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BACKGROUND: Patient safety climate constitutes an important element for quality improvement. Its current evidence base has been generated in hospital settings in developed countries. Studies in dentistry are limited. OBJECTIVE: To systematically explore the evidence regarding assessing patient safety climate in dentistry. METHODS: We developed a search strategy to explore MEDLINE, SCOPUS, and Web of Science databases from January 1st, 2002, to December 31st, 2022, to include observational studies on patient safety culture or patient safety climate assessment. Methodological features and item data concerning the dimensions employed for assessment were extracted and thematically analyzed. Reported scores were also collected. RESULTS: Nine articles out of 5584 were included in this study. Most studies were generated from high-income economies. Our analysis revealed methodological variations. Non-randomized samples were employed (ranging from 139 to 656 participants), and response rates varied from 28% to 93.7%. Three types of measurement instruments have been adapted to assess patient safety climate. These mainly consisted of replacing words or rewording sentences. Only one study employed an instrument previously validated through psychometric methods. In general, patient safety climate levels were either low or neutral. Only one study reported scores equal to or greater than 75. DISCUSSION: Despite diverse assessment tools, our two-decade analysis reveals a lag compared with medicine, resulting in methodological variations for assessing patient safety climate. Collaboration is vital to elevate standards, prioritize patient safety across oral healthcare services, and advocate for integrating safety climate into local and national quality and patient safety strategies.
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PURPOSE: The present study aims to translate, adapt and validate a Spanish version of the Knee Injury and Osteoarthritis Outcome Score, Joint Replacement (KOOS, JR), including a reliability and validity analysis in patients with knee osteoarthritis (OA). METHODS: This study conducted a prospective validation study following the six stages of the "Guidelines for the Process of Cross-Cultural Adaptation of Self-Report Measures". Psychometric testing was conducted in patients with knee osteoarthritis. Subjects answered the Spanish KOOS, JR (S-KOOS, JR) and a validated Spanish Oxford Knee Score (S-OKS). Retest was conducted at 10 days. Acceptability, floor and ceiling effect, internal consistency (Cronbach's α), reproducibility (mixed-effect model coefficient [MEMC]) and construct validity (Spearman's correlation; p = 0.05) were assessed. RESULTS: Forty-one patients (mean age: 65.6 ± 5.39; 48.8% female) participated in the study. All patients (100%) answered both scores during the first assessment and 38 (92.7%) during the second assessment. All patient-reported outcomes measures were answered completely (100%). The S-KOOS, JR resulted in 100% acceptability when answered. There were no ceiling or floor effects detected. The Cronbach's α for the S-KOOS, JR was 0.927 and its MEMC was 0.852 (CI 95% 0.636-1.078). The Spearman's correlation between the S-KOOS, JR and the S-OKS was 0.711 (CI 0.345-0.608; p < 0.001) and 0.870 (CI 0.444-0.651; p < 0.001) for the first and second assessments, respectively. CONCLUSION: The S-KOOS, JR has very high internal consistency and reproducibility, with a high correlation with the S-OKS; it is a reliable and valid instrument for characterising Spanish-speaking patients suffering from knee OA. LEVEL OF EVIDENCE: IV.
