A Community Survey on Association of Sociodemographic Characteristics with Risk Perception and Awareness about Oral Cancer in Lagos, Nigeria

ABSTRACT Objective: To assess the level of oral cancer awareness and risk factors perception and the relationship between this awareness and the sociodemographic and behavioral characteristics. Material and Methods: This descriptive study was conducted among rural and urban residents in Lagos State, Nigeria. A multi-stage random sampling method was utilized. The sociodemographic and behavioral characteristics of respondents, as well as their knowledge about oral cancer risk factors, were assessed with a validated questionnaire. The bivariate association was done using an independent t-test and one-way ANOVA. Multivariate regression was used to determine the association between predictor variables and oral cancer knowledge scores. The statistical significance level is set at p<0.05. Results: 590 participants between 18 and 82 years (mean age 34.5 ±13.7) completed the survey. The prevalence of cigarette smoking was 25.7%, of which 16 (1.5%) were heavy smokers (20+ cigarettes per day). The prevalence of alcohol consumption was 66.1%, with 57 (9.7%) being heavy drinkers, consuming drinks for 5-7 days of the week. A high proportion of the respondents (>60%) exhibited gaps in their knowledge of oral cancer. Uneducated participants had lower oral cancer knowledge than those with >12 years of formal education (aOR = 5.347; 95% CI: 4.987-6.240). Participants who were smokers had lower oral cancer knowledge compared with non-smokers (aOR = 3.341; 95% CI: 2.147-4.783); Participants who consumed alcohol had more deficient oral cancer knowledge compared with non-drinkers (aOR = 1.699; 95% CI: 1.087-2.655); While heavy smokers aOR = 4.023; 95% CI: 3.615-4.825) and heavy drinkers aOR = 4.331; 95% CI: 3.158-5.939) had lower oral cancer knowledge compared with those who did not abuse both substances. Conclusion: A high proportion of the respondents exhibited gaps in their knowledge of oral cancer in their responses. Delayed diagnosis of oral cancer can be reduced by increasing the awareness and knowledge of the populace about risk factors and also in the recognition of its signs and symptoms.

Análise da imunoexpressão de BAX e MMP-9 no líquen plano oral / Analysis of BAX and MMP-9 immunoexpression in oral lichen planus

Introdução: O líquen plano oral é uma doença crônica imunologicamente mediada relativamente comum, que acomete a mucosa oral. Clinicamente, o LPO é classificado em seis padrões bem identificados: placa, reticular, bolhoso, atrófico, papular e erosivo.Sendo os mais comuns oos tipos reticulares e erosivos. A ativação dos linfócitos TCD4+ no LPO, pode induzir os ceratinócitos ao processo de apoptose através da respostaimunológica citotóxica. A proteína Bax desempenha uma função relevante para o processo apoptótico. Deste modo, a presente pesquisa consistiu em um estudo transversal retrospectivo, descritivo, quantitativo e comparativo. Objetivo: Avaliar a expressão imuno-histoquímica das proteínas MMP9 e Bax no LPO. Método: Foram utilizados 43 casos de LPO para análise da imunoexpressão de Bax e MMP-9. Os resultados foram analisados através dos testes estatísticos apropriados e serão considerados significativos, valores onde p<0,05. Resultado: A imunoexpressão de MMP9 foi significativamente maior nos ceratinócitos e quando analisados os subtipos de líquen plano oral, não foram observados diferenças estatísticas entre os tipos reticulares e erosivos para as proteínas analisadas. Conclusões: Com essas observações, infere-se que a alteração na expressão das proteínas estudadas sugere um distúrbio nos mecanismos apoptóticos, os quais estão associados às lesões de LPO, e podemos concluir também que as imunoexpressões dessas proteínas não apresentaram diferença, quando relacionada ao tipo clínico reticular ou erosivo. Com esse resultado pode-se contribuir para um maior entendimento sobre os possíveis mecanismos celulares envolvidos na etiopatogenia dessa lesão (AU).

Background: Oral lichen planus is a relatively common immune-mediated chronic disease that affects the oral mucosa. Clinically, OLP is classified into six well-identified patterns: plaque, reticular, bullous, atrophic, papular, and erosive. The most common being the reticular and erosive types. The activation of TCD4+ lymphocytes in the OLP can induce keratinocytes to the process of apoptosis through the cytotoxic immune response. Thus, the present research consisted of a retrospective, descriptive, quantitative and comparative crosssectional study. Objective: to evaluate the immunohistochemical expression of MMP-9 and Bax proteins in OLP. Methods: We used 20 cases of Inflammatory Fibrous Hyperplasia as control. The results were analyzed through the appropriate statistical tests and will be considered significant, values where p<0.05. Results: The immunoexpression of MMP-9 was significantly higher in keratinocytes and when the subtypes of oral lichen planus were analyzed, no statistical differences were observed between the reticular and erosive types for the proteins analyzed. Conclusions: With these observations, it is inferred that the alteration in the expression of the studied proteins suggests a disturbance in the proliferative and apoptotic mechanisms, which are associated with a pathological behavior of the oral mucosa, and consequently with a repercussion on the lesions of OLP, and we can also conclude that the immunoexpression of these proteins had no difference, when related to the reticular or erosive clinical type. This research aims to contribute to a greater understanding of the possible cellular mechanisms involved in the etiopathogenesis of this lesion, thus enabling the understanding of the clinical aspects of the pathology (AU).

Association between religion, mental health and social distancing during the Covid-19 pandemic / Associação entre religião, saúde mental e distanciamento social na pandemia de Covid-19 / Asociación entre religión, salud mental y distanciamiento social en la pandemia Covid-19

This cross-sectional study aimed to analyze the association of religiosity with behaviors and perceptions in the context of social distancing measures during the COVID-19 pandemic, as well as mental health outcomes, in a university community in Central-West Brazil. A sample of 1,796 subjects responded to an online form with socio-demographic questions and the DASS-21 and PWBS scales. Religion was associated with the frequency of interactions, perceptions of the duration of the social distancing measures, changes in emotional state and history of psychological illness. The prevalence of symptoms of depression, anxiety and stress was lower among people with religion and their scores in psychological well-being were higher. (AU)

Trata-se de um estudo transversal com o objetivo de analisar a associação entre religiosidade e comportamentos e percepções frente ao distanciamento social decorrente da pandemia de Covid-19 e estado de saúde mental em uma comunidade universitária do Centro-Oeste brasileiro. Participaram do estudo 1796 sujeitos, os quais responderam a um formulário online com questões sociodemográficas e às escalas DASS-21 e EBEP. Observou-se associação entre religião e frequência de interações, percepção sobre a duração do distanciamento social e mudanças no estado emocional e histórico de alterações psicológicas. Constatou-se menor prevalência de sintomas relacionados à depressão, à ansiedade e ao estresse e maiores escores de bem-estar psicológico entre aqueles com religião. (AU)

