Restoration of a Vital Tooth With Extensive Crown Destruction Using Glass Fiber and Polyethylene Fiber-reinforced Composite Resin: A Clinical Case.

Conservative restorative dentistry has been evolving in the last 25 years, focusing mainly on the development of direct restorative materials. Resin-based composites remain an excellent conservative alternative for restoration of teeth with extensive caries lesions. Over time, several strategies have been proposed to improve the mechanical properties of these composites so that they can adequately withstand masticatory forces. Glass fiber-reinforced resin-based composites and their use in situations where there is great loss of tooth structure have gained popularity due to their favorable mechanical properties. Combined techniques with polyethylene fibers can further enhance their clinical performance. This study presents a brief review of their most important qualities and potential use in direct restorative procedures. In addition, a clinical case is described where a vital tooth with extensive coronal destruction was restored using polyethylene fibers embedded in glass fiber-reinforced flowable resin under resin-based composite. The reinforcement of both the remaining tooth structure and the restoration with fibers is a valid treatment option since the network structure formed by the fiber reinforcement can increase the longevity of the direct composite restorations. There are few reports in the literature describing the use of a combined technique using polyethylene fibers embedded in glass fiber-reinforced flowable resin under resin-based composite. Thus, clinical follow-up of this case is required.

[Transcultural adaptation of AGRASS questionnaire to evaluate the management of heathcare risks]. / Adaptación transcultural del Questionário AGRASS para evaluar la gestión de riesgos asistenciales.

OBJECTIVE: To cross-culturally adapt the Questionário AGRASS for evaluation of healthcare risk management in health services. MATERIAL AND METHODS: The work was carried out following 5 stages: 1) initial translation to Spanish; 2) Synthesis; 3) translation back to Portuguese; 4) experts review, and 5) pretest performed in a specialized Costa Rican hospital. RESULTS: The AGRASS Questionnaire translated and adapted into Spanish has the same dimensional structure as the original, with 2 dimensions and 9 subdimensions. Thirty-nine of the 40 original items were approved (general validation index=100% per item). Its application was considered viable, with items well understood and with useful results that identify opportunities for improvement in healthcare risk management. CONCLUSIONS: The AGRASS Questionnaire is culturally adapted to the Costa Rican reality and future studies can evaluate its contribution to other hospital contexts in Ibero-American countries.

Limited Etching Time Increases Self-adhesive Resin Cement Adhesion to Enamel.

AIM: To evaluate the influence of different enamel etching times on the bond strength of two self-adhesive resin cements (RCs) with and without thermocycling (TMC). METHODS: One hundred twenty bovine teeth were used. Blocks of enamel (8×4×2mm) were obtained, polished, and randomly divided into two groups, according to the RC used: MaxCem Elite or RelyX U200. Groups were subdivided into four groups (n=16), according to the etching time: Control (0 seconds), 5 seconds, 10 seconds, and 20 seconds. Three RC cylinders (1-mm diameter) were built on each enamel block. The specimens were submitted to two storage conditions: 24 hours in distilled water or TMC (5000 cycles/5°C-55°C). Afterward, the specimens were submitted to the shear bond strength (SBS) test. The failure modes and adhesive interfaces were analyzed by scanning electron microscopy (SEM) and confocal laser scanning microscopy (CLSM). Data were analyzed with three-way analysis of variance (ANOVA) and Tukey test (α=0.05). RESULTS: Etching increased the SBS for both the RCs,especially forthe groups etched for 5 and 10 seconds. TMC affected negatively the SBS of the control groups (p<0.05). No resin tags were observed in control groups, and the formation of tags was time dependent. CONCLUSION: The 10 seconds etching time was more effective in increasing the enamel-resin bond strength. TMC negatively affected bond strength in specimens without acid etching.

Technical non-invasive study of the novo-hispanic painting the Pentecost by Baltasar de Echave Orio by spectroscopic techniques and hyperspectral imaging: In quest for the painter's hand.