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Artroplastia de Substituição , Osteoartrite do Joelho , Humanos , Feminino , Pessoa de Meia-Idade , Idoso , Masculino , Osteoartrite do Joelho/diagnóstico , Osteoartrite do Joelho/cirurgia , Reprodutibilidade dos Testes , Comparação Transcultural , Inquéritos e Questionários , Psicometria , Qualidade de VidaRESUMO
Introducción: El proceso de evaluación a distancia es una modalidad que ha sido utilizada en los últimos años. Sin embargo, la pandemia por COVID-19 ha ocasionado su rápida adaptación. El personal docente ha reportado las ventajas de este modo de evaluación; no obstante, la opinión de los estudiantes de odontología en torno a las ventajas y desventajas de esta modalidad no ha sido explorada. Objetivo: Explorar las ventajas y desventajas de las tecnologías de la información y comunicación (TIC), específicamente en el proceso de evaluación a distancia reportadas por estudiantes de odontología. Material y métodos: Se realizó un estudio transversal retrospectivo, en una muestra no aleatoria de 310 estudiantes de tercer año, distribuidos en cuatro generaciones, adscritos a la Facultad de Odontología de la FES Iztacala. Se administró un cuestionario estructurado para la medición de sus opiniones en torno a las evaluaciones a distancia. Se realizó un análisis descriptivo y bivariado. Resultados: De un total de los 382 estudiantes potencialmente elegibles, 310 aceptaron participar (96%). Conclusiones: La opinión mayoritaria fue la preferencia a los exámenes por Internet y mejor a distancia. Queda pendiente la duda: ¿cuál será el comportamiento cuando los estudios profesionales vuelvan a la normalidad después de la pandemia COVID-19? (AU)
Introduction: The process of distance assessment has been employed in the last years. However, COVID-19 pandemic has accelerated its adoption. Academic personnel have previously reported the benefits of this mode of assessments. Nevertheless, dentistry-students' opinions around the advantages and disadvantages of this mode of assessment has not been explored. Objective: Explore the advantages and disadvantages concerning the ICT skills specifically about the process of distance assessment of dental students. Material and methods: A retrospective cross-sectional study was conducted in a non-randomized sample of 310 of third-year students distributed in four years attending to the School of Dentistry at FES Iztacala. A structured questionnaire was distributed to measure students' opinions around the advantages and disadvantages of distance assessments. A descriptive and bivariate analysis was conducted. Results: Questionnaires were returned by 310 students (96% response rate). Conclusion: Students' perceptions of their ICT skills has increased, matched by better equipment and greater appreciation of e-learning (AU)
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Humanos , Masculino , Feminino , Estudantes de Odontologia , Educação a Distância , Avaliação Educacional , COVID-19 , Faculdades de Odontologia , Epidemiologia Descritiva , Estudos Transversais , Inquéritos e Questionários , Tecnologia da Informação , MéxicoRESUMO
We present the case of a 63-year-old immunocompetent man with unilateral acute retinal necrosis (ARN). He consulted for blurred vision, eye pain, photophobia, and headache. Papillitis and peripheal chorioretinitis associated with vasculitis and peripheral retinal ischemia was confirmed. PCR from aqueous humor sample detected varicella zoster virus. The patient was treated with a combined therapy of oral corticosteroids, oral / intravenous acyclovir along with weekly intravitreous ganciclovir doses followed by oral valaciclovir for three months. A progressive decrease in viral load in aqueous humor was demonstrated during treatment. Follow-up showed improvement in the inflammatory condition and a slight recovery of visual acuity, however, finally he presented a retinal detachment with total loss of one-sided vision. ARN is an uncommon complication caused by some herpesviruses with a poor visual prognosis, an outcome that can be improved with early diagnosis and treatment using appropriate antivirals. Prolonged treatment reduces relapse frequency and fellow eye compromise.
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Herpesvirus Humano 3 , Síndrome de Necrose Retiniana Aguda , Aciclovir/uso terapêutico , Antivirais/uso terapêutico , Seguimentos , Herpesvirus Humano 3/genética , Humanos , Masculino , Pessoa de Meia-Idade , Reação em Cadeia da Polimerase , Síndrome de Necrose Retiniana Aguda/diagnóstico , Síndrome de Necrose Retiniana Aguda/tratamento farmacológicoRESUMO
Resumen Presentamos el caso de un varón de 63 años, inmunocompetente, con una necrosis retinal aguda (NRA) unilateral. Consultó por visión borrosa, dolor ocular, fotofobia y cefalea. Se confirmó una papilitis y coriorretinitis periférica asociada a vasculitis e isquemia retinal periférica. El estudio molecular por RPC de humor acuoso detectó la presencia de virus varicela zoster. El paciente fue tratado con terapia combinada con corticoesteroides orales, aciclovir oral/intravenoso, ganciclovir intravítreo semanal y luego valaciclovir oral por tres meses. Se demostró una disminución progresiva de la carga viral en el humor acuoso durante el tratamiento. El seguimiento mostró una mejoría del cuadro inflamatorio y una leve recuperación de la agudeza visual, sin embargo, finalmente presentó un desprendimiento de retina con pérdida casi total de la visión unilateral. La NRA es una complicación infrecuente provocada por algunos virus herpes con mal pronóstico visual, desenlace que puede ser mejorado con un diagnóstico y tratamiento precoz con antivirales. El tratamiento prolongado permite evitar la recaída y el compromiso contralateral.
