Dental health status and oral health-related quality of life in older people of Puerto Montt, Chile / Estado de salud dental y calidad de vida relacionada a salud bucal en personas mayores, de Puerto Montt, Chile

Abstract: Introduction: Older people tend to have poor oral health, which can affect their quality of life. This study aimed to explore the relationship of the Oral Health-Related Quality of Life (OHRQoL) with sociodemographic variables and the dental health status of older people who belong to Elderly Clubs in the district of Puerto Montt, Chile. Material and methods: A cross-sectional study was carried out in 140 elderly people from Elderly Clubs in the district of Puerto Montt, Chile. Sociodemographic and dental variables were studied using a questionnaire and clinical examination. The GOHAI instrument validated in Chile was applied to measure the OHRQoL. Results: The mean of the total GOHAI was 50.8±8.6 points, and the median was 53. Of the 140 elderly people, 87.9% were females, the means of age and years of education were 73.2±6.2 and 7.5±4.4 years, respectively. 30% were edentulous, the number of remaining teeth was 7.8±8.1, the OHI-S was 1.3±1.0. 85.7% wore dentures, and the time of denture wearing was 8.8±9.4 years. Significant associations were found between the total GOHAI and non-belonging to an indigenous people (p=0.024), being edentulous (p=0.006), and the presence of healthy teeth (p=0.039). Conclusion: The GOHAI showed a significant relationship with not-belonging to an indigenous ethnicity, being edentulous, and the number of healthy teeth. The OHRQoL was higher in males, with formal education, edentulous, dentated without teeth mobility, with complete dentures, and moderate denture hygiene.

Introducción: Las personas mayores suelen presentar una salud bucal deficitaria, la que puede repercutir en su calidad de vida. El objetivo fue explorar la relación de la Calidad de Vida Relacionada a Salud Bucal (CVRSB) con variables sociodemográficas y del estado de salud dental en personas mayores pertenecientes a clubes del Adulto Mayor de la comuna de Puerto Montt, Chile. Material y Métodos: Se realizó un estudio transversal en 140 personas mayores de clubes del Adulto Mayor en Puerto Montt. Mediante cuestionario y examen clínico se estudiaron variables sociodemográficas y dentales y se aplicó el instrumento GOHAI validado en Chile para medir CVRSB. Resultados: La media del GOHAI total fue de 50.8±8.6 puntos y la mediana fue de 53. De las 140 personas mayores, 87.9% eran mujeres, las medias de edad y escolaridad fueron 73.2±6.2 y 7.5±4.4 años, respectivamente. El 30% era desdentado total, el número de piezas remanentes fue de 7.8±8.1, el IHO-S fue de 1.3±1.0. El 85.7% utilizaba prótesis, el tiempo de uso fue de 8.8±9.4 años. Se encontraron asociaciones significativas entre total GOHAI y la no-pertenencia a pueblo indígena (p=0.024), desdentamiento general (p=0.006) y la presencia de dientes sanos (p=0.039). Conclusión: El GOHAI presentó relación significativa con la no-pertenencia a pueblo Indígena, desdentamiento general y número de dientes sanos. La CVRSB fue mayor en hombres, con educación formal, edéntulos, dentados sin movilidad, portadores de prótesis totales e higiene de prótesis regular.

Cardiorespiratory fitness improves prediction of mortality of standard cardiovascular risk scores in a Latino population.

BACKGROUND: Cardiorespiratory fitness (CRF) is a powerful predictor of mortality. This study evaluated the predictive value of CRF for mortality in Chilean subjects without atherosclerotic disease compared with the Framingham, European Systematic Coronary Risk Evaluation (SCORE), and 2013 ACC/AHA risk scores and determined the incremental predictive value of CRF when added to these scores. HYPOTHESIS: CRF improves prediction of all-cause and cardiovascular disease (CVD)-related mortality of the standard international risk scores. METHODS: Cross-sectional study, which evaluated 4064 subjects between 2002 and 2016. Cardiovascular (CV) risk factors, anthropometric and biochemical parameters, and blood pressure were measured. CRF was determined by metabolic equivalents during maximum stress test. The Framingham, SCORE, and ACC/AHA risk scores were calculated for all subjects. After a median follow-up of 9 years, all-cause and CVD-related mortality were assessed. Receiver operating curves were built to determine mortality prediction for CRF, the risk scores, and CRF added to the scores. RESULTS: As of August 2016, 99 deaths were reported, 33 of which were CVD-related. All risk scores and CRF predicted CVD-related mortality, with CRF identified as the best predictor: CRF: C = 0.88 (95% CI: 0.82-0.93) vs Framingham: C = 0.68 (95% CI: 0.60-0.76), SCORE: C = 0.76 (95% CI: 0.70-0.83), and ACC/AHA: C = 0.79 (95% CI: 0.73-0.85). Predictive power of the three scores improved when CRF was added to the model, but this was only significant for the Framingham score. CONCLUSIONS: CRF is a good predictor of both, all-cause and CV mortality and a better predictor of CVD-related deaths than standard risk scores in this population.

