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BACKGROUND: Therapeutic drug monitoring (TDM) of everolimus is required to prevent organ rejection in patients who have undergone transplant. Volumetric absorptive microsampling (VAMS) is a minimally invasive method for accurately collecting a small amount of blood from a patient's fingers. This study aimed to assess the applicability of VAMS for TDM of everolimus. METHODS: VAMS and venous blood samples were collected from 45 liver transplant recipients who had been receiving stable everolimus doses for at least 7 days. Whole blood everolimus concentrations were measured using ultrahigh performance liquid chromatography with tandem mass spectrometry. Deming regression and Bland-Altman analysis were performed to compare everolimus concentrations measured using VAMS (C VAMS ) and venous blood samples (C IV ). The regression coefficient (r 2 ) between C VAMS and C IV was calculated using a linear regression. The effects of the hematocrit and blood sampling time on the difference between C VAMS and C IV were investigated. RESULTS: Thirty-two participants were included in the final analysis. The Deming regression line was C IV = 1.04 × C VAMS + 0.55 [95% confidence interval (CI) of slope, 0.91-1.18; 95% CI of intercept, -0.05 to 1.16]. C VAMS and C IV were strongly correlated (r 2 = 0.92), with no proportional or constant bias. The mean difference between C VAMS and C IV was -0.79 ng/mL, with the 95% limit of agreement ranging from -2.55 to 0.97 ng/mL in a Bland-Altman plot. No effect of the hematocrit or blood sampling time was observed. CONCLUSIONS: VAMS and venous blood sampling showed good agreement for the measurement of whole blood everolimus concentrations. Less invasive VAMS can substitute for more invasive venous blood sampling in the TDM of everolimus in liver transplant patients.
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Everolimus , Trasplante de Hígado , Humanos , Everolimus/uso terapéutico , Monitoreo de Drogas/métodos , Cromatografía Liquida/métodos , Recolección de Muestras de Sangre/métodos , Pruebas con Sangre Seca/métodosRESUMEN
WHAT IS KNOWN AND OBJECTIVE: Dried blood spot (DBS) sampling is a minimally invasive method of blood sampling that enables monitoring of drug concentrations to be more convenient. This study aimed at developing a DBS sampling method for an accurate and precise prediction of radotinib plasma concentrations (Cp ) in patients with chronic myeloid leukaemia (CML). METHODS: Dried blood spot and venous blood samples were simultaneously collected from fifty CML patients who had been receiving radotinib for at least a week. Radotinib concentrations were measured using a high-performance liquid chromatographic method with tandem mass spectrometric detection. Unmeasured Cp was predicted directly based on a Deming regression between DBS concentrations (CDBS ) and Cp . Unmeasured Cp was also predicted from CDBS corrected by each patient's haematocrit (Hct). Both prediction methods were evaluated for their accuracy and precision using Deming regression and Bland-Altman analysis. RESULTS AND DISCUSSION: The Deming regression equation between CDBS and Cp was obtained as follows: Cp = 1.34âCDBS + 4.26 (r2 = .97). Cp was directly predictable using Cp,pred1 = 1.34âCDBS + 4.26. With Hct correction, Cp was alternatively predictable using Cp,pred2 = CDBS / (1-Hct + Hct2 ). The slopes of Deming regression line between predicted and measured Cp were 0.99 and 1.02 for the direct and Hct-corrected method, respectively. The mean biases (accuracy) were -0.44% and 1.6% with the 95% limits of agreement (precision) of -22.4% to 21.5% and -20.5% to 23.7%, respectively. More than 93% of predicted and measured Cp pairs had their differences within 20% of the mean of each pair in both methods. WHAT IS NEW AND CONCLUSIONS: Radotinib CDBS are highly correlated with radotinib Cp. Radotinib Cp can be accurately and precisely predicted from CDBS using direct or Hct-corrected prediction methods. Both appear to be appropriate for the therapeutic monitoring of radotinib in patients with CML.
