RESUMO
OBJECTIVE: To determine the prevalence and predictive factors of visual manifestations in a large registry of patients with GCA. METHODS: ARTESER is a large Spanish multicentre registry supported by the Spanish Society of Rheumatology. It includes patients with GCA from across the entire country diagnosed between June 2013 and March 2019. The variables collected at diagnosis were demographics, clinical manifestations (including all visual manifestations), laboratory, temporal artery biopsy, and imaging findings (ultrasound, FDG-PET/CT, MRI angiography, CT angiography). Patients with and without visual involvement were compared in a bivariate analysis. Multivariate logistic regression was performed to determine potential predictive factors of visual manifestations. RESULTS: The study population comprised 1636 GCA patients, of whom 599 (36.6%) presented visual manifestations. Anterior ischemic optic neuropathy was the most frequent (n = 274 of 599; 45.7%) ocular complication. The independent predictors that increased the risk (OR; 95% confidence interval) of visual involvement were older age (1.027; 1.009-1.045) and jaw claudication (1.724; 1.325-2.243). The variables associated with a reduced risk were polymyalgia rheumatica (0.541; 0.414-0.708), fever (0.373; 0.264-0.527), longer symptom duration (0.946; 0.909-0.985), and higher erythrocyte sedimentation rate (ESR) (0.992; 0.988-0.997), common features of patients with large vessel-GCA. CONCLUSION: One-third of GCA patients present visual manifestations at diagnosis. Older age and jaw claudication are independent predictors of visual manifestations, whereas polymyalgia rheumatica, fever, longer symptom duration, and high ESR reduce the risk of visual involvement.
RESUMO
Ramalina farinacea is a widely distributed epiphytic lichen from the Macaronesian archipelagos to Mediterranean and Boreal Europe. Previous studies have indicated a specific association between R. farinacea and Trebouxia microalgae species. Here, we examined the symbiotic interactions in this lichen and its closest allies (the so-called "R. farinacea group") across ten biogeographic subregions, spanning diverse macroclimates, analyzing the climatic niche of the primary phycobionts, and discussing the specificity of these associations across the studied area. The most common phycobionts in the "R. farinacea group" were T. jamesii and T. lynnae, which showed a preference for continentality and insularity, respectively. The Canarian endemic R. alisiosae associated exclusively with T. lynnae, while the other Ramalina mycobionts interacted with both microalgae. The two phycobionts exhibited extensive niche overlap in an area encompassing Mediterranean, temperate Europe, and Macaronesian localities. However, T. jamesii occurred in more diverse climate types, whereas T. lynnae preferred warmer and more humid climates, often close to the sea, which could be related to its tolerance to salinity. With the geographical perspective gained in this study, it was possible to show how the association with different phycobionts may shape the ecological adaptation of lichen symbioses.
RESUMO
INTRODUCTION: To reach the diagnosis of giant cell arteritis (GCA), signs, symptoms, laboratory tests, imaging findings, and occasionally anatomopathological results from temporal artery biopsy are evaluated. This study describes the results of an algorithm analysis based on clinical and ultrasound evaluation of patients with suspected GCA, highlighting its diagnostic utility by contrasting its use in different clinical suspicion scenarios. METHOD: Prospective multicenter study evaluating patients referred with suspected GCA through a preferential circuit (fast track), grouping them according to low or high clinical suspicion of GCA. Each of these scenarios is evaluated by biopsy and ultrasound for all patients, resulting in positive, indeterminate, or negative outcomes, yielding six possible groups. Potential areas of improvement are explored, emphasizing that, following a negative or indeterminate ultrasound, 18-FDG-PET-CT could be recommended. We analyze the results and application of a diagnostic algorithm, confirming its efficiency and applicability based on whether there is high or low clinical suspicion. RESULTS: Sixty-nine patients (41 in the high suspicion group and 28 in the low suspicion group). There were 41 new diagnoses of GCA: 35 in the high suspicion group and 6 in the low suspicion group. Using ultrasound alone, the initial algorithm has an overall diagnostic efficiency of 72.5%, which improves to 80.5% when including 18F-FDG-PET/CT. The negative predictive value of ultrasound in patients with low clinical suspicion is 84.6%, and the positive predictive value of ultrasound in patients with high suspicion is 100%, improving sensitivity from 57.1% to 80.8% with 18F-FDG-PET/CT in this scenario. Temporal artery biopsy was performed on all patients, with no differences in sensitivity or specificity compared to ultrasound. In cases where all three tests - ultrasound, biopsy, and 18F-FDG-PET/CT - are performed, sensitivity increases to 92.3% in patients with high clinical suspicion. CONCLUSION: In situations of high clinical suspicion, the algorithm provides sufficient information for the diagnosis of GCA if ultrasound is positive. A negative ultrasound is sufficient to rule out the diagnosis in the context of low clinical suspicion. 18-FDG-PET-CT may be useful in patients with high suspicion and negative or indeterminate ultrasound results.
