Oral health-related quality of life in a group of patients with rheumatoid arthritis.

BACKGROUND: Rheumatoid arthritis (RA) and periodontitis (PD) are chronic diseases that are associated with connective tissue and bone destruction, which affects the quality of life of the people suffering from these conditions. The identification of social conditions and the determinants of RA and PD would permit the elaboration of policies and strategies based on social reality. OBJECTIVES: The aim of the present study was to identify the relationship between oral health-related quality of life (OHRQoL) and the indicators of general health and oral health in patients with RA. MATERIAL AND METHODS: A cross-sectional study involving 59 patients with RA was conducted between 2019 and 2020. Demographic, general health, periodontal, and oral health parameters were collected. In addition, the Oral Health Impact Profile-14 (OHIP-14) questionnaire was administered to each patient. A description of the OHIP-14 dimensions according to different variables was performed. The relationship between OHRQoL and general/oral health indicators was analyzed with logistic and linear regression analyses. RESULTS: The highest OHIP-14 scores were found in people that were 60 years of age and over, single, had low educational achievements, a low socioeconomic status, were unemployed, and had no health affiliation. In the adjusted model, the prevalence of the impact on OHRQoL was 1.34 (1.10-5.29) times greater in those with erosive RA than in those without, and 2.22 (1.16-29.50) times greater in those who self-reported morning stiffness. Regarding the stage of PD, those with stage IV had a prevalence of the impact on the OHRQoL of 70%, an average extent of 3.4 ±4.5 and a severity score of 11.5 ±22.0, with statistically significant differences. CONCLUSIONS: The dimensions with the greatest impact on the OHRQoL of patients were physical pain, discomfort and psychological disability. The type of RA and the severity of PD are indicators of worse scores on the OHRQoL scale.

Lack of association between periodontitis and rheumatoid arthritis.

BACKGROUND AND OBJECTIVE: Periodontitis and rheumatoid arthritis (RA) have been associated in a bidirectional way. The objective of this study was to determine the association between clinical parameters of periodontitis and RA. MATERIALS AND METHODS: Seventy-five (75) participants distributed in 3 groups (21 patients with periodontitis without RA, 33 patients with periodontitis with RA and 21 patients with reduced periodontium with RA) were included in this cross-sectional study. A full periodontal and medical examination was performed in each patient. Additionally, subgingival plaque samples for the detection of Porphyromonas gingivalis (P. gingivalis) and blood samples for biochemical markers of RA were also taken. Logistic regression analysis adjusted for confounding variables, Spearman's rank correlation coefficient and a linear multivariate regression were used to analyze the data. RESULTS: Patients with RA presented less severity of periodontal parameters. The highest levels of anti-citrullinated protein antibodies were detected in non-periodontitis patients with RA. Covariates such as age, P. gingivalis, diabetes, smoking, osteoporosis and use of medication were not associated with RA. All periodontal variables and P. gingivalis expressed a negative correlation with biochemical markers of RA (P<0.05). CONCLUSIONS: Periodontitis was not associated with RA. Furthermore, there was no correlation between periodontal clinical parameters and biochemical markers of RA.

Lack of association between periodontitis and rheumatoid arthritis / Falta de asociación entre periodontitis y artritis reumatoide

Background and objective: Periodontitis and rheumatoid arthritis (RA) have been associated in a bidirectional way. The objective of this study was to determine the association between clinical parameters of periodontitis and RA. Materials and methods: Seventy-five (75) participants distributed in 3 groups (21 patients with periodontitis without RA, 33 patients with periodontitis with RA and 21 patients with reduced periodontium with RA) were included in this cross-sectional study. A full periodontal and medical examination was performed in each patient. Additionally, subgingival plaque samples for the detection of Porphyromonas gingivalis (P. gingivalis) and blood samples for biochemical markers of RA were also taken. Logistic regression analysis adjusted for confounding variables, Spearman's rank correlation coefficient and a linear multivariate regression were used to analyze the data. Results: Patients with RA presented less severity of periodontal parameters. The highest levels of anti-citrullinated protein antibodies were detected in non-periodontitis patients with RA. Covariates such as age, P. gingivalis, diabetes, smoking, osteoporosis and use of medication were not associated with RA. All periodontal variables and P. gingivalis expressed a negative correlation with biochemical markers of RA (P<0.05). Conclusions: Periodontitis was not associated with RA. Furthermore, there was no correlation between periodontal clinical parameters and biochemical markers of RA.(AU)