Abstract We present the case of a 63-year-old immunocompetent man with unilateral acute retinal necrosis (ARN). He consulted for blurred vision, eye pain, photophobia, and headache. Papillitis and peripheal chorioretinitis associated with vasculitis and peripheral retinal ischemia was confirmed. PCR from aqueous humor sample detected varicella zoster virus. The patient was treated with a combined therapy of oral corticosteroids, oral / intravenous acyclovir along with weekly intravitreous ganciclovir doses followed by oral valaciclovir for three months. A progressive decrease in viral load in aqueous humor was demonstrated during treatment. Follow-up showed improvement in the inflammatory condition and a slight recovery of visual acuity, however, finally he presented a retinal detachment with total loss of one-sided vision. ARN is an uncommon complication caused by some herpesviruses with a poor visual prognosis, an outcome that can be improved with early diagnosis and treatment using appropriate antivirals. Prolonged treatment reduces relapse frequency and fellow eye compromise.
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Humanos , Masculino , Pessoa de Meia-Idade , Síndrome de Necrose Retiniana Aguda/diagnóstico , Síndrome de Necrose Retiniana Aguda/tratamento farmacológico , Herpesvirus Humano 3/genética , Antivirais/uso terapêutico , Aciclovir/uso terapêutico , Reação em Cadeia da Polimerase , SeguimentosRESUMO
Los fragmentos posterolaterales (FPLs) en fracturas de platillo tibial son frecuentes, pero difíciles de reducir y estabilizar. Actualmente existe controversia sobre cómo deben ser abordados; si bien un abordaje anterolateral es más seguro, este puede ser insuficiente para lograr una correcta reducción. Los abordajes posterolaterales y posteriores ofrecen una visión directa y permiten una fijación con ventaja biomecánica; sin embargo, son más demandantes y exponen al paciente a una mayor morbilidad. A continuación, se presenta una nota técnica sobre la reducción y fijación de FPLs con una placa rim por medio de un abordaje anterolateral extendido a través del espacio paraligamento colateral lateral.
Posterolateral fragments (PLFs) are commonly seen in tibial plateau fractures, but their reduction and fixation are challenging. There is no consensus about the ideal approach to fix this particular fragment. Even though an anterolateral approach is a safe option, it may impair a correct reduction. The posterolateral and posterior approaches offer direct visualization of the fragment, and enable a fixation with a biomechanical advantage; however, they are more demanding and expose the patient to a higher risk if morbidity. The following technical note describes the reduction and fixation of PLFs with a rim plate through an extended anterolateral approach using the paralateral collateral ligament space.
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Humanos , Masculino , Idoso , Fraturas da Tíbia/cirurgia , Placas Ósseas , Fixação Interna de Fraturas/métodos , Fraturas da Tíbia/reabilitação , Ligamentos Colaterais , Fixação Interna de Fraturas/instrumentaçãoRESUMO
El día del odontólogo tradicionalmente se festeja el 9 de febrero, en conmemoración a Santa Apolonia, quien el 9 de febrero del año 248 d.C., por no renunciar a su fe cristiana, es martirizada quitándole los dientes. Sin embargo, existe una historia de origen maya, escrita en el Popol Vuh, la de Vucub Caquix, ave mítica antropomorfa, a quien se le extraen los dientes. Este hecho acontece antes de la creación del mundo, el 13 de agosto del año 3114 a.C. Este hallazgo surge al relacionar el Popol Vuh con las imágenes representadas en la vasija maya K 1226, la estela 25 de Izapa y las inscripciones de la estela de Cobá, Quintana Roo. Por lo anterior, proponemos que este acontecimiento podría tomarse en cuenta para conmemorar en México el día del dentista el 13 de agosto, puesto que ello sería una forma de revalorar y reafirmar nuestra identidad prehispánica (AU)
The dentist's day is traditionally celebrated on February 9, in commemoration of Santa Apolonia, who on February 9 of the year 248 AD, for not giving up her Christian faith, is martyred by taking her teeth. However, there is a story of Mayan origin, written in Popol Vuh, that of Vucub Caquix, a mythical anthropomorphic bird, whose teeth are extracted. This fact occurs before the creation of the world, on August 13, 3114 BC. This finding arises when the Popol Vuh is related to the images represented in the Mayan vessel K 1226, stela 25 of Izapa and the inscriptions of the stela de Cobá, Quintana Roo. Therefore, we propose that this event could be taken into account to commemorate August 13, as the day of the dentist, as a way to revalue and reaffirm our pre-Hispanic identity (AU)
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Humanos , Animais , Indígenas Norte-Americanos , Cultura Indígena , Cosmovisão , História da Odontologia , Aniversários e Eventos Especiais , Santos , México/etnologia , MitologiaRESUMO
Robot-Assisted Rehabilitation (RAR) is relevant for treating patients affected by nervous system injuries (e.g., stroke and spinal cord injury). The accurate estimation of the joint angles of the patient limbs in RAR is critical to assess the patient improvement. The economical prevalent method to estimate the patient posture in Exoskeleton-based RAR is to approximate the limb joint angles with the ones of the Exoskeleton. This approximation is rough since their kinematic structures differ. Motion capture systems (MOCAPs) can improve the estimations, at the expenses of a considerable overload of the therapy setup. Alternatively, the Extended Inverse Kinematics Posture Estimation (EIKPE) computational method models the limb and Exoskeleton as differing parallel kinematic chains. EIKPE has been tested with single DOF movements of the wrist and elbow joints. This paper presents the assessment of EIKPE with elbow-shoulder compound movements (i.e., object prehension). Ground-truth for estimation assessment is obtained from an optical MOCAP (not intended for the treatment stage). The assessment shows EIKPE rendering a good numerical approximation of the actual posture during the compound movement execution, especially for the shoulder joint angles. This work opens the horizon for clinical studies with patient groups, Exoskeleton models, and movements types.
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Exoesqueleto Energizado , Reabilitação/instrumentação , Reabilitação/métodos , Extremidade Superior/fisiologia , Fenômenos Biomecânicos , Humanos , Amplitude de Movimento Articular/fisiologia , Processamento de Sinais Assistido por ComputadorRESUMO
CONTEXT AND OBJECTIVE: Many clinical investigations use generic and/or specific questionnaires to obtain information about participants and patients. There is disagreement about whether the administration method can affect the results. The aim here was to determine whether, among patients with intermittent claudication (IC), there are differences in the Walking Impairment Questionnaire (WIQ) and European Quality of Life-5 Dimension (EQ-5D) scores with regard to: 1) the questionnaire administration method (self-administration versus face-to-face interview); and 2) the type of interviewer (vascular surgeon, VS, versus general practitioner, GP). DESIGN AND SETTING: Cross-sectional observational multicenter epidemiological study carried out within the Spanish National Health Service. METHODS: 1,641 evaluable patients with IC firstly completed the WIQ and EQ-5D questionnaires and then were interviewed by their doctor on the same day. Pearson correlations and Chi-square tests were used. RESULTS: There was a strong correlation (r > 0.800; P < 0.001) between the two methods of administering the WIQ and EQ-5D questionnaires, and between the VS and GP groups. Likewise, there was a high level of concordance (P > 0.05) between the different dimensions of the WIQ-distance and EQ-5D (self-administration versus face-to-face) in the VS and GP groups. CONCLUSION: There was no difference between the different methods of administering the WIQ and EQ-5D questionnaires, among the patients with IC. Similarly, the two types of interviewers (VS or GP) were equally valid. Therefore, it seems unnecessary to expend effort to administer these questionnaires by interview, in studies on IC.
RESUMO CONTEXTO E OBJETIVO: Muitas investigações clínicas usam questionários genéricos e/ou específicos para obter informações sobre os participantes e pacientes. Não se sabe se o modo de administração pode afetar os resultados. O objetivo foi determinar se, nos pacientes com claudicação intermitente (CI), existem diferenças nas pontuações do Walking Impairment Questionnaire (WIQ) e do European Quality of Life-5 Dimension (EQ-5D) no que diz respeito a: 1) a forma de administrar o questionário (autoadministrado versus entrevista presencial); e 2) o tipo de entrevistador: cirurgião vascular (CV) ou médico generalista (MG). TIPO DE ESTUDIO E LOCAL: Estudo epidemiológico observacional, transversal, multicêntrico realizado no Serviço Nacional de Saúde espanhol. METODO: 1.641 pacientes avaliáveis com CI completaram inicialmente o WIQ e questionários EQ-5, e depois, no mesmo dia, foram entrevistados pelo seu médico. Foram utilizados correlações de Pearson e testes de qui-quadrado. RESULTADOS: Houve forte correlação (r > 0,800; P < 0,001) entre os dois métodos de administração do WIQ e EQ-5D; e entre os grupos CV e MG. Também houve alto nível de concordância (P > 0,05) entre as diferentes dimensões do WIQ-distância e EQ-5D (autoadministrado versus entrevista presencial), nos grupos CV e MG. Conclusão: Em pacientes com CI, não há diferenças entre as diferentes formas de administrar os questionários WIQ e EQ-5D. Da mesma forma, os dois tipos de entrevistador (CV ou MG) foram igualmente válidos. Portanto, não parece necessário despender esforço para administrar esses questionários através de entrevista, em estudos de CI.