Assuntos
Algoritmos , Arterite de Células Gigantes , Tomografia por Emissão de Pósitrons combinada à Tomografia Computadorizada , Ultrassonografia , Arterite de Células Gigantes/diagnóstico , Arterite de Células Gigantes/diagnóstico por imagem , Humanos , Estudos Prospectivos , Idoso , Feminino , Masculino , Idoso de 80 Anos ou mais , Biópsia , Pessoa de Meia-Idade , Fluordesoxiglucose F18 , Artérias Temporais/patologia , Artérias Temporais/diagnóstico por imagem , Sensibilidade e Especificidade , Compostos RadiofarmacêuticosRESUMO
Introduction: This was an ambispective cohort study evaluating the prognostic significance of lymphocytic foci and its lymphoid composition in minor salivary gland biopsy (MSGB) for short-term disease flare and severity in Sjögren's syndrome (SS). Methods: The inclusion criteria comprised individuals meeting the ACR/EULAR 2016 criteria who underwent MSGB with an infiltration of more than 50 lymphocytes and received clinical diagnosis between September 2017 and December 2018. Patients with inadequate biopsy samples were excluded. The number of lymphocytic foci and their lymphoid composition in MSGB were assessed using immunofluorescence staining. Major organ damage and improvements in the EULAR Sjögren's Syndrome Disease Activity Index (ESSDAI) were measured. Statistical analyses, including Cox and linear regressions, were conducted. Results: A total of 78 patients with at least one lymphocytic focus were included in the study. The presence of higher T-cell counts in lymphocytic foci in MSGB was associated with severe disease flare, and a logarithmic transformation of T-cell count indicated increased risk (HR 1.96, 95% CI 0.91-4.21). Improvements in the ESSDAI were associated with higher total lymphocyte count and T- and B-cell numbers in the lymphoid composition of the lymphocytic foci. Seropositive patients exhibited higher T CD4+ cell numbers. Correlation analysis showed negative associations between age and lymphocytic foci and the T-cell count. Positive correlations were observed between antinuclear antibody (ANA) titers and total lymphocyte numbers. Discussion: Patients with a higher number of T cells in the lymphocytic infiltrates of lymphocytic foci may have a two-fold risk of severe disease flare. The number of B cells and T CD4+ cells in the lymphocytic infiltrates of lymphocytic foci showed a weak but positive relation with the ESSDAI improvement during follow-up. Age and seropositivity appeared to influence the lymphoid composition of the lymphocytic foci.
Assuntos
Guanidinas , Glândulas Salivares Menores , Síndrome de Sjogren , Humanos , Glândulas Salivares Menores/patologia , Seguimentos , Prognóstico , Estudos de Coortes , Exacerbação dos Sintomas , Linfócitos B/patologia , Biópsia , Inflamação/patologiaRESUMO
OBJECTIVE: Aortitis in Giant Cell Arteritis (GCA-aortitis) is a frequent complication that may lead to aneurysms. Tocilizumab (TCZ) was approved in GCA, but the efficacy in GCA-aortitis and aneurysms has not been analyzed to date. Our aim was to assess the effectiveness and safety of TCZ in a wide series of GCA-aortitis and aneurysms. METHODS: Multicentre observational study with GCA-aortitis treated with TCZ. GCA was diagnosed by: a) ACR criteria, b) temporal artery biopsy, and/or c) imaging techniques. Aortitis was diagnosed mainly by PET/CT. Main outcomes were EULAR and imaging remission. Others were clinical remission, analytical normalization, corticosteroid-sparing effect, and the prevention and improvement of aneurysms. RESULTS: 196 patients with GCA-aortitis treated with TCZ. After 6 months, 72.2% reached EULAR remission but only 12% an imaging remission; increasing up-to 81.4% and 31.8%, respectively, at 24 months. A rapid clinical remission, ESR and CRP normalization was observed in 47.4%, 84.3% and 55.6%, at 1 month, increasing to 89.6%, 85.3% and 80.3% at 24 months, respectively. Aneurysms were present in 10 (5%) patients. Five of them required early surgery, while 3 others enlarged. No patient on TCZ therapy developed aneurysms during follow-up. CONCLUSION: In patients with GCA-aortitis treated with TCZ, a rapid and maintained clinical and analytical improvement was observed. However, there was an uncoupling between clinical and EULAR remission with imaging remission.
