with breast cancer undergoing RT treatment. Design: We conducted a controlled, randomized, double-blind clinical trial. Setting: Radiation Oncology Unit of the Reina Sofía Hospital and 5 Primary Care centers of the Cordoba and Guadalquivir Health District (Spain). Interventions: Patients assigned to the experimental group (GTA) were treated with Alantel, while those in the control group (GTE) were treated with a moisturizer and emollient cream. Main outcome measures: The primary outcome variable was the incidence of RD. RD-free time, duration of RD, quality of life, and product safety were also assessed. Results: Seventy patients were included in the study, 35 in the GTA and 35 in the GTE. The incidence of RD was lower in the GTA (71.4%) than in the GTE (91.4%) after 4 weeks of follow-up (RR = 0.78; NNT = 5; p < 0.031). The Skindex-29 questionnaire showed differences in the statement: "My skin condition makes it hard to work or do hobbies" (17.1% in the GTE vs. 2.9% in GTA; p = 0.024). Conclusions: The higher efficacy of Alantel® compared to the control cream in reducing the incidence of RD in women with breast cancer has been demonstrated.

COVID-19 and the forgotten pandemic: follow-up of neurocognitive disorders during lockdown in Argentina. / COVID-19 y la pandemia olvidada: el seguimiento de las enfermedades neurocognitivas durante la cuarentena en Argentina.

INTRODUCTION: Health systems in numerous countries around the world are suffering a serious burden as a consequence of the COVID-19 pandemic. As a result of this situation, the follow-up of such chronic diseases as dementia may be at risk. Similarly, neuropsychiatric complications related to lockdown measures may also be neglected; Argentina's lockdown has been the longest implemented in Latin America. This study aims to determine the frequency of the different types of medical consultations for neurocognitive disorders and the predictors for requiring consultation since the beginning of the lockdown. METHODS: We performed a descriptive, observational, cross-sectional study based on data collected through an online survey. RESULTS: Data were collected on 324 participants, with 165 (50.9%) having had at least one medical consultation. Consultations were held by telephone in 109 cases (33.6%), by e-mail in 62 (19.1%), by video conference in 30 (9.3%), and at the emergency department in 23 (7.1%). Predictors of requiring consultation were Clinical Dementia Rating scores ≥1 (P<.001) and diagnosis of Alzheimer disease (P=.017). Higher Neuropsychiatric Inventory scores were found in the group of respondents who did require medical consultation (P<.001), but no significant differences were found between groups for Zarit Burden Interview scores. CONCLUSION: We identified a high prevalence of behavioural disorders and caregiver burden during lockdown. Nevertheless, only 50% of respondents had sought medical consultation (by telephone or email in 52.7% of cases). Care of people with dementia must be emphasised, guaranteeing follow-up of these patients.

[Real patients in virtual reality: the link between phantom heads and clinical dentistry]. / Echte patiënten in de virtuele realiteit: de schakel tussen fantoom en kliniek.

Preclinical training in phantom heads has until now been considered the 'gold standard' for restorative dental education, but the transition from preclinic to the treatment of real patients has remained a challenge. With the introduction of the latest generation of virtual reality simulators, students and dental practitioners can make digital impressions of their patients in virtual reality models and practice procedures in virtual reality before clinically performing them. In this way, clinical decisions can be investigated and practiced prior to actual treatment, enhancing the safety of the treatment and the self-confidence to perform it. With the 3M™ True Definition Scanner and the Moog Simodont Dental Trainer, 3 masters students and a general dental practitioner practiced their procedures in virtual reality prior to performing them on real patients. They were very satisfied with this preparation and the result of the treatment.

Innovation in dental education: The "On-the-Fly" approach to simultaneous development, implementation and evidence collection.

INTRODUCTION: This study outlines an approach for education innovation and addresses the ambivalence between evidence-based and non-evidence-based conditions. The "on-the-fly" approach was described as involving implementation during the development of an innovation for dental education. MATERIALS AND METHODS: The process of designing and implementing cutting-edge technology of the MOOG Simodont Dental Trainer (DT) whilst systematically collecting evidence illustrates the "on-the-fly" approach. RESULTS: Using the "on-the-fly" approach for developing, implementing and collecting evidence simultaneously in an academic environment appears feasible in serving both the professionals, users and developers and system designers. During the implementation of the new technology, growing evidence stepwise strengthened its position; therefore, showing stakeholders that evidence was used to improve the technology seemed to support and increase acceptance of the new technology. CONCLUSIONS: When pioneering an innovative technology in a specialty field, the development stage often precedes evidence for its effectiveness. Consciously choosing the "on-the-fly" approach clarifies to stakeholders in advance about the lack of evidence in an innovation and the need of their support to collect such evidence for improvement and in order to facilitate implementation.

Challenges in the transition to clinical training in dentistry: An ADEE special interest group initial report.

INTRODUCTION: Curricular integration in higher education has been widely supported in the educational literature. As a result, several health care and specifically dental curricula have evolved from compartmentalised disciplinary training to integrated modalities; however, in many courses, a pre-clinical-clinical watershed remains a barrier to integration in dental education. This article introduces a general description of the pre-clinical-clinical transition in dentistry according to the outcomes of the discussion held during the first working group session of the "Transition to Clinical Training" Special Interest Group during the 2016 annual meeting of the Association for Dental Education in Europe. MATERIALS AND METHODS: An online questionnaire was made available before the meeting to survey the curricular characteristics of the participants' schools. During the meeting, a working session related to the pre-clinical-clinical transition occurred. Conclusions from the discussion are summarised in this article. RESULTS: Fourteen dental schools from 12 countries participated in the online survey. The included programmes had an average duration of 5.3 years (SD = 0.48), with high school or the local equivalent as the required entrance level for dentistry. The hybrid curriculum was the leading curriculum design (n = 9) followed by competence-based curricula (n = 3), with patient treatment as the core of clinical training in every included programme. CONCLUSION: The pre-clinical-clinical transition in dentistry is a recognisable matter in dental education that requires assessment and research to ease the management of a stage with relevant influence on educational outcomes. This article presents an initial framework for further research and educational intervention.

