RESUMO
The objective of this study was to quantify the prevalence of and identify the factors associated with dental pain among elementary- and middle-school students in Mexico. An ecological study was carried out with data from the 2008 National School-based Student-Health Survey. Information on dental pain from schoolchildren (aged 5 to 16 years) was collected from public schools across the 32 states of Mexico. In the original study, a questionnaire was used to explore various factors that affect the oral and dental health status of schoolchildren. The outcome variable was the prevalence rate (for dental pain) reported at state level. Various contextual socioeconomic variables were included, in addition to dental caries. Analyses were performed using Stata software. 52.9% of interviewees were girls; 26.9% of male and female schoolchildren in Mexico experienced gum or dental pain during the period analyzed (95% Confidence Interval = 26.02, 27.77%); according to the Spearman correlation results, self-reported dental pain was unrelated (p > 0.05) to the socioeconomic and sociodemographic variables that make up the Gross Domestic Product (GDP) and the Human Development (HDI), as well as the marginalization and the Gini indices. However, the estimated percentages of self-reported dental pain and caries were positively correlated in the elementary- (r = 0.8958, p < 0.0001), middle-school (r = 0.8958, p < 0.0001) and total populations (r = 0.8542, p < 0.0001). Prevalence of self-reported dental pain was 28%, or about one in three, of the Mexican children and adolescents in the study sample. The state-level sociodemographic and socioeconomic risk indicators were not associated with the prevalence of dental pain. Self-reported caries was positively correlated with self-reported dental pain.
Assuntos
Autorrelato , Odontalgia , Humanos , México/epidemiologia , Criança , Feminino , Masculino , Adolescente , Odontalgia/epidemiologia , Prevalência , Pré-Escolar , Cárie Dentária/epidemiologia , Fatores SocioeconômicosRESUMO
Introducción: la notificación de reacciones adversas a medicamentos es una obligación a nivel mundial. Aunque se han establecido muchas metodologías para esta acción, en la actualidad existen problemas. Objetivo: determinar la frecuencia de sospecha de reacciones adversas a la administración de medicamentos en pacientes y comparar la accesibilidad del llenado del formato de la NOM220 de la Secretaría de Salud y la Tarjeta Amarilla propuesta por la Organización Mundial de la Salud. Métodos: estudio transversal y observacional. Participaron 50 médicos responsables de las clínicas de diabetes del Estado de Hidalgo. Inicialmente, los médicos fueron capacitados para identificar las sospechas de reacciones adversas a la administración de medicamentos en los pacientes atendidos. Se realizó un diseño cruzado, en el que el 50 por ciento de los médicos utilizaron por tres meses el formato de la NOM220 y 50 por ciento la Tarjeta Amarilla. Después intercambiaron formatos y los utilizaron durante los tres meses siguientes. Al cabo de este periodo, respondieron un cuestionario para determinar la utilidad, claridad, tiempo de llenado y practicidad de ambos formatos. Se realizó estadística descriptiva y análisis bivariado para determinar los factores asociados a las sospecha de reacciones adversas a medicamentos, con el software SPSS (versión 17). Resultados: se registraron 46 sospechas de reacciones adversas a medicamentos en 46 pacientes con el formato de la NOM220 y 78 sospechas de reacciones adversas a medicamentos con la Tarjeta Amarilla en 78 pacientes. Todas las sospechas de reacciones adversas a la administración de medicamentos fueron tipo A. Los médicos recomiendan la utilización de la Tarjeta Amarilla, consideran claro el formato, sencillo, legible, fácil de llenar, entendible y accesible (p< 0,05). Conclusiones: los resultados permiten proponer la Tarjeta Amarilla como una alternativa más accesible para la notificación de sospechas de reacciones adversas a medicamentos, o se hagan adecuaciones al formato de la NOM220(AU)
Introduction: the reporting of adverse drug reactions is a global obligation. Although many methods have been implemented, there are still problems at present. Objective: to determine the frequency of suspected adverse reactions in patients and to compare the access to filling out the NOM220 formats of the Secretaría de Salud and the Yellow Card suggested by the World Health Organization. Methods: a cross-sectional and observational study was made. Fifty physicians responsible for the diabetes clinics in the state of Hidalgo participated in the study. First, the physicians were trained to identify the suspected adverse drug reactions in their patients. A crossover design was created where 50 percent of physicians used the NOM220 format and 50 percent the Yellow Card. Three months later, they exchanged the formats and used them during the following three