[Clostridioides difficile toxin B gen amplification cycle threshold as a predictor of severity]. / Umbral del ciclo de amplificación del gen de la toxina B de Clostridioides difficile como predictor de gravedad.

BACKGROUND: Clostridioides dfficile infection (CDI) is the main cause of nosocomial diarrhea, generally associated with the use of antibiotics. This infection can cause uncomplicated diarrhea to pseudomembranous colitis or toxic megacolon. Recent studies have attempted to relate the threshold cycle (Ct) value of RT-PCR with mortality, as a fast, simple, objective and efficient method. AIM: To evaluate Ct as a predictor of poor outcome in patients with C. dfficile disease with/without clinical signs of severity. METHODS: We carried out a retrospective study between January 2015 and December 2018, including all patients in the reference area of the Hospital Universitario de Canarias in Tenerife (396,483 inhabitants) in patients with clinical criteria of severity and patients without clinical severity criteria (according to the guide for the clinical practice of CDI of the Society of Healthcare Epidemiology of America (SHEA) and the Infectious Diseases Society of North America (IDSA). RESULTS: A total of 202 CDI episodes were diagnosed. 77.7% (n = 157) presented clinical severity criteria. The presence of ulcerative colitis (p < 0.001), fever (p < 0.001), leukocytosis (p < 0.001), neutrophilia (p < 0.001), creatininemia (p = 0.005) were presented as risk factors for the development of severe CDI (S-CDI). Female sex, institutionalization, previous admission and death were described more frequently in the group with S-CDI, not finding significant differences. We found no differences with respect to the days of previous stay, or of post-CDI stay, although in the latter, the mean was higher in the case of S-CDI patients. No significant differences were found in terms of Ct in both groups; being only one point lower in patients with severity criteria (Ct = 26.1) than without severity criteria (Ct = 27.4) (p = 0.326). Conclusión: Based on the results of our study, it has not been possible to systematically implement the Ct value as a predictor of severity to the clinical report, and it is not possible to extrapolate this predictive variable from S-CDI and standardize the Ct value as a predictor of severity. CONCLUSION: Basándonos en los resultados de nuestro estudio, no ha sido posible la implementación sistemática del valor Ct como predictor de gravedad al informe clínico, no siendo posible extrapolar esta variable predictora de enfermedad por C difficile-G y estandarizar el valor Ct como factor predictor de gravedad.

Umbral del ciclo de amplificación del gen de la toxina B de Clostridioides difficile como predictor de gravedad / Clostridioides difficile toxin B gen amplification cycle threshold as a predictor of severity

INTRODUCCIÓN: La infección por Clostridioides dfficile (ICD) es la principal causa de diarrea nosocomial, generalmente asociada al consumo de antimicrobianos. Esta infección puede causar desde diarrea no complicada hasta colitis pseudomembranosa o megacolon tóxico. Estudios recientes han intentado relacionar el valor el ciclo umbral (Ct) de la RT-PCR con la mortalidad, como un método rápido, sencillo, objetivo y eficaz. OBJETIVO: Evaluar el Ct como predictor de mala evolución en pacientes con y sin criterio clínico de dicha gravedad. PACIENTES Y MÉTODOS: Realizamos un estudio retrospectivo entre enero 2015 y diciembre 2018, incluyendo todos los pacientes del área de referencia del Hospital Universitario de Canarias en Tenerife (396.483 habitantes) en pacientes con criterios clínicos de gravedad (de acuerdo a la Guía para la Práctica Clínica de la enfermedad por C. dfficile de la Sociedad de Epidemiología del Cuidado de la Salud de América (SHEA) y la Sociedad de Enfermedades Infecciosas de Norteamérica (IDSA) y pacientes sin criterios clínicos de gravedad evaluando el Ct como predictor de mala evolución. RESULTADOS: Se diagnosticó un total de 202 episodios de ICD. El 77,7% (n = 157) presentó criterios clínicos de gravedad. La presencia de colitis ulcerosa (p < 0,001), fiebre (p < 0,001), leucocitosis (p < 0,001), neutrofilia (p < 0,001), creatininemia (p = 0,005) se presentaron como factores de riesgo para el desarrollo de ICD grave. El sexo femenino, la institucionalización, el ingreso previo y el exitus se describieron con mayor frecuencia en el grupo con ICD-G, no encontrando diferencias significativas. No encontramos diferencias respecto a los días de estancia previa, o de estancia post-ICD, aunque en este último, la media fue mayor en el caso de los pacientes con ICD-G. No se encontraron diferencias significativas en cuanto al Ct en ambos grupos; siendo sólo un punto menor en pacientes con criterio de gravedad (Ct = 26,1) que sin criterios de gravedad (Ct = 27,4) (p = 0,326).

