Impact of COVID-19 on mental health of health care workers in Spain: a mix-methods study.

BACKGROUND: Spain's lockdown measures couldn't prevent the severe impact of the COVID-19 first wave, leading to high infections, deaths, and strain on healthcare workers (HCWs). This study aimed to explore the mental health impact on HCWs in the Balearic Islands during the initial months of the pandemic, the influencing factors, and the experiences of those in a COVID-19 environment. METHODS: Using a mixed-methods approach, the study encompassed quantitative and qualitative elements. Cross-sectional survey data from April to June 2020 comprised HCWs who were emailed invitations. The survey covered demographics, work, clinical and COVID-19 variables, along with psychological distress and PTSD symptoms, using validated measures. Additionally, semi-structured interviews with HCWs offered qualitative insights. RESULTS: Three hundred thirty-six HCWs averaging 46.8 years, mainly women (79.2%), primarily nurses in primary care with over 10 years of experience. Anxiety symptoms were reported by 28.8%, 65.1% noted worsened sleep quality, and 27.7% increased psychoactive drug usage. Psychological distress affected 55.2%, while 27.9% exhibited PTSD symptoms. Gender, age, experience, COVID-19 patient contact, and workload correlated with distress, PTSD symptoms, sleep quality, and psychoactive drug usage. Interviews uncovered discomfort sources, such as fear of infection and lack of control, leading to coping strategies like information avoidance and seeking support. LIMITATIONS: Static cross-sectional design, non-probabilistic sample, and telephone interviews affecting non-verbal cues, with interviews conducted during early pandemic lockdown. CONCLUSIONS: HCWs faced significant psychological distress during the pandemic's first wave, underscoring the necessity for robust support and resources to counteract its impact on mental health.

Effect of antibiotic prophylaxis for preventing infectious complications following impacted mandibular third molar surgery. A randomized controlled trial.

BACKGROUND: The objective of this study was to determine the effect of antibiotic prophylaxis in preventing postoperative infections after extraction of impacted mandibular third molars. MATERIAL AND METHODS: A Parallel-group, randomized, blind, placebo-controlled trial was performed. 154 patients were randomly allocated to 2 groups; experimental (n=77) receiving 2g amoxicillin 1 hour prior to surgery and control (n=77) receiving placebo. Primary outcome was postoperative infections and secondary outcome was the need for rescue analgesia. RESULTS: 4.5% of patients developed postoperative infections, five patients of the control group (4 alveolar osteitis, 1 surgical site infection) and two of the experimental group (1 alveolar osteitis, 1 surgical site infection). Difference between groups was not statistically significant, RR=0.4 (95%CI 0.08-1.99, 𝘱=0.41) NNTB=26. Rescue analgesia intake was significantly higher in the control group (41 vs 18 patients of experimental group) RR=0.49 (95%CI 0.32-0.75, 𝘱<0.05) NNTB=3. CONCLUSIONS: The use of 2g amoxicillin 1 hour before surgery was not effective in significantly reducing the risk of postoperative infections from impacted mandibular third molars extraction, when compared to placebo. Nevertheless, antibiotic prophylaxis was associated with a reduced need for rescue analgesia.

Diseño y evaluación de una cartilla para el Programa de Salud Bucodental en niños desde el nacimiento / Design and evaluation of a booklet for the Oral Health Program in children from birth

Fundamento: En España no existe un control preventivo de la salud bucodental desde el nacimiento. Estoconlleva una serie de riesgos, como el aumento decaries en niños. El objetivo de este trabajo fue diseñar una cartilla odontopediátrica para la valoración yseguimiento clínico de la salud bucodental en niños,así como su evaluación por profesionales de la salud yprogenitores/tutores. Método: Diseño de la cartilla, en 2018, por odontopediatras de la Clínica Odontológica Universitaria de Murcia,a partir de una revisión bibliográfica, para instruir enhábitos preventivos (dietéticos e higiene bucodental) ycurativos (planificación de visitas y tratamientos odontopediátricos). Evaluación del diseño preliminar, en2019, por un grupo de cuarenta odontopediatras, odontólogos, pediatras y progenitores/tutores, muestreadospor conveniencia. Cumplimentaron un cuestionario consus datos, opinión sobre distintos aspectos de la cartilla y sugerencias. Resultados: La evaluación de la versión preliminar de lacartilla por profesionales de salud y progenitores/tutoresfue positiva; se modificó atendiendo a sus sugerencias yse confeccionó la versión final: cartilla de 16 páginas, condatos de filiación del niño y progenitores/tutores, conenfoque preventivo y curativo, haciendo coincidir en eltiempo revisiones pediátricas y odontopediátricas. Conclusiones: La cartilla odontopediátrica se ha creado y ha sido valorada positivamente por distintosprofesionales y tutores. Se recomienda su uso para laatención odontológica temprana, pudiendo ampliarse aotros sistemas de salud a nivel autonómico en España.(AU)

