Systematic mapping review of interventions to prevent blood loss, infection and relapse in orthognathic surgery

BACKGROUND

This systematic mapping review aims to identify, describe, and organize the currently available evidence in systematic reviews (SR) and primary studies regarding orthognathic surgery (OS) co-interventions and surgical modalities, focusing on the outcomes blood loss, infection and relapse.

MATERIAL AND METHODS

A comprehensive search strategy was performed to identify all SRs, randomized controlled trials and observational studies that evaluate surgical modalities and perioperative co-interventions in OS that evaluate the outcomes blood loss, infection and relapse, regardless of language or publication date. Searches were conducted in MEDLINE, EMBASE, Epistemonikos, Lilacs, Web of Science, and CENTRAL. In addition, grey literature was screened.

RESULTS

27 SRs and 150 primary studies fulfilled the inclusion criteria, 91 from SRs, and 59 from our search strategy. Overall, the quality of the SRs was graded as "Critically low," and only two SRs were rated as "High" quality. 11 PICO questions were extracted from SRs and 31 from primary studies, which focused on osteosynthesis methods, surgical cutting devices, use of antibiotics, and induced hypotension. In addition, evidence bubble maps for each outcome were created to analyze in a visual manner the existing evidence.

CONCLUSIONS

Future primary and secondary high-quality research should be addressed focused on the eight knowledge gaps identified in this mapping review. We concluded that the evidence mapping approach is a practical methodology for organizing the current evidence and identifying knowledge gaps in OS, helping to reduce research waste and canalize future efforts in developing studies for unsolved questions.

Human papillomavirus infection and lung adenocarcinoma: special benefit is observed in patients treated with immune checkpoint inhibitors

BACKGROUND

Human papilloma virus (HPV) has been associated with the development and modulation of response in a series of neoplasms. In the case of lung adenocarcinoma, its role in etiology and pathogenesis is still controversial. Considering that this infection brings foreign epitopes, it could be of prognostic significance in patients with lung adenocarcinoma treated with immunotherapy.

METHODS

In a retrospective cohort study we evaluated the presence of HPV genomic material in lung adenocarcinoma primary lesions with the INNO-LiPA platform. Viral replication was also evaluated by detecting the presence of oncoprotein E6/E7 messenger RNA (mRNA) by quantitative RT-PCR. To confirm possible hypotheses regarding viral oncogenesis, vascular endothelial growth factor (VEGF) and hypoxia-inducible factor 1 (HIF1) were evaluated with stromal fibrosis and immunoscore.

RESULTS

A total of 133 patients were included in the analysis, of whom 34 tested positive for HPV, reaching an estimated prevalence of 25.6% [95% confidence interval (CI) 18.2% to 32.9%]. E6/7 mRNA was identified in 28 out of the 34 previously positive cases (82.3%). In immune checkpoint inhibitor (ICI)-treated patients, the median overall survival reached 22.3 months [95% CI 19.4 months- not reached (NR)] for HPV-negative and was not reached in HPV-positive (HPV+) ones (95% CI 27.7-NR; P = 0.008). With regard to progression-free survival, HPV- patients reached a median of 9.2 months (95% CI 7.9-11.2 months) compared to 14.3 months (95% CI 13.8-16.4 months) when HPV was positive (P = 0.001). The overall response rate for HPV+ patients yielded 82.4% compared to 47.1% in negative ones. No differences regarding programmed death-ligand 1, VEGF, HIF1, stromal fibrosis, or immunoscore were identified.

CONCLUSIONS

In patients with HPV+ lung adenocarcinoma, a significant benefit in overall response and survival outcomes is observed.

