The influence of continuous renal replacement therapy on 1,3-ß-d-glucan levels in critically ill patients: a single-center retrospective propensity score study.

1,3-ß-d-Glucan (BDG) is commonly used for diagnosing invasive fungal infections (IFIs). While exposure to cellulose-based hemodialyzers is known to cause false-positive BDG results, the impact of modern hemofilters used in continuous renal replacement therapy (CRRT) remains unclear. This retrospective, single-center cohort study aimed to evaluate the effect of CRRT on BDG levels in critically ill patients. We included adult intensive care unit (ICU) patients with ≥1 BDG measurement between December 2019 and December 2020. The primary outcome was the rate of false-positive BDG results in patients exposed to CRRT compared to unexposed patients. Propensity score analysis was performed to control for confounding factors. A total of 103 ICU patients with ≥1 BDG level were identified. Most (72.8%) were medical ICU patients. Forty patients underwent CRRT using hemofilter membranes composed of sodium methallyl sulfonate copolymer (AN 69 HF) (82.5%) and of polyarylethersulfone (PAES) (17.5%). Among the 91 patients without proven IFI, 31 (34.1%) had false-positive BDG results. Univariable analysis showed an association between CRRT exposure and false-positive BDG results. However, the association between CRRT exposure and false-positive BDG results was no longer significant across three propensity score models employed: 1:1 match (n = 32) (odds ratio (OR) 1.65, p = .48), model-adjusted (n = 91) (OR 1.75, p = .38), quintile-adjusted (n = 91) (OR 1.78, p = .36). In this single-center retrospective analysis, exposure to synthetic CRRT membranes did not independently increase the risk of false-positive BDG results. Larger prospective studies are needed to further evaluate the association between CRRT exposure and false-positive BDG results in critically ill patients with suspected IFI.

Diagnóstico situacional de un grupo de Unidades Productoras de Servicios de Medicina de Rehabilitación (UPS-MR) del Perú: estudio preliminar / Situational diagnostic of a group of units producing medical rehabilitation services (UPMRS) in Peru: a preliminary study

Objetivo : Describir el diagnóstico situacional de un grupo de Unidades Productoras de Servicios de Medicina de Rehabilitación (UPS-MR) del Perú evaluadas en el 2019 y 2020. Material y métodos : Estudio observacional, transversal y descriptivo del análisis secundario de datos de la evaluación que realizó la Dirección Ejecutiva de Investigación y Docencia en Prevención de Riesgos y Promoción de la Salud del Instituto Nacional de Rehabilitación "Dra. Adriana Rebaza Flores" AMISTAD PERÚ - JAPÓN a UPS-MR durante los años 2019 y 2020. Las variables fueron: logro en el equipamiento, infraestructura, documentos/herramientas de gestión y manuales y guías de práctica clínica, funciones, recursos humanos, procedimientos y logro total. Cada logro tenía como puntaje mínimo 0% y como puntaje máximo 100%. Además, se realizó un análisis secundario para comparar el logro de las UPS-MR según nivel de categorización y región. Resultados: Catorce UPS-MR fueron incluidas en la investigación. Seis (42,9%) fueron de categoría III-1 y 6 (42,9%) eran de la región Lima. El mayor logro fue en las funciones (74,1%) y el menor logro en los recursos humanos y procedimientos (41,9% y 40,8%). Finalmente, el logro total tuvo una media de 58,3%±14,6%. Conclusiones : Las UPS-MR tienen el mayor logro en las funciones y los menores logros en recursos humanos y procedimientos. El logro total fue alrededor del 50%.

SUMMARY Objective : To describe the situational diagnostic of a group of units producing medical rehabilitation services (UPMRS) in Peru from 2019 to 2020. Methods: This a cross-sectional study that included a secondary analysis of an evaluation performed by the Dirección Ejecutiva de Investigación y Docencia en Prevención de Riesgos y Promoción de la Salud of the Instituto Nacional de Rehabilitación "Dra. Adriana Rebaza Flores" AMISTAD PERÚ - JAPÓN a UPMRS from 2019 to 2020. Variables included in the analyses were achievement of infrastructure, equipment, documents of administration, guidelines of clinical practice, human resources and total achievement. The minimal score per achievement was 0% and the maximum was 100%. Achievements stratified by region and categorization were made. Results: Fourteen PMRS were included; six (42.9%) were category III-1 and six (42.9%) were from Lima Region. Best achievement was in functions (74.1%) and worst was in human resources and procedures (41.9% and 40.8%, respectively). Finally, total achievement had a mean score of 58.3%±14.6%. Conclusions: UPMRS had better achievements in functions and worse in human resources and procedures, total achievement was 50%.

