ABSTRACT
BACKGROUND: Patients with obesity have an increased risk for adverse COVID-19 outcomes. Body mass index (BMI) does not acknowledge the health burden associated this disease. The performance of the Edmonton Obesity Staging System (EOSS), a clinical classification tool that assesses obesity-related comorbidity, is compared with BMI, with respect to adverse COVID-19 outcomes. METHODS: 1071 patients were evaluated in 11 COVID-19 hospitals in Mexico. Patients were classified into EOSS stages. Adjusted risk factors for COVID-19 outcomes were calculated and survival analysis for mechanical ventilation and death was carried out according to EOSS stage and BMI category. RESULTS: The risk for intubation was higher in patients with EOSS stages 2 and 4 (HR 1.42, 95% CI 1.02-1.97 and 2.78, 95% CI 1.83-4.24), and in patients with BMI classes II and III (HR 1.71, 95% CI 1.06-2.74, and 2.62, 95% CI 1.65-4.17). Mortality rates were significantly lower in patients with EOSS stages 0 and 1 (HR 0.62, 95% CI 0.42-0.92) and higher in patients with BMI class III (HR 1.58, 95% CI 1.03-2.42). In patients with a BMI ≥ 25 kg/m2, the risk for intubation increased with progressive EOSS stages. Only individuals in BMI class III showed an increased risk for intubation (HR 2.24, 95% CI 1.50-3.34). Mortality risk was increased in EOSS stages 2 and 4 compared to EOSS 0 and 1, and in patients with BMI class II and III, compared to patients with overweight. CONCLUSIONS: EOSS was associated with adverse COVID-19 outcomes, and it distinguished risks beyond BMI. Patients with overweight and obesity in EOSS stages 0 and 1 had a lower risk than patients with normal weight. BMI does not adequately reflect adipose tissue-associated disease, it is not ideal for guiding chronic-disease management.
Subject(s)
COVID-19 , Obesity , Adult , Aged , COVID-19/complications , COVID-19/epidemiology , COVID-19/mortality , Comorbidity , Female , Hospitalization , Humans , Male , Middle Aged , Obesity/complications , Obesity/epidemiology , Obesity/physiopathology , Retrospective Studies , Severity of Illness Index , Treatment OutcomeABSTRACT
Cerebral palsy (CP) is a condition caused by brain damage before, during, or shortly after birth. Communication can be a challenge when treating patients with CP. Some patients can communicate verbally, while others use augmentative alternative communication tools or have individualized means of communication. Therefore, professional dental treatment in individuals with CP is challenging, especially if the patient is affected by dental trauma and requires emergency treatment. This report shows how individualized communication skills assessment allowed us to successfully manage a 9-year-old patient with CP, who suffered extrusive luxation of the permanent lower incisor. In the present case, the teeth were repositioned briefly after the trauma had occurred and then stabilized with a flexible splint according to international guidelines. The teeth remained vital and periodontal repair was observed during the 4-year follow-up.
Subject(s)
Cerebral Palsy/complications , Dental Care for Children/methods , Dental Care for Chronically Ill/methods , Tooth Avulsion/diagnostic imaging , Tooth Avulsion/therapy , Child , Chile , Female , HumansABSTRACT
Estudio Retrospectivo, descriptivo, transversal. Se encontró que la tasa de incidencia de accidentalidad acumulada fue de 2.1%; los accidentes ocurren durante el desplazamiento a su jornada laboral 8/21(38.1%); y ocurren por la tarde (71.4%); estos accidentes fueron clasificados como atrapamiento 6/21 (28.6%), caída con golpes/atropellamiento 5 (23.8%), cortadura con maquina 2/21 (9.5%), de miembro superior/mano(s) 10/21 (47.6%), miembros inferiores 6/21(28.6%); traumáticas 9/21(42.9%), fractura 8/21(38.1%), quemadura 2/21 (9.5%); los factores relacionados fueron sexo masculino (p=0.000), no uso de elementos de protección (p=0.000), trabajar en el área de mantenimiento/taller industrial/producción (p=0.006; RR: 4.88) sin piso antideslizante (90.5% vrs 9.5%; p=0.000). concluyendo que la tasa de accidentalidad encontrada es baja, aunque deben reforzarse las estrategias de prevención en algunas áreas de la empresa