Effect of curing-light attenuation on color stability and physical and chemical properties of resin cements containing different photoinitiators.

This study aimed to evaluate the effect of light attenuation by ceramic veneers on the degree of conversion (DC), flexural strength (FS) and color change (CC) of resin cements containing different photoinitiators. Thus, samples included resin cements containing different photoinitiators: (a) camphorquinone (CQ)/ethyl 4-(dimethylamino)benzoate (EDMAB); (b) CQ/4-(N,N-dimethylamino) phenethyl alcohol (DMPOH); (c) CQ/2(dimethylamino) ethyl methacrylate (DMAEMA); (d) CQ/ethyl 4-(dimethylamino)benzoate (EDMAB) + diphenyl(2,4,6-trimethylbenzoyl)-phosphine oxide (TPO); (e) TPO; and (f) phenylbis(2.4.6-trimethylbenzoyl)phosphine oxide (BAPO). Ceramic veneers (10 × 10 mm) were 0.4 mm, 0.7 mm, 1.0 mm or 1.5 mm thick. The light irradiance of a multiple-peak LED through ceramic veneers was measured (n = 5) using a spectrometer. DC (micro-Raman spectrometer) and FS (Bar-shaped specimens) were tested in cements with and without the veneers. Color change was evaluated before and after UV artificial aging. Data were submitted to ANOVA and Tukey's test (α = 0.05). The violet spectrum showed the lowest irradiance values through the veneer, considering all thicknesses. BAPO had the highest DC values for all veneers. CQ/EDMAB + TPO, CQ + EDMAB, and CQ + DMPOH showed similar DC values concerning all thicknesses. TPO (1.0 mm) showed the lowest DC and FS values. CQ + TPO and CQ/amines showed similar FS values. CQ + EDMAB and CQ + DMAEMA showed the highest color change values while TPO showed the lowest. It was concluded that the physical and chemical properties of the resin cement were improved with BAPO. CQ/EDMAB + TPO showed the greatest color stability, considering all veneer groups and control, without affecting the other properties assessed.

Sun-safe behaviours, personal risk, level of concern, and knowledge about cutaneous melanoma in italy: time for social marketing?

INTRODUCTION: The incidence of cutaneous melanoma is increasing, although 80-95% of all deaths caused by melanoma can be avoided through protective behaviours. There is evidence that social marketing as an approach in public health can improve health-related behaviours and encourage sun-safe behaviours. METHODS: A multicentre survey was conducted to collect and compare data about cutaneous melanoma risk, knowledge, concern, and protective behaviours across Northern, Central, and Southern Italy, and explore how these data could potentially inform a social marketing intervention to improve sun-safe behaviours. Data were analysed using descriptive and inferential statistics. RESULTS: A total of 1,028 questionnaires were collected. Apart from 'Personal Risk' no statistically significant differences were found between the three regions. About 30% (n = 344) of the total sample had high levels of personal risk, and low levels of concern and protective behaviour, and over 70% (n = 711) gave priority to sun tanning. The worst scores were related to knowledge about melanoma (30% wrong answers, and over 40% 'don't know'). Protective behaviour was moderately correlated with age (p = 0.03). Personal risk was significantly higher in women (10.84 vs 10.05), and lower in individuals with a degree (9.46 vs 11.38; p < 0.001). CONCLUSIONS: Over 70% of our sample gave priority to sun tanning, which combined with low levels of concern and knowledge about melanoma, and high levels of personal risk, confirm that much still needs to be done in terms of melanoma prevention, but all these are aspects that could be effectively addressed through social marketing interventions.

Improving the quality of communication during handover in a Paediatric Emergency Department: a qualitative pilot study.