This paper presents a combination of noninvasive techniques for the study of superimposed painting stages in The Pentecost, a Mexican Colonial panel painting attributed to Baltasar de Echave Orio (1558 - 1619). The application of reflected hyperspectral imaging (HSI) analysis for mapping the distribution of the pigments in the paint surface and the use of ultraviolet (UV) fluorescence photography and X-ray radiography as complementary imaging techniques provide new insights into the making process of the artwork, its manufacturing and conservation state. For a better understanding of the in situ results gathered, we studied a series of paint mock-up samples created following recipes and studio practices from art treatises. The use of spot analytical methods such as fiber optic reflectance spectroscopy (FORS) and X-ray fluorescence spectroscopy (XRF) allowed for a robust identification of the artist's materials.

Early wound healing outcomes after regenerative periodontal surgery with enamel matrix derivatives or guided tissue regeneration: a systematic review.

BACKGROUND: Proper wound healing after regenerative surgical procedures is an essential issue for clinical success. Guided tissue regeneration (GTR) and application of enamel matrix derivatives (EMD) are common means to regenerate periodontal tissues. Both methods bear considerable advantages due to their special characteristics, but also go along with certain disadvantages. Today, there is no consensus in the literature whether GTR or EMD show better results regarding early wound healing, which is considered a crucial stage in periodontal regeneration. Therefore, the aim of the present systematic review was to compare the early wound healing after regenerative periodontal surgery with either EMD or GTR treatment. METHODS: An electronic literature search in PubMed was performed to identify randomized clinical trials (RCTs) or clinical trials (CTs) comparing regenerative surgery employing EMD and/or GTR in patients with chronic periodontitis. Among the finally included studies, a qualitative and quantitative data extraction regarding early wound healing parameters was performed. Primary outcome parameters were early wound healing index (EWH), flap dehiscence, membrane exposure, suppuration and abscess formation during the first 6 weeks. As secondary parameters, swelling and allergic reactions were assessed. RESULTS: Seven studies reporting 220 intrabony periodontal defects in 199 patients were analysed. Flap dehiscence was observed in two studies in 12% of the GTR treated sites and in 10.3% of those treated with EMD. Membrane exposure was evaluated in five studies and was registered in the 28.8% of the defects, while no dehiscence was reported on the EMD group. Swelling was reported only in one study in 8/16 GTR sites and 7/16 EMD sites. Due to considerable heterogeneity of parameters no meta-analysis was possible. CONCLUSIONS: Due to considerable heterogeneity of the published studies a clear beneficial effect of the EMD on the early wound healing outcomes after surgical treatment of periodontal intrabony defects cannot be confirmed. Standardized RCT studies are needed in order to allow for proper comparison of early wound healing after both types of surgical approaches.

Identification of natural red and purple dyes on textiles by Fiber-optics Reflectance Spectroscopy.

Understanding dye chemistry and dye processes is an important issue for studies of cultural heritage collections and science conservation. Fiber Optics Reflectance Spectroscopy (FORS) is a powerful technique, which allows preliminary dye identification, causing no damage or mechanical stress on the artworks subjected to analysis. Some information related to specific light scattering and absorption can be obtained in the UV-visible and infrared range (300-1400nm) and it is possible to discriminate the kind of support fiber in the near infrared region (1000-2500nm). The main spectral features of natural dye fibers samples, such as reflection maxima, inflection points and reflection minima, can be used in the differentiation of various red natural dyes. In this work, a set of dyed references were manufactured following Mexican recipes with red dyes (cochineal and brazilwood) in order to determine the characteristic FORS spectral features of fresh and aged dyed fibers for their identification in historical pieces. Based on these results, twenty-nine indigenous textiles belonging to the National Commission for the Development of Indigenous People of Mexico were studied. Cochineal and brazilwood were successfully identified by FORS in several pieces, as well as the mixture of cochineal and indigo for purple color.

The Latin American experience of allografting patients with severe aplastic anaemia: real-world data on the impact of stem cell source and ATG administration in HLA-identical sibling transplants.

