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Introduction: Shortage of medicines in Peruvian healthcare facilities is a significant public health issue that may affect patient satisfaction., Objective: To estimate the association between access to medicines and the level of satisfaction with the received care from users of healthcare facilities in Peru during 2016., Methods: An analytical cross-sectional study was conducted using data from the 2016 National Survey of User Satisfaction in Health (ENSUSALUD). Access to medicines at the healthcare facilities' pharmacy and patient satisfaction were measured using self-report questions. Crude and adjusted ordinal logistic regression models were used to estimate Odds ratios with 95% confidence intervals. The complex sample design of the 2016 National Health User Satisfaction Survey was considered in all calculations., Results: Data from 10 386 healthcare facility users were included. After receiving medical care, 19.6% had partial access to medications, 6.8% had no access, and 6% were dissatisfied with the care received. Users with partial access to drugs had 87% higher odds of dissatisfaction (Odds ratio: 1.87; 95% confidence interval: 1.56 to 2.23), while users without access to medications had 51% higher odds of dissatisfaction (OR: 1.51; 95% CI: 1.06 to 2.16), compared to users with full access to drugs, adjusted for confounding variables., Conclusions: Patients with limited access to medicine at pharmacies in Peruvian healthcare facilities reported higher dissatisfaction with the care received., Competing Interests: The authors declare that they have no conflicts of interest in the publication of this study., (This work is licensed under a Creative Commons Attribution 4.0 International License.)

Objective: The purpose of this article was to analyze the effect of an instructional video on practical tutorial and to ascertain whether an instructional video improves students' performance on practical performance and reduces the stress associated with learning., Materials and Methods: A randomized controlled trial was conducted on a group of 78 first-year students. A pretest was conducted by administering questionnaires to evaluate the interest in the use of videos as well as the level of stress. Students were randomly assigned into two groups: control and test. Students assigned to the control group received conventional teaching, while the experimental group received both conventional teaching and watched a video. Thereafter, a satisfaction questionnaire was distributed to each of the groups, and they were awarded a grade., Results: A total of 98.7% of students wished to learn fixed prosthodontics through instructional videos, as they believed that the videos could reduce their worry and stress levels. At the end of the first tutorial, the total grade was significantly lower for the test group ( p = 0.003). However, the subjective value of stress was significantly lower in the test group ( p = 0.0007) as well as the subjective value of tutorial difficulty ( p = 0.0004). Students felt that they better understood the objectives of the tutorial "thanks to the video" ( p = 0.0001)., Conclusion: This study did not reveal any improvement in terms of performance when an instructional video was used for tutorials in comparison with the conventional teaching method. However, the results show a reduction in the level of stress., Competing Interests: None declared., (European Journal of Dentistry. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial-License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/).)

The wide use of chairside CAD/CAM restorations has increased the diversity of the restorative material. For the practitioner, the selection of the appropriate material is difficult amongst the variety offered by the market. Information on the characteristics of the products can be difficult to assess due to the lack of up-to-date classification and the lack of reliability of manufacturer's advertising. The purpose of this article is to structure the data on restorative materials provided by various sources in order for the practitioner to choose the product most suited to the clinical situation. The objective is to classify chairside CAD/CAM materials and to define their characteristics and indications.

For many practitioners, longevity of full glass ceramic crowns in the posterior area, molars and premolars, remains a real challenge. The purpose of this article is to identify and evaluate the parameters that can significantly influence their resistance when preparing a tooth. The analysis proposed in this article relies on interrelated studies conducted at three levels: in vitro (mechanical tests), in silico (finite elements simulations) and in vivo (clinical survival rates). The in vitro and the in silico studies proved that an appropriate variation of the geometric design of the preparations enables to increase up to 80% the mechanical strength of ceramic reconstructions. The in vivo clinical study of CAD/CAM full ceramic crowns was performed in accordance with the principles stated within the in vitro and the in silico studies and provided a 98.97% success rate over a 6 years period. The variations of geometric design parameters for dental preparation allows for reconstructions with a mechanical breaking up to 80% higher than that of a non-appropriate combination. These results are confirmed in clinical practice.

The aim of this study was to evaluate the changes in the transition layer at the interface between yttria partial stabilized tetragonal zirconia polycrystalline (Y-TZP) core and veneering feldspathic ceramic (VITA VM(®)9), under different manufacturing methods. Confocal Raman microscopy and energy dispersive X-ray spectroscopy (EDS) analyses were carried out on tapered veneered cross sections of the interface. For some samples, an additional firing of the core was used, as the application of an optional liner material between the core and veneer. Single Raman spectra were distinguishable between Y-TZP and the veneering materials. VM(®)9 and liner spectra were broadly superimposable. No substantial differences appeared in their chemical elemental composition. 2D Raman images and EDS analysis emphasized changes in the interdiffusion thickness; the additional firing of the core decreased the interdiffusion zone, and the highest firing temperature of the liner increased the interdiffusion zone. These results, which will help us understand the changes in this transition layer, are discussed.

Intratumoral activity of the progesterone-dependent enzyme 17 beta-hydroxysteroid dehydrogenase (E2DH) was measured in 114 patients with breast cancer (33 pre- and 81 postmenopausal) before and/or after 8 days of a progestin treatment (lynestrenol, 10 mg/day). In 12 postmenopausal patients, the ability of E2DH to be stimulated by lynestrenol was compared to estradiol receptor (ER) and progesterone receptor (PR) levels. In premenopausal patients, E2DH was higher when tumors were excised in the luteal phase than when excised in the follicular phase. In postmenopausal patients, E2DH was higher after progestin treatment. However, E2DH stimulation by lynestrenol depended on receptor levels. It was most often markedly stimulated in ER-positive, PR-positive tumors. It remained low in ER-negative, PR-negative tumors. Intratumoral measurement of the progesterone-dependent enzyme E2DH in breast cancer after progestin treatment could therefore provide a fine and reliable index of the presence and functional character of PR and hormone dependency of the tumor.