RESUMO
INTRODUCCIÓN: Determinar la situación de salud bucal en párvulos ingresados a un programa promocional-preventivo en la comuna de Melipilla durante el año 2018. MATERIAL Y MÉTODOS: Estudio transversal realizado en 860 párvulos de entre dos a cinco años de edad matriculados en 17 establecimientos educacionales de la comuna, ubicados en zona urbana y rural. La experiencia de caries dental como variable dependiente y sexo, edad y zona geográfica del establecimiento educacional (urbano-rural) como variable independiente fueron medidas en un contexto comunitario (en aula). Estudio aprobado por Comité Científico de Ética de Universidad Finis Terrae y Servicio de Salud Metropolitano Occidente. RESULTADOS: El estudio abarcó al 88,5% de los párvulos matriculados, con promedio de edad de 3,76 ± 1,06 años. El 53,5% correspondieron a niñas. Un 34,1% (IC:95% 30,74:37,48) presentó caries dental, sin diferencias por sexo, zona geográfica, si por edad. A mayor edad, mayor daño por caries dental. Cada párvulo en promedio presentó un diente primario con caries (diente cariado:1,14 ± 2,28). El tercio de la población más afectada por caries dental presentó en promedio tres dientes primarios con daño. DISCUSIÓN: Los resultados muestran un elevado daño por caries dental cuyo inicio es temprano; esto pone de manifiesto la necesidad de avanzar en el desarrollo de políticas públicas de salud bucal destinadas a la primera infancia. (AU)
INTRODUCTION: To determine the oral health situation in the infants admitted to a pro-motional-preventive program in the municipality of Melipilla during the year 2018.MATERIAL AND METHODS: Cross-sectional study conducted with 860 infants between two to five years of age enrolled in 17 educational establishments in the community, located in urban and rural settings. The incidence of cavities as related to the variables of sex, age and geographical area of the educational establishment (urban-rural) as an independent variables were measured in a community context (in the classroom). Study approved by the Scientific Committee of Ethics of the Finis Terrae University and the Western Metropolitan Health Service.RESULTS: The study covered 88.5% of the enrolled children of 3.76 ± 1.06 years with an average age of 3,76 ± 1,06. 53.5% were girls. 34.1% (IC:95% 30,74:37,48) had cavities, without differences by sex or geographical area, but by age. The older you get, the more damage you get from tooth decay. Each toddler had on average one primary tooth with cavities (decayed tooth: 1.14 ± 2.28). One third of the population most affected by cavities presented on average three primary teeth with damage.DISCUSSION: The results show a high damage by cavities whose onset is early; This highlights the need to improve the development of public oral health policies aimed at early childhood. (AU)
Assuntos
Humanos , Masculino , Feminino , Pré-Escolar , Diagnóstico da Situação de Saúde , Saúde Bucal , Cárie Dentária/epidemiologia , Zona Rural , Chile , Prevalência , Estudos Transversais , Área Urbana , Cárie Dentária/prevenção & controleRESUMO
ABSTRACT BACKGROUND: Chile has implemented numerous successful food and nutrition initiatives since the early 20th century, aiming to address malnutrition in all its forms. AIM: To summarize the major nutrition and food-related policies, strategies, and programs implemented in Chile, using the NOURI-SHING Framework. MATERIAL AND METHODS: The NOURISHING framework proposes a methodology for reporting, monitoring, and categorizing actions to promote healthier eating in three main domains: food environment, food system and behavior change communication. The data collection was carried out reviewing the databases of the Chilean Ministries of Health, Education and Social Development, and the Parliament. Information about nutrition related public health policies, strategies or programs was obtained from peer reviewed articles, official reports, official State websites, as well as interviews with former and current stakeholders. RESULTS: Chile has mandatory nutritional labeling that was updated to front-of-package warning labels about critical nutrients. In addition, the advertising of unhealthy foods and breast milk substitutes is restricted, among other food and nutrition policies. Nevertheless, strategies related to mass and social media communication campaigns, or periodic education and information interventions still need to be implemented. CONCLUSIONS: Using the NOURISHING framework, a comprehensive summary and description of nutrition and food public health policies implemented in Chile is described. An overview of the policy changes required according to the nutritional needs of the population and the nutritional transition in Chile is provided.