Se trata de un estudio transversal con el objetivo de analizar la asociación entre religiosidad, comportamientos y percepciones frente al distanciamiento social resultante de la pandemia Covid-19 y el estado de salud mental en una comunidad universitaria de la región Centro-Oeste de Brasil. Participaron en el estudio 1796 sujetos, que respondieron un formulario en línea con preguntas sociodemográficas y las escalas DASS-21 y EBEP. Se observó asociación entre religión y frecuencia de interacciones, la percepción de la duración del aislamiento social y los cambios en el estado emocional y el historial de cambios psicológicos. Se observó una menor prevalencia de síntomas relacionados con la depresión, la ansiedad y el estrés, y puntuaciones más altas de bienestar psicológico entre quienes profesaban una religión. (AU)

Developmental characteristics of younger school-aged boys in relation to the socio-economic environment / Características del desarrollo de niños menores en edad escolar en relación con el entorno socioeconómico

SUMMARY: The main goal of this research was to determine whether there is a statistically significant difference in the anthropometric characteristics of fourth grade elementary school students, who live in different demographic environments in Montenegro. The research was conducted on a sample of 120 students, fourth grade elementary school, male (60 students from urban areas and 60 students from rural areas). To measure anthropometric characteristics, 12 measures were applied (Body height, arm length, leg length, shoulder width, elbow diameter, knee diameter, body weight, upper arm circumference, lower leg circumference, skin fold of the back, skin fold of the upper arm, skin fold of the abdomen). After conducting research with the application of appropriate statistical procedures: descriptive analysis, multivariate analysis of variance (MANOVA) and analysis of variance (ANOVA), it was noticed that there is a statistically significant difference in the treated space of anthropometric characteristics. Boys from rural areas are more dominant than boys from urban areas in the longitudinal and transverse dimensionality of the skeleton and in volume on certain body segments, and boys from urban areas are more dominant than boys from rural areas in body weight and subcutaneous fat, which puts them at risk for obesity.

El objetivo principal de esta investigación fue determinar si existe una diferencia estadísticamente significativa en las características antropométricas de los estudiantes de cuarto grado de primaria, que viven en diferentes entornos demográficos en Montenegro. La investigación se realizó sobre una muestra de 120 estudiantes, cuarto grado de primaria, sexo masculino (60 estudiantes de zona urbana y 60 estudiantes de zona rural). Para medir las características antropométricas se aplicaron 12 medidas (Altura del cuerpo, longitud del brazo, longitud de la pierna, ancho del hombro, diámetro del codo, diámetro de la rodilla, peso corporal, circunferencia del brazo, circunferencia de la pierna, pliegue de la piel de la espalda, pliegue de la piel de la parte superior brazo, pliegue cutáneo del abdomen). Después de realizar la investigación con la aplicación de los procedimientos estadísticos apropiados: análisis descriptivo, análisis de varianza multivariante (MANOVA) y análisis de varianza (ANOVA), se observó que existe una diferencia estadísticamente significativa en el espacio tratado de características antropométricas. Los niños de áreas rurales son más dominantes que los niños de áreas urbanas en la dimensionalidad longitudinal y transversal del esqueleto y en volumen en ciertos segmentos del cuerpo, y los niños de áreas urbanas son más dominantes que los niños de áreas rurales en peso corporal y grasa subcutánea, lo que los pone en riesgo de obesidad.

Comportamiento de características seleccionadas en pacientes hospitalizados por neumonía adquirida en la comunidad y algunas asociaciones de interés práctico / Behavior of selected characteristics in patients hospitalized for community-acquired pneumonia and some associations of practical interest

La neumonía adquirida en la comunidad constituye una de las afecciones respiratorias que provoca más demanda de asistencia médica, y es responsable del mayor número de fallecidos por enfermedades infecciosas en Cuba. El objetivo del estudio ha sido determinar el comportamiento de características seleccionadas en pacientes hospitalizados por neumonía y precisar la existencia de asociaciones entre algunas de estas características.Se realizó un estudio observacional, con diseño descriptivo, que incluyó 1,809 pacientes hospitalizados por neumonía entre enero de 2012 y febrero de 2020. Fueron analizadas características relacionadas con las condiciones de base, clínico-radiológicas, y relativas al manejo y la evolución, mediante análisis bivariante y multivariante (regresión logística). La serie estuvo constituida fundamentalmente por pacientes ancianos (79%), mientras que el 20% presentaba la condición de encamamiento. Esta condición se asoció significativamente con el estado de demencia avanzada (OR 7,6[5,5;10,4]), y fue determinante en la presentación "solapada" del proceso (OR 1,5[1,09;2]). La presentación "solapada" de la neumonía estuvo significativamente asociada al ingreso tardío (OR 1,6[1,2;2,2]). Como conclusiones se ratifica el lugar que ocupan varios elementos en las características de la morbilidad por neumonía: edad avanzada, presencia de comorbilidades, y presentación no clásica del proceso. Fueron constatadas interrelaciones de importancia práctica entre la presencia de comorbilidades particulares, las formas clínicas de presentación, el momento del ingreso, y la utilización de antimicrobianos durante la atención prehospitalaria del paciente. Se destaca el papel del encamamiento en la extensión radiológica del proceso neumónico y en la presencia de derrame pleural de mediana o gran cuantía al momento del ingreso.

Community-acquired pneumonia is one of the respiratory conditions that causes the greatest demand for medical care, and is responsible for the largest number of deaths from infectious diseases in Cuba. The objective of the study was to determine the behavior of selected characteristics in patients hospitalized for pneumonia and to specify the existence of associations between some of these characteristics. An observational study, with a descriptive design, was carried out, which included 1,809 patients hospitalized for pneumonia between January 2012 and February 2020. Characteristics related to the basic, clinical-radiological conditions, and relative to management and evolution were analyzed, through analysis bivariate and multivariate (logistic regression). The series consisted mainly of elderly patients (79%), while 20% were bedridden. This condition was significantly associated with the state of advanced dementia (OR 7.6[5.5;10.4]) and was decisive in the "overlapping" presentation of the process (OR 1.5[1.09;2]). The "overlapping" presentation of pneumonia was significantly associated with late admission (OR 1.6[1.2;2.2]). As conclusions, the place occupied by several elements in the characteristics of pneumonia morbidity is ratified: advanced age, presence of comorbidities, and non-classical presentation of the process. Interrelationships of practical importance were found between the presence of comorbidities, the clinical forms of presentation, the time of admission, and the use of antimicrobials during the patient's prehospital care. The role of bed rest in the radiological extension of the pneumonic process and in the presence of medium or large pleural effusion at the time of admission is highlighted.

