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Zanatta F.B.,University of Santa Maria in Ecuador
Oral health & preventive dentistry | Year: 2011

To compare the removal of dental biofilm with soft and medium filament toothbrushes. Twenty-five patients refrained from performing mechanical or chemical plaque control for 96 hours prior to the experiment in order to allow dental biofilm accumulation on the tooth surfaces. After the period of dental biofilm accumulation, quadrants were randomised and participants brushed different quadrants with soft and medium toothbrushes, with or without dentifrice. After plaque disclosure, the Quigley-Hein (Turesky) plaque index was assessed by a blinded examiner before and after toothbrushing. In addition, photographs before and after brushing were taken for evaluation of gingival abrasion. The results revealed that medium toothbrushes removed high amounts of dental biofilm compared to soft toothbrushes (P < 0.05). Considering gingival abrasion, intergroup analysis demonstrated a statistically significant difference on the cervical regions, with a higher proportion of abrasions in the medium toothbrush group (P < 0.01). Medium toothbrushes have a greater ability to remove biofilm and cause gingival abrasion than do soft toothbrushes. Source

Background: In ICUs, many patients are unable to participate in decision-making regarding life-sustaining treatments. This study evaluated the opinions of family members about family and physician participation in life-sustaining treatment decisions and examined factors that influence those decisions. Methods: This was a prospective exploratory observational study that used convenience sampling. Inquiry interviews were conducted over a 3-year period, with 126 family members (out of 303 potential participants) of patients with acute-on-chronic respiratory failure, who had been admitted to the respiratory ICU and were dependent on invasive or noninvasive mechanical ventilation. Patients of ≤ 18 years old, with a stay of < 3 days, and oncologic patients were excluded. Results: Ninety-eight percent (123/126) of the participant family members had an opinion about their involvement in decision-making about life-sustaining treatments. Physician choice was preferred by 54/123 (44%), 55/123 (45%) wished to share the decision with the physician, and 14/123 (11%) wished the family to decide. All the patients were incompetent at the time of inquiry. Autonomy prior to admission to the respiratory ICU influenced the decision. Conclusions: A majority of the families relied on physicians to help in the decision-making process about life-sustaining treatments in patients with acute-on-chronic respiratory diseases. From the family's point of view, the principle of autonomy can be exercised by delegating the decision-making process to the physician. To assume a uniform ethical conduct is to antagonize the definition of ethics. © 2014 Daedalus Enterprises. Source

Bassetti M.,University of Santa Maria in Ecuador
Hematology / the Education Program of the American Society of Hematology. American Society of Hematology. Education Program | Year: 2013

Despite big advances in antimicrobial therapies and infection strategies, the emergence of antibiotic resistance represents an emergency situation, especially in immunocompromised hosts. Specifically, infections due to multidrug resistant, gram-negative pathogens are responsible for high mortality rates and may leave few effective antimicrobial options. Furthermore, although new compounds are available for severe methicillin-resistant staphylococcal infections, there is a paucity of novel classes of antimicrobials to target resistant gram-negatives. A careful assessment of the clinical conditions and underlying comorbidities, along with knowledge about the previous history of colonization or infections due to multidrug-resistant bacteria, represent key points in approaching the hematological patient with signs of infection. A de-escalation therapy with initial use of wide-spectrum antimicrobials followed by a reassessment after 72 hours of treatment may represent a good option in severe infections if a resistant pathogen is suspected. Prompt empiric or targeted therapy using combination regimens (ie, antipseudomonal beta-lactam plus an aminoglycoside or a quinolone) with the addition of colistin, along with increased dosage and therapeutic drug monitoring, represent options for these life-threatening infections. Continuous epidemiological surveillance of local bacteremias is necessary, along with stringent enforcement of antibiotic stewardship programs in cancer patients. Source

Primary SS is characterized by an increased risk of lymphoma in patients with prelymphomatous manifestations (i.e. myoepithelial sialadenitis or mixed cryoglobulinaemia). Serum B-lymphocyte stimulator (s-BLyS) levels in SS-related B-cell lymphoproliferative disorders were studied by integrating the results with the disease activity score and with molecular analyses of B-cell expansion in the salivary glands. Seventy-six primary SS patients (with or without lymphoma or prelymphomatous manifestations), 56 HCV-related cryoglobulinaemic vasculitis patients and 55 controls were studied. s-BLyS and molecular analyses of B-cell expansion in the salivary gland tissues were performed. Patients with SS and persistent parotid swelling underwent parotid biopsy. s-BLyS differed between SS subgroups, higher levels being documented in patients with lymphoma or prelymphomatous manifestations vs SS without [1.85 (0.45-4.12) ng/ml vs 1.12 (0.56-1.98) ng/ml; P < 0.0001]. s-BLyS levels significantly correlated with the European League Against Rheumatism (EULAR) SS disease activity index (r = 0.62, P < 0.0001, Spearman's test). Clonal B-cell expansion in the salivary glands, but not polyclonal B-cell expansion, was associated with higher s-BLyS levels [1.98 (0.45-4.12) ng/ml vs 1.15 (0.56-3.25) ng/ml; P = 0.013)]. Higher s-BLyS levels and tissue clonal B-cell expansion characterize SS with B-cell lymphoproliferative disorders, even at prelymphomatous stages. This subgroup of SS patients showed the highest EULAR SS disease activity index scores. This represents a biologic rationale for targeting both clonal B-cell expansion and s-BLyS overproduction in SS. Source

University of Santa María in Ecuador and University of Santiago de Chile | Date: 2015-06-01

The invention provides a method for verifying the age of an animal providing meat using volatile profiles that comprises the step of providing a sample of animal meat. The method uses one or more chemical analyses to obtain a profile of a set of volatile organic compounds from a sample of meat from an animal. The profile is fit to a mathematically discriminating function resulting. The data obtained is analyzed in order to establish a correlation between the age of the animal (tooth development) and volatiles exuded by meat.

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