The Impact of Charlson Comorbidity Index on the Functional Capacity of COVID-19 Survivors: A Prospective Cohort Study with One-Year Follow-Up.

Objective: To determine the association between the Charlson comorbidity index (CCI) score after discharge with 6-min walk test (6MWT) 1 year after discharge in a cohort of COVID-19 survivors. Methods: In this prospective study, data were collected from a consecutive sample of patients hospitalized for COVID-19. The CCI score was calculated from the comorbidity data. The main outcome was the distance walked in the 6MWT at 1 year after discharge. Associations between CCI and meters covered in the 6MWT were assessed through crude and adjusted linear regressions. The model was adjusted for possible confounding factors (sex, days of hospitalization, and basal physical capacity through sit-to-stand test one month after discharge). Results: A total of 41 patients were included (mean age 58.8 ± 12.7 years, 20/21 men/women). A significant association was observed between CCI and 6MWT (meters): (i) crude model: ß = −18.7, 95% CI = −34.7 to −2.6, p < 0.05; (ii) model adjusted for propensity score including sex, days of hospitalization, and sit-to-stand: ß = −23.0, 95% CI = −39.1 to −6.8, p < 0.05. Conclusions: A higher CCI score after discharge indicates worse performance on the 6MWT at 1-year follow-up in COVID-19 survivors. The CCI score could also be used as a screening tool to make important clinical decisions.

Changes in health-related quality of life after orthognathic surgery: a multicenter study.

OBJECTIVE: To evaluate changes in general and oral health-related quality of life (HRQoL) in patients with dentofacial deformity undergoing orthognathic surgery, and whether these changes vary according to type of deformity. MATERIAL AND METHODS: This is a prospective longitudinal multicenter study of patients with dentofacial deformities (n = 90). The Orthognathic Quality of Life Questionnaire (OQLQ), Oral Health Impact Profile (OHIP-14), and Short-Form Health Survey version2 (SF-36v2) were self-completed by patients before surgery, 3 and 6 months after orthognathic surgery. Change was tested using paired t-test, and compared between Class II and Class III of dentofacial deformity by unpaired t-test. The magnitude of change was examined estimating the standardized response mean (SRM). RESULTS: The OQLQ and OHIP-14 showed statistically significant improvements 6 months after surgery, compared with the pre-surgical evaluation, but the SF-36v2 only in the physical component summary. The SRM was large in OQLQ oral function (-1.11) and dentofacial facial aesthetics (-0.76) dimensions, and moderate in most of OHIP-14 dimensions. Differences in mean change between Class II and III were statistically significant for global scores of OQLQ (-10.08 vs -20.30, p = 0.0271) and OHIP-14 (-3.79 vs -10.56, p = 0.0144). CONCLUSIONS: A significant improvement was observed in oral HRQoL and in the physical component of general health in patients with dentofacial deformities Class II and III after orthognathic surgery. Improvement was greater among Class III than in Class II patients. CLINICAL RELEVANCE: These results provide patients, oral health care professionals, and planners with valuable information to make evidence-based decisions and facilitate shared clinical decision-making, taking into account the patients' perspective.

Anthracene induces oxidative stress and activation of antioxidant and detoxification enzymes in Ulva lactuca (Chlorophyta).

In order to analyze whether the marine macroalga Ulva lactuca can absorb and metabolize anthracene (ANT), the alga was cultivated with 5 µM ANT for 0-72 h, and the level of ANT was detected in the culture medium, and in the alga. The level of ANT rapidly decreased in the culture medium reaching a minimal level at 6 h, and rapidly increased in the alga reaching a maximal level at 12 h and then decreased to reach a minimal level at 48 h of culture. In addition, ANT induced an increase in hydrogen peroxide that remained until 72 h and a higher increase in superoxide anions that reach a maximal level at 24 h and remained unchanged until 72 h, indicating that ANT induced an oxidative stress condition. ANT induced an increase in lipoperoxides that reached a maximal level at 24 h and decreased at 48 h indicating that oxidative stress caused membrane damage. The activity of antioxidant enzymes SOD, CAT, AP, GR and GP increased in the alga treated with ANT whereas DHAR remained unchanged. The level of transcripts encoding these antioxidant enzymes increased and those encoding DHAR did not change. Inhibitors of monooxygenases, dioxygenases, polyphenol oxidases, glutathione-S-transferases and sulfotransferases induced an increase in the level of ANT in the alga cultivated for 24 h. These results strongly suggest that ANT is rapidly absorbed and metabolized in U. lactuca and the latter involves Phase I and II metabolizing enzymes.

Benzopyrene induces oxidative stress and increases expression and activities of antioxidant enzymes, and CYP450 and GST metabolizing enzymes in Ulva lactuca (Chlorophyta).