Fundamento y objetivo: La periodontitis y la artritis reumatoide (AR) se han asociado de forma bidireccional. El objetivo de este estudio fue determinar la asociación entre parámetros clínicos de periodontitis y AR. Materiales y métodos: Setenta y cinco (75) participantes distribuidos en 3 grupos (21 pacientes con periodontitis sin AR, 33 pacientes con periodontitis con AR y 21 pacientes con periodonto reducido con AR) fueron incluidos en este estudio transversal. En cada paciente se realizó un examen médico y periodontal completo. Además, también se tomaron muestras de placa subgingival para la detección de Porphyromonas gingivalis(P. gingivalis) y muestras de sangre para marcadores bioquímicos de AR. Para analizar los datos se utilizó el análisis de regresión logística ajustado por variables de confusión, el coeficiente de correlación de rangos de Spearman y una regresión lineal multivariada. Resultados: Los pacientes con AR presentaron menor severidad de los parámetros periodontales. Los niveles más altos de anticuerpos antiproteína citrulinada se detectaron en pacientes con AR sin periodontitis. Las covariables como la edad, P. gingivalis, diabetes, tabaquismo, osteoporosis y uso de medicamentos no se asociaron con la AR. Todas las variables periodontales y P. gingivalis expresaron una correlación negativa con los marcadores bioquímicos de AR (p<0,05). Conclusiones: La periodontitis no se asoció con la AR. Además, no hubo correlación entre los parámetros clínicos periodontales y los marcadores bioquímicos de la AR.(AU)

The Effect of Periodontal Treatment on Clinical and Biological Indicators, Quality of Life, and Oral Health in Rheumatoid Arthritis Patients: A Quasi-Experimental Study.

Non-surgical periodontal therapy (NSPT) has been shown to have systemic effects. It has been suggested that, similar to rheumatoid arthritis (RA), periodontitis (PD) has an impact on general health, in terms of psychological, physical, and social aspects. This study determines the effect of periodontal treatment in RA activity, health-related quality of life, and oral health self-perception before and after periodontal treatment in RA patients. A quasi-experimental, prospective, non-randomized study was conducted, and 52 patients were included in the study. Periodontal parameters and the instruments disease activity score-28 (DAS-28), SF-36, and OHIP-14 were measured at baseline and at 3 months after NSPT. All differences were statistically assessed. The study protocol was registered in Clinical Trials (NCT04658615). No statistically significant differences were found in the scores of DAS-28 before and after the intervention in the group with PD and reduced periodontium. When the effect of periodontal treatment was analyzed in the group of 29 patients who were followed up, it was found that there were statistically significant differences before and after in variables such as psychological distress, emotional role, and mental health, which indicates an improvement in the scores of these variables. NSPT influenced the health-related quality of life measured with SF-36 and OHIP-14 in patients with RA. In conclusion, NSPT has an effect on self-reported quality of life and health indicators more than the RA activity as measured with DAS-28. However, the clinical effect of periodontal treatment in RA patients provides important data to support periodontal care in patients.

Effects of nonsurgical periodontal therapy in patients with rheumatoid arthritis: a prospective before and after study / Efectos de la terapia periodontal no quirúrgica en pacientes con artritis reumatoide: estudio prospectivo de antes y después

