Is self-perception of oral health associated with expectations of employability?

Abstract The aim of this study was to develop and validate a questionnaire that allows a systematic evaluation of the impact of self-perceived oral health on expectations of getting a job on adult population seeking dental care, and to describe its associations with demographic characteristics, job related, and health coverage variables. We designed a descriptive cross-sectional study including men and women aged 18 to 65 years from a population seeking dental services in a walk-in clinic. In a first stage we design and validated an instrument on a sample of 100 subjects. The questionnaire was registered in a Likert scale, with higher scores represented higher impact of the oral status self-perception on employability. We calculated internal consistency, construct validity, and domains validation. The final instrument consisted in an 18-item questionnaire (Cronbach α = 0.814), grouped into two domains based on exploratory and confirmatory factor analysis. The total variance explained with values >1 was 66 percent, grouping questions into six components. One domain refers to oral health status and importance of dental aesthetics, while the other refers to specific job-seeking elements. In a second stage we applied the questionnaire on 800 participants from the same population of reference. Women, people who intended to change jobs, those younger than 40 years old, having health insurance, and higher educational level showed statistically significant higher scores than their counterparts (p<0.001). We developed a tool that enables evaluating the impact of self-perceived oral health on expectations of getting a job for adults seeking emergency care in a dental clinic.

Encefalopatía Posterior Reversible asociada a Exacerbación de Enfermedad Pulmonar Obstructiva Crónica / Reversible Posterior Encephalopathy associated with Exacerbation of Chronic Obstructive Pulmonary Disease

Resumen El Síndrome de Encefalopatía Reversible Posterior (PRES) es una entidad clínica y radiológica reversible. Existen varias entidades clínicas que se asocian con PRES. La enfermedad pulmonar obstructiva crónica (EPOC) es un factor predisponente poco frecuente para el desarrollo de esta patología. Se presenta el caso de una mujer de 71 años de edad que estaba siendo tratada por una exacerbación aguda de EPOC y desarrolló alteración del sensorio y crisis convulsivas. Los hallazgos de imágenes características, los síntomas clínicos asociados y su historial médico llevaron a un diagnóstico de PRES en nuestro paciente. A pesar de que la asociación de PRES y EPOC es una entidad poco común, el diagnóstico de PRES debe ser un diferencial en caso de que un paciente desarrolle encefalopatía o convulsiones en la exacerbación de EPOC.

Abstract Posterior Reversible Encephalopathy Syndrome (PRES) is a reversible clinical and radiological entity. There are several entities that are associated with PRES. Chronic obstructive pulmonary disease (COPD) is a rare factor for the development of this condition. We present the case of a 71-years-old woman who was being treated for an acute exacerbation of COPD and developed sensory impairment and seizures. The findings of characteristic images, associated clinical symptoms and their medical history led to a diagnosis of PRES in our patient. Although the association of PRES and COPD is a rare entity, the diagnosis of PRES should be a differential if a patient develops encephalopathy or seizures in the exacerbation of COPD.

Factores Asociados A La Mortalidad De La Hemorragia Cerebral Intraparenquimatosa Espontánea En Pacientes Mayores De 50 Años De Edad Que Acudieron Al Hospital Teodoro Maldonado Carbo Durante El Año 2017 / Factors Associated With Mortality Of Spontaneous Intraparenchymal Cerebral Hemorrhage In Patients Over 50 Years Of Age Who Attended The Teodoro Maldonado Carbo Hospital During The Year 2017

Resumen Objetivos: Determinar los factores asociados a la mortalidad de la hemorragia cerebral intraparenquimatosa espontánea en pacientes mayores de 50 años de edad que acudieron al Hospital Teodoro Maldonado Carbo durante el año 2017. Materiales y métodos: Mediante un estudio observacional retrospectivo analítico, con 92 pacientes diagnosticados de hemorragia intraparenquimatosa espontánea primaria, se evaluaron las características demográficas, factores de riesgo, factores de mal pronóstico y la mortalidad a los 30 días. La Intracerebral Hemorrage Grading Scale (ICH-GS) fue aplicada en nuestra población para evaluar la correlación de los puntajes obtenidos con la mortalidad a los 30 días. Resultados: De los 92 pacientes, (edad media: 69 años, media de la Escala de Coma de Glasgow [GCS] al ingreso: 11 puntos, media del volumen supratentorial e infratentorial 36.63 y 13.92 ml respectivamente, localización del hematoma más frecuente: tálamo [21,74%]). La mortalidad a 30 días fue del 31,40%. En un análisis univariado, GCS (odds ratio [OR] = 2.20, intervalo de confianza [IC] del 95% = 1.04- 4.65, p <0,04), volumen infratentorial (OR = 3.74 por ml, IC del 95% = 1.25 a 11.120, p <0.02) y la extensión ventricular (OR = 5.43, IC 95% = 1.40-22.35, P = 0.02), fueron predictores significativos para la mortalidad a los 30 días. La correlación de Pearson mostró correlaciones de 0.6556 entre el puntaje ICH-GS y la mortalidad a 30 días (P < 0.001). Conclusión: El puntaje de la GCS al ingreso junto con el volumen infratentorial y la extensión intraventricular son predictores significativos de mortalidad a los 30 días en pacientes con Hemorragia intracerebral (HIC) primaria espontánea, siendo útil para identificar pacientes de alto riesgo a corto plazo.

Abstract Objective: To determine the factors associated with the mortality of spontaneous intraparenchymal cerebral hemorrhage in patients over 50 years old who attended the Teodoro Maldonado Carbo Hospital during 2017. Methods: A retrospective analytical observational study of 92 patients of diagnosis of spontaneous primary intraparenchymal hemorrhage, 30-day mortality was evaluated according to demographic characteristics, risk factors and poor prognostic factors. The Intracerebral Hemorrhage Grading Scale (ICH-GS) scale was applied in our population to evaluate the correlation of the scores obtained with the 30-day mortality. Results: From 92 patients (mean age: 69 years, mean Glasgow Coma Scale [GCS] on admission: 10, mean supratentorial and infratentorial volume, respectively 36.63 and 13.92 ml, most common hematoma location: thalamus (21.74%). at 30 days it was [31.40%]). In a univariate analysis, GCS (odds ratio [OR] = 2.20, 95% confidence interval [CI] = 1.04- 4.65, p <0.04), infratentorial volume (OR) = 3.74 per ml, 95% CI = 1.25 to 11,120, p <0.02) and the ventricular extension was (OR = 5.43, 95% CI = 1.40-22.35, P = 0.02) were significant predictors for 30-day mortality The Pearson correlation showed correlations of 0.6556 between the IC-GS score and the 30-day mortality (P <0.001). Conclusions: The GCS score at admission together with infratentorial volume and intraventricular extension are significant predictors of 30-day mortality in patients with primary spontaneous Intracerebral Hemorrhage (ICH) being useful for identifying high-risk patients in the short term.