Pre-surgical regional blocks in orthognathic surgery: prospective study evaluating their influence on the intraoperative use of anaesthetics and blood pressure control.

In orthognathic surgery, maxillary (CNV2) and mandibular (CNV3) divisions of the trigeminal nerve can be blocked successfully prior to surgery. In this study, it was hypothesized that regional blocks (nerve block over a particular region: bilateral CNV2 and CNV3 divisions of the trigeminal nerve) would decrease the total requirement for intraoperative anaesthetic agents and facilitate the process of hypotensive anaesthesia. Local anaesthesia containing 1/100,000 epinephrine and 10ml 0.5% levobupivacaine was injected into the planned incisions in 50 patients. Twenty-five patients (group A) underwent orthognathic surgery without regional blocks and another 25 patients (group B) underwent surgery with regional blocks. The anaesthetic protocol was the same in both groups and administered by a single anaesthesiologist. The mean arterial pressure was recorded at several points throughout the operation, as well as all the medications used. The blood loss and the amounts of medications administered were lower in group B than in group A. In patients receiving regional blocks, the amounts of fentanyl and nicardipine required were significantly lower. The use of pre-emptive anaesthesia in orthognathic surgery may reduce the overall amounts of medications required for hypotensive anaesthesia, facilitate the intraoperative control of blood pressure, and decrease intraoperative blood loss.

Afectación de la calidad de vida en mujeres con incontinencia urinaria / Impact on quality of life in women with urinary incontinence

Objetivo Valorar la repercusión que la incontinencia urinaria tiene en la calidad de vida de las mujeres atendidas en el Centro Urológico San Ignacio (Sevilla).Material y métodos Estudio descriptivo sobre 34 mujeres que acudieron a consulta entre 2008 y 2009, diagnosticadas de incontinencia urinaria en cualquiera de sus principales formas clínicas de presentación: incontinencia urinaria de esfuerzo, de urgencia y mixta. La recogida de datos se realizó mediante 2 cuestionarios: uno para valorar aspectos de severidad clínica de la incontinencia, y otro, el Kings Health Questionnaire, para valorar la calidad de vida. Resultados La edad media de las pacientes fue 52,97 con una desviación típica de 11,41 años y con 7,55 años de evolución de incontinencia, el 60% padecían incontinencia de esfuerzo. Las dimensiones: salud general, gravedad e impacto de la incontinencia son las más afectadas. La correlación entre la calidad de vida y los parámetros de severidad de los síntomas es baja, siendo el número de absorbentes usados al día, el que mejor correlaciona con 5 de las 9 dimensiones, destacando la dimensión limitaciones de la AVD (r=0,632 para p=0,000).Conclusiones Las dimensiones más afectadas son las relacionadas con la percepción de salud general, con el impacto que este problema provoca en sus vidas y con la esfera física de las mujeres. En cuanto a la relación entre calidad de vida y severidad clínica encontramos relaciones débiles y sobre todo con el número de absorbentes utilizados al día (AU)

Objective The aim of this study is to evaluate the impact of urinary incontinence on quality of life in women treated in the Urological Center San Ignacio, in Seville. Material and methods A descriptive study was made on 34 women who had come to consultation between 2008 and 2009, and who had been diagnosed of stress, urge or mixed urinary incontinence. Data collection was made using two questionnaires: one based on the King's Health Questionnaire to assess quality of life and the other to evaluate clinical severity aspects of urinary incontinence. Results Our patients’ average age was 52.97 years old, with a standard deviation of 11.41, their incontinence had an evolution of 7.55 years, and 60% of them suffered from stress urinary incontinence. The most affected dimensions were General Health, Severity Measurements and Urinary Incontinence Impact. Correlation between Quality of Life and Symptoms Severity was low, although Number of Absorbents used per day showed a higher correlation with 5 of the 9 dimensions, highlighting the dimension daily life activities limitations (r=0.632 para p< 0.001).Conclusions The most affected dimensions were those related to women's health perception, impact on daily life and physical aspects. We found low correlation between quality of life and clinical severity, especially with the number of absorbents used per day (AU)

Osteoblastoma of the hyoid bone.

Osteoblastoma is a rare bone tumor that usually affects the vertebrae. We present the first known case of osteoblastoma arising in the hyoid bone, in a patient who presented with a neck mass and dysphagia. The radiographic appearance of the tumor is similar to that of low-grade chondrosarcoma, with well-defined expansion of the bone and central chondroid matrix.

Abnormal septal motion in cardiac tamponande with pulse paradoxus. Echocardiographic and hemodynamic observations.

In a patient with cardiac tamponade and pulses paradoxus the echocardiogram showed markedly abnormal septal motion, consisting of posterior displacement during inspiration. This displacement resulted from an increase in right ventricular size and a decrease in left ventricular volume, not attributable to a change in position of the heart. The correlation of this finding with hemodynamic events showed that the inspiratory drop in arterial pressure followed septal displacement. These observations support the hypothesis that pulsus paradoxus may be caused by competition of the ventricles for filling within a relatively rigid pericardial space. Displacement of the interventricular septum could be the mechanism by which this completition takes place.