Manifestaciones de la enfermedad periodontal en pacientes con artritis reumatoide

Introducción: Las enfermedades periodontales inmunoinflamatorias crónicas, están catalogadas entre las afecciones más comunes del género humano, las que pueden estar asociadas a enfermedades sistémicas como la artritis reumatoidea. Objetivo: Identificar las manifestaciones periodontales más comunes en pacientes con artritis reumatoidea. Métodos: Se realizó un estudio observacional descriptivo de corte transversal. El universo estuvo constituido por 107 pacientes con diagnóstico de artritis reumatoidea, la muestra no probabilística de 50 pacientes que acudieron a consulta estomatológica durante el periodo, que cumplieron con los criterios de inclusión y exclusión previstos en el estudio. Las principales variables estudiadas fueron: edad, sexo, tiempo de diagnóstico de artritis reumatoide, presencia de enfermedad periodontal (gingivitis y periodontitis), factores de riesgo. Resultados: Prevaleció las edades entre 49 a 58 años, seguido de 39 a 48 años para un 34 y 26 % respectivamente, predominó el sexo femenino con un 46 % de afectadas por gingivitis y con más de siete años para un 58 %, la higiene bucal deficiente seguido de la dieta cariogénica prevaleció en un 50 % y 54% respectivamente. Conclusiones: Predominó el sexo femenino de pacientes diagnosticadas con artritis reumatoidea afectadas por gingivitis, ambas enfermedades son inflamatorias sistémicas, por lo que se puede explicar la conexión entre las dos.

Introduction: Chronic immunoinflammatory periodontal diseases are classified among the most common affections of the human gender, which may be associated with systemic diseases such as rheumatoid arthritis. Objective: To identify the most common periodontal manifestations in patients with rheumatoid arthritis. Methods: A cross-sectional descriptive observational study was carried out. The universe consisted of 107 patients diagnosed with rheumatoid arthritis, the non-probabilistic sample of 50 patients who attended a dental consultation during the study period, who met the inclusion and exclusion criteria provided for in the study. The main variables studied were: age, sex, time since diagnosis of rheumatoid arthritis, presence of periodontal disease (gingivitis and periodontitis), risk factors. Results: Ages between 49 and 58 years prevailed, followed by 39 to 48 years with 34 and 26% respectively, predominantly female with 46% affected by gingivitis, affected with more than 7 years with 58%, the poor oral hygiene followed by the cariogenic diet prevailed with 54 and 50% respectively. Conclusions: The female sex prevailed in patients diagnosed with rheumatoid arthritis affected by gingivitis, both diseases are systemic inflammatory, so the connection between the two can be explained.

Enfermedad periodontal como factor de riesgo del bajo peso al nacer

Introducción: El bajo peso al nacer constituye una problemática de salud a nivel mundial, existe controversia sobre la asociación de la enfermedad periodontal con los diferentes resultados perinatales adversos. Objetivo: Determinar si la enfermedad periodontal es un factor de riesgo del bajo peso al nacer. Métodos: Se realizó un estudio observacional, descriptivo transversal en gestantes que aportaron recién nacidos vivos con bajo peso pertenecientes al municipio de Pinar del Río, durante el año 2019. El universo lo conformaron 94 gestantes, la muestra no probabilística la integraron 72 que cumplieron con los criterios de inclusión definidos por los autores de la investigación. Las variables fueron: edad materna, edad gestacional al nacimiento, factores de riesgo (hipertensión arterial, asma bronquial, anemia, sepsis vaginal, sepsis urinaria, hábito de fumar), ganancia de peso durante la gestación (adecuada, insuficiente, excesiva), valoración nutricional (normopeso, sobrepeso, desnutrida, obesa) y presencia de enfermedad periodontal (gingivitis y periodontitis). Las fuentes empleadas fueron las historias clínicas de las madres y recién nacidos, la estadística fue descriptiva con distribución de frecuencias absolutas y relativas. Resultados: Predominaron las edades maternas entre 20 a 25 años y la edad gestacional entre 33 y 36 semanas, la sepsis vaginal constituyó la principal enfermedad asociada al embarazo, predominó la ganancia inadecuada de peso y el normopeso. Conclusiones: La enfermedad periodontal no se asoció como factor de riesgo de resultados perinatales adversos como el bajo peso al nacer.

