Periodontal treatment needs in Argentine adult subjects

The aim of the present study was to assess the periodontal treatment needs of the population that spontaneously sought treatment from general dentists. 3694 patients (2000 females and 1494 males, age range between 18 and 84 years) were evaluated using the Community Periodontal Index (CPI). Data were reported according to the percentage of subjects with the highest Score: 14.3% presented pocket depth > or = 5.5 mm (Score 4), 26.4% pocket depth between 3.5 and 5.5 (Score 3), 38.3% presented pockets < or = 3.5 mm with calculus or overhanging restorations (Score 2), 17.2% pockets < or = 3.5 mm with bleeding upon probing without calculus (Score 1) and 3.2% were healthy (Score 0). Analyzing the data according to age it was observed that in the group > 40 years the percentage of patients with Score 4 was higher (25.1%) compared to the other two groups of 18-34 years (6.4%) and 34-45 years (14.3%). Only 16.4% of the patients consulted for periodontal reasons (gingival bleeding or tooth mobility), whereas 88% requested treatment for other reasons (pain, caries, esthetics, replacement of teeth, etc.). However 77% of the patients in this last group needed periodontal treatment. 96.8% of the patients attending the general dentistry office needed periodontal treatment: 17.2% oral hygiene instruction, 65.2% oral hygiene instruction and scaling and 14.3% complex treatment.     

PKA and Epac activation mediates cAMP-induced vasorelaxation by increasing endothelial NO production

Vascular relaxation induced by 3′,5′-cyclic adenosine monophosphate (cAMP) is both endothelium-dependent and endothelium-independent, although the underlying signaling pathways are not fully understood. Aiming to uncover potential mechanisms, we performed contraction–relaxation experiments on endothelium-denuded and intact rat aorta rings and measured NO levels in isolated human endothelial cells using single cell fluorescence imaging. The vasorelaxant effect of forskolin, an adenylyl cyclase activator, was decreased after selective inhibitor of protein kinase A (PKA), a cAMP-activated kinase, or L-NAME, an endothelial nitric oxide synthase (eNOS) inhibitor, only in intact aortic rings. Both selective activation of PKA with 6-Bnz-cAMP and exchange protein directly activated by cAMP (Epac) with 8-pCPT-2′–O-Me-cAMP significantly relaxed phenylephrine-induced contractions. The vasorelaxant effect of the Epac activator, but not that of the PKA activator, was reduced by endothelium removal. Forskolin, dibutyryl cAMP (a cAMP analogue), 6-Bnz-cAMP and 8-pCPT-2′–O-Me-cAMP increased NO levels in endothelial cells and the forskolin effect was significantly inhibited by inactivation of both Epac and PKA, and eNOS inhibition. Our results indicate that the endothelium-dependent component of forskolin/cAMP-induced vasorelaxation is partially mediated by an increase in endothelial NO release due to an enhanced eNOS activity through PKA and Epac activation in endothelial cells.     

Preoperative Education in Cholecystectomy in the Context of a Multimodal Protocol of Perioperative Care: A Randomized, Controlled Trial

Background

Preoperative education is a key point in multimodal protocols of perioperative care. We investigated whether preoperative education for patients undergoing open cholecystectomy would reduce the incidence of perioperative symptoms.

Methods

This was a randomized, single-blinded, clinical trial that included adult (18–65 years old) candidates for elective open cholecystectomy. All patients took part in the ERAS/ACERTO protocol of perioperative care except that only the intervention group received preoperative education. The main endpoints of the study were the presence and intensity of postoperative symptoms (e.g., nausea, vomiting, pain) measured by a visual analogue scale, 24 h after the operation.

Results

A total of 74 patients (34 in the intervention group, 40 in the control group) completed the study. The intervention group had significantly lower median (interquartile range) scores for nausea [0 (4) vs. 2.5 (5.8), p = 0.04] and pain [0.2 (2.3) vs. 3.1 (3.45), p < 0.01] than the controls. High well-being (score ≥6) was reported by 79.4 % (27 patients) of the intervention group in contrast to 57.5 % (23 patients) of the controls (p = 0.04).

Conclusions

Preoperative education is highly effective in the context of a multimodal protocol for enhancing the recovery of patients submitted to open cholecystectomy.     

Aerobic and anaerobic microorganisms and antibiotic sensitivity of odontogenic maxillofacial infections

Odontology - This study aimed to identify the aerobic and anaerobic causal microorganisms of odontogenic infections and their antibiotic sensitivity. Purulent exudates were taken from patients with...     

Child safety from the perspective of essential needs

OBJECTIVE:

to characterize the maternal care for children under one year of age with a view to child health promotion at home.

METHOD:

exploratory study with qualitative data analysis, thematic mode, based on the conceptual framework of the essential needs of children, based on interviews recorded with 16 mothers.

RESULTS:

the analysis of the maternal narratives showed elements that facilitate the promotion of child safety: presence and involvement of the parents, constant surveillance for physical and emotional protection, experiences to stimulate child development, support networks for childcare at home; and inhibiting elements of child safety: limited perception of characteristics of child development and of children''s singularities, overprotection and difficulties to set limits.

CONCLUSION:

the study enhances the understanding of home care in child health promotion, directing professional actions to guarantee ongoing nurturing relationships, protection, respect for individual differences, experiences appropriate to child development, limit setting and construction of stable and supportive social networks. In addition, the relevance of considering the maternal perspective in child health care is considered, as a strategy to apprehend aspects related to the attendance of the growth and development needs, particularly for child health promotion at home.