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Benzamidas/administración & dosificación , Pruebas con Sangre Seca/métodos , Leucemia Mielógena Crónica BCR-ABL Positiva/tratamiento farmacológico , Inhibidores de Proteínas Quinasas/administración & dosificación , Pirazinas/administración & dosificación , Adulto , Anciano , Benzamidas/farmacocinética , Cromatografía Líquida de Alta Presión/métodos , Monitoreo de Drogas/métodos , Femenino , Humanos , Masculino , Persona de Mediana Edad , Inhibidores de Proteínas Quinasas/farmacocinética , Pirazinas/farmacocinética , Reproducibilidad de los Resultados , Espectrometría de Masas en Tándem/métodos , Adulto JovenRESUMEN
AIM: The aim of this study was to investigate if pregnant women with both obesity and periodontitis are more likely to experience preterm birth (PTB) in women with pre-eclampsia (PE) than pregnant women with only obesity or only periodontitis. MATERIALS AND METHODS: The study examined a total of 328 pregnant women at 21-24 weeks of gestation. Overweight and obesity was defined based on criteria proposed by the WHO Expert Consultation. Periodontal conditions were assessed by measuring periodontal clinical attachment loss. PTB was defined as delivery at <37 weeks, and PE was defined as blood pressure higher than 140/90 mmHg on two separate occasions with at least 1+ proteinuria on a random urine screen after the 20th week of pregnancy. RESULTS: After adjusting for other important cofactors, pregnant women with periodontitis were 5.56 times [95% confidence interval (CI) = 1.22-25.39] more likely to have PTB with PE than women without periodontitis. The association was much stronger (odds ratio = 15.94, 95% CI = 3.31-76.71) in women with both obesity and periodontitis. CONCLUSIONS: Our results of this study indicate that pregnant women with both pre-pregnancy obesity and periodontitis are significantly more likely to have PTB with PE than pregnant women with only periodontitis.
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Periodontitis , Femenino , Humanos , Recién Nacido , Obesidad , Pérdida de la Inserción Periodontal , Preeclampsia , Embarazo , Nacimiento Prematuro , Estudios ProspectivosRESUMEN
BACKGROUND: Oily fish is a major dietary source of omega-3 polyunsaturated fatty acids (ω-3 PUFAs). These nutrients improve endothelial dysfunction, reduce ß-amyloid induced damage of neurovascular units, and might prevent the occurrence of cerebral microbleeds. However, this relationship has not been investigated so far. AIM: To evaluate the association between oily fish intake and cerebral microbleeds in a population of frequent fish consumers living in coastal Ecuador. METHODS: Cerebral microbleeds were identified by gradient-echo MRI and oily fish consumption was calculated in community-dwellers aged ≥60 years enrolled in the Atahualpa Project. The association between cerebral microbleeds and fish servings was examined in regression models adjusted for relevant confounders. A predictive model was constructed using quintiles of fish servings to take into account the non-linearity in the relationship. RESULTS: Out of 311 eligible individuals, 293 (94 %) were enrolled. Cerebral microbleeds were recognized in 37 (13 %) individuals. Mean fish consumption was 8.8 ± 5.4 servings per week (ω-3 PUFAs estimates: 10.2 ± 7.1 g). Multivariate analysis showed an inverse relationship between cerebral microbleeds and fish consumption (p < 0.001). Predictive margins of CMB were higher for individuals in the lowest (≤4.3) than for those in the highest (≥13.1) quintile of fish servings (17.4 vs 2.3 %, p < 0.001). CONCLUSIONS: This study shows a lower cerebral microbleed presence among older adults eating large amounts of oily fish (13 servings per week, equivalent to about 15 g of ω-3 PUFAs). These high requirements can be more readily accomplished in other populations by taking fish oil preparations. Longitudinal studies are warranted to assess whether these interventions reduce incident cerebral microbleeds in high-risk individuals.
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Hemorragia Cerebral/prevención & control , Ácidos Grasos Omega-3/administración & dosificación , Alimentos Marinos , Anciano , Anciano de 80 o más Años , Animales , Dieta , Femenino , Peces , Humanos , Masculino , Persona de Mediana EdadRESUMEN
Due to their high content of omega-3 polyunsaturated fatty acids, oily fish consumption is likely associated with a better cognitive performance. However, information on this association is controversial, with some studies showing a positive effect while others showing no association. We aimed to assess the effects of oily fish consumption on cognitive performance in a population of frequent fish consumers living in rural coastal Ecuador. Atahualpa residents aged ≥60 years were identified during a door-to-door survey and evaluated by the use of the Montreal Cognitive Assessment (MoCA). Oily fish servings per week were calculated in all participants. We estimated whether fish intake correlated with MoCA scores in generalized multivariate linear models adjusted for demographics, cardiovascular risk factors, edentulism and symptoms of depression. Out of 330 eligible persons, 307 (93%) were enrolled. Mean MoCA scores were 19 ± 4.8 points, and mean oily fish consumption was 8.6 ± 5.3 servings per week. In multivariate analyses, MoCA scores were related to fish servings (ß 0.097, 95% CI 0.005-0.188, p = 0.038). Locally weighted scatterplot smoothing showed an inflection point in the total MoCA score curve at four fish servings per week. However, predictive margins of the MoCA score were similar across groups below and above this point, suggesting a direct linear relationship between oily fish intake and cognitive performance. Simple preventive measures, such as modifying dietary habits might be of value to reduce the rate of cognitive decline in community-dwelling older adults living in underserved populations.