Relationship between intrinsic and extrinsic factors with Erosive Tooth Wear in adults: a cross-sectional study.

The objective of this study was to explore the relationship between intrinsic and extrinsic factors and a high cumulative score of the Basic Erosive Wear Examination (BEWE) in a Chilean adult group. A cross-sectional study was performed with the Ethics Committee's approval from the Universidad de los Andes. A consecutive adult (18 to 46 years old) sampling (n = 553) from the Health Center in San Bernardo-Chile, was selected from September 2016 to January 2017. Dental exams were performed by two trained and calibrated examiners, according to the BEWE index. In order to search for potentially related factors, a hetero-applied questionnaire previously developed and evaluated was applied. Our interest was individuals with severe erosion tooth wear (BEWE ≥ 14). Logistic regression models reporting crude odds ratio (OR) and adjusted OR by age, 95% confidence interval (95%CI), and p-values were estimated. Variables, odds ratios and 95% CI related with BEWE ≥ 14 were: age (OR 1.1 [1.07-1.14]); currently drinking alcohol (OR 1.59 [1.06-2.39]); esophagitis (OR 8.22 [1.60-42.22]); difficulty to swallow (OR 2.45 [1.10-5.44]); chest pain (OR 2.07 [1.18-3.64]); anorexia (OR 3.82 [1.07-13.68]); vitamin C intake (OR 1.92 [1.08-3.43]). Age, alcohol consumption, self-reported esophagitis, history of gastric symptoms, anorexia, and vitamin C intake were related as risk factors to high BEWE scores in this sample of Chilean adults in San Bernardo, Chile.

Metabolic Alkalosis Pathogenesis, Diagnosis, and Treatment: Core Curriculum 2022.

Metabolic alkalosis is a widespread acid-base disturbance, especially in hospitalized patients. It is characterized by the primary elevation of serum bicarbonate and arterial pH, along with a compensatory increase in Pco2 consequent to adaptive hypoventilation. The pathogenesis of metabolic alkalosis involves either a loss of fixed acid or a net accumulation of bicarbonate within the extracellular fluid. The loss of acid may be via the gastrointestinal tract or the kidney, whereas the sources of excess alkali may be via oral or parenteral alkali intake. Severe metabolic alkalosis in critically ill patients-arterial blood pH of 7.55 or higher-is associated with significantly increased mortality rate. The kidney is equipped with sophisticated mechanisms to avert the generation or the persistence (maintenance) of metabolic alkalosis by enhancing bicarbonate excretion. These mechanisms include increased filtration as well as decreased absorption and enhanced secretion of bicarbonate by specialized transporters in specific nephron segments. Factors that interfere with these mechanisms will impair the ability of the kidney to eliminate excess bicarbonate, therefore promoting the generation or impairing the correction of metabolic alkalosis. These factors include volume contraction, low glomerular filtration rate, potassium deficiency, hypochloremia, aldosterone excess, and elevated arterial carbon dioxide. Major clinical states are associated with metabolic alkalosis, including vomiting, aldosterone or cortisol excess, licorice ingestion, chloruretic diuretics, excess calcium alkali ingestion, and genetic diseases such as Bartter syndrome, Gitelman syndrome, and cystic fibrosis. In this installment in the AJKD Core Curriculum in Nephrology, we will review the pathogenesis of metabolic alkalosis; appraise the precipitating events; and discuss clinical presentations, diagnoses, and treatments of metabolic alkalosis.