Abstract Background: periodontal therapy has been suggested to have systemic effects. However, studies of periodontal therapy in rheumatoid arthritis patients have produced controversial results. Aim: To compare the effects of nonsurgical periodontal therapy on biochemical markers of rheumatoid arthritis and periodontal parameters in patients with and without rheumatoid arthritis. Methods: a prospective before-and-after study was conducted that included 21 participants without and 29 participants with rheumatoid arthritis. Periodontal parameters, Porphyromonas gingivalis detection, C-reactive protein, rheumatoid factor and anti-citrullinated protein antibodies were measured at baseline and three months after nonsurgical periodontal therapy and the changes were statistically assessed. Results: In general, both groups presented statistically significant improvement in periodontal parameters (p<0.05). There was an increase in the counts of P. gingivalis in both groups at three months. In addition, there was a reduction in levels of anti-citrullinated protein antibodies and rheumatoid factor in participants with rheumatoid arthritis. In contrast, C-reactive protein levels increased in both groups but were higher in the rheumatoid arthritis group. Periodontal parameters in rheumatoid arthritis participants under disease-modifying antirheumatic drugs presented a slightly higher improvement (p <0.05). Conclusions: Nonsurgical periodontal therapy has similar improvements in periodontal parameters in patients with and without rheumatoid arthritis. In addition, nonsurgical periodontal therapy may benefit serum levels of anti-citrullinated protein antibodies and rheumatoid factors in patients with rheumatoid arthritis. NCT04658615.

Resumen Antecedentes: se ha sugerido que la terapia periodontal tiene efectos sistémicos. Sin embargo, los estudios de la terapia periodontal en pacientes con artritis reumatoide han producido resultados controvertidos. Objetivo: comparar los efectos de la terapia periodontal no quirúrgica sobre los marcadores bioquímicos de la artritis reumatoide y los parámetros periodontales en pacientes con y sin artritis reumatoide. Métodos: se realizó un estudio prospectivo de antes y después que incluyó a 21 participantes sin artritis reumatoide y 29 participantes con artritis reumatoide. Se midieron los parámetros periodontales, detección de Porphyromonas gingivalis, proteína C reactiva, factor reumatoide y anticuerpos anti-proteína citrulinada al inicio del estudio y tres meses después de la terapia periodontal no quirúrgica y los cambios se evaluaron estadísticamente. Resultados: En general, ambos grupos presentaron mejoría estadísticamente significativa en los parámetros periodontales (p <0.05). Hubo un aumento en los recuentos de P. gingivalis en ambos grupos a los tres meses. Además, hubo una reducción en los niveles de anticuerpos anti-proteína citrulinada y factor reumatoide en participantes con artritis reumatoide. Por el contrario, los niveles de proteína C reactiva aumentaron en ambos grupos, pero fueron más altos en el grupo de artritis reumatoide. Los parámetros periodontales en los participantes con artritis reumatoide bajo fármacos antirreumáticos modificadores de la enfermedad presentaron una mejoría ligeramente mayor (p <0.05). Conclusiones: La terapia periodontal no quirúrgica tiene mejoras similares en los parámetros periodontales en pacientes con y sin artritis reumatoide. Además, la terapia periodontal no quirúrgica puede beneficiar los niveles séricos de anticuerpos anti-proteína citrulinada y factor reumatoide en pacientes con artritis reumatoide. NCT04658615.

Association Between Tobacco Smoking, Dental Status and Self-perceived Oral Health in Elderly Adults in Colombia.

Tobacco smoking is responsible for several health problems, including mouth diseases. The aim of the present study was to establish the association between smoking and dental status and self-perceived oral health in a large group of elderly Colombian adults. Analysis of 18,937 survey records of participants aged ≥ 60 years old was conducted. Information regarding age, sex, skin color, socioeconomic level, education, marital status, denture use, partial tooth loss or edentulism, Geriatric Oral Health Assessment Index (GOHAI) and tobacco smoking was retrieved from the database. A descriptive analysis and multivariate logistic regression analysis were performed. Half of the participants were edentulous in the maxilla while mandibular teeth were more frequently retained in more than 60% of the participants. After adjusting for sex and age, smoking consistently increased the odds of partial or complete edentulism in the maxilla (OR 1.05; 95% CI 1.02-1.09) and mandible (OR 1.04; 95% CI 1.00-1.08). Nonetheless, the increase in the odds in the mandible was not statistically significant. The habit of smoking was associated with increased tooth loss that in the long-term may result in poor oral health affecting the quality of life of elderly people.

