Mandibular bone mass density in a medieval population and its relationship with stable isotopes δ13C and δ15N.

The aim of this study was to compare the level of bone mass in digital orthopantomograms in two populations (medieval and current) using two radiomorphometric indexes, and to correlate the mandibular bone mass value, in the medieval mandible population, with stable isotope data δ13C and δ15N. An observational, cross-sectional, and analytical study on mandibles from two diachronic groups, 15 mandibles from the medieval settlement of La Torrecilla (Granada, Spain) and 15 mandibles from current patients at the Faculty of Dentistry of the University of Granada (Spain), matched by age and sex was conducted. The bone mass density was determined using the Mandibular Cortical Width Index (MCW) and the Mandibular Panoramic Index (PMI) in digital panoramic radiographs. In the medieval group, the values of bone mass density were correlated with those of two stable isotopes (δ13C and δ15N). The mean value of MCW in mm in the medieval group was 3.96 ± 0.60 (mean ± standard deviation) and in the current group was 4.02 ± 1.01. The PMI was 0.33 ± 0.06 and 0.35 ± 0.08 in the medieval and current groups respectively, with similar results in both groups (p = 0.820 and p = 0.575). A negative correlation was found between both morphometric indices and the δ15N isotope (rs = 0.56, p = 0.030 and rs = 0.61, p = 0.016, respectively). The bone mass density in mandibles belonging to the two compared populations, determined by two quantitative radiomorphometric indices, is similar. Within the medieval population, there is an inverse correlation between the δ15N value and bone mass density.

Diferencias según el género en el perfil clínico de riesgo del paciente amputado de miembro inferior.

OBJETIVO: Analizar las diferencias según el sexo en el perfil clínico de riesgo de los pacientes amputados de miembro inferior por causa no traumática. MÉTODO: Estudio retrospectivo descriptivo con 697 pacientes amputados de miembro inferior por causa no traumática, en un Servicio de Angiología y Cirugía Vascular, durante un periodo de 5 años y divididos en función del sexo. Se analizaron variables demográficas (edad) y clínicas (causa, comorbilidad, factores de riesgo cardiovascular y nivel de amputación). RESULTADOS: La edad media (± desviación estándar) de las mujeres fue mayor (75.3 ± 12 frente a 68.9 ± 11 años; p < 0.001) y ellas presentaron mayor frecuencia de factores de riesgo cardiovascular concomitantes, tales como diabetes, hipertensión y obesidad, que los varones, mientras que ellos presentaron mayor frecuencia de tabaquismo. No hubo diferencia significativa entre sexos respecto a la distribución de las causas de amputación, siendo la principal causa la isquémica, destacando la arteriosclerosis. Las mujeres presentaron mayor frecuencia y predisposición para un nivel de amputación mayor. CONCLUSIONES: En nuestro estudio, las mujeres presentaron un perfil de riesgo cardiovascular más desfavorable y el sexo femenino fue un predictor independiente de amputación mayor de miembro inferior por causa no traumática. OBJECTIVES: To analyse the possible gender differences within the clinical risk profile of lower-limb amputee patients who had a non-traumatic amputation. METHOD: A retrospective study with 697 lower-limb amputee patients, classified according to their gender, has been conducted at the Angiology and Vascular Surgery Department for 5 years. The variables considered were demographic variables (age and gender) and clinic variables (cause of the amputation, comorbidity, cardiovascular risk factors and the amputation level). RESULTS: Regarding to the results, the average of women was older than men (75.3 ± 12 vs. 68.9 ± 11 years; p < 0.001), showing an increasing frequency to concomitant cardiovascular risk factors, such as diabetes, hypertension, and obesity. However, men present a higher frequency to smoking. There were no gender differences in the main cause of the amputation, the ischemic cause, being notably into this cause the subgroup of arteriosclerosis cause. Women showed a higher frequency and predisposition for major amputation. CONCLUSIONS: This study showed that women had a more unfavorable cardiovascular risk profile than men, being the female gender an independent predictor to a major lower-limb amputation with non-traumatic amputation.

