Accuracy of Mean Value of Central Venous Pressure from Monitor Digital Display: Influence of Amplitude of Central Venous Pressure during Respiration.

Background A simple measurement of central venous pressure (CVP)-mean by the digital monitor display has become increasingly popular. However, the agreement between CVP-mean and CVP-end (a standard method of CVP measurement by analyzing the waveform at end-expiration) is not well determined. This study was designed to identify the relationship between CVP-mean and CVP-end in critically ill patients and to introduce a new parameter of CVP amplitude (ΔCVP= CVPmax - CVPmin) during the respiratory period to identify the agreement/disagreement between CVP-mean and CVP-end.Methods In total, 291 patients were included in the study. CVP-mean and CVP-end were obtained simultaneously from each patient. CVP measurement difference (|CVP-mean - CVP-end|) was defined as the difference between CVP-mean and CVP-end. The ΔCVP was calculated as the difference between the peak (CVPmax) and the nadir value (CVPmin) during the respiratory cycle, which was automatically recorded on the monitor screen. Subjects with |CVP-mean - CVP-end|≥ 2 mmHg were divided into the inconsistent group, while subjects with |CVP-mean - CVP-end| < 2 mmHg were divided into the consistent group.Results ΔCVP was significantly higher in the inconsistent group [7.17(2.77) vs.5.24(2.18), P<0.001] than that in the consistent group. There was a significantly positive relationship between ΔCVP and |CVP-mean - CVP-end| (r=0.283, P <0.0001). Bland-Altman plot showed the bias was -0.61 mmHg with a wide 95% limit of agreement (-3.34, 2.10) of CVP-end and CVP-mean. The area under the receiver operating characteristic curves (AUC) of ΔCVP for predicting |CVP-mean - CVP-end| ≥ 2 mmHg was 0.709. With a high diagnostic specificity, using ΔCVP<3 to detect |CVP-mean - CVP-end| lower than 2mmHg (consistent measurement) resulted in a sensitivity of 22.37% and a specificity of 93.06%. Using ΔCVP>8 to detect |CVP-mean - CVP-end| >8 mmHg (inconsistent measurement) resulted in a sensitivity of 31.94% and a specificity of 91.32%.Conclusions CVP-end and CVP-mean have statistical discrepancies in specific clinical scenarios. ΔCVP during the respiratory period is related to the variation of the two CVP methods. A high ΔCVP indicates a poor agreement between these two methods, whereas a low ΔCVP indicates a good agreement between these two methods.

Associated Factors of Oral Health-related Quality of Life in Chinese Adolescents Aged 12-15 Years.

adolescents aged 12 to 15 years based on the 4th National Oral Health Survey and to explore its associated factors. METHODS: Students aged 12 to 15 years were recruited using to a multistage stratified random sampling method. All the subjects received oral examination and completed a questionnaire. Information relating to OHRQoL was collected through a Mandarin version of the child oral impacts on daily performances (Child-OIDP) questionnaire. The relationship between the Child-OIDP scores and independent variables was assessed using a Mann-Whitney U-test, Kruskal-Wallis test and a multivariate Poisson regression. RESULTS: A total of 89,582 subjects were included in the analysis, of whom 76.6% reported oral impacts in the last 6 months. Eating was the most affected daily performance. The results of the regression analysis showed that factors associated with adolescents' OHRQoL included sex, location of residence, region, only child status, parents' level of education, frequency of sugar consumption, self-perception of general/oral health, dental appointments in the past 12 months, oral health knowledge status, age, decayed, missing and filled teeth (DMFT) index and number of teeth with gingival bleeding. CONCLUSION: Oral impacts were common among Chinese adolescents, although most were not so severe. Eating was the most commonly affected performance. Sex, location of residence, region, only child status, parents' level of education, frequency of sugar consumption, selfperception of general/oral health status, dental appointments in the previous 12 months, oral health knowledge status, age, DMFT index and number of teeth with gingival bleeding were found to be associated with OHRQoL.

Cost-effectiveness Analysis of Comprehensive Oral Health Care for Severe Early Childhood Caries in Urban Beijing, China.