We studied 298 patients with severe aplastic anaemia (SAA) allografted in four Latin American countries. The source of cells was bone marrow (BM) in 94 patients and PBSCs in 204 patients. Engraftment failed in 8.1% of recipients with no difference between BM and PBSCs (P=0.08). Incidence of acute GvHD (aGvHD) for BM and PBSCs was 30% vs 32% (P=0.18), and for grades III-IV was 2.6% vs 11.6% (P=0.01). Chronic GvHD (cGvHD) between BM and PBSCs was 37% vs 59% (P=0.002) and extensive 5% vs 23.6% (P=0.01). OS was 74% vs 76% for BM vs PBSCs (P=0.95). Event-free survival was superior in patients conditioned with anti-thymocyte globulin (ATG)-based regimens compared with other regimens (79% vs 61%, P=0.001) as excessive secondary graft failure was seen with other regimens (10% vs 26%, P=0.005) respectively. In multivariate analysis, aGvHD II-IV (hazard ratio (HR) 2.50, confidence interval (CI) 1.1-5.6, P=0.02) and aGvHD III-IV (HR 8.3 CI 3.4-20.2, P<0.001) proved to be independent negative predictors of survival. In conclusion, BM as a source of cells and ATG-based regimens should be standard because of higher GvHD incidence with PBSCs, although the latter combining with ATG in the conditioning regimen could be an option in selected high-risk patients.

Inulin as a novel biocompatible coating: evaluation of surface affinities toward CaHPO4, α-Fe2O3, ZnO, CaHPO4@ZnO and α-Fe2O3@ZnO nanoparticles.

The introduction of biocompatible coatings onto nanoparticle surfaces can be synthetically challenging. In this work, calcium phosphate (brushite, CaHPO4⋅2H2O), iron oxide (hematite, α-Fe2O3), zinc oxide (ZnO), and CaHPO4@ZnO and α-Fe2O3@ZnO nanoparticles were synthesized and treated with the biocompatible, biodegradable, polysaccharide inulin {(2R,3S,4S,5R)-2-[[(2R,3S,4S,5R)-3,4-dihydroxy-2,5-bis(hydroxymethyl)oxolan-2-yl]oxymethyl]-5-(hydroxymethyl)oxolane-2,3,4-triol} under mild conditions. The products were fully characterized by Fourier transforms infrared (FTIR) spectroscopy, energy dispersive spectroscopy (EDS), dynamic light scattering (DLS), differential thermogravimetric/differential thermal analysis (TGA/DTA), transmission electron microscopy (TEM) and powder X-ray diffraction (XRD). Surface interactions among hematite and brushite with inulin are weak, but coating the nanoparticle surface with ZnO increased the affinity toward the polysaccharide. Inulin adsorption on the nanoparticle surface was confirmed by thermal and spectroscopic analyses. The nanoparticles had diameters ranging from 50 to 80nm, with nearly spherical morphology. The nanoparticles sizes, stability and solubility in water could make them useful as components for enriched foods.

In vitro antibacterial activity of meclofenamate metal complexes with Cd(II), Pb(II), Co(II), and Cu(II). Crystal structures of [Cd(C14H10NO2Cl2)2∙(CH3OH)]n and [Cu(C14H10NO2Cl2)2(C5H5N)2].

The synthesis and characterization of five metal complexes derived from sodium meclofenamate (1) are reported: [Cd(C14H10NO2Cl2)2∙(CH3OH)]n∙nCH3OH (6), [Pb(C14H10NO2Cl2)2]n (7), [Co(C14H10NO2Cl2)]n (8), [Cu(C14H10NO2Cl2)]n (9), and [Cu(C14H10NO2Cl2)2(C5H5N)2] (10) (C14H10NO2Cl2=meclofenamate; C5H5N=pyridine). The characterization of the compounds was based on FTIR and UV-visible spectroscopy, mass spectrometry and, in the case of complexes 6 and 10, single crystal X-ray diffraction analysis. For compound 6, the structural analysis revealed a 1-D polymeric chain structure, in which pentagonal planar [Cd(RCOO)2(CH3OH)] units were linked through bridging carboxylate functions of the meclofenamate ligands. The overall coordination environment of the Cd(II) ions was seven-coordinate, since each carboxylate group exhibited a µ3-bridging coordination mode. On the other hand, for complex 10 a discrete mononuclear structure was observed, in which the six-coordinate copper(II) metal atoms were coordinated by two pyridine molecules and the carboxylate functions of two meclofenamate entities, in an anisobidentate coordination mode. The antibacterial activity of compounds 6-9 against four strains of Gram positive (Staphylococcus aureus and Bacillus subtilis) and Gram negative (Escherichia coli and Pseudomonas aeruginosa) bacteria was examined, finding that only complex 6 was active. Additionally, it was found that the Co(II) and Cu(II) complexes 8 and 9 showed peroxidase activity.

