Validación del Cuestionario pediátrico de calidad de vida™ (Pediatric Quality of Life Inventory™) Módulo neuromuscular, versión 3. 0 en español para Argentina / Validation of the Pediatric Quality of Life Inventory™, Neuromuscular Module, version 3. 0 in Spanish for Argentina

Objetivo: Evaluar las propiedades psicométricas del Cuestionario pediátrico de calidad de vida (PedsQLTM 3.0) Módulo Neuromuscular, versión en español para Argentina, en niños entre 2 y 18 años con enfermedades neuromusculares. Población y métodos: Estudio observacional, analítico, prospectivo, de validación, realizado en el Hospital Garrahan entre el 19 de marzo de 2019 y el 9 de marzo de 2020. A los 10-15 días se realizó el retest del cuestionario para validar en los pacientes que reportaron estabilidad. Resultados: Participaron 185 niños y sus padres. Sobre la factibilidad de la herramienta, los participantes comprendieron fácilmente su contenido. La confiabilidad resultó aceptable, con una consistencia interna de 0,82 en niños y 0,87 en padres y un coeficiente de correlación intraclase en el retest de 0,70 en niños y 0,82 en familiares. Sobre la validez del constructo se confirmaron 8 de 11 hipótesis establecidas (72,7 %). Conclusión: El cuestionario fue validado en sus propiedades psicométricas

Objective: To assess the psychometric properties of the Pediatric Quality of Life Inventory™ (PedsQL™ 3.0), Neuromuscular Module, version in Spanish for Argentina, for children aged 2-18 years with neuromuscular disease. Population and methods: Observational, analytical, prospective validation study conducted in Hospital Garrahan between March 19th, 2019 and March 9th, 2020. The retest questionnaire was administered 10-15 days later to validate it among patients who reported a stable condition. Results: A total of 185 children and their parents participated. In terms of the questionnaire's feasibility, its content was easily understood by participants. Its reliability was acceptable, with an internal consistency of 0.82 among children and 0.87 among parents and a retest intraclass correlation coefficient of 0.70 among children and 0.82 among parents. In relation to the construct validity, 8 of the 11 hypotheses established (72.7 %) were confirmed. Conclusion: The questionnaire's psychometric properties were validated.

Association between metabolic syndrome and periodontitis: a systematic review and meta-analysis

Abstract The aim of the present study was to evaluate the association between metabolic syndrome (MS) and periodontitis (PD), through a systematic review and meta-analysis. Original observational studies assessing the association between MS and PD in adults, published before May 11th (2017), were identified through electronic searches of MEDLINE, EMBASE and Cochrane Library databases. The PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guideline was used. For studies to be included, they had to mention the criteria used to diagnose MS and to have used at least one clinical measure to diagnose PD. There was no language restriction. Three reviewers independently identified eligible studies for possible inclusion in the systematic review and meta-analysis. The quality of the studies was evaluated by the Newcastle-Ottawa scale for observational studies. A random model meta-analysis was conducted. The strategies used to investigate heterogeneity were sequential analysis, subgroup analysis, univariate meta-regression and sensitivity analysis. Thirty-three studies met the inclusion criteria for the systematic review, and 26 had enough information to be included in the meta-analysis, totaling 52,504 patients. MS and PD were associated with an odds ratio of 1.38 (95%CI 1.26-1.51; I2 = 92.7%; p < 0.001). Subgroup analysis showed that complete periodontal examination (I2 = 70.6%; p < 0.001) partially explained the variability between studies. The present findings suggest an association between MS and PD. Individuals with MS are 38% more likely to present PD than individuals without this condition. Prospective studies should be conducted to establish cause and effect relations between MS and PD.

Tooth Loss in Patients under Periodontal Maintenance in a Private Practice: A Retrospective Study

Abstract The aim of the present study was to evaluate the incidence and causes of tooth loss in periodontal subjects from a private practice in Brazil. Two trained examiners extracted data from the records of subjects who sought periodontal treatment from 1980 to 2013. Only records of patients who completed the non-surgical periodontal treatment and had at least one visit for maintenance were included. Data were analyzed by chi-square test, Student's t-test, Kaplan-Meier survival curve and Cox regression. A total of 3,319 records were reviewed and 737 records included (58.6% women, mean age of 46.6±13.0 years at the beginning of the treatment). Maintenance period ranged from 1 to 33 years (7.4±6 years). During this period, 202 individuals (27.4%) lost 360 teeth, 47.5% of losses within the first five years (n=171). Non-compliers lost more teeth than compliers (p<0.001), respectively 211 and 149 teeth. Regarding reasons of tooth loss, 84 individuals lost 38% of the teeth from periodontal disease progression (n=137). Survival analysis showed that most patients lost only one tooth from periodontal disease, and differences in the survival rates between compliers and non-compliers were observed following the second tooth loss. Approximately one-third of tooth losses was related to periodontal disease progression, and there was stability in time of the proportion of losses from disease progression and other reasons. Therefore, it is possible to conclude that compliant patients in a private practice lose fewer teeth than do non-compliers. Among compliers, periodontal disease progression was not the main cause of tooth loss.