Impacto del nivel socioeconómico sobre el perfil del paciente amputado de miembro inferior por causa no traumática / Impact of socioeconomic status on the clinical profile of patients with non-traumatic lower-limb amputation

INTRODUCCIÓN: Analizar la influencia del nivel socioeconómico (NSE) sobre el perfil clínico del paciente amputado de miembro inferior por causa no traumática. MÉTODOS: Estudio retrospectivo con 697 pacientes amputados de miembro inferior, en un Servicio de Angiología y Cirugía Vascular, durante un periodo de 5 años. Los pacientes fueron divididos según NSE (bajo, medio y alto). Se analizaron variables demográficas (edad y género) y clínicas (causa, comorbilidad, factores de riesgo cardiovascular y nivel de amputación). RESULTADOS: La edad media fue 70,5 ± DE 11,9 años y la mediana 72 años. El NSE bajo presentó mayor frecuencia de hombres amputados. Todos los factores de riesgo cardiovascular fueron más frecuentes en este nivel, aunque solo fue estadísticamente significativo en diabetes (85,8% bajo, 69,3% medio, 65% alto; p < 0,01) y obesidad (31,4% bajo, 22,6% medio, 12,5% alto, p < 0,01). La retinopatía diabética fue la única comorbilidad que mostró asociación significativa con el NSE bajo (21,1% bajo, 15,3% medio, 12,5% alto, p < 0,03). No existió diferencia entre los NSE respecto de la causa de amputación. Se observó mayor frecuencia de amputación mayor en el NSE bajo, siendo esta diferencia estadísticamente significativa (63,6% bajo, 41,2% medio, 55% alto, p < 0,04) y una mayor predisposición a este nivel de amputación. CONCLUSIONES: El NSE bajo determina un perfil de riesgo vascular más desfavorable en los pacientes amputados de miembro inferior por causa no traumático y una mayor predisposición a sufrir amputación mayor. Este NSE muestra una influencia negativa sobre diabetes, obesidad y retinopatía diabética en estos pacientes

INTRODUCTION: To analyse the influence of socioeconomic status on the clinical profile of patients undergoing non-traumatic lower-limb amputation. METHODS: Retrospective study of 697 lower-limb amputee patients in an Angiology and Vascular Surgery Department during a 5-year period. Patients were classified according to their socioeconomic status (low, medium and high). We analysed demographic (age and gender) and clinical variables (cause of amputation, comorbidity, cardiovascular risk factors and amputation level). RESULTS: Mean age was 70.5 ± 11.9 years, and the median was 72 years. The low socioeconomic status group presented a higher frequency of amputations in men. Cardiovascular risks factors were more frequent in this socioeconomic group, and the difference was statistically significant for diabetes (85.8% low, 69.3% medium, 65% high; P < .01) and obesity (31.4% low, 22.6% medium, 12.5% high, P < .01). Diabetic retinopathy was the only comorbidity with a significant association with low socioeconomic status (21.1% low, 15.3% medium, 12.5% high, P < .03). Regarding the cause for amputation, there was no difference in terms of socioeconomic status. The low socioeconomic level showed a higher frequency of major amputation, which was a significant difference (63.6% low, 41.2% medium, 55% high, P < .04) and a higher predisposition for this amputation level. CONCLUSIONS: The low socioeconomic status has been shown to determine an unfavourable vascular risk profile in lower-limb non-traumatic amputees and a higher predisposition of a major amputation. This socioeconomic level demonstrates a negative influence on these patients' diabetes, obesity and diabetic retinopathy

Impact of socioeconomic status on the clinical profile of patients with non-traumatic lower-limb amputation. / Impacto del nivel socioeconómico sobre el perfil del paciente amputado de miembro inferior por causa no traumática.

INTRODUCTION: To analyse the influence of socioeconomic status on the clinical profile of patients undergoing non-traumatic lower-limb amputation. METHODS: Retrospective study of 697 lower-limb amputee patients in an Angiology and Vascular Surgery Department during a 5-year period. Patients were classified according to their socioeconomic status (low, medium and high). We analysed demographic (age and gender) and clinical variables (cause of amputation, comorbidity, cardiovascular risk factors and amputation level). RESULTS: Mean age was 70.5 ± 11.9 years, and the median was 72 years. The low socioeconomic status group presented a higher frequency of amputations in men. Cardiovascular risks factors were more frequent in this socioeconomic group, and the difference was statistically significant for diabetes (85.8% low, 69.3% medium, 65% high; P<.01) and obesity (31.4% low, 22.6% medium, 12.5% high, P<.01). Diabetic retinopathy was the only comorbidity with a significant association with low socioeconomic status (21.1% low, 15.3% medium, 12.5% high, P<.03). Regarding the cause for amputation, there was no difference in terms of socioeconomic status. The low socioeconomic level showed a higher frequency of major amputation, which was a significant difference (63.6% low, 41.2% medium, 55% high, P<.04) and a higher predisposition for this amputation level. CONCLUSIONS: The low socioeconomic status has been shown to determine an unfavourable vascular risk profile in lower-limb non-traumatic amputees and a higher predisposition of a major amputation. This socioeconomic level demonstrates a negative influence on these patients' diabetes, obesity and diabetic retinopathy.