Efeito do probiótico lactobacilus casei adjunto a terapia periodontal em modelo experimental de periodontite: uma relação entre periodonto e intestino / Effect of the probiotic lactobacilus casei as an adjunct to periodontal therapy in an experimental model of periodontitis: a relationship between periodontium and intestine

A periodontite é uma condição crônica inflamatória que pode influenciar a microbiota intestinal. O tratamento padrão ouro para a periodontite inclui a raspagem e o alisamento corono-radicular (RACR), porém em casos complexos pode-se utilizar terapias adjuvantes, como os probióticos. A utilização deste tratamento adjuvante poderá contribuir para a melhoria da condição periodontal e a simbiose intestinal. O objetivo deste estudo foi avaliar o efeito na inflamação periodontal e intestinal da utilização do Lactobacillus casei (LC) adjunto a RACR em camundongos Balb/c com periodontite, induzida por ligadura. Este estudo é um ensaio pré-clínico, in vivo, randomizado, cego e controlado por placebo, constituído por 36 camundongos Balb/c machos. Os animais foram submetidos a indução da periodontite por colocação de ligadura com fio de seda 4.0 ao redor do segundo molar superior direito, sendo divididos em 4 grupos,o grupo controle: Sem Periodontite e sem RACR (n=8); Grupo Ligadura: Com Periodondite e sem RACR (n=10); Grupo raspagem: Com Periodontite e com RACR (n=10) ; Grupo raspagem + L.casei (n=8): Com Periodontite e com RACR + administração de LC, por gavagem, durante 30 dias. Foram realizadas análises de citocinas pelo método ELISA no tecido gengival (IL-6), intestinal (IL-1ß, IL-6 e IL-10) e sanguíneo (IL-1ß e IL-6), além de análises bioquímicas (TGO, TGP, ureia e creatinina) e contagem diferencial de leucócitos do sangue. Foram coletados fragmentos do intestino grosso desses animais e analisados quanto a biomarcadores do estresse oxidativo (SOD, GSH e MDA), atividade da acetilcolinesterase (AChE) e foi realizada contagem da população de Bactérias Produtoras de Ácido Láctico das fezes dos animais. A utilização do LC adjunto a RACR resultou em uma redução na expressão da IL-6 no tecido gengival de camundogos com Periodontite (p < 0,05). Para as inteleucinas séricas (IL-1ß e IL-6), não houve diferenças entre os grupos (p > 0,05). Já para as citocinas intestinais houve uma redução na expressão de IL-10 (p < 0,05), para os grupos em que foi induzida a Periodontite. Com relação ao estresse oxidativo intestinal os animais do Grupo raspagem e raspagem + LC tiveram uma redução dos níveis de MDA (p < 0,05), para a SOD e o GSH, não houve diferenças significativas entre os 4 grupos pesquisados (p < 0,05). Conclui-se que o uso de LC adjunto a RACR em camungongos com periodontite induzida por ligadura pode reduzir a liberação de IL-6 no tecido gengival. Com relação aos efeitos intestinais foi observada a modulação da resposta inflamatória, com a redução de MDA, nos animais que receberam o tratamento periodontal. E a redução da expressão da IL-10, nos animais com Periodontite (AU).

Periodontitis is a chronic inflammatory condition that can influence the gut microbiota. The gold standard treatment for periodontitis includes scaling and crown-root planing, but in complex cases adjuvant therapies such as probiotics can be used. The use of this adjuvant treatment may contribute to the improvement of periodontal condition and intestinal symbiosis. The aim of this study was to evaluate the effect on periodontal and intestinal inflammation of the use of Lactobacillus casei (LC) adjunct to scaling and root planing (RACR) in Balb/c mice with ligature-induced periodontitis. This study is a preclinical, in vivo, randomized, blinded, placebo-controlled trial consisting of 40 male Balb/c mice. The animals were submitted to periodontitis induction by placing a 4.0 silk suture ligature around the upper right second molar. The sample was divided into 4 groups, each with 10 animals: Group I: Without Periodontitis and without RACR; Group II: With Periodontitis and without RACR; Group III: With Periodontitis and with RACR; Group IV: With Periodontitis and with RACR + gavage of LC, for 30 days. Cytokine analyzes were performed by the ELISA method in gingival tissue (IL-6), intestinal tissue (IL-1ß, IL-6 and IL-10) and blood (IL-1ß and IL-6), the blood was also subjected to analysis biochemical (TGO, TGP, urea and creatinine) and differential leukocyte count. Fragments of the large intestine of these animals were collected and analyzed for biomarkers of oxidative stress (SOD, GSH and MDA), acetylcholinesterase (AChE) activity, and the population of Lactic Acid-Producing Bacteria in the animals' feces was counted. The use of LC adjunct to RACR resulted in a reduction in the expression of IL-6 in the gingival tissue of mice with Periodontitis (p < 0.05), for the blood inteleukins (IL-1ß and IL-6), there were no differences between the groups (p > 0.05). As for intestinal cytokines, there was a reduction in the expression of IL-10 (p < 0.05), for the groups that presented Periodontitis. Regarding intestinal oxidative stress, the animals in Groups III and IV had a reduction in MDA levels (p < 0.05), for SOD and GSH, there were no significant differences between the 4 groups studied (p < 0.05 ). It is concluded that the use of LC adjunct to RACR in mice with ligation-induced periodontitis can reduce the release of IL-6 in the gingival tissue. Regarding the intestinal effects, two effects were found: The first related to the modulation of the inflammatory response, with the reduction of MDA, in the animals that received periodontal treatment. And the second related to a pro-inflammatory effect, with the reduction of IL-10 expression (AU).

Factors Associated with Oral Health Literacy among Patients with Type 2 Diabetes Mellitus Attending Hospital Universiti Sains Malaysia

Abstract Objective: To determine the oral health literacy (OHL) level and its associated factors among patients with type 2 diabetes mellitus attending Hospital Universiti Sains Malaysia (USM). Material and Methods: This cross-sectional study involved 135 diabetic patients with a mean age of 62.6 years old (SD=9.05) who attended the Diabetes Outpatient Clinic at Hospital USM, a teaching hospital in the north-eastern corner of Peninsular Malaysia. The Malay version of the Oral Health Literacy Instrument (OHLI-M) was used to assess the level of OHL among respondents. An additional self-administered questionnaire was used to obtain other variables of interest. Systematic random sampling was applied in this study. The data were analyzed using an independent t-test and ANOVA to determine factors associated with oral health literacy among respondents. Results: Most respondents have at least one oral health problem (62.2%). The most common problem was cavitated tooth (42.2%). Other problems include toothache (17.8%), mobile tooth (17.8%), and swollen gums (16.3%). OHL level for most respondents (40.7%) was inadequate. The mean total OHLI-M score was 67.9 (SD=17.74). The OHL score was significantly lower in respondents with the following characteristics: female, no formal education or had primary education, unemployed, lower income group, never visited a dentist, and had swollen gums. Conclusion: The OHL of most patients with type 2 diabetes mellitus attending the Diabetes Outpatient Clinic, Hospital USM still need to be improved. Oral health problems were common in patients with type 2 diabetes mellitus in this study. This study also highlighted the link between OHL and socio-demographic factors. Improving the OHL of patients may increase their capability to obtain and understand oral health messages needed to take appropriate actions that will eventually prevent oral diseases associated with diabetes mellitus (AU).