Resumo O objetivo do presente estudo foi avaliar a incidência e causas de perda dentária em pacientes em manutenção periódica preventiva (MPP) de uma clínica privada. Dois examinadores extraíram os dados de registros de pacientes que procuraram tratamento periodontal entre 1980 a 2013. Os registros de pacientes que completaram o tratamento periodontal não cirúrgico e tiveram ao menos uma visita de MPP foram incluídos. Os dados foram avaliados utilizando os testes chi-quadrado, T de Student, curva de sobrevida de Kaplan-Meier e regressão de Cox. Dos 3.319 prontuários, 737 foram incluídos (58,6% mulheres, 46,6±13,0 anos). O período de MPP variou de 1 a 33 anos (7,4±6 anos). Durante este período, 202 indivíduos (27,4%) perderam 360 dentes, 47,5% das perdas durante os primeiros 5 anos de manutenção (n=171). Indivíduos irregulares nas consultas de MPP perderam mais dentes (p<0.001) do que indivíduos com regularidade, 211 e 149 dentes respectivamente. Oitenta e quatro indivíduos perderam 38% de dentes por progressão de doença periodontal (n=137). A maioria dos indivíduos perdeu 1 dente por doença periodontal, e foram observadas diferenças na sobrevida a partir da segunda perda dentária quando comparados indivíduos regulares e irregulares na MPP. Aproximadamente um terço dos dentes perdidos estava relacionado à progressão de doença periodontal. Foi observada uma estabilidade na proporção de perdas por progressão de doença e outras razões ao longo do tempo. Desta forma, conclui-se que indivíduos com uma frequência regular de MPP perdem menos dentes e a progressão de doença nesses indivíduos não é a principal razão para perda dentária.

Agreement between clinical and histopathologic diagnoses and completeness of oral biopsy forms

Abstract The present study aimed to assess the rate of agreement between clinical and histopathological diagnoses and to report the frequency of completed forms for specimens that were subjected to histopathological examination and retrospectively examined. Data from 8,168 specimens submitted to histopathological examination were retrieved from the records. A total of 5,368 cases were included. Agreement was defined based on the definition of lesion nature according to its diagnostic category. Sensitivity, specificity, and positive and negative predictive values were calculated for each diagnostic category. The highest rate of agreement was observed for periapical lesions (92.6%), followed by potentially malignant disorders (90.1%) and non-neoplastic proliferative disorders (89.3%). Low rates of histopathological confirmation of the clinical impression were observed for mesenchymal tumors (25.0%) and cysts (44.2%). Sensitivity values were > 0.70 for all lesions, except for cysts (0.51). Specificity was relatively high, ranging from 0.97 to 1.00. The frequency of incomplete biopsy forms ranged from 16.8% (malignant tumors of oral mucosal epithelium) to 51.0% (nonspecific inflammatory reaction). The most frequently completed biopsy forms corresponded to epithelial malignant tumors (83.2%) and glandular inflammation (72.3%). In conclusion, there was an acceptable level of agreement. The low level of completeness of biopsy forms indicates little awareness about the relevance of gathering detailed information during clinical examination.

Qualidade de vida relacionada à saúde bucal: perspectivas para a periodontia / Oral health-related quality of life: periodontal perspectives

O conceito de qualidade de vida, principalmente na área médica, tem sido abordado nas últimas décadas. Na Odontologia, abre-se, também, uma perspectiva interessante à medida que se percebe que as condições bucais determinam, sim, impactos relacionados à percepção de qualidade de vida. Recentemente, vem se demonstrando, por exemplo, que a doença periodontal interfere, negativamente, com esta percepção. Por outro lado, apesar de identificado por poucos estudos, o tratamento periodontal tem demonstrado ser capaz de proporcionar uma melhora na percepção dos pacientes. Na odontologia, existem diversos instrumentos capazes de avaliar o impacto de problemas bucais na qualidade de vida das pessoas. No entanto, neste universo, ainda desconhecido, muitas são as dúvidas a respeito destas pesquisas. Condições a serem avaliadas, instrumentos a serem utilizados e populações a serem investigadas ainda são questões abertas. Portanto, o objetivo do presente estudo é, a partir de uma revisão da literatura referente aos impactos causados pela doença periodontal e o efeito de seu tratamento na qualidade de vida relacionada à saúde bucal dos pacientes, trazer informações que possam auxiliar o dia a dia do periodontista na busca por métodos que possam conferir uma abordagem completa das propostas terapêuticas empregadas

The concept of quality of life has been widely discussed in the last few decades. It is well known that conditions, such as, denture usage, caries and number of teeth can produce impacts on oral health related quality of life. Recently, studies described that periodontal disease has an important effect on patients’ perceptions concerning their quality of life. On the other hand, although described by few studies, periodontal treatment can be beneficial regarding these impacts. In dentistry, there are several instruments capable to evaluate the effect of oral problems on people’s quality of life. However, there are still doubts upon this subject. Conditions evaluated, questionnaires used and populations investigated are still questions to be answered. Therefore, the aim of this study is, from a review of the literature referring to impacts caused by periodontal diseases and its treatment on oral health related quality of life, to provide information to assist periodontists on the search of methods that can provide complete therapeutic approaches