Paleo-oncología

La paleo-oncología es el estudio de carcinomas y sarcomas en animales, poblaciones humanas antiguas y sus precursores homínidos. Estas poblaciones resultan informativas sobre las posibles influencias en el cáncer de la evolución morfológica y funcional, la dieta, el estilo de vida y otros factores ambientales. La prevalencia del cáncer en poblaciones antiguas podría haber diferido de la de los humanos modernos, debido a diferencias sustanciales en la exposición a agresores externos, por el envejecimiento, y la disponibilidad de las intervenciones terapéuticas contemporáneas. Los datos físicos disponibles sobre el cáncer en la antigüedad incluyen la evidencia de su existencia en fósiles de animales y humanos, y en sus precursores. Las dificultades de la investigación paleo-oncológica incluyen un registro tisular limitado. Al evaluar el cáncer en restos antiguos, también se debe abordar el problema de la pseudopatología, en la que un cambio tisular observado puede representar una lesión tumoral antemortem o un artefacto postmortem. Los descubrimientos arqueológicos futuros y la aplicación de técnicas de diagnóstico mejoradas pueden permitir que la paleo-oncología proporcione contribuciones a nuestra comprensión actual del cáncer.

Genotyping Squamous Cell Lung Carcinoma in Colombia (Geno1.1-CLICaP)

Background

Lung cancer is a public health problem, and squamous cell carcinoma (SCC) is the second most prevalent subtype of this neoplasm. Compared to other subtypes, including adenocarcinoma, SCC is less well understood in terms of molecular pathogenesis, limiting therapeutic options among targeted agents approved for other disease subgroups. In this study, we sought to characterize the SCC genomic profile using a validated Next Generation Sequencing (NGS) platform.

Methods

The comprehensive NGS assay (TruSight Tumor 170) was used in order to target the full coding regions of 170 cancer-related genes on SCC samples. PD-L1 expression in tumor cells (TCs) was assessed using clone 22C3 (Dako). Clinical outcomes were correlated with molecular profile, including progression free survival (PFS), overall response rate (ORR), and overall survival (OS).

Results

A total of 26 samples were included, median age was 67 years (r, 33–83) and 53.8% were men. Tobacco consumption was identified in all subjects (mean 34-year package). For first-line treatment 80.8% of patients received cisplatin or carboplatin plus gemcitabine. In terms of molecular profile, we identified a high prevalence of inactivating mutations in TP53 (61.5%), PIK3CA (34.6%), MLL2 (34.6%), KEAP1 (38.4%), and NOTCH1 (26.9%). PD-L1 expression ranged from negative, 1, 2–49, and ≥50% in 23.1, 38.5, 26.9, and 11.5%, respectively. Interestingly, the genetic alterations did not have an effect in PFS, OS or ORR in this study. However, PDL1 expression was higher among those who had mutations in TP53 (p = 0.037) and greater expression of PDL1 was related to PIK3CA alterations (p = 0.05).

Conclusions

The genomic profile of SCC encompasses important genes including TP53, PIK3CA and KEAP1. TP53 mutations could be associated with PDL1 expression, generating hypothesis regarding specific treatment options.

Fatal consequences of decreased sensitivity to pain and temperature in a frontotemporal dementia patient

Frontotemporal dementia (FTD) is a heterogeneous syndrome characterized by the progressive damage of frontal and temporal brain regions. These networks largely overlap with those involved in pain and temperature processing. Although the impaired perception of pain and temperature has been previously described to be relatively common in patients with FTD, these symptoms are often not consistently assessed by Neurologists. We present the case of a patient with a probable behavioral variant FTD who died due to scalding with hot water in the shower. Impairments in the perception of pain and temperature might have played a fundamental role in this accident.

A laboratory study of root canal and isthmus disinfection in extracted teeth using various activation methods with a mixture of sodium hypochlorite and etidronic acid

AIM

To evaluate in a laboratory setting the antibiofilm activity of several irrigating protocols including conventional irrigation, ultrasonic activation and XP-endo Finisher, with a mixture of sodium hypochlorite and etidronic acid in infected isthmuses and root canals of extracted human mandibular molar teeth.

