Tratamiento endodóntico en una sesión comparado con múltiples sesiones en pacientes con dentición permanente / Single versus multiple visits for endodontic treatment in permanent teeth

RESUMEN: Introducción: El tratamiento endodóntico corresponde a un procedimiento común en la práctica odontológica y su éxito depende de una serie de factores, entre los cuales se ha planteado que existe una diferencia entre los resultados de los tratamientos realizados en una o múltiples visitas. Métodos: Realizamos una búsqueda en Epistemonikos, la mayor base de datos de revisiones sistemáticas en salud, la cual es mantenida mediante el cribado de múltiples fuentes de información, incluyendo MEDLINE, EMBASE, Cochrane, entre otras. Extrajimos los datos desde las revisiones identificadas, analizamos los datos de los estudios primarios, realizamos un meta análisis y preparamos una tabla de resumen de los resultados utilizando el método GRADE. Resultados y conclusiones: Identificamos 10 revisiones sistemáticas que en conjunto incluyeron 46 estudios primarios, de los cuales, 26 corresponden a ensayos aleatorizados que evalúan el tratamiento endodóntico en dientes vitales y no vitales. Concluimos que el tratamiento endodóntico en una sesión podría resultar en poca o nula diferencia sobre el dolor a corto plazo e infecciones postoperatorias, pero la certeza de la evidencia es baja. Además, podría reducir levemente el riesgo de exodoncias dentarias, también podría aumentar el uso de analgésicos y flare-ups, pero la certeza de la evidencia es baja. Finalmente, no está claro el efecto del tratamiento endodóntico en una sesión sobre el dolor a mediano plazo, debido a que la certeza de la evidencia existente ha sido evaluada como muy baja.

ABSTRACT: Introduction: Endodontic treatment is a common procedure in dentistry and its success depends on several factors. It has been suggested that there is a difference in terms of effectiveness on endodontic treatments performed in one compared to those performed in multiple visits. Methods: We searched in Epistemonikos, the largest database of systematic reviews in health, which is maintained by screening multiple information sources, including MEDLINE, EMBASE, Cochrane, among others. We extracted data from the systematic reviews, reanalyzed data of primary studies, conducted a meta-analysis and generated a summary of findings table using the GRADE approach. Results and conclusions: We identified 10 systematic reviews including 46 studies overall, of which 26 were randomized trials. We concluded that single versus multiple visits for endodontic treatment in permanent teeth may make little or no difference to short-term pain and postoperative infection, but the certainty of the evidence has been assessed as low. Also, single visit treatment may reduce the risk of extraction due to endodontic problem, increased the risk of painkiller use and flare-ups, but the certainty of the evidence has been assessed as low. We are uncertain about the effect of single visit treatment on medium-term pain, as the certainty of the evidence has been assessed as very low.

Association between health literacy with health seeking behavior in undergraduate students in Shandong / 中国学校卫生

Objective@#To understand relationship between health literacy and health seeking behavior of undergraduate students in Shandong Province.@*Methods@#A total of 1 460 undergraduate students from three universities in Shandong Province were selected through stratified random sampling method and received a questionnaire survey. Data were analyzed by one-way ANOVA, Chi-square test and regression analysis.@*Results@#The proportion of students with basic health literacy was 64.4% (41.37±10.34). The proportion of students with basic knowledge and concept, healthy lifestyle and behavior, and basic skills was 49.6% (16.28±4.58), 70.3% (17.24±4.99) and 83.7% (7.85±1.58), respectively. About 28.1% of undergraduate students reported delay in seeking medical treatment, 71.9% reported prompt in seeking medical treatment, and 24.2% preferred to seek medical treatment in primary medical institutions, 45.5% secondary hospital and 30.3% tertiary hospital. Grade, major, the ability to gather and understand health information was the main factors affecting health literacy. Major and health information screening ability was the main factors affecting health seeking behavior. Grade, major, origin, the awareness and gathering of health information was the main factors affecting the choose of medical institutions(P<0.05). Basic knowledge and concept, basic skills and health literacy was positively correlated with the timing of health seeking behavior, while basic knowledge and concept, healthy lifestyle and behavior, and basic skills might give information on students’ preference on selecting a medical institution.@*Conclusion@#Attention should be paid to the cultivation of health information literacy. An integrated health education and health promotion model of "family-community-hospital-university" should be established.