Urinary sodium-to-potassium ratio and body mass index in relation to high blood pressure in a national health survey in Chile.

Several lifestyle and sociodemographic factors are associated with blood pressure (BP). The authors conducted a retrospective study of 4870 subjects from the National Health Survey 2009 in Chile to identify exposure factors associated with increasing BP levels. Subjects with isolated urinary excretion of sodium (n = 2873), potassium, and creatinine were included to estimate daily salt intake and urinary sodium/potassium (Na/K) ratio. Hypertension was defined according to European guidelines 2018 and American guidelines ACC/AHA 2017. Proportional odds models were developed to analyze education level, sedentarism, smoking, alcohol intake, estimated urinary Na/K ratio, estimated daily salt intake, and body mass index (BMI) as factors associated with increasing BP levels (from high-normal BP to hypertension). Logistic regression models were checked for overdispersion. Mean age and BMI of the population were 42 years old and 27 kg/m2 , respectively; 19% had low education level and 27% had hypertension according to European guidelines, whereas 47% according to ACC/AHA criteria. Mean estimated urinary Na/K ratio was 4 ± 2, and mean salt consumption was 10 ± 2 g/day. Estimated urinary Na/K ratio (OR, 1.11; 95% CI, 1.01-1.21), BMI (OR, 1.10; 95% CI, 1.07-1.13), estimated daily salt intake (OR, 1.10; 95% CI, 1.03-1.17), and alcohol intake (OR, 1.03; 95% CI, 1.01-1.05) were significantly associated with hypertension. This study highlights that a healthy diet and weight control should be important components of BP management plans, and it suggests that public policies should include close monitoring of these factors to reduce hypertension prevalence and improve its management in a Latino population.

[Five o'clock tea and the risk of metabolic syndrome]. / La ingesta de "once", en reemplazo de la cena, se asocia al riesgo de presentar síndrome metabólico.

BACKGROUND: Seventy four percent of Chileans replaced the traditional dinner for the consumption of "five o'clock tea" (5CT), a mealtime that includes bread and is simliar to western breakfast. The latter favors the intake of unhealthy foods. AIM: To study whether the consumption of "5CT", instead of dinner, could be a risk factor for the development of metabolic syndrome (MetSyn). MATERIAL AND METHODS: Anthropometric parameters, mean blood pressure, lipid profile, thyroid stimulating hormone and fasting glucose were measured in 489 subjects aged 39 ± 12 years (33% women) who attended a primary cardiovascular prevention (CV) program. A 24-hour recall and usual meal times were registered during a dietary interview. To determine the association between the consumption of "5CT" or dinner and the probability of presenting two or more components of MetSyn, we built an odds proportional model adjusted by age and sex. In addition, severity for MetSyn was calculated. RESULTS: Nineteen percent of participants had MetSyn and 39%, two or more MetSyn components. Those who consumed "5CT" instead of dinner, had 54% more probability of having 2 or more MetSyn components (Odds ratio = 1.54, confidence intervals 1.032.32, p = 0.04). Participants who included processed carbohydrates in their last meal had a higher probability of having components of MetSyn. This probability decreased among participants who ate dinner with a low proportion of refined carbohydrates. CONCLUSIONS: Subjects who eat "5CT", instead of dinner as the last meal, have a higher cardiometabolic risk and MetSyn severity.

Salud bucal, higiene y hábitos bucales en personas con trastorno del espectro autista / Oral health, hygiene practices and oral habits of people with autism spectrum disorder

ABSTRACT Introduction: People with autism spectrum disorder have a higher risk of dental complications due to the characteristics of the condition itself. Objective: To describe the oral health status, hygiene practices and oral habits of a group of Chilean children, adolescents and adults with autism spectrum disorder. Methods: A descriptive study was conducted of 123 subjects with autism spectrum disorder. A questionnaire was applied which dealt with socio-demographic information, dental history, oral hygiene practices and oral habits. Each participating subject underwent oral examination to determine their experience with and prevalence of caries, scores on the Simplified Oral Hygiene Index and the gingival index, and the presence of dental trauma, deep/ogival palate, anterior open bite, and anterior and posterior crossbite. Results: 48 percent of the subjects with autism spectrum disorder brushed twice a day, and 68.0 percent required assisted tooth-brushing; 94.3 percent had oral habits, of which bruxism and oral breathing were the most frequent, accounting for 57.7 percent and 52.9 percent, respectively. Prevalence of caries was 33.3 percent, the dental caries index for permanent dentition was 1.1 ± 1.8, and the dental caries index for deciduous and permanent dentition was 2.6 ± 3.3. OHI-S for the 123 subjects was 1.30 ± 0.58. Conclusions: Most subjects required assistance with tooth-brushing and brushed twice a day. Bruxism and oral breathing were the most prevalent oral habits. A low prevalence of caries, a very low dental caries index for permanent dentition and a fair Oral Hygiene Index were observed in the 123 subjects with autism spectrum disorder(AU)