Introduction: Low birth weight is a health problem worldwide, there is controversy about the association of periodontal disease with different adverse perinatal outcomes. Objective: To determine if periodontal disease is a risk factor for low birth weight. Methods: An observational, descriptive, cross-sectional study was carried out in pregnant women who provided live newborns with low weight belonging to the municipality of Pinar del Río, during 2019. The universe (94) pregnant women and the sample (72) through a non-probabilistic sample at the discretion of the authors, according to inclusion criteria. The variables were: maternal age, gestational age at birth, risk factors (hypertension, bronchial asthma, anemia, vaginal sepsis, urinary sepsis, smoking), weight gain during pregnancy (adequate, insufficient, excessive), evaluation nutritional status (normal weight, overweight, malnourished, obese) and presence of periodontal disease (gingivitis and periodontitis). The sources used were the medical records of the mothers and newborns and the statistics were descriptive with distribution of absolute and relative frequencies. Results: Maternal ages between 20 to 25 (33,3 %) and gestational age between 33 and 36 weeks (47,2 %) predominated, vaginal sepsis was the main disease associated with pregnancy (22,2 %), predominated inadequate weight gain (41,7 %) and normal weight with (59,7 %). Conclusions: Periodontal disease was not associated as a risk factor for adverse perinatal outcomes such as low birth weight.

Efectividad de los métodos radiográficos periapicales por paralelismo y bisección / Effectiveness of periapical radiographic methods by parallelism and bisection

RESUMEN Introducción: la radiografía periapical constituye el método clásico y más empleado en Estomatología. Se puede realizar con dirección bisectal o por paralelismo; esta última alcanza una generalización y eficacia marcada, debido al desarrollo de sistemas posicionadores y de enfoque de la película. Objetivo: determinar la efectividad de los métodos radiográficos periapicales por bisección y paralelismo, en la Clínica Estomatológica Docente Antonio Briones Montoto. Métodos: se realizó un estudio descriptivo transversal, entre diciembre 2017 y abril 2018, en el Departamento de Radiología de la clínica estomatológica seleccionada en una muestra de 80 pacientes, a los que se le realizó una radiografía periapical por bisección y otra por paralelismo de región de bicúspides y/o molares superiores. Se compararon las imágenes obtenidas. Resultados: las imágenes parciales se produjeron en 12,5 y 4 % con bisección y paralelismo. Las distorsiones más frecuentes fueron las superposiciones del piso del seno maxilar y del cigomático a las raíces en un 45 y 26,5 % con dirección bisectal y de 10 y 5 % con paralelismo; mientras que la necesidad de repetir radiografías fue de un 25 y 6,25 %. Conclusiones: todas las imágenes producidas con el método periapical por paralelismo con la utilización de sistemas de Extensión de Cono Paralelo, presentaron un enfoque total, con escasas y leves distorsiones de las imágenes con ahorro, la necesidad de repetir radiografías fue mínima, además, resultó muy fácil de aprender y realizar por personal novel.

ABSTRACT Introduction: periapical radiography constitutes the classic and more used method in Dentistry, which can be carried out with bisectal direction or by parallelism, reaching this last one, a generalization and marked efficacy due to the development of system positioners and a coating approach. Objective: to determine the effectiveness of periapical radiographic methods by bisection and parallelism at Antonio Briones Montoto Dentistry Teaching Clinic. Methods: a cross-sectional descriptive study was carried out between December 2017 and April 2018 in the Radiology Department of the chosen dentistry clinic in a sample of 80 patients, who were given a periapical radiography by bisection and another by parallelism of the region of bicuspids and/or upper molars by trained students of the fourth academic-year of dentistry studies and comparing the images obtained. Results: partial images were produced in 12,5 % and 4 % with bisection and parallelism respectively. The most frequent distortions were the overlapping of the maxillary sinus and zygomatic floor to the roots in 45 and 26,5 % with bisectal direction, 10 and 5 % with parallelism; while the need to repeat X-rays was 25 and 6,25 % respectively. Conclusions: by the periapical and parallelism methods using XCP systems, all the images produced presented a total approach, with scarce and slight distortions of the images saving resources because the need to repeat X-rays was minimal, in addition, it was very easy to learn and perform by novel personnel.

Health-related quality of life of patients diagnosed with COPD in Extremadura, Spain: results from an observational study.