Relación entre desnutrición y depresión en mujeres adultas mayores en la consulta de un hospital de Quito, 2017 / Relationship between malnutrition and depression in eldery women in the outpatient clinic of a hospital in Quito, 2017

INTRODUCCIÓN. La desnutrición y la depresión son problemas frecuentes en adultos mayores y tienen características propias. Varios factores modificables están asociados. OBJETIVO. Determinar la existencia de relación entre desnutrición y depresión en mujeres mayores de 65 años atendidas en la consulta externa del Hospital de Especialidades Carlos Andrade Marín en el año 2017. MATERIALES Y MÉTODOS. Estudio relacional, transversal en mujeres con estado nutricional normal y desnutrido. La muestra fue de 160 mujeres adultas mayores, en dos grupos de 80 pacientes con y sin desnutrición. Se aplicaron las escalas de: Yesavage para depresión, de Katz para dependencia y de Gijón para valoración socio-familiar. La asociación se estableció mediante Chi Cuadrado de homogeneidad, la fuerza de asociación se midió con Razón de prevalencia. RESULTADOS. La proporción de depresión en pacientes con desnutrición fue el doble que en las no desnutridas, p valor de 0,003 y OR de 2,82 (1,42-5,59). Además, se encontró relación estadísticamente significativa entre desnutrición con: viudez, baja instrucción, bajos ingresos, dependencia, poca ayuda social, aislamiento; y, vivienda con barreras arquitectónicas. CONCLUSIÓN. Existió asociación entre desnutrición y depresión. Las pacientes con desnutrición tienen más probabilidades de presentar síntomas depresivos.

INTRODUCTION. Malnutrition and depression are frequent problems in older adults and have their own characteristics. Several modifiable factors are associated. OBJECTIVE. To determine the existence of a relationship between malnutrition and depression in women over 65 years of age treated in the outpatient clinic of the Carlos Andrade Marín Specialty Hospital in 2017. MATERIALS AND METHODS. Relational, cross-sectional study in women with normal and malnourished nutritional status. The sample was 160 older adult women, in two groups of 80 patients with and without malnutrition. The following scales were applied: Yesavage for depression, Katz for dependency and Gijón for socio-family assessment. The association was established by Chi Square of homogeneity, the strength of association was measured with Reason of prevalence. RESULTS. The proportion of depression in patients with malnutrition was double that in the non-malnourished, p value of 0,003 and OR of 2,82 (1,42-5,59). In addition, a statistically significant relationship was found between malnutrition with: widowhood, low education, low income, dependency, little social help, isolation; and, housing with architectural barriers. CONCLUSIONS. There was an association between malnutrition and depression. Patients with malnutrition are more likely to have depressive symptoms.

Relationship between Re-visits and Complaints' Characters of Out Patient Department and Emergency Department in One Tertiary Hospital

PURPOSE: Emergency department (ED) and Outpatient department (OPD) are similar to some extent, but there are differences. The difference is complaints that can be encountered during practice. The aim of this study was to investigate complaints of OPD and ED and factors associated with Re-visits. METHODS: We retrospectively investigated 431 official complaints of visitors and 426 re-visitors in one tertiary university hospital OPD and ED between January 1, 2011 and December 31, 2014. RESULTS: ED complaints were 18 times more common than OPD. The two groups differed in chronic disease, follow up duration and frequency, transportation, visiting day of the week, visiting time, relation between patient and claimant, claimant age, related department, medical department, method of expression, major reason for complaints, treatment result, and re-visit. The factors associated with ED re-visits were chronic disease, follow up duration and frequency, treatment result, and expression method. CONCLUSION: Doctors, particularly emergency physicians in the ED, were the subject of the most common complaints. Patients had more complaints about the subjective time delay than the ED retention time. Emergency physicians should be more alert for first visit patients.

Factors associated to medical consultations by elderly adults in southern Brazil: a population based study / Fatores associados à realização de consultas médicas por idosos no Sul do Brasil: estudo de base populacional

Objective: To analyze the prevalence of medical consultations in the last three months among elderly adults and associated factors. Methods: A cross-sectional, population-based study was carried out with 1,705 elderly adults (60+ years of age) in the urban region of Florianópolis, Santa Catarina, Brazil, in 2009 and 2010. The sampling selection was performed in two stages. The sample was complex, with census tracts as primary and households as secondary sampling units. For association analysis, Poisson regression was performed using predisposing factors, enabling factors and need as independent variables, according to Andersen's theoretical model. Results: The response rate was 89.2%. The prevalence of medical appointments by elderly adults was 70.4% (95%CI 67.5 - 73.4). Factors associated with higher prevalence of medical consultations in the crude analysis were female gender, accumulation of chronic diseases, negative self-perception of health, and report of chronic pain. The multivariate analysis showed that having at least one chronic disease and negative self-perception of health was positively associated with the outcome. Conclusion: Only variables from the need dimension were associated with medical consultations, indicating an equal use of this service. .

Objetivo: Analisar a prevalência de consultas médicas nos últimos três meses e os fatores associados entre idosos. Métodos: Estudo transversal de base populacional com 1.705 idosos com 60 anos ou mais, residentes na área urbana do município de Florianópolis, Santa Catarina, em 2009 e 2010. A amostra foi complexa, sendo os setores censitários as unidades primárias de amostragem e os domicílios o segundo estágio. Para análise de associação foi realizada a regressão de Poisson, tendo como variáveis independentes fatores predisponentes, capacitantes e de necessidade, segundo modelo teórico de Andersen. Resultados: A taxa de resposta foi de 89,2%. A prevalência de consultas médicas foi de 70,4% (intervalo de confiança de 95% 67,5 -73,4). Na análise bruta associaram-se com maior prevalência de consultas médicas o sexo feminino, o maior acúmulo de doenças crônicas, a autopercepção negativa de saúde e o relato de dor crônica. A análise multivariável identificou que possuir pelo menos uma doença crônica e ter autopercepção de saúde negativa estiveram associados positivamente ao desfecho. Conclusão: Apenas variáveis da dimensão de necessidade se associaram ao desfecho, apontando para uma igualdade no uso desse serviço. .

The study on the influencing factors of rheumatism's treatment / 中华风湿病学杂志

Objective To study influencing factors in patients with rheumatic diseases.Methods One hundred and twenty patients with rheumatic diseases were selected from November 2013 to February 2014 in our hospital for the study.The influencing factors in patients with rheumatic diseases were obtained by proposed questionnaires,and then the univariate and multivariate Logistic regression analysis were performed to study factors affecting the treatment.Results Patients older than 50 of the observation group accounted for 38％ (18/48),the proportion of farmer,patients with primary school education level or below,and monthly income ＜3 000 RMB was 35％(17/48),60％(29/48),and 46％ (22/48) respectively.Compared with the control group,they were significantly higher than the control group,which were 64％(46/72),58％ (42/72),79％(57/72),65％(47/72) (x2=8.058,P=0.005; x2=6.025,P=0.014; x2=4.986,P=0.226; x2=4.456,P=0.035) respectively.Using the treatment as the dependent variable,age ≥50 years of age,farmer,primary school and lower education level,and monthly income ＜3 000 RMB as the independent variable,we carried out the regression analysis.Age (OR=1.124,95％CI:1.084-7.236),occupation (OR=1.871,95％CI:1.054-7.243),education level (OR=1.982,95％CI:1.157-6.256),monthly income (OR=1.363,95％CI:1.012-8.227) are the influencing factors of rheumatism's treatment.Conclusion The treatment of rheumatic diseases are influenced by many factors,and more societal support should be provided to help patients with rheumatic disease receive professional treatment and better control of the disease.

Cross-sectional study on clinical characteristic and medical care-seek behavior of patients with systemic lupus erythematosus / 中华风湿病学杂志

Objective To investigate the clinical characteristics of systemic lupus erythematosus (SLE) and the situation of diagnosis after onset. Methods Three hundred outpatients diagnosed with SLE were investigated in the People's Hospital, the Third Hospital of Peking University, Xinjiang People's Hospital and the Affiliated Hospital from May to July 2008, including gender, age of onset, clinical manifestations and the site of first hospitalization. Results ① In the cross-sectional study, 300 SLE patients were investigated. The male-to-female ratio was 1:13. ② The most common manifestations at onset were arthritis (46.3%), rash (34.%) and fever (32.7%). Lupus nephritis was found to occur in a significantly higher frequency in male patients than female as the initial manifestation. 60.9% patients had lupus nephritis in the first year after onset. ③ 99.1% of the patients were correctly diagnosed after visiting rheumatologists. 23.7% of the SLE patients were not correctly diagnosed for more than one year after disease onset. Conclusion Arthritis, rash and fever are the most common initial clinical manifestations of SLE. Lupus nephritis is more commonly seen in male SLE patients than female at the disease onset. The diagnosis of lupus is delayed in certain proportion of patients.

Prevalência de consultas médicas e fatores associados: um estudo de base populacional no sul do Brasil / Prevalence of medical visits and associated factors: a population-based study in Southern Brazil

OBJETIVO: Descrever a prevalência de consultas médicas e os fatores associados na população adulta de um município de médio porte do sul do Brasil. MÉTODOS: Realizou-se estudo transversal de base populacional em Lages, Santa Catarina. A população de referência foram os adultos (20 a 59 anos). O processo de amostragem foi por conglomerados e foram entrevistadas 2.022 pessoas. O desfecho foi a realização de consulta médica nos 12 meses anteriores à pesquisa. Também foram coletadas informações relativas à natureza do serviço utilizado (público/privado) e a avaliação do mesmo. As variáveis independentes foram sexo, raça/cor de pele, estado civil, renda per capita, escolaridade, autopercepção da saúde, estado nutricional, diabetes autorreferido, nível pressórico elevado, tabagismo e problemas com álcool. Foi realizada regressão de Poisson obtendo-se a Razão de Prevalência como medida de efeito. RESULTADOS: A prevalência de consultas médicas nos 12 meses anteriores à entrevista foi de 76 por cento (IC95 por cento 73,6-78,4). As mulheres, os mais ricos, aqueles com diabetes, fumantes, ex-fumantes, com problemas com álcool e que avaliaram negativamente a sua saúde reportaram maior prevalência do desfecho. Também se observou que entre os estratos com menor renda a utilização do Sistema Único de Saúde para a realização das consultas médicas foi mais elevada. CONCLUSÃO: A realização de consultas médicas variou entre estratos da população. As políticas de saúde das três esferas de governo devem considerar tal desigualdade para subsidiar suas ações para o setor a fim de propor políticas equânimes.

OBJECTIVE: describe the prevalence of medical visits and associated factors in an adult population of a midsized town in Southern Brazil. METHODS: a population-based cross-sectional study was carried out in a representative random cluster sampling in Lages, Santa Catarina. The reference population were adults (aged 20 to 59 years) and 2,022 persons were queried. The outcome was medical visits during twelve months prior to the survey. Information related to kind of service (public/private) and evaluation of this service were also collected. The independent variables were gender, race/skin color, marital status, income, educational background, health self-perception, nutritional state, self-reported diabetes, hypertension, smoking and alcohol problems. Poisson regression was carried out and the Prevalence Rate was obtained. RESULTS: the prevalence of medical visits was 76.0 percent (CI95 percent 73.6-78.4). Women, the wealthier, those who have diabetes, smokers, ex-smokers, those with alcohol problems, also those who evaluated their health negatively, reported a greater prevalence of medical visits. It was also observed that among lower income people, medical visits to the Public Health System (Sistema Único de Saúde) were more frequent.. CONCLUSION: Prevalence of medical visits varied according to the population queried. Health policies at the three government levels must acknowledge such inequality to subsidize actions in the sector to propose equanimous policies.

Prevalência de consultas médicas e fatores associados, Pelotas (RS), 1999-2000 / Prevalencia de consultas médicas y factores asociados en Pelotas (Sur de Brasil), 1999-2000 / Prevalence of medical visits and associated factors, Pelotas, Southern Brazil, 1999-2000

OBJETIVO: Estimar a prevalência de consultar com médico e analisar fatores a ela associados. MÉTODOS: Estudo transversal de base populacional realizado de dezembro de 1999 a abril de 2000, na cidade de Pelotas (RS). Foram incluídos 1.962 indivíduos de ambos os sexos, de 20 a 69 anos, residentes na zona urbana. Os dados foram coletados por meio de questionários padronizados e pré-codificados. O desfecho "consultar com médico nos 12 meses antes da entrevista" foi analisado com fatores socioeconômicos, demográficos, presença de doenças crônicas e distúrbios psiquiátricos, estado nutricional, tabagismo, consumo de bebidas alcoólicas, e internação no ano anterior à entrevista. Foi realizada regressão de Poisson seguindo modelo hierarquizado, controlada por variáveis de confusão, considerando nível de significância <0,05. RESULTADOS: Entre os entrevistados, 1.395 (70,9 por cento) haviam consultado com médico no período analisado. A análise multivariada entre os homens revelou que os indivíduos que apresentaram maiores prevalências de consultas com médico possuíam renda familiar per capita maior de 10 salários mínimos, mais de 60 anos de idade, diabetes mellitus, índice de massa corporal maior ou igual a 25 kg/m² e que haviam sido hospitalizados. As mulheres com renda familiar per capita acima de seis salários mínimos, com mais de 60 anos, brancas, não fumantes, com hipertensão arterial, com diabetes e as que haviam sido hospitalizadas apresentaram maiores prevalências do desfecho. CONCLUSÕES: Foram identificadas iniqüidades em saúde em relação à cor da pele e renda familiar e alta prevalência de consulta com médicos, principalmente entre os indivíduos mais idosos e com algumas doenças crônicas não transmissíveis.

OBJECTIVE: To estimate the prevalence of visiting doctors and to analyze associated factors. METHODS: Cross-sectional, population-based study performed in the city of Pelotas, Southern Brazil, between December 1999 and April 2000. A total of 1,962 individuals of both sexes, aged between 20 and 69 years and living in the urban area were included in this study. Data were collected with standardized, pre-coded questionnaires. The outcome "visited doctor during the 12 months prior to interview" was analyzed with socioeconomic and demographic factors, presence of chronic diseases and psychiatric disorders, nutritional status, smoking, alcohol consumption, and hospitalizations in the year prior to interview. Poisson regression was used, according to a hierarchical model, controlled by confounding variables, and considering a significance level of <0.05. RESULTS: Among interviewees, 1,395 (70.9 percent) had visited a doctor in the period analyzed. Multivariate analysis among men revealed that individuals who showed higher prevalences of medical visits had a per capita family income higher than 10 minimum wages per month, were over 60 years of age, suffered from diabetes mellitus, had a body mass index equal to or above 25kg/m², and had been hospitalized. Women who had a per capita family income higher than six minimum wages per month, were over 60 years of age, white and non-smokers, suffered from hypertension and diabetes, and had been hospitalized showed higher outcome prevalences. CONCLUSIONS: Health inequalities were identified in relation to ethnicity and family income. In addition, there was high prevalence of medical visits, especially among individuals who were older and suffered from certain chronic, non-communicable diseases.

OBJETIVO: Estimar la prevalencia de consultas con un médico y analizar factores asociados a ella. MÉTODOS: Se realizó estudio transversal de base poblacional de diciembre de 1999 a abril de 2000, en la ciudad de Pelotas (Sur de Brasil). Fueron incluidos 1.962 individuos de ambos sexos, de 20 a 69 años, residentes en la zona urbana. Los datos fueron colectados por medio de cuestionarios estandarizados y pre-codificados. La condición "consultar con médico en los 12 meses antes de la entrevista" fue analizada con factores socioeconómicos, demográficos, presencia de enfermedades crónicas y disturbios psiquiátricos, estado nutricional, tabaquismo, consumo de bebidas alcohólicas e internación en el año anterior a la entrevista. Fue realizada una regresión de Poisson siguiendo el modelo jerarquizado, controlado por variables de confusión, considerando nivel de significancia <0,05. RESULTADOS: Entre los entrevistados, 1.395 (70,9 por ciento) habían consultado con un médico en el período analizado. El análisis multivariado entre los hombres reveló que los individuos que presentaron mayor prevalencia de consultas con médico poseían renta familiar per capita mayor de 10 salarios mínimos, más de 60 años de edad, diabetes mellitas, índice de masa corporal mayor o igual a 25 kg/m2 y que habían sido hospitalizados. Las mujeres con renta familiar per capita por encima de seis salarios mínimos, con mas de 60 años, blancas, no fumadoras, con hipertensión arterial, con diabetes y las que habían sido hospitalizadas presentaron mayor prevalencia de la condición. CONCLUSIONES: Fueron identificadas inequidades en salud con relación al color de la piel y renta familiar y alta prevalencia de consulta con médicos, principalmente entre los individuos de mayor edad y con algunas enfermedades crónicas no transmisibles.

Relationship Between Outpatients Amount and Climate in Guangzhou City / 广州中医药大学学报

[ Objective ] To explore the relationship between outpatients amount and climate in Guangzhou City. [Methods] Correlation regression analysis of the relationship between monthly outpatients amount and simultaneous meteorological indexes was carried out in various departments of three hospitals of Guangzhou from the year of 1993 to 2001. [Results] The main meteorological factors affecting monthly outpatients amount are: monthly average atmospheric pressure, monthly lowest temperature, monthly sunshine hours, monthly rainfall, monthly relative humidity and monthly average wind speed. Monthly average atmospheric pressure, monthly lowest temperature, monthly relative humidity and monthly average wind speed are negatively correlated with monthly outpatients amount while monthly sunshine hours and monthly rainfall are positively correlated. Then the corresponding multivariate linear regression equations are established. The results of analysis showed that the main meteorological indexes which were related to the occurrence of diseases are the above six. [Conclusion] The corresponding multivariate linear regression equations can be used to forecast the epidemic trend of diseases in an area and this will provide evidences for the forecast of occurrence and prevalence of diseases.