Factores relacionados con la adherencia al tratamiento de tuberculosis en el Departamento de Boyacá / Factors related with adherence to treatment of tuberculosis in the Department of Boyacá

Resumen Introducción: la tuberculosis es una enfermedad infecciosa crónica causada por Mycobacterium tuberculosis, capaz de afectar cualquier órgano o tejido siendo la forma más común la enfermedad pulmonar. Objetivo: identificar los factores que afectan la adherencia al tratamiento antituberculoso en pacientes del Departamento de Boyacá durante los años 2017-2019. Metodología: estudio descriptivo retrospectivo que utilizó como fuentes de información datos registrados en la base del programa departamental de Tuberculosis y SIVIGILA. Se realizó análisis univariado, determinando la distribución de las variables y análisis bivariado en el que se exploró la asociación entre la adherencia al tratamiento de tuberculosis y las variables independientes, se utilizó la prueba de Chi cuadrado. Resultados: se incluyeron 402 pacientes, la adherencia al tratamiento antituberculoso fue 96,5% y la no adherencia de 3,5%. El 66,7% eran de sexo femenino; 55,7% vivián en zona urbana; 66,5% pertenecían al régimen subsidiado; 89,7% mestizos; 91,2% correspondían a otros grupos poblacionales, seguido del 7,5% de población privada de la libertad y 1,3% habitantes de calle. Dentro de las comorbilidades la coinfección con VIH con 4,2% fue la de mayor presencia. Entre las causas de no adherencia al tratamiento fueron desinterés, cambio frecuente de domicilio, contrato finalizado con la EPS y suspensión del tratamiento por toxicidad hepática. El paciente con mayor probabilidad de abandonar el tratamiento pertenece al sexo masculino, al grupo poblacional de migrantes o habitantes de calle y se encuentra afiliado al régimen subsidiado, ​​​​se encontró una relación estadísticamente significativa entre estas variables y el resultado con la adherencia al tratamiento. Conclusiones: si bien el resultado obtenido en el presente trabajo no es elevado, es importante realizar vigilancia de la adherencia al tratamiento antituberculoso para disminuir el riesgo de complicaciones derivadas de su abandono como mayor mortalidad, desarrollo de resistencia bacteriana y un período de contagiosidad más prolongado.

Abstract Introduction: Tuberculosis is a chronic infectious disease caused by Mycobacterium tuberculosis, capable of affecting any organ or tissue, the most common form being lung disease. Objective: Identify the factors that affect adherence to tuberculosis treatment in patients from the Department of Boyacá during the years 2017-2019. Methodology: Retrospective descriptive study that used as information sources data registered in the database of the departmental Tuberculosis program and SIVIGILA. A univariate analysis was carried out, determining the distribution of the variables and a bivariate analysis in which the association between adherence to tuberculosis treatment and the independent variables was explored, using the Chi-square test. Results: 402 patients were included, adherence to anti-tuberculosis treatment was 96.5% and non-adherence 3.5%. 66.7% were female; 55.7% lived in an urban area; 66.5% belonged to the subsidized regime; 89.7% mestizo; 91.2% corresponded to other population groups, followed by 7.5% of the population deprived of liberty and 1.3% homeless. Within the comorbidities, coinfection with HIV 4.2% was the one with the greatest presence. Among the causes of non-adherence to treatment were lack of interest; frequent change of address; Terminated contract with the EPS and suspension of treatment due to liver toxicity. The patient with the highest probability of abandoning treatment belongs to the male sex, to the population group of migrants or street dwellers and is affiliated with the subsidized regime, a statistically significant relationship was found between these variables and the result with adherence to treatment. Conclusions: Although the result obtained in this study is not high, it is important to monitor adherence to tuberculosis treatment to reduce the risk of complications derived from its abandonment, such as increased mortality, development of bacterial resistance, and a longer period of contagiousness.

Association of abdominal obesity to hypertension history in Panamanian college students / Asociación de la obesidad abdominal con el antecedente de hipertensión en estudiantes universitarios panameños

Introduction: Abdominal obesity is the excess of deposits of fat in the abdominal region and it is an independent risk factor for cardiovascular disease. Hypertension is a metabolic risk factor for non-communicable diseases, and it is the leading cause of premature death in the world. Objective: to determine the association between abdominal obesity and hypertension, hyperglycemia, and hyperlipidemia history in Panamanian college students. Materials and methods: Analytical cross- sectional study carried out in 434 college students from four different cities of a private university in Panamá. Every participant in the study signed written consent. Abdominal obesity was established as a waist circumference of ≥80 cm in women and ≥90 cm in men. Hypertension, hyperglycemia, and hyperlipidemia history were established with the basic questionnaire in the STEPS World Health Organization Instrument. Descriptive, as well as bivariate and multivariate analysis, were realized using logistic regression models. Results: 36.41% of participants had abdominal obesity (no statistically significant difference was found by sex). 14.29%, 9.22%, and 13.82% of the students surveyed reported a history of hypertension, hyperglycemia, and hyperlipidemia respectively (no statistically significant difference was found by sex). After adjusting by sex, age, and socioeconomic level, abdominal obesity was associated with hypertension antecedent (OR=2.06, CI 95%: 1.183-3.597, p=0.011). Conclusions: Students who evidenced abdominal obesity were more likely to have a hypertension history. The study recommends implementing strategies that promote healthy living habits to reduce future cardiovascular risk in the Panamanian university population(AU)