MAIN CONCLUSION: Benzopyrene is rapidly incorporated and metabolized, and induces oxidative stress and activation of antioxidant enzymes, and CYP450 and GST metabolizing enzymes in Ulva lactuca. To analyze absorption and metabolism of benzo[a]pyrene (BaP) in Ulva lactuca, the alga was cultivated with 5 µM of BaP for 72 h. In the culture medium, BaP level rapidly decreased reaching a minimal level at 12 h and, in the alga, BaP level increased until 6 h, remained stable until 24 h, and decreased until 72 h indicating that BaP is being metabolized in U. lactuca. In addition, BaP induced an initial increase in hydrogen peroxide decreasing until 24 h, superoxide anions level that remained high until 72 h, and lipoperoxides that initially increased and decreased until 72 h, showing that BaP induced oxidative stress. Activities of antioxidant enzymes superoxide dismutase (SOD), catalase (CAT), ascorbate peroxidase (AP), glutathione reductase (GR) and glutathione peroxidase (GP) were increased, whereas dehydroascorbate reductase (DHAR) activity was unchanged. The level of transcripts encoding these antioxidant enzymes was increased, but transcripts encoding DHAR remained unchanged. Interestingly, the activity of glutathione-S-transferase (GST) was also increased, and inhibitors of cytochrome P450 (CYP450) and GST activities enhanced the level of BaP in algal tissue, suggesting that these enzymes participate in BaP metabolism.

Cross-cultural adaptation and validation of the Spanish version of the Orthognathic Quality of Life Questionnaire for patients with dentofacial deformities.

OBJECTIVE: The aim of this study was to develop a Spanish version of the Orthognathic Quality of Life Questionnaire (OQLQ) that is conceptually equivalent to the original questionnaire, as well as acceptable, reliable, valid, and responsive for use in Chilean patients with dentofacial deformities. MATERIAL AND METHODS: The recommended standard methodology, with direct and back-translation, was used. A prospective longitudinal multicenter study of adult patients diagnosed with dentofacial deformity was carried out, self-administrating OQLQ, OHIP-14 (Oral Health Impact Profile), and SF-36 (Short Form 36 Health Survey) during the presurgery visit in order to examine construct validity. To evaluate reproducibility, questionnaires were re-administered 4 weeks later to subjects with a stable dental condition. Responsiveness was assessed among subjects followed up until 3 months after surgery. RESULTS: Of the 230 patients under presurgical orthodontic treatment included in the study, 216 completed the questionnaire, 142 formed the reliability sub-sample, and 30 were evaluated 3 months after surgery. Cronbach's alpha ranged from 0.78 to 0.94 and test-retest intraclass correlation coefficients ranged from 0.84 to 0.91 (p = 0.001) by dimension. The correlation matrix between OQLQ dimensions and SF-36 and OHIP-14 confirmed most of the associations previously hypothesized as moderate (rs > 0.4). Confirmatory factor analysis supported the same structure as the original instrument, considering four dimensions. Responsiveness was demonstrated by the large improvement observed in the global score 3 months after surgery: mean change ±SD = -15.1 ± 18.05 and standard response mean = -0.84 (p < 0.001). CONCLUSIONS: The Spanish version of OQLQ has demonstrated good levels of reliability, validity, and responsiveness - similar to those of the original questionnaire.

Trends of maxillofacial trauma: An update from the prospective register of a multicenter study in emergency services of Chile

Background: Determine the behavior of the maxillofacial trauma of adults treated in 3 tertiary care centers in the central zone of Chile. Material and Methods: descriptive, cross-sectional, multicenter study, based on the prospective records of maxillofacial trauma cases attended between May 2016 and April 2017 by dental and maxillofacial clinical teams of Adult Emergency Units of hospitals Dr. Sótero del Río (metropolitan region), Carlos Van Buren and Dr. Gustavo Fricke (region V). Age, sex, date of occurrence, type of trauma according to ICD-10, etiology, legal medical prognosis and associated injuries were recorded, stratifying by sex and age. Chi square and unpaired Wilcoxon tests were used to compare by groups. Results: 2.485 cases and 3.285 injuries were investigated. The male: female ratio was 1.7: 1 with age under 30 predominant, followed by older adults. Variability was observed in the yearly, weekly and daily presentation The highest frequencies were in January and September, weekends and at night. The main etiologies were violence (42.3%), falls (13.1%) and road traffic crashes (12.9%) with differences by age and sex (p <0.05). 31,9% of the injuries occurred in hard tissue, being fractures in nasal bones predominant (S02.2). Conclusions: the profile of the maxillofacial trauma in Chile seems to be mixed by age, affecting young people and the elderly. The male sex predominates; the main cause, which varies by age group, is violence. Their surveillance is possible from hospital emergency records

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La certificación como indicador de descentralización en salud. Una mirada a la luz del cumplimiento de requisitos en municipios colombianos / The certification as indicator of decentralization in health. A look in the light of the fulfillment of requirements in Colombian municipalities

En este artículo se describen los resultados de una encuesta llevada a cabo durante los años 2003-2004 para determinar el cumplimiento de los criterios para la certificación de descentralización en salud otorgada por el Ministerio de la Protección Social en una muestra representativa de municipios colombianos.