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Objectives: The aim of this investigation was to assess the impact of the COVID-19 pandemic on dentists in Latin America during the initial year of the outbreak, specifically within the timeframe preceding vaccination campaigns. This study determined the various facets in which dentists were affected and exactly what proportion of them was harmed. Methods: A comprehensive 33 question survey was distributed across 19 Latin American countries after the first year of the COVID-19 pandemic's presence in the region. Results: There was an absence of statistically significant differences in responses among the surveyed countries in Latin America, with the exception of four questions out of the total 33. Some relevant findings of Latin American were: one in three dental professionals experienced discrimination based on their occupation. Concurrently, three out of four dentists reported initiating new activities to lessen discomfort. Notably, 8.63 % of respondents sought assistance from a psychologist or psychiatrist, while 17.71 % resorted to the consumption of psychoactive substances within the first year of the pandemic.Furthermore, 7.28 % of the professionals indicated that they still had not obtained all the necessary personal protective equipment for their work and 92.05 % disclosing that they personally financed these essential resources. A certain percentage of dentists stated that the quality of care decreased due to the implementation of the new safety measures (40.03 %) or due to their own feelings during patient interactions (23.11 %). Lastly, 38.85 % of dentists contemplated leaving the profession. Conclusions: The impact of the COVID-19 pandemic on dentists was decidedly adverse, manifesting both in personal and professional fields, despite the diverse measures undertaken by these professionals to mitigate its effects.
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Introduction: The use of high-flow nasal cannulas (HFNC) in patients with hypoxemic ventilatory failure reduces the need for mechanical ventilation and does not increase mortality when intubation is promptly applied. The aim of the study is to describe the behavior of HFNC in patients who live at high altitudes, and the performance of predictors of success/failure of this strategy. Methods: Prospective multicenter cohort study, with patients aged over 18 years recruited for 12 months in 2020 to 21. All had a diagnosis of hypoxemic respiratory failure secondary to pneumonia, were admitted to intensive care units, and were receiving initial management with a high-flow nasal cannula. The variables assessed included need for intubation, mortality in ICU, and the validation of SaO2, respiratory rate (RR) and ROX index (IROX) as predictors of HFNC success / failure. Results: One hundred and six patients were recruited, with a mean age of 59 years and a success rate of 74.5%. Patients with treatment failure were more likely to be obese (BMI 27.2 vs 25.5; OR: 1.03; 95% CI: .95-1.1) and had higher severity scores at admission (APACHE II 12 vs 20; OR 1.15; 95% CI: 1.06-1.24). Respiratory rates after 12 (AUC .81 CI: .70-.92) and 18â h (AUC .85 CI: .72-0.90) of HFNC use were the best predictors of failure, performing better than those that included oxygenation. ICU mortality was higher in the failure group (6% vs 29%; OR 8.8; 95% CI:1.75-44.7). Conclusions: High-flow oxygen cannula therapy in patients with hypoxemic respiratory failure living at altitudes above 2600â m is associated with low rates of therapy failure and a reduced need for mechanical ventilation in the ICU. The geographical conditions and secondary physiological changes influence the performance of the traditionally validated predictors of therapy success. Respiratory rate <30 proved to be the best indicator of early success of the device at 12â h of use.
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Ventilação não Invasiva , Pneumonia , Insuficiência Respiratória , Adulto , Altitude , Cânula , Estudos de Coortes , Humanos , Pessoa de Meia-Idade , Oxigenoterapia , Pneumonia/complicações , Pneumonia/terapia , Estudos Prospectivos , Insuficiência Respiratória/etiologia , Insuficiência Respiratória/terapiaRESUMO
In the title compound, C23H18N3O3 (+)·CF3SO3 (-), the asymmetric unit contains two crystallographically independent organic cations with similar conformations. Each cation shows a moderate distortion between the planes of the amide groups and the quinolinium rings with dihedral angles of 14.90â (2) and 31.66â (2)°. The quinolinium and phenyl rings are slightly twisted with respect to each other at dihedral angles of 6.99â (4) and 8.54â (4)°. The tri-fluoro-methane-sulfonate anions are linked to the organic cations via N-Hâ¯O hydrogen-bonding inter-actions involving the NH amide groups. In the crystal, the organic cations are linked by weak C-Hâ¯O(nitro group) inter-actions into supramol-ecular chains propagating along the b-axis direction.