Patient experience and non-surgical periodontal therapy in a postgraduate periodontal training program: A qualitative study

ABSTRACT: Objective: To explore patient experience for non-surgical periodontal therapy using phenomenography. Methods: This qualitative study was performed in a postgraduate specialist training program in periodontics. Patients reported their experiences through in-depth interviews in order to recognize the impact of non-surgical periodontal therapy on their quality of life and their satisfaction. A homogeneous sampling procedure was used, establishing redundancy after the fifteenth interview. Interviews were audio recorded, transcribed and analyzed by three researchers who codified the answers into categories to determine the emerging topics. Results: The core emerging themes were: (i) lack of information about periodontal disease; (ii) experience during treatment; (iii) treatment implications; and (iv) clinician-patient relationship. Conclusions: Patients seem to have limited knowledge about periodontal diseases. Reasons for attendance mainly include bleeding gums, tooth mobility, and aesthetic problems. Therapy can generate pain, fear, and is considered invasive, whereas dentine hypersensitivity may occur post-operatively. Despite this, patients would be willing to undergo treatment again and were generally satisfied with the level of care and treatment received.

Percepción de las vías del parto de mujeres en edad reproductiva: una revisión de la literatura / Perception regarding the delivery routes of women in reproductive age: a literature review

OBJETIVO: Explorar la percepción de mujeres en edad reproductiva con respecto a las vías del parto reportada en la evidencia disponible. MÉTODO: Se llevó a cabo una revisión sistematizada de artículos en las bases de datos PubMed, SciELO, SCOPUS, Web of Science, LILACS, Cochrane Library y Biblioteca Virtual de Salud. La búsqueda se realizó entre agosto y noviembre del año 2020. Los términos MeSH usados fueron "Perception", "Delivery Obstetric", "Cesarean Section" y "Woman", junto con los términos DECS "Percepción", "Parto Obstétrico", "Cesárea" y "Mujeres". Además, se utilizaron los términos libres "Perceptions", "Vaginal Delivery", "Obstetric Deliveries", "Abdominal Deliveries", "Caesarean Section" y "Womens Groups". En la totalidad de las bases de datos utilizadas se aplicaron como límites de búsqueda "Last 5 Years" y "Free Full Text". RESULTADOS: Respecto a la percepción de las vías de parto, se constató la preferencia de la vía vaginal sobre la cesárea. Además, se evidenciaron factores que influyen en el proceso, tales como miedo, experiencia previa, influencia de terceros, religión, cultura, nivel socioeconómico y zona demográfica. CONCLUSIONES: La evidencia revisada sugiere que las mujeres prefieren la vía del parto vaginal sobre la cesárea, siendo el miedo el factor más influyente al momento de su elección, seguido por los factores asociados a experiencias previas, el nivel socioeconómico y las creencias.

OBJECTIVE: To explore the perception of women of reproductive age regarding delivery routes reported in the available evidence. METHOD: A systematized review of articles in PubMed, SciELO, SCOPUS, Web of Science, LILACS, Cochrane Library, Biblioteca Virtual de Salud databases, was carried out. The search was conducted between August and November 2020. MeSH descriptors "Perception", "Delivery Obstetric", "Cesarean Section" and "Woman", along with DECS descriptors "Percepciones", "Parto Obstétrico", "Cesárea" and "Mujeres", were used. Also, free terms "Perceptions", "Vaginal Delivery", "Obstetric Deliveries", "Abdominal Deliveries", "Caesarean Section" and "Womens Groups". In the totality of databases limits of search "Last 5 years" and "Free Full Text", were used. RESULTS: Regarding the perception of the delivery routes, the preference of the vaginal route over caesarean section was verified. In addition, factors that influence the process such as fear, previous experience, influence of third parties, religion, culture, socioeconomic level and demographic area were evidenced. CONCLUSIONS: The reviewed evidence suggests that women prefer the vaginal delivery route over caesarean section with fear being the most influential factor at the time of their choice, and secondly, the factors associated with previous experiences, socioeconomic level and beliefs.

Relationship between intrinsic and extrinsic factors with Erosive Tooth Wear in adults: a cross-sectional study