BACKGROUND: Clostridioides dfficile infection (CDI) is the main cause of nosocomial diarrhea, generally associated with the use of antibiotics. This infection can cause uncomplicated diarrhea to pseudomembranous colitis or toxic megacolon. Recent studies have attempted to relate the threshold cycle (Ct) value of RT-PCR with mortality, as a fast, simple, objective and efficient method. AIM: To evaluate Ct as a predictor of poor outcome in patients with C. dfficile disease with/without clinical signs of severity. METHODS: We carried out a retrospective study between January 2015 and December 2018, including all patients in the reference area of the Hospital Universitario de Canarias in Tenerife (396,483 inhabitants) in patients with clinical criteria of severity and patients without clinical severity criteria (according to the guide for the clinical practice of CDI of the Society of Healthcare Epidemiology of America (SHEA) and the Infectious Diseases Society of North America (IDSA). RESULTS: A total of 202 CDI episodes were diagnosed. 77.7% (n = 157) presented clinical severity criteria. The presence of ulcerative colitis (p < 0.001), fever (p < 0.001), leukocytosis (p < 0.001), neutrophilia (p < 0.001), creatininemia (p = 0.005) were presented as risk factors for the development of severe CDI (S-CDI). Female sex, institutionalization, previous admission and death were described more frequently in the group with S-CDI, not finding significant differences. We found no differences with respect to the days of previous stay, or of post-CDI stay, although in the latter, the mean was higher in the case of S-CDI patients. No significant differences were found in terms of Ct in both groups; being only one point lower in patients with severity criteria (Ct = 26.1) than without severity criteria (Ct = 27.4) (p = 0.326). CONCLUSION: Based on the results of our study, it has not been possible to systematically implement the Ct value as a predictor of severity to the clinical report, and it is not possible to extrapolate this predictive variable from S-CDI and standardize the Ct value as a predictor of severity. Conclusion: Basándonos en los resultados de nuestro estudio, no ha sido posible la implementación sistemática del valor Ct como predictor de gravedad al informe clínico, no siendo posible extrapolar esta variable predictora de enfermedad por C difficile-G y estandarizar el valor Ct como factor predictor de gravedad.

Online audio-visual information on oral cancer for Spanish-speaking laypersons. A cross-sectional study.

BACKGROUND: Lack of knowledge and awareness of oral cancer seem to be the main causes of diagnostic delay. Online resources are often used by patients to obtain health/medical information. However, there are no reports on the quality and usefulness of oral cancer audio-visual resources in Spanish. The aims of this investigation were to disclose the type of information about oral cancer available, and whether it may be useful to shorten the patients' oral cancer appraisal time-interval. MATERIAL AND METHODS: Cross-sectional study undertaken at three video-sharing sites on October, 13th 2019. KEYWORDS: "Cáncer oral"; "cáncer de boca". The first 100 results in each viewing list were retrieved by three reviewers. Demographical data was recorded, and interaction indexes, viewing rates, comprehensiveness, and usefulness were calculated for each video. The presence of non-scientifically supported information was also assessed. A descriptive analysis was undertaken, and relationships between variables were explored using the Spearman correlation test. RESULTS: A total of 127 videos were selected. They were produced mainly by mass-media (46.5%; n=59) and their length ranged from 0.28 to 105.38 minutes (median 4.15 minutes; IQR: 2.34-9.67). The most viewed video (10,599,765 views; visualization rate 726,508.9) scored 0 both in usefulness and comprehensiveness. The most useful video gathered 44,119 views (visualization rate 2.033.13). A highly significant positive correlation (0.643; p<0.001) could be observed between usefulness and comprehensiveness of the videos, together with negative correlations between the visualization rate and usefulness (-0.186; p<0.05), and visualization rate and comprehensiveness (-0.183; p<0.05). CONCLUSIONS: Online audio-visual material about oral cancer in Spanish is incomplete, of limited usefulness, and often includes non-scientifically supported information. Most of these resources are produced by mass media and healthcare professionals, with minor contributions from educational and healthcare institutions. Visualization rates negatively correlated with the usefulness and comprehensiveness of the contents in these digital objects.

Oral cancer awareness in North-Western Spain: a population-based study.