METHODOLOGY

Fifty-six mesial roots of mandibular molars, half of them with a continuous isthmus from the cervical to the apical third between the two root canals (type 1), and the other half with a continuous isthmus from the cervical to the middle third and one canal in the apical third (type 2), were included. The root canals were contaminated for 7 days with an Enterococcus faecalis suspension. There were three experimental groups plus a control group (n = 7 per type of root canal anatomy). All the root canals, except for the control group that was not treated, were chemomechanically prepared and then assigned to one of the experimental groups according to the final adjunctive procedure: conventional irrigation, ultrasonic activation or XP-endo Finisher activation. The irrigating solution used was a combination of 2.5% sodium hypochlorite and 9% etidronic acid, and the final protocols were applied for three cycles of 30 s with a 3 mL volume. The antibiofilm activity was evaluated at each location (root canal and isthmus) and third (cervical, middle and apical) using confocal laser scanning microscopy and the live/dead technique. Statistical analysis was performed using SPSS (descriptive statistics) and SUDAAN (P-value calculations).

RESULTS

Root canals had significantly lower biovolume values than the isthmuses (P < 0.05). The biovolume in the root canals was significantly reduced in all the experimental groups in all the thirds except for conventional irrigation in the apical third (P > 0.05). In the cervical and middle thirds, ultrasonic activation was associated with the lowest biovolumes (P < 0.05), followed by XP-endo Finisher. In the isthmus, disinfection was similar in all the thirds for all the protocols. Conventional irrigation was associated with intermediate values with no significant differences from the control group or from the activated protocols (P > 0.05), although the latter were significantly different from the control group (P < 0.05). No differences were found between ultrasonic activation and XP-endo Finisher in the middle and apical thirds (P > 0.05) in the isthmuses.

CONCLUSIONS

In this laboratory study on extracted teeth, the isthmus was more difficult to disinfect than root canals. In the root canals, ultrasonic activation and XP-endo Finisher had a greater effectiveness than conventional irrigation. In the isthmuses, no differences were observed between the two activation techniques and conventional irrigation.

Ageing and inequality: unintentional death in the elderly in Campinas in the 21st century

According to WHO falls are the second leading cause of preventable unintentional death and people older than 65 years of age are more likely to suffer from fatal falls. Low and middle-income countries are most affected with 80% of fall related deaths. This study provides an overall view of fall-related deaths in the city of Campinas, Brazil, with special attention to the elderly in the last 2 decades. This study aims to highlight the unequal distribution of deaths related to fall, concerning the elderly in Campinas (total population of around 1,000,000), which in 2010 had a very high Human Develop Index (0.805), but also a very high inequality rate (Gini index of 0.56 in 2010).

This ecological study in Campinas evaluates fall-related deaths in the elderly between years 2000 and 2018. Trend analysis were applied to the specific mortality ratios related to falls obtained from Brazil's official databases. Specific mortality trends were also analyzed regarding Human Development Index by neighborhood. The number of deaths due to fall in the elderly throughout the period totaled 1700 (1 million of population). The annual average was 85 (minimum of 31 in 2000 and maximum of 157 in 2018). Although trend analysis of mortality in the elder due to “overall external causes” and of mortality due to “fall in the elderly” didn't show clear growing tendencies (R2=0.546 and R2=0.622), the ratio between “number of deaths due to fall in the elderly” and “total deaths due to fall” shows a reliable average of 1.17% increase per year (from 3.73% in 2000 to 26.03% in 2018, R2=0.93). Trend-analysis based on community HDI mortality rates additionally shows a tendency of increase both in “number of deaths” and “mortality rate” in low-HDI elder (with R2=0.85 and R2=0.786).

Despite decreasing violence levels in Campinas, fatal deaths due to fall seem to target low-HDI elder population. Effort must be taken in all levels of the healthcare system as well as in policies to soften inequality's effect.

Key messages

Violent, unintentional causes of death in the elderly population are increasing along with population ageing. Politicians and health managers must pay attention to inequality-related health problems and take into account population ageing for a sustainable universal health system coverage.

Multigene Mutation Profiling and Clinical Characteristics of Small-Cell Lung Cancer in Never-Smokers vs. Heavy Smokers (Geno1.3-CLICaP)

Objectives: Lung cancer is a heterogeneous disease. Presentation and prognosis are known to vary according to several factors, such as genetic and demographic characteristics. Small-cell lung cancer incidence is increasing in never-smokers. However, the disease phenotype in this population is different compared with patients who have a smoking history.