International collaborative research: a Colombian model that promotes infant health and research capacity.

Current collaborative efforts in international research with resource-poor nations are frequently paternalistic and deprive these nations of the skills necessary to build independent research capacity. Resource-poor nations have become progressively suspicious of research endeavors originated in industrialized nations that have minimal impact on the health care needs of their populations. The current trend toward globalization requires that certain standards be established to guide these collaborative efforts to create strong partnerships that promote independent evidence-based health research. The objective of this paper is to present a comprehensive approach to health-related international collaborative research with resource-poor nations using as an example a model that has been developed in Colombia, South America.

[Definition and validation of quality indicators of prescription in primary care]. / Definición y validación de indicadores de calidad de la prescripción en atención primaria.

OBJECTIVE: To define and validate a battery of prescription indicators on the use of anti-hypertensives, lipid-lowerers, diabetes drugs, and insulin, as measurements of family doctors' quality of prescription in primary health care. DESIGN: Transversal, descriptive study. SETTING: Two primary care health districts, Camas and Sierra Norte, Spain. PARTICIPANTS: Eighty three family doctors, 94.32% of the doctors in the study area. DEFINITION AND VALIDATION OF INDICATORS: To construct the prescription indicators, we used evidence found in the scientific bibliography available. To validate it, we analysed its statistical relationship with a series of selected clinical tests, collected from the clinical records. RESULTS: For each doctor, there was a statistically significant relationship between the index of quality of prescription and the clinical quality seen in the records (P=.004). The variables of age, sex, and training fine-tuned the model. CONCLUSIONS: There is a statistically significant relationship between a good prescription indicator and proper control of intermediate health variables.

Definición y validación de indicadores de calidad de la prescripción en atención primaria

Objetivo. Definir y validar una batería de indicadores de prescripción sobre el uso de antihipertensivos, hipolipemiantes, antidiabéticos y insulinas, como medidores de la calidad de la prescripción de médicos de familia en el ámbito de la atención primaria de salud (APS). Diseño. Estudio descriptivo, transversal. Emplazamiento. Agrupación de 2 distritos sanitarios de atención primaria, Camas y Sierra Norte. Participantes. Un total de 83 médicos de familia, lo que supone el 94,32 por ciento de los médicos del área de estudio. Defición y validación de indicadores. Para la construción de los indicadores de prescripción nos basamos en las evidencias halladas en la bibliografía científica disponible. Para su validación analizamos su relación estadística con una serie de pruebas clínicas seleccionadas, que se recogieron de las historias clínicas. Resultados. Se observó una relación estadísticamente significativa entre el índice de calidad de prescripción y la calidad clínica observada en las historias, para cada médico (p = 0,004). Las variables edad, sexo y formación ajustan mejor el modelo. Conclusiones. Hay una relación estadísticamente significativa entre un buen indicador de prescripción y el adecuado control de variables intermedias de salud.(AU)

Definición y validación de indicadores de calidad de la prescripción en atención primaria / Definition and validation of quality indicators of prescription in primary care