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In the centrosymmetric title compound, C26H16N4O4 {systematic name: 6,13-bis-[(pyridin-4-yl)meth-yl]-6,13-di-aza-tetra-cyclo-[6.6.2.0(4,16)0(11,15)]hexa-deca-1,3,8,10,15-pantaene-5,7,12,14-tetrone}, the central ring system is essentially planar [maximum deviation = 0.0234â (8)â Å] and approximately perpendicular to the terminal pyridine ring [dihedral angle = 84.38â (3)°]. The mol-ecules displays a trans conformation with the (pyridin-4-yl)methyl groups on both sides of the central naphthalene di-imide plane. In the crystal, mol-ecules are linked by π-π stacking between parallel pyridine rings [centroid-centroid distances = 3.7014â (8) and 3.8553â (8)â Å] and weak C-Hâ¯O hydrogen bonds, forming a three-dimensional supra-molecular architecture.
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OBJECTIVE: To establish the prevalence of the Barrett esophagus (BE) in non-selected patients who underwent upper gastrointestinal endoscopy (UGE) and identified risk factors associated. METHODS: Case-control study on patients who underwent UGE between 2001-2003. Demographic data was gathered as well as the presence of esophagitis, H. pylori, hiatal hernia presence and length, nighttime symptoms, smoking, and alcohol consumption. RESULTS: The global frequency of EB was 0.26%. Average age in patients with EB was 57.3 +/- 17 years old against 49 +/- 15 years old on the control group (p = 0.16). 69% of the patients with EB were men compared to 56% on the control group (p = 0.41). No difference regarding the presence of hiatal hernia was found between EB (79.6%) and patients without EB (72.5%) (p = 0.75). However, patients with EB presented a longer hiatal hernia (p < 0.05). There was no difference regarding the presence of esophagitis (p = 0.32), H. pylori (p = 0.61), smoking (p = 0.39), alcohol consumption (p = 0.34), nocturnal symptoms (p = 0.53) or extra-esophageal manifestations (p = 0.31). A significant difference existed regarding the presence of heartburn and the length of symptoms: patients with EB stated a history longer than 5 years in comparison with the control group (p < 0.005 and < 0.01 respectively). CONCLUSIONS: The frequency of EB was 0.26% in Mexican non-selected population; the extents of hiatal hernia and history heartburn as well as a longer duration of symptoms were significantly associated to EB.
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Esôfago de Barrett/epidemiologia , Adulto , Idoso , Esôfago de Barrett/patologia , Estudos de Casos e Controles , Endoscopia do Sistema Digestório , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Prevalência , Fatores de RiscoRESUMO
BACKGROUND: Whether H. pylori infection plays a role in FD is ill defined; however, it is recommended to prescribe eradication treatment in patients with dyspepsia without alarm symptoms. Results of this advice are controversial, principally due to absence of instruments that provide an objective measure of changes in symptoms and quality of life. OBJECTIVE: Our aim was to evaluate significant changes in symptom severity and quality of life in patients with functional dyspepsia (FD) following Helicobacter pylori (H. pylori) eradication treatment. METHODS: We conducted an open clinical trial in adult patients with FD who were H. pylori-positive by means of 14C breath test. Treatment consisted of 2 weeks on lanzoprazole, amoxicillin, and clarithromycin. Score change on the severity of dyspepsia assessment (SODA) test instrument was used to evaluate modifications in symptom severity and quality of life. RESULTS: One hundred patients were included in this trial; treatment compliance was observed in 77% of these, while cure of H. pylori infection was obtained in 82.7% of patients. Only 11.7% displayed absence of dyspepsia symptoms and improvement in quality of life. No significant changes were obtained in global assessment nor in pain, or symptoms in health perception quality of life when initial SODA scores were compared with after-treatment results. CONCLUSIONS: There was no improvement of FD symptoms or quality of life after H. pylori eradication treatment.