Material and Methods: To further investigate the clinical and genetic characteristics of this patient subgroup, a cohort of small cell lung cancer patients was divided into smokers (n = 10) and never/ever-smokers (n = 10). A somatic mutation profile was obtained using a comprehensive NGS assay. Clinical outcomes were compared using the Kaplan-Meier method and Cox proportional models.

Results: Median age was 63 years (46–81), 40% were men, and 90% had extended disease. Smoker patients had significantly more cerebral metastases (p = 0.04) and were older (p = 0.03) compared to their non-smoker counterparts. For never/ever smokers, the main genetic mutations were TP53 (80%), RB1 (40%), CYLD (30%), and EGFR (30%). Smoker patients had more RB1 (80%, p = 0.04), CDKN2A (30%, p = 0.05), and CEBPA (30%, p = 0.05) mutations. Response rates to first-line therapy with etoposide plus cisplatin/carboplatin were 50% in smokers and 90% in never/ever smokers (p = 0.141). Median overall survival was significantly longer in never smokers compared with smokers (29.1 months [23.5–34.6] vs. 17.3 months [4.8–29.7]; p = 0.0054). Never/ever smoking history (HR 0.543, 95% CI 0.41–0.80), limited-stage disease (HR 0.56, 95% CI 0.40–0.91) and response to first-line platinum-based chemotherapy (HR 0.63, 95% CI 0.60–0.92) were independently associated with good prognosis.

Conclusion: Our data supports that never/ever smoker patients with small-cell lung cancer have better prognosis compared to their smoker counterparts. Further, patients with never/ever smoking history who present with small-cell lung cancer have a different mutation profile compared with smokers, including a high frequency of EGFR, MET, and SMAD4 mutations. Further studies are required to assess whether the differential mutation profile is a consequence of a diverse pathological mechanism for disease onset.

Critical care usage after major gastrointestinal and liver surgery: a prospective, multicentre observational study

BACKGROUND

Patient selection for critical care admission must balance patient safety with optimal resource allocation. This study aimed to determine the relationship between critical care admission, and postoperative mortality after abdominal surgery.

METHODS

This prespecified secondary analysis of a multicentre, prospective, observational study included consecutive patients enrolled in the DISCOVER study from UK and Republic of Ireland undergoing major gastrointestinal and liver surgery between October and December 2014. The primary outcome was 30-day mortality. Multivariate logistic regression was used to explore associations between critical care admission (planned and unplanned) and mortality, and inter-centre variation in critical care admission after emergency laparotomy.

RESULTS

Of 4529 patients included, 37.8% (n=1713) underwent planned critical care admissions from theatre. Some 3.1% (n=86/2816) admitted to ward-level care subsequently underwent unplanned critical care admission. Overall 30-day mortality was 2.9% (n=133/4519), and the risk-adjusted association between 30-day mortality and critical care admission was higher in unplanned [odds ratio (OR): 8.65, 95% confidence interval (CI): 3.51-19.97) than planned admissions (OR: 2.32, 95% CI: 1.43-3.85). Some 26.7% of patients (n=1210/4529) underwent emergency laparotomies. After adjustment, 49.3% (95% CI: 46.8-51.9%, P<0.001) were predicted to have planned critical care admissions, with 7% (n=10/145) of centres outside the 95% CI.

CONCLUSIONS

After risk adjustment, no 30-day survival benefit was identified for either planned or unplanned postoperative admissions to critical care within this cohort. This likely represents appropriate admission of the highest-risk patients. Planned admissions in selected, intermediate-risk patients may present a strategy to mitigate the risk of unplanned admission. Substantial inter-centre variation exists in planned critical care admissions after emergency laparotomies.

Associated factors with health-compromising behaviors among patients treated for oral cancer

BACKGROUND

To improve eradication strategies of health-compromising behaviors between oral cancer survivors, this study aimed to explore the extent of clustering of risk behaviors and to assess possible factors associated.

MATERIAL AND METHODS

A cross-sectional study was carried out among oral cancer patients at least 6 months after treatment. They completed a questionnaire about smoking, alcohol consumption, oral hygiene habits and dental visits. Presence of clusters was evaluated through pairwise Pearson correlations and principal component analysis. Factors associated with each identified cluster were analyzed with multivariate models.