months. After this period, questionnaire was administered to determine the usefulness, clarity, filling out time and convenience of the formats. Descriptive statistics and bivariate analyses were applied to determine the factors associated with the suspected adverse drug reactions with SPSS software (version 17). Results: a total of 46 suspected adverse reactions were registered in 46 patients using NOM220 format and 78 with the Yellow Card in 78 patients. All the suspected adverse reactions were type A. The physicians recommended the use of Yellow Card since they considered that it is practical, simple, readable, understandable, accessible and requires less time to fill it out (p< 0.05). Conclusions: the results allow selecting the Yellow Card as the most accessible choice for reporting suspected drug adverse reactions; additionally, they suggest that adjustments should be also made in the NOM220 format(AU)
Assuntos
Humanos , Animais , Masculino , Diabetes Mellitus/etnologia , Efeitos Colaterais e Reações Adversas Relacionados a Medicamentos/epidemiologia , Farmacovigilância , Estudos Transversais , Estudos Prospectivos , Estudo Observacional , MéxicoRESUMO
Recientemente se ha puesto más atención en todo el mundo a las conmociones cerebrales que ocurren durante la práctica del deporte, a nivel escolar, amateur o profesional. La conmoción cerebral se define como una alteración repentina y transitoria en la conciencia inducida por fuerzas biomecánicas traumáticas de transmisión directa o indirectamente al cerebro. Este tipo de lesiones ocurren más comúnmente en deportes de contacto, como el boxeo, el fútbol americano y el soccer, luchas, hockey, entre otros. Se debe sospechar conmoción cerebral en cualquier deportista que sufra un traumatismo craneoencefálico, haya perdido o no el estado de conciencia. Estos deportistas, no deben regresar a la práctica deportiva de manera inmediata, y se recomiendan unos días de descanso mental y físico, para su total recuperación. Se deben evitar los traumatismos en la cabeza de manera repetitiva, ya que existe evidencia que en algunos deportistas puede producir un estado de encefalopatía traumática crónica. En la presente revisión se abordan las diferentes definiciones de conmoción cerebral, su manejo y sus consecuencias a largo plazo. Asimismo, se anexa la versión en español de la herramienta de evaluación de conmoción, Sport Concussion Assessment Tool 2 (SCAT2).
Recently, there has been increased attention to concussions that occur during sports activities, both at school level or amateur and professional level. Concussion is defined as a sudden and transient alteration of consciousness induced by traumatic biomechanical forces transmitted directly or indirectly to the brain. Such injuries most commonly occur in contact sports such as boxing, football, soccer, wrestling, hockey, among others. Concussion should be suspected in any athlete who suffers a head injury, whether or not it is associated to loss of consciousness. These athletes should not return to their sports activities immediately, and a few days of mental and physical leave are recommended in order to ensure full recovery. Repeat head injuries should be avoided, since there is evidence that in some athletes they can lead to chronic traumatic encephalopathy. The present review focuses on the different definitions of concussion, management and long-term consequences. It also contains the Spanish version of the Sport Concussion Assessment Tool 2 (SCAT2).
Assuntos
Humanos , Concussão Encefálica/diagnóstico , Concussão Encefálica/etiologia , Concussão Encefálica/terapia , Esportes , Traumatismos Craniocerebrais/complicações , Concussão Encefálica/complicações , Concussão Encefálica/epidemiologia , Fatores de Risco , Sinais e Sintomas , Índices de Gravidade do Trauma , Lesão Encefálica Crônica/etiologia , Traumatismos em Atletas/complicaçõesRESUMO
Introducción: la presencia de fibronectina fetal en secreciones vaginales ha sido considerada como un predictor de trabajo de parto en embarazo de término y de pretérmino. Objetivo: evaluar la validez predictiva de la fibronectina en embarazadas que acudieron al Hospital General SSH de Pachuca, México. Metodología: se incluyeron pacientes embarazadas que acudieron al hospital para control de su embarazo. Se determinó la fibronectina fetal en todas las participantes y se dio un seguimiento hasta el inicio del trabajo de parto. Resultados: participaron un total de 148 pacientes, siendo un grupo con 53 pacientes con menos de 37 semanas de gestación (SG) y otro grupo con 95 pacientes con 37 ó más SG. En general, la prueba mostró una sensibilidad promedio de 72,5 por ciento y una especificidad promedio de 82,9 por ciento para ambos grupos. Conclusión: sobre la base de los resultados obtenidos, recomendamos utilizar la prueba de fibronectina en embarazadas a partir de las 32 semanas de gestación, tanto en los servicios de urgencias como de consulta externa.