RESUMEN Introducción: Las personas con trastorno del espectro autista tienen un mayor riesgo de presentar complicaciones dentales, debido a las características propias de la enfermedad. Objetivo: Describir el estado de salud bucal, hábitos de higiene y hábitos bucales de un grupo de niños, adolescentes y adultos chilenos con trastorno del espectro autista. Métodos: Se realizó un estudio descriptivo de 123 sujetos con trastorno del espectro autista. Se aplicó un cuestionario sobre información socio-demográfica, antecedentes dentales, hábitos de higiene bucal y hábitos bucales, y se realizó un examen odontológico a cada participante para determinar la experiencia y prevalencia de caries, la puntuación según el índice de higiene bucal simplificado y el índice gingival, así como la presencia de traumatismo dentario, paladar profundo/ojival, mordida abierta anterior y mordida cruzada anterior y posterior. Resultados: El 48 por ciento de los sujetos con trastorno del espectro autista se cepillaba dos veces al día y el 68,0 por ciento tenía un cepillado asistido. El 94,3 por ciento presentaba hábitos bucales, de los cuales los más frecuentes eran el bruxismo con 57,7 por ciento y la respiración bucal con 52,9 por ciento. La prevalencia de caries fue de 33,3 por ciento, el índice total de caries en dentición permanente de 1,1 ± 1,8 y el índice total de caries en dentición temporal y permanente de 2,6 ± 3,3. El índice de higiene bucal simplificado para los 123 sujetos fue de 1,30 ± 0,58. Conclusiones: La mayor parte de los sujetos tenían un cepillado asistido y lo realizaban dos veces al día. Los hábitos bucales más prevalentes fueron el bruxismo y la respiración bucal. En los 123 sujetos con trastorno del espectro autista se observó una baja prevalencia de caries, un índice total de caries en dentición permanente muy bajo y un índice de higiene bucal regular(AU)

Conocimiento sobre enfermedad coronaria en familiares de pacientes con evento cardiovascular / Knowledge about coronary disease in relatives of patients with cardiovascular event

Objetivo: describir los conocimientos que refieren los familiares de sujetos con enfermedad cardiovascular, previo a la asistencia a un taller educativo. Materiales y métodos: estudio descriptivo en 103 familiares de pacientes con enfermedad cardiovascular, que participaron en talleres educativos relacionados con enfermedad coronaria entre marzo y agosto de 2013. Los talleres eran los siguientes: 1. La enfermedad coronaria; 2. Ejercicio en enfermedad cardiovascular; 3. Adherencia a medicamentos y 4. Factores psicosociales y enfermedad cardiovascular. Se compararon diferencias entre proporción de sujetos con conocimiento informal y formal en cada taller. Resultados:103 familiares participaron en los talleres (80% mujeres; edad promedio 49± 1.55años). El 39% refiere no tener ningún conocimiento respecto al tema a tratar. El 28% sí tiene conocimientos sobre el tema y la obtiene de fuentes informales como internet, diarios o revistas. Existió una proporción significativamente mayor de sujetos con conocimiento informal sobre ejercicio y adherencia a medicamentos. Conclusiones: estos resultados muestran que: hay poco conocimiento formal de enfermedad cardiovascular y del manejo de sus factores de riesgo, y alto nivel de apoyo del sexo femenino. La necesidad de educar, reforzar y aclarar el conocimiento para mejorar la adherencia al tratamiento y la prevención de nuevos eventos cardiovasculares, es un trabajo importante de enfermería, que debe desarrollarse prestando especial atención al entorno familiar del paciente..(AU)

Objective: to describe the knowledge referred by relatives of subjects with cardiovascular disease prior to attending an educational workshop. Materials and methods:descriptive study in 103 relatives of patients with cardiovascular disease, who participated in educational workshops related to coronary disease between March and August 2013. The workshops were the following: 1. Coronary disease; 2. Exercise in cardiovascular disease; 3. Adherence to medications and 4. Psychosocial factors and cardiovascular disease. Differences were compared between proportion of subjects with informal and formal knowledge in each workshop. Results: 103 relatives participated in the workshop (80% women, average age 49 ± 1.55 years). 39% report having no knowledge about the subject to be treated. 28% do have knowledge about the subject and get it from informal sources such as the internet, newspapers or magazines. There was a significantly higher proportion of subjects with informal knowledge about exercise and medication adherence. Conclusions: these results show that: there is little formal knowledge of cardiovascular disease and the management of its risk factors, and high level of support of the female sex. The need to educate, reinforce and clarify knowledge to improve adherence to treatment and the prevention of new cardiovascular events, is an important work of nursing, which should be developed paying special attention to the patient's family environment..(AU)