A 10-year study of specimens submitted to oral pathology laboratory analysis: lesion occurrence and demographic features

The purpose of the present paper was to describe the range of lesions histologically diagnosed in an oral pathology laboratory in southern Brazil. A retrospective study of 8,168 specimen analyses recorded between 1995 and 2004 was conducted. The records were retrieved from the Oral Pathology Laboratory, School of Dentistry, Federal University of Rio Grande do Sul, RS, Brazil. A total of 6,831 valid cases (83.63%) were examined. Of these, inflammatory lesions were the most common occurrences (n = 4,320; 63.24%). Benign and malignant tumors accounted for 7.66% (n = 523) and 1.9% (n = 130) of the occurrences, respectively. Significant associations were observed between nonneoplastic proliferative disorders and benign mesenchymal tumors in females, and between squamous cell carcinoma and leukoplakia in males. Most diagnoses were benign in nature and had an inflammatory etiology. The association of some demographic characteristics with the occurrence of lesions suggests that these characteristics should be considered in performing differential diagnoses.

Cuidado enfermero en el recién nacido prematuro / Nursing care in premature newborn

Introducción: La prematuréz se define como la edad gestacional del neonato entre 21 y 37 semanas de gestación. Continúa siendo un factor importante de morbilidad y mortalidad neonatal en el mundo. En Estados Unidos se presenta en cerca del 11 % de los embarazos, es responsable del 70 % de las muertes neonatales y del 50 % de las discapacidades neurológicas. Objetivo: Gestionar el cuidado enfermero y la tecnología del cuidado neonatal mediante la solución de problemas de salud con el fin de incrementar el promedio y la calidad de vida del paciente prematuro. Desarrollo: Valoración clínica de enfermería por patrones funcionales de salud, entre los que destacan: percepción y control de la salud, aspecto nutricional y metabólico, eliminación, actividad y ejercicio, reposo y sueño, cognoscitivo y perceptual, autopercepción y autoconcepto, función y relación, sexualidad y reproducción, afrontamiento y tolerancia al estrés y por último valores y creencias. Aplicando los diagnósticos enfermeros por patrones funcionales de salud de North American Nursing Diagnosis Association. Conclusiones: La aplicación de los patrones funcionales de Marjory Gordon en el contexto de los cuidados del prematuro ofertan el incremento en sus posibilidades de supervivencia, permitiendo un manejo profesionalizado por el personal de enfermería.

Introduction: Prematurity in newborns is defined as gestational age of the newborn between the 21 and 37 weeks of gestation, and it continues being an important factor of neonatal morbid-mortality on the world. In the United States it is present in about 11 % of pregnancy women; it is responsible for 70 % of neonatal deaths, and for 50 % of neurological incapacities. Objective: To take charge of the nursing care and the technology of neonatal care through solving health problems with the goal of increasing the average and life quality of premature patient. Implementation: Clinical assessment by functional health patterns, such as perception and control of health, nutritional and metabolic aspect, voiding, activity and exercise, relaxation and sleeping, cognitive and perceptual, self-perception and self-concept, function and relationship, sexuality and reproduction, facing and stress tolerance, and values and beliefs, applying the nursing diagnosis by health functional patterns from the North American Nursing Diagnosis Association. Conclusions: The application of Marjory Gordon's functional patterns within the context of premature newborn care offer increasing possibilities of staying alive, allowing a professionalized care by nursing personnel.

Influência do consumo de etanol nas glândulas salivares / Influence of ethanol consumption in salivary glands

Objetivos: Realizar uma revisão da literatura sobre efeitos do consumo de etanol nas glândulas salivares. Fontes de Dados: Foi realizada uma busca no banco de dados Medline, utilizando as palavras alcohol/ethanol, salivary glands. Fonte de Dados: Tem sido observada na população uma elevação no consumo de bebidas alcoólicas pela população, ocasionando alterações em diversos sistemas. Aumento do volume das glândulas salivares e redução do fluxo salivar são frequentes em indivíduos alcoolistas. Como a saliva tem propriedades protetoras, a redução do fluxo torna a boca mais suscetível a injúrias, como as relacionadas à carie e à periodontite. Podem ser observadas alterações morfológicas, como acúmulo de tecido adiposo, hiperplasia dos ductos e redução da proporção de células acinares. O consumo de etanol é responsável ainda pela redução dos níveis de imunoglobulinas presentes na saliva. A degradação do etanol para metabólitos tóxicos, como o aceltaldeído, que podem modificar a função das glândulas salivares. Existe possibilidade de a saliva redistribuir o acetaldeído na boca, potencializando o dano produzido pelo consumo de etanol. além disso, podem estar presentes, como redução das prosta-glandinas, desnutrição, alterações do sistema imune e estresse oxidativo, este último envolvido na patogênese de uma série de doenças crônico-degenerativas, entre elas o câncer. Conclusões: Os pacientes alcoolistas devem receber uma atenção especial em relação aos cuidados bucais, pois suas condições locais e sistêmicas os tornam mais suscetíveis a doenças da boca, como cárie, periodontite e câncer.