Introducción: La obesidad abdominal es el exceso de grasa en la región abdominal y un factor de riesgo de enfermedad cardiovascular. La hipertensión es un factor de riesgo metabólico asociado a enfermedades no transmisibles, y es la causa principal de muerte prematura en el mundo. Objetivo: Determinar la asociación entre la obesidad abdominal y los antecedentes de hipertensión, hiperglucemia e hiperlipidemia en universitarios panameños. Materiales y métodos: Estudio transversal analítico realizado en 434 universitarios de cuatro ciudades de una universidad privada de Panamá. Cada participante firmó el consentimiento informado. La obesidad abdominal fue establecida con una circunferencia de la cintura ≥80 cm en mujeres and ≥90 cm en hombres. Los antecedentes de hipertensión, hiperglucemia e hiperlipidemia fueron establecidos mediante el Cuestionario Básico del Instrumento STEPS de la OMS. Análisis descriptivos, bivariados y multivariados fueron realizados utilizando modelos de regresión logística. Resultados: El 36,41 % de los participantes registró obesidad abdominal (no hubo diferencia estadísticamente significativa según sexo): El 14,29 %, 9,22 % y el 13,82 % de los participantes reportaron antecedente de hipertensión, hiperglucemia e hiperlipidemia respectivamente (no hubo diferencia estadísticamente significativa según sexo). Después de ajustar por sexo, edad, y nivel socioeconómico, la obesidad abdominal se asoció con el antecedente de hipertensión (OR=2,06, IC 95 %: 1,183-3,597, p=0,011). Conclusiones: Los estudiantes que evidenciaron obesidad abdominal tuvieron una mayor probabilidad de antecedente de hipertensión. Se recomienda la implementación de estrategias para promover hábitos saludables y reducir el riesgo cardiovascular en la población universitaria panameña(AU)

A study on pharmacist intervention in anti-epileptic drugs at a tertiary care hospital

Background: Antiepileptic drugs (AEDs) have been used for the treatment of epilepsy and other neurological disorders since 19th century. Several classes of AEDs are available for epilepsy, many of them are also used for migraines, bipolar disorder, schizophrenia, depression, and neuropathy. Methods: Total 212 patients participated in an Ambi-directional observational cohort study conducted at Mallige medical center, Bangalore. Reviewed and evaluated both inpatients and outpatients case sheets and the data were entered into Microsoft excel. The data was analysed using version 27 of SPSS and statistical significance was determined by using p value less than 0.05 and Pearson correlation. Results: The result show that among 212 patients 130 were males and 82 females and the major risk factors were hypertension and type 2 diabetes mellitus. Levetiracetam and pregabalin were the commonest AED prescribed. Among 109 adverse drug reaction (ADRs) occurred in 82 patients, dizziness, and sedation (20%) were common. Valproate (17.4%) was the main drug causing ADRs and treatment was discontinued in 2 patients due to phenytoin (PHT) toxicity. A total of 90 drug-drug interaction (DDI) was observed using online drug database. Conclusions: This study revealed that monitoring and evaluating the prescription pattern in these patients enables modification in prescribing pattern that improves the patient抯 quality of life and can reduce drug related problems. Clinical pharmacist plays an important role in evaluating the prescribing pattern of drugs based on standard treatment guidelines and rationality of prescriptions.

Prevalence of preeclampsia and its associated risk factors in Rajshahi region, Bangladesh

Background: Although preeclampsia claims lives of 70,000 mothers and 500,000 newborns each year, in Bangladesh the comprehensive data-sets are not well-documented. We studied the prevalence of preeclampsia, its trend and the associated risk factors in Rajshahi, Bangladesh.Methods: Using a cross-sectional longitudinal design, 90 women hospitalized with preeclampsia in 7 hospitals of Rajshahi, Bangladesh were considered in the study, of which Rajshahi medical college hospital (RMCH) is a tertiary referral hospital. The data were collected by interviewing the patients, physical examinations and analyzing patients� pathological profile. For statistical analyses, SPSS software was employed. Results: During the five years (2013-2017), RMCH admitted pregnant mothers for delivery or with obstructed complications had increased from 11,523 to 17,201, leading to an increase in preeclamptic patients from 407 to 435. Its prevalence rate (3.21%) was found to be decreased linearly with time. The preeclamptic patients were of 16-40 years, averaging 25.90�65 years. The youngest (� years) preeclamptic mothers (24%) were at high risk of preeclampsia. The obese (40%) and overweight (29%) preeclamptic mothers experienced severe oedema, headache, vomiting, lower abdominal pain and hyperacidity. About three-fourths of the concerned patients were of lower socio-economic class, of which the majority was below education level 10. The majority were from joint families (58%) who took less than 2.2 L of drinking water per day.Conclusions: The average prevalence preeclampsia rate was 3.21% that was found to decrease linearly with time. The youngest but obese (BMI of � kg/m2) mothers were vulnerable for preeclampsia. Other risk factors include lower socio-economic class, less education, white complexion, joint family type and taking less amount of fluid.