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Cognición , Ácidos Grasos Omega-3/administración & dosificación , Conducta Alimentaria , Peces , Anciano , Anciano de 80 o más Años , Animales , Enfermedades Cardiovasculares/epidemiología , Trastornos del Conocimiento/epidemiología , Depresión/epidemiología , Ecuador/epidemiología , Femenino , Humanos , Masculino , Persona de Mediana Edad , Boca Edéntula/epidemiología , Pruebas Neuropsicológicas , Factores SocioeconómicosRESUMEN
BACKGROUND: The purposes of this study were to estimate the fluoride intake from food and drink in 5-year-old Korean children, and to measure the association between estimated fluoride intake and dental caries prevalence. METHODS: The study involved a secondary analysis of raw data from the 4(th) Korea National Health and Nutrition Examination Survey (KNHANES; 2007-2009). The study subjects were 167 boys and 147 girls aged 5 years who had undergone both physical and nutritional examination as part of the survey. The KNHANES comprised a health questionnaire, a physical examination, and a nutritional examination. The nutritional examination of KNHANES consisted of 3 parts: a dietary life survey, a food-frequency questionnaire, and a food intake investigation. The food intake investigation used the 24-h recall method, with information being provided by the children's parents. On the basis of this information, we evaluated the fluoride content in a total of 310 food items using the hexamethyldisiloxane (HMDS)-facilitated diffusion method, modified using Taves' microdiffusion method. As part of the KNHANES survey, oral examinations were conducted at a mobile examination centre by trained dentists using dental mirrors under a fluorescent light. These examinations were performed using methods proposed by the World Health Organization. RESULTS: The dietary fluoride intake of 5-year-old Korean children was estimated to be 0.35 mg/day, or 0.016 mg/kg/day. The "decayed or filled surfaces" (dfs) indices of primary teeth were higher in children who had a lower dietary intake of fluoride. There was a significant inverse association between dietary fluoride intake and the prevalence of dental caries. CONCLUSION: The inverse association between dietary fluoride intake levels and prevalence of dental caries implies that the introduction of community caries prevention programmes may be beneficial. Such programmes would include water fluoridation and a fluoride supplementation programme.
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Caries Dental/epidemiología , Fluoruros/administración & dosificación , Preescolar , Femenino , Humanos , Masculino , Encuestas Nutricionales , Prevalencia , República de CoreaRESUMEN
AIM: The aim of this prospective study was to investigate the relationship between periodontitis and preeclampsia in never-smokers. MATERIALS AND METHODS: Pregnant women were recruited at 21 to 24 weeks of gestation from March 2009 to June 2013. Information on demographics, health behaviours, obstetric history, and systemic diseases that can influence periodontal status and preeclampsia was collected. Full-mouth periodontal probing was performed by two trained examiners. The inter-examiner Kappa value was 0.822 for clinical attachment loss (CAL). Periodontitis was defined as clinical periodontal attachment loss (CAL) of 4.0 mm or greater on 2 or more sites not on the same tooth. Information on the occurrence of preeclampsia was collected by five obstetricians. RESULTS: We studied a total of 283 subjects, comprised of 67 subjects with periodontitis and 216 subjects without periodontitis. Of these, 13 (4.6%) women were diagnosed with preeclampsia. After adjusting for all confounders, the adjusted odds ratio of periodontitis for preeclampsia was 5.56 (95% confidence interval of 1.49-20.71). CONCLUSIONS: There was a significant relationship between periodontitis and the occurrence of preeclampsia among never-smokers.