RESULTS

Among 142 patients, 14.8% smoked, 51.7% consumed alcohol, 52.1% performed oral hygiene less than twice a day, and 74.6% visited to dentist when there was a problem or never. There were two distinct clusters: smoking-alcohol consumption (general risk behaviors cluster) and oral hygiene-dental attendance (oral risk behaviors cluster). Multivariate analysis showed significant associations between males and both clustering patterns of health compromising behaviors, patients with clinical stage I or with longer follow-up and the presence of general risk behaviors cluster and worse social class and the presence of oral risk behaviors cluster.

CONCLUSIONS

A high proportion of patients treated for oral cancer presented health-compromising behaviors occurring in clusters which reinforce the need for health promotion strategies to target multiple behaviors. Factors analyzed suggest that chances of having detrimental behavioral clustering are higher in male, patients with clinical stage I, with lower social class and those with longer follow-up after treatment.

Outcomes of oral lichen planus and oral lichenoid lesions treated with topical corticosteroid

OBJECTIVE

To determine corticosteroid treatment effectiveness in patients with oral lichen planus/oral lichenoid lesions (OLP/OLL).

MATERIAL AND METHODS

Twenty-one patients with OLP and eighty-one patients with OLL received 0.05% clobetasol propionate (CP) or 0.05% triamcinolone acetonide (TA) in aqueous solution (AS) or orabase (OB), evaluating responses to treatment and follow-up compliance.

RESULTS

Lesions were atrophic (72 of 102; 70.6%), extensive (58 of 100; 58%), producing eating difficulties (62 of 102; 60.8%), and spontaneous pain (30 of 102; 29.4%); 50 patients (49%) received CP-AS. The mean ± SD percentage of follow-ups attended was 43 ± 32%. Symptom remission was achieved in 46% of patients receiving CP-AS, 36.36% of those receiving TA-AS, 20% of those receiving CP-OB, and 25% of those receiving TA-OB. Follow-up compliance was poor in 66.7% of patients. Among 51 patients with continuous symptoms, 64.7% evidenced total remission at treatment completion; among 33 with intermittent symptoms, 73.1% had outbreaks 2-3 times/year and 51.5% controlled outbreaks with <6 corticosteroid applications. Adverse effects were observed in seven patients (6.8%) (moon face, hirsutism, capillary fragility) in induction stage, subsiding with dose; among 15 patients under maintenance treatment for >6 months, one showed hypothalamic-pituitary-adrenal (HPA) axis inhibition but not adrenal insufficiency.

CONCLUSIONS

Our treatment proved highly effective and safe. Recall programs are desirable to enhance follow-up compliance.

A system for finger tremor quantification in patients with Parkinson's disease

The current diagnosis of Parkinson's disease (PD) is based on a subjective assessment by the specialist. The monitoring of the tremor that presents in the hand index fingers in a patient with Parkinson's is one of the most important parameters to diagnose the evolution of the disease in an objective manner. This research analyze the tremor in the hand index fingers of patients with PD with medication and without medication. A sensor based in a triaxial accelerometer was used to acquire the data produced by the acceleration changes of parkinsonian tremor in the case of three activities: postural tremor, action tremor and rest tremor. Acquired data were processed in Matlab; the data were filtered and the spectral power density (PSD) was estimated with the Burg periodogram. It has been verified that the system presented in this article can accurately detect the parkinsonian tremors of the patients evaluated, additionally has been found that with the medication the tremors do not disappear completely, these remained with the same frequencies of PD but with a very small amplitude.

A system to monitor tremors in patients with Parkinson's disease

In this work the design and development of a system to monitor tremors in patients with Parkinson's disease based on Arduino open-source prototyping platform is presented. For processing data tremors acquired by the sensor device we have developed an Android application which allows an evaluation of the state of PD patients based on three types of tests that are in the Unified Parkinson's Disease Rating Scale recommended by the Movement Disorder Society (MDS-UPDRS); the tests performed in the application are: postural tremor of the hands, kinetic tremors of the hands and resting tremor amplitude. The results of PD Patients showed that despite receiving medication to minimize symptoms of their disease, patients have a considerable tremor amplitude, which affects the normal development of their daily activities. In addition, the spectral analysis of the tremors shows that two of the patients were correctly diagnosed with PD while the third patient showed spectral characteristics which led us to suggest to the treating physician reconsider the diagnosis.