Abstract The objective of this study was to explore the relationship between intrinsic and extrinsic factors and a high cumulative score of the Basic Erosive Wear Examination (BEWE) in a Chilean adult group. A cross-sectional study was performed with the Ethics Committee's approval from the Universidad de los Andes. A consecutive adult (18 to 46 years old) sampling (n = 553) from the Health Center in San Bernardo-Chile, was selected from September 2016 to January 2017. Dental exams were performed by two trained and calibrated examiners, according to the BEWE index. In order to search for potentially related factors, a hetero-applied questionnaire previously developed and evaluated was applied. Our interest was individuals with severe erosion tooth wear (BEWE ≥ 14). Logistic regression models reporting crude odds ratio (OR) and adjusted OR by age, 95% confidence interval (95%CI), and p-values were estimated. Variables, odds ratios and 95% CI related with BEWE ≥ 14 were: age (OR 1.1 [1.07-1.14]); currently drinking alcohol (OR 1.59 [1.06-2.39]); esophagitis (OR 8.22 [1.60-42.22]); difficulty to swallow (OR 2.45 [1.10-5.44]); chest pain (OR 2.07 [1.18-3.64]); anorexia (OR 3.82 [1.07-13.68]); vitamin C intake (OR 1.92 [1.08-3.43]). Age, alcohol consumption, self-reported esophagitis, history of gastric symptoms, anorexia, and vitamin C intake were related as risk factors to high BEWE scores in this sample of Chilean adults in San Bernardo, Chile.

Academics' and students' experiences in a chilean dental school during the COVID-19 pandemic: A qualitative study.

INTRODUCTION: The quick spread of COVID-19 has caused part of the world's population to adopt quarantine protocols that have limited professional activities, including dental training programmes. This study aimed to explore the experiences of students and personnel at a Chilean dental school during the COVID-19 pandemic. MATERIALS AND METHODS: This phenomenological descriptive qualitative study reported staff and students' experiences during the pandemic through in-depth, semi-structured interviews. These were recorded on audio and video with a digital platform. Three researchers then transcribed and analyzed the recordings and codified the answers into categories to determine the emerging topics until a saturation point was reached. RESULTS: The core emerging themes among the staff group were (1) change in the personal/professional life balance, (2) online learning through digital platforms, (3) staff perceptions of students' learning experiences, and (4) concerns about the future. For students, the themes were (1) changes in the learning process, (2) online learning through digital platforms, (3) interpersonal relationships, and (4) concerns about the future. CONCLUSION: The COVID-19 pandemic has been a period of learning for our dental school staff and students. Even though online learning has been a useful tool for delivering didactic (theoretical) concepts, it has been unable to replace conventional education, including skills training. Students and teachers reported being overwhelmed at the beginning of the pandemic, but they have shown remarkable adaptability and resilience during this period.

Índice de Masa Corporal una medida antropométrica asociada a Índice TG/HDL, un novel factor de riesgo cardio-metabólico / Body Mass Index An Anthropometric Measure Associated With TG / HDL Index, A Novel Cardio-Metabolic Risk Factor

Objetivos: determinar la relación entre obesidad e índice TG/HDL en pacientes atendidos en el servicio de consulta externa de endocrinología del hospital nacional Sergio Bernales en el año 2018. Métodos: el estudio fue observacional, analítico, tipo casos y controles no emparejado a razón de 4:1, con un total 288 sujetos de estudio siendo 230 controles y 58 casos quienes cumplieron con criterios de selección, involucro a los pacientes atendidos en el servicio de consulta externa endocrinología. La muestra fue aleatoria simple, se incluyeron las variables, Sexo, edad, Índice de masa corporal, Colesterol total, Triglicéridos total, HDL-c, LDL-c, Índice TG/HDL. Se empleó un modelo de regresión logística para obtener un Odds Ratio para fuerza de asociación. Resultados: La frecuencia relativa de obesidad fue del 65.52% y 29.13%, para los casos y controles respectivamente, a su vez una significancia estadística con la prueba exacta de Fisher, P-valor 0.000. Se encontró un por regresión logística bivariada una relación entre Obesidad e Índice TG/HDL-c (OR 4.62, p=0.000, IC95% 2.51-8.52). Conclusiones: se encontró una relación entre la Obesidad y el índice TG/HDL-c pudiéndose extrapolar a población adulta atendida en el servicio de endocrinología de Lima Metropolitana, este es el primer artículo publicado al respecto a nivel nacional, se recomiendan estudios prospectivos para determinar causalidad.