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Periodontitis/complicaciones , Preeclampsia , Adulto , Consumo de Bebidas Alcohólicas , Índice de Masa Corporal , Estudios de Cohortes , Dispositivos para el Autocuidado Bucal , Raspado Dental , Ejercicio Físico , Femenino , Estudios de Seguimiento , Edad Gestacional , Conductas Relacionadas con la Salud , Estado de Salud , Humanos , Pérdida de la Inserción Periodontal/complicaciones , Índice Periodontal , Embarazo , Resultado del Embarazo , Nacimiento Prematuro , Estudios Prospectivos , Historia ReproductivaRESUMEN
AIMS: The aim of this study was to examine whether metabolic syndrome (MS) is associated with periodontitis in a representative sample of Korean adults, who were involved in the Fourth Korea National Health and Nutrition Examination Survey (KNHANES). MATERIALS AND METHODS: A total of 7178 subjects over the age of 19 years who participated in KNHANES were examined. MS was defined as the definition proposed by the National Cholesterol Education Program Adult Treatment Panel III and the abdominal obesity cut-off line based on Korean Society for the Study of Obesity. The periodontal status was assessed by the Community Periodontal Index. Multivariate logistic regression analysis was carried out adjusting for the sociodemographics, oral health behaviours and status, and health behaviour. All analyses considered a complex sampling design, and multivariate analysis was also performed in the subgroups (age, gender, current smoking status). RESULTS: Multivariate logistic regression analysis revealed significant associations between MS and periodontitis. After adjusting for all covariates, the adjusted odds ratio (OR) of periodontitis (community periodontal index ≥ 3) was 1.55 (1.32-1.83) for MS. In subgroup analysis, periodontitis is associated with MS in subjects over age 40 and the adjusted ORs were higher in females and in the smoker group than in males and in non-smokers. CONCLUSIONS: MS is associated with periodontitis.
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Síndrome Metabólico/complicaciones , Periodontitis/complicaciones , Adulto , Factores de Edad , Glucemia/análisis , Presión Sanguínea , HDL-Colesterol/sangre , Índice CPO , Femenino , Encuestas Epidemiológicas , Humanos , Modelos Logísticos , Masculino , Síndrome Metabólico/sangre , Persona de Mediana Edad , Obesidad Abdominal/complicaciones , Higiene Bucal , Índice Periodontal , Periodontitis/sangre , República de Corea , Triglicéridos/sangreRESUMEN
A limited sampling strategy (LSS) to estimate the exposure to isoniazid was developed considering N-acetyltransferase 2 (NAT2) genotypes in Korean patients with tuberculosis. The influence of the genotypes on the pharmacokinetics of isoniazid was also evaluated. A total of 33 participants participated in the study and received isoniazid 300 mg once daily. Evaluable participants consist of ten slow (SA), fourteen intermediate (IA) and six rapid acetylators (RA). As expected, isoniazid exposure was higher (mean AUC, 28.4 versus 7.6 mg*h/L) and systemic clearance lower (mean apparent clearance, 14.8 versus 50.6 L/h) in SAs than RAs. The formulas to estimate isoniazid exposure were constructed using one or more concentration-time points that correlate with the area under the concentration-time curve (AUC). The LSS using a formula of single concentration-time point at 4 h post dose (C4) is applicable for all acetylators to the therapeutic drug monitoring (TDM) of isoniazid in patients with tuberculosis when evaluated using the Deming regression and Bland-Altman plot (AUC = 1.53 + 10.03*C4, adjusted r2 = 0.95, p < 0.001). Considering that SAs are more prone to adverse effects, pre-dose NAT2 genotyping would be valuable for optimal isoniazid dosing in conjunction with TDM.
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Antituberculosos/farmacocinética , Arilamina N-Acetiltransferasa/genética , Isoniazida/farmacocinética , Variantes Farmacogenómicas , Tuberculosis/tratamiento farmacológico , Acetilación , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Antituberculosos/administración & dosificación , Arilamina N-Acetiltransferasa/metabolismo , Toma de Decisiones Clínicas , Cálculo de Dosificación de Drogas , Monitoreo de Drogas , Femenino , Genotipo , Humanos , Isoniazida/administración & dosificación , Masculino , Persona de Mediana Edad , Farmacogenética , Pruebas de Farmacogenómica , Fenotipo , Valor Predictivo de las Pruebas , Seúl , Resultado del Tratamiento , Tuberculosis/diagnóstico , Tuberculosis/microbiología , Adulto JovenRESUMEN
BACKGROUND: Dasatinib is administered at a fixed starting dosage of 100 mg once daily regardless of patient-specific factors. However, such fixed dosing may not be optimal for the treatment of Asian patients with chronic myeloid leukemia in chronic phase (CP-CML). PATIENTS AND METHODS: The dose-limiting toxicities (DLTs) and molecular responses (MRs) of dasatinib therapy were evaluated using clinical data obtained from 102 patients newly diagnosed with CP-CML at 17 hospitals in South Korea. RESULTS: By 36 months after the initiation of a fixed dose regimen of dasatinib 100 mg once daily as the first-line therapy, 55.9% of patients experienced at least one type of DLT. The 3 most frequent DLTs were thrombocytopenia (45.5%), pericardial or pleural effusion (30.9%), and anemia (7.3%). Patients with higher dasatinib dose adjusted for body weight (Dose/BW) had a greater rate of DLT occurrence (logit [P] = 1.58 × [Dose/BW] - 2.27, P = .03). As median Dose/BW increased from 1.23 to 2.00 mg/kg, the rate of DLT occurrence increased from 43.5% to 66.7% (P = .03). However, Dose/BW did not affect the achievement rate of major MR (60.9% to 69.6%, P = .92). CONCLUSION: The starting dosage of dasatinib may need to be reduced (eg, 80 mg once daily or lower) for Asian patients with CP-CML, especially with lighter BW, to alleviate the risk of DLT occurrence without compromising the achievement of MR.