ANTECEDENTES: Chile ha implementado numerosas iniciativas sobre nutrición y alimentación desde el comienzo del siglo 20, para combatir la malnutrición en todas sus formas. OBJETIVO: Recopilar las principales políticas y programas sobre nutrición y alimentación implementados en Chile utilizando la estructura NOURISHING. MATERIAL Y MÉTODOS: La estructura NOURISHING propone un método para informar, monitorear y categorizar las acciones destinadas hacia una alimentación más saludable en tres dominios: ambiente nutricional, sistemas de alimentación y comunicación para lograr cambios de comportamiento. Se recolectó información desde bases de datos de los Ministerios de Salud, Educación y Desarrollo Social y del Congreso. La información acerca de políticas, programas o estrategias de salud pública se obtuvo de artículos revisados por pares, informes oficiales, sitios de internet del Estado y de entrevistas con quienes están o estuvieron involucrados en estos programas. RESULTADOS: Dentro de las políticas de nutrición y alimentos en Chile, se destaca el sistema obligatorio de etiquetado nutricional que ha evolucionado hacia la incorporación de advertencias en envases de alimentos señalando la presencia de nutrientes críticos. En Chile también se ha restringido la publicidad de alimentos no saludables y sustitutos de leche materna, entre otras políticas. Sin embargo, aún falta implementar campañas de comunicación y educación masiva sobre nutrición y alimentación saludable. CONCLUSIONES: Utilizando la estructura NOURISHING entregamos un resumen y descripción de los programas de nutrición y alimentación implementados en Chile en las últimas décadas. Se entrega una visión general de los cambios requeridos de acuerdo con las necesidades de la población y la transición nutricional que se ha experimentado.
Assuntos
Humanos , Estado Nutricional , Política Nutricional , Chile , Alimentos , Política de SaúdeRESUMO
OBJETIVO: Evaluar la Garantía Explícita en Salud Oral en el Adulto de 60 años (GES-60 años) desde la percepción de la calidad de vida. MÉTODO: Se realizó una evaluación antes y después de la prestación del programa GES-60, sin grupo control. Se utilizó el cuestionario Geriatric Oral Health Assessment Index (GOHAI) para cuantificar los cambios en la percepción de la calidad de vida como un indicador de resultado del programa. Se aplicó el test no paramétrico de Wilcoxon para datos emparejados en STATA 12.0. RESULTADOS: Participaron 103 adultos en el estudio y 85,5% fueron mujeres. Al término del programa GES-60 se presentaron mejoras significativas en la valoración global de la percepción de la calidad de vida relacionada con salud oral, como también en cada una de las dimensiones, particularmente en términos de la limitación psicológica. CONCLUSIÓN: Existe una significativa contribución del programa en el mejoramiento de la percepción de la calidad de vida de la población intervenida.
OBJECTIVE: To evaluate the Explicit Guarantee in Oral Health for Adults 60 years of Age (GES-60) on the basis of their perception of quality of life. METHOD: Evaluations were conducted before and after users participated in the GES-60 program, without a control group. The Geriatric Oral Health Assessment Index (GOHAI) was used to quantify changes in the perception of quality of life as an indicator of the program's results. The nonparametric Wilcoxon test was used to analyze matched data in STATA 12.0. RESULTS: A total of 103 adults participated in the study, and 85.5% were women. At the end of the GES-60 program, there were significant improvements in the overall assessment of the participants' perception of quality of life related to oral health, in each of the dimensions, particularly in terms of psychological limitations. CONCLUSION: The program significantly improves the target population's perception of quality of life.
Assuntos
Humanos , Masculino , Feminino , Pessoa de Meia-Idade , Idoso , Qualidade de Vida , Saúde Bucal , Percepção , Avaliação de Programas e Projetos de Saúde , Chile , Saúde Pública , Inquéritos e Questionários , Assistência Odontológica para IdososRESUMO
Resumen Introducción: Las enfermedades de origen infeccioso son importantes productoras de morbilidad y mortalidad. Objetivo: Describir la tendencia temporal de las tasas de los episodios de hospitalización por enfermedades infecciosas en Chile entre los años 2004 y 2014. Métodos: Estudio descriptivo usando el Registro Nacional de Egresos hospitalarios, identificando los episodios de hospitalización por enfermedades infecciosas incluyendo parasitarias. Se calcularon las tasas de egresos hospitalarios y se estandarizaron por edad. Mediante regresión de Poisson se estimó el porcentaje de cambio anual (PCA). Resultados: Los episodios de hospitalización por enfermedades infecciosas han disminuido (PCA de −4%). Las mujeres presentan menos episodios que los hombres. La magnitud de las tasas según grupos etarios, es mayor para personas de 0-9 años, y de 80 años y más. Conclusiones: En la última década hubo una reducción de episodios de egreso hospitalario por enfermedades infecciosas.