La ingesta de "once", en reemplazo de la cena, se asocia al riesgo de presentar síndrome metabólico / Five o'clock tea and the risk of metabolic syndrome

Background: Seventy four percent of Chileans replaced the traditional dinner for the consumption of "five o'clock tea" (5CT), a mealtime that includes bread and is simliar to western breakfast. The latter favors the intake of unhealthy foods. Aim: To study whether the consumption of "5CT", instead of dinner, could be a risk factor for the development of metabolic syndrome (MetSyn). Material and Methods: Anthropometric parameters, mean blood pressure, lipid profile, thyroid stimulating hormone and fasting glucose were measured in 489 subjects aged 39 ± 12 years (33% women) who attended a primary cardiovascular prevention (CV) program. A 24-hour recall and usual meal times were registered during a dietary interview. To determine the association between the consumption of "5CT" or dinner and the probability of presenting two or more components of MetSyn, we built an odds proportional model adjusted by age and sex. In addition, severity for MetSyn was calculated. Results: Nineteen percent of participants had MetSyn and 39%, two or more MetSyn components. Those who consumed "5CT" instead of dinner, had 54% more probability of having 2 or more MetSyn components (Odds ratio = 1.54, confidence intervals 1.032.32, p = 0.04). Participants who included processed carbohydrates in their last meal had a higher probability of having components of MetSyn. This probability decreased among participants who ate dinner with a low proportion of refined carbohydrates. Conclusions: Subjects who eat "5CT", instead of dinner as the last meal, have a higher cardiometabolic risk and MetSyn severity.

Cintura e índice de masa corporal: los mejores predictores antropométricos en la reducción y progresión de la agregación de factores de riesgo cardiometabólicos / Waist and body mass index: The best anthropometric predictors in the reduction and progression of the aggregation of cardiometabolic risk factor

El objetivo de este estudio fue determinar el impacto de la variación de distintas mediciones antropométricas en la evolución del síndrome metabólico (SM). El estudio fue prospectivo en 178 sujetos que asistieron a un programa de salud cardiovascular entre el año 2013 y 2016. Se recolectaron datos demográficos, historia médica, factores de riesgo cardiovascular, y se midió perfil lipídico, glicemia de ayuno, presión arterial y medidas antropométricas (IMC, perímetro de cintura y cadera y % de grasa corporal). Se consideró la agregación de 2 o más componentes de síndrome metabólico (SM), excluyendo cintura y se determinó la probabilidad de reversión del SM, considerándose como la reducción desde 2 o más componentes a 1 o ninguno. El tiempo de seguimiento promedio fue de 2 años. La edad promedio fue de 40 años y 37% eran mujeres. Según los modelos de odds proporcionales, ajustados por edad, sexo y tiempo de seguimiento, aquellos sujetos con 2 o más componentes de SM triplicaron su probabilidad de revertir el SM por cada reducción de 1 Kg/m2 de IMC por año (OR IMC = 3,03; 1,74-5,28; p<0,001). En el caso de cintura, esta probabilidad aumentó en 52% por la reducción de 1 cm por año (ORcintura =1,52; 1,28-1,81; p<0,001). Finalmente una reducción de 0,01 en el índice cintura/cadera aumentó en 26% la probabilidad de revertir el SM (ORcintura/cadera =1,26; 1,06-1,491; p<0,01); sin embargo, el % de grasa corporal no tuvo un efecto significativo Los cambios en IMC y circunferencia de cintura serían los parámetros antropométricos más confiables para monitorear la evolución del SM(AU)