Objectives: to determine the relationship between obesity and the TG / HDL index in patients treated at the endocrinology outpatient service of the Sergio Bernales national hospital in 2018. Methods: the study was observational, analytical, case-control type not matched to ratio of 4: 1, with a total of 288 study subjects, 230 controls and 58 cases who met the selection criteria, involved the patients treated in the endocrinology outpatient service. The sample was simple random, the variables were included: Sex, age, Body mass index, Total cholesterol, Total triglycerides, HDL-c, LDL-c, TG / HDL index. A logistic regression model was used to obtain an Odds Ratio for the strength of association. Results: The relative frequency of obesity was 65.52% and 29.13%, for cases and controls respectively, in turn a statistical significance with Fisher's exact test, P-value 0.000. A bivariate logistic regression found a relationship between Obesity and TG / HDL-c Index (OR 4.62, p = 0.000, 95% CI 2.51-8.52). Conclusions: a relationship was found between Obesity and the TG / HDL-c index, which can be extrapolated to the adult population treated in the endocrinology service of Metropolitan Lima, this is the first article published in this regard at the national level, prospective studies are recommended to determine causality.

Variations in Insurance Policies Regarding Adherence to the AGA Guideline for Therapeutic Drug Monitoring in IBD.

BACKGROUND: The American Gastroenterological Association (AGA) published guidelines on therapeutic drug monitoring (TDM) in inflammatory bowel disease (IBD) in August 2017 recommending use of reactive TDM to guide treatment changes in patients with active IBD who are being treated with anti-tumor necrosis factor (anti-TNF) agents or thiopurines. We sought to determine if changes in national clinical practice guidelines result in changes in health care insurance policies within 6 months of publication. METHODS: Using the National Association of Insurance Commissioners Market Share Reports of the top 125 insurance companies by market share in 2016, we reviewed the largest 50 companies for their publicly available online policies regarding TDM of anti-TNF and thiopurine in IBD. For those with available policies, we looked for whether proactive and/or reactive TDM was covered. Policies were also looked for genetic or enzymatic activity of thiopurine methyltransferase (TPMT) testing before use of thiopurine. All these policies were reviewed within the week of publication of the AGA guideline. They were reviewed again 1, 3, and 6 months later for evaluation of any policy changes after the published AGA guidelines. RESULTS: Fifty of the largest insurance company policies were included. With regards to TDM policy for anti-TNF, we did not find a difference between baseline and 6 months values (P=0.38). With regards to TDM policy for thiopurine, we did not find a difference between baseline and 6 months values (P=1.00). About half of the companies did not have a policy regarding TPMT testing for thiopurine use. Of those with available policies for TPMT testing, there was no difference between baseline and 6 months values (P=0.13). CONCLUSIONS: Even after publication of national guidelines, a large number of the largest health insurance companies do not have a policy regarding reactive TDM for anti-TNF and/or thiopurines. Majority of those with a policy, fail to meet the current standards set forth by the practice guidelines. A significant gap remains between the insurance policies and AGA guidelines. Further studies are needed to determine how to effectuate change to improve insurance company adherence to clinical practice guidelines.

Is the risk of preeclampsia higher in donor oocyte pregnancies? A systematic review and meta-analysis.

OBJECTIVE: Preeclampsia (PE) occurs in 4.6% of pregnancies worldwide. The social phenomenon of increasing maternal age has raised the demand for donor oocytes. Egg donation has allowed women with poor ovarian reserve, premature ovarian failure, genetic disorders or surgical menopause to get pregnant. Recipients provide a unique model of immune response because of the differences in the genetic makeup of mothers and fetuses. In PE, immune tolerance may be impaired as a result of having non-autologous eggs implanted. Egg donation is a highly successful assisted reproductive technology, despite the significant number of issues arising from the implantation of non-autologous eggs. This study aimed to determine whether there is an association between egg donation and preeclampsia. METHODS: A systematic review of the literature available in PubMed and Google Scholar was carried out from January of 1995 to August of 2016 using the terms 'oocyte donation, preeclampsia', 'oocyte donation, in vitro fertilization, preeclampsia', 'oocyte donation, preeclampsia, outcomes pregnancies', 'oocyte donation, obstetric outcome.' Only six retrospective cohort studies met the selection criteria. RESULTS: The meta-analysis revealed a statistically significant association between egg donation and onset of preeclampsia (OR 4.50; 95% CI: 3.28-6.19; p<0.0001). CONCLUSION: Oocyte donation is associated with increased risk of preeclampsia in singleton pregnancies. Therefore, it is crucial to properly record and assess this finding when egg donation is the chosen assisted reproductive technology to attain pregnancy.

There is no association between the presence of anti-thyroid antibodies and increased reproductive loss in pregnant women after ART: a systematic review and meta-analysis.