Background: There is no preventive control of oralhealth from birth in Spain. This situation entails anumber of risks, such as increased caries lesions inchildren. The objective of this study was to design apediatric dentistry booklet for the clinical assessmentand follow-up of oral health in children, as well as itsevaluation by health professionals and parents.Method: Design of the booklet, in 2018, by pediatricdentists of the Murcia University Dental Clinic, basedon a bibliographic review, to instruct in preventive(dietary and oral hygiene) and curative (planning ofpediatric dental visits and treatments) habits. A convenience sampling of forty pediatric dentists, dentists,pediatricians and parents was carried out to evaluatethe preliminary design, in 2019. They completed a questionnaire with their data, opinion on different aspects ofthe booklet and suggestions. Results: The evaluation of the preliminary version ofthe booklet by health professionals and parents waspositive. It was modified in line with their suggestionsand the final version was made: a 16-page booklet, withdata on the child’s affiliation and parents, with a preventive and curative approach, making pediatric andpediatric dental check-ups coincide in time. Conclusions: The pediatric dentistry booklet was created and has been positively valued by professionalsand parents, its use is recommended for early dentalcare, and can be extended to other health systems atthe regional level in Spain.(AU)

[Design and evaluation of a booklet for the Oral Health Program in children from birth].

BACKGROUND: There is no preventive control of oral health from birth in Spain. This situation entails a number of risks, such as increased caries lesions in children. The objective of this study was to design a pediatric dentistry booklet for the clinical assessment and follow-up of oral health in children, as well as its evaluation by health professionals and parents. METHOD: Design of the booklet, in 2018, by pediatric dentists of the Murcia University Dental Clinic, based on a biblio-graphic review, to instruct in preventive (dietary and oral hygiene) and curative (planning of pediatric dental visits and treatments) habits. A convenience sampling of forty pediatric dentists, dentists, pediatricians and parents was carried out to evaluate the preliminary design, in 2019. They completed a questionnaire with their data, opinion on different aspects of the booklet and suggestions. RESULTS: The evaluation of the preliminary version of the booklet by health professionals and parents was positive. It was modified in line with their suggestions and the final version was made: a 16-page booklet, with data on the child's affilia-tion and parents, with a preventive and curative approach, making pediatric and pediatric dental check-ups coincide in time. CONCLUSIONS: The pediatric dentistry booklet was created and has been positively valued by professionals and parents, its use is recommended for early dental care, and can be extended to other health systems at the regional level in Spain.

Intimate partner violence and perinatal health: a systematic review.

BACKGROUND: Physical, psychological and sexual intimate partner violence (IPV) has been described in the literature as different types of IPV experienced by women during pregnancy all over the world. OBJECTIVES: To review and summarise systematically the empirical evidence on the links between IPV during pregnancy and the perinatal health of mothers and fetuses/neonates. SEARCH STRATEGY: MEDLINE (Ovid), CINAHL, Embase, Nursing@ovid (Ovid) and LILACS were searched (2008-2018). SELECTION CRITERIA: Observational studies that examined perinatal health outcomes (i.e. pre-term birth, low birthweight, miscarriage, perinatal death and premature rupture of membranes) in pregnant women exposed to IPV. DATA COLLECTION AND ANALYSIS: Information on study characteristics, type of IPV measured, study design, methodological quality and outcome variable extracted. RESULTS: Fifty studies were included. Twenty-nine analysed undifferentiated IPV (n = 25 489), 34 included physical IPV (n = 7333), 22 analysed psychological IPV (n = 7833) and 18 examined sexual IPV (n = 2388). Fifteen studies were from Asia, 12 from North America and Oceania, and 12 from Central and South America. The studies examined the association between IPV and 39 different perinatal health outcomes. The most frequent outcomes reported were pre-term birth (50%), low birthweight (46%), miscarriage (30%), perinatal death (20%) and premature rupture of membranes (20%). A significant association with perinatal health outcomes was reported by 12 of the studies analysing undifferentiated IPV, 18 physical IPV, six psychological IPV and two sexual IPV. CONCLUSIONS: The relation between IPV and perinatal health outcomes can be seen in different epidemiological designs and countries. In all, 39 different outcomes were identified and 29 were associated with IPV. TWEETABLE ABSTRACT: A variety of poor perinatal health outcomes are associated with psychological, physical and sexual IPV.