Cáncer oral: etiología, lesiones precancerosas y tratamiento / Oral cancer: etiology, precancerous lesions and treatment

Introducción: el cáncer oral es una de las neoplasias malignas más comunes en el mundo, sin embargo, a pesar de las herramientas diagnósticas actuales, existe un alto grado de morbilidad y mortalidad debido al diagnóstico tardío y a la falta de conciencia por parte de la población sobre el consumo de tabaco, alcohol, entre otras sustancias. Objetivo: el objetivo de la presente revisión es brindar información actual sobre las lesiones precancerosas, etiología, diagnóstico y tratamiento del cáncer oral. Material y métodos: se realizó una búsqueda bibliográfica en cinco bases de datos digitales sobre artículos revisados por pares desde el 2015 hasta la actualidad. Conclusión: el cáncer oral es una patología frecuente que causa graves consecuencias y secuelas en las personas que lo padecen, un conocimiento amplio de las lesiones premalignas junto con el diagnóstico temprano por parte del profesional y una mayor conciencia sobre los factores de riesgo, juegan un papel fundamental para prevenir la presencia y desarrollo de esta patología (AU)

Introduction: oral cancer is one of the most common malignant neoplasms in the world, despite the current diagnostic tools, there is a high degree of morbidity and mortality due to late diagnosis and lack of awareness of the population on the consumption of tobacco, alcohol, among other substances. Objective: the objective of this review is to provide present information of the precancerous lesions, etiology, diagnosis and treatment of oral cancer. Material and methods: a bibliographic search was carried out in five digital databases on peerreviewed articles from 2015 to the present. Conclusion: oral cancer is a frequent pathology that can cause serious consequences and sequelae in people who suffer it, an extensive knowledge of premalignant lesions among with an early diagnosis by the professional and a greater awareness of risk factors, play a fundamental role to prevent the establishment and/or progression of this pathology (AU)

Prevención del cáncer de piel en preescolares: experiencia parental en fotoprotección

Fundamento: como promedio se han generan tres millones de casos de cáncer de piel a nivel global en los últimos años. Esta situación ocurre entre otras razones por la constante exposición a la radiación solar y la no aplicación de fotoprotección. Objetivo: determinar la experiencia parental en fotoprotección durante la infancia. Método: se realizó un estudio etnográfico en la Unidad Educativa de la Parroquia San Juan del Cantón Riobamba, Provincia Chimborazo, durante el período de estudio de octubre 2022 a octubre 2023. Se realizaron 14 entrevistas a cuidadores de preescolares, los que fueron escogidos a través del muestreo no probabilístico. Se dispuso de dos técnicas de recolección de la información: el autorreportaje y la entrevista semiestructurada. Resultados: se describieron cada una de las categorías que emergieron en el estudio según el nivel de frecuencia: fotounidad, fotoexperiencia-conocimiento y fotosanidad. Se construyó un mapa representacional en el cual se determinó que la familia en sí representa la fotounidad, mediante la participación de todos sus miembros en la protección de los efectos nocivos del sol. La sombrilla que cubre a la familia refleja la fotoexperiencia-conocimiento adquiridos por los cuidadores, que actúan como protección al daño solar mediante medidas preventivas y de cuidado. El sol y sus rayos solares simbolizan la fotosanidad, que corresponde a la exposición a rayos solares y sus efectos nocivos para la salud. Conclusiones: la implementación de medidas de fotoprotección desde edades tempranas resulta de vital importancia para la prevención del cáncer de piel, por lo que es necesario brindarles a los padres información adecuada sobre los riesgos solares y las medidas preventivas.

Foundation: on average, three million cases of skin cancer have been generated globally in recent years. This situation occurs among other reasons due to constant exposure to solar radiation and non-application of photoprotection. Objective: determine parental experience in photoprotection during childhood. Method: an ethnographic study was carried out in the Educational Unit of the San Juan Parish of the Cantón Riobamba, Chimborazo Province, during the study period from October 2022 to October 2023. 14 interviews were carried out with preschool caregivers, who were chosen through of non-probabilistic sampling. Two information collection techniques were available: self-report and semi-structured interview. Results: each of the categories that emerged in the study were described according to the level of frequency: photounity, photoexperience-knowledge and photosanity. A representational map was constructed in which it was determined that the family itself represents photounity, through the participation of all its members in protecting themselves from the harmful effects of the sun. The umbrella that covers the family reflects the photo-experience-knowledge acquired by the caregivers, which act as protection from sun damage through preventive and care measures. The sun and its solar rays symbolize photosanity, which corresponds to exposure to sunlight and its harmful effects on health. Conclusions: the implementation of photoprotection measures from an early age is of vital importance for the prevention of skin cancer, so it is necessary to provide parents with adequate information about sun risks and preventive measure.