Background: Infectious diseases are important causes of burden of illness and mortality. Aim: To describe the temporal trends of hospital discharges due to infectious in Chile from 2004 to 2014. Methods: Descriptive study. National Hospital Discharge Registry were used. We included all hospital discharges with main diagnosis of infectious diseases including parasitic diseases. Rates were calculated and standardized. The anual percentage change (APC) was estimated by Poisson regression. Results: During a stated period of time in hospitalization of infectious diseases decreased (APC −4%). Women had fewer hospital discharged compared to men. Patients aged between 0 and 9 years and those who aged 80 years and older showed greater rates than other age groups. Conclusions: Chile has experimented a reduction in hospital discharges due to infectious diseases.
Assuntos
Humanos , Masculino , Feminino , Recém-Nascido , Lactente , Pré-Escolar , Criança , Adulto , Pessoa de Meia-Idade , Idoso , Idoso de 80 Anos ou mais , Doenças Transmissíveis/epidemiologia , Hospitalização/estatística & dados numéricos , Distribuição de Poisson , Chile/epidemiologia , Fatores Sexuais , Doenças Transmissíveis/classificação , Incidência , Fatores EtáriosRESUMO
Objetivo: Descrever as características clínicas e epidemiológicas de pacientes vítimas de queimaduras infligidas intencionalmente internados em uma unidade de terapia intensiva de um centro de tratamento especializado em queimaduras de um hospital universitário. Método: Foi realizado um estudo longitudinal retrospectivo na unidade de Terapia Intensiva de um Centro de Tratamento de Queimados. A amostragem foi de conveniência de todos os pacientes adultos queimados internados consecutivamente no período de maio de 2011 a novembro de 2013. Foram coletados dados clínicos e do diagnóstico da queimadura, além de escores prognósticos. Resultados: Dos 178 pacientes incluídos no estudo, 19,7% tiveram lesões intencionais, sendo 10,7% ocasionadas por tentativa de suicídio e 9,0% por tentativa de homicídio. As lesões autoinfligidas e por agressão foram mais graves quando comparadas a lesões acidentais. A média da superfície corpórea queimada total foi maior nas lesões intencionais (39,2%; DP=21,6%) comparada às acidentais (25,3%, DP=15,6%; p<0,001) e a lesão inalatória foi mais frequente nas intencionais (71,43%) do que nas acidentais (38,4%; p<0,001). A taxa de mortalidade foi maior nas queimaduras intencionais (65,7%) comparada aos acidentes (30,7%; p<0,001). As mulheres foram o principal grupo de risco associado às queimaduras intencionais (p<0,001). As variáveis clínicas e prognósticos apresentaram resultados semelhantes entre os pacientes com queimaduras por tentativa de suicídio e homicídio. Conclusões: Identificou-se que as lesões intencionais são um fator de risco para o pior prognóstico e mortalidade de pacientes queimados.
Objective: To describe the clinical and epidemiological features of burn victims inflicted intentionally admitted to an intensive care unit of a specialized burn center at a university hospital. Method: Retrospective longitudinal study conducted in the intensive care unit of a Burn Treatment Center. Convenience sampling of all burned adult patients consecutively admitted from May 2011 to November 2013. Clinical data and burn diagnosis as well as prognostic scores were collected. Results: Of the 178 patients included in the study 19.7% had intentional injuries, 10.7% caused by attempted suicide and 9.0% attempted homicide. Self-inflicted injury and assault resulted in more serious injury compared to accidental injuries. The average of the total burned body area was higher in intentional injuries (39.2% and standard deviation SD=21.6%) compared with accidental (25.3%, SD=15.6%, p<0.001) and inhalation injury was more frequent in intentional (71.43%) than in accidental (38.4%; p<0.001). The mortality rate was higher in intentional burns (65.7%) compared to accidents (30.7%; p<0.001). Women had higher risk associated intentional burns (p<0.001). Clinical and prognostic variables showed similar results among patients with burns of attempted suicide and homicide. Conclusions: It was found that intentional injuries are a risk factor for poor prognosis and mortality in burned patients.