Silver-loaded nanoparticles affect ex-vivo mechanical behavior and mineralization of dentin.

BACKGROUND: The aim was to evaluate the effect of silver loaded nanoparticles (NPs) application on the triboscopic, crystallographic and viscoelastic properties of demineralized dentin. Polymethylmetacrylate-based NPs and Ag loaded NPs were applied on demineralized dentin. MATERIAL AND METHODS: Treated and untreated surfaces were probed by a nanoindenter to test viscoelasticity, and by atomic force microscopy to test nanoroughness and collagen fibril diameter. X-ray diffraction and transmission electron microscopy through selected area diffraction and bright-field imaging were also used. RESULTS: Dentin treated with Ag-NPs attained the lowest complex modulus, and the highest tan delta values after 7 days of storage. Dentin treated with undoped-NPs achieved the lowest nanoroughness and the greatest collagen bandwidths among groups. Crystals were identified as hydroxyapatite with the highest crystallographic maturity and crystallite size in dentin treated with undoped-NPs. Texture increased in all samples from 24 h to 7 d, except in dentin surfaces treated with Ag-NPs at 310 plane. Polyhedral, block-like, hexagonal or plate-like shaped apatite crystals constituted the bulk of minerals in dentin treated with Ag-NPs, after 7 d. Polyhedral or rounded/drop-like, and polymorphic in strata crystal apatite characterized the minerals when undoped-NPs were used, with more crystalline characteristics after 7 d than that found when Ag-NPs were applied. Ag-NPs application did not improve the mechanical performance of dentin and did not produce dentin remineralization. However, energy was dissipated through the dentin without showing stress concentration; contrary was occurring at dentin treated with undoped-NPs, that provoked bridge-like mineral deposits at the dentin surface. CONCLUSIONS: Ag-NPs application did not enhance the mechanical properties of cervical dentin, though the energy dissipation did not damage the dentin structure. Remineralization at dentin was not produced after Ag-NPs application, though improved crystallinity may lead to increase stability of the apatite that was generated at the dentin surface.

A zinc oxide-modified hydroxyapatite-based cement facilitated new crystalline-stoichiometric and amorphous apatite precipitation on dentine.

AIM: To evaluate the remineralization ability of two endodontic sealer cements. METHODOLOGY: Mid-coronal dentine surfaces were subjected to: (i) 37% phosphoric acid (PA) or (ii) 0.5 mol L-1 ethylenediaminetetraacetic acid (EDTA) conditioning prior to the application of two experimental hydroxyapatite-based cements, containing sodium hydroxide (calcypatite) or zinc oxide oxiapatite respectively. Samples were stored in simulated body fluid for 24 h or 21 days. Remineralization of the dentine surfaces were studied by Raman spectroscopy (mapping with K-means cluster and hierarchical cluster analysis) was undertaken. Nanoroughness and collagen fibril width measurements were performed with an atomic force microscopy. ANOVA and Student-Newman-Keuls test were performed (α=0.05). RESULTS: Phosphoric acid+oxiapatite promoted both the highest dentine mineralization (P < 0.05) and crystallographic maturity at the dentine surface. Noncrystalline amorphous-like apatites were also formed. Dentine treated with PA+calcypatite attained the roughest surface (P < 0.05) with minimal fibril width (P < 0.05). Cross-linking of collagen only became greater in the group PA+oxiapatite after 21 days. The maximum relative mineral concentration and structure of collagen linked to the amide I and ratio amide III/AGEs was obtained after using PA+calcypatite at 21-days time-point (P < 0.05). EDTA produced a lower stoichiometric hydroxyapatite (P < 0.05) with decreased maturity, at the expense of carbonate band widening, although it favoured the nucleation of carbonated calcium phosphate. CONCLUSIONS: Dentine surfaces treated with PA+oxiapatite attained the highest dentine remineralization with both crystalline-stoichiometric and amorphous apatites, at 21 days. EDTA conditioning facilitated amorphous-bulk mineral precipitation. The amorphization was more intense after using oxiapatite and provided an ion-rich environment favouring in situ dentine remineralization.