Frailty and Associated Factors in the Elderly: A Cross-sectional Study from a Tertiary Care Hospital of Northeast India

Background: Despite the unfavorable impact of frailty on the health of the elderly, research on frailty in Northeast India remains scarce. This study aimed to assess the prevalence of frailty among elderly inpatients and identify associated factors. Subjects and Methods: This cross-sectional study was conducted among 200 elderly (above 60 years of age) inpatients at a tertiary care hospital. A semistructured pro forma was used to collect data on sociodemographic details and other laboratory parameters. The Fried frailty phenotype was used to assess frailty. Quantitative data were presented as means ± standard deviation, whereas qualitative data were presented as frequency and percentages. The Chi-square/Fisher’s exact test was applied to determine the association, and P < 0.05 was considered statistically significant. Results: The majority of the study participants were male, <70 years, and had a caretaker at home. The proportion of frail among the hospitalized elderly was 50% (95% confidence interval = 42.87%–57.13%). The rest 49.5% were categorized as robust and 0.5% were categorized as prefrail. Frailty was significantly associated with increased age, status of presence of caretaker, addiction, and higher body mass index. Comorbidities such as hypertension, chronic kidney disease, stroke, anemia, diabetes, chronic pulmonary disease, ischemic heart disease, and malignancy were also significantly associated. Conclusions: Frailty is a significant concern among hospitalized elderly individuals. Further research is needed to identify effective interventions to alleviate its impact. Community-level studies should elucidate the relationship between modifiable risk factors and frailty, aiming to enhance the quality of life for our aging population.

Salud metabólica y riesgo cardiovascular global en pacientes obesos. Servicio de Endocrinología. Cienfuegos, 2021-2022

Fundamento: la prevalencia cada vez mayor de sobrepeso y obesidad, dos componentes importantes del síndrome metabólico, representa un serio riesgo para la salud. Objetivos: relacionar los factores asociados a los obesos sanos metabólicamente y no sanos y estimar el riesgo cardiovascular global en ambos grupos. Métodos: se realizó un estudio descriptivo, correlacional de corte transversal en 112 pacientes de 18 años o más con diagnóstico de obesidad que fueron atendidos en la Consulta de Nutrición en el Servicio de Endocrinología del Hospital General Universitario Gustavo Aldereguía Lima, de Cienfuegos, desde mayo del 2021 hasta mayo del 2022. Se analizaron las variables siguientes: edad, sexo, hábitos dietéticos, estilo de vida, fenotipo (sanos y no sanos metabólicamente). Resultados: la frecuencia de obesos sanos metabólicamente fue del 35 % y la de los no sanos del 65 %. Ambos grupos consumen frecuentemente frutas y verduras. El 91,1 % consumía bebidas azucaradas y el 85,7 % no practicaban ejercicios físicos, sin significación estadística. Se evidenció una asociación significativa del riesgo cardiovascular global y la condición de tener un fenotipo obeso metabólicamente no saludable con respecto a los sanos. Conclusiones: el fenotipo obeso no sanos metabólicamente se evidenció en más de la mitad de los participantes del estudio, la interacción de elementos biológicos con estilo de vida poco saludables está relacionado con el riesgo cardiovascular global en el fenotipo obeso metabólicamente no saludable con respecto a los sanos.

Foundation: The overweight and obesity increasing prevalence, two important components of metabolic syndrome, represents a serious health risk. Objectives: relate the factors associated with metabolically healthy and unhealthy obese people and estimate the global cardiovascular risk in both groups. Methods: a descriptive, cross-sectional correlational study was carried out in 112 patients aged 18 years or older with a diagnosis of obesity that were looked after in the Endocrinology Service Nutrition Consultation of the Gustavo Aldereguía Lima University Hospital, in Cienfuegos, from May 2021 to May 2022. The analyzed variables were: age, sex, dietary habits, lifestyle, phenotype (metabolically healthy and unhealthy). Results: The frequency of metabolically healthy obese people was 35% and that of unhealthy people was 65%. Both groups frequently consume fruits and vegetables. 91.1% consumed sugary drinks and 85.7% did not practice physical exercise, without statistical significance. A significant association was evident between global cardiovascular risk and the condition of having a metabolically unhealthy obese phenotype compared to healthy people. Conclusions: the metabolically unhealthy obese phenotype was shown in more than half of the studied participants; the interaction of biological elements with unhealthy lifestyle is related to global cardiovascular risk in the metabolically unhealthy obese phenotype regarding the healthy.

Analysing The Role of Lifestyle Factors on Hypertension Among Rural Indonesian Adults: A Case-Control Study

Background: Hypertension is a degenerative disease, arising from unhealthy lifestyle and becoming a world health problem. It is estimated that 46% of adults with hypertension are unaware of their condition, hence it is called the “silent killer”. This study aims to Lifestyle Risk Factors of Hypertension Incidence upon Productive Age. Methodology: The type of research used was analytical observational with case control design the samples in this study were 152 (76 cases and 76 controls). The sampling technique in this research was probability sampling using systematic random sampling. Data were processed using Stata version 14 program. The analysis performed was chi-square test and logistic regression test. Results: The results showed exposure to cigarette smoke (OR= 3.398; 95%CI=1.540-7.683), alcohol consumption (OR= 4.277; 95%CI=1.608-12.606), sleep patterns (OR= 2.628; 95%CI=1.299-5.337), physical activity (OR= 1.75; 95%CI=0.824-3.746), stressful state (OR= 1.793; 95%CI=0.897-3.590;), and coffee consumption (OR= 1.258; 95%CI=0.613- 2.587;). In multivariate analysis, the most risk factor for hypertension was alcohol consumption (OR=4.948; 95%CI=1.841-13.302; ?-value =0.002). Conclusions: Risk factors for hypertension included exposure to cigarette smoke, alcohol consumption and sleep patterns and the most risk factor for hypertension was alcohol consumption. It is highly suggested that relevant stake holders to determine programs and policies in order to prevent and treat hypertension more effectively.