Comparison of Oncostatin M in Patients with Chronic Periodontitis with and without Diabetes

Abstract Objective: To compare the Oncostatin M (OSM) concentrations in tissues of patients with chronic periodontitis with and without diabetes. Material and Methods: Sixty-four subjects visiting the dental outpatient department were categorized as "healthy" (Group 1), "periodontitis" (Group 2), and "diabetes with periodontitis" (Group 3) groups. The clinical oral examination included assessment of plaque, gingivitis, probing depth, clinical attachment level. Blood glucose was assessed for group 3 patients. OSM concentration in the tissues was assessed using ELISA in all groups. Results: The mean OSM was 0.02 ± 0.04 pg/mg in the healthy group, 0.12 ± 0.09 pg/mg in the chronic periodontitis group and 0.13 ± 0.10 pg/mg in the diabetes-periodontitis group. A significantly higher mean OSM was seen in Group 2 and Group 3 than Group 1. The amount of OSM positively correlated with probing depth and clinical attachment level. Conclusion: Periodontal disease causes a rise in Oncostatin M, independent of the diabetic status. Expression of OSM in the gingival tissues can serve as an inflammatory marker.

Atribuciones, creencias, expectativas de madres adolescentes y adultas colombianas y su interacción con variables sociodemográficas / Attributions, beliefs, expectations of Colombian adolescent and adult mothers and their interaction with socio-Demographic variables

Resumen Las atribuciones, creencias y expectativas de los padres influyen en su interacción con los hijos. Este estudio compara las atribuciones, creencias y expectativas de madres adolescentes y adultas acerca de sus hijos, de todos los niños y de sí mismas como madres, y analiza la interacción con el sexo del hijo, procedencia, estado civil, grado educativo y nivel socioeconómico de las madres. Se administró la guía de entrevista para padres y el Cuestionario de Factores Cognitivos de los padres a 200 madres biológicas, 100 adolescentes con una edad promedio de 19.7 años y 100 adultas con una edad promedio de 37.1, de niveles socioeconómicos bajo y medio, procedentes de diferentes regiones de Colombia. La prueba t evidenció atribuciones sesgadas y creencias distorsionadas acerca de los hijos y de todos los niños y creencias de poco control y baja autoeficacia en las madres adolescentes. Las madres adultas presentan expectativas irreales acerca de los hijos y de todos los niños, y atribuciones distorsionadas con respecto a sí mismas como madres. El análisis de varianza bifactorial confirma que el estado civil interactúa significativamente con las expectativas que tienen las madres acerca de todos los niños y con las atribuciones acerca de sí mismas como madres. El tamaño del efecto indicó que la edad y procedencia de las madres tienen un efecto moderado en las creencias con respecto a los hijos y en las atribuciones y creencias acerca de todos los niños. Intervenciones psicológicas que modifiquen las atribuciones, creencias y expectativas de madres adolescentes y adultas permitirán relaciones madres-hijos sanas.

Abstract Parents' attributions, beliefs, and expectations influence their interaction with their children. This study compares the attributions, beliefs and expectations of adolescent and adult mothers about their own children, all children and themselves as mothers. It also analyzes the interaction with the sex of the child, origin, marital status, educational and socioeconomic level of the mothers. The Questionnaire of Parents' Cognitive Factors was administered to 200 biological mothers, 100 adolescents with an average age of 19.7 years old and 100 adults with an average age of 37.1, all of them from low and medium socioeconomic levels and different regions of Colombia. The t Test showed biased attributions and distorted beliefs about own children and all children, as well as low-control and low-self-efficacy in adolescent mothers. Adult mothers present unrealistic expectations about their own children and all children and distorted attributions regarding themselves as mothers. The Bifactorial Analysis of Variance confirms that marital status interacts significantly with mothers' expectations about all children and with attributions about themselves as mothers. The effect size indicated that the age and provenance of mothers have a moderate effect on beliefs regarding their own children and on attributions and beliefs about all children. Psychological interventions that modify the attributions, beliefs and expectations of adolescent and adult mothers will allow healthy mother-child relationships.

Eficácia da implantoplastia adjuvante no tratamento cirúrgico da peri-implantite / Efficacy of adjuvant implantoplasty in the surgical treatment of peri-implantitis

A terapia cirúrgica tem sido apontada como a estratégia mais apropriada para o tratamento da peri-implantite. Uma dessas técnicas é a implantoplastia, cuja proposta é a modificação da superfície do implante através da remoção de roscas expostas, tornando-a menos aderente ao biofilme. O estudo objetivou avaliar o efeito da implantoplastia no tratamento da peri-implantite, através da comparação entre dois grupos de intervenção: um com e outro sem implantoplastia. Assim, trata-se de um ensaio clínico prospectivo, controlado, randomizado e cego. 13 participantes com 33 implantes foram alocados aleatoriamente em dois grupos: acesso cirúrgico + debridamento mecânico (grupo controle-I) e acesso cirúrgico + debridamento mecânico + implantoplastia (grupo teste- II). Os desfechos primários foram avaliados no baseline e aos 3 meses: Índice de Placa Visível -IPV, Índice de Sangramento Gengival -ISG, Profundidade de Sondagem -PS, Sangramento à Sondagem -SS e Faixa de Mucosa Ceratinizada -MC. Avaliou- se a qualidade de vida pelo Oral Health Impact Profile -OHIP14 e também os marcadores de estresse oxidativo pelas amostras salivares. Os resultados apontaram que 69,2% eram mulheres, com idade média de 60,6 anos. Dos 32 implantes, 16 receberam a terapia I e 16 a terapia II. De todas as reabilitações, 53,8% foram totais e 30,8% foram parciais, sendo as demais unitárias. O teste de Mann-Whitney apontou que os valores de IPV e do ISG no grupo II foram maiores do que no grupo I aos 3 meses, mas não foram significativos (p=0,193; p=0,419). O SS foi maior no grupo I (50%) do que no grupo II (41,6%) aos 3 meses, porém, sem significância (p=0,759). Aos 3 meses, todos os parâmetros - exceto SS no grupo II - diminuíram de valor, sendo significativos para o IPV no grupo I (p=0,038), ISG nos grupos I e II (p=0,011 e p=0,015) e PS no grupo II (p=0,041). O ANOVA Split-Plot não mostrou interação entre tempo e tratamento. O OHIP14 mostrou que no baseline houve predomínio da "Dor física", "Desconforto psicilógico" e "Incapacidade física", enquanto que aos 3 meses houve melhora dos itens avaliados. A análise salivar mostrou que houve uma redução dos níveis de marcadores de estresse oxidativo após o tratamento, sendo significativo para o superóxido dismutase (Z=-2,701; p=0,007). Conclusão: não há evidências suficientes de que a adição da implantoplastia melhore os parâmetros clínicos no tratamento cirúrgico da peri-implantite aos 3 meses, em relação ao debridamento mecânico realizado de forma isolada (AU).