Impact of accelerometer and pedometer use on physical activity and glycaemic control in people with Type 2 diabetes: a systematic review and meta-analysis.

BACKGROUND: Self-directed pedometer use increases physical activity levels in the general population; however, evidence of benefit for Type 2 diabetes is unclear and has not been systematically reviewed for accelerometers. AIM: To examine the impact of using physical activity monitoring devices (pedometers and accelerometers) on free-living physical activity and HbA1c levels in people with Type 2 diabetes. METHODS: We conducted a systematic literature review. Bibliographic databases included Medline, Embase, Web of Science, CINAHL, SportDiscus and the Cochrane Central Register of Controlled Trials. We included controlled trials evaluating interventions based on the use of pedometers or accelerometers to promote physical activity in people with Type 2 diabetes. Primary outcomes were physical activity (min/week or steps) and HbA1c [mmol/mol (%)]. Secondary outcomes were weight, blood pressure and lipid profile. RESULTS: Twelve trials (1458 participants) were identified, of which nine studied pedometers and three accelerometers. Random-effects meta-analysis showed an overall increase in physical activity (standardized mean difference 0.57, 95% CI 0.24, 0.91) in the intervention groups. Accelerometers and pedometers produced a similar effect size. No significant differences were observed in HbA1c , BMI, blood pressure or lipid profile. CONCLUSIONS: People with Type 2 diabetes, provided with an accelerometer or pedometer, substantially increased their free-living physical activity. There is no evidence that monitor use alone improves HbA1c or other clinical outcomes. Further trials are needed to compare the relative effects of activity monitors within differing complex interventions.

Omega-3 fatty acids as adjunctive treatment for bexarotene-induced hypertriglyceridaemia in patients with cutaneous T-cell lymphoma.

BACKGROUND: Bexarotene is an oral retinoid approved for treating cutaneous T-cell lymphoma (CTCL) in patients resistant to first-line systemic treatment. Hypertriglyceridaemia is an unavoidable adverse effect of bexarotene therapy, and requires monitoring because of the risk of developing pancreatitis. Therefore, prophylactic hypolipidaemic therapy, usually with a fibrate alone, is required for preventing bexarotene-induced hypertriglyceridaemia. Despite these measures, a large number of patients develop very severe hypertriglyceridaemia. AIM: To assess the lipid metabolism changes before and after the use of a combination of omega-3 fatty acids (n-3 FA) plus fenofibrate compared with fenofibrate alone as a more effective lipid-lowering therapy in patients with CTCL treated with bexarotene. METHODS: From January 2005 to January 2013, we analysed all 25 patients with CTCL treated with bexarotene. The first 18 consecutively enrolled patients received fenofibrate alone as a lipid-lowering therapy, and the next 7 consecutively enrolled patients received a combination of fenofibrate and n-3 FA. RESULTS: Data for all 25 consecutive patients with CTCL treated with bexarotene were evaluated. Of these, 24 patients (96%) developed hypertriglyceridaemia despite the hypolipidaemic therapy, with this being very severe (> 11.2 mmol/L) in 20% of the cases. Of the 18 patients receiving fenofibrate alone, 5 (28%) developed very severe hypertriglyceridaemia, compared with none of the 7 patients treated with the n-3 FA combination. CONCLUSIONS: Our results suggest that the n-3 FA combination may be more effective than fibrate alone for preventing bexarotene-induced hypertriglyceridaemia.

Effects of interventions promoting monitoring of medication use and brief messaging on medication adherence for people with Type 2 diabetes: a systematic review of randomized trials.