Objetivo: Describir las características clínicas y epidemiológicas de pacientes víctimas de quemaduras infligidas intencionalmente internados en una unidad de cuidados intensivos de un centro de tratamiento especializado para quemaduras de un hospital universitario. Método: Estudio retrospectivo longitudinal en la unidad de cuidados intensivos de un centro de tratamiento especializado para quemaduras. El muestreo fue de conveniencia, de todos los pacientes adultos quemados internados consecutivamente a partir de mayo de 2011 hasta noviembre de 2013. Se recogieron datos clínicos y del diagnóstico de quemaduras, así como las puntuaciones de pronóstico. Resultados: De los 178 pacientes incluidos en el estudio, 19,7% tenían lesiones intencionales, siendo 10,7% por tentativa de suicidio y 9,0% por tentativa de homicidio. Las lesiones autoinfligidas y por agresión resultaron en lesiones más graves cuando comparadas a lesiones accidentales. El promedio de la superficie total del cuerpo quemado fue mayor en las lesiones intencionales (39,2%; DE=21,6%) en comparación a las accidentales (25,3%; DE=15,6%, p<0,001) y la lesión por inhalación fue más frecuente en las intencionales (71,43%) que en las accidentales (38,4%; p<0,001). La tasa de mortalidad fue mayor en las quemaduras intencionales (65,7%) en comparación a los accidentes (30,7%; p<0,001). Las mujeres fueron el principal grupo de riesgo asociado a quemaduras intencionales (p<0,001). Las variables clínicas y pronóstico presentaron resultados similares entre los pacientes con quemaduras de intento de suicidio y homicidio. Conclusiones: Se identificó que las lesiones intencionales son un factor de riesgo para peor pronóstico y mortalidad en pacientes quemados.
Assuntos
Humanos , Tentativa de Suicídio , Perfil de Saúde , Queimaduras/mortalidade , Agressão , Homicídio , Estudos Retrospectivos , Estudos LongitudinaisRESUMO
El aislamiento geográfico y condiciones medioambientales hacen a la población de Juan Fernández altamente vulnerable, siendo relevante conocer la calidad de vida relacionada con salud oral. Se realizó un estudio transversal en 137 habitantes mayores de 14 años. Se aplicó OHIP-14 para medir calidad de vida relacionada con salud oral previo consentimiento informado. El análisis estadístico fue realizado STATA 12.0. Un 51,8% es población femenina, con una edad media de 42,26 (DE 16,5). Un 91,97%, percibe que la salud oral afecta su calidad de vida, siendo levemente mayor en mujeres. Las molestias psicológicas son una manifestación en 80,29% de los encuestados. Un 75,91% percibe incomodidad por dolor en su boca, 62,77% manifiesta problemas de incapacidad psicológica. Existe mayor impacto en la calidad de vida relacionada con salud oral a medida que aumenta la edad. Por cada año de vida, el valor del OHIP-14 aumenta 0,07 (IC:95% 0,040,1). Los resultados obtenidos sugieren la necesidad de generar políticas públicas que consideren la salud oral desde una perspectiva integral, con énfasis en poblaciones altamente vulnerables considerando la mejora en la calidad de vida como un resultado a esperar
Geographic isolation and environmental conditions make the population of Robinson Crusoe Island, in the Juan Fernández archipielago highly vulnerable. It is therefore relevant to know the quality of life related to oral health (QOLRTO). In this report a cross sectional study in 137 inhabitants over 14 years of age was carried out. OHIP-14 was applied to measure QOLRTO, after informed consent was obtained. Statistical analysis was made in STATA 12.0. The population is 51.8% female, mean age 42.26 (SD 16.5) being similar in both sexes. Of the subjects studied, 91.97% perceived that oral health affects their quality of life, being slightly higher in women. Psychological distress was a manifestation in 80.29% of subjects, while 75.91% perceived discomfort and mouth pain, and 62.77% reported psychological disability issues. There is a greater impact of oral health issues with increasing age. For each year of life, the value of the OHIP-14 increased 0.07 (CI 95%, 0.04 to 0.1). The results suggest that public health policies that include a comprehensive oral health perspective, with emphasis on highly vulnerable populations should be considered
Assuntos
Humanos , Masculino , Feminino , Pessoa de Meia-Idade , Idoso , Adulto Jovem , Qualidade de Vida , Saúde Bucal , Modelos Lineares , Chile , Fatores Sexuais , Estudos Transversais , Inquéritos e QuestionáriosRESUMO