Surgical therapy has been identified as the most appropriate strategy for the treatment of peri-implantitis. One of these techniques is implantoplasty, whose proposal is to modify the surface of the implant by removing exposed threads, making it less adherent to the biofilm. The study aimed to evaluate the effect of implantoplasty in the treatment of peri-implantitis, by comparing two intervention groups: one with and the other without implantoplasty. Thus, it is a prospective, controlled, randomized and blinded clinical trial. 13 participants with 33 implants were randomly allocated into two groups: surgical access + mechanical debridement (control-I group) and surgical access + mechanical debridement + implantoplasty (test-II group). The primary outcomes were assessed at baseline and at 3 months: Plaque Index -PI, Gingival Bleeding Index -GBI, Probing Depth -PD, Bleeding on Probing -BoP, and Keratinized Mucosal Band -MK. Quality of life was evaluated by the Oral Health Impact Profile -OHIP14 and oxidative stress markers by salivary samples. The results showed that 69.2% were women, with an average age of 60.6 years. Of the 32 implants, 16 received therapy I and 16 received therapy II. Of all rehabilitations, 53.8% were total and 30.8% were partial, with the rest being single. The Mann-Whitney test showed that the values of PI and GBI in group II were higher than in group I at 3 months, but they were not significant (p=0,193; p=0,419). The BoP was higher in I group (50%) than in II group (41.6%) at 3 months, however, without significance (p=0,759). At 3 months, all parameters - except BoP in II group - decreased in value, being significant for PI in I group (p=0,038), GBI in I and II groups (p=0,011 and p=0,015) and PD in II group (p=0,041). Split-Plot ANOVA showed no interaction between time and treatment. The OHIP14 showed that at baseline there was a predominance of "Physical pain", "Psychological discomfort" and "Physical disability", while at 3 months there was an improvement in the evaluated items. Salivary analysis showed that there was a reduction in the levels of oxidative stress markers after treatment, being significant for superoxide dismutase (Z=-2,701; p=0,007). Conclusion: there is insufficient evidence that the addition of implantoplasty improves clinical parameters in the surgical treatment of peri-implantitis at 3 months, in relation to mechanical debridement alone (AU).

Escala de Crenças Sobre Violência Conjugal (ECV): versão brasileira / Beliefs Scale on Marital Violence (ECVC): brazilian version / Escala de Creencias Sobre Violencia Conyugal (ECVC): versión brasileña

Este estudo visou traduzir, adaptar e verificar evidências de validade da Escala de Crenças sobre Violência Conjugal (ECVC), bem como investigou diferenças nos índices de concordância com crenças legitimadoras de violência conjugal, considerando as variáveis gênero, escolaridade e possuir filhos. Os participantes foram adultos brasileiros (N = 1.337), maiores de 18 anos, sendo 66,34% pertencentes ao gênero feminino e 33,65% masculino. Foram realizadas análises fatoriais confirmatórias e exploratórias, e análise de comparação das médias através de uma ANOVA. Os 25 itens da escala apresentaram cargas fatoriais superiores a 0,46. A versão brasileira da escala apresentou estrutura unidimensional. Foi observado que os três indicadores utilizados para avaliar a consistência interna apresentaram valores satisfatórios. Por fim, identificou-se que participantes do gênero masculino, com menor escolaridade e com filhos apresentaram maior concordância com crenças legitimadoras de violência conjugal. Os resultados encontrados reforçam as qualidades psicométricas da escala indicando sua aplicabilidade. (AU)

This study aimed to translate, adapt, and verify the evidence of validity of the Belief Scale on Conjugal Violence (Escala de Crenças sobre Violência Conjugal - ECVC), as well as to investigate differences in the indices of agreement with legitimizing beliefs of conjugal violence, considering the variables gender, education, and having children. Participants were Brazilian adults (N = 1,337), over 18 years old, 66.34% of whom were women and 33.65% men. Confirmatory and exploratory factor analyses were conducted, as well as a comparison of means using ANOVA. The 25 items on the scale presented factorial loadings greater than 0.46. The Brazilian version of the scale had a unidimensional structure, and the three indicators used to assess internal consistency showed satisfactory values. Finally, results indicated that men with less education and with children showed greater agreement with beliefs legitimizing conjugal violence. The results reinforce the psychometric qualities of the scale, indicating its applicability. (AU)

Este estudio tuvo como objetivo traducir, adaptar y verificar evidencias de validez de la Escala de Creencias sobre Violencia Conyugal (ECVC), así como investigar diferencias en los índices de concordancia con las creencias legitimadoras de violencia conyugal, considerando las variables género, educación y tener hijos. Los participantes eran adultos brasileños (N = 1.337), mayores de 18 años, de los cuales el 66,34% eran mujeres y el 33,65% hombres. Se realizaron análisis factoriales confirmatorios y exploratorios, y análisis de comparación de medias a través de ANOVA. Los 25 ítems de la escala presentaron cargas factoriales superiores a 0,46. La versión brasileña de la escala tenía una estructura unidimensional. Se observó que los tres indicadores utilizados para evaluar la consistencia interna presentaron valores satisfactorios. Finalmente, se identificó que los varones, con menor nivel educativo y con hijos, mostraron mayor acuerdo con las creencias legitimadoras de la violencia conyugal. Los resultados encontrados denotan las cualidades psicométricas de la escala, reforzando su aplicabilidad. (AU)

Validity of Zulliger-SC in the cognitive assessment of elderly and long-lived adults / Validade do Zulliger-SC na avaliação cognitiva de adultos idosos e longevos / Validez de Zulliger-SC en la evaluación cognitiva de adultos mayores y longevos

This study sought evidence of validity of the Zulliger method to evaluate cognitive processes in elderly and long-lived adults and to verify the relationship between cognition and external variables. Participated 142 subjects, aged between 18 and 96 years old. The Zulliger Comprehensive System (ZSC), Mini-Mental State Examination and sociodemographic protocols were used as of data collection. The older and long-lived adults presented a significant decrease in mediation (X-%, XA%, P) and abstract reasoning (M) when compared to young and middle-aged adults. Education and socioeconomic status (SES) demonstrated significant and positive correlations with cognitive processes (R, ZF, W, M, DQ+ and Intellectualization). The findings are fundamental to psychological practice and to directing measures for cognitive preservation in human aging. (AU)

Esse estudo buscou evidências de validade do método de Zulliger para avaliar processos cognitivos em adultos idosos e longevos e verificar a relação entre cognição e variáveis externas. Participaram 142 indivíduos, com idades entre 18 e 96 anos. Utilizaram-se para a coleta de dados: Zulliger no Sistema Compreensivo (ZSC), Miniexame de Estado Mental e protocolo sociodemográfico. Adultos mais velhos e longevos apresentaram diminuição significativa na mediação (X-%, XA%, P) e raciocínio abstrato (M), comparados aos adultos jovens e de meia idade. A educação e o nível socioeconômico (NSE) demonstraram correlações positivas e significativas com processos cognitivos (R, ZF, W, M, DQ+ e Intelectualização). Os achados são fundamentais na prática psicológica e para direcionar medidas na preservação cognitiva no envelhecimento humano. (AU)

El presente estudio buscó evidencias de validez del método de Zulliger para evaluar procesos cognitivos en ancianos y longevos y para verificar la relación entre la cognición y las variables externas. Participaron 142 individuos con edades entre 18 y 96 años. Se utilizaron como instrumentos: Zulliger en el Sistema Comprensivo (ZSC), Mini Examen del Estado Mental y protocolos sociodemográficos. Ancianos y longevos presentaron una disminución significativa en la mediación (X-%, XA%, P) y el razonamiento abstracto (M) en comparación con los adultos jóvenes y de mediana edad. La educación y el nivel socioeconómico (NSE) demostraron correlaciones positivas y significativas con los procesos cognitivos (R, ZF, W, M, DQ+ e Intelectualización). Los hallazgos son fundamentales para la práctica psicológica y para dirigir medidas para la preservación cognitiva en el envejecimiento humano. (AU)

