The effect of dentist experience on the treatment of individuals with disability under general anesthesia

AIMS

The aim of the present work was to assess in patients with severe disability operated under general anesthesia whether the progressive acquisition of experience by the dental team affects the type of procedure performed and the duration of operations.

METHODS AND RESULTS

A study group of 911 patients who underwent dental treatment under general anesthesia between 1997 and 2014 was conformed. Information was collected from every patient including: dental diagnosis, dental procedures and duration of the operating times. To analyze the impact of the operators' experience, the study period was divided into three 6-year periods. The most prevalent systemic diagnosis was "mental disease and behavior disorders" (42.9%). The most common dental procedures were extractions and fillings. Fewer extractions were performed during the third 6-year period (p = .000). Compared with the other two periods, during the first period fewer composite fillings (p = .000 and p = .000, respectively) and more fissure sealants (p = .001 and p = .023, respectively) were performed. The number of amalgam fillings decreased progressively (p = .000). There was a statistically significant reduction in the mean duration of the operations between the first and third period (p = .002).

CONCLUSION

The dental team's experience entailed a significant reduction in the duration of operations.

Bi-species imposex monitoring in Galicia (NW Spain) shows contrasting achievement of the OSPAR Ecological Quality Objective for TBT

Imposex is decreasing worldwide after the total ban on tributyltin (TBT) from antifouling paints. In order to assess improvement in the NE Atlantic, the OSPAR Convention designed an Ecological Quality Objective (EcoQO) based on the VDSI (vas deferens sequence index, an agreed measure of imposex) in the rock snail Nucella lapillus; wherever this is not available, the mud snail Nassarius reticulatus was proposed as a proxy. We determined VDSI in Galician populations of rock (n≥34) and mud (n≥18) snails at regular intervals from pre-ban times until 2009 and 2011, respectively. While imposex in the former started decreasing in 2006 and by 2009 the EcoQO had been met in the area, VDSI in the latter was not significantly reduced until 2011 and values contradict such an achievement. This suggests that the OSPAR imposex bi-species scheme may not be of direct application in the current post-ban scenario.

A combined whelk watch suggests repeated TBT desorption pulses

Environmental quality in coastal Europe has improved since the complete 2003 ban on the use of tributyltin (TBT) in antifouling paints. However, there is evidence that TBT is entering the water column, presumably from illegal practices. We determined the concentration of butyltins (BTs: TBT and derivatives) in populations of two gastropods, the rock snail Nucella lapillus (n=17) and the mud snail Nassarius reticulatus (n=18) at regular intervals from pre-ban times until 2009 and 2011, respectively, in NW Spain. Although a substantial decline in TBT occurred shortly after the ban, no significant changes were observed in either species over the last 3-year period of study. In addition, the proportion of TBT relative to the sum of BTs (a marker of recent pollution) in the most recent rock snail samples unexpectedly increased; this proportion therefore showed a generally decreasing but oscillatory trend over time. The results are consistent with the theoretical expectation of BT desorption from sediments; however, this natural phenomenon is now interpreted as a recurrent episode rather than a unique, transient event. Evidence of this subtle input improves our understanding of TBT persistence in the environment in Europe and worldwide.

Hydrogeochemical variables regionalization--applying cluster analysis for a seasonal evolution model from an estuarine system affected by AMD

This study describes the spatial evolution of the hydrogeochemical parameters which characterise a strongly affected estuary by Acid Mine Drainage (AMD). The studied estuarine system receives AMD from the Iberian Pyrite Belt (SW Spain) and, simultaneously, is affected by the presence of an industrial chemical complex. Water sampling was performed in the year of 2008, comprising four sampling campaigns, in order to represent seasonality. The results show how the estuary can be divided into three areas of different behaviour in response to hydrogeochemical variables concentrations that define each sampling stations: on one hand, an area dominated by tidal influence; in the opposite end there is a second area including the points located in the two rivers headwaters that are not influenced by seawater; finally there is the area that can be defined as mixing zone. These areas are moved along the hydrological year due to seasonal chemical variations.

Impact of millennial mining activities on sediments and microfauna of the Tinto River estuary (SW Spain)

In this paper, we analyze two short cores collected in the Tinto estuary (SW Spain), and describe the palaeoenvironmental evolution of this area during the last two millennia, along with the influence of historical mining activities and recent industrial pollution on sediments and microfauna (foraminifera and ostracoda). Although there were no significant changes in the distribution of microorganisms, a first pollution period (0-150 AD) was recorded in high sediment pollution by Cu in the shallow palaeochannels of the middle estuary. During this period and the following 1700 years, tolerant pioneer species of both foraminifera and ostracoda were found predominantly in the inner, protected areas of the estuary, while the bottom sediments were subjected to high hydrodynamic gradients, and consequently showed lower density and diversity of organisms. In the last 150 years, acid mine drainage processes, introduction of a new mining period, and the polluted inputs derived from two industrial processes resulted in increased heavy metal contamination of the bottom sediments, and corresponding extirpation of ostracodes and restriction of foraminifers to the inner zones of the estuary.

[Diffuse pulmonary calcification in a patient with renal insufficiency]

We report the case of a 37-year-old man with chronic renal insufficiency, on hemodialysis, with no respiratory symptoms but whose chest radiograph showed parenchymal consolidation in the middle and upper lung fields. High resolution computed tomography showed a high-attenuating diffuse alveolar pattern that indicated calcium deposits. Bronchoscopy revealed metastatic calcification on the interalveolar septa and bronchiolar and arteriolar. The present report, based on radiologic and bronchoscopic findings, describes the pathogenesis and anatomical distribution of the patient's diffuse pulmonary calcification.

Origin of the anomalies in light and middle REE in sediments of an estuary affected by phosphogypsum wastes (south-western Spain)

Sc, Y, Th, Cu and rare earth elements (REE) concentrations have been analyzed in 14 samples of surface sediments and in two gravity cores by means of ICP-MS. Mean concentrations of Sc, Y and Th in surface sediments are 6.23, 4.76 and 16.30 ppm, respectively, lower than those present in the Upper Continental Crust (UCC). Cu concentration in these sediments is very high, 1466 ppm, and is caused by inputs from the Odiel and Tinto rivers, affected by acid mine drainage. SigmaREE mean concentration is 106.8 ppm, lower than that observed in other rivers and estuaries. In the cores, Sc, Y and Th concentrations show a significant increase in the intermediate levels, between 10 and 40 cm depth. The same pattern exists with Cu, where concentrations of 4440 ppm can be reached. Vertical evolution patterns for Sc, Y, Cu and heavy REE (HREE) are similar, and contrary to those shown by Th, light REE (LREE) and middle REE (MREE). Plots of North American Shale Composite (NASC)-normalized REE data of surface sediments show a slight depletion in REE concentrations. Most samples present with middle REE enrichment relative to light REE and heavy REE. Conversely, samples of the intermediate levels of the cores show significant enrichment of REE relative to NASC and high values in the (La/Gd)NASC and (La/Yb)NASC ratios. These anomalies in the fractionation patterns caused by enrichments in LREE and MREE concentrations is related to the presence of high concentrations of Th. They were generated by effluents from fertilizer factories between 1968 and 1998 which used phosphorite as source material.