BACKGROUND: An early diagnosis depends greatly on patient awareness. Thus, the aim of this study was to investigate general awareness of oral cancer and knowledge about its risk factors, signs and symptoms. MATERIAL AND METHODS: Cross-sectional population-based survey of randomly selected respondents conducted from March 1, 2015 to 30 June 2016. RESULTS: A total of 5,727 people entered the survey (response rate: 53%). When asked what cancers participants had heard about, 20.3% mentioned oral cancer. Regarding risk factors, tobacco was mentioned by 55.3% of the sample (n=3,169), followed by alcohol (12.5%; n=708), poor oral hygiene (10.8%; n=618), diet (6.5%; n=377), and genetics (4.5%; n=248). CONCLUSIONS: General population has low awareness of oral cancer with poor knowledge of risk factors and main alarm signs. In addition, individuals in the risk group scored lower values in the main variables analysed; even those highly educated showed insufficient awareness and knowledge of oral cancer. In these circumstances, there is clear need for educational interventions tailored to the target audience and aimed at increasing knowledge and awareness of oral cancer to promote primary prevention of oral cancer and minimising the time interval of patients with symptomatic oral cancer in their path to treatment.

[Oral hygiene habits. Results of a population-based study].

Oral pathologies, in addition to being highly prevalent, have a systemic impact that can be prevented by regularly eliminating the dental biofilm. This population-based, cross-sectional study analysed the oral hygiene habits of 3,289 adults through community surveys in the four provincial capitals of Galicia between March 2015 and June 2016. Sex, level of periodontal awareness, education, tobacco habit, frequency of visits to the dentist and level of oral hygiene were registered according to the use of oral hygiene products and the frequency of their use. Oral hygiene was limited to brushing their teeth once a day in 86% of those surveyed, while regular interdental hygiene was a minority practice. The variables associated with good habits were periodontal awareness, frequent visits to the dentist, being a woman and a high educational level. Oral self-care is insufficient, especially in interdental hygiene, which justifies the need for educational interventions in the community.

Hábitos de higiene oral. Resultados de un estudio poblacional / Oral hygiene habits. Results of a population-based study

Las patologías orales, además de muy prevalentes, tienen un impacto sistémico que puede prevenirse eliminando regularmente el biofilm dental. Este estudio transversal de base poblacional analizó los hábitos de higiene oral referidos por 3.289 adultos mediante encuestas comunitarias en las cuatro capitales de Galicia entre marzo de 2015 y junio de 2016. Se registró sexo, nivel de alerta periodontal, nivel de estudios, hábito tabáquico, régimen de visitas odontológicas y nivel de higiene oral según el uso de elementos de higiene oral y su frecuencia de uso. La higiene oral se limitó al cepillado dental al menos una vez al día en el 86% de los encuestados, siendo minoritaria la higiene interdental regular. Las variables asociadas a buenos hábitos fueron la alerta periodontal, las visitas odontológicas frecuentes, ser mujer, y alto nivel educativo. Los autocuidados orales son inadecuados, especialmente en higiene interdental, lo que justifica la necesidad de intervenciones educativas de ámbito comunitario

Oral pathologies, in addition to being highly prevalent, have a systemic impact that can be prevented by regularly eliminating the dental biofilm. This population-based, cross-sectional study analysed the oral hygiene habits of 3,289 adults through community surveys in the four provincial capitals of Galicia between March 2015 and June 2016. Sex, level of periodontal awareness, education, tobacco habit, frequency of visits to the dentist and level of oral hygiene were registered according to the use of oral hygiene products and the frequency of their use. Oral hygiene was limited to brushing their teeth once a day in 86% of those surveyed, while regular interdental hygiene was a minority practice. The variables associated with good habits were periodontal awareness, frequent visits to the dentist, being a woman and a high educational level. Oral self-care is insufficient, especially in interdental hygiene, which justifies the need for educational interventions in the community

People would rather see a physician than a dentist when experiencing a long-standing oral ulceration. A population-based study in Spain.

BACKGROUND: Primary care physicians have been reported to be the first choice for patients with oral ulcerations. This study investigates the health-seeking behaviour of lay public in Galicia (North-western Spain) if experiencing a long-standing oral ulceration. MATERIAL AND METHODS: Cross-sectional population-based survey of randomly selected respondents conducted from March 1, 2015 to 30 June 2016. RESULTS: A total of 5,727 pedestrians entered the study (response rate: 53%), mostly in the 45-64 age group (30.2%; n=1,728), 47.7% of them (n=2,729) were males. Most participants (42.1%; n=2,411) reported to visit their dentist once a year and had secondary or compulsory education as their highest educational achievement (28.18%, n=1,614; 28%, n=1,600 respectively). When questioned what they would do if they had a wound/ulceration lasting longer than 3 weeks, most participants answered they would go to see their primary care physician (62.8%; n=3,597) and less than one quarter of the sample (23.8%; n=1,371) would seek consultation with their dentist. CONCLUSIONS: General Galician population would seek professional consultation about a long-standing oral ulceration, relying mostly on primary care physicians. Those neglecting these lesions are elderly, less-schooled people and unaware of oral cancer.