Fenotipos clínicos de la enfermedad pulmonar obstructiva crónica en los pacientes atendidos en el Hospital neumológico de La Habana / Clinical phenotypes of chronic obstructive pulmonary disease in patients treated at the Hospital Neumológico de La Habana

Introducción: La identificación de los fenotipos clínicos son claves en la modulación de la expresión clínica, para un tratamiento integrado de la EPOC. Objetivos: Caracterizar los fenotipos clínicos de la EPOC en los pacientes atendidos en el Hospital Neumológico Benéfico Jurídico. Métodos:Se realizó un estudio observacional descriptivo retrospectivo, en 172 pacientes con diagnóstico de EPOC, en el Hospital Neumológico Benéfico Jurídico durante el año 2017.Resultados: El 38,4 % de los pacientes tenían edad entre 70-79 años. Del total de pacientes, el 54,6 % eran del sexo masculino. El 52,9 % eran fumadores activos y el 41,3 % exfumadores. Aunque las diferencias no fueron significativas, la edad avanzada y el sexo masculino fueron más frecuentes en el fenotipo enfisematoso agudizador y agudizador bronquítico crónico. El tabaquismo activo fue más frecuente en el fenotipo enfisematoso agudizador. Todos los pacientes con el fenotipo agudizador bronquítico crónico tuvieron dos o más exacerbaciones, mientras que el enfisematoso agudizador se relacionó con una severidad grave de la EPOC (46,7 %). Conclusiones: El sexo masculino y la edad avanzada muestran una tendencia a relacionarse con el fenotipo enfisematoso agudizador y agudizador bronquítico crónico, mientras que el tabaquismo activo es más frecuente en el fenotipo enfisematoso agudizador. El fenotipo agudizador bronquítico crónico se relaciona con mayores exacerbaciones y el enfisematoso agudizador con una mayor severidad de la EPOC.

Introduction: The identification of clinical phenotypes are key in the modulation of clinical expression, for an integrated treatment of COPD. Objectives: To characterize the clinical phenotypes of COPD in patients treated at the Hospital Neumológico Benéfico Jurídico. Methods: A retrospective descriptive observational study was carried out in 172 patients with a diagnosis of COPD at the Hospital Neumológico Benéfico Jurídico in 2017. Results: 38.4 % of the patients were between 70-79 years of age. Of the total number of patients, 54.6 % were male. 52.9 % were active smokers and 41.3 % ex-smokers. Although the differences were not significant, advanced age and male sex were more frequent in the exacerbator emphysematous and chronic bronchial exacerbator phenotype. Active smoking was more frequent in the exacerbating emphysematous phenotype. All patients with the chronic bronchial exacerbator phenotype had two or more exacerbations, while exacerbation emphysematous was associated with severe severity of COPD (46.7 %). Conclusions: Male sex and advanced age show a tendency to be related to the exacerbating emphysematous phenotype and chronic bronchitis exacerbator, while active smoking is more frequent in the exacerbating emphysematous phenotype. The chronic bronchitis exacerbator phenotype is related to greater exacerbations and exacerbation emphysematous with a greater severity of COPD

Estudo de evidências de validade discriminante para o Desenho da Família Cinética / Study of evidence of discriminant validity for the Kinetic Family Drawing Test / Estudio de evidencias de validez discriminante para el Dibujo de la Familia Kinética

Esta pesquisa teve como objetivo principal investigar evidências de validade discriminante para o Desenho da Família Cinética. Pretendeu também analisar a influência de variáveis sociodemográficas, bem como a frequência e capacidade de discriminação de cada item de análise dessa técnica projetiva. Participaram 112 crianças de 9 a 12 anos pertencentes a dois grupos critério, sendo 80 da amostra normativa e 32 da amostra clínica (com problemas de aprendizagem). Os instrumentos utilizados foram o Desenho da Família Cinética, sua folha de correção e as Matrizes Progressivas e Coloridas de Raven. Os dados foram analisados por meio de estatísticas descritivas e inferenciais com o auxílio do software SPSS. Os principais resultados mostraram que a variável sociodemográfica Idade gerou efeito nos resultados obtidos; houve diferença estatisticamente significativa entre os grupos-critério, corroborando para as evidências de validade discriminante; e apenas 38,46% dos itens de análise obtiveram diferença estatisticamente significativa entre os grupos critério. (AU)

This study aimed to investigate evidence of discriminant validity for the Kinetic Family Drawing test. It also intended to analyze the influence of sociodemographic variables, to evaluate the frequency and discriminatory capacity of each analysis item of this projective technique. Participants were 112 children from 9 to 12 years of age, belonging to two criterion groups, 80 from the normative sample and 32 from the clinical sample (with learning problems). The instruments used were the Kinetic Family Drawing test, its correction sheet and Raven's Progressive and Colored Matrices. Data were analyzed through descriptive and inferential statistics using the SPSS software. The main results showed that the sociodemographic variable age influenced the results obtained; there was a statistically significant difference between the criterion groups, corroborating the evidence of discriminant validity; while only 38.46% of the analysis items obtained statistically significant difference between the criterion groups. (AU)

Esta investigación tuvo como objetivo principal investigar las evidencias de validez discriminatorias para el Dibujo de la Familia Kinética. También se pretendía analizar la influencia de las variables sociodemográficas, así como evaluar la frecuencia y la capacidad discriminatoria de cada ítem de análisis de esta técnica proyectiva. Participaron un total de 112 niños de 9 a 12 años, pertenecientes a dos grupos de criterios, 80 de la muestra normativa y 32 de la muestra clínica (con problemas de aprendizaje). Los instrumentos utilizados fueron el Dibujo de la Familia Kinética, su hoja de corrección y las Matrices Progresivas Coloreadas de Raven. Los datos se analizaron mediante estadística descriptiva e inferencial con la ayuda del software SPSS. Los principales resultados mostraron que la variable sociodemográfica edad tuvo un efecto sobre los resultados obtenidos; hubo una diferencia estadísticamente significativa entre los grupos de criterios, corroborando la evidencia de validez discriminante; y solo el 38.46% de los ítems de análisis obtuvieron diferencias estadísticamente significativas entre los grupos de criterios. (AU)

Factores intrínsecos y extrínsecos asociados con caídas en adultos mayores: estudio de casos y controles en México / Intrinsic and extrinsic factors associated with falls in older adults: a case-control study in Mexico

Resumen Antecedentes: Las caídas tienen un origen multifactorial. Objetivo: Estimar el riesgo de caídas y su asociación con algunos factores intrínsecos y extrínsecos en adultos mayores. Métodos: Estudio de casos y controles que incluyó pacientes de ambos sexos con edades ≥ 60 años. Los casos fueron pacientes que ingresaron al servicio de urgencias de un hospital de segundo nivel, con diagnóstico de lesión o fractura secundaria a una caída; los controles fueron pacientes que acudieron a unidades de medicina familiar. El análisis estadístico que se realizó fue descriptivo, bivariante y multivariante. Se utilizó el programa SPSS versión 22.0. Resultados: Se incluyeron 342 pacientes (171 casos y 171 controles). La edad promedio fue 76.1 ± 8.8 años, el 66 % fueron mujeres y por autorreporte el 97.1 % tenían enfermedades crónicas. Se observaron diferencias en el índice de masa corporal, en la proporción de casos con deterioro cognitivo, uso de dispositivos para caminar y dependencia para realizar actividades básicas e instrumentales de la vida diaria. El análisis multivariante ajustado reveló asociación entre el evento caída con deterioro cognitivo y dependencia para realizar actividades instrumentales de la vida diaria. Conclusiones: El deterioro cognitivo y la dependencia para realizar actividades instrumentales de la vida diaria se asociaron al riesgo de caer.