BACKGROUND: COPD is a high prevalence chronic disease that involves large reductions of health-related quality of life (HRQL) of patients. This study aims to describe the HRQL of patients with COPD in Extremadura (Spain). METHODS: This is a cross-sectional observational study carried out using a representative sample of patients diagnosed with COPD in Extremadura. The inclusion criteria were patients of legal age, diagnosed with COPD at least 12 months prior to the visit, residing in Extremadura, with electronic medical records available for the 12 months prior to the visit and providing informed consent. The intervention aimed to elicit HRQL indicators obtained from two validated questionnaires: EuroQol - 5 Dimensions - 5 Levels (EQ-5D-5L), and St. George's Respiratory Questionnaire-COPD (SGRQ-C). The main outcome measures were general HRQL (utility and visual analogue scale) and specific quality of life of COPD patients (total score and three component scores: Symptoms, Activity, and Impacts). Stepwise multiple regression analysis was applied to evaluate the association of EQ-5D-5L and SGRQ-C with respect to clinical and sociodemographic characteristics of the patients. RESULTS: We recruited 386 patients (mean age 71.8 ± 10.3 years, 76.2% males). In the EQ-5D-5L, participants reported greater problems with respect to mobility (56.5%) and pain/discomfort (48.2%). The mean utility was 0.72 ± 0.31, and the SGRQ-C total score was 40.9 ± 25.0. The results of both questionnaires were associated with number of exacerbations in the last 12 months, level of COPD severity, gender, and education level of the patient (p < 0.05). CONCLUSIONS: The results for both utility and total SGRQ-C score indicate that having suffered exacerbations in the last year, presenting a higher level of severity, being a woman, and having a low education level are related to worse HRQL in patients with COPD.

Social economic costs of COPD in Extremadura (Spain): an observational study.

Purpose: COPD has been associated with a high number of comorbidities and a relatively high level of health care resource utilization. This study aimed to estimate the social economic impact of COPD in the autonomous community of Extremadura (Spain) in 2015. Patients and methods: This is a retrospective observational study carried out using a representative sample of patients diagnosed with COPD in Extremadura. Sociodemographic data, data on health care resource utilization, formal and informal care received by the patients, and loss of labor productivity in the last 12 months were collected through an electronic data collection platform. Direct health care costs were estimated using the bottom-up approach, costs of informal care were assessed using the substitution method, and labor productivity losses were calculated using the human capital method. Results: A sample of 386 patients was obtained (mean age: 71.8±10.3 years, males: 76.2%). The results show an average annual cost per patient of 3,077 euros. Direct health care costs represented 43.8% (1,645 euros), direct non-health care costs amounted to 38.3% (1,440 euros), and labor productivity losses represented 17.9% (672 euros) of the average annual cost. The total annual cost of patients with COPD in Extremadura reached 36.2 million euros in 2015. Conclusion: COPD poses a significant burden for the health care system and the society of Extremadura. The implementation of preventive and control measures could result in a substantial reduction in the economic impact.

Determining the Value of Two Biologic Drugs for Chronic Inflammatory Skin Diseases: Results of a Multi-Criteria Decision Analysis.

BACKGROUND AND OBJECTIVE: Multi-criteria decision analysis (MCDA) is a tool that systematically considers multiple factors relevant to health decision-making. The aim of this study was to use an MCDA to assess the value of dupilumab for severe atopic dermatitis compared with secukinumab for moderate to severe plaque psoriasis in Spain. METHOD: Following the EVIDEM (Evidence and Value: Impact on DEcision Making) methodology, the estimated value of both interventions was obtained by means of an additive linear model that combined the individual weighting (between 1 and 5) of each criterion with the individual scoring of each intervention in each criterion. Dupilumab was evaluated against placebo, while secukinumab was evaluated against placebo, etanercept and ustekinumab. A retest was performed to assess the reproducibility of weights, scores and value estimates. RESULTS: The overall MCDA value estimate for dupilumab versus placebo was 0.51 ± 0.14. This value was higher than those obtained for secukinumab: 0.48 ± 0.15 versus placebo, 0.45 ± 0.15 versus etanercept and 0.39 ± 0.18 versus ustekinumab. The highest-value contribution was reported by the patients' group, followed by the clinical professionals and the decision makers. A fundamental element that explained the difference in the scoring between pathologies was the availability of therapeutic alternatives. The retest confirmed the consistency and replicability of the analysis. CONCLUSIONS: Under this methodology, and assuming similar economic costs per patient for both treatments, the results indicated that the overall value estimated of dupilumab for severe atopic dermatitis was similar to, or slightly higher than, that of secukinumab for moderate to severe plaque psoriasis.

Atrición dentaria en la oclusión permanente / Teeth attrition in permanent occlusion