Women submitted to ART treatments represent a select subgroup of individuals. Several studies have described the relationship between TAI and pregnancy outcomes as a result of ART, with contradictory results. The purpose of this systematic review was to determine the association between TAI and the risk of miscarriage in pregnancies resulting from ART. MEDLINE via PubMed, LILACS and Embase were searched for studies published in peer-reviewed journals from 1999 to 2017. The studies were summarized using the fixed effects model and the Peto's method to calculate RR in order to flesh out the association between TAI and spontaneous abortion. Only four papers were included in this systematic review and meta-analysis. Thirty-one miscarriages were observed in 210 clinical pregnancies of women with antithyroid antibodies; and 158 miscarriages were seen in 1,371 pregnancies without antithyroid antibodies. The meta-analysis failed to find an association between TAI and higher risk of reproductive loss, RR=0.94 95% confidence interval: 0.71-1.24; p=0.879. In conclusion, the presence of antithyroid antibodies was not associated with increased reproductive loss in patients submitted to ART treatments. It is our opinion that the presence of antithyroid antibodies should be considered as a secondary biomarker of autoimmune disease, rather than an actual cause of miscarriage in patients undergoing ART. Due to the small amount of evidence on the matter, the determination of TAI before the initiation of ART should be limited to research contexts.

Gestational Chronodisruption Impairs Circadian Physiology in Rat Male Offspring, Increasing the Risk of Chronic Disease.

Chronic exposure to light at night, as in shift work, alters biological clocks (chronodisruption), negatively impacting pregnancy outcome in humans. Actually the interaction of maternal and fetal circadian systems could be a key factor determining a fitting health in adults. We propose that chronic photoperiod shift (CPS) during pregnancy alter maternal circadian rhythms and impair circadian physiology in the adult offspring, increasing health risks. Pregnant rats were exposed to normal photoperiod (12 h light, 12 h dark) or to CPS until 85% of gestation. The effects of gestational CPS were evaluated on the mother and adult offspring. In the mother we measured rhythms of heart rate, body temperature, and activity through gestation and daily rhythms of plasma variables (melatonin, corticosterone, aldosterone, and markers of renal function) at 18 days of gestation. In adult offspring, we measured rhythms of the clock gene expression in the suprachiasmatic nucleus (SCN), locomotor activity, body temperature, heart rate, blood pressure, plasma variables, glucose tolerance, and corticosterone response to ACTH. CPS altered all maternal circadian rhythms, lengthened gestation, and increased newborn weight. The adult CPS offspring presented normal rhythms of clock gene expression in the SCN, locomotor activity, and body temperature. However, the daily rhythm of plasma melatonin was absent, and corticosterone, aldosterone, renal markers, blood pressure, and heart rate rhythms were altered. Moreover, CPS offspring presented decreased glucose tolerance and an abnormal corticosterone response to ACTH. Altogether these data show that gestational CPS induced long-term effects on the offspring circadian system, wherein a normal SCN coexists with altered endocrine, cardiovascular, and metabolic function.

Hemifacial Spasm in a Child Treated With Microvascular Decompression of the Facial Nerve.

BACKGROUND: Hemifacial spasm is a rare condition in children that is characterized by involuntary contractions of muscles innervated by the ipsilateral facial nerve. PATIENT DESCRIPTION: We describe a 6-year-old girl who presented with intermittent involuntary spasms of the right face. Magnetic resonance imaging demostrated a loop of the anterior inferior cerebral artery contacting and elevating the cisternal segment of the right facial nerve; this finding was confirmed at surgery where microvascular decompression of the facial nerve was performed without complication. Following surgery she had immediate remission of symptoms, but the hemifacial spasms slowly recurred within 8 months of surgery only to resolve by age 11 years. CONCLUSION: This is the youngest patient reported with hemifacial spasms related to a vascular etiology, which initially responded to surgical treatment. The authors review this syndrome in children and discuss possible etiologies and management options.