AIMS: To assess the impact of interventions promoting the monitoring of medication use and brief messaging to support medication adherence in patients with Type 2 diabetes mellitus, and to investigate the extent of theory use to guide intervention development. METHODS: We systematically searched for controlled trials, published from 1990 onwards in Medline, Embase, CINAHL, PsycINFO and the Cochrane library, that evaluated interventions based on monitoring and brief messaging to support medication adherence in patients with Type 2 diabetes, to examine the effectiveness of such interventions. RESULTS: A total of 11 trials, comparing 15 interventions, were identified. Only a small minority presented a low risk of bias. Three interventions were based on delivering brief messages, six were based on monitoring medication adherence, and six used both strategies. Messaging interventions included the use of short message service text messages, web-based feedback, and messages delivered through monitoring devices. Monitoring interventions included remote self-reporting of medication and telephone calls with healthcare staff. Improvements in medication adherence were observed in six interventions, although effect sizes were generally moderate. Only two interventions improved both adherence and clinical outcomes. A meta-analysis of five trials (eight interventions) combining monitoring and messaging strategies showed that the pooled difference in medication adherence between intervention and control was moderate and not statistically significant [standardized mean difference = 0.22 (95% CI -0.05; 0.49)]. Only four trials were based on explicit theoretical frameworks. CONCLUSIONS: Although interventions based on messaging and monitoring have the potential to improve medication adherence in patients with Type 2 diabetes, evidence of their efficacy is limited and additional high-quality, theory-based research is needed.

Riesgo de infección del sitio quirúrgico, según tiempo operatorio en cirugía maxilofacial mayor limpia contaminada: estudio observacional analítico / Risk of surgical site infection according to operating time in major clean-contaminated maxillofacial surgery. Observational analytical study

Introducción: La infección del sitio quirúrgico (ISQ) sigue generando gran morbimortalidad, a pesar de los avances en control de infecciones y técnicas quirúrgicas. Objetivos Determinar si en cirugía maxilofacial mayor limpia contaminada el aumento del tiempo operatorio incrementa la proporción de infección del sitio quirúrgico. Materiales y método Estudio observacional analítico en pacientes ASA I intervenidos en cirugía maxilofacial mayor limpia contaminada entre los años 1997 y 2010 en el Hospital Clínico San Borja Arriarán (Santiago, Chile). Las variables medidas fueron género, edad, tiempo operatorio e ISQ. Se realizó un análisis estadístico mediante prueba de Chi cuadrado, test de la t de Student y regresión logística simple, con un IC del 95 por ciento y el paquete estadístico SPSS. Resultados De un total de 522 pacientes presentaron ISQ 36 (6,9 por ciento). Al comparar los 2 grupos, con ISQ y sin ISQ, no hubo diferencias significativas según género (p = 0,319) y edad (p = 0,238), pero sí según tiempo operatorio (p = 0,046). Se obtuvo un OR = 1,003 (IC 95 por ciento = 1,000-1,006) entre el tiempo operatorio y la infección del sitio quirúrgico. Conclusión Se encontraron diferencias significativas en la proporción de ISQ al aumentar el tiempo operatorio. Sin embargo, esta asociación no es clínicamente significativa.

Introduction: Despite advances in infection control and surgical techniques, surgical site infection (SSI) continues to be a cause of high morbidity and mortality. Objectives To determine if operating time increases the proportion of surgical site infections in clean-contaminated maxillofacial surgery. Materials and method This was an observational analytical study, including ASA I patients undergoing clean-contaminated maxillofacial surgery between 1997 and 2010 at the Clinical Hospital San Borja Arriarán (Santiago, Chile). The outcome variable was surgical site infection. Predictor variables were gender, age, operating time and SSI. Statistical analysis was performed using chi-squared test, Student t test, and simple logistic regression. Results A total of 522 patients met the inclusion criteria. The infection rate was 6.9 percent. Statistically significant differences were only observed in the operation time (P = .046) with an Odds ratio of 1.003 (95 percent CI = 1.000-1.006). Conclusion Significant differences in the proportion of SSI were found when operation time increased. However, this association is not clinically significant.

Zinc induces apatite and scholzite formation during dentin remineralization.

The aim of this study was to ascertain whether zinc may improve the repair ability of demineralized dentin. Dentin disks were demineralized by phosphoric acid during 15 s and immersed in artificial saliva, remineralizing solution, a zinc chloride solution and a zinc oxide solution. Dentin specimens were analyzed after 24 h and 1 month of storage. Surface morphology was assessed by atomic force and scanning electron microscopy, mechanical properties were analyzed by nanohardness testing in a TriboIndenter, and chemical changes at the surfaces were determined by X-ray diffraction, Raman and energy-dispersive elemental analyses. After phosphoric acid application, dentin was only partially demineralized. Demineralized dentin was remineralized after 24 h of storage in any of the tested solutions (nanohardness increased and hydroxylapatite formation was detected by Raman). Remineralization was maintained up to 1 month in dentin stored in remineralizing solution, zinc chloride and zinc oxide. Zinc and phosphate were important for hydroxylapatite homeostasis. Scholzite formation was encountered in dentin stored in zinc-containing solutions. Zinc might allow to reach the balance between dentin demineralization and remineralization processes.