Introducción: el conocimiento de los factores que desencadenan o exacerban el desgaste dentario mecánico como resultado de la masticación o parafunción, sus consecuencias, así como el interés de detectarlos tempranamente, resulta de gran importancia. Objetivo: evaluar el comportamiento de la atrición dentaria y su relación con la presencia de desgaste cervical y las alteraciones de la guía de oclusión. Material y método: se realizó una investigación observacional, descriptiva, transversal en pacientes mayores de 19 años de edad con atrición dentaria que acudieron al Servicio de Estomatología pertenecientes al área de salud del Policlínico Universitario "Raúl Sánchez", Municipio Pinar del Río, en el período comprendido de enero a febrero de 2013. Se seleccionaron 60 pacientes mediante un muestreo no probabilístico por criterios, se les aplicó un examen clínico-bucal y se confeccionó la historia clínica individual. Los datos recolectados se analizaron mediante la prueba no paramétrica de ji cuadrado. Resultados: se determinó que el desgaste de grado 2 fue el más característico, la mitad de los pacientes con grado de desgaste 2 presentaron la alteración de función en grupo. El grupo de edad más representativo de la muestra fue el de 31 a 40 años, predominando el sexo femenino. La mayoría de los pacientes con atrición en dientes posteriores poseían desgaste cervical, mientras que este no estuvo presente en dientes anteriores con atrición dentaria. Conclusiones: se demostró la existencia de atrición dentaria así como la relación de esta patología con las alteraciones de la guía de oclusión y el grado de desgaste dentario.

Introduction: the development of knowledge concerning trigger mechanisms orB factors that exacerbate mechanical dental attrition resulting from mastication or oral parafunctional habits, its consequences, as well as the interest of its early detection is very important. Objective: to assess the behavior of dental attrition and its relation to the presence of cervical attrition and the alterations of the occlusion guide. Material and Method: an observational, descriptive and cross-sectional research was conducted in patients older than 19 years old with dental attrition attending Dentistry Service of RaC:l SC!nchez University Polyclinic, Pinar del RC-o municipality from January/February 2013; a non-probabilistic sample through criteria was used, 60 patients were chosen, a clinical-oral examination was applied to create an individual clinical chart. Data were collected and analyzed by means of a non-parametric chi square test. Results: degree 2 attrition prevailed; half of patients from this group presented this degree with alteration on functions. Ages from 31 to 40 were the most representative on the sample chosen, where female sex predominated. The majority of patients showed cervical attrition in posterior teeth, while anterior teeth showed no signs. Conclusions: the existence of dental attrition was demonstrated, as well as the relation of this pathology to the alterations of the occlusion guide and the degree of teeth wearing away.

Atrición dentaria en la oclusión permanente / Teeth attrition in permanent occlusion

El conocimiento de los factores que desencadenan o exacerban el desgaste dentario mecánico como resultado de la masticación o parafunción, sus consecuencias, así como el interés de detectarlos tempranamente, resulta de gran importancia. El objetivo fue evaluar el comportamiento de la atrición dentaria y su relación con la presencia de desgaste cervical y las alteraciones de la guía de oclusión. Se realizó una investigación observacional, descriptiva, transversal en pacientes mayores de 19 años de edad con atrición dentaria que acudieron al Servicio de Estomatología pertenecientes al área de salud del Policlínico Universitario Raúl Sánchez, Municipio Pinar del Río, en el período comprendido de enero a febrero de 2013. Se seleccionaron 60 pacientes mediante un muestreo no probabilístico por criterios, se les aplicó un examen clínico-bucal y se confeccionó la historia clínica individual. Los datos recolectados se analizaron mediante la prueba no paramétrica de ji cuadrado. Se determinó que el desgaste de grado 2 fue el más característico, la mitad de los pacientes con grado de desgaste 2 presentaron la alteración de función en grupo. El grupo de edad más representativo de la muestra fue el de 31 a 40 años, predominando el sexo femenino. La mayoría de los pacientes con atrición en dientes posteriores poseían desgaste cervical, mientras que este no estuvo presente en dientes anteriores con atrición dentaria. Se demostró la existencia de atrición dentaria así como la relación de esta patología con las alteraciones de la guía de oclusión y el grado de desgaste dentario(AU)

The development of knowledge concerning trigger mechanisms orB factors that exacerbate mechanical dental attrition resulting from mastication or oral parafunctional habits, its consequences, as well as the interest of its early detection is very important. The objective was to assess the behavior of dental attrition and its relation to the presence of cervical attrition and the alterations of the occlusion guide. An observational, descriptive and cross-sectional research was conducted in patients older than 19 years old with dental attrition attending Dentistry Service of RaC:l SC!nchez University Polyclinic, Pinar del RC-o municipality from January/February 2013; a non-probabilistic sample through criteria was used, 60 patients were chosen, a clinical-oral examination was applied to create an individual clinical chart. Data were collected and analyzed by means of a non-parametric chi square test. Degree 2 attrition prevailed; half of patients from this group presented this degree with alteration on functions. Ages from 31 to 40 were the most representative on the sample chosen, where female sex predominated. The majority of patients showed cervical attrition in posterior teeth, while anterior teeth showed no signs. The existence of dental attrition was demonstrated, as well as the relation of this pathology to the alterations of the occlusion guide and the degree of teeth wearing away