El objetivo de este estudio fue conocer el nivel de conocimientos de salud oral y la utilización de GES odontológico en 200 puérperas atendidas en el servicio integral de la mujer de una clínica privada, del sector norte de Santiago de Chile durante el año 2011. Se aplicó un cuestionario auto-administrado compuesto de 24 preguntas relacionadas con el nivel de conocimiento sobre enfermedades orales, prevención, gestación, atención odontológica y desarrollo dentario. El punto de corte para ser considerado como buen nivel de conocimiento fue igual o mayor a 14 puntos y regular entre 7 y 13 puntos. La edad promedio de la muestra estudiada fue de 29,11 años (+5,71) y la mitad refirió tener un solo hijo. El 57 por ciento refiere educación universitaria, un 70,5 por ciento declaró estar trabajando y sólo un tercio de ellas recibió atención dental durante su embarazo. Existe un nivel de conocimientos bueno en un 35 por ciento de las puérperas y regular en un 64 por ciento, siendo los conocimientos sobre prevención en salud oral los mejores evaluados y el de crecimiento y desarrollo dentario los más deficientes. La edad media fue mayor en el grupo con mejor nivel de conocimientos. Al hacer el análisis estadístico según las categorías de la encuesta no se observó diferencias estadísticamente significativas entre el nivel de conocimientos y haber recibido atención dental durante el embarazo (p=0,64). La relación entre el nivel de conocimientos sobre salud oral y paridad (p=0,37), nivel educacional (p=0,35) y ocupación (p=0,39) no fueron estadísticamente significativas. Se analizó también el puntaje en comparación a las diferentes variables mediante regresión lineal múltiple, solo el nivel educacional de la madre (IC95 por ciento= 0,3:1,8; p=0.007) y la paridad (IC95 por ciento= -0,1:1,5; p=0.05) fueron significativos, sin embargo el intervalo de confianza para la paridad no rechaza la hipótesis nula. Las madres con nivel educacional superior o técnico...
The aim of this study was to determine the level of oral health knowledge in 200 postpartum women attending an integral service for women of a private clinic in the northern sector of Santiago de Chile during the year 2011. We used a self-administered questionnaire based on 24 questions related to the level of knowledge of oral diseases, prevention, pregnancy, dental care and dental development. The cutoff score for being considered a good level of knowledge was higher than or equal to 14 points and regular cooperation between 7 and 13 points. The average age of the sample was 29.11 years (+ 5.71) and half reported having one child. 57% refers university education, 70.5% reported to be working and only a third received dental care during pregnancy. Thirty-five percent of puerperal women had a good level of knowledge and 64% had a regular level. The highest score identified was the knowledge on prevention in oral health and the lowest was health growth and development of dental. The mean age was higher in the group with higher level of knowledge. No statistically significant difference was observed between the level of knowledge and having received dental care during pregnancy (p = 0.635). The relation between level of oral health knowledge and parity (p = 0.367), educational level (p = 0.345) and occupation (p = 0.388) was not statistically significant. Using linear regression we analyzed the relation between level of knowledge score and other variables. The level of education of the mother (95% CI = 0.3:1.8, P = 0.007) and parity (95% CI = -0.1: 1.5, p = 0.05) were significant, but the confidence interval for parity does not reject the null hypothesis. Mothers with higher or technical level of education...
Assuntos
Humanos , Adulto , Feminino , Gravidez , Assistência Odontológica , Conhecimentos, Atitudes e Prática em Saúde , Saúde Bucal , Período Pós-Parto , Chile , Estudos Transversais , Fatores Socioeconômicos , Inquéritos e QuestionáriosRESUMO
Objetivos: Conocer la situación de salud oral y calidad de vida del adulto mayor que asiste a centros de salud pública del área oriente de Santiago de Chile durante los años 2011-2012. Material y métodos: Estudio descriptivo de corte transversal en una muestra probabilística de 380 adultos mayores. Se evaluó historia de caries, estado periodontal y situación protésica. La percepción de calidad de vida se midió con el Geriatric Oral Health Assessment Index (GOHAI). Se establecieron dos categorías: ômala calidad de vidaõ (puntuación ≤ 57) y ôbuena calidad de vidaõV (puntuación >57). El análisis estadístico se hizo en programa STATA 11.0. Resultados: La edad media fue de 71,33 años (D.E. ± 7,26); 66,1% son mujeres; 51,6% casado y 78,9% pensionado. Un 32,4% tiene educación media completa. El COPD fue de 22,16 (IC: 95% 21,72-22,60) mayor en mujeres (p>0,05) y aumenta con la edad (p< 0.05). Un 44% tiene entre 1 y 4 piezas dentarias con lesiones de caries dental. El edentulismo fue de 7,1%. Un 20% presentó sacos periodontales > a 5,5 mm. Un 43% presenta higiene oral regular. Un 59,5% usa prótesis removible en el maxilar superior y 40,3% en el inferior. Un 76,6% percibe como mala su calidad de vida. Conclusión: Los adultos mayores son un grupo de especial interés para la salud pública debido a la mala percepción de su calidad de vida y vulnerabilidad de su salud bucal.
