Comparative study of postoperative morbidity in dental treatment under general anesthesia in pediatric patients with and without an underlying disease.

OBJECTIVES: To identify and quantify the variables and their influence on postoperative morbidity in dental treatment under general anesthesia (GA) in pediatric patients with and without an underlying disease. METHODS: A prospective, descriptive, and comparative analysis was conducted of healthy (n = 49) and disabled/medically compromised (n = 81) children treated under GA. Intra-/post-surgical, clinical epidemiology, technical, care-related, and pharmacologic data were gathered, as were postoperative complications. RESULTS: The average age of ASA I patients (6.7 ± 4.4 years) was younger than that of ASA II-III patients (9.0 ± 4.5 years). Average hospitalization time was 4.27 ± 6.5 h in ASA I and 7.41 ± 6.8 h in ASA II-III. Significant differences were found between the two groups in fillings, pulpotomies, oral surgery, and scaling. Postoperative morbidity in ASA I and ASA II-III was similar both in frequency and severity and decreased during the first 72 h. The most common complication in both groups was toothache. CONCLUSION: Postoperative morbidity is high after dental treatment under GA, but it is not higher in disabled/medically compromised patients.

Georeferenced scanning system to estimate the leaf wall area in tree crops.

This paper presents the use of a terrestrial light detection and ranging (LiDAR) system to scan the vegetation of tree crops to estimate the so-called pixelated leaf wall area (PLWA). Scanning rows laterally and considering only the half-canopy vegetation to the line of the trunks, PLWA refers to the vertical projected area without gaps detected by LiDAR. As defined, PLWA may be different depending on the side from which the LiDAR is applied. The system is completed by a real-time kinematic global positioning system (RTK-GPS) sensor and an inertial measurement unit (IMU) sensor for positioning. At the end, a total leaf wall area (LWA) is computed and assigned to the X, Y position of each vertical scan. The final value of the area depends on the distance between two consecutive scans (or horizontal resolution), as well as the number of intercepted points within each scan, since PLWA is only computed when the laser beam detects vegetation. To verify system performance, tests were conducted related to the georeferencing task and synchronization problems between GPS time and central processing unit (CPU) time. Despite this, the overall accuracy of the system is generally acceptable. The Leaf Area Index (LAI) can then be estimated using PLWA as an explanatory variable in appropriate linear regression models.

Innovative LIDAR 3D Dynamic Measurement System to estimate fruit-tree leaf area.

In this work, a LIDAR-based 3D Dynamic Measurement System is presented and evaluated for the geometric characterization of tree crops. Using this measurement system, trees were scanned from two opposing sides to obtain two three-dimensional point clouds. After registration of the point clouds, a simple and easily obtainable parameter is the number of impacts received by the scanned vegetation. The work in this study is based on the hypothesis of the existence of a linear relationship between the number of impacts of the LIDAR sensor laser beam on the vegetation and the tree leaf area. Tests performed under laboratory conditions using an ornamental tree and, subsequently, in a pear tree orchard demonstrate the correct operation of the measurement system presented in this paper. The results from both the laboratory and field tests confirm the initial hypothesis and the 3D Dynamic Measurement System is validated in field operation. This opens the door to new lines of research centred on the geometric characterization of tree crops in the field of agriculture and, more specifically, in precision fruit growing.

Percepción, actitudes y necesidades de los profesionales de atención primaria con relación al paciente con demencia / Perception, attitudes and needs of Primary Care professionals as regards the patient with dementia

ObjetivoConocer la percepción, las actitudes y las necesidades expresadas por los profesionales de atención primaria de nuestro medio, con relación al diagnóstico y el seguimiento de los pacientes con trastornos cognitivos.DiseñoEstudio transversal en 26 Áreas Básicas de Salud (ABS) de Girona.EmplazamientoABS de la Región Sanitaria de Girona.ParticipantesMédicos y diplomados en enfermería (DUE).MedicionesCuestionario autoadministrado por los propios profesionales en el contexto de las reuniones periódicas de los equipos.ResultadosRespondieron la encuesta 218 profesionales (108 médicos y 110 diplomados de enfermería [DUE]) de 19 ABS (73% del total). El 98,6% de los participantes creyó necesario realizar formación en demencias pero el 49,1% de médicos y el 74,5% de DUE refirió no haber realizado nunca formación específica o no en los últimos 5 años. El 88,7% de los médicos refiere no realizar el diagnóstico de demencia de forma habitual y solamente en el 25,5% de los casos se efectúa en las fases leves de demencia. Las principales barreras referidas por los médicos para el diagnóstico de demencia fueron la poca confianza en el diagnóstico (32,6%) y la falta de tiempo en la consulta (31,4%). El 87% de los médicos refirió dificultades en el seguimiento y control de estos enfermos.ConclusionesEste estudio aporta información útil para los agentes implicados en la atención a la demencia. Identifica aspectos de formación prioritarios y las barreras y dificultades para el diagnóstico, tratamiento y seguimiento de estos enfermos en el ámbito de la atención primaria(AU)