INTRODUCTION: There is a dearth of literature that specifically addresses the handover reporting process among healthcare staff working in children's Emergency Department (ED). Widespread gaps in service provision, such as gaps in communication in handover reports to ambulance staff have been noted in the general literature on the topic. There are also improvements observed in handover when a structured mnemonic was encouraged. Structured reports improve communication, safety and may reduce medication errors. Thus, the improvement of handover reporting in children's ED has important implications for children's healthcare practice. However, little is known about communication processes during handover reports in Italian children's ED or its consequences for errors or risks. METHODS: A qualitative description methodology was used. Semi-structured interviews were used to collect data from five children's ED nurses. Thematic content analysis was used to identify common themes. RESULTS: Emergent themes were: interpersonal influences on handover; structural issues; and local contextual factors. CONCLUSIONS: The findings of this pilot study prompted the need for a standardized tool that improves communication during handover. As such, standardizing the communication process during handover could be effectively resolved by using a mnemonic tool adapted for handover in a paediatric emergency department.

Which procedures and materials could be applied for full pulpotomy in permanent mature teeth? A systematic review.

Objective: Coronal pulpotomies were recently re-investigated as an alternative to root canal treatment in vital permanent teeth. General dentists may be interested in knowing how to perform full pulpotomy, in particular in face of difficult endodontic cases of vital teeth. Material and methods: A systematic review was undertaken on the PubMed and Cochrane databases in order to determine which procedure should be applied for pulp capping and coronal restoration in routine dental practice. Fifty-three publications were included and allocated to one of two methodological categories: histological and clinical studies. Results and conclusions: There is no evidence to recommend one single procedure for full pulpotomy in vital permanent teeth that can be indicated for different pulpal diagnoses which differ greatly in terms of the inflammation process from healthy teeth to irreversible pulpitis. For each clinical case, all actions aiming to prevent pre-operative contamination, to control per-operative infection and to achieve a complete seal above the radicular pulp sections are unavoidable steps that should be complied with. Reproducing procedures adopted in high quality trials could insure high success rates.

Developing a Stoma Acceptance Questionnaire to improve motivation to adhere to enterostoma self-care.

INTRODUCTION: In stoma care, patient education is often weak in terms of improving patients' level of acceptance of living with a stoma. Self-care educational interventions in enterostomal patients, which according to Orem's Theory should take into account these patients' specific needs, require instruments that measure patients' stoma acceptance to improve motivation based on the resumption of activities they used to carry out before having a stoma. The aim of the study was to develop an instrument that measures the level of stoma acceptance to improve motivation to adhere to enterostoma self-care. METHODS: Aspects that improve stoma acceptance and consequently motivation to adhere to enterostoma self-care were identified through 10 focus groups. In the focus groups, the motivation indicators were grouped, categorised and results entered into a Stoma Acceptance Questionnaire (SAQ). The SAQ was then piloted with 104 enterostomal patients from three general hospitals. To assess the construct validity of the SAQ, Mokken Scaling was used to explore the latent structure of the SAQ. Mokken scaling is a non-parametric method that falls under the umbrella of methods described as item response theories (IRT). RESULTS: The theme "Living with a stoma"; "Autonomy"; "Support"; "Ability to deal with stoma", plus a common underlying theme: "Stoma acceptance" were dissussed by the Focus Groups. The experts identified the items of the (SAQ) through these themes. Mokken Scaling identified the "resumption of enterostomal patients' normal activities" as a measure of stoma acceptance, thus confirming the construct validity of the SAQ. CONCLUSIONS: The tool proposed affords a pioneering example of how this gap can be bridged. Indeed, the SAQ could enable nurses adopting a standardized approach for the assessment of enterostomal patients' motivation to resume their normal activities and identify needs linked to this. The SAQ could also be used to measure the effectiveness of psychosocial and educational interventions aimed at improving stoma acceptance.

Compression of hard core-soft shell nanoparticles at liquid-liquid interfaces: influence of the shell thickness.