Objectives: The purpose of this study was to determine de the status of oral health and life quality of older adults who attend in public health centers in the area orient of Santiago, Chile during the years 2011-2012. Material and method: A descriptive cross-sectional study in a random sample of 380 older adults. Was evaluated the history of caries, periodontal and prosthetic situation. The perceived life quality was measured with the Geriatric Oral Health Assessment Index (GOHAI). Were established two categories: ôBad quality lifeõ (score ≤ 57) and ôGood life qualityõ (score >57). The statistical analysis was done in STATA 11.0. Results, the average age was 71.33 years (E.D. ±7.26); 66.1% are women; 51.6% are married y 78.9% retired. 32.4% have completed secondary education. The CAOD was 22.16 (CI 95% 21.72 to 22.60) more in women (p> 0.05) and increased with age (p <0.05). The 44% have between 1 and 4 teeth with dental caries. Edentulous was 7.1%. The 20% presented periodontal pockets> 5.5 mm. About 43% have regular oral hygiene. The 59.5% a removable prosthesis used in the maxilla and 40.3% in the mandible. The 76.6% perceived bad quality of life. Conclusion: The elderly are a group of special interest for public health due to poor perception of their life quality and oral health vulnerability.
Assuntos
Humanos , Masculino , Feminino , Idoso , Qualidade de Vida , Saúde Bucal , Epidemiologia Descritiva , Estudos TransversaisRESUMO
Hemos realizado 166 polipectomías endoscópicas rectocolónicas en 159 pacientes (78 varones y 81 mujeres). Noventa polipectomías fueron realizadas mediante asa de alambre y 76 resecciones mediante biopsia térmica y/o reiterativa. El procedimiento fue muy bien tolerado y en esta serie se presentó solamente una hemorragia que fue leve y cedió en forma espontánea. Diecisiete de los pólipos resecados endoscópicamente resultaron ser malignos y sólo en 2 la invasión cancerosa iba más allá de la muscular de la mucosa, lo que representa el 11.7% de las lesiones polipoídeas malignas; lo que demuestra que la mayoría de las lesiones de este tipo (88.3%) encuentra en este procedimiento su tratamiento definitivo. El método de la polipectomía endoscópica se discute en base a la clasificación de Yamada para las lesiones elevadas. En aquellas que son aplanadas y de ancha base de implantación se prefiere la ablación mediante biopsia térmica y/o biopsia reiterativa, mientras en las subpedunculadas y pediculadas la polipectomía con asa de alambre es el método más empleado
Assuntos
Pré-Escolar , Criança , Adolescente , Adulto , Pessoa de Meia-Idade , Humanos , Masculino , Feminino , Endoscopia , Pólipos do Colo/cirurgiaRESUMO
La presente investigación se realizó en el Subcentro de la Ferroviaria Baja correspondiente al segundo nivel de atención del Sistema Regionalizado de Salud del Ministerio de Salus Pública. Es una Institución adscrita a la Universidad Central del Ecuador a través de la Facultad de Ciencias Médicas y en la actualidad depende de la Escuela Nacional de Enfermería constituyendo la primera Unidad Operativa de Salud que se dirige por una enfermera profesional. Como primera actividad se realizó un diagnóstico de Salud de esta Unidad Operativa identificando como su principal problema la organización administrativa de este Sub Centro y surge la necesidad de evaluar la calidad de atención que ofrece esta Institución y determinar que factores estan favoreciendo o limitando el cumplimiento de sus labores. Por esta razón es que a través de éste trabajo hemos querido profundizar en el análisis de "Como influye la organización Administrativa del Sub Centro de Salud de la Ferroviaria Baja en la atención integral de Salud de la población del área de influencia de éste, en Quito durante el mes de abril de 1986...