The objective of this study was to determine the impact of variation of different anthropometric parameters at follow-up in the evolution of the metabolic syndrome (MetS). Prospective study in 178 subjects who attended a cardiovascular health program between 2013 and 2016. Demographical data, medical history and cardiovascular (CV) risk factors (RFs) were collected. In addition, fasting lipid profile, blood glucose, blood pressure and anthropometrical parameters (BMI, WC, hip, and fat percentage) were measured. To determine the evolution of MetS, the clustering of 2 or more of the MetS components were considered, excluding WC. Odds proportional models adjusted by age, sex and time of follow-up were built to determine the probability of reverting the MetS. MetS reversion was considered as the reduction to 1 or 0 components in subjects with 2 or more. Mean follow-up time was 2 years. Mean age was 40 years old and 37% were women. According to the odds proportional models, subjects tripled their chance of reverting MetS for each 1 kg/m2 of BMI reduction (ORBMI=3.03; 1.74-5.28; p<0.001). For WC, the chance of reverting MetS increased 52% for each reduction of 1 cm of waist (ORwaist =1.52; 1.28-1.81; p<0.001). A reduction of 0.01 in the waist to hip ratio increased in 26% the chance of reverting MetS (ORwaist/hip=1.26; 1.06-1.491; p<0.01); however, fat percentage did not have a significant effect on the evolution of the MetS. BMI and WC are the most reliable anthropometrical parameters for monitoring the evolution of MetS aggregation in the out-patient clinical setting(AU)

[Evaluation the American College of Cardiology and American Heart Association Predictive score for cardiovascular diseases]. / Superioridad del nuevo puntaje de riesgo ACC/AHA 2013 por sobre el puntaje de Framingham, en la predicción de riesgo de mortalidad cardiovascular en Santiago.

BACKGROUND: Recently, the American College of Cardiology and American Heart Association (ACC/AHA) proposed a new cardiovascular risk (CV) score. AIM: To evaluate the new risk score (ACC/AHA 2013) in a Chilean population. MATERIAL AND METHODS: Between 2002 and 2014, body mass index (BMI), waist circumference, blood pressure, lipid profile and fasting blood glucose levels were measured and a survey about CV risk factors was responded by 3,284 subjects aged 40 to 79 years (38% females), living in urban Santiago. ACC/AHA 2013, FRAM and Chilean FRAM scores were calculated. All-cause mortality was determined in July 2014 by consulting the Death Registry of the Chilean Identification Service, with an average follow up of 7 ± 3 years. RESULTS: The prevalence of risk factors were 78% for dyslipidemia, 37% for hypertension, 20% for smoking, 7% for diabetes, 20% for obesity and 54% for physical inactivity. The mean FRAM, Chilean FRAM and ACC/AHA scores were 8, 3 and 9%, respectively. During follow-up, 94 participants died and 34 deaths were of cardiovascular cause. Participants who died had a higher prevalence of hypertension (p < 0.01) and diabetes (p < 0. 01) and tended to be older (p = 0.06). The FRAM score for 10 years for deceased and surviving patients was 12 and 8%, respectively (p = NS). The figures for the Chilean FRAM were 5 and 2%, respectively (p = 0.09). The figures for the ACC/AHA 2013 score were 33 and 9%, respectively (p = 0.04). According to receiver operating characteristic curves, ACC/AHA 2013 had a higher area under de curve for CV mortality than FRAM and Chilean FRAM. CONCLUSIONS: The new ACC/AHA 2013 score, is better than traditional FRAM and Chilean FRAM scores in predicting cardiovascular mortality in a low risk population.

Does Good Aerobic Capacity Attenuate the Effects of Aging on Cardiovascular Risk Factors? Results from a Cross-Sectional Study in a Latino Population.

Background. High aerobic capacity is associated with low cardiovascular (CV) risk. The aim of this study was to determine the CV RF burden in subjects with aerobic capacity ≥10 METs and compare it with those having <10 METs. Methods. Cross-sectional study in 2646 subjects (mean age 48 ± 12 years). Demographics, medical history, physical activity, cardiovascular RFs, fasting lipids and blood glucose levels, blood pressure, and anthropometric measurements were collected. Aerobic capacity was determined by exercise stress test. The ACC/AHA 2013 pooled cohort equation was used to calculate CV risk. Logistic models were built to determine the probability of having ≥2 RFs versus 0-1 RF, by age and sex, according to aerobic capacity. Results. 15% of subjects had aerobic capacity < 10 METs. The ACC/AHA scores were 15% in men and 6% in women with <10 METs and 5% and 2%, respectively, in those with ≥10 METs. The probability of having ≥2 RFs increased with age in both groups; however, it was significantly higher in subjects with <10 METs (odds ratio [OR]: 2.54; 95% CI: 1.92-3.35). Conclusions. Aerobic capacity ≥ 10 METs is associated with a better CV RF profile and lower CV risk score in all age groups, regardless of gender.