Conocimientos, hábitos y aptitudes en fotoprotección para prevenir el cáncer de piel

Fundamento: El cáncer de piel es una de las neoplasias más frecuentes, con un considerable aumento en las últimas dos décadas. Las campañas de fotoprotección han tenido un impacto positivo en la población y permiten a las personas sanas el cuidado de su piel y la prevención del cáncer. Objetivo: Describir los principales resultados obtenidos en los estudios científicos relacionados con los conocimientos, hábitos y aptitudes en fotoprotección para la prevención del cáncer de piel en población de riesgo mayor de 18 años. Método: Se realizó una revisión sistemática en las bases de datos Scopus y Pubmed en (inglés), Scielo y CUIDEN en (español), con perfil de acceso desde la biblioteca electrónica de la Universidad de Granada en el período de estudio comprendido desde mayo de 2018 hasta julio de 2022. Se elaboró la pregunta guía a través del acrónimo PICOT, términos de búsqueda y se utilizaron los descriptores en Ciencias de la Salud y del Medical Subject Headings, respectivamente. Resultados: Conocer las conductas de riesgo y de protección es útil para orientar las intervenciones individuales o a nivel comunitario para disminuir la morbilidad asociada a la exposición solar. Se ha demostrado que las campañas de prevención del cáncer de piel son eficaces y rentables. Los médicos de atención primaria juegan un papel importante en la prevención del cáncer de piel. El asesoramiento sobre factores de riesgo modificables y estrategias para evitar el sol, en pacientes con antecedentes personales o familiares de cáncer de piel, debe ser parte de la medicina preventiva. Conclusiones: Los estudios científicos que abordan conocimientos, hábitos y aptitudes en relación con la fotoprotección para la prevención del cáncer de piel, destacan entre sus principales resultados, que la principal conducta para garantizar una adecuada acción protectora saludable es direccionar programas de educación en la prevención primaria de salud.

Foundation: Skin cancer is one of the most common neoplasms, with an increase in the last two decades. Photoprotection campaigns have had a positive impact on the population and allow healthy people to care for their skin and prevent cancer. Objective: To describe the main results obtained in scientific studies related to knowledge, habits and skills in photoprotection for the prevention of skin cancer in a population at risk over 18 years of age. Method: A systematic review was carried out in the databases Scopus and Pubmed in (English), Scielo and CUIDEN in (Spanish), with access profile from the electronic library of the University of Granada in the study period from May 2018 to July 2022. The guiding question was developed through the PICOT acronym, search terms and the descriptors in Health Sciences and Medical Subject Headings were used, respectively. Results: Knowing risk and protective behaviors is useful to guide individual or community-level interventions to reduce morbidity associated with sun exposure. Skin cancer prevention campaigns have been shown to be effective and cost-effective. Primary care physicians play an important role in skin cancer prevention. Counseling on modifiable risk factors and strategies to avoid the sun, in patients with a personal or family history of skin cancer, should be part of preventive medicine. Conclusions: Scientific studies that address knowledge, habits and skills in relation to photoprotection for the prevention of skin cancer, highlight among their main results that the main conduct to guarantee adequate healthy protective action is to direct education programs in primary prevention of health.

Relación entre la periodontitis y la enfermedad cerebrovascular isquémica

La periodontitis es un trastorno inmunoinflamatorio de etiología microbiana causado por gérmenes únicos en la cavidad bucal que pueden diseminarse a través del torrente sanguíneo, activan la respuesta inflamatoria del huésped y favorecen la formación, maduración y exacerbación de la placa de ateroma. Varios estudios clínicos han investigado la posible relación entre la enfermedad periodontal y las enfermedades consecuentes de la aterosclerosis como la cardiopatía isquémica y la enfermedad cerebrovascular isquémica. Se realizó una revisión bibliográfica exhaustiva de artículos científicos publicados en las bases de datos: Pubmed, Medline, LILACS, Scielo, en el período comprendido entre el 2012 y el 2022, en idioma español e inglés. Se utilizaron como descriptores: periodontitis, enfermedad cerebrovascular y aterosclerosis. Los reportes incluidos indican que la enfermedad cerebrovascular y la enfermedad aterosclerótica presentan las alteraciones con mayores asociaciones con la periodontitis, sin embargo, se necesitan estudios más amplios para determinar el papel de la severidad y extensión de la periodontitis en estas enfermedades.

Periodontitis is an immunoinflammatory disorder of microbial etiology caused by unique germs in the oral cavity that can spread through the bloodstream, activate the host's inflammatory response and promote the formation, maturation and exacerbation of atheromatous plaque. Several clinical studies have investigated the possible relationship between periodontal disease and diseases resulting from atherosclerosis such as ischemic heart disease and ischemic cerebrovascular disease. An exhaustive bibliographic review of scientific articles published in the databases: Pubmed, Medline, LILACS, Scielo, in the period between 2012 and 2022, in Spanish and English was carried out. The following were used as descriptors: periodontitis, cerebrovascular disease and atherosclerosis. The included reports indicate that cerebrovascular disease and atherosclerotic disease present the alterations with the greatest associations with periodontitis, however, larger studies are needed to determine the role of the severity and extent of periodontitis in these diseases.