Occlusal trauma is associated with periodontitis: A retrospective case-control study.

BACKGROUND: Excessive occlusal forces and occlusal trauma have been implicated as co-destructive factors for periodontitis in animal models. The objective of this study was to assess the association between occlusal trauma and periodontitis. METHODS: A total of 167 cases and 205 controls were included for analysis. Occlusal trauma was the exposures of interest and was registered for cases and controls. Additional clinical co-variables were registered as well for further analysis. The association of the exposure and periodontitis was determined by the odds ratio and logistic regression analysis adjusted for confounders. RESULTS: Amalgam restorations, pathogenic occlusion and occlusal trauma were more frequent in cases as compared to controls (P ≤ 0.05). The distribution of pathogenic occlusion and occlusal trauma was similar according to the stage and class of periodontitis. Logistic regression analysis showed a significant association for cigarette smoking, systemic conditions, amalgam restorations, pathogenic occlusion, and occlusal trauma with periodontitis (P ≤ 0.05). After adjusting for confounding variables in the model, amalgam restorations and occlusal trauma remained strongly associated with periodontitis (P ≤ 0.05). CONCLUSIONS: Occlusal trauma is strongly associated with periodontitis. Additional long-term prospective studies are necessary to further understand the impact of the occlusal condition and periodontitis.

Effects of nonsurgical periodontal therapy in patients with rheumatoid arthritis: a prospective before and after study.

Background: periodontal therapy has been suggested to have systemic effects. However, studies of periodontal therapy in rheumatoid arthritis patients have produced controversial results. Aim: To compare the effects of nonsurgical periodontal therapy on biochemical markers of rheumatoid arthritis and periodontal parameters in patients with and without rheumatoid arthritis. Methods: a prospective before-and-after study was conducted that included 21 participants without and 29 participants with rheumatoid arthritis. Periodontal parameters, Porphyromonas gingivalis detection, C-reactive protein, rheumatoid factor and anti-citrullinated protein antibodies were measured at baseline and three months after nonsurgical periodontal therapy and the changes were statistically assessed. Results: In general, both groups presented statistically significant improvement in periodontal parameters (p<0.05). There was an increase in the counts of P. gingivalis in both groups at three months. In addition, there was a reduction in levels of anti-citrullinated protein antibodies and rheumatoid factor in participants with rheumatoid arthritis. In contrast, C-reactive protein levels increased in both groups but were higher in the rheumatoid arthritis group. Periodontal parameters in rheumatoid arthritis participants under disease-modifying antirheumatic drugs presented a slightly higher improvement (p <0.05). Conclusions: Nonsurgical periodontal therapy has similar improvements in periodontal parameters in patients with and without rheumatoid arthritis. In addition, nonsurgical periodontal therapy may benefit serum levels of anti-citrullinated protein antibodies and rheumatoid factors in patients with rheumatoid arthritis. NCT04658615.

Antecedentes: se ha sugerido que la terapia periodontal tiene efectos sistémicos. Sin embargo, los estudios de la terapia periodontal en pacientes con artritis reumatoide han producido resultados controvertidos. Objetivo: comparar los efectos de la terapia periodontal no quirúrgica sobre los marcadores bioquímicos de la artritis reumatoide y los parámetros periodontales en pacientes con y sin artritis reumatoide. Métodos: se realizó un estudio prospectivo de antes y después que incluyó a 21 participantes sin artritis reumatoide y 29 participantes con artritis reumatoide. Se midieron los parámetros periodontales, detección de Porphyromonas gingivalis, proteína C reactiva, factor reumatoide y anticuerpos anti-proteína citrulinada al inicio del estudio y tres meses después de la terapia periodontal no quirúrgica y los cambios se evaluaron estadísticamente. Resultados: En general, ambos grupos presentaron mejoría estadísticamente significativa en los parámetros periodontales (p <0.05). Hubo un aumento en los recuentos de P. gingivalis en ambos grupos a los tres meses. Además, hubo una reducción en los niveles de anticuerpos anti-proteína citrulinada y factor reumatoide en participantes con artritis reumatoide. Por el contrario, los niveles de proteína C reactiva aumentaron en ambos grupos, pero fueron más altos en el grupo de artritis reumatoide. Los parámetros periodontales en los participantes con artritis reumatoide bajo fármacos antirreumáticos modificadores de la enfermedad presentaron una mejoría ligeramente mayor (p <0.05). Conclusiones: La terapia periodontal no quirúrgica tiene mejoras similares en los parámetros periodontales en pacientes con y sin artritis reumatoide. Además, la terapia periodontal no quirúrgica puede beneficiar los niveles séricos de anticuerpos anti-proteína citrulinada y factor reumatoide en pacientes con artritis reumatoide. NCT04658615.