Background: The presence of fetal fibronectin in vaginal secretions has been regarded as a predictor of labor in pregnant term and preterm. Objective: For this reason the purpose of this study was to evaluate the predictive validity of fibronectin in pregnant women who attended the General Hospital SSH Pachuca, Hidalgo, Mexico. Methodology: We included pregnant patients admitted to hospital for pregnancy control. Fetal fibronectin was determined in all participants and then followed until the onset of labor. Results: A total of 148 patients participated. One group with 53 patients less than 37 weeks gestation, and another group of 95 patients with 37 or more weeks gestation. In general, the test showed an average sensitivity of 72.5 percent and specificity 82.9 percent average for both groups. Conclusion: Based on these results, we recommend using fibronectin test in pregnant women after 32 weeks of gestation, both in emergency departments and outpatient clinics.
Assuntos
Humanos , Adolescente , Adulto , Feminino , Gravidez , Adulto Jovem , Fibronectinas/análise , Trabalho de Parto , Fibronectinas/fisiologia , México , Valor Preditivo dos Testes , Terceiro Trimestre da Gravidez , Reprodutibilidade dos Testes , Sensibilidade e EspecificidadeRESUMO
Introducción: el empiema cerebral en pediatría es una rara infección intracraneal que puede ser secundaria a una meningitis, sinusitis, o por mecanismos como trauma craneal, cirugía neurológica o como resultado de la diseminación hematógena desde un sitio remoto. Objetivo: describir un caso de empiema cerebral causado por Escherichia coli en un lactante. Metodología: presentar un caso clínico, con aislamiento de Escherichia coli fuera del periodo gris de la meningitis. Se realiza una revisión acerca de los factores de riesgo, la etiología y tratamiento del empiema cerebral en niños. Resultados: masculino de 5 meses, sin inmunodeficiencia, cráneo con plagiocefalia; antecedente de otitis de 3 semanas de evolución previo a su ingreso al hospital. El paciente manifestó fiebre, crisis convulsivas y deterioro rostro-caudal. El líquido cefalorraquídeo con pleocitosis e hipoglucorraquia. Las imágenes tomográficas revelaron la presencia de empiema cerebral. Se logró el aislamiento de Escherichia coli en el cultivo, requirió drenaje quirúrgico y antibioticoterapia sistémica por 4 semanas. Conclusiones: el empiema cerebral por Escherichia coli en lactantes después del periodo gris es muy raro. Su tratamiento consiste en la evacuación quirúrgica oportuna, la erradicación del foco infeccioso primario y la administración apropiada de antimicrobianos sistémicos.
Introduction: Brain empyema in children is a rare intracranial infection that may result from meningitis, sinusitis, or mechanisms such as head trauma, neurological surgery or hematogenous spread from a remote site. Objective: To describe a case of brain empyema caused by Escherichia coli in an infant. Methodology: A case report is presented with isolation of Escherichia coli arising after the overlap period of meningitis (1-3 months). A literature review of the risk factors, etiology and treatment of brain empyema in children is conducted. Results: The case report is about a 5 month-old male infant with no history of immunodeficiency, plagiocephalic, and with a 3 week-long history of otitis prior to admission. The patient had fever, seizures and rostro-caudal deterioration, cerebrospinal fluid pleocytosis and hypoglycorrhachia. The tomographic images revealed brain empyema. It was posible to isolate Escherichia coli from culture and surgical drainage was required plus systemic antibiotic therapy for 4 weeks. Conclusions: Brain empyema caused by Escherichia coli in infants after the overlap period are very rare. Treatment consists in prompt surgical evacuation, eradication of the primary infection and proper administration of systemic antimicrobials.