Superioridad del nuevo puntaje de riesgo ACC/AHA 2013 por sobre el puntaje de Framingham, en la predicción de riesgo de mortalidad cardiovascular en Santiago / Evaluation the American College of Cardiology and American Heart Association Predictive score for cardiovascular diseases

Background: Recently, the American College of Cardiology and American Heart Association (ACC/AHA) proposed a new cardiovascular risk (CV) score. Aim: To evaluate the new risk score (ACC/AHA 2013) in a Chilean population. Material and Methods: Between 2002 and 2014, body mass index (BMI), waist circumference, blood pressure, lipid profile and fasting blood glucose levels were measured and a survey about CV risk factors was responded by 3,284 subjects aged 40 to 79 years (38% females), living in urban Santiago. ACC/AHA 2013, FRAM and Chilean FRAM scores were calculated. All-cause mortality was determined in July 2014 by consulting the Death Registry of the Chilean Identification Service, with an average follow up of 7 ± 3 years. Results: The prevalence of risk factors were 78% for dyslipidemia, 37% for hypertension, 20% for smoking, 7% for diabetes, 20% for obesity and 54% for physical inactivity. The mean FRAM, Chilean FRAM and ACC/AHA scores were 8, 3 and 9%, respectively. During follow-up, 94 participants died and 34 deaths were of cardiovascular cause. Participants who died had a higher prevalence of hypertension (p < 0.01) and diabetes (p < 0. 01) and tended to be older (p = 0.06). The FRAM score for 10 years for deceased and surviving patients was 12 and 8%, respectively (p = NS). The figures for the Chilean FRAM were 5 and 2%, respectively (p = 0.09). The figures for the ACC/AHA 2013 score were 33 and 9%, respectively (p = 0.04). According to receiver operating characteristic curves, ACC/AHA 2013 had a higher area under de curve for CV mortality than FRAM and Chilean FRAM. Conclusions: The new ACC/AHA 2013 score, is better than traditional FRAM and Chilean FRAM scores in predicting cardiovascular mortality in a low risk population.

Impacto de un programa de rehabilitación cardiovascular fase II sobre la calidad de vida de los pacientes / Quality of life: impact of a phase II cardiovascular rehabilitation program

Antecedentes: La rehabilitación cardiovascular (RCV) ha demostrado mejorar la capacidad física (CF) y la calidad de vida. La relación de estos aspectos ha sido escasamente reportada en Chile. Objetivos: 1) Determinar el impacto de la RCV fase II sobre la calidad de vida, medida por la encuesta SF36 y, 2) determinar qué factores, relacionados con el paciente, pueden incidir en esta relación. Método: Estudio prospectivo en sujetos que completaron 36 sesiones de un programa de RCV y Prevención Secundaria (PREV2). Se registraron al ingreso y final de la RCV: antecedentes médicos, factores de riesgo cardiovascular (CV), parámetros antropométricos, previsión de salud, CF (determinada por los metros caminados en test de marcha de 6 minutos-TM6) y puntaje en la encuesta SF36. Resultados: 277 sujetos (78% hombres, edad 59 años). Hubo una mejoría significativa en: a) los metros caminados (diferencia final/inicial= 56 metros, p<0.0001), b) puntaje de salud física (68 vs 79; p<0.0001), c) salud emocional (68 vs 78, p<0.0001) del SF36. Los hombres caminaron más metros promedio (p<0.0001). Hubo una asociación significativa entre los deltas del TM6 final-inicial y SF36 final-inicial, sólo para salud física (p<0.01). Por un aumento de 10 metros caminados en el TM6 final se incrementa el puntaje de la SF36 para salud física (Hombres: 0.38/ Mujeres: 1.52). La mejoría en la salud emocional sólo se asoció significativamente con los cambios en la salud física (p<0.0001). Conclusion: Los pacientes que asisten a un programa de RCV mejoran significativamente su capacidad aeróbica, y su percepción de salud física y emocional.

Background: Cardiovascular rehabilitation (CVR) has been shown to improve functional capacity (FC) and quality of life. The relation between these aspects has been scarcely reported in Chile. Objectives: 1) To determine the impact of the CVR phase II program on quality of life as measured by the SF36 survey and 2) to determine which patient related factors can influence this relationship. Method: Prospective study in subjects who completed 36 sessions of an RCV and Secondary Prevention program (PREV2). Medical records, cardiovascular risk factors (CV), anthropometric parameters, health forecast, functional capacity (FC) (determined by meters walked on 6-minute Walking test-TM6) and SF36 scores were recorded at the beginning and end of the CVR. Results: Data on 277 subjects (78% men, age 59 years) was analyzed. There was a significant improvement in: a) walking meters (final / initial difference = 56 meters, p <0.0001), b) physical health score (68 vs 79, p <0.0001), c) emotional health (68 vs 78, p <0.0001) of the SF36. The men walked more meters (p <0.0001). There was a significant association between delta TM6 final-initial and SF36 final-initial only for physical health (p <0.01). For an increase of 10 meters walked in the final TM6, SF36 score for physical health increased 0.38 points in men ad 1.52 in women. Improvement in emotional health was significantly associated only with changes in physical health (p <0.0001). Conclusion: Patients attending a phase II cardiovascular rehabilitation program significantly improve their aerobic capacity, and their perception of physical and emotional health.

