ABSTRACT
OBJECTIVES: To evaluate the effectiveness of Bengal Smiles, a school-based dental sealant programme and assess outcomes related to the U.S. Healthy People 2020 oral health objectives. METHODS: A needs assessment identified high caries prevalence in Idaho children and supported the need for a school-based dental sealant programme at a local Title 1 school. Children (n=54) ages 6-12 were screened by dental hygiene students for suspected dental caries, sealant placement and need for referral for dental treatment. Sealant retention and sealant caries rates were computed at 12 months (n=32) using descriptive statistics. Caries rates were analysed with a t test for paired samples, while a chi-square test was used to determine a difference in referral treatment rates before and after the intervention of administrative staff who contacted parents of children in need of dental treatment. RESULTS: Bengal Smiles participants had a 16% decrease in suspected dental caries; however, there was no statistically significant difference in caries rates (P=.21) at baseline and 12 months. Sealant prevalence increased 370%. Sealant retention outcomes were 74% fully retained with 0% caries, 13% partially retained with 25% caries and 13% no retention with 25% caries. At 12 months, 50% of participants referred for dental treatment accessed care. The intervention of contacting parents had no statistically significant effect on increasing dental treatments (P=.75). CONCLUSIONS: School-based sealant programmes eliminate disparities in accessing oral health care and contribute to attaining U.S. Healthy People 2020 oral health objectives.
Subject(s)
Dental Caries/prevention & control , Pit and Fissure Sealants , School Health Services/organization & administration , Child , Dental Caries/epidemiology , Female , Health Services Needs and Demand , Humans , Idaho/epidemiology , Male , Prevalence , Program Evaluation , Treatment Outcome , United States/epidemiologyABSTRACT
Chronic obstructive pulmonary disease (COPD) is one of the most prevalent chronic diseases, with an increasing rate in morbidity and mortality. In recent years, there has been a greater awareness about the clinical importance of systemic effects and other chronic conditions associated with COPD, as these significantly impact on the course of disease. The most studied extrapulmonary manifestations in COPD include the presence of concomitant cardiovascular disease, skeletal muscle wasting, osteoporosis and lung cancer. Anaemia is a recognised independent marker of mortality in several chronic diseases. Recent studies have shown that anaemia in patients with COPD may be more frequent than expected, with a prevalence ranging from 5% to 33%. Some evidence suggests that systemic inflammation may play an important pathogenic role, but anaemia in COPD is probably multifactorial and may be caused by others factors, such as concealed chronic renal failure, decreased androgenic levels, iron depletion, angiotensin-converting enzyme inhibitor treatment and exacerbations. Low levels of haemoglobin and haematocrit in COPD patients have been associated with poor clinical and functional outcomes as well as with mortality and increased healthcare costs. Despite the potential clinical benefit of successfully treating anaemia in these patients, evidence supporting the importance of its correction on the prognosis of COPD is uncertain.
Subject(s)
Anemia/complications , Pulmonary Disease, Chronic Obstructive/complications , Acute Disease , Androgens/physiology , Anemia/mortality , Anemia/therapy , Chronic Disease , Erythropoiesis/physiology , Erythropoietin/biosynthesis , Exercise Tolerance/physiology , Glomerular Filtration Rate/physiology , Health Resources/statistics & numerical data , Hemoglobins/metabolism , Humans , Pulmonary Disease, Chronic Obstructive/mortality , Quality of Life , Renal Insufficiency, Chronic/complications , Renal Insufficiency, Chronic/physiopathology , Renin-Angiotensin System/physiologyABSTRACT
Introducción. La anemia está relacionada con varias patologías crónicas e inflamatorias y es un factor de mal pronóstico cuando se asocia a la insuficiencia cardiaca o al infarto de miocardio. A pesar de la importancia de la hemoglobina como molécula transportadora de oxígeno, no hay suficientes estudios que recojan la prevalencia de la anemia en pacientes con enfermedad pulmonar obstructiva crónica (EPOC). Objetivo. Determinar el porcentaje y las características de la anemia en pacientes con EPOC ingresados en un hospital de tercer nivel durante un año. Métodos. De las historias clínicas digitales se recogieron datos antropométricos y clínicos, historia de tabaquismo, hemograma, analítica de rutina, función