Soft hydrogel particles show a rich structural and mechanical behaviour compared to hard particles, both in bulk and when confined in two dimensions at a fluid interface. Moreover, encapsulation into hydrogel shells makes it possible to transfer the tunability of soft steric interactions to hard nanoparticle cores, which bear interest for applications, e.g. in terms of optical, magnetic and reinforcement properties. In this work, we investigate the microstructures formed by hard core-soft shell particles at liquid-liquid interfaces upon compression. We produced model particles with the same silica core and systematically varied the shell-to-core ratio by synthesising shells with three different thicknesses. These particles were spread at an oil-water interface in a Langmuir-Blodgett trough and continuously transferred onto a solid support during compression. The transferred microstructures were analysed by atomic force and scanning electron microscopy. Quantitative image analysis provided information on the particle packing density, the inter-particle distance, and the degree of order of the monolayers. We discovered several essential differences compared to purely soft hydrogel particles, which shed light on the role played by the hard cores in the assembly and compression of these composite monolayers.

Determinants of adherence to seasonal influenza vaccination among healthcare workers from an Italian region: results from a cross-sectional study.

OBJECTIVES: Notwithstanding decades of efforts to increase the uptake of seasonal influenza (flu) vaccination among European healthcare workers (HCWs), the immunisation rates are still unsatisfactory. In order to understand the reasons for the low adherence to flu vaccination, a study was carried out among HCWs of two healthcare organisations in Liguria, a region in northwest Italy. METHODS: A cross-sectional study based on anonymous self-administered web questionnaires was carried out between October 2013 and February 2014. Through univariate and multivariate regression analysis, the study investigated the association between demographic and professional characteristics, knowledge, beliefs and attitudes of the study participants and (i) the seasonal flu vaccination uptake in the 2013/2014 season and (ii) the self-reported number of flu vaccination uptakes in the six consecutive seasons from 2008/2009 to 2013/2014. RESULTS: A total of 830 HCWs completed the survey. Factors statistically associated with flu vaccination uptake in the 2013/2014 season were: being a medical doctor and agreeing with the statements 'flu vaccine is safe', 'HCWs have a higher risk of getting flu' and 'HCWs should receive flu vaccination every year'. A barrier to vaccination was the belief that pharmaceutical companies influence decisions about vaccination strategies. DISCUSSION: All the above-mentioned factors, except the last one, were (significantly) associated with the number of flu vaccination uptakes self-reported by the respondents between season 2008/2009 and season 2013/2014. Other significantly associated factors appeared to be level of education, being affected by at least one chronic disease, and agreeing with mandatory flu vaccination in healthcare settings. CONCLUSIONS: This survey allows us to better understand the determinants of adherence to vaccination as a fundamental preventive strategy against flu among Italian HCWs. These findings should be used to improve and customise any future promotion campaigns to overcome identified barriers to immunisation.

Composites reinforced via mechanical interlocking of surface-roughened microplatelets within ductile and brittle matrices.

Load-bearing reinforcing elements in a continuous matrix allow for improved mechanical properties and can reduce the weight of structural composites. As the mechanical performance of composite systems are heavily affected by the interfacial properties, tailoring the interactions between matrices and reinforcing elements is a crucial problem. Recently, several studies using bio-inspired model systems suggested that interfacial mechanical interlocking is an efficient mechanism for energy dissipation in platelet-reinforced composites. While cheap and effective solutions are available at the macroscale, the modification of surface topography in micron-sized reinforcing elements still represents a challenging task. Here, we report a simple method to create nanoasperities with tailored sizes and densities on the surface of alumina platelets and investigate their micromechanical effect on the energy dissipation mechanisms of nacre-like materials. Composites reinforced with roughened platelets exhibit improved mechanical properties for both organic ductile epoxy and inorganic brittle cement matrices. Mechanical interlocking increases the modulus of toughness (area under the stress-strain curve) by 110% and 56% in epoxy and cement matrices, respectively, as compared to those reinforced with flat platelets. This interlocking mechanism can potentially lead to a significant reduction in the weight of mechanical components while retaining the structural performance required in the application field.

