RESUMEN
OBJECTIVE: The study objectives were to estimate the standardized incidence and evaluate factors associated with moderate/severe pediatric traumatic brain injury (p-TBI) in children aged 5-15 years in Western, Mexico. METHODS: The study was cross-sectional in design. We estimated the standardized incidence of moderate/severe p-TBI using the direct methods of the World Health Organization (WHO) standard populations. We utilized the Glasgow Coma Scale (GCS) to identify moderate/severe p-TBI patients (GCS ≤ 13). Logistic regression analysis was applied to evaluate variables associated with moderate/severe p-TBI. RESULTS: The standardized incidence of patients diagnosed with moderate/severe p-TBI was 31.0/100,000 person-years (95 % CI 28.7-33.4). According to age, the moderate/severe TBI group was included. A total of 254 (38.5 %) patients were aged 5-9 years, 343 (52.0 %) were aged 10-14 years, and 62 (9.5 %) were aged 15 years. Factors associated with moderate/severe TBI in the crude analysis were male sex (OR 5.50, 95 % CI 4.16-7.39, p < 0.001), primary school (OR 2.15, 95 % CI 1.62-2.84, p < 0.001), and falls (OR 1.34, 95 % CI 1.02-1.77, p = 0.035). Factors associated with moderate/severe p-TBI in the adjusted analysis were male sex (OR 6.12, 95 % CI 4.53-8.29, p < 0.001), primary school (OR 3.25, 95 % CI 2.31-4.55, p < 0.001), and falls (OR 1.78, 95 % CI 1.28-2.47, p < 0.001). CONCLUSION: The incidence of moderate/severe p-TBI in children aged 5-15 years in western Mexico in this study was higher than that in other studies. One of the biggest factors associated with moderate/severe p-TBI was male sex, specifically those with lower education levels and those who were prone to falls.
Asunto(s)
Lesiones Traumáticas del Encéfalo , Humanos , Niño , Masculino , Femenino , México/epidemiología , Adolescente , Lesiones Traumáticas del Encéfalo/epidemiología , Preescolar , Incidencia , Estudios Transversales , Escala de Coma de Glasgow , Factores de Riesgo , Factores SexualesRESUMEN
(1) Dental caries, periodontitis, or peri-implantitis are commensal infections related to oral biofilm former bacteria. Likewise, magnesium oxide nanoparticles (MgO-NPs) were studied to introduce them to the antibacterial properties of a few microorganisms. Considering this, the purpose of the present investigation was to determine the antibacterial properties of MgO-NPs on representative oral strains. (2) Methods: MgO-NPs with a cubic crystal structure were obtained by magnesium hydroxide mechanical activation. After synthesis, the MgO-NPs product was annealed at 800 °C (2 h). The MgO-NPs obtained were tested against ten oral ATCC strains at ten serial concentrations (1:1 20.0-0.039 mg/mL per triplicate) using the micro-broth dilution method to determine the minimal inhibitory concentration (MIC) or minimal bactericidal concentration (MIB). Measures of OD595 were compared against each positive control with a Student's t-test. Viability was corroborated by colony-forming units. (3) Results: The polycrystalline structure had an average size of 21 nm as determined by X-ray diffraction and transmission electron microscopy (high resolution). Antimicrobial sensitivity was observed in Capnocytophaga gingivalis (MIB/MIC 10-5 mg/mL), Eikenella corrodens (MIB 10 mg/mL), and Streptococcus sanguinis (MIB 20 mg/mL) at high concentrations of the MgO-NPs and at lower concentrations of the MgO-NPs in Actinomyces israelii (MIB 0.039 mg/mL), Fusobacterium nucleatum subsp. nucleatum (MIB/MIC 5-2.5 mg/mL), Porphyromonas gingivalis (MIB 20 mg/mL/MIC 2.5 mg/mL), Prevotella intermedia (MIB 0.625 mg/mL), Staphylococcus aureus (MIC 2.5 mg/mL), Streptococcus mutans (MIB 20 mg/mL/MIC 0.321 mg/mL), and Streptococcus sobrinus (MIB/MIC 5-2.5 mg/mL). (4) Conclusions: The MgO-NPs' reported antibacterial properties in all oral biofilm strains were evaluated for potential use in dental applications.
