A three-dimensional Oral health-related quality of life framework for temporomandibular joint disorders: A structural analysis of the Oral Health Impact Profile-14.

OBJECTIVES: the objective is to analyze the structure and relationship between the components of the Oral health-related quality of life using the Oral Health Impact Profile-14 (OHIP-14) for patients with temporomandibular joint disorders (TMJD). METHODS: two studies were examinated by means of factor analysis, multidimensional scaling and their spatial display in a cross-sectional design (n = 153). RESULTS: three-dimensional solutions with an adequate fit were found: residual distribution, root mean square of residuals (RMSR) = 0.04, Goodness of Fit Index (GFI) = 0.96, and Adjusted Goodness of Fit Index (AGFI) = 0.93; and Stress I = 0.023, respectively. The overall ordinal alpha coefficient was 0.92 (CI=0.90 to 0.94). The ordinal alpha coefficients for functional impact, psychosocial impact and psychological impact factors were 0.87 (CI=0.84 to 0.90), 0.88 (CI=0.84 to 0.91) and 0.78 (CI= 0.72 to 0.83), respectively. Item 9 was the most central, followed by 7 and 11. Items 1 and 2 had minor associations. There was no evidence of differences between centers: edge weight differences (M = 0.226, p = 0.94), global strength invariance test (S = 1.88, p = 0.1), centrality invariance test (p >0.05), edge invariance test (p >0.05). CONCLUSIONS: the links between the dimensions and the items seem to involve psychological components. Oral health-related quality of life emerged as a three-dimensional structure (Functional Impact, Psychosocial Impact and Psychological Impact) of functional and psychosocial elements in which physical, psychological, and social disability were essential, while theoretical functional limitation was least important. CLINICAL SIGNIFICANCE: the three-dimensional OHRQoL system for temporomandibular disorders (TMD) is a worthwhile alternative to interpret psychological and psychosocial aspects.

Características del parto y resultados neonatales en mujeres inmigrantes / Characteristics of labour and neonatal outcomes in immigrant women

OBJETIVO: identificar las características específicas del parto y resultados neonatales según la nacionalidad de las mujeres en el Hospital Infanta Cristina de Parla (Madrid).MÉTODO: estudio observacional longitudinal con recogida retrospectiva de información, utilizando datos de 404 partos (202 de mujeres gestantes españolas y 202 de mujeres gestantes inmigrantes)asistidos en el Servicio de Ginecología y Obstetricia del Hospital Infanta Cristina de la localidad de Parla (Madrid) durante los años 2012 y 2013. RESULTADOS: la población inmigrante proviene de hasta 30 países diferentes. Las mujeres gestantes africanas son el grupo mayoritario(37%), seguidas por americanas (28%), resto de Europa (19%)y Asia (16%).Las mujeres gestantes inmigrantes del área de salud estudiada tienen menor edad (media 29 años (DE: 5,1)), menor duración de la gestación (media 39,2 semanas DE: 1,2), menor índice de utilización de analgesia epidural (71,8%) y neonatos con mayor peso(peso medio 3.352 g DE: 431) que las mujeres gestantes españolas, de manera estadísticamente significativa. Los resultados obstétricos y perinatales referentes al tipo de registro cardiotocográfico, tipo de parto, pinzamiento de cordón umbilical, test de Apgar, pH de arteria umbilical y tipo de reanimación neonatal no presentan diferencias significativas entre inmigrantes y españolas. CONCLUSIONES: las mujeres gestantes inmigrantes del área estudiada presentan características obstétricas similares a las españolas. A diferencia de las españolas son más jóvenes, utilizan menos la analgesia epidural y sus recién nacidos presentan mayor peso al nacimiento

OBJECTIVE: to identify the specific characteristics of labour and neonatal results according to the nationality of women in the Hospital Infanta Cristina in Parla (Madrid).METHOD: a longitudinal observational study with retrospective collection of information, using data from 404 labours (202 for Spanish pregnant women and 202 for immigrant pregnant women), managed at the Gynaecology and Obstetrics Unit of the Hospital Infanta Cristina located in Parla (Madrid) during the years2012 and 2013.RESULT: the immigrant population originates from up to 30different countries. African pregnant women form the majority group (37%), followed by American women (28%), women from the rest of Europe (19%) and Asian women (16%).The immigrant pregnant women in the healthcare area studied are younger (mean 29-year-old (SD: 5.1)), their pregnancy has as horter duration (mean 39.2 weeks, SD: 1.2), a lower rate of use of epidural analgesia (71.8%), and newborns with a higher weight(mean weight of 3,352 g SD: 431) than Spanish pregnant women, in a statistically significant way. There are no significant differences between immigrant and Spanish women regarding obstetric and perinatal outcomes about the type of cardiotocographic record, type of labour, umbilical cord clamping, Apgar Test, umbilical artery pH, and type of neonatal resuscitation. CONCLUSIONS: the immigrant pregnant women of the area studied present obstetric characteristics similar to Spanish women. Unlike Spanish women, they are younger, they use epidural anaesthesia to a lower extent, and their newborns have a higher weight at birth

Malnutrición asociada a disfagia orofaríngea en pacientes mayores de 65 años ingresados en una unidad médico-quirúrgica / Relationship between dysphagia and malnutritition in patients over 65 years of age