Calidad de vida relacionada con la salud en pacientes con cáncer escamocelular bucal, en la ciudad de Medellín (Colombia) / Health-related quality of life of patients with oral squamous cell carcinoma in Medellin (Colombia)

RESUMEN Objetivo: Determinar la CVRS de pacientes sobrevivientes al cáncer escamocelular bucal (CEB) tratados en la ciudad de Medellín en el periodo 2000-2011 y sus factores relacionados. Métodos: Estudio transversal anidado a una cohorte dinámica de análisis de supervivencia, en pacientes con CEB tratados en nueve centros oncológicos de la ciudad. Participaron 95 sobrevivientes. Según información de la historia clínica y encuesta estructurada, se recolectaron variables sociodemográficas y clínicas y el instrumento QLQ-C30 para CVRS. Se realizó análisis descriptivo, análisis bivariado entre las funciones del instrumento de CVRS según variables del estudio y análisis multivariado por regresión logística para observar las variables que más influyen en la CVRS en estos pacientes (odds ratio [OR], intervalos de confianza al 95% [IC 95%]). Resultados: Las escalas de calidad de vida y salud general y las escalas funcionales presentaron puntajes por encima del 75%, indicando mejor situación en estos aspectos. Cuando se analizan la escala de síntomas y de enfermedad y tratamiento, los puntajes no superan el 25%. Se presentaron diferencias estadísticamente significativas entre algunas funciones y dimensiones de la escala. Al analizar la CVRS en el modelo de regresión logística, las personas con problemas financieros (OR 22.93; IC 95% 5.11-102.84) reportaron más afectación en su CVRS. Conclusiones: La CVRS y sus diferentes dimensiones se ven afectadas en estos pacientes por factores sociodemográficos y clínicos.

ABSTRACT Objective: To determine the health-related quality of life (HRQoL) and associated factors of oral squamous cell carcinoma (OSCC) survivor patients. Methods: We conducted a cross-sectional study nested in a survival analysis dynamic cohort of OSCC patients cared for in nine cancer centers in the city of Medellin during the period 2000-2011. 95 survivors participated in this research. Sociodemographic and clinical variables were collected by clinical record and a survey. In addition, the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC QLQ-C30) was used for the assessment of HRQoL. We did a descriptive analysis of the study variables and a bivariate analysis between the dimensions of the QLQ-C30 instrument and the different study variables. Finally, we performed a multivariate analysis to observe the most influent variables in the HRQoL in these patients (odds ratios [OR], and 95% confidence intervals [95% CI]). Results: The scales of quality of life, global health, and functional scales presented scores above 75%, which indicates a better situation in these aspects. The scores of the scales of symptoms and symptoms of disease and treatment did not exceed 25%. Statistically significant differences occurred between some functions and dimensions of the scale. In the analysis of HRQoL by logistic regression model, patients with financial difficulties (OR 22.93, 95% CI 5.11-102.84) had a greater negative impact on their HRQoL. Conclusions: In these patients, HRQoL in its different dimensions is affected by some sociodemographic and clinical variables.