pulmonar, gasometría arterial y los estudios básicos de anemia (EBA) disponibles. Resultados. Se incluyeron 177 pacientes con una edad media de 70 años (rango 44-95) que presentaban un volumen máximo espirado en el primer segundo de una espiración forzada (FEV1) media (DE) del 35(15)% y un nivel de hemoglobina (Hb) de 136(22) g/dl. Entre ellos, 66 pacientes (37%) estaban en insuficiencia respiratoria crónica (IRC) y 59 recibían oxigenoterapia domiciliaria (33%). De los pacientes incluidos, 56 (31%) presentaron anemia (Hb < 130 g/dl en hombres y < 120 g/dl en mujeres), con una Hb media de 111(13) g/dl, y la normocítica normocrómica fue el tipo morfológico más frecuente en 32 casos (58%). En 24 (42,85%) pacientes se disponía de un EBA que mostró una anemia de trastornos crónicos en 10 casos (41%), ferropénica en 6 (25%) y de otros tipos en 8 (34%). De los pacientes con IRC, 35 (53%) eran anémicos y sólo 8 (4,5%) tenían eritrocitosis. Conclusión. La anemia fue un hallazgo frecuente en estos pacientes y fue una comorbilidad infradiagnosticada
Introduction. Anemia is related to chronic and inflammatory diseases. Moreover, it is a factor of worse outcome in heart failure or myocardial infarction. Despite the importance of hemoglobin as a globular oxygen carrying protein, there are few studies on anemia and chronic obstructive pulmonary disease (COPD). Objective. To determine the frequency and the characteristics of the anemia in COPD patients admitted to a tertiary hospital within a one year period. Methods. Anthropometric and clinical data, tobacco habit, lung function tests, arterial blood gases and a basic study of anemia (BSA) were collected from digital clinical files. Results. A total of 177 patients were enrolled. Mean age was 70 (range 44-95), FEV1 was 35 (15%) and hemoglobin (Hb) 136(22) g/dl. Sixty-six (37%) patients had chronic respiratory failure (CRF) and 59 (33%) were receiving long-term oxygen therapy. A total of 56 (31%) had anemia (Hb < 130 g/dl in men or < 120 g/dl in women) with a mean Hb of 111(13). Anemia was normocytic normochromic in 32 cases (58%). BSA was obtained in 24 patients (42.85%) and showed that 10 patients (41%) had anemia of chronic disease, 6 patients (25%) had iron deficiency and 8 (34%) had other causes. It should be mentioned that 35 patients (53%) had CRF had anemia but only 8 patients had erythrocytosis (4.5%). Conclusion. Anemia was frequent in these patients and was an underdiagnosed comorbidity
Subject(s)
Male , Female , Adult , Middle Aged , Aged , Aged, 80 and over , Humans , Pulmonary Disease, Chronic Obstructive/complications , Anemia/epidemiology , Anemia/etiology , Retrospective Studies , Anemia/diagnosisABSTRACT
INTRODUCTION: Anemia is related to chronic and inflammatory diseases. Moreover, it is a factor of worse outcome in heart failure or myocardial infarction. Despite the importance of hemoglobin as a globular oxygen carrying protein, there are few studies on anemia and chronic obstructive pulmonary disease (COPD). OBJECTIVE: To determine the frequency and the characteristics of the anemia in COPD patients admitted to a tertiary hospital within a one year period. METHODS: Anthropometric and clinical data, tobacco habit, lung function tests, arterial blood gases and a basic study of anemia (BSA) were collected from digital clinical files. RESULTS: A total of 177 patients were enrolled. Mean age was 70 (range 44-95), FEV1 was 35 (15%) and hemoglobin (Hb) 136(22) g/dl. Sixty-six (37%) patients had chronic respiratory failure (CRF) and 59 (33%) were receiving long-term oxygen therapy. A total of 56 (31%) had anemia (Hb < 130 g/dl in men or < 120 g/dl in women) with a mean Hb of 111(13). Anemia was normocytic normochromic in 32 cases (58%). BSA was obtained in 24 patients (42.85%) and showed that 10 patients (41%) had anemia of chronic disease, 6 patients (25%) had iron deficiency and 8 (34%) had other causes. It should be mentioned that 35 patients (53%) had CRF had anemia but only 8 patients had erythrocytosis (4.5%). CONCLUSION: Anemia was frequent in these patients and was an underdiagnosed comorbidity.
Subject(s)
Anemia/epidemiology , Pulmonary Disease, Chronic Obstructive/complications , Adult , Aged , Aged, 80 and over , Anemia/diagnosis , Anemia, Iron-Deficiency/epidemiology , Comorbidity , Data Interpretation, Statistical , Female , Forced Expiratory Volume , Hemoglobins/analysis , Humans , Male , Middle Aged , Oxygen Inhalation Therapy , Pulmonary Disease, Chronic Obstructive/diagnosis , Pulmonary Disease, Chronic Obstructive/epidemiology , Pulmonary Disease, Chronic Obstructive/therapy , Respiratory Insufficiency/etiologyABSTRACT
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