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Pueblo Asiatico , Dasatinib/administración & dosificación , Leucemia Mielógena Crónica BCR-ABL Positiva/tratamiento farmacológico , Inhibidores de Proteínas Quinasas/administración & dosificación , Protocolos de Quimioterapia Combinada Antineoplásica/efectos adversos , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapéutico , Dasatinib/efectos adversos , Monitoreo de Drogas , Femenino , Humanos , Estimación de Kaplan-Meier , Leucemia Mielógena Crónica BCR-ABL Positiva/diagnóstico , Leucemia Mielógena Crónica BCR-ABL Positiva/etiología , Masculino , Dosis Máxima Tolerada , Terapia Molecular Dirigida/métodos , Oportunidad Relativa , Inhibidores de Proteínas Quinasas/efectos adversos , República de Corea , Resultado del TratamientoRESUMEN
Oily fish are recommended as part of a healthy diet due to their high content of long-chain omega-3 polyunsaturated fatty acids (ω-3 PUFAs), proteins, and other nutrients. There is preliminary evidence of beneficial effects of ω-3 PUFAs in the prevention of sarcopenia (a major component of frailty). In this study, we aimed to assess the relationship between dietary oily fish intake and a measure of frailty - the Edmonton Frail Scale (EFS) score - in community-dwelling older adults living in rural coastal Ecuador. A total of 363 Atahualpa residents were enrolled. The mean fish servings per week were 8.8 ± 5.2 and mean EFS score was 5 ± 2.8 points. A linear regression model showed no association between the amount of oily fish intake and EFS scores. However, an interaction model, with participants stratified according to their median age and fish intake in quintiles, showed a significant effect for both variables on the EFS score (ß coefficient = 0.104; 95% C.I.: 0.003-0.206; p = 0.044). At the lowest quintile of fish intake, younger individuals have lower EFS scores than their older counterparts. As the consumption of oily fish increases, mean EFS scores margins were found to be progressively reduced in subjects aged 60-69 years but were largely unaffected in persons aged ≥70 years. It appears that oily fish intake has a positive effect on the frailty status of younger subjects but is superseded by the effects of age in the older population.
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Dieta , Ácidos Grasos Omega-3/administración & dosificación , Peces , Fragilidad/epidemiología , Anciano , Animales , Estudios Transversales , Ecuador , Femenino , Humanos , Vida Independiente , Masculino , Persona de Mediana Edad , Factores de Riesgo , Población Rural , Alimentos Marinos/estadística & datos numéricosRESUMEN
PURPOSE: This study aimed to evaluate the level of professional ethics awareness and medical ethics competency in order to assess the potential need for ethics items to be included on the Korean Dental Hygienist Licensing Examination. METHODS: In total, 358 clinical dental hygienists and dental hygiene students completed a structured questionnaire to evaluate their level of ethical awareness and medical ethics competency. The sub-factors of medical ethics were classified into relationships with patients, medical and social relations, and individual specialized fields. RESULTS: Only 32.1% of participants indicated that they had taken a course on professional ethics in the university curriculum, but 95.2% of respondents considered professional ethics to be important. The overall score for medical ethics competency was average (3.37 out of 5). The score for relationships with patients was 3.75 points, followed by medical and social relations (3.19 points) and individual specialized fields (3.16 points). The level of professional ethics awareness was higher among participants who had taken a course on professional ethics than among those who had not done so or who did not remember whether they had done so. CONCLUSION: Dental hygienists were aware of the importance of professional ethics, but their medical ethics competency was moderate. Therefore, medical ethics should be treated as a required subject in the university curriculum, and medical ethics competency evaluations should be strengthened by adding ethics items to the Korean Dental Hygienist Licensing Examination.