Atrofodermia de Pasini e Pierini / Atrophoderma of Pasini and Pierini

No disponible

Análise da concordancia diagnóstica entre o diagnóstico presencial e oteledermatológico / Analyze of diagnostic concordance between face-to-face and teledermatology diagnosis

O presente estudo analisou a concordância entre a análise dermatológica presencial e digital. No presente estudo, 100 pacientes com diversas dermatoses foram analisados por três avaliadores através da teledermatologia. A teledermatologia off-line mostrou-se prática, realizável e com alto índice de concordância diagnóstica (AU)

The current study analyzed the concordance between face-to-face and teledermatology diagnosis. One hundred patients with different dermatoses were studied and they were analized by three different observers. Off-line teledermatology was practice, realizable and with high index of diagnostic concordance (AU)

Should pulp chamber pulpotomy be seen as a permanent treatment? Some preliminary thoughts.

AIM: To investigate the benefits of pulpotomy (to the level of the floor of the pulp chamber) as an endodontic treatment for teeth with vital pulps. METHODOLOGY: Seventeen patients, aged 7-54 years (mean of 37.2 year), were treated by pulpotomy and filling with ProRoot MTA(®) in premolar or molar teeth with vital pulps and without clinical evidence of irreversible pulpitis. The patients were then followed up for 12 to 24 months and the teeth then assessed by clinical and radiographic examination. Statistical analysis was performed with Kaplan-Meier survival probability statistics to estimate the survival of the treated teeth. RESULTS: At 24 months, the survival rate without any complementary treatment was estimated to be 82%. Two of the 17 treated teeth required root canal treatment for pain control and one for prosthetic reasons. CONCLUSIONS: Under the conditions of this study, pulpotomy offered a viable alternative to root canal treatment for teeth with vital pulps in the short term. However, there is insufficient clinical evidence to consider this technique for the treatment of every permanent tooth. Nevertheless, it should be considered as a potential alternative approach to be further developed for future applications.

Tratamento de cromomicose com criocirurgia e itraconazol sistêmico / Treatment of cromoblastomycosis with cryosurgery and systemic itraconazole

Relato de caso de cromicose focal tratado com sucesso através de criocurgia e itraconazol sistêmico (AU)

Case report of focal cromoblastomycos is treated successful with cryosurgery and systemic itraconazol (AU)

Poroceratose de Mibelli / Porokeratosis of Mibell

A poroceratose de Mibelli é uma genodermatose disceratósica (..) (AU)

Mibelli's porokeratosis is a rare dyskeratotic genodermatosis. All clinical forms (..) (AU)

Carcinoma verrucoso / Verrucous carcinoma

O carcinoma verrucoso é uma rara e indolente forma do carcinoma espinocelular, descrito por Ackerman em 1948. Clinicamente manifesta-se comouma lesão verrucosa, de progressivo e lento crescimento e bom prognóstico. O tratamento de escolha é a exérese cirúrgica sendo que o pacientedeve ser regularmente acompanhado pelo risco de recorrências (AU)

Verrucous carcinoma is a rare and indolent variant of squamous cell carcinoma, described by Ackerman in 1948. Clinically, present as a verrucouslesion, usually slowly progressive. The prognosis is good. Treatment of choice is surgery. Patients require frequent reevaluation because recurrencesmay occur (AU)

Dermatoscopia. Uma alternativa diagnóstica em infestacões cutâneas / Dermatoscopy. A diagnostic alternative in cutaneous infestations

Infestações cutâneas por insetos são comuns. Algumas vezes, seu diagnóstico clínico pode ser difícil. A dermatoscopia pode ser útil na identificação do agente e confirmar a afecção (AU)

Cutaneous infestations for insects are common. Sometimes, clinical diagnosis can be difficult. Dermatoscopy can be useful in the agent’s identification and to confirm the disease (AU)