OBJECTIVE: To evaluate the cost-effectiveness of comprehensive oral health care for severe early childhood caries (S-ECC) in urban Beijing, China. METHODS: A randomised cluster sampling method was used to select 187 children aged 3 to 5 years with S-ECC from two kindergartens in urban Beijing. Comprehensive oral health care and questionnaires for the parents/guardians were provided to the test group, while an oral health examination and questionnaires for the parents/guardians were provided to the control group. Data were collected and a Markov model was established for a cost-effectiveness analysis. RESULTS: One year later, 614 RMB yuan and 184 RMB yuan were needed for the control and test group, respectively, to reduce one average decayed tooth. The cost for the test group was continuously lower than for the control group during the 4-year simulation. The cumulative cost for the test group was lower than for the control group when the model was circulated for more than 1.5 years. At this time, the change of decayed teeth was stable in the test group. CONCLUSION: Comprehensive oral health care had extraordinary cost-effectiveness for S-ECC. The optimal time to process S-ECC may be after 1.5 years.

Oral Health Knowledge, Attitudes, Behaviour and Oral Health Status of Chinese Diabetic Patients Aged 55 to 74 Years.

OBJECTIVE: To understand the oral health knowledge, attitude, behaviour and oral health status of Chinese diabetic patients so as to facilitate the development of oral health education programmes for diabetic patients in China. METHOD: A face-to-face questionnaire was conducted for 1,024 diabetic patients and 8,030 non-diabetic people aged 55 to 74 years old in order to understand their oral health knowledge, attitudes, and behaviour. Oral health examination was implemented including caries, gingival bleeding, dental calculus, periodontal attachment loss, etc. according to the Oral Health Surveys Basic Methods 5th Edition. RESULTS: Compared with non-diabetic patients, those with diabetes had more oral health knowledge and more positive attitudes. The proportion of people who formed toothbrushing habits was higher in diabetic patients, but that of regular scaling and flossing is as low as that in non-diabetic people. The detection rate of deep periodontal pockets in diabetic patients was higher than that in non-patients, while the caries situation was better than that in non-patients. CONCLUSION: This study has shown that the oral health knowledge, attitude, behaviour and oral health status of the 55 to 64-year-old diabetic population are not optimistic. There is a great need for a systematic oral health education programme in China. The contradiction between a large number of diabetes patients and limited health resources requires us to give priority to the improvement of oral health behaviours, such as educating patients to develop toothbrushing and flossing habits.

Utilisation of Oral Health Services and Economic Burden of Oral Diseases in China.

OBJECTIVE: To evaluate the use of oral health services, the economic burden of oral diseases and related influential factors in China. METHOD: Using the multistage, stratified, equal proportion, random sampling method in the 4th National Oral Health Survey of China conducted in 2015 to 2016, residents aged 3 to 5 years, 12 to 15 years, 35 to 44 years, 55 to 64 years, and 65 to 74 years respectively were recruited, clinically examined and answered a questionnaire. Utilisation of oral health services were assessed in all the age groups and the economic burden of oral diseases in the past 12 months were assessed in the 3 to 5 years and 35 to 74 year-old groups. Chi-squared tests, t tests, correlation analysis and a one-way ANOVA were used to determine the relationships of different factors with utilisation of oral health services and the economic burden of oral diseases. RESULTS: In the subject groups - 3 to 5 years, 12 to 15 years and 35 to 74 years - the prevalence of the utilisation of oral health services in the past 12 months was 14.6% (5,876/40,353), 23.6% (27,936/118,592), and 20.1% (2,708/13,461), respectively. In all three groups, receiving dental treatment was the most common reason for subjects' recent dental visit. The average dental cost in the past 12 months was 403.43 CNY (median = 100) for 3 to 5-year-old children and 850.83 CNY (median = 300) for adults aged 35 to 74 years old. Area, education and annual household income per person were the socio-economic influential factors. Oral health status, oral hygiene and attitudes to and knowledge of oral health affected the utilisation of oral health services and the economic burden of oral diseases. CONCLUSION: The percentage of dental service utilisation was relatively low, and the economic burden was high. The related factors for both utilisation of oral health services and the economic burden of oral diseases included living in area, educational attainment, household income, perceived oral health status, and oral hygiene.