Intervención educativa sobre cáncer bucal y su prevención en estudiantes preuniversitarios

Fundamento el aumento de la incidencia del cáncer bucal constituye un problema de salud mundial, por ello surge la necesidad de realizar acciones educativas que tributen a la prevención de la enfermedad desde edades tempranas. Objetivo evaluar la efectividad de una intervención educativa sobre cáncer bucal y su prevención en estudiantes de un centro preuniversitario. Métodos se realizó un estudio preexperimental, de intervención educativa, con diseño preprueba/posprueba, en el periodo comprendido entre noviembre de 2021 a mayo de 2022. Se trabajó con la totalidad del universo, el cual estuvo constituido por 125 estudiantes de la escuela Roberto Rodríguez, del municipio Morón, Ciego de Ávila. Se utilizó estadística descriptiva e inferencial. Resultados el 52,0 % de los participantes perteneció al sexo femenino. La media de edad para ambos sexos fue de 15,86 ± 1,053 años. El 36,8 % cursaba el onceno grado. Se determinaron inadecuados niveles de información en la etapa diagnóstica en cuanto a: generalidades (96,0 %), factores de riesgo (91,2 %), autoexamen bucal (96,0 %) y medidas de promoción y prevención (95,2 %). Después de aplicada la intervención se logró elevar el nivel cognoscitivo hasta un 97,6 %, 99,2 %, 96,8 % y 99,2 % respectivamente. El test de McNemar arrojó resultados significativos (p = 0,000; p < 0,05). Conclusiones se logró una modificación estadísticamente significativa de la información en cada uno de los encuestados, por lo que se pudo inferir que la intervención educativa resultó efectiva.

Foundation the increase in the incidence of oral cancer constitutes a global health problem, there is a need to carry out educational actions that contribute to the prevention of the disease from an early age. Objective to evaluate the effectiveness of an educational intervention on oral cancer and its prevention in students from a pre-university center. Methods a pre-experimental educational intervention study was carried out, with a pre-test/post-test design, from November 2021 to May 2022. The entire universe was studied, 125 students from the Roberto Rodríguez School in Morón municipality, Ciego de Ávila. Descriptive and inferential statistics were used. Results 52.0% of the participants were female. The mean age for both sexes was 15.86 ± 1.053 years. 36.8% were in eleventh grade. Inadequate levels of information were determined in the diagnostic stage in terms of: generalities (96.0%), risk factors (91.2%), oral self-examination (96.0%) and promotion and prevention measures (95.2%). %). After applying the intervention, the cognitive level was raised to 97.6%, 99.2%, 96.8% and 99.2% respectively. The McNemar test showed significant results (p = 0.000; p < 0.05). Conclusions a statistically significant modification of the information was achieved in each of the respondents, so it could be inferred that the educational intervention was effective.

Síndrome de desgaste profesional en el personal de salud durante la pandemia de COVID-19 / Burnout Syndrome in Health Care Personnel During the COVID-19Pandemic

La Organización Mundial de la Salud (OMS) define el estrés laboral como una reacción que puede manifestarse ante exigencias y presiones laborales que ponen a prueba la capacidad que tiene cada persona para afrontar ciertas situaciones y que se agravan en el personal de salud que atiende pacientes con la COVID-19. Es decir, lo que resulta del desequilibrio entre las presiones y exigencias a las que se enfrenta el individuo, por una parte, y los conocimientos adquiridos por otra parte. El Síndrome de desgaste profesional, conocido también como síndrome de agotamiento emocional o psicológico, o por el anglicismo burnout, es un tipo de estrés laboral que engloba un estado de agotamiento físico, emocional y mental que conlleva a consecuencias individuales y sociales. El objetivo de esta revisión narrativa es identificar los factores de riesgo para el desarrollo del Síndrome de desgaste profesional en el personal de salud relacionado con la atención de pacientes con la COVID-19. Se realizó una búsqueda en la base de datos PubMed, se incluyeron artículos originales, estudios aleatorizados, revisiones sistemáticas y otros textos en español e inglés, publicados durante el periodo 2020-2023. Los principales factores de riesgo identificados en la literatura para el desarrollo de Síndrome de desgaste profesional fueron la juventud, sexo femenino, la soltería, la carga de trabajo y el nivel de satisfacción laboral de los profesionales.

The WHO defines occupational stress as a reaction that may occur when a person is faced with work-related demands and pressures that test the individual's ability to cope with certain situations, and it exacerbates in healthcare personnel who provide care to patients with COVID-19. That is, what results from the imbalance between the pressures and demands that the individual faces, on the one hand, and the knowledge acquired on the other hand. Burnout syndrome is a type of work-related stress that encompasses a state of physical, emotional and mental exhaustion that leads to individual and social consequences. The objective of this systematic review is to identify the risk factors for the development of Burnout Syndrome in health personnel related to the care of patients with COVID-19. A search was carried out in the PubMed database, including original articles, randomized studies, systematic reviews, and textbooks in Spanish and English, published during the period 2020-2023. The main risk factors for the development of Burnout Syndrome identified in the literature were youth, female sex, singleness, workload and the level of job satisfaction of the professionals

Comparison of Ectasia versus Pseudoectasia using the Ectasia Risk Factor Score System