Mindfulness effects on cognition: Preliminary results

Background

Mindfulness-based cognitive therapy (MBCT) is a psychotherapeutic intervention that has been shown effective in several clinical conditions. Nevertheless, research is still needed on its effectiveness on cognition.

Objective

To analyze possible effects on cognition of the addition of MBCT intervention versus a brief structured group psycho-education to the standard treatment of subsyndromal bipolar depression. Our hypothesis was that MBCT could improve some aspects of cognitive function to a higher degree than psycho-education and treatment as usual (TAU).

Methods/design

A randomized, multicenter, prospective, versus active comparator, evaluator-blinded clinical trial was conducted. Forty patients with BD and subclinical or mild depressive symptoms were randomly allocated to:

– MBCT added to psychopharmacological treatment (n = 16);

– a brief structured group psycho-educational intervention added to psychopharmacological treatment (n = 17);

– standard clinical management, including psychopharmacological treatment (n = 7).

Assessments were conducted at screening, baseline, post-intervention (8 weeks) and 4-month follow-up.

Results

Cognition results point to significant improvement in Stroop Color test as well as processing speed in TMT A test (P < 0.05) in the two psychological intervention groups versus TAU.

Conclusion

These preliminary findings suggest that the addition of MBCT or psycho-education to usual treatment could improve some cognitive dimensions in subsyndromal bipolar depressive patients.

Disclosure of interest

The authors have not supplied their declaration of competing interest.

A Colorimetric Interdental Probe as a Standard Method to Evaluate Interdental Efficiency of Interdental Brush

The aim of this study is to evaluate the concordance between the empirical choice of interdental brushes of different diameters compared to the gold standard, the IAP CURAPROX(©) calibrating colorimetric probe. It is carried out with the aim of facilitating the consensus development of best practices. All the subjects' interproximal spaces were evaluated using the reference technique (colorimetric probe), then after a time lapse of 1.2 ± 0.2 hours, using the empirical clinical technique (brushes) by the same examiner. Each examiner explored 3 subjects. The order the patients were examined with the colorimetric interdental probe (CIP) was random. 446 sites were selected in the study out of 468 potential sites. The correspondence of scores between interdental bushes vs. colorimetric probe is 43.0% [95%-CI: 38.5-47.6]. In 33.41% of the 446 sites, the brush is inferior to the probe; in 23.54% of cases, the brush is superior to the probe. Among the discrepancies there is thus a tendency for the subjects to use brushes with smaller diameter than that recommended by the colorimetric probe. This review has found very high-quality evidence that colorimetric probes plus interdental brushing is more beneficial than interdental brushing alone for increase the concordance between the empirical choice of interdental brushes of different diameters compared to the gold standard. Uncertainties remain and further research is required to provide detailed data on user satisfaction.

Wind variability in a coastal area (Alfacs Bay, Ebro River delta)

Abstract. Wind spatial heterogeneity in a coastal area (Alfacs Bay, northwestern Mediterranean Sea) is described using a set of observations and modelling results. Observations in three meteorological stations (during 2012–2013) along the coastline reveal that wind from the N–NW (strongest winds in the region) appears to be affected by the local orography promoting high wind variability on relatively short spatial scales (of the order of few kilometres). On the other hand, sea breezes in late spring and summer also show noticeable differences in both spatial distribution and duration. The importance of wind models' spatial resolution is also assessed, revealing that high resolution (= 3 km) substantially improves the results in comparison to coarse resolution (9 km). The highest-resolution model tested (400 m) also presents noticeable improvements during some events, showing spatial variability not revealed by coarser models. All these models are used to describe and understand the spatial variability of the typical wind events in the region. The results presented in this contribution should be considered on hydrodynamic, ecological and risk management investigations in coastal areas with complex orography.

