ABSTRACT
Se realizó una investigación observacional, descriptiva y de corte transversal; con la participación de 492 alumnos con edades comprendidas entre 6 y 12 años, matriculados en centros escolares primarios de la parroquia Alangasí, provincia de Pichincha y de la parroquia Puerto Baquerizo Moreno en la ciudad de San Cristóbal, Islas Galápagos, Ecuador; cuyos tutores legales dieron el respectivo consentimiento. El Sistema Internacional para la Detección y Evaluación de Caries (ICDAS) se utilizó para evaluar el estado de los primeros molares (16, 26, 36 y 46). Entre la población de estudio predominó la presencia del género femenino, además de la categoría que implican lesiones de caries en esmalte dental o en la de sano. Atendiendo a las medias, se apreció mayor afectación en los primeros molares de los participantes de Quito (1,51-2,37) en comparación con los de San Cristóbal (1,18-1,46); no observándose diferencias importantes atendiendo al género. Sin embargo, durante el análisis de los datos entre tipos de colegio se halló que la población de la escuela fiscal tenía más afectación (1,91-2,37). Además, hubo asociaciones entre categorías de las variables involucradas.
An observational, descriptive and cross-sectional research was carried out; with the participation of 492 students between the 6 and 12 years of age, enrolled in primary schools in the town of Alangasí, Pichincha province and in the town of Puerto Baquerizo Moreno in the city of San Cristóbal, Galapagos Islands, Ecuador; whose legal guardians gave the respective consent. The International Caries Detection and Assessment System (ICDAS) was used to assess the state of the first molars (16, 26, 36 and 46). The presence of the female gender predominated among the study population, as well as the category that implies caries lesions in dental enamel or in healthy teeth. Based on the means, greater affectation was observed in the first molars of the participants from Quito (1.51-2.37) compared to those ones from San Cristóbal (1.18-1.46); not observing important differences according to gender. However, during the analysis of the data between school types, it was found that the population of the fiscal school had more affectation (1.91-2.37). In addition, there were associations between categories of the variables involved.
Subject(s)
Humans , Male , Female , Child , Health Status , Dental Caries , Molar , Patients , Schools , Data AnalysisABSTRACT
ABSTRACT Objective: to identify predictive factors for lethality and complications of deep fascial space infections of the neck (DFSIN), establishing an early and aggressive treatment in the neck before the progression to descending mediastinitis. Methods: we retrospectively analyzed 133 cases of DFSIN treated at Discipline of Head and Neck Surgery of the Medicine School of Santa Casa de Misericórdia de São Paulo. We accessed demographic characteristics, associated diseases, clinical presentation, laboratorial tests, length of hospital stay, number of involved anatomic neck spaces, intra-operative and microbiology findings. We analyzed these data using logistic regression to predict DFSIN lethality and life threatening complications (mediastinitis, septic shock, pneumonia, pleural empyema, skin necrosis). Results: lethality and complication ratios were 9% and 50.3%, respectively. The logistic regression model showed that patients with septic shock were more likely to have progression to death (p < 0.001) and, the presence of more than two involved neck spaces (p < 0.001) and older individuals (p = 0.017) were more likely to have complicated deep neck infections. Descending necrotizing mediatinitis increased the lethality ratio by 50%, and was associated to necrotizing fasciitis (p=0.012) and pleural empyema (p<0.001). Conclusion: septic shock is a lethal predictive factor and age as well as more than two involved neck spaces are the predictive factors for complications. Necrotizing fasciitis is an important factor for complications and death. Therefore, its surgical treatment must be more aggressive. Descending mediastinitis has a high lethal rate and the successful treatment is based on early diagnosis and aggressive surgical approach.
RESUMO Objetivo: identificar os fatores preditivos de letalidade e complicações associados às infecções dos espaços fasciais profundos do pescoço, com intuito de estabelecer tratamento mais precoce antes de evolução para a mediastinite. Métodos: estudo retrospectivo de 133 casos, tratados na Disciplina de Cirurgia de Cabeça e Pescoço da Faculdade de Ciências Médicas da Santa Casa de São Paulo. Por meio da análise de regressão logística, estes dados foram estudados para a predição de letalidade e complicações graves (mediastinite, choque séptico, empiema pleural, pneumonia e necrose de pele). Resultados: a taxa de letalidade identificada foi de 9% e, de complicações de 50,3%. Identificou-se como fator preditivo de letalidade, a presença de choque séptico (p<0,001) e, para o ocorrência de complicações, a idade (p=0,017) e o acometimento de mais de dois espaços anatômicos (p<0,001). A ocorrência de mediastinite descendente necrosante esteve associada à presença de fasciíte necrosante (p=0,012) e empiema pleural (p<0,001). Conclusão: o fator preditivo de letalidade foi a presença de choque séptico e, para ocorrência de complicações graves, a idade e/ou a presença de mais de dois espaços anatômicos acometidos pela infecção. A fasciíte necrosante é fator importante para ocorrência de complicações e morte. Nestes casos, a conduta cirúrgica deve ser mais agressiva. A mediastinite descendente apresenta taxa de letalidade alta e o sucesso no tratamento está no diagnóstico precoce e na intervenção cirúrgica agressiva.
Subject(s)
Humans , Adult , Fasciitis, Necrotizing/mortality , Infections/complications , Infections/etiology , Neck , Retrospective Studies , Empyema, Pleural , Fascia , Middle AgedABSTRACT
Objetivo: Determinar los cambios favorables esqueletales y faciales, en niños de 7 a 10 años, con patrón Esqueletal Clase II, que visitaron la clínica de Odontopediatría y fueron tratados con aparatos de ortopedia funcional. Metodología: La siguiente investigación es un estudio de tipo descriptivo observacional prospectivo, que se realizó a través de la toma de radiografías cefalométricas en 29 sujetos, de edades entre los 7 y 10 años, que utilizaron aparatos de ortopedia funcional en el periodo de julio 2014 y julio 2015; los datos se obtuvieron trazando las medidas cefalométricas SNA, SNB, ANB, convexidad, línea estética de Ricketts y ángulo naso labial; estos resultados fueron comparados con las misma medidas trazadas por los bachilleres que realizaron el diagnóstico inicial. Resultado: Los cambios cefalómetros encontrados se expresan de la siguiente manera: SNA: Con un intervalo de confianza de 0.459, demostrando que hay cambios leves cefalométricos, pero no los suficientes para obtener una significancia estadística. SNB: Con un intervalo de confianza de 0.180, demostrando que para esta medida hubo cambios cefalométricos leves, pero no para alcanzar una significancia estadística. ANB: Con intervalo de confianza de 0.004, lo que demostró, que si hay significancia estadística por lo tanto, los aparatos de ortopedia funcional si lograron cambios cefalométricos. Convexidad: Con un intervalo de confianza de 0.036, lo que demuestra que si hay significancia estadística, por lo tanto, los aparatos de ortopedia funcional si lograron cambios cefalométricos. Línea estética de Ricketts: Con un intervalo de confianza de 0.075, no logrando obtener una significancia estadística, pero mejorando las medidas cefalométricas progresivamente. Ángulo naso labial: Con un intervalo de confianza de 0.495, demostrando cambios cefalométricos pero no alcanzando la significancia estadística. Conclusión: Los aparatos de ortopedia funcional colocados por los bachilleres en las clínicas de Odontopediatría, si logran cambios cefalométricos, aunque la mayoría de las variables encontradas no alcanzaron una significancia estadística, ya que existieron factores determinantes por parte de los niños que impidieron el desarrollo en su totalidad del aparato de ortopedia funcional.
Objective: To determine favorable skeletal and facial changes in children aged 7 to 10 years, with skeletal class II pattern, who visited the pediatric dentistry clinic and were treated with functional orthopedic appliances. Methodology: The following research is a prospective observational descriptive study, which was performed through the use of cephalometric radiographs in 29 subjects, aged between 7 and 10 years, who used functional orthopedic appliances in the period of July 2014 and July 2015; the data were obtained by tracing the cephalometric measurements SNA, SNB, ANB, CONVEXITY, AESTHETIC LINE OF RICKETTS and NASO LABIAL ANGLE; these results were compared with the same measures drawn by the students who performed the initial diagnosis. Result: The cephalometers changes are expressed as follows: SNA: With a confidence interval of 0.459, shows that there are slight cephalometric changes, but not enough to obtain a statistical significance. SNB: With a confidence interval of 0.180, shows that there were slight cephalometric changes, but not enough to reach a statistical significance. ANB: With a confidence interval of 0.004, shows that there is statistical significance, functional orthopedic appliances achieved cephalometric changes. CONVEXITY: With a confidence interval of 0.036, shows that there is statistical significance, therefore, functional orthopedic appliances achieved cephalometric changes. AESTHETIC LINE OF RICKETTS: With a confidence interval of 0.075, failing to obtain a statistical significance, but improving cephalometric measurements progressively. NASO LABIAL ANGLE: With a confidence interval of 0.495, showing cephalometric changes but not reaching the statistical significance. Conclusion: Functional orthopedic appliances placed by the dental students in pediatric dentistry clinics achieve cephalometric changes, although most of the variables found did not reach statistical significance, there were determinants on the children´s side, which prevented the development of the functional orthopedic appliance.
Subject(s)
Orthodontics, Interceptive , Child , Cephalometry , MalocclusionABSTRACT
Objetivou-se identificar o impacto da anemia falciforme no cotidiano de adolescentes. Pesquisa quali- quantitativa, descritiva e exploratória com 12 adolescentes inscritos num ambulatório da cidade de Curitiba, estado do Paraná. A coleta dos dados ocorreu entre 15 de janeiro a 30 abril de 2014. Teve como referencial teórico as Representações Sociais e metodológico o Discurso do Sujeito Coletivo. Dos resultados encontrados, metade dos adolescentes era afrodescendente, quase todos foram diagnosticados na Triagem Neonatal no Teste do Pezinho. Os jovens demonstraram algum conhecimento da doença; a maioria referiu não se sentir diferente perante outros adolescentes sem a doença; foram frequentes os relatos de dor, cansaço, uso de medicamentos e limitações ao convívio social; o motivo de internação mais frequente foi por crise álgica. Ações educativas em serviços de saúde, com foco nas singularidades de paciente e família, minimizarão os impactos da doença e promoverão qualidade de vida dos jovens com anemia falciforme (AU).
The present study aimed to identify the impact of sickle cell disease on the daily lives of adolescents. Exploratory, descriptive, qualitative and quantitative research with 12 adolescents enrolled in an outpatient unit of the city of Curitiba, state of Paraná. Data collection was performed between January 15 and April 30, 2014. The theory of Social Representations was the reference of the research, and the technique used was Collective Subject Discourse methodology. Half of the adolescents were of African descent, and almost all of them were diagnosed at the National Newborn Screening Program Guthrie test. The youngsters had some knowledge of the disease; most of them reported not feeling different from other adolescents not affected by the disease; there were frequent reports of pain, fatigue, medication use and limitations of social life; the most common reason for hospitalization was pain episodes. Educational actions in health services focused on the characteristics of the patients and their families, will minimize the impacts of the disease and promote the quality of life of adolescents with sickle cell disease (AU).
Estudio cuya finalidad fue identificar el impacto de la anemia falciforme en el cotidiano de adolescentes. Investigación cualitativa cuantitativa, descriptiva y exploratoria con 12 adolescentes inscriptos en ambulatorio de la ciudad de Curitiba, Paraná. Los datos fueron obtenidos entre 15 de enero y 30 de abril de 2014. El referencial teórico fue de las Representaciones Sociales y, el metodológico, del Discurso del Sujeto Colectivo. Acerca de los resultados, mitad de los adolescentes era afrodescendiente, casi todos fueron diagnosticados en la Selección Neonatal en el Test de Guthrie. Los jóvenes demostraron algún conocimiento de la enfermedad; la mayoría declara no sentirse diferente delante de otros adolescentes sin la enfermedad; fueron frecuentes los relatos de dolor, cansancio, uso de medicamentos y limitaciones del convivir social; el motivo de internación más frecuente fue por crisis de dolor. Acciones educativas en servicios de salud, con foco en las singularidades de paciente y familia podrán minimizar los impactos de la enfermedad y promover cualidad de vida de los jóvenes con anemia falciforme (AU).
Subject(s)
Adolescent , Public Health Nursing , Chronic Disease , Adolescent , Qualitative Research , Anemia, Sickle CellABSTRACT
El crecimiento craneofacial y patrón Esqueletal es importante porque todos los mecanismos de crecimiento, son procesos morfogenéticos encaminados hacia un equilibrio funcional del complejo maxilofacial. Por lo tanto, el objetivo es Describir y comparar radiográficamente el crecimiento y patrón Esqueletal craneofacial más frecuentes por género, con una muestra de 165 radiografías del Centro de Imágenes la Facultad de Odontología de la Universidad de El Salvador, efectuadas en Agosto 2006-2007. Esta investigación es de tipo Descriptiva. Las variables fueron género, patrón Esqueletal y tipo de crecimiento. Los datos se procesaron en el programa Stadistical Product for Service Solutions 16.0 (SPSS). El crecimiento craneofacial en el género femenino es 44.2% neutro y 14.5% vertical; el género masculino presento crecimiento neutro un 32.7%, 7.9% vertical y 0.6% horizontal. Siendo el crecimiento neutro más frecuente para ambos géneros. El patrón Esqueletal presento en el género femenino 13.3% clase I, 45.5% clase II y el género masculino presento 6.7% clase I; 31.1% clase II; y 2.4% clase III. Siendo el patrón clase II más frecuente. Se obtuvo un alto número de pacientes clase II considerándose este uno de los más complejos, combinado con un crecimiento vertical, podría dificultar el manejo del paciente. Importante recordar a estudiantes y odontólogos a reorientar el crecimiento, modificando hábitos o funciones incorrectas con el uso de aparatología; utilizadas en forma precoz durante la maduración del niño; además mediante una detección temprana con hallazgos clínicos, patrón Esqueletal y crecimiento craneofacial; el manejo podría verse simplificado y obtener mejores resultados.
Craniofacial growth and skeletal pattern is important because all growth mechanisms are morphogenetic processes directed towards a functional balance of the maxillofacial complex. Therefore, the objective is to describe and radiographically compare the most frequent growth and craniofacial skeletal pattern by gender, with a sample of 165 radiographs from the Imaging Center of the Faculty of Dentistry of the University of El Salvador, carried out in August 2006-2007. This research is descriptive. The variables were gender, skeletal pattern and type of growth. The data were processed in the Statistical Product for Service Solutions 16.0 (SPSS) program. The craniofacial growth in the female gender is 44.2% neutral and 14.5% vertical; the male gender presented neutral growth of 32.7%, 7.9% vertical and 0.6% horizontal. Being the most frequent neutral growth for both genders. The skeletal pattern presented in the female gender 13.3% class I, 45.5% class II and the male gender presented 6.7% class I; 31.1% class II; and 2.4% class III. Being the most frequent class II pattern. A high number of class II patients was obtained, considering this one of the most complex, combined with vertical growth, it could make patient management difficult. It is important to remind students and dentists to reorient growth, modifying incorrect habits or functions with the use of appliances; used early during the maturation of the child; also by early detection with clinical findings, skeletal pattern and craniofacial growth; the handling could be simplified and get better results.