Objectives@#To evaluate and compare ectasia and pseudoectasia in post-myopic LASIK patients presenting with corneal topographic changes indicative of ectasia using the Ectasia Risk Factor Score System (ERFSS).@*Methods@#Single-center retrospective comparative case series of a consecutive chart review of cases in 18 years who underwent bilateral myopic-LASIK and showed topographic changes indicative of ectasia.@*Results@#Four patients were included. Group 1: pseudoectasia eyes, consisting of two patients with bilateral pseudoectasia, and Group 2: ectasia eyes, consisting of two patients with unilateral ectasia. The clinical course of the cases was discussed and compared based on the ERFSS parameters: topography pattern, residual stromal bed thickness, age, preop thinnest cornea, and pre-operative spherical equivalent (SE) manifest refraction (MR). Group 1 scored zero to low risk for developing ectasia while Group 2-eyes with ectasia scored moderate risk. The predictive value of the ERFSS was 1 in this study.@*Conclusion@#The ERFSS is a good measure in deciding the suited treatment plan for patient undergoing refractive procedure. Knowing the clinical course of ectasia and pseudoectasia is helpful in the therapeutic approach since pseudoectasia is reversible when identified and managed early as seen in this study.

Cohort studies in public health practice and their significance / 上海预防医学

Cohort studies play an important role in elucidating the association between risk factors and diseases， and are widely used in etiology research， the assessment of disease prognosis， understanding the natural history of diseases， and the surveillance following the market release of new drugs. The data produced by cohort studies possess great scientific value and can provide essential evidence for public health practice. A well-conceived scientific design is a prerequisite to conducting a cohort study， and the design should focus on aspects such as sample size， selection of exposed and non-exposed populations， follow-up procedures， outcome assessments， research duration， and the choice of analytical indicators and methods. Cohort studies have become an important way to obtain scientific evidence. Internationally renowned population-based cohorts， such as China Kadoorie biobank and the Framingham heart study cohort， have provided a wealth of scientifically valuable evidence for promoting human health. The quality of data produced by a cohort study is extremely important， and a cohort study should continuously incorporate new technologies and methods to provide objective， accurate， and reliable means to determine exposure and outcomes， as well as control for bias. Cohort studies have great potential for application and will continue to provide abundant high-quality scientific evidence for the development of strategies and measures to enhance human health.

Clinical follow-up study of SARS-CoV-2 Omicron infection / 上海预防医学

ObjectiveTo observe the clinical course and explore the risk factors for SARS-CoV-2 RNA negative conversion duration （NCD） in asymptomatic and mild-symptomatic patients infected with the SARS-CoV-2 Omicron variant. MethodsClinical data were collected from 244 confirmed cases of corona virus disease （COVID-19） with Omicron variant infection admitted to a temporal makeshift hospital in Shanghai from April 9， 2022 to May 20， 2022. Demographic and clinical data were analyzed， with a primary focus on the time of COVID-19 nucleic acid conversion. Univariate and multivariate Cox regression analysis were used to determine identify risk factors associated with NCD. ResultsThe median duration of negative RNA conversion was 9 days （ranged 7‒12 days）. The percentage of patients with positive nucleic acid results on the 5th， 7th， 10th， and 14th days after confirmed infection was 68.4%， 47.1%， 20.1%， and 5.7%， respectively. Kaplan-Meier curves indicated a median nucleic acid conversion time of 12 days （ranged 10‒14 days） for patients with hypertension， 9 days （ranged 7‒11 days） in patients without hypertension， and 11 days （ranged 9‒13 days） for patients aged ≥60 years， and 9 days （ranged 7‒11 days） for patients aged <60 years. Multivariate Cox regression analysis showed that only hypertension was an independent risk factor of NCD （RR=1.60； 95% CI： 1.03‒2.49， P=0.036）. ConclusionIn asymptomatic or mildly symptomatic patients infected with the Omicron variant， 20.1% patients continue to exhibit positive viral nucleic acid on the 10th days of infection. The independent risk factor associated with the conversion of SARS-CoV-2 nucleic acid to negative is hypertension.

Epidemiological characteristics of high-risk population for cardiovascular disease of Shanghai residents / 上海预防医学

ObjectiveTo investigate the high-risk detection rate and aggregation of cardiovascular diseases（CVD） in 8 districts of Shanghai and influencing factors， and to provide scientific references for prevention and control of CVD. MethodsBased on the Cardiovascular Disease Screening and Management Program in Shanghai from 2016 to 2021， 104 685 participants aged 35 to 75 in 8 districts of Shanghai were selected for analysis. χ2 test and multivariate logistic regression were used for statistical analysis of the influencing factors of CVD and aggregation of CVD. ResultsThe proportion of high-risk CVD individuals in the population was 19.17%， including the high-risk individuals with hypertension （8.65%）， dyslipidemia （6.33%）， CVD history （5.58%）， and WHO assessed risk ≥20% types （2.69%）， respectively. Old age， overweight and obesity， central obesity， smoking， drinking， farmers， unmarried， and low family income were the risk factors of CVD， while high education level was the protective factor. In the participants， 16 323 people （81.34%） were classified as CVD high-risk groups； The number of aggregation of 1， 2 and ≥3 high risk types of CVD were 16 323（81.34%）， 3 236（16.13%）， 509（2.54%）， respectively. Old age， low education level， low annual family income， farmers， unmarried， smoking， drinking， overweight， obesity and central obesity were associated with the risk of aggregation of high risk types of CVD， and the correlation strength increased with the increase of aggregation types. ConclusionThe prevention and control of CVD in Shanghai should focus on the hypertension， elderly， overweight， obesity， central obesity， smoking， drinking， low educated， low family income， farmers and unmarried people， and targeted intervention measures should be taken to reduce the risk of CVD among residents.