Objetivo. Definir y validar una batería de indicadores de prescripción sobre el uso de antihipertensivos, hipolipemiantes, antidiabéticos e insulinas, como medidores de la calidad de la prescripción de médicos de familia en el ámbito de la atención primaria de salud (APS). Diseño. Estudio descriptivo, transversal. Emplazamiento. Agrupación de 2 distritos sanitarios de atención primaria, Camas y Sierra Norte. Participantes. Un total de 83 médicos de familia, lo que supone el 94,32% de los médicos del área de estudio. Definición y validación de indicadores. Para la construcción de los indicadores de prescripción nos basamos en las evidencias halladas en la bibliografía científica disponible. Para su validación analizamos su relación estadística con una serie de pruebas clínicas seleccionadas, que se recogieron de las historias clínicas. Resultados. Se observó una relación estadísticamente significativa entre el índice de calidad de prescripción y la calidad clínica observada en las historias, para cada médico (p = 0,004). Las variables edad, sexo y formación ajustan mejor el modelo. Conclusiones. Hay una relación estadísticamente significativa entre un buen indicador de prescripción y el adecuado control de variables intermedias de salud

Objective. To define and validate a battery of prescription indicators on the use of anti-hypertensives, lipid-lowerers, diabetes drugs, and insulin, as measurements of family doctors' quality of prescription in primary health care. Design. Transversal, descriptive study. Setting. Two primary care health districts, Camas and Sierra Norte, Spain. Participants. Eighty three family doctors, 94.32% of the doctors in the study area. Definition and validation of indicators. To construct the prescription indicators, we used evidence found in the scientific bibliography available. To validate it, we analysed its statistical relationship with a series of selected clinical tests, collected from the clinical records. Results. For each doctor, there was a statistically significant relationship between the index of quality of prescription and the clinical quality seen in the records (P=.004). The variables of age, sex, and training fine-tuned the model. Conclusions. There is a statistically significant relationship between a good prescription indicator and proper control of intermediate health variables

[Prevalence of diabetes treated with drugs in Andalucía. Evolution of the oral antidiabetics and insulin prescription between 1994 and 2000]. / Prevalencia de diabetes tratada con fármacos en Andalucía. Evolución de la prescripción de antidiabéticos orales e insulina entre 1994 y 2000.

CONTEXT: [corrected] Diabetes is an important, complex, expensive, and increasingly frequent disease. The objective of this study was to investigate the diabetes mellitus prevalence and evolution in the Adalusian population between 1994 and 2000. METHODS: We used and indirect method for estimating the rate of prevalence of the disease based on antidiabetic drug consumption data at regional level, using the official billing data, and the annual population data. RESULTS: The prevalence estimated for diabetes mellitus in Andalusia was, 4.41%. This prevalence ranged from 2.47% in 1994 up to 4.41% in 2000. Oral antidiabetics/insulin use ratio was 2.31. The study shows an important variability of the prescription habits in diabetic patients in Andalucía. CONCLUSIONS: The prevalence observed in diabetes mellitus in Andalucía increased between 1994 and 2000. An important variability was observed among the different provinces.

Prevalencia de diabetes tratada con fármacos en Andalucía. Evolución de la prescripción / Prevalence of diabetes treated with drugs in Andalucía

Fundamento. La diabetes es una enfermedad importante, compleja, costosa y cada vez más frecuente. El objetivo de este estudio fue investigar la prevalencia y evolución de la diabetes mellitus en la población andaluza entre 1994 y 2000. Métodos. Utilizamos un método indirecto para estimar la tasa de prevalencia de la enfermedad a partir de datos de consumo de medicamentos para la diabetes a nivel regional, usando los datos de facturación oficial y los datos de población anuales. Resultados. La prevalencia estimada en diabetes mellitus en Andalucía fue de 4,41 por ciento. Esta prevalencia varió desde el 2,47 por ciento en 1994 hasta el 4,41 por ciento en 2000. La razón entre antidiabéticos orales/insulina fue de 2,31. El estudio muestra una importante variabilidad de los hábitos de prescripción en pacientes diabéticos en Andalucía. Conclusiones. La prevalencia observada en diabetes mellitus en Andalucía aumentó entre 1994 y 2000.Se observó una importante variabilidad entre las diferentes provincias (AU)