Effect of statins on outcomes in immunosuppressed patients with bloodstream infection.

Although it has been suggested that statins have a beneficial effect on the outcome of bloodstream infection (BSI) in immunosuppressed patients, prospective studies testing this hypothesis are lacking. We performed an observational analysis of consecutive cancer patients and transplant recipients hospitalized at two tertiary hospitals in Spain (2006-2009). The first episode of BSI occurring in statin users was compared with those occurring in non-statin users. During the study period, 668 consecutive episodes of BSI in 476 immunosuppressed patients were recorded. Underlying diseases were solid tumor (46.2%), hematologic malignancy (35.1%), and transplantation (18.7%). Fifty-nine (12.4%) patients were receiving statins at the onset of BSI. Comparing with statin non-users, patients on statin treatment were older (67.3 vs. 58.7 years; p < 0.001) and had higher frequency of comorbidities (74.6% vs. 40.6%; p < 0.001). There were no significant differences in intensive care unit admission (6.8% vs. 7.7%; p = 1) and overall mortality (15.3% vs. 24%; p = 0.13) between groups. In a multivariate analysis, prior statin use was not associated with increased survival (odds ratio [OR], 0.52; 95% confidence interval [CI], 0.22-1.23; p = 0.14). In conclusion, prior statin use is not associated with increased survival in immunosuppressed patients with BSI. Caution is warranted in attributing beneficial effects to statin use in infections among immunocompromised patients.

Do social inequalities exist in terms of the prevention, diagnosis, treatment, control and monitoring of diabetes? A systematic review.

The major increase in the prevalence of diabetes mellitus (DM) has led to the study of social inequalities in health-care. The aim of this study is to establish the possible existence of social inequalities in the prevention, diagnosis, treatment, control and monitoring of diabetes in Organisation for Economic Co-operation and Development (OECD) countries which have universal healthcare systems. We searched MEDLINE, EMBASE and the Cochrane Database of Systematic Reviews for all relevant articles published up to 15 December 2007. We included observational studies carried out in OECD countries with universal healthcare systems in place that investigate social inequalities in the provision of health-care to diabetes patients. Two independent reviewers carried out the critical assessment using the STROBE tool items considered most adequate for the evaluation of the methodological quality. We selected 41 articles from which we critically assessed 25 (18 cross-sectional, 6 cohorts, 1 case-control). Consistency among the article results was found regarding the existence of ethnic inequalities in treatment, metabolic control and use of healthcare services. Socioeconomic inequalities were also found in the diagnosis and control of the disease, but no evidence of any gender inequalities was found. In general, the methodological quality of the articles was moderate with insufficient information in the majority of cases to rule out bias. This review shows that even in countries with a significant level of economic development and which have universal healthcare systems in place which endeavour to provide medical care to the entire population, socioeconomic and ethnic inequalities can be identified in the provision of health-care to DM sufferers. However, higher quality and follow-up articles are needed to confirm these results.

[Impotence in diabetic patients: detection of prevalence and social-health implications]. / Impotencia en pacientes diabéticos: detección de prevalencia e implicaciones sociosanitarias.

OBJECTIVES: To classify information received from diabetics on erectile dysfunction (ED) and to find whether help is being sought or there is just passive resignation. DESIGN: Epidemiological, descriptive, crossover study. SETTING: Urban Health Centre. PATIENTS: 102 patients involved in the Diabetes Programme for over a year were studied. MEASUREMENTS AND MAIN RESULTS: A data collection sheet with the variables listed under objectives was designed. Average age was 63 +/- 12. Overall prevalence of ED was 56%, age being the most important related variable found (p < 0.01). 30% of patients with ED had requested medical care; only 18% had been treated. However, 54% of impotent diabetics accepted the theoretical possibility of treatment with intracavernous injections. CONCLUSIONS: A high prevalence of ED was detected in the diabetic patients studied. They considered the medical information on possible treatments scant (18%) and generally inadequate. Most preferred to be treated by the Primary Care doctor. Primary Care professionals must become more sensitive to ED and provide correct therapeutic information.