Prevalence and influencing factors of reduced visual acuity among young children in Changning District， Shanghai / 上海预防医学

ObjectiveTo analyze the prevalence of reduced visual acuity of young children in Changning district of Shanghai and to explore the influencing factors， so as to provide a reference basis for formulating prevention and control measures for children’s reduced visual acuity. MethodsVisual acuity examination and questionnaire survey were conducted on 5 772 middle class children in kindergartens and first grade children in primary schools who participated in the refractive screening in Changning District in 2019. χ2 test and logistic regression analysis were used to explore the influencing factors of reduced visual acuity. ResultsThe overall prevalence of reduced visual acuity among lower-aged children was 10.4% （596/5 772）. The prevalence of reduced visual acuity in the first grade children was 10.1% （284/2 822）， and that in the middle class children of kindergarten was 10.8% （312/2 900）. The prevalence of reduced visual acuity was 10.2% （298/2 933） in boys and 10.7% （298/2 789） in girls. 98.1% of young children had one or more bad habits when using eyes. Multivariate logistic regression analysis showed that frequent excessive head lowering （OR=1.713） and sometimes too close to the screen （OR=1.294） were independent risk factors for reduced visual acuity in young children； After stratification by age， frequent excessive head lowering （OR=1.997） increased the risk of reduced visual acuity of children in the first grade of primary school. Premature birth （OR=1.841）， sometimes excessive head lowering （OR=1.363） and frequent excessive head lowering （OR=2.002） increased the risk of reduced visual acuity of children in the middle class of kindergarten. ConclusionFor young children， we should pay more attention to their daily eye use distance， correct their bad behaviors for using eyes such as excessively lowering their head when using eyes and too close to the video screen when using electronic products， so as to prevent and delay the occurrence and development of reduced visual acuity.

Clinical Characteristics and Potential Risk Factors Analysis of Liver Injury Related to Epimedii Folium Preparation / 中国实验方剂学杂志

ObjectiveThis paper aims to analyze the clinical characteristics and medication rationality of liver injury related to Epimedii Folium preparation （EP） and explore the possible risk factors of liver injury， so as to provide a reference for the safe clinical application of Epimedii Folium （EF）. MethodA retrospective analysis was conducted on liver injury cases related to EP from 2012 to 2016. ResultThe number of reported liver injury cases and the proportion of severe cases related to the use of EP show an increasing trend， indicating the objective existence of liver injury caused by EP. There are more cases of liver injury related to EP in women than in men， with an onset age range of 15-91 years old and a median onset age of 60 years old （median onset ages for men and women are 59 and 60 years old， respectively）. The time span from taking EP alone to the occurrence of liver injury is 1-386 days， with a median of 38 days. The time span from taking both EP and Western medicine to the occurrence of liver injury is 1-794 days， with a median of 34 days. EF-related liver injury preparations are mostly composed of traditional Chinese medicines that promote immunity and tonify the liver and kidney， indicating that immune stress in the body may be the mechanism of liver injury caused by the use of EP alone or in combination. There is no increasing trend of toxicity with time or dose in the liver injury caused by EP. By further exploring its risk factors， it is found that patients have unreasonable medication methods such as excessive dosage， repeated use， and multi-drug combination， which may also be one of the important risk factors for EF-related liver injury. ConclusionEP has a certain risk of liver injury and should be emphasized in clinical diagnosis and treatment. Immune stress may be the mechanism of liver injury caused by EP， and in clinical use， it is necessary to be vigilant about the risk of liver injury caused by unreasonable use and combined use with Western medicine.

Risk Factors for Postoperative Sore Throat in Patients with a Double-lumen Endotracheal Tube / 中山大学学报(医学科学版)

ObjectiveTo investigate risk factors for postoperative sore throat in patients with double-lumen endotracheal intubation. MethodsThe data used in this post-hoc analysis were prospectively collected from a randomized， controlled trial. Age from 18 to 65 years old， ASAI-Ⅲ patients undergoing general anesthesia with a double-lumen endotracheal tube were enrolled. The perioperative data collected retrospectively were as follows： gender， age， smoking history， endotracheal tube diameter， duration of endotracheal tube， dose of Sufentanil， use of Flurbiprofen Axetil， cough after extubation， etc..Dynamometer was applied to assess extubation force. According to occurrence of postoperative sore throat， patients were divided into two groups： those who experienced sore throats and those who did not. Comparative analysis and multivariate logistic regression analysis were performed to screen the risk factors. ROC curve was used for predicting the predictive value of risk factors. ResultsAmong the 163 patients ， 74 （45.4%） had postoperative sore throat vs 89 （54.6%） not had. Multivariate logistic regression showed female ［OR95%CI=3.83（1.73， 8.50）， P=0.000 1］ and extubation force ［OR95%CI=1.78（1.45， 2.17）， P＜0.001］ were independent risk factors for postoperative sore throat. AUC value showed the extubation force was 0.773［95%CI（0.701， 0.846）， P＜0.001］. Youden index was 0.447， and the cut-off valve of extubation force was 13N. ConclusionFemale and extubation force were risk factors for sore throat in patients with double lumen endotracheal intubation.