Abstract Background: Falls have a multifactorial origin. Objective: To estimate the risk of falls and their association with some intrinsic and extrinsic factors in elderly. Methods: Case-control study that included individuals of both genders aged ≥ 60 years. Cases were patients who were admitted to the emergency department of a secondary care hospital diagnosed with injury or fracture secondary to a fall; the controls were patients who attended family medicine units. Descriptive, bivariate and multivariate statistical analysis was carried out. The SPSS program, version 22.0, was used. Results: Three-hundred and forty-two patients were included (171 cases and 171 controls). Mean age was 76.1 ± 8.8 years, 66 % were women and 97.1 % had self-reported chronic diseases. Differences were observed in body mass index, in the proportion of cases with cognitive impairment, use of walking devices and dependence to perform basic and instrumental activities of daily living. Adjusted multivariate analysis revealed an association between the fall event and cognitive impairment and dependence to perform instrumental activities of daily living. Conclusions: Cognitive impairment and dependence to perform instrumental activities of daily living were associated with the risk of falling.

Association between Oral Health Literacy and Socioeconomic Variables in Users of Centers for Dental Specialties

ABSTRACT Objective: To test possible associations between Oral Health Literacy (OHL) level and socioeconomic covariates among users of Centers for Dental Specialties (CEOs). Material and Methods: The Health Literacy in Dentistry (HeLD-14) instrument was applied to 130 adult users of CEOs located in 13 municipalities in the state of São Paulo - Brazil, as well as socioeconomic issues. The researcher applied instruments in a specific room after randomly selecting individuals in the waiting room and invitation acceptance. Each item was ranked on a 5-point scale, ranging from 0 to 4, in which high scores indicate minimal difficulties in performing functions (high OHL) and low scores indicate very limited abilities to perform functions (low OHL). Statistical analysis using the Levene test was used to verify the possibility of using the one-way ANOVA test, and in case results show positive values (p>0.05), the Kruskal Wallis test was used. Results: The average age of participants was 45 years, with more than half being female (68.7%) with 9-11 years of schooling (48.4%). When considering the total value of HeLD-14 questions, OHL was associated with covariates schooling, marital status and family income. Conclusion: OHL levels were associated with socioeconomic variables, contributing to evidence in this field of specialized care.

Quality of Life in Iranian Patients with Oral and Head and Neck Cancer

ABSTRACT Objective: To assess sociodemographic factors and cancer information on patients' quality of life with head and neck cancer. Material and Methods: This cross-sectional study was conducted on 69 patients with head and neck cancer who attended in one of the oncology centers in Mashhad, Iran, from September 2019 to December 2019. Data was collected through a questionnaire consisted of demographic information (gender, age, educational level, and job) and cancer information (type, location, treatment, clinical stage) and standard quality of life questionnaire (QLQ-H&N35). Data analyzed in SPSS22 software using T, ANOVA, Linear regression tests at 0.05 significant levels. Results: 49 participants (72.1%) were men. The mean age was 60.48 ± 13.74 years. Forty-nine participants (72.1%) had squamous cell carcinoma and 26 participants (38.2%) had a larynx tumor. Forty-six participants (67.6%) were in clinical stage 3, mainly with a problem and complain about hard food swallowing, xerostomia and speech. The mean score of QLQ-H&N35 was 42.06 ± 20.12 from 90. Quality of life in 47.1% of cases was moderate. There was no significant relationship between gender, job, educational level, type and location of cancer (p>0.05). There was a significant relationship between the patient's age, clinical stage, type of treatment, and quality of life (p<0.05). Conclusion: Quality of life in 47.1% was moderate. Clinical stage, age of patients and type of treatment statically and significantly affected the quality of life. Assessing quality of life in HNC patients can identify important side effects of treatment that affected quality of life and look for ways to improve QoL.

Association between living arrangement and quality of life for older adults in the community / Associação entre arranjo domiciliar e qualidade de vida de idosos da comunidade / Asociación entre la conformación domiciliaria y la calidad de vida de los adultos mayores en la comunidad

Objective: to compare the sociodemographic and economic characteristics of the older adults in the community according to the living arrangement and to verify the association between the type of living arrangement and the quality of life scores. Method: a cross-sectional epidemiological study conducted with 796 older adults in the community. To assess quality of life (dependent variable), network and social support (adjustment variable), validated and applied chi-square tests, descriptive statistical analysis, multiple comparison analysis (ANOVA) and multiple linear regression model (p<0.05) were used. Results: the older adults who lived only with their spouses had better quality of life scores in all domains and facets, except in the death and dying domain, which did not show any significant difference. The lowest scores for quality of life were identified in the groups with the presence of children and, exceptionally, in the domain of social relationships and, in the facets death and dying and intimacy, those who lived alone had worse assessments. In the adjusted model, there was an association between the type of living arrangement and the different domains and facets of quality of life. Conclusion: living arrangement was associated with quality of life scores for older adults in the community, even after adjusting for the gender, age, number of morbidities, and social support variables.

Objetivo: comparar as características sociodemográficas e econômicas de idosos da comunidade segundo o arranjo domiciliar e verificar associação entre o tipo de arranjo domiciliar e os escores de qualidade de vida. Método: estudo epidemiológico transversal, com 796 idosos da comunidade. Para avaliar qualidade de vida (variável dependente), rede e apoio social (variável de ajuste), foram utilizados instrumentos validados e aplicados teste qui-quadrado, análise estatística descritiva, análise de comparações múltiplas (ANOVA) e modelo de regressão linear múltipla (p<0,05). Resultados: os idosos que residiam somente com os cônjuges apresentaram melhores escores de qualidade de vida em todos os domínios e facetas, exceto no domínio morte e morrer, que não evidenciou diferença significativa. Os menores escores de qualidade de vida foram identificados nos grupos com a presença dos filhos, sendo que, excepcionalmente no domínio relações sociais e nas facetas morte e morrer e intimidade, aqueles que viviam sozinhos tiveram piores avaliações. No modelo ajustado, verificou-se associação entre o tipo de arranjo domiciliar e os diferentes domínios e facetas de qualidade de vida. Conclusão: o arranjo domiciliar apresentou associação com escores de qualidade de vida de idosos da comunidade, mesmo após ajuste para as variáveis sexo, idade, número de morbidades e apoio social.