RESUMEN
INTRODUCTION: Sodium ibuprofenate in hypertonic saline (NaIHS) administered directly to the lungs by nebulization and inhalation has antibacterial and anti-inflammatory effects, with the potential to deliver these benefits to hypoxic patients. We describe a compassionate use program that offered this therapy to hospitalized COVID-19 patients. METHODS: NaIHS (50 mg ibuprofen, tid) was provided in addition to standard of care (SOC) to hospitalized COVID-19 patients until oxygen saturation levels of > 94% were achieved on ambient air. Patients wore a containment hood to diminish aerosolization. Outcome data from participating patients treated at multiple hospitals in Argentina between April 4 and October 31, 2020, are summarized. Results were compared with a retrospective contemporaneous control (CC) group of hospitalized COVID-19 patients with SOC alone during the same time frame from a subset of participating hospitals from Córdoba and Buenos Aires. RESULTS: The evolution of 383 patients treated with SOC + NaIHS [56 on mechanical ventilation (MV) at baseline] and 195 CC (21 on MV at baseline) are summarized. At baseline, NaIHS-treated patients had basal oxygen saturation of 90.7 ± 0.2% (74.3% were on supplemental oxygen at baseline) and a basal respiratory rate of 22.7 ± 0.3 breath/min. In the CC group, basal oxygen saturation was 92.6 ± 0.4% (52.1% were on oxygen supplementation at baseline) and respiratory rate was 19.3 ± 0.3 breath/min. Despite greater pulmonary compromise at baseline in the NaIHS-treated group, the length of treatment (LOT) was 9.1 ± 0.2 gs with an average length of stay (ALOS) of 11.5 ± 0.3 days, in comparison with an ALOS of 13.3 ± 0.9 days in the CC group. In patients on MV who received NaIHS, the ALOS was lower than in the CC group. In both NaIHS-treated groups, a rapid reversal of deterioration in oxygenation and NEWS2 scores was observed acutely after initiation of NaIHS therapy. No serious adverse events were considered related to ibuprofen therapy. Mortality was lower in both NaIHS groups compared with CC groups. CONCLUSIONS: Treatment of COVID-19 pneumonitis with inhalational nebulized NaIHS was associated with rapid improvement in hypoxia and vital signs, with no serious adverse events attributed to therapy. Nebulized NaIHS s worthy of further study in randomized, placebo-controlled trials (ClinicalTrials.gov: NCT04382768).
RESUMEN
Research has documented the deleterious effects on caregivers of providing care for an individual with traumatic brain injury (TBI). TBI caregivers in Mexico specifically have reduced health-related quality of life (HRQOL) across both physical and mental health domains. The purpose of the current study was to uncover the system of connections between Mexican TBI caregivers' HRQOL and their mental health. A cross-sectional survey was conducted at a public medical facility in Guadalajara, México. Ninety family caregivers of individuals with TBI completed measures of HRQOL, satisfaction with life, depression, and burden. A canonical correlation analysis revealed that the better the caregivers' HRQOL, the better their mental health was, with the effect reaching a large-sized effect. A distinct pattern emerged linking caregivers' higher energy levels and better social functioning to lower depression and greater satisfaction with life. A series of multiple regressions similarly uncovered that the most robust independent HRQOL predictors of caregiver mental health were vitality and social functioning. Especially for TBI caregivers with poor health, behavioral health interventions in Latin America that target the HRQOL domains of social functioning and vitality may significantly improve caregiver mental health, and as a result, informal care for TBI.
Asunto(s)
Lesiones Encefálicas/enfermería , Cuidadores/psicología , Salud Mental , Calidad de Vida , Adulto , Depresión/psicología , Femenino , Humanos , Masculino , México , Persona de Mediana Edad , Satisfacción Personal , Encuestas y CuestionariosRESUMEN
BACKGROUND: Traumatic brain injury (TBI) is a leading cause of death in Mexico, and Mexican TBI caregivers have been shown to experience significant mental health problems and high levels of family needs. OBJECTIVE: This study investigated the associations between family needs and Mexican TBI caregiver mental health. METHODS: Ninety TBI caregivers from Guadalajara, Mexico completed measures assessing their own mental health (depression, anxiety, burden, satisfaction with life, and self-esteem) and family needs (physical health, informational, financial, social support, and household). RESULTS: Family health needs were uniquely associated with all indices of caregiver mental health, and household needs were uniquely associated with caregiver depression, burden, and anxiety. Additionally, social support needs were related to caregiver satisfaction with life, informational needs to burden, and financial needs to self-esteem. CONCLUSIONS: Interventions for TBI caregivers in Mexico-and likely in other global regions with high levels of familism-should include an emphasis on overall family health, the delineation of family roles regarding household responsibilities, the improvement of social support networks and the social presence of family members, and the provision of complete and relevant information regarding TBI. When these needs are more comprehensively met, caregiver mental health will likely improve.
Asunto(s)
Lesiones Encefálicas/psicología , Cuidadores/psicología , Salud de la Familia , Salud Mental , Adulto , Femenino , Humanos , Masculino , México , Persona de Mediana EdadRESUMEN
PURPOSE: This study examined the influence of five types of impairments in individuals with traumatic brain injury (TBI)-and caregiver stress due to these impairments-on the mental health of family caregivers in Guadalajara, Mexico. METHOD: Ninety caregivers completed measures of TBI impairments and of their own mental health. The majority were female (92.20%) with a mean age of 47.12 years (SD = 12.67). Caregivers dedicated a median of 50 hours weekly to caregiving and had spent a median of 11 months providing care. RESULTS: Two canonical correlation analyses suggested that these two sets of variables were broadly related, such that more severe impairments in individuals with TBI and more caregiver stress due to those impairments were associated with lower caregiver mental health. Across both analyses, social impairments were most associated with increased caregiver burden. Follow-up analyses also uncovered that caregiver stress due to cognitive impairments was uniquely associated with caregiver burden and anxiety. CONCLUSIONS: These results are the first to provide evidence that social and cognitive impairments in individuals with TBI from Latin America are the impairments most associated with caregiver mental health and highlight the need for interventions that target social and cognitive functioning.
Asunto(s)
Adaptación Psicológica , Ansiedad/etiología , Lesiones Encefálicas/psicología , Cuidadores/psicología , Depresión/etiología , Salud Mental , Estrés Psicológico/epidemiología , Estrés Psicológico/etiología , Adulto , Ansiedad/epidemiología , Lesiones Encefálicas/epidemiología , Depresión/epidemiología , Familia , Femenino , Necesidades y Demandas de Servicios de Salud , Humanos , Masculino , México/epidemiología , Persona de Mediana Edad , Satisfacción Personal , Calidad de la Atención de Salud , Autoimagen , Aislamiento Social , Estigma Social , Apoyo Social , Estrés Psicológico/psicología , Encuestas y CuestionariosRESUMEN
OBJECTIVE: To compare the mental health of family caregivers of individuals with Traumatic brain injury (TBI) to an age-matched healthy control from Guadalajara, Mexico. SETTING: Hospital Civil Fray Antonio Alcade, a public medical facility in Guadalajara, Mexico. PARTICIPANTS: Ninety family caregivers of individuals with TBI and 89 healthy controls (n = 179) did not differ with respect to age, sex, marital status, education, or household income. MAIN OUTCOME MEASURES: Outcome measures assessed satisfaction with life (Satisfaction with Life Scale), depression (Patient Health Questionnaire-9), social support (Interpersonal Support Evaluation List), self-esteem (Rosenberg Self-Esteem Scale), and anxiety (State-Trait Anxiety Inventory). RESULTS: A multivariate analysis of variance found that in comparison to controls, TBI caregivers reported substantially lower mental health scores across all indices, as well as lower social support in two out of three comparisons. The effect sizes of the social support differences were small; two out of five mental health differences reached medium-sized effects; and the other three reached large-sized effects. CONCLUSIONS: Because TBI caregivers' mental health influences the quality of informal care they can provide, mental health interventions for family caregivers are an extremely important part of TBI rehabilitation in Latin America, especially considering familism as a core value in Latino culture.
Asunto(s)
Lesiones Encefálicas/epidemiología , Lesiones Encefálicas/psicología , Cuidadores/psicología , Apoyo Social , Adulto , Análisis de Varianza , Ansiedad/etiología , Lesiones Encefálicas/complicaciones , Estudios de Casos y Controles , Femenino , Humanos , Masculino , México , Persona de Mediana Edad , Satisfacción del Paciente , Autoimagen , Encuestas y CuestionariosRESUMEN
OBJECTIVE: The aim of this study was to examine the influence of three types of social support (appraisal, belonging, and tangible) on caregiver mental health (anxiety, burden, depression, and satisfaction with life) among Mexican caregivers of individuals with traumatic brain injury. DESIGN: This is a cross-sectional study of 90 family caregivers from Hospital Civil Fray Antonio Alcade in Guadalajara, Mexico. RESULTS: More months spent caregiving was associated with decreases in all three types of social support. Older age and fewer years of education were associated with lower appraisal social support. More hours per week spent caregiving was associated with lower caregiver state anxiety and greater satisfaction with life. Appraisal, belonging, and tangible social support were all significantly correlated with more salubrious caregiver mental health outcomes, except satisfaction with life. Appraisal social support independently predicted lower caregiver depression. CONCLUSIONS: Particularly in Latin America, strong social support networks and family connections seem closely tied to key mental health outcomes such as depression. Rehabilitation interventions aimed at strengthening perceptions of social support of caregivers of individuals with traumatic brain injury that specifically target availability of advice may improve mental health and contribute to more optimal informal care for individuals with traumatic brain injury.
Asunto(s)
Lesiones Encefálicas/psicología , Cuidadores/psicología , Costo de Enfermedad , Salud Mental , Apoyo Social , Adulto , Ansiedad/epidemiología , Lesiones Encefálicas/terapia , Estudios Transversales , Depresión/epidemiología , Femenino , Humanos , Masculino , México , Persona de Mediana Edad , Satisfacción Personal , Autoimagen , Factores Socioeconómicos , Encuestas y CuestionariosRESUMEN
La distimia se define como un trastorno afectivo crónico que persiste por lo menos dos años en adultos y un a ño en adolescentes y niños. Según el DSM IV-TR, se clasifica en dos subtipos: la distimia de inicio temprano, antes de los 21 años, y la de inicio tardío después de los 21 años. Generalmente antes de los 21 años se puede observar trastornos de conducta, déficit de atención e hiperactividad y algunos síntomas vegetativos. Es importante distinguir tempranamente la distimia de otros tipos de depresión, a fin de brindar un tratamiento oportuno que atenúe el impacto continuo de síntomas caracterizados por pobre conciencia del estado de ánimo, pensamiento negativo, baja autoestima y anergia, lo que deteriora progresivamente la calidad de vida. La etiología es compleja y multifactorial, dados los variados mecanismos biológicos, psicológicos y sociales involucrados. Varias hipótesis tratan de explicar la etiología de la distimia; destacan la hipótesis genética que incluye además factores ambientales y la hipótesis aminérgica, que apunta a una deficiencia de serotonina, noradrenalina y dopamina en el sistema nervioso central. Desde nuestro punto de vista, no se puede concebir la distimia como un simple trastorno depresivo leve; es una entidad diferente caracterizada por un trastorno depresivo crónico que puede persistir toda la vida, con importantes repercusiones en la calidad de vida, tanto del sujeto que la padece como de sus familiares.
Dysthymia is defined as a chronic mood disorder that persists for at least two years in adults, and one year in adolescents and children. According to DSM IV-TR, Dysthymia is classified into two subtypes: early-onset, when it begins before 21 years-old, and late onset Dysthymia, when it starts after this age. Before age 21, symptoms of conduct disorder, attention deficit disorder and hyperactivity with a few vegetative symptoms are usually present. It is important to distinguish it from other types of depression, as earlier as possible. This would allow providing these patients with the appropriate treatment to attenuate the impact of symptoms, such as poor awareness of self-mood, negative thinking, low self-esteem, and low energy for social and family activities, which progressively deteriorate their life quality. The etiology of Dysthymia is complex and multifactorial, given the various biological, psychological and social factors involved. Several hypotheses attempt to explain the etiology of Dysthymia, highlighting the genetic hypothesis, which also includes environmental factors, and an aminergic hypothesis suggesting a deficiency in serotonin, norepinephrine and dopamine in the central nervous system. From our point of view, dysthymia cannot be conceived as a simple mild depressive disorder. It is a distinct entity, characterized by a chronic depressive disorder which could persist throughout life, with important repercussions on the life quality of both patients and families.
Asunto(s)
Humanos , Niño , Adolescente , Trastorno Distímico , Calidad de Vida , Trastorno por Déficit de Atención con Hiperactividad , Trastorno de la Conducta , Afecto , Depresión , Trastorno Depresivo MayorRESUMEN
Dysthymia is defined as a chronic mood disorder that persists for at least two years in adults, and one year in adolescents and children. According to DSM IV-TR, Dysthymia is classified into two subtypes: early-onset, when it begins before 21 years-old, and late onset Dysthymia, when it starts after this age. Before age 21, symptoms of conduct disorder, attention deficit disorder and hyperactivity with a few vegetative symptoms are usually present. It is important to distinguish it from other types of depression, as earlier as possible. This would allow providing these patients with the appropriate treatment to attenuate the impact of symptoms, such as poor awareness of self-mood, negative thinking, low self-esteem, and low energy for social and family activities, which progressively deteriorate their life quality. The etiology of Dysthymia is complex and multifactorial, given the various biological, psychological and social factors involved. Several hypotheses attempt to explain the etiology of Dysthymia, highlighting the genetic hypothesis, which also includes environmental factors, and an aminergic hypothesis suggesting a deficiency in serotonin, norepinephrine and dopamine in the central nervous system. From our point of view, dysthymia cannot be conceived as a simple mild depressive disorder. It is a distinct entity, characterized by a chronic depressive disorder which could persist throughout life, with important repercussions on the life quality of both patients and families.
RESUMEN
OBJECTIVE: The goal of the present study was to assess the health-related quality of life of a group of family caregivers of individuals with traumatic brain injury from Guadalajara, Mexico. PATIENTS AND METHODS: Ninety family caregivers of individuals with traumatic brain injury and 83 healthy controls completed the Short-Form 36, a self-report health-related quality of life measure composed of 8 component areas: physical functioning, role-physical, bodily pain, general health, vitality, social functioning, mental health, and role-emotional. The samples were statistically similar with respect to age, gender, marital status, and education. However, caregivers had significantly lower household income than controls. RESULTS: After controlling for income, results showed significantly lower scores for traumatic brain injury caregivers compared with healthy controls on 6 Short-Form 36 subscales: role-emotional, vitality, mental health, social functioning, bodily pain, and general health. CONCLUSION: Caregivers of individuals with traumatic brain injury living in Guadalajara, Mexico report having poorer health-related quality of life across various domains including mental and general health. Future studies should be conducted to determine which specific factors (e.g. lack of services, physical strain of providing care) are responsible for reduced health-related quality of life in these areas. It is likely that resources, such as respite services, adult day-care, aides, outpatient rehabilitation, psycho-educational programs, and support groups would increase health-related quality of life for these individuals.
Asunto(s)
Lesiones Encefálicas/enfermería , Cuidadores/psicología , Calidad de Vida , Adulto , Lesiones Encefálicas/rehabilitación , Emociones , Femenino , Estado de Salud , Atención Domiciliaria de Salud , Humanos , Masculino , México , Persona de Mediana Edad , Rol , Autoinforme , Factores SocioeconómicosRESUMEN
Objetivo: estimar el costo de la atención dado por la prevalencia de caries dental en estudiantes preuniversitarios de la Universidad Nacional Autónoma de México (UNAM). Método: se realizó un estudio transversal descriptivo en una población de 78.870 estudiantes preuniversitarios (efectuado entre 2003 y 2005). La necesidad de tratamiento por caries se determinó por medio del índice de dientes cariados, perdidos y obturados (CPOD), como es indicado en el Examen Médico Automatizado (EMA). La estimación del costo de atención se obtuvo a partir de la sumatoria de los costos directos (material dental) e indirectos (barreras de protección) por diente y por tratamiento, de acuerdo con los precios establecidos para la atención de pacientes en la Facultad de Odontología de la UNAM. Resultados: el 47,3% de los estudiantes presentó caries dental; el 31,9%, pérdida dental, y el 59,1%, obturaciones dentales. El gasto mínimo de atención para el número de dientes cariados (105.029) fue de $27.832.685 (pesos mexicanos); no obstante, para el número de dientes perdidos (101.802) el costo total estimado fue de $77.878.530. Se encontraron diferencias estadísticamente significativas entre el número de dientes con experiencia de caries y el sexo. Conclusiones: los altos costos estimados para la atención del grupo poblacional estudiado en materia de salud dental hacen pensar en la necesidad de establecer programas y metas específicas en los niveles educativos secundario, medio superior y superior, que promuevan favorablemente el autocuidado.
