ABSTRACT
@#<p style="text-align: justify;"><strong>BACKGROUND:</strong> Periodontitis affects more than half of patients with diabetes. In resource poor areas in the Philippines, access to routine dental visits may be difficult and thus, a selective approach might be needed to identify those who need dental evaluation and management. An easy-to-administer oral health self-report questionnaire was developed in order to predict serious (moderate to severe) periodontitis.<br /><strong>OBJECTIVE:</strong> The study aims to determine the validity of the Oral Health Screening Questionnaire for Persons with Diabetes (OHSQPD) in estimating the prevalence of serious periodontitis.<br /><strong>METHODOLOGY:</strong> A cross-sectional criterion-referenced study of 175 participants with T2DM were included in the study. They were asked to answer the questionnaire and then made to undergo a full dental examination to identify the presence and severity of periodontitis. The validity of the questionnaire was assessed by determining the sensitivity, specificity, positive predictive value, negative predictive value and area under the receiver-operating curve (AUROC) with the dental examination as the gold standard.<br /><strong>RESULTS:</strong> Using the questionnaire, the prevalence of serious periodontitis was 61% (106) based on an optimal cut-off score of ?12. At this score, the questionnaire yielded a sensitivity of 80.4% and a specificity of 70.6%, with an AUROC of 0.83.<br /><strong>CONCLUSION:</strong> The OHSQPD is a valid tool in detecting serious periodontitis</p>
Subject(s)
Humans , Male , Female , Aged , Middle Aged , Adult , Surveys and Questionnaires , Diabetes Mellitus , Periodontitis , Oral Health , PhilippinesABSTRACT
Background@#The likelihood of periodontitis among type 2 diabetes is thrice the non-diabetic population and progresses rapidly when uncontrolled. An inexpensive and easy way of dental assessment via self-reported oral health questionnaire has great potential as a screening tool.@*Objective@#This study aims to validate self-reported oral health measures, socio-demographic and medical variables in predicting the severity of periodontitis in Filipino adults with type 2 diabetes. @*Methodology@#The validated self-reported oral health questionnaires created by the CDC Periodontal Disease Surveillance Project was translated into Filipino and used. A cross-sectional study of 180 participants was conducted in a single institution. Multivariable logistic regression analyses were used to determine significant predictors of serious periodontitis. @*Results@#Male sex [OR=2.17], low educational status [OR=2.98], poor glycemic control [OR=2.58], less frequent dental visits [OR=2.77] and teeth loss >6 [OR=5.02] were considered to be predictive of serious periodontitis. Self reported oral health variables like gum disease –Q1 [OR=8.33], state of gum health –Q2 [OR=0.39], loose teeth –Q3 [OR=63.0], brushing of teeth –Q4 [OR=0.65], use of mouthwash –Q4 [OR=0.69] and poor tooth appearance –Q5 [OR=48.42] were also shown to be significantly predictive of serious periodontitis. A recommended set of questions and proposed scoring system based on the logistic regression analysis of each predictor’s strength was then formulated. @*Conclusion@#The use of specific self-reported oral health questions, certain socio-demographic and medical variables appeared to be highly predictive of serious periodontitis among Filipinos with type 2 diabetes. This provides a cost-effective and rapid method of screening patients who are in need of immediate dental evaluation.
Subject(s)
Periodontitis , Diabetes Mellitus, Type 2 , Dental CareABSTRACT
BACKGROUND: Anaplastic thyroid cancer (ATC) is a rare type of thyroid malignancy and one of the most aggressive solid tumors, responsible for between 14% and 50% of the total annual mortality associated with thyroid cancer. METHODS: A retrospective study was made of all ATC cases diagnosed by biopsy in the Philippine General Hospital between 2008 and 2013. RESULTS: A total of 15 patients were identified, with a median age at diagnosis of 63 years. All tumors were at least 6 cm in size upon diagnosis. All patients had a previous history of thyroid pathology, presenting with an average duration of 11 years. Eleven patients presented with cervical lymphadenopathies, whereas seven exhibited signs of distant metastases, for which the lungs appeared to be the most common site. More than 70% of the patients presented with a rapidly growing neck mass, leading to airway obstruction. Only three patients were treated using curative surgery; the majority received palliative and supportive forms of treatment. In addition, only three patients were offered radiotherapy. Chemotherapy was not offered to any patient. Only two patients were confirmed to still be alive during the study period. The median survival time for the other patients was 3 months; in the majority of cases the patient died within the first year following diagnosis. CONCLUSION: Our experience with ATC demonstrated concordance with other institutions with respect to current clinical profile, presentation, and prognosis. An absence of distant metastases and lymph node involvement was associated with improved survival outcomes, whereas age at diagnosis and tumor size did not affect survival. Curative surgery offers the most effective means of prolonging survival. Radiotherapy and chemotherapy in combination with surgery represents a promising treatment strategy.