Fully switchable multiwavelength fiber laser assisted by a random mirror

A real-time switchable and reconfigurable multiwavelength laser has been experimentally carried out. The laser cavity is based on a random distributed mirror and a novel real-time reconfigurable filter mirror structure. The proposed laser has been demonstrated to generate any combination of wavelengths at the 50 and 100 GHz International Telecommunications Union (ITU) grids specifications. By simultaneously using Er-doped fiber and Raman amplification, a 15 nm wide lasing window at the C band can be utilized to create up to 18 different lasing wavelengths into the ITU grid that can be switched automatically and in real time when desired.

Study of heating capacity of focused IR light soldering systems

An experimental study about four optical setups used for developing a Focused IR Light Soldering System (FILSS) for Surface Mount Technology (SMT) lead-free electronic devices specifically for Ball Grid Arrays (BGA) is presented. An analysis of irradiance and infrared thermography at BGA surface is presented, as well as heat transfer by radiation and conduction process from the surface of the BGA to the solder balls. The results of this work show that the heating provided by our proposed optical setups, measured at the BGA under soldering process, meets the high temperature and uniform thermal distribution requirements, which are defined by the reflow solder method for SMT devices.

Association of the oral health impact profile with malnutrition risk in Spanish elders

The objective of this study was to determine any relationship between oral health-related quality of life (OHR-QoL) and malnutrition risk in the elderly using the oral health impact profile (OHIP). We studied 250 institutionalized elderly people, 162 females and 88 males, with and without teeth. Data were gathered on: general health; oral health; malnutrition risk, measured with the Mini Nutritional Assessment (MNA); and OHR-QoL, evaluated with the OHIP. A multivariate binary logistic regression model was constructed with malnutrition presence/risk as dependent variable. Mean age was 82.7 ± 8.2 years. Malnutrition or malnutrition risk was shown by 36.8% of the sample. OHIP was associated with malnutrition/risk after adjustment for age, sex, functional status, and mild dementia diagnosis. Malnutrition/risk was 3.43-fold more likely in participants with OHIP-reported "problems" than in those with none. The conclusion of the study was that OHIP-measured OHR-QoL is associated with malnutrition risk.

Internal modulation of a random fiber laser

A characterization of a modulated random mirror laser has been experimentally carried out. Unlike conventional internally modulated fiber lasers, no distortion of the modulating frequency or self-mode-locking effects were measured. The behavior of the laser using pulsed and analog modulation up to 12 GHz is shown.

E-cadherin in non-tumor epithelium adjacent to oral cancer as risk marker for the development of multiple tumors

Our aim was to find out whether the loss of E-cadherin is a risk factor for the development of multiple tumours in the oral cavity and whether it could serve as a diagnostic marker for oral premalignant fields. We studied 77 oral squamous cell carcinomas (SCC) with associated non-tumour epithelia from 61 patients. Immunohistochemical studies (antibody NHC-38) were used to investigate E-cadherin expression, which was completely lost in basal (48% of cases) and parabasal (43%) layers of non-tumour epithelia close to the tumour and in basal (47%) and parabasal (38%) layers of non-tumour epithelia distant from the tumour. In multiple tumours E-cadherin expression was significantly lower than in single tumours in the basal, parabasal layers, and the middle third of close (p=0.002, <0.001, <0.001) and distant (p=0.041, p<0.001, p=0.005) non-tumour epithelia, respectively. Downregulation of E-cadherin may be valuable as a risk marker for the development of multiple tumours in the oral cavity and for the diagnosis of premalignant fields.

High precision micro-displacement fiber sensor through a suspended-core Sagnac interferometer

A sensing system for micro-displacement measurement based in a suspended-core fiber Sagnac interferometer is presented. The suspended-core fiber characterization was made through the use of an optical backscatter reflectometer, screening its multimodal and birefringent behavior. Its sensitivity to displacement measurements is shown to be due only to birefringence, being that core-cladding mode coupling is negligible. High precision (~0.45 μm) was obtained using three different measurement instruments, showing an extremely high stability and high insensitivity to temperature, demonstrating that the sensing system has the ability for low cost applications.