Impaired Fasting Glucose in Nondiabetic Range: Is It a Marker of Cardiovascular Risk Factor Clustering?

BACKGROUND: Impaired fasting glucose (IFG) through the nondiabetic range (100-125 mg/dL) is not considered in the cardiovascular (CV) risk profile. AIM: To compare the clustering of CV risk factors (RFs) in nondiabetic subjects with normal fasting glucose (NFG) and IFG. MATERIAL AND METHODS: Cross-sectional study in 3739 nondiabetic subjects. Demographics, medical history, and CV risk factors were collected and lipid profile, fasting glucose levels (FBG), C-reactive protein (hsCRP), blood pressure (BP), anthropometric measurements, and aerobic capacity were determined. RESULTS: 559 (15%) subjects had IFG: they had a higher mean age, BMI, waist circumference, non-HDL cholesterol, BP, and hsCRP (p < 0.0001) and lower HDL (p < 0.001) and aerobic capacity (p < 0.001). They also had a higher prevalence of hypertension (34% versus 25%; p < 0.001), dyslipidemia (79% versus 74%; p < 0.001), and obesity (29% versus 16%; p < 0.001) and a higher Framingham risk score (8% versus 6%; p < 0.001). The probability of presenting 3 or more CV RFs adjusted by age and gender was significantly higher in the top quintile of fasting glucose (≥98 mg/dL; OR = 2.02; 1.62-2.51). CONCLUSIONS: IFG in the nondiabetic range is associated with increased cardiovascular RF clustering.

Body fat and its relationship with clustering of cardiovascular risk factors.

BACKGROUND: Body mass index (BMI) and waist circumference (WC) are the most commonly measured anthropometric parameters given their association with cardiovascular risk factors (RFs). The relationship between percentage body fat (%BF) and cardiovascular risk has not been extensively studied. AIMS: This study evaluated %BF and its relationship with cardiometabolic RFs in healthy subjects and compared these findings with the relationship between BMI/ WC and cardiovascular RFs. METHODS: This was a cross-sectional study of 99 males and 83 females (mean age 38 ± 10 years) evaluated in a preventive cardiology program. All subjects completed a survey about RFs and lifestyle habits. Anthropometric parameters, systolic blood pressure (SBP), diastolic blood pressure (DBP), fasting lipid profile, and blood glucose were collected. Body fat was determined using four skinfold measurements. Fat mass index (FMI) was also calculated. RESULTS: Percentage body fat was significantly and directly associated with total cholesterol (R(2)=0.11), triglycerides (R(2)=0.14), low-density lipoprotein cholesterol (R(2)=0.16), non-high-density lipoprotein cholesterol (R(2)=0.24), fasting blood glucose (R(2)=0.16), SBP (R(2)=0.22), and DBP (R(2)=0.13) (p<0.001 for all) and inversely related to high-density lipoprotein cholesterol (R(2)=0.32; p<0.001). When the models of %BF, FMI, WC, and BMI were compared, all of them were significantly related to the same cardiometabolic RFs and the clustering of them. CONCLUSION: Percentage body fat and FMI were significantly associated with biochemical variables and to the clustering of RFs. However, these associations were similar but not better than WC and BMI.

Introducción: El índice de masa corporal (IMC) y la circunferencia de cintura (CC) son los parámetros antropométricos que se miden con mayor frecuencia dada su asociación con los factores de riesgo cardiovascular (RC). La relación entre el porcentaje de grasa corporal (%GC) y el riesgo cardiovascular no se ha estudiado ampliamente. Objetivo: Evaluar el %GC y su relación con los FR cardiometabólico en sujetos sanos y comparar estos resultados con la relación IMC/CC y FR cardiovascular Métodos: Se realizó un estudio transversal en 99 hombres y 83 mujeres participantes asistentes a un programa de cardiología preventiva (edad 38 ± 10 años). Todos los sujetos completaron una encuesta sobre los FR y hábitos de estilos de vida. Se evaluaron antropométricamente , se les tomo presión arterial sistólica (PAS) y diastólica (PAD), perfil lipídico y glicemia en ayunas. La grasa corporal se determinó a través de cuatro mediciones de pliegues cutáneos. También se calculó el índice de masa grasa (IMG). Resultados: El porcentaje de grasa corporal se asoció significativamente y directamente con el colesterol total (R2=0,11), triglicéridos (R2=0,14), colesterol LDL (R2=0,16), colesterol VLDL (R2=0,24), glicemia (R2=0,16), PAS (R2=0,22) y PAD (R2=0,13) (p.

Resting position of the head and malocclusion in a group of patients with cerebral palsy.