ObjectiveTo find out the perception, attitudes and needs expressed by primary care professionals in the Girona (Spain) health area as regards the diagnosis and monitoring of patients with cognitive disorders.DesignCross sectional study conducted in 26 primary healthcare areas (ABS) in Girona.SettingPrimary healthcare areas (ABS) in Girona.ParticipantsPhysicians and primary nursing care (PNC).Main measuramentsSelf-administered questionnaire by the professionals in the centres. In the context of regular meetings of the teams.ResultsA total 218 practitioners from 19 ABS (73% of total) responded to the questionnaire (108 physicians and 110 primary nursing care-PNC-). Almost all (98.6%) of participants thought they needed training in dementia, but 49.1% of physicians and 74.5% of PNC mentioned never having any specific training or not in the last 5 years. A total of 88.7% of doctors do not make a diagnosis of dementia on a regular basis, and only in 25.5% of cases do they make one in the mild stages of dementia. The main barriers reported by physicians in the diagnosis of dementia were the lack of confidence in diagnosis (32.6%) and lack of consultation time (31.4%). The great majority (87%) of physicians mentioned difficulties in monitoring and control of these patients.ConclusionsThis study provides useful information for those involved in the care of dementia. It identifies priority training issues, and barriers and difficulties in the diagnosis, treatment and monitoring of these patients in the field of primary care(AU)

[Perception, attitudes and needs of Primary Care professionals as regards the patient with dementia]. / Percepción, actitudes y necesidades de los profesionales de atención primaria con relación al paciente con demencia.

OBJECTIVE: To find out the perception, attitudes and needs expressed by primary care professionals in the Girona (Spain) health area as regards the diagnosis and monitoring of patients with cognitive disorders. DESIGN: Cross sectional study conducted in 26 primary healthcare areas (ABS) in Girona. SETTING: Primary healthcare areas (ABS) in Girona. PARTICIPANTS: Physicians and primary nursing care (PNC). MAIN MEASURAMENTS: Self-administered questionnaire by the professionals in the centres. In the context of regular meetings of the teams. RESULTS: A total 218 practitioners from 19 ABS (73% of total) responded to the questionnaire (108 physicians and 110 primary nursing care-PNC-). Almost all (98.6%) of participants thought they needed training in dementia, but 49.1% of physicians and 74.5% of PNC mentioned never having any specific training or not in the last 5 years. A total of 88.7% of doctors do not make a diagnosis of dementia on a regular basis, and only in 25.5% of cases do they make one in the mild stages of dementia. The main barriers reported by physicians in the diagnosis of dementia were the lack of confidence in diagnosis (32.6%) and lack of consultation time (31.4%). The great majority (87%) of physicians mentioned difficulties in monitoring and control of these patients. CONCLUSIONS: This study provides useful information for those involved in the care of dementia. It identifies priority training issues, and barriers and difficulties in the diagnosis, treatment and monitoring of these patients in the field of primary care.

[Characteristics of avoidable hospitalization in Spain]. / Características de la hospitalización evitable en España.

BACKGROUND AND OBJECTIVE: Hospitalizations that could have been prevented with a timely and effective ambulatory care are known as avoidable hospitalizations (AH). The measure of AH is an indicator of the quality of primary health care centers. The objective of this study was to determine the factors that influence the level of AH at the Spanish public hospitals. MATERIAL AND METHOD: We identified the characteristics of hospitalised patient as AH. We studied the total hospitalizations in public hospitals of Spain in 2000 related to AH. RESULTS: AH admissions were the 15.8% of total in Spanish hospitals and the 16.6% of hospital stays. Patients' mean age was high, 54 years, males (age-adjusted OR = 1.54) with a large length of stay and presurgery stay, higher comorbidity (0.63 [0.8]), public financing, and admission was basically emergency-caused and in high complexity hospitals. There is a direct relationship between frequency of AH and hospital complexity. CONCLUSIONS: The control of AH is very important because its repercussion on the total hospitalary case-mix. We observe an inducing effect of the hospital offer because the hospital capacity increase the number of AH admissions.