Creencias y prácticas de salud bucal de padres de párvulos: estudio cualitativo / Beliefs and practices of oral health in parents of pre-school children: a qualitative study

Dentro de los procesos patológicos bucales, la caries dental constituye una enfermedad de alta prevalencia, siendo prevenible con medidas de higiene bucal fácilmente adquiribles desde temprano en la vida. Desde los 90 en Chile se ha direccionado la instalación del hábito del cepillado dental diario, al menos 2 veces al día, con pasta fluorada como medida preventiva en niños de 6 y más años, abarcando luego a párvulos, según la evidencia disponible. Objetivo Explorar las creencias, conocimientos y prácticas de los padres y/o apoderados de preescolares de 2 y 3 años, de una comuna urbana de la región metropolitana Lo Prado. Método Investigación cualitativa, con diseño descriptivo de una muestra no probabilística, homogénea, de 14 apoderados mediante entrevistas en profundidad. Resultados Los resultados de las descripciones hechas por las madres y/o padres de los párvulos generó categorías: 1) importancia de la salud bucal y su cuidado; 2) encargado del cuidado de la salud bucal; 3) uso de pasta de dientes fluoradas; 4) percepción de la salud bucal del párvulo; 5) uso de estímulos positivos o negativos asociados; y 6) necesidad de mayor información para el cuidado de la salud bucal. Conclusiones La salud bucal se percibe correlacionada con una buena apariencia, siendo importante una buena higiene para lograrla, a lo que se suma el consumo de pocos hidratos de carbono. Las mujeres son las encargadas de transmitir el conocimiento, enseñar y supervisar la higiene de los menores, quedando el resto de la familia relegada a un plano de apoyo.

Among oral pathologies, dental caries is the one that is easy to prevent with dental hygiene measures. Since the 1990's, oral health education has aimed at instilling the habit of tooth brushing twice a day with fluoride toothpaste to prevent this disease. However, there is a need to understand the effect of the context on the expected outcomes. Objective This study aimed to determine the oral health practices of parents of pre-school children in an urban community of the Metropolitan Region of Chile, Lo Prado. Method This was a qualitative study with a descriptive design, and a non-probabilistic sample of 14 parents, using in-depth interviews. Results The analysis of the results was performed starting from transcription and codification of the descriptions made by the mothers, generating categories: (1) Oral health care, (2) persons in charge of teaching the tooth brushing habit, (3) use of fluoride dentifrices, (4) perception of oral health status, (5) associated positive or negative stimuli, and (6) the need for more information on oral health issues. Conclusions Oral health is perceived to correlate with a good appearance, and to attain it, a good oral hygiene is considered important, along with a reduction in the amount of carbohydrates ingested. Women are the ones that are socially in charge of the establishment and maintenance of this habit.

Factores asociados a accidentes, enfermedades y ausentismo laboral: análisis de una cohorte de trabajadores formales en Chile / Factors associated with accidents, illness and absenteeism: analysis of a cohort of formal workers in Chile

Objetivo: Estimar la asociación entre factores de riesgo y la ocurrencia de enfermedades, accidentes y ausentismo laboral en trabajadores formales. Método: Estudio de cohorte retrospectiva usando dos fuentes de información: registro de evaluaciones ocupacionales preventivas y de episodios de accidentes y enfermedades laborales (2009-2012). Se realizó un análisis descriptivo de variables de salud y de factores de riesgo. Regresiones logísticas para la ocurrencia de enfermedades y accidentes. Se usó una regresión Poisson-cero-inflado para el ausentismo laboral. Resultados: los > 60 años tienen un exceso de riesgo de enfermedad laboral (OR-ajustada 19,18 respecto a < 30 años) y los sedentarios una OR-ajustada 1,75. Los < 30 años tienen una OR-ajustada de 1,38, los que tienen circunferencia de cintura (CC) superior a la recomendada una OR-ajustada de 1,31 y los sedentarios 1,23 para la probabilidad de accidentes de trabajo. Las mujeres tienen una OR-ajustada 1,99 y CC-superior 1,29 para la probabilidad de accidente de trayecto. Ser mujer (IRR 1,45), tener > 60 años (IRR 2,69), trabajar en actividades inmobiliarias (IRR 2,37) y en explotación de minas (IRR 2,38), tienen una probabilidad mayor de más días de ausentismo. Conclusiones: Factores no modificables (sexo y edad), junto con factores modificables, como el sedentarismo y el estado nutricional, contribuyen a eventos laborales no deseados.