Características Sociodemográficas y Clínicas de los Pacientes Tratados por Primera Vez por Cáncer Escamocelular Oral. Medellín, Colombia / Sociodemographic and Clinic Characteristics of the Patients Threatened at First Time for Squamous Cell Oral Cancer. Medellín, Colombia

RESUMEN: Este estudio pretendió describir las características sociodemográficas y clínicas de los pacientes tratados por primera vez por cáncer escamocelular oral (CEB) en Medellín (Colombia). Para ello se realizó un estudio descriptivo anidado en una cohorte dinámica retrospectiva de casos de CEB, procedente de 9 centros oncológicos especializados de la ciudad entre 2000 y 2011, según la información de las historias clínicas y clasificadas según la CIE-10. Se recolectaron variables sociodemográficas y clínicas como: tratamiento recibido, localización del tumor, estadio del tumor, atención recibida (profesional), reporte de consumo de alcohol o cigarrillo, complicaciones asociadas al tratamiento de CEB. Se describieron las variables del estudio y pruebas Chi cuadrado para observar diferencias entre algunas características clínicas y el sexo. Se encontraron 778 casos de CEB en el periodo estudiado, con una edad promedio de diagnóstico de 63,5 (±13,6) años. Más de la mitad tenían estratos socioeconómicos y niveles educativos bajos. Un 56 % de las mujeres y un 63 % de los hombres fueron diagnosticados en un estadio IV del tumor. Los tratamientos más realizados fueron de tipo combinado o cirugía. Un 35% presentaron problemas cardiovasculares, aunque no se reportaron diferencias estadísticamente significativas entre la presencia de determinadas comorbilidades y el sexo. Se reportó el consumo de alcohol en un 19 % y de cigarrillo en un 51 % con mayor consumo en hombres en ambos casos y diferencias estadísticamente significativas (p<0,0001) con respecto a las mujeres. En cuanto a complicaciones asociadas al tratamiento para CEB, se reportaron con mayor frecuencia disfagia (47 %) y mucositis (24 %). Más de la mitad de los tumores de presentaron en la lengua. Se requieren estrategias que permitan sistemas de vigilancia epidemiológica para el CEB, así como mejorar los programas de prevención y tratamiento precoz para esta enfermedad en consonancia con las políticas y los planes nacionales y globales.

ABSTRACT: This study aimed to describe the sociodemographic and clinical characteristics of patients treated for first-time oral squamous cell carcinoma (OSCC), in Medellín (Colombia). For this purpose, a descriptive study was carried out within a retrospective dynamic cohort of OSCC cases from 9 specialized oncology centers in the city between 2000 and 2011, according to the information of the clinical records and classified according to the ICD-10. Sociodemographic characteristics were recorded and clinical variables were collected such as: Treatment received, tumor location, tumor stage, care received (professional), report of alcohol or cigarette consumption, complications associated with OSCC treatment. The study variables were described, and Chi square test was calculated in order to observe differences between some clinical characteristics and sex. In the study period 778 cases of OSCC were found, with an average age of diagnosis of 63.5 (± 13.6) years. More than half had low socioeconomic and educational levels. Fifty six percent of women and 63 % of men were diagnosed in stage IV of the tumor. Treatments performed most, were either combined or for surgery. Thirty five percent of the cases had cardiovascular problems, although no statistically significant differences were reported between the presence of certain comorbidities and sex. Alcohol consumption was reported in 19 % and smoking in 51 %, with higher consumption in men in both cases and statistically significant differences (p <0.0001) with respect to women. Regarding complications associated with treatment for OSCC, dysphagia (47 %) and mucositis (24 %) were reported more frequently. More than half of the tumors were presented in the tongue. Strategies are required that allow epidemiological surveillance systems for the OSCC, as well as to improve prevention and early treatment programs for this disease in line with national and global policies and plans.

Conocimientos y actitudes sobre la transmisión de la tuberculosis en estudiantes de odontología y terapia respiratoria

Introducción. La tuberculosis sigue siendo un problema importante de salud pública, que afecta tanto a trabajadores como estudiantes de la salud, quienes deben tener unos conocimientos adecuados y sólidos para asegurar una adecuada prevención y control de la enfermedad. Objetivo. Evaluar los conocimientos y actitudes sobre la transