Association between Poor Oral Health and Frailty in Middle-Aged and Older Individuals: A Cross-Sectional National Study.

OBJECTIVES: Older adults with poor oral health may be at higher risk of being pre-frail or frail. However, very few studies have examined this association in Latin American countries and middle-aged individuals. Therefore, we aimed to investigate the association between oral health and frailty status among Chilean adults ≥40 years. DESIGN: Cross-sectional study. SETTING AND PARTICIPANTS: We included 3,036 participants ≥40 years from the Chilean National Health Survey 2016-2017. METHODS: Frailty status was assessed with a 49-item frailty index, while the number of teeth, self-reported oral health, tooth decay, use of prostheses, and oral pain were the oral health conditions included. To assess the association between oral health conditions and frailty, we used multinomial logistic regression models status adjusted for sociodemographic and lifestyle variables. RESULTS: Overall, 40.6% and 11.8% of individuals were classified as pre-frail and frail, respectively. After adjusting for confounders, individuals with ≤20 teeth had a higher likelihood of being frail (odds ratio (OR): 1.94 [95% CI: 1.18-3.20]) than people with >20 teeth. Moreover, people with bad or very bad oral health, as well as oral pain, had a higher likelihood of being pre-frail (OR: 2.04 [95% CI: 1.40-2.97] and OR: 2.92 [95% CI: 1.58-5.39], respectively). Middle-aged individuals with fewer teeth and poor self-reported oral health had a higher likelihood of being pre-frail and frail than people ≥60. CONCLUSIONS AND IMPLICATIONS: Individuals with poor global oral health were more likely to be pre-frail or frail. This association seems to be stronger in people <60 years old. Our results are consistent with previously published reports.

Association between adiposity levels and cognitive impairment in the Chilean older adult population.

Although both obesity and ageing are risk factors for cognitive impairment, there is no evidence in Chile on how obesity levels are associated with cognitive function. Therefore, the aim of the present study was to investigate the association between adiposity levels and cognitive impairment in older Chilean adults. This cross-sectional study includes 1384 participants, over 60 years of age, from the Chilean National Health Survey 2009-2010. Cognitive impairment was evaluated using the Mini-Mental State Examination. BMI and waist circumference (WC) were used as measures of adiposity. Compared with people with a normal BMI, the odds of cognitive impairment were higher in participants who were underweight (OR 4·44; 95 % CI 2·43, 6·45; P < 0·0001), overweight (OR 1·86; 95 % CI 1·06, 2·66; P = 0·031) and obese (OR 2·26; 95 % CI 1·31, 3·21; P = 0·003). The associations were robust after adjustment for confounding variables. Similar results were observed for WC. Low and high levels of adiposity are associated with an increased likelihood of cognitive impairment in older adults in Chile.

[Allergens and nonspecific inducers. Bases for environmental control and prevention in childhood allergy]. / Alérgenos y desencadenantes inespecíficos. Bases para el control ambiental y la prevención en alergia infantil.

Environmental control and preventive measures are reviewed after detailed consideration of antigens which act as allergens and the biological and molecular characteristics of the most frequent allergenic particles as well as the importance of air pollutants, infectious agents and non specific irritants in the allergy sensitization. Dust mites, pollens and mould spores are the most ubiquitous allergens, but in the early childhood trophoallergens are more important than aeroallergens. The purpose of environmental control is avoid or minimize contact of atopic child with allergens and other factors which might predispose to sensitization or induce allergic symptoms. Breast feeding, delayed and controlled introduction of solid foods and avoidance of potentially most allergenic foods by nursing mothers are considered as useful measures, particularly in the allergy-risk children (those with a positive family history).

[Complete triploidy in a live newborn infant. Review and contribution of a new case]. / Triploidía completa en un recién nacido vivo. Revisión y aportación de un nuevo caso.

A preterm newborn with complete triploidy and serious hyaline membrane disease is reported. Characteristic pattern of malformations (large, posterior fontanelle, low-set malformed ears, hypertelorism, exophthalmos, micrognathia, syndactylies of the third and fourth digits of all extremities, micropenis and cryptorchism), and abnormal hematologic features (decreased number of red blood cells and increased RBC indices) suggested diagnosis which was confirmed by a 69,XXY karyotype. As factors with possible causal responsibility authors remark first-month abdominal radiation and chronic exposure to industrial toxic during pregnancy in the mother and no specific trend toward chromosome rupture in the father, and second trimester pre-eclampsia. No familial previous cases of chromosome anomalies nor congenital malformations were referred. From the review of 56 published reports they conclude that triploidy syndrome has a characteristic and recognizable array of phenotype abnormalities.

[Fasciitis with eosinophilia: Shulman syndrome. Report of a case and review of the literature]. / Fascitis con eosinofilia: síndrome de Shulman. Presentación de un caso y revisión de la literatura.

A twelve year-old boy who developed, after a period of strenuous physical work, an illness characterized by thickened skin over his right thigh and hemiabdomen, flexion contractures in right wrist and elbow and in right metacarpophalangeal joints without Raynaud's phenomenon or other visceral symptoms is presented. Pertinent laboratory studies showed hypereosinophilia and hypergammaglobulinemia. Deep-fascia biopsy showed typical findings of fasciitis with eosinophilia. Prednisone therapy resulted in sustained improvement. Periarticular osteopenia of the right hand and mast cell infiltration in fascial biopsy are remarkable features. Authors stress striking differences between fasciitis with eosinophilia or Shulman's syndrome and scleroderma. Clinical picture, laboratory changes, typical histology and a usually rapid response to corticosteroids, as well as some autoimmune diseases possibly associated, suggest a different disease and an immunological pathogenesis. From literature review authors conclude that cases of Shulman's syndrome reported in children are very limited and that this disease should by ruled out in every child with thickened skin changes and articular flexion contractures.

[Acute transient myositis after influenza]. / Miositis aguda transitoria postgripal.

The clinical picture, biological findings and outcome of acute myositis during recovery from influenza are so characteristic that can clearly cut-off it from other diseases affecting the muscles. Five cases of acute bilateral lower-limb myositis are described. A flu-like illness had begun to wane before the onset of severe leg pain, preventing the children from walking. All had abnormal serum CPK and SGOT levels. Virological studies were performed with negative findings. The pathogenic mechanism is unknown. We though that more aggressive studies are not justified in view of the transient nature of the patient's illness and their complete recovery. We stress the need of recognizing such disease in every child complaining of lower leg pain associated with very painful walking into a epidemiological setting of a "influenza-like" illness. We also have reviewed the published bibliography is considered.

[How to recognize an allergic child]. / Cómo reconocer a un niño alérgico.

The morphological signs and functional characteristics which allow the suspicion, by clinical observation, of atopy in a child are described; they are called atopic stigmata; none of them is pathognomonic and is in conjunction of possible allergic disease when they are more valuable. We stress on the significance of the family history and personal antecedents of atopic allergy. If there is atopic disease in one or both parents or some brother or sister, then the allergy-risk in the child is very important. Indications of assess serum IgE levels, as well as their limitations, are discussed. The value of cord blood IgE is useful as a predictive parameter. Diagnostic research must be restricted to what is indicated by a complete and detailed anamnesis and physical exploration.