Objective: To determine the association among lifestyle-related risk factors and the occurrence of occupational diseases, accidents and absenteeism in a cohort of formal workers. Method: A retrospective cohort study was carried out by using two information sources: a registry of preventive occupational evaluations and another registry of episodes of occupational accidents and diseases (2009-2012). A descriptive analysis was performed of health variables and risk factors. Logistic regressions were used to calculate the likelihood of occupational accidents and diseases and a zero-inflated Poisson regression was used to model occupational absenteeism. Results: A total of 47.221 workers were included, of which 86,3% were men. The mean follow-up was 1,96 years. Workers aged >60 years had an excess risk of occupational diseases, with an OR of 19.18 compared with workers aged <30 years, while sedentary workers had an OR of 1,75. The likelihood of occupational accidents was higher in workers younger than 30 years (OR 1,38), those with a waist circumference (WC) higher than recommended (OR 1,31) and those who were sedentary (OR 1,23). Women had an OR of 1.99 and those with a WC higher than recommended had an OR of 1,29 for the likelihood of a commuting accident to and from work. Female sex (IRR 1,45), age >60 years (IRR 2,69), and working in the property sector (IRR 2,37) and in mining (IRR 2,38) conferred a higher probability of absenteeism. Conclusions: Unmodifiable factors (age and sex), as well as modifiable factors, such as sedentariness and nutritional status, contribute to undesired occupational events.

Conocimientos y prácticas en prevención de caries y gingivitis en educadores de párvulos, JUNJI, Santiago / Knowledge and preventive practices regarding cavities and gingivitis among Kindergarten teachers fron the National Board of Kindergartens of Santiago

Objetivos: La caries dental y la gingivitis son prevalentes en la población infantil. El propósito de este estudio fue describir los conocimientos que poseen los educadores de párvulos de la provincia de Santiago, en la prevención de caries y gingivitis de los preescolares, así como las prácticas declaradas que realizan durante la jornada escolar, que pudiesen favorecer el control de éstas. Método: Se realizó un estudio descriptivo, transversal, y cuantitativo, con un muestreo probabilístico estratificado proporcional, por conglomerados, bietápico para seleccionar unamuestra de 209 profesionales, de la Junta Nacional de Jardines Infantiles de Santiago, quiénes respondieron un cuestionario auto-administrado, previamente validado. (Confiabilidad 0.78, alphade Cronbach). Resultados: El nivel de conocimientos fue catalogado como bueno (0.69, intervalo de confianza0.67-0.70). En cuanto a las prácticas preventivas, en el 98 por ciento de los establecimientos se realiza cepillado dental. En relación al tipo de alimentos consumidos, priman las frutas y leche, con un 52.3 por ciento y un 58.3 por ciento respectivamente. Los tópicos con menor porcentaje de respuestas correctas correspondieron a uso de fluorurostópicos, edad de inicio y frecuencia de cepillado. Conclusión: Existe un nivel adecuado de conocimientos en los docentes, lo que constituye una herramienta valiosa para generar y mantener cambios conductuales favorables a la salud bucal. En el ámbito de las prácticas declaradas, prácticamente la totalidad de los educadores consultados reporta que sus pupilos realizan el cepillado dentario, con una frecuencia de dos veces al día, siendo concordante con lo recomendado como efectivo en la literatura especializada.

Purposes: Dental cavities and gingivitis are prevalent among the pediatric population. The purpose of the present work was to describe the knowledge in cavity and gingivitis prevention among kindergarten teachers in the province of Santiago and to assess their declared practices during the full school day which might prevent such conditions. Methods: A cross-sectional, descriptive, and quantitative study was conducted with proportional stratified probabilistic cluster two-stage to select a sample of 209 professionals from the National Board of Kindergartens of the province of Santiago, who answered a previously validated self administered survey (Cronbach’s alpha reliability of 0.78). Results: The degree of knowledge was rated as good (0.69, Confidence Interval 0.67-0.70). As for preventive practices, tooth brushing was carried out in 98 percent of the facilities. With regard to the kind of food consumed, fruits and milk prevailed, with 52.3 percent and 58.3 percent respectively. The topics with the lowest correct answer rates were those regarding the use of topical fluoride, the onset of tooth brushing habits and tooth brushing frequency. Conclusions: There is an adequate degree of knowledge among teachers. Such knowledge constitutes a valuable tool to generate and sustain behavioral changes favoring oral health. In the field of declared practices, practically all the teachers surveyed reported that their pupils toothbrush on a twice a week basis, thus being in accordance with the recommended effective tooth brushing practice in the specialized literature.