Objective: Estimate the cost of dental care generated by the dental decay prevalence in high school students at Universidad Nacional Autónoma de México (UNAM). Methods: A cross-sectional study was carried out with a population of 78,870 high schoolers (conducted between the years 2003 and 2005). The need for dental caries treatment was determined by the decayed, missing and filled teeth index (DMFT) as it is indicated at the Automated Medical Exam (EMA, acronym in Spanish). The estimation of dental care cost included a combination of direct (dental materials) and indirect costs (protection barriers) per tooth and treatment needed, using the price list for patients attending the dental service at the dental school of UNAM as a reference. Results: 47.3% of the students presented dental cavities, 31.9% lost teeth, and 59.1% had fillings. Minimum dental care expense estimated for decayed teeth (105,029) was $27,832,685 and $77,878,530 (Mexican pesos) for lost teeth (101,802). Statisticallysignificant differences were found when comparing dental caries prevalence and gender. Conclusions: The high dental care costs estimated for the population of high school students studied makes relevant the need for the development of programs and goals at the secondary and tertiary education levels. They should emphasize self-care.
Asunto(s)
Atención Odontológica , Caries Dental , Economía y Organizaciones para la Atención de la SaludRESUMEN
OBJECTIVE: To determine the prevalence of dental decay and tooth loss, and to consider the treatment needs for students at the Mexican National Autonomous University (UNAM). MATERIALS AND METHODS: A cross sectional study was designed including 77 191 students corresponding to the years of entrance to high school 2003, 2004 and 2005. Oral health data were obtained from the DMF-T index included in the Automatized Medical Exam (AME), a student self-answer instrument administered by the General Medical Services Department, UNAM. The analysis of the AME was univaried with the purpose of identifying the distribution and frequency of the variables. RESULTS: The prevalence of dental decay and tooth loss was 48.0% and 34.2%, respectively. The DMF-T index was 5. The treatment needs for dental decay and tooth loss for a student were considered as at least one lost tooth. CONCLUSIONS: Approximately half of the students from UNAM high schools need at least restorations and dental prosthesis. This suggests that oral health programs have not yet reached the expected health indexes according to international regulations, as well as the need to develop new research projects directed toward identifying disease severity and the factors that are detrimental to oral health.
Asunto(s)
Caries Dental/epidemiología , Pérdida de Diente/epidemiología , Adolescente , Estudios Transversales , Femenino , Humanos , Masculino , México , PrevalenciaRESUMEN
OBJETIVOS: Conocer la prevalencia de caries y pérdida dental para calcular las necesidades terapéuticas en estudiantes de educación media superior que ingresan a la Universidad Nacional Autónoma de México (UNAM). MATERIAL Y MÉTODOS: Se realizó un estudio transversal descriptivo en el que se obtuvo una muestra de 77 191 estudiantes correspondientes a las generaciones de ingreso al bachillerato 2003, 2004 y 2005. Los datos de salud bucal se obtuvieron a partir del índice CPOD incluido en el Examen Médico Automatizado (EMA), instrumento de autorrespuesta estandarizado que aplica la Dirección General de Servicios Médicos (DGSM). El análisis del EMA fue univariado con la finalidad de identificar la distribución y la frecuencia de las variables. RESULTADOS: La prevalencia de caries y pérdida dental fue de 48.0 y 34.2 por ciento, respectivamente, con una cuantificación del índice CPOD de 5. Las necesidades de tratamiento para caries y pérdida dental se obtuvieron en al menos un diente por estudiante. CONCLUSIONES: Cerca de la mitad de los alumnos que ingresan al bachillerato de la UNAM requiere al menos la atención de una caries o prótesis dental. Lo anterior evidencia que las políticas en salud bucal instrumentadas no han alcanzado los índices en salud esperados en relación con los objetivos internacionales, así como la necesidad de impulsar nuevas líneas de investigación orientadas a identificar la gravedad de la enfermedad y factores vinculados con el deterioro de la salud bucal.
OBJECTIVE: To determine the prevalence of dental decay and tooth loss, and to consider the treatment needs for students at the Mexican National Autonomous University (UNAM). MATERIALS AND METHODS: A cross sectional study was designed including 77 191 students corresponding to the years of entrance to high school 2003, 2004 and 2005. Oral health data were obtained from the DMF-T index included in the Automatized Medical Exam (AME), a student self-answer instrument administered by the General Medical Services Department, UNAM. The analysis of the AME was univaried with the purpose of identifying the distribution and frequency of the variables. RESULTS: The prevalence of dental decay and tooth loss was 48.0 percent and 34.2 percent, respectively. The DMF-T index was 5. The treatment needs for dental decay and tooth loss for a student were considered as at least one lost tooth. CONCLUSIONS: Approximately half of the students from UNAM high schools need at least restorations and dental prosthesis. This suggests that oral health programs have not yet reached the expected health indexes according to international regulations, as well as the need to develop new research projects directed toward identifying disease severity and the factors that are detrimental to oral health.
Asunto(s)
Adolescente , Femenino , Humanos , Masculino , Caries Dental/epidemiología , Pérdida de Diente/epidemiología , Estudios Transversales , México , PrevalenciaRESUMEN
OBJECTIVE: to evaluate the association of family factors with malnutrition and oral condition in adolescence. METHODS: a cross-sectional study of 456 adolescents was carried out to examine associations between family factors and risk for overweight or overweight (ROoO), risk for short stature or short stature (RSSoSS), and a DMFT (decayed, filled and missing-teeth) index > or = 8. RESULTS: the risk factors for ROoO were maternal educational level of high school or above (OR = 1.9, IC 95 % = 1.16-3.14) and having less than two siblings (OR = 1.6, IC 95 % = 1.13-2.34). Age > 15 years is associated with a DMFT index > or = 8 (OR = 1.9, IC 95 % = 1.14-2.34). CONCLUSIONS: a higher maternal educational level and having one or no siblings were ROoO risks. Increased age was a risk factor for caries.
Asunto(s)
Caries Dental/epidemiología , Estado de Salud , Estado Nutricional , Salud Bucal , Adolescente , Estudios Transversales , Femenino , Humanos , MasculinoRESUMEN
OBJECTIVE: Determining the oral health status (dental decay and gingivitis) of adolescents from Mexico City and affection pattern by tooth type and treatment needs. MATERIAL AND METHODS: A cross-sectional study was designed for 590 adolescents aged 13 to 16 from an urban area of Mexico City. Oral exploration formed part of the health diagnosis provided by the Schools Promoting Health Programme. The DMFT (decayed, missing and filled teeth) index was used for determining dental decay. Diagnosis with no probe was used for evaluating gingivitis. Chi2 tests were applied and risks were calculated for evaluating the association between dental decay, gingivitis and affection pattern by tooth type according to sex and age. RESULTS: The prevalence of dental decay and gingivitis was 92,2 % and 13,7 %, respectively. DMFT index was 7,3. Being aged 14 and over represented a significant risk for dental decay (OR=3,1; CI95 %=1,5-6,4). The treatment needs index for dental decay was 95,7 %, representing an expenditure of 642 450 Mexican pesos (59 818,4 US dollars). DISCUSSION: Regarding adolescents' oral health status, dental caries was the affection having the highest prevalence and its risk increased with age. The DMFT index was twice as high as WHO standards.
Asunto(s)
Salud Bucal , Higiene Bucal , Adolescente , Estudios Transversales , Femenino , Humanos , Masculino , México , Adulto JovenRESUMEN
Objetivo: Determinar el estado de salud bucal (caries dental y gingivitis) en adolescentes de la Ciudad de México, así como el patrón de afección por tipo de diente y las necesidades de tratamiento dental. Material y Métodos: Se realizó un estudio transversal en 590 escolares, entre 13 y 16 años de edad. La exploración bucal formó parte del diagnóstico integral del Programa Escuelas Promotoras de Salud. La presencia de caries dental se definió a partir del índice CPOD (diente cariado, perdido y obturado). La presencia de gingivitis se determinó por el diagnóstico sin sonda propuesto por el CONAVE. Se aplicaron pruebas de X2 y se calcularon riesgos para evaluar la relación de caries, gingivitis y patrón de afección por el tipo de diente acorde con edad y sexo. Resultados: La prevalencia de caries dental fue del 92,2 por ciento, encontrando un índice CPOD de 7,3; la prevalencia de gingivitis fue de 13,7 por ciento. La edad de 14 o más años representó un riesgo estadísticamente significativo de caries dental (RMP = 3,1; IC95: 1,5 - 6,4). El índice de necesidades de tratamiento para caries fue del 95,7 por ciento, lo que representa un gasto de 642 450 pesos mexicanos (59 818,4 dólares americanos). Discusión: Con relación al estado de salud bucal en adolescentes, la caries dental es la enfermedad de mayor prevalencia y su riesgo aumenta con la edad. En promedio, el índice CPOD fue dos veces mayor que los estándares establecidos por la Organización Mundial de la Salud-OMS.
Objective: Determining the oral health status (dental decay and gingivitis) of adolescents from Mexico City and affection pattern by tooth type and treatment needs. Material and Methods: A cross-sectional study was designed for 590 adolescents aged 13 to 16 from an urban area of Mexico City. Oral exploration formed part of the health diagnosis provided by the Schools Promoting Health Programme. The DMFT (decayed, missing and filled teeth) index was used for determining dental decay. Diagnosis with no probe was used for evaluating gingivitis. Chi2 tests were applied and risks were calculated for evaluating the association between dental decay, gingivitis and affection pattern by tooth type according to sex and age. Results: The prevalence of dental decay and gingivitis was 92,2 percent and 13,7 percent, respectively. DMFT index was 7,3. Being aged 14 and over represented a significant risk for dental decay (OR=3,1; CI95 percent=1,5-6,4). The treatment needs index for dental decay was 95,7 percent, representing an expenditure of 642 450 Mexican pesos (59 818,4 US dollars). Discussion: Regarding adolescents' oral health status, dental caries was the affection having the highest prevalence and its risk increased with age. The DMFT index was twice as high as WHO standards.
Asunto(s)
Adolescente , Femenino , Humanos , Masculino , Adulto Joven , Salud Bucal , Higiene Bucal , Estudios Transversales , México , Adulto JovenRESUMEN
Los quistes del colédoco son dilataciones saculares o fusiformes, locales o generalizadas del árbol biliar. Son la segunda malformación de vías biliares después de la atresia de vías biliares; siendo más frecuente en el sexo femenino. El 80 por ciento de los casos se diagnóstican en la primera década de la vida. En el neonato los quistes del colédoco por lo general se manifiestan por ictericia persistente, a menudo con una masa abdominal palpable en hipocondrio derecho. En niños mayores y adultos se puede presentar como manifestación de una de sus complicaciones: colangitis, pancreatitis, hipertensión portal y peritonitis biliar por ruptura del quiste. Sólo 30 por ciento de los pacientes desarrollan la tríada clásica de ictericia, dolor abdominal y masa en hipocondrio derecho. La ecografía es el método diagnóstico de elección,otros estudios como la tomografía, colangioresonancia, la colangiopancreatografía retrógrada endoscópica son útiles para confirmar el diagnóstico o cuando se desea descartar afección intrahepática concomitante. Presentamos a continuación a una preescolar de 2 años de edad, la cual debuta con una pancreatitis aguda de evolución tórpida como complicación de quiste del colédoco
Asunto(s)
Humanos , Preescolar , Femenino , Colangiografía , Pancreatitis , Quiste del Colédoco/complicaciones , Quiste del Colédoco/diagnóstico , Quiste del Colédoco/irrigación sanguínea , Pediatría , VenezuelaRESUMEN
Se conoce con el nombre de leishmaniasis cutánea, La enfermedad producida por protozoarios del género leishmania, que amerita la presencia de un insecto (flebótomo) que actúa como vector. Con un período de incubación entre 2-3 meses, aunque puede ser de pocos días a un año o más. Las lesiones iniciales están bajo la forma de pápulas eritematosas o papulovesículas eritematosas, que aumentan lenta y progresivamente de tamaño, localizándose en partes descubiertas del cuerpo, sin compromiso de mucosas. La clínica es inespecífica e indistinguible de otras patologías de piel. El presente caso trata de un escolar masculino de 5 años, quién dos semanas posteriores a la picadura de insecto en región de antebrazo izquierdo, presentó induración con signos de flogosis y úlcera de bordes mal delimitados, con signos de infección sobre agregada, de tres meses de evolución. La presentación atípica de la lesión dificultó el diagnóstico. Se realizó biopsia de la lesión, intradermoreacción de montenegro, e inmunofluoresencia para leishmaniasis que resultaron positivas, respondiendo adecuadamente a tratamiento con glucantime