Ultralong 250 km remote sensor system based on a fiber loop mirror interrogated by an optical time-domain reflectometer

A 253 km ultralong remote displacement sensor system based on a fiber loop mirror interrogated by a commercial optical time-domain reflectometer is proposed and experimentally demonstrated. The use of a fiber loop mirror increases the signal-to-noise ratio, allowing the system to interrogate sensors placed 253 km away from the monitoring system without using any optical amplification. The displacement sensor was based on a long period grating spliced inside of the loop mirror, which modifies the mirror reflectivity accordingly to the applied displacement.

Comparative validity of the OIDP and OHIP-14 in describing the impact of oral health on quality of life in a cross-sectional study performed in Spanish adults

OBJECTIVES

We aimed to compare the utility and validity of two popular socio-dental indicators (OIDP and OHIP-14) for describing the impact of oral conditions on quality of life applied simultaneously.

STUDY DESIGN

We recruited a consecutive sample of 270 healthy Spanish workers visiting the Employment Risk Prevention Centre for a routine medical check-up. OHIP-14 was self-completed before the oral examination and the face to face interview of the OIDP was performed. Both instruments were compared by evaluating its reliability and its validity.

RESULTS AND CONCLUSIONS

The standardised Cronbach alphas for OHIP-14 and OIDP were 0.89 and 0.74 respectively. OIDP showed lower face validity but higher content validity than OHIP-14. Both indicators showed high construct and criterion validity, since individuals perceiving need for dental treatment or having any complaint about their mouth obtained significantly higher total OIDP and OHIP scores than their counterparts. The prevalence of impacts was much higher using the OHIP (80.7%) than the OIDP (27.8%).

Multiple sclerosis prevalence in Malaga, Southern Spain estimated by the capture–recapture method

Background: Although not definitively proven, there is commonly accepted to be a latitudinal gradient in the distribution of multiple sclerosis (MS), which is more frequent in temperate zones. The European Mediterranean countries are situated in a zone of median frequency, although ever increasing figures have been noted in the last decades.

Objective: The objective of this study was to assess the current prevalence rate of MS in the province of Malaga, Southern Spain.

Methods: The capture–recapture method (CRM) uses independent sources of data and permits the number of non-registered cases of a given disease to be estimated, and by doing so, to avoid ascertainment bias.

Results: Use of this method showed the estimated prevalence rate of MS in the province of Malaga, Southern Spain, to be 125/105 (95% confidence interval: 102/105–169/105), higher than the figures published previously.

Conclusions: Although we recognize that these data need to be confirmed in further studies and in other areas of the country using a similar method, we believe this study is the first to find such high figure of prevalence, being very similar to the figures reported in recent years in other southern European countries.

Factors associated with fainting: before, during and after whole blood donation

BACKGROUND  Whole blood (WB) donation encompasses several periods during which some donors faint. Identification of factors associated with fainting during each period should guide intervention strategies. Reducing faint reactions may reduce donor injuries and disability. METHODS  Blood donation was divided into three periods: Period 1 - registration; Period 2 - phlebotomy; and Period 3 - post-phlebotomy. Period 3 consists of two sub-periods (3A - on-site and 3B - off-site). For each Period, stratified rates of fainting in relation to various donor and donation characteristics were calculated and multivariable logistic regression analyses to identify factors associated with fainting were conducted. Donor injuries in each period were also analysed. RESULTS  Of the 956 766 donors registered in 2007, 554 534 (58%) donated WB. There were 43 fainting episodes and two injuries in Period 1 and 1520 faints and 73 injuries in Periods 2 and 3. Regression analyses showed that youth and donor first-time status are associated with fainting in all periods; but most significantly in Period 1. Small estimated blood volume is notably not a factor in Period 1 but is significant in Periods 2 and 3. The highest injury rate is seen in Period 3A (0·07 and 0·09/1000 donations) for male and female donors, respectively. CONCLUSIONS  Variability in factors associated with fainting across defined periods of the donation process suggest differing underlying mechanisms and the possibility that interventions for the reactions most associated with injury during each time period can be designed. The highest rate of injury per donation occurred in ambulating donors.