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Higienistas Dentales , Higiene Bucal , Ética Médica , Ética Profesional , Humanos , República de Corea , EstudiantesRESUMEN
The purpose of this study is to find out effective methodology of anatomical curriculum by comparing the education effects and satisfaction using different teaching tools, plastic model and three-dimensional (3D) application. A survey was conducted on the satisfaction level, understanding, and the usefulness of the tools used in the lectures of the two dental hygiene students groups who used the 3D application and the plastic model respectively. The interest in anatomical structure of the 3D App group was 4.20, which was significantly higher than that of the plastic model group 3.60, and the usefulness of the content of anatomy education was 4.31 in the 3D App group, significantly higher than the plastic model group (P<0.05). It was found that the interest in anatomical structure of students increased by 0.347 when using 3D applications compared to the case without the use (P=0.012) and understanding in anatomical structure and class concentration increased by 0.191, respectively, but these results were marginally significant. We expect that this study serves as a reference for the development and supplementation of anatomy teaching and learning method.
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PURPOSE: This study aimed to investigate current issues and areas for improvement in the Korean Dental Hygienist National Licensing Examination (KDHNLE) through an expert Delphi survey. METHODS: A Delphi survey was conducted from May through August 2016 in Korea. This Delphi survey included 20 persons representing the field of dental hygiene (7 groups from various dental hygiene-related organizations). The Delphi survey was administered through e-mail as 3 rounds of questionnaire surveys regarding the issues facing the KDHNLE and potential solutions to those challenges. The primary Delphi survey was an open questionnaire. In each round, subjects' responses were categorized according to the detailed themes of their responses. The minimum value of the content validity ratio of the survey results was determined by the number of panels participating in the Delphi survey. RESULTS: Issues facing the KDHNLE were identified from the results of the Delphi survey. The following 4 items had an average importance score of 4.0 or higher and were considered as important by over 85% of the panels: the failure of the practical test to reflect actual clinical settings, the focus of the practical test on dental scaling, the gap between the items evaluated on the national examination and actual practical work, and insufficiency in strengthening the expertise of licensed dental hygienists. The following items were suggested for improvement: more rigorous rater training, adjustment of the difficulty of the licensing examination, the introduction of a specialized dental hygienist system, and more rigorous refresher training for licensed dental hygienists. CONCLUSION: Based on the above results, the KDHNLE should be improved according to the core competencies of dental hygienists, including on-site clinical practice experience.
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Competencia Clínica/normas , Higienistas Dentales , Evaluación Educacional/normas , Licencia en Odontología/normas , Higiene Bucal/educación , Evaluación Educacional/métodos , Humanos , República de CoreaRESUMEN
The effect of fish consumption on blood pressure is controversial. The authors measured blood pressure and calculated oily fish servings per week in 677 community-dwellers aged 40 years and older living in rural coastal Ecuador. Using regression models with linear splines, the authors evaluated whether dietary fish intake was related to blood pressure levels, after adjusting for relevant confounders. Mean oily fish consumption was 9.1±5.6 servings per week. There was a nonlinear relationship between systolic pressure and fish servings. In the group of individuals consuming up to five servings per week, each serving significantly reduced systolic pressure by 2.3 mm Hg (P=.020). Any extra serving provided no further effects. The study shows an inverse relationship between oily fish consumption and systolic pressure. Currently recommended amounts of dietary oily fish intake per week (1-2 servings) might be insufficient to exert beneficial effects of fish in the control of blood pressure.
