Nivel de conocimiento, actitudes y prácticas sobre enfermedad periodontal en pacientes diabéticos / Level of knowledge, attitudes and practices on periodontal disease in diabetic patients

RESUMEN Fundamento: La diabetes mellitus y la enfermedad periodontal tienen una relación bidireccional, siendo la prevención la herramienta indispensable para lograr el mejoramiento del nivel de salud bucal. Objetivo: Identificar el nivel de conocimientos, actitudes y prácticas de la enfermedad periodontal en pacientes diabéticos. Metodología: Se realizó un estudio observacional descriptivo de corte transversal de septiembre de 2019 a abril de 2020 en la población diabética de 19 a 40 años del Consultorio Médico de Familia n.o 11 del área de salud de Zaza del Medio perteneciente al municipio Taguasco, provincia Sancti Spíritus. Se estudiaron las variables edad, sexo, nivel de conocimiento, actitudes y prácticas sobre salud bucal. Resultados: En el 67.9 % de los pacientes se observó bajo nivel de conocimientos sobre la enfermedad periodontal, actitud desfavorable el 78.6 % y prácticas deficientes el 57.1 %. Conclusiones: La mayoría de los pacientes diabéticos presentó bajo nivel de conocimientos, actitud desfavorable y prácticas deficientes para lograr la salud periodontal.

ABSTRACT Background: Diabetes mellitus and periodontal disease have a bidirectional relationship, being prevention the essential tool to achieve an improvement in the level of oral health. Objective: To identify the level of knowledge, attitudes and practices of periodontal disease in diabetic patients. Methodology: A cross-sectional descriptive observational study was conducted from September 2019 to April 2020 in the diabetic population aged 19 to 40 years at the doctor´s office 11 in Zaza del Medio health area of Taguasco municipality in Sancti Spíritus province. The variables age, sex, level of knowledge, attitudes and practices on oral health were studied. Results: 67.9 % of the patients had a low level of knowledge about periodontal disease, 78.6 % had an unfavorable attitude and 57.1 % had deficient practices. Conclusions: The majority of diabetic patients presented low level of knowledge, non-favorable attitude and poor practices to accomplish periodontal health.

Diagnóstico educativo sobre salud bucal en escolares de Trinidad / Educational diagnosis on oral health in schoolchildren from Trinidad city

RESUMEN Fundamento: En escolares de 4.to grado están presentes enfermedades bucales y se realizan acciones curativas, mientras que las educativas precedidas de un diagnóstico educativo, son deficientes e insuficientes. Objetivo: Identificar los conocimientos, actitudes, prácticas sobre salud bucal y la eficiencia del cepillado bucodental en los escolares de 4.to grado. Metodología: Se realizó un estudio observacional, descriptivo y transversal durante el curso 2020-2021 de la Escuela Primaria Pepito Tey del municipio Trinidad, provincia Sancti Spíritus, con la totalidad (71) de los escolares de 4.to grado. Las variables estudiadas fueron: conocimientos, prácticas, actitudes sobre salud bucal y eficiencia del cepillado bucodental. Se utilizaron métodos del nivel teórico, empírico y estadístico-matemático con la aplicación de un cuestionario y una guía de entrevista, para la eficiencia del cepillado se determinó el Índice de Love. Resultados: Se constató el 71.8 % de los escolares con conocimientos insuficientes, el 74.6 % con actitud desfavorable y el 81.7 % con prácticas insuficientes sobre salud bucal, así como el 93 % con cepillado bucodental no eficiente. Conclusiones: Más de la tercera parte de los escolares tuvo conocimientos insuficientes, actitudes no favorables y prácticas insuficientes de salud bucal y la mayoría un cepillado no eficiente.

ABSTRACT Background: Oral diseases and curative actions are present in 4th grade schoolchildren while educational actions preceded by an educational diagnosis are deficient and insufficient. Objective: To identify the knowledge, attitudes, practices on oral health and the efficiency of Oral brushing in 4th grade schoolchildren. Methodology: An observational, descriptive and cross-sectional study was carried out during the 2020-2021 academic course at Pepito Tey primary school in Trinidad city, in Sancti Spíritus province, with all (71) of the 4th grade students. The variables studied were: knowledge, practices, attitudes about oral health and efficiency of oral brushing. Some methods from the theoretical, empirical and statistical-mathematical level were used with the application of a questionnaire and an interview guide, for brushing efficiency. Results: 71.8 % of schoolchildren with insufficient knowledge were found, 74.6 % with an unfavorable attitude and 81.7 % with insufficient practices on oral health, as well as the 93 % with inefficient oral brushing. Conclusions: More than a third of the schoolchildren had insufficient knowledge, unfavorable attitudes and insufficient practices of oral health and most brushing is not efficient.

Screening and diagnosing postpartum depression: when and how? / Triagem e diagnóstico de depressão pós-parto: quando e como?