UNLABELLED: Cerebral palsy are found as a result of these disorders, along with associated neuromuscular functional alterations that affect the resting position of the head. In this context, the resting position of the head could be responsible for several skeletal and dental occlusal disorders among patients with cerebral palsy. OBJECTIVE: To assess the presence of malocclusions in patients with cerebral palsy, define the most frequent types of malocclusions, and evaluate how the resting position of the head may be implicated in the development of such malocclusions. STUDY DESIGN: Forty-four patients aged between 12-55 years (18 males and 26 females) were studied. Occlusal conditions, the Dental Aesthetic Index (DAI), changes in the resting position of the head, and breathing and swallowing functions were assessed. RESULTS: Orthodontic treatment was required by 70.8% of the patients, the most frequent malocclusions being molar class II, open bite and high overjet. These individuals showed altered breathing and swallowing functions, as well as habit and postural disorders. The resting position of the head, especially the hyperextended presentation, was significantly correlated to high DAI scores. CONCLUSIONS: The results obtained suggest that patients with cerebral palsy are more susceptible to present malocclusions, particularly molar class II malocclusion, increased open bite, and high overjet. Such alterations in turn are more common in patients with a hyperextended position of the head. Key words:Cerebral palsy, malocclusion, head position, disabled patients.

Training adults and children with an autism spectrum disorder to be compliant with a clinical dental assessment using a TEACCH-based approach.

The specific neuropsychological and sensory profile found in persons with autism spectrum disorders complicate dental procedures and as a result of this, most are treated under general anesthesia or unnecessary sedation. The main goal of the present study was to evaluate the effectiveness of a short treatment and education of autistic and related communication-handicapped children-based intervention program (five sessions) to facilitate a 10-component oral assessment in children (n = 38, aged 4-9 years) and adults (n = 34, aged 19-41) with autism spectrum disorder (with or without associated intellectual disability). The assessment ranges from entering into the examination room to the evaluation of the dental occlusion. There were statistically significant differences in the number of components reached and in compliance before and after the training program.

Oral manifestations in a group of adults with autism spectrum disorder.

OBJECTIVE: A number of studies have evaluated the buccodental health of patients with autism spectrum disorder (ASD), though most have involved children, and no specific oral manifestations have been described. The present study describes the buccodental disorders and hygiene habits in a group of adults with ASD. STUDY DESIGN: A prospective case-control study was made of a group of patients with ASD (n=30), with a mean age of 27.7±5.69 years, and of a healthy age- and gender-matched control group (n=30). An evaluation was made of the medical history, medication, oral hygiene habits and oral diseases, with determination of the CAOD, CAOS and OHI-S oral hygiene scores. RESULTS: Most of the patients in the ASD group used two or more drugs and were assisted in brushing 2-3 times a day. The most frequent manifestations were bruxism, self-inflicted oral lesions and certain malocclusions. The CAOD and CAOS scores were significantly lower than in the controls. CONCLUSIONS: Adults with ASD and assisted dental hygiene presented fewer caries than the non-disabled population. However, bruxism, ogival palate and anterior open bite were frequent in the patients with ASD.

[Association between cardiorespiratory fitness and cardiovascular risk factors in healthy individuals]. / Actividad física y potencia aeróbica: ¿Cómo influyen sobre los factores de riesgo cardiovascular clásicos y emergentes?

BACKGROUND: Cardio respiratory fitness (FIT) is associated with a better profile in most modifiable cardiovascular risk factors (RF). In Chile, sedentary lifestyle is highly prevalent, reaching almost 90%. AIM: To determine the association between FIT and traditional and emergent RF in a primary prevention population. MATERIAL AND METHODS: We prospectively studied 1973 subjects (36% women, mean age 56+/- 13 years) without history of cardiovascular disease and absence of ischemic changes on exercise testing. We assessed cardiovascular RF and determined body mass index (BMI), waist circumference, systolic and diastolic blood pressure, fasting blood lipids, glucose, C-reactive protein (CRP) and fibrinogen. FIT was measured by a Sci f-reported physical activity questionnaire and by a maximal treadmill exercise test, expressed in metabolic equivalents (METs). RESULTS: Subjects in the highest FIT according to the treadmill test had significantly lower BMI, waist circumference, systolic and diastolic blood pressure, total cholesterol, triglycerides, glucose, CRP and fibrinogen, and higher HDL cholesterol (adjusted by age and gender). LDL cholesterol did not show significant changes. The same pattern of RF (including LDL cholesterol) and CRP was observed when using Sci f-reported physical activity as a FIT parameter There was a significant association between both methods to measure FIT (p <0.0001, Chi-square Mantel-Haenszel). CONCLUSIONS: Our findings show that a better level off IT, assessed by exercise testing or through Sci f report is associated with improved levels of traditional and emergent RF.