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Presión Sanguínea/fisiología , Grasas Insaturadas en la Dieta/farmacología , Aceites de Pescado/farmacología , Hipertensión/epidemiología , Vigilancia de la Población , Medición de Riesgo/métodos , Adulto , Determinación de la Presión Sanguínea , Ecuador/epidemiología , Femenino , Humanos , Hipertensión/fisiopatología , Masculino , Persona de Mediana Edad , Prevalencia , Factores de Riesgo , Población RuralRESUMEN
AIM: Using a population-based, cross-sectional design, we aimed to assess whether the presence of calcifications in the carotid siphon (as seen on computed tomography) is associated with silent markers of cerebral small vessel disease (on magnetic resonance imaging) in apparently healthy older adults living in Atahualpa, a rural Ecuadorian village. METHODS: Stroke-free Atahualpa residents aged ≥60 years identified during a door-to-door survey underwent head computed tomography for assessment of carotid siphon calcifications, and brain magnetic resonance imaging for identification of white matter hyperintensities and silent lacunar infarcts. We evaluated the association between calcifications and markers of small vessel disease using logistic regression models adjusted for demographics and cardiovascular risk factors. RESULTS: The mean age of the 236 participants was 71 ± 8 years, and 139 (59%) were women. Computed tomography readings showed high calcium content in the carotid siphon in 64 individuals (27%), and magnetic resonance imaging showed moderate-to-severe white matter hyperintensities in 51 (30%) and lacunar infarcts in 28 (12%). In the univariate analysis, individuals with high calcium content were older and were more likely to have high fasting glucose levels than those with low calcium content. After adjusting for confounding variables, we found an independent association between high calcium content in the carotid siphon and moderate-to-severe white matter hyperintensities (OR 2.3, 95% CI 1.1-4.9, P = 0.035) as well as lacunar infarcts (OR 3.1, 95% CI 1.3-7.6, P = 0.013). CONCLUSIONS: The present study shows a direct relationship between calcium content in the carotid siphon and silent small vessel disease in an indigenous Latin American population. Geriatr Gerontol Int 2016; 16: 1063-1067.
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Calcinosis/complicaciones , Enfermedades de los Pequeños Vasos Cerebrales/etiología , Enfermedades de los Pequeños Vasos Cerebrales/fisiopatología , Angiografía por Resonancia Magnética/métodos , Anciano , Anciano de 80 o más Años , Calcinosis/diagnóstico por imagen , Enfermedades de los Pequeños Vasos Cerebrales/diagnóstico por imagen , Estudios Transversales , Países en Desarrollo , Ecuador , Femenino , Humanos , Incidencia , Vida Independiente/estadística & datos numéricos , Modelos Logísticos , Masculino , Persona de Mediana Edad , Análisis Multivariante , Vigilancia de la Población , Prevalencia , Medición de Riesgo , Población Rural , Índice de Severidad de la Enfermedad , Accidente Cerebrovascular/diagnóstico por imagen , Accidente Cerebrovascular/etiología , Accidente Cerebrovascular/fisiopatología , Tasa de SupervivenciaRESUMEN
BACKGROUND/OBJECTIVES: Due to the content of omega-3 and vitamin D, fish consumption is likely to be associated with better sleep. However, current data are limited to a single study that is not representative of the population at large. The present study aimed to assess the effects of oily fish consumption on sleep quality in community dwelling adults living in rural coastal Ecuador. METHODS: Atahualpa residents aged ≥40 years and who were identified during a door-to-door survey were interviewed with field instruments directed at assessing cardiovascular risk factors, sleep quality, and fish consumption. Using parametric regression and generalized linear models adjusted for demographics and cardiovascular risk factors, the study evaluated whether oily fish consumption is associated with a lower Pittsburgh sleep quality index (PSQI). RESULTS: Out of 721 eligible people, 677 (94%) were enrolled. Mean oily fish consumption was 9 ± 6 servings per week (one serving = 140 grams). Poor sleep quality was noticed in 187 (28%) individuals. Oily fish intake was higher in individuals with good sleep quality (p = 0.013). There was an inverse association between the PSQI score and oily fish servings per week in both parametric regression (ß = -0.040; 95% CI -0.690 to -0.011, p = 0.007) and the adjusted generalized linear model (ß = -0.032; 95% CI -0.605 to -0.004, p = 0.025). CONCLUSIONS: Oily fish consumption is associated with better sleep quality. Even in people who ingest more than the recommended amount of fish, an increase in fish intake is associated with further improvement in the quality of sleep.