OBJETIVOS: El objetivo principal es conocer la relación existente entre disfagia orofaríngea, situación de riesgo nutricional y deterioro funcional en pacientes mayores de 65 años ingresados en una unidad de hospitalización médico-quirúrgica. Los objetivos secundarios son determinar la prevalencia de disfagia orofaríngea, conocer el estado nutricional y la capacidad funcional de estos pacientes. METODOLOGÍA: Estudio observacional, analítico y transversal que incluyó durante los meses de febrero a marzo del 2013 a pacientes mayores de 65 años ingresados en la unidad de Digestivo-Urología del Hospital Universitario de la Princesa. Se registraron las siguientes variables: edad, sexo, índice de masa corporal, soporte familiar, diagnóstico, comorbilidad, disfagia orofaríngea (EAT-10 y método de evaluación clínica volumen-viscosidad), malnutrición (Mininutritional Assessment) y capacidad funcional de los pacientes (índice de Barthel). RESULTADOS: Se reclutó a 167 pacientes, siendo la prevalencia de disfagia y de malnutrición del 30,8 y 15,4% respectivamente. En pacientes con disfagia orofaríngea la prevalencia de problemas nutricionales aumentó hasta el 75%. En el análisis de regresión logística, la obtención de una puntuación baja en el índice de Barthel (OR 0,97 [IC 95%; 0,95-0,99]), la presencia de comorbilidad (OR 7,98 [IC 95%; 3,09-20,61]) y padecer disfagia (OR 4,07 [IC 95%; 1,57-10,52]) se asociaron a una mayor probabilidad de padecer malnutrición. Discusión: La disfagia orofaríngea es uno de los problemas más infradiagnosticados y subestimados entre los pacientes ancianos y que mayor afectación tiene sobre su estado nutricional. Sugerimos detectarla de forma precoz mediante los métodos diagnósticos establecidos y con la colaboración de un equipo multidisciplinar

AIMS: The main objective of this study was to understand the relationship between oropharyngeal dysphagia, nutritional risk factors and functional impairment in the elderly (> 65 y) admitted to a medical-surgical hospital unit. Secondary objectives were to determine the prevalence of oropharyngeal dysphagia, the nutritional status and their functional capacity. METHODS: A cross-sectional observational study was performed. It included patients over 65 years of age admitted to the Gastroenterology-Urology Department in La Princesa University Hospital (Madrid, Spain) during the months of February and March. The following variables were recorded: age, sex, body mass index, family support, diagnosis, comorbidity, oropharyngeal dysphagia (EAT-10 and volume-viscosity evaluation method), malnutrition (Mininutritional Assessment) and functional capacity (Barthel index). RESULTS: A total of 167 patients were recruited, with 30.8% and 15.4% prevalence of dysphagia and malnutrition, respectively. Prevalence of malnutrition increased to 75% in patients with oropharyngeal dysphagia. The logistic regression analysis showed how conditions as low score on the Barthel index (OR 0.97 [95% CI, 0.95-0.99]), comorbidity (OR 7.98 [CI 95%, 3.09-20.61]) and dysphagia (OR 4.07 [CI 95%, 1.57-10.52]) were associated with a greater likelihood of suffering malnutrition. Discussion: Oropharyngeal dysphagia is one of the most underdiagnosed and underestimated conditions among elderly patients and one that has a greater effect on their nutritional status. Accordingly, we suggest using established diagnostic methods with a multidisciplinary team collaboration for its early detection

[Relationship between dysphagia and malnutritition in patients over 65 years of age]. / Malnutrición asociada a disfagia orofaríngea en pacientes mayores de 65 años ingresados en una unidad médico-quirúrgica.

AIMS: The main objective of this study was to understand the relationship between oropharyngeal dysphagia, nutritional risk factors and functional impairment in the elderly (>65y) admitted to a medical-surgical hospital unit. Secondary objectives were to determine the prevalence of oropharyngeal dysphagia, the nutritional status and their functional capacity. METHODS: A cross-sectional observational study was performed. It included patients over 65 years of age admitted to the Gastroenterology-Urology Department in La Princesa University Hospital (Madrid, Spain) during the months of February and March. The following variables were recorded: age, sex, body mass index, family support, diagnosis, comorbidity, oropharyngeal dysphagia (EAT-10 and volume-viscosity evaluation method), malnutrition (Mininutritional Assessment) and functional capacity (Barthel index). RESULTS: A total of 167 patients were recruited, with 30.8% and 15.4% prevalence of dysphagia and malnutrition, respectively. Prevalence of malnutrition increased to 75% in patients with oropharyngeal dysphagia. The logistic regression analysis showed how conditions as low score on the Barthel index (OR 0.97 [95% CI, 0.95-0.99]), comorbidity (OR 7.98 [CI 95%, 3.09-20.61]) and dysphagia (OR 4.07 [CI 95%, 1.57-10.52]) were associated with a greater likelihood of suffering malnutrition. DISCUSSION: Oropharyngeal dysphagia is one of the most underdiagnosed and underestimated conditions among elderly patients and one that has a greater effect on their nutritional status. Accordingly, we suggest using established diagnostic methods with a multidisciplinary team collaboration for its early detection.