Factores asociados a la mortalidad en pacientes cirróticos / Factors associated with mortality in cirrhotic patients

Introducción: La cirrosis hepática representa en Perú el 9,1 por ciento de las causas de mortalidad. Existe poca evidencia sobre la influencia de variables epidemiológicas y clínicas en la mortalidad de pacientes con cirrosis hepática en Latinoamérica, en especial en países en vías de desarrollo, como Perú. Objetivo: Identificar los factores asociados a la mortalidad en pacientes cirróticos. Métodos: Estudio trasversal en pacientes cirróticos atendidos en el Hospital Cayetano Heredia, de Piura, Perú, en el año 2017. La variable dependiente fue la mortalidad hospitalaria y las variables independientes fueron las características epidemiológicas, clínicas y de laboratorio. Se utilizó la prueba exacta de Fisher y la prueba de t para estimar los factores asociados a la mortalidad. Resultados: De 52 pacientes, la frecuencia de mortalidad debido a cirrosis fue de 35,4 por ciento. Tener ascitis moderada (p = 0,004), grado de encefalopatía (p = 0,001), leucocitosis (p = 0,004), enfermedad descompensada según índice de Child Pugh (p = 0,023), índice de Meld entre 30-39 puntos (p < 0,001) y niveles de creatinina (p = 0,009) resultaron asociados a una mayor frecuencia de mortalidad. Conclusión: La presencia de ascitis moderada, grado de encefalopatía, leucocitosis, enfermedad descompensada según índice de Child Pugh, índice de Meld entre 30-39 y los niveles de creatinina, están asociados a la mortalidad en pacientes cirróticos(AU)

Introduction: Liver cirrhosis represents 9,1 percent of causes of mortality in Peru. There is little evidence on the influence of epidemiological and clinical variables on the mortality of patients with liver cirrhosis in Latin America, especially in developing countries such as Peru. Objective: To identify the factors associated with mortality in cirrhotic patients. Methods: Cross-sectional study in cirrhotic patients treated at the Cayetano Heredia Hospital in Piura, Peru, year 2017. The dependent variable was hospital mortality and the independent variables were epidemiological, clinical and laboratory characteristics. Fisher's exact test and the T test were used to estimate the factors associated with mortality. Results: Of 52 patients, the frequency of mortality due to cirrhosis was 35,4 percent. Have moderate ascites (p = 0,004), degree of encephalopathy (p = 0,001), leukocytosis (p = 0,004), decompensated disease according to the Child Pugh index (p = 0,023), Meld index between 30-39 points (p < 0,001) and creatinine levels (p = 0,009) were associated with a higher frequency of mortality. Conclusion: The presence of moderate ascites, degree of encephalopathy, leukocytosis, decompensated disease according to the Child Pugh index, Meld index between 30-39, creatinine levels are associated with mortality in cirrhotic patients(AU)

Evaluation of color change using CIE LAB coordinates on tooth structure subjected to different concentrations of peroxide carbamide

ABSTRACT: Aim: The aim of this study was to evaluate the optical behavior of tooth color using CIE L*A*B* space; the teeth were subjected to novel bleaching gels containing peroxide carbamide with potassium oxalate. Materials and Method: Three different carbamide peroxide gels were experimentally fabricated. They consisted of 10% (G10), 16% (G16) and 37% (G37) concentrations. Sixty recently extracted premolars were subjected to different bleaching protocols. Color change (ΔE) was assessed using the CIE L*a*b* system after the application of each gel. The data were analyzed using one-way ANOVA with Tukey's post hoc test (α=5%) and a t-test. Results: The G10 and G16 gels exhibited an increase in ΔE*ab parameters from T0 to T1 (T0: application day of the gels. T1: 14th day measurement); a small decrease from T1 to T2 was also noted (T2: control measurement, 28th day). However, no statistically significant differences were found (p=0,22 for G10 and p=0,10 for G16). The G37 gel also exhibited an increase in ΔE*ab parameters, with similar results after the first application of 45 min, the second application of 45 min, and the third application of 45 min (T1, T2 and T3, respectively. T4: control measurement, 14th day). No statistically significant differences were observed between the three times of application (p>0,69), and an appreciable difference was noted between times T3 and T4 (p=0,000). Conclusions: The presented formulations of peroxide carbamide at 10%, 16%, and 37% are clearly effective. The G10 and G16 gels exhibited better effectiveness than the G37 gel.