Objetivo: comparar las características sociodemográficas y económicas de los adultos mayores de la comunidad según la conformación domiciliaria y verificar la asociación entre el tipo de conformación domiciliaria y los puntajes de calidad de vida. Método: estudio epidemiológico transversal con 796 ancianos de la comunidad. Para evaluar la calidad de vida (variable dependiente), la red y el apoyo social (variable de ajuste), se utilizaron instrumentos validados y aprobados, pruebas de chi-cuadrado, análisis estadístico descriptivo, análisis de comparación múltiple (ANOVA) y modelo de regresión lineal múltiple (p<0,05). Resultados: los adultos mayores que vivían solamente con sus cónyuges obtuvieron mejores puntajes de calidad de vida en todos los dominios y facetas, excepto en el dominio muerte y morir, que no mostró diferencia significativa. Los puntajes más bajos en calidad de vida se identificaron en los grupos con presencia de hijos y, de manera excepcional en el dominio de las relaciones sociales y en las facetas muerte y morir e intimidad, aquellos que vivían solos tuvieron peores evaluaciones. En el modelo ajustado, se verificó asociación entre el tipo de conformación domiciliaria y los diferentes dominios y facetas de calidad de vida. Conclusión: la conformación domiciliaria se asoció con puntajes de calidad de vida de los adultos mayores de la comunidad, incluso después del ajuste por las variables sexo, edad, número de morbilidades y apoyo social.

Infusión intravenosa de ketamina a bajas dosis durante cirugía de artrodesis de columna. Una estrategia en el manejo del dolor agudo posoperatorio / Intravenous ketamine infusión at low doses during spinal arthodesis surgery. A strategy in acute postoperative pain management

INTRODUCTION: Acute postoperative pain is a complex problem given the pathophysiological characteristics, increasing health costs and complications and hindering recovery[1],[2]. Spinal arthrodesis is one of the most painful surgical procedures, presenting intense and disabling pain[3],[4]. Multimodal analgesia has been the tool with the best results, based on opioids; however, the combined use of drugs and dependence on opiates are important consequences. Therefore, the analgesic behavior during the use of subanesthetic doses of ketamine is described in the patients undergoing this procedure. METHODOLOGY: A prospective case series study was conducted from January-December 2019, with patients undergoing spinal arthrodesis who met the inclusion criteria, at the Hernando Moncaleano Perdomo University Hospital, Neiva. A univariate statistical analysis of all the variables is performed, with a joint interpretation of the results. RESULTS: A total of 17 patients underwent surgery, one of whom was excluded due to complications related to the surgical material. 88% of the patients showed evaluations of mild or absent pain in at least 4 times, with a number of morphine rescues in 24 hours of 1-2 per patient and patient ambulation in 90% on the first day. CONCLUSIONS. Postoperative spinal arthrodesis patients receiving intravenous ketamine infusion-based analgesia at subanesthetic doses showed mild or absent pain scores at almost all times.

INTRODUCCIÓN: El dolor agudo postoperatorio es un problema complejo dada las características fisiopatológicas, aumentando los costos en salud y las complicaciones y dificultando la recuperación[1],[2]. La artrodesis de columna, es uno de los procedimientos quirúrgicos más dolorosos, presentando un dolor intenso e incapacitante[3],[4]. La analgesia multimodal ha sido la herramienta con mejores resultados, tomando como base los opioides; sin embargo, el uso combinado de fármacos y la dependencia a opiáceos son consecuencias importantes. Por lo anterior, se describe el comportamiento analgésico durante el uso de dosis subanestésicas de ketamina en los pacientes llevados a dicho procedimiento. METODOLOGÍA: Se realiza un estudio tipo serie de casos, prospectivo de enero-diciembre de 2019, con los pacientes llevados a artrodesis de columna que cumplieron con los criterios de inclusión en el Hospital Universitario Hernando Moncaleano Perdomo, Neiva. Se realiza un análisis estadístico univariado de la totalidad de las variables, con una interpretación conjunta de los resultados. RESULTADOS: Se intervinieron un total de 17 pacientes, uno de los cuales fue excluido por complicaciones relacionadas con el material quirúrgico. El 88% de los pacientes mostraron valoraciones de dolor leve o ausente en al menos 4 tiempos, con número de rescates de morfina en 24 h de 1-2 por paciente y deambulación de los pacientes en el 90% en el primer día. CONCLUSIONES: Los pacientes posoperatorios de artrodesis de columna que recibieron analgesia basada en infusión endovenosa de ketamina a dosis subanestésicas mostraron valoraciones de dolor leve o ausente, en casi todos los tiempos.

Relación entre contaminación atmosférica y consultas por enfermedades respiratorias en atención primaria de urgencia / Relationship between air pollution and respiratory disease consultations in primary emergency care

Resumen La presente investigación indaga la relación entre los niveles de contaminación ambiental por material particulado 2,5 y consultas respiratorias según tipo de enfermedad respiratoria y edad de los usuarios que consultaron en los Servicios de Atención Primaria de Urgencia de 2 comunas de la Región de Ñuble, Chile, entre los años 2016 y 2017 mediante un diseño de tipo ecológico. La unidad de análisis correspondió a medias agrupadas (promedios) de consultas diarias por enfermedades respiratorias y de concentración de material particulado 2,5. Los análisis estadísticos utilizados fueron Anova, test estadístico Dickey-Fuller, análisis inferencial basado en correlación de Spearman y Cross-Correlation. Se observó una correlación positiva entre los niveles de contaminación ambiental y consultas por enfermedades respiratorias registrados al día siguiente y al noveno día posterior a un episodio de emergencia ambiental. Desde la entrada en vigencia del Plan de Prevención y Descontaminación Atmosférica no se observan diferencias significativas en las concentraciones de MP2,5 entre los años 2016 y 2017. Los mayores niveles de contaminación ambiental se concentran entre los meses de abril a septiembre. En conclusión, existe relación entre los niveles de contaminación ambiental por MP2,5 con el número de consultas por enfermedades respiratorias y la edad de los usuarios.

The present investigation inquires the relation between the levels of environmental pollution by air borne particulate matter 2,5 and respiratory-related consultatons according to type of respiratory disease and age of the users who were admitted in the Primary Healthcare Emergency Services in two communes in Chile's Ñuble Region, between 2016 and 2017 through an ecological design. The unit of analysis corresponded to pooled means (averages) of daily consultations for respiratory diseases and concentration of particulate matter 2.5. The statistical methods used were: Anova, statistical test Dickey-Fuller, inferential analysis based on Spearman's correlation and Cross-Correlation. A positive correlation was observed between environmental pollution and consultations related to respiratory diseases recorded the next day and the ninth day after an environmental emergency episode. Since the entry into force of the Atmospheric Prevention and Decontamination Plan, no significant differences have been observed in the concentrations of PM2.5 between 2016 and 2017. The highest levels of environmental pollution are concentrated between the months of April to September. In conclusion, there is a relation between the levels of environmental pollution by PM2.5, the number of respiratory diseases consultatons and the age of users.