A national study of health care service utilization and substance use after the 2010 Chilean earthquake.

OBJECTIVE: A national epidemiological survey in Chile assessed adaptive (health care utilization) and maladaptive (substance use) postearthquake behaviors. METHODS: Three months after the 8.8-magnitude 2010 Bio-Bio earthquake, face-to-face interviews were conducted with a representative sample of 2,108 adults. Logistic regression analyses examined predictors of health care service utilization and substance use. RESULTS: Few participants utilized available government- and community-based psychosocial resources (16.6%). A minority reported increased substance use (13.2%). Lower self-efficacy was correlated with increased health care utilization (odds ratio [OR]=.92, 95% confidence interval [CI]=.88-.96) and use of tranquilizers, illicit and psychotropic drugs, and alcohol (OR=.95, CI=.91-.99); this pattern was not limited to residents of areas with the heaviest impacts. CONCLUSIONS: Self-efficacy beliefs elucidate variability in survivors' behaviors postdisaster and may provide an avenue to encourage salubrious responses. Postdisaster interventions should broadly target the population; those less heavily affected may need, and be as likely to use, available resources.

Exposure to rapid succession disasters: a study of residents at the epicenter of the Chilean Bío Bío earthquake.

We examined cumulative and specific types of trauma exposure as predictors of distress and impairment following a multifaceted community disaster. Approximately 3 months after the 8.8 magnitude earthquake, tsunami, and subsequent looting in Bío Bío, Chile, face-to-face interviews were conducted in 5 provinces closest to the epicenter. Participants (N = 1,000) were randomly selected using military topographic records and census data. Demographics, exposure to discrete components of the disaster (earthquake, tsunami, looting), and exposure to secondary stressors (property loss, injury, death) were evaluated as predictors of posttraumatic stress (PTS) symptoms, global distress, and functional impairment. Prevalence of probable posttraumatic stress disorder was 18.95%. In adjusted models examining specificity of exposure to discrete disaster components and secondary stressors, PTS symptoms and global distress were associated with earthquake intensity, tsunami exposure, and injury to self/close other. Increased functional impairment correlated with earthquake intensity and injury to self/close other. In adjusted models, cumulative exposure to secondary stressors correlated with PTS symptoms, global distress, and functional impairment; cumulative count of exposure to discrete disaster components did not. Exploratory analyses indicated that, beyond direct exposure, appraising the tsunami and looting as the worst components of the disaster correlated with greater media exposure and higher socioeconomic status, respectively. Overall, threat to life indicators correlated with worse outcomes. As failure of government tsunami warnings resulted in many deaths, findings suggest disasters compounded by human errors may be particularly distressing. We advance theory regarding cumulative and specific trauma exposure as predictors of postdisaster distress and provide information for enhancing targeted postdisaster interventions.

Prevalencia de retenciones de caninos en pacientes tratados en la clínica de ortodoncia de UNITEC / Prevanlence o f impacted canines in patients treated in the orthodontic clinic of UNITEC

Se realizó un estudio de tipo epidemiológico en la clínica de ortodoncia de la Universidad Tecnológica de México, en 601 pacientes que solicitaron tratamiento ortodóntico, de los cuales 35 presentaron retenciones de caninos, para determinar la tasa de prevalencia de caninos retenidos en la población mexicana y comparar los resultados con los estudios norteamericanos y europeos.Hallando una tasa de prevalencia de retención de caninos del 5.8, la cual es muy significativa, indicando que la retención de caninos es un hallazgo común en los pacientes que solicitaron tratamiento ortodóntico.Además se describen diferentes características relacionadas con la retención de caninos y se sugieren medidas preventivas para tratar de aminorar estas retenciones

Comparison of the Efficacy and Tolerability of Dexketoprofen and Ketoprofen in the Treatment of Primary Dysmenorrhea.

Dexketoprofen, the pure S(+)-enantiomer of ketoprofen, is a promising new analgesic, but few clinical trials have yet examined its efficacy and tolerability. In this study, patients with a history of primary dysmenorrhea were treated with dexketoprofen doses of 12.5 and 25 mg, ketoprofen 50 mg, and placebo using a randomized, four-way crossover design. Efficacy analyses showed that dexketoprofen 12.5 and 25 mg and racemic ketoprofen 50 mg significantly reduced pain intensity compared with placebo from 1 h after dose to 4-6 h after dose. Interestingly, dexketoprofen at 12.5 mg was significantly superior to placebo at 30 min after dose. Mean pain relief scores also demonstrated that both doses of dexketoprofen and racemic ketoprofen were significantly superior to placebo at 1-6 h after the first dose. No indices of analgesic efficacy showed any significant differences between the two doses of dexketoprofen or between dexketoprofen and ketoprofen. After repeated dose administration, similar results were obtained. There were no significant effects of any treatment on activities of daily living, menstrual flow, or associated symptoms. Dexketoprofen was effective, well tolerated, and had no difference in the incidence of adverse events compared to ketoprofen or placebo.