Abstract Introduction: Prevalence rates of postpartum depression (PPD) vary widely, depending on the methodological parameters used in studies: differences in study populations, diagnostic methods, and postpartum time frame. There is also no consensus on the ideal time to perform screening, on whether PPD can only be diagnosed in the early postnatal period, or on how soon after a delivery depression may be related to it. Objective: To review which instruments have been used over recent years to screen and diagnose PPD and the prevailing periods of diagnosis. Methods: Only articles published within 5 years and related exclusively to screening and diagnosis were selected. The sample comprised 22 articles. Results: The Edinburgh Posnatal Depression Scale (EPDS) was the most common screening tool, used in 68% of the sample (15 articles), followed by the Beck Depression Inventory (BDI-II) (27%, 6 articles), and the Patient Health Questionnaire-9 (PHQ-9) (18%, 4 articles). Screening time frame was reported in 21/22 articles: 0 to 3 months postpartum in 9 (43%), up to 6 months in 4 (19%), and up to 12 months or more in 8 (38%). In short, 13 articles screened during the first 6 months (59%) while only 8 (36%) screened up to 1 year. Conclusion: The most frequent PPD diagnosis tool was the EPDS, but other scales were also used. The most common period for diagnosis was up to 3 months postpartum. However, some researchers diagnosed PPD 12 months or more postpartum. Greater standardization of parameters for investigation of this disease is needed.

Resumo Introdução: A prevalência de depressão pós-parto (DPP) varia consideravelmente dependendo dos parâmetros metodológicos utilizados: diferentes populações, métodos de diagnóstico e o tempo pós-parto considerado. Também não há consenso sobre o momento ideal para a triagem, se a DPP pode ser diagnosticada apenas no período puerperal, e por quanto tempo após o parto a depressão pode ser relacionada a ele. Objetivo: Revisar os instrumentos mais usados recentemente para rastreamento e diagnóstico de DPP e os períodos predominantes de diagnóstico. Métodos: Foram selecionados apenas artigos relacionados exclusivamente ao rastreio e diagnóstico publicados num período de 5 anos. A amostra incluiu 22 artigos. Resultados: A Escala de Depressão Pós-Parto de Edimburgo (EPDS) foi a ferramenta mais frequente, utilizada em 68% da amostra (15 artigos), seguida pelo Inventário de Depressão de Beck (27%, 6 artigos) e o Patient Health Questionnaire-9 (PHQ-9) (18%, 4 artigos). O tempo de rastreio foi definido em 21/22 artigos: 0-3 meses pós-parto em 9 (43%), < 6 meses em 4 (19%), e ≤ 12 meses em 8 (38%). Treze artigos selecionaram as mulheres durante os primeiros 6 meses (59%), enquanto apenas 8 (36%) o fizeram até 1 ano. Conclusão: A EPDS foi o instrumento mais utilizado para o diagnóstico de DPP, mas outras escalas também foram aplicadas. O período mais comum para o diagnóstico foi de < 3 meses pós-parto. No entanto, alguns pesquisadores consideraram o diagnóstico de PPD em ≤ 12 meses após o parto. Há necessidade de maior padronização de parâmetros em relação à investigação desta doença.

Use of psychotropic medications during pregnancy: perception of teratogenic risk among physicians in two Latin American countries

Objective: Pregnant women and their health care professionals commonly believe that use of medications during pregnancy may be harmful to the unborn fetus. The objective of this study was to evaluate the risk perception of psychotropic drug use in pregnancy among physicians in different medical specialties. Method: This was a convenience survey conducted at outpatient clinics in the cities of Recife, Brazil, and La Plata, Bahía Blanca, and Buenos Aires, Argentina. Physicians who agreed to participate were asked to rate their perception of teratogenic risk among different classes of drugs, which included antidepressants, antipsychotics, anticonvulsants, and benzodiazepines. Results: Two hundred and thirty-eight physicians completed the survey (response rate, 98%). These included psychiatrists, obstetricians, neurologists, cardiologists, gastroenterologists, and general practitioners. Among different specialties, a minority of psychiatrists perceived psychotropic drugs to be highly teratogenic (antidepressants, 12.5%; antipsychotics, 15%; benzodiazepines, 25%) as compared with other specialties (p < 0.003 for each drug class). There was no difference in perceived risk of antiepileptic drugs among specialties, including psychiatrists. Conclusion: The risk associated with use of psychotropic drugs in pregnancy was overestimated by physicians of all medical specialties, except psychiatry. All physicians should be aware of the safety/risk of psychotropic agents in pregnancy, as they may be required to give advice and/or prescribe these drugs to pregnant women. .

Evaluación de calidad de vida en pacientes con depresión mayor: predictibilidad de los niveles de severidad / Quality of life assessment in patients with major depression: predictability of severity levels

El objetivo de este estudio fue valorar la calidad de vida en un grupo (n igual 66) de pacientes con diferentes niveles de depresión mayor medida con el Beck Depression Inventory (BDI), y analizar la posibilidad de predecir el grado de severidad del trastorno por medio de los puntajes de CV obtenidos. La CV fue evaluada con el WHOQOL-Bref, forma abreviada del WHOQOL-100, un elemento genérico transcultural desarrollado simultáneamente en 18 países por la Organización Mundial de la Salud. Los resultados muestran que la repercusión de la depresión sobre la CV está correlacionada con la gravedad del episodio: los pacientes con puntajes más alto de BDI muestran los valores más bajos de CV. Esta correlación es estadísticamente significativa en todos los dominios. El análisis de regresión mostró una ralación lineal que permite predecir la gravedad de la depresión en concordancia con el deterioro de la CV. Estos resultados sugieren que la evaluación de CV es un procedimiento importante para estimar, no solamente la severidad de la depresión sino, además, el impacto de los tratamientos desde la perspectiva del paciente, lo que muestra su utilidad cuando la toma de decisiones está dirigida a seleccionar diferentes alternativas terapéuticas