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Dieta , Peces , Sueño/fisiología , Adulto , Anciano , Animales , Enfermedades Cardiovasculares/prevención & control , Ecuador , Femenino , Humanos , Masculino , Persona de Mediana Edad , Factores de Riesgo , Población Rural , Encuestas y CuestionariosRESUMEN
BACKGROUND: The purpose of this study is to investigate whether overweight and obesity before pregnancy are associated with periodontitis during pregnancy. METHODS: This study examined a total of 315 pregnant females at 21 to 24 weeks of gestation. Overweight and obesity were defined based on criteria proposed by the World Health Organization Expert Consultation. Periodontal conditions were assessed by measuring clinical periodontal attachment loss (AL). To investigate whether obese pregnant females have increased risk according to the extent of periodontitis, the data were divided into two groups: 1) generalized periodontitis and 2) localized periodontitis. A comparison among underweight, normal-weight, and overweight/obese groups for explanatory variables was analyzed using the χ(2) test for categorical variables and an analysis of variance for continuous variables. Multivariate logistic regression analysis was performed with adjustments for age, health and oral health behaviors, and obstetric information. RESULTS: Age, age at first delivery, periodontitis, and periodontal conditions (two or more interproximal sites with AL ≥4 mm not on the same tooth) were significantly associated with body mass index (BMI) (P <0.05). The adjusted odds ratio of periodontitis was 4.57 (95% confidence interval = 2.30 to 9.07) for overweight and obese females (BMI ≥23 kg/m(2)), after adjusting for all of the covariates. CONCLUSION: There is a strong association between prepregnancy overweight/obesity and periodontitis in pregnant females.
Asunto(s)
Obesidad/complicaciones , Periodontitis/complicaciones , Complicaciones del Embarazo , Adulto , Consumo de Bebidas Alcohólicas , Índice de Masa Corporal , Peso Corporal , Atención Odontológica/estadística & datos numéricos , Raspado Dental , Ejercicio Físico , Femenino , Humanos , Edad Materna , Persona de Mediana Edad , Higiene Bucal , Sobrepeso/complicaciones , Paridad , Pérdida de la Inserción Periodontal/clasificación , Embarazo , Fumar , Delgadez/complicacionesRESUMEN
The National Oral Health Screening Program (NOHSP) is a general population-based program in Korea. The objective of this study was to assess the association between participation in the NOHSP and dental visit for periapical abscess (PA) and advanced periodontal disease (APD) among Korean adults. Data were obtained for subjects from the National Health Insurance database. The authors conducted a retrospective cohort study of 9358 randomly selected subjects who were between 40 and 64 years old in 2002. The outcomes of dental visit for PA or APD from the years 2003 to 2007 were compared between the screening and nonscreening groups. The nonscreening group had 19% higher risk of PA and 15% higher risk of APD. This study suggests that the NOHSP may decrease the risk of dental visit because of PA and APD by preventing the progress of lesion to the advanced stage among Korean adults.
Asunto(s)
Servicios de Salud Dental/estadística & datos numéricos , Tamizaje Masivo/estadística & datos numéricos , Programas Nacionales de Salud/estadística & datos numéricos , Absceso Periapical/terapia , Enfermedades Periodontales/terapia , Adulto , Bases de Datos Factuales , Femenino , Humanos , Masculino , Persona de Mediana Edad , Salud Bucal , Enfermedades Periodontales/patología , República de Corea , Estudios Retrospectivos , Medición de Riesgo , Índice de Severidad de la EnfermedadRESUMEN
BACKGROUND: The aim of this study is to confirm the association among oral health behaviors, periodontitis, and preeclampsia in Korean women. METHODS: This study is designed as a case-control study. Sixteen women with preeclampsia and 48 without preeclampsia post-delivery were included in this study from November 2007 to January 2010. Information was collected on demographics, health behaviors, and obstetric and systemic diseases that may influence the periodontal condition and preeclampsia. Full-mouth periodontal probing was conducted by one trained examiner (KHB). Localized periodontitis was defined as periodontal clinical attachment loss (AL) ≥ 3.5 mm on two or three sites not on the same tooth. In addition, generalized periodontitis was defined as clinical AL ≥ 3.5 mm on ≥ 4 sites not on the same tooth. Gingival crevicular fluid was collected using a sterilized paper point for quantitative analysis of Treponema denticola, Porphyromonas gingivalis, Prevotella intermedia (Pi), and Tannerella forsythia (previously T. forsythensis). RESULTS: After adjusting for confounders, the adjusted odds ratio (OR) was 4.79 (95% confidence interval [CI]: 1.02 to 29.72) for localized periodontitis and 6.60 (95% CI: 1.25 to 41.61) for generalized periodontitis. In addition, the proportion of floss or interdental brush users in women with preeclampsia was lower than that in women without (adjusted OR: 0.21; 95% CI: 0.02 to 0.93). Pi was significantly more prevalent in women with preeclampsia (P = 0.028). CONCLUSION: These results indicate that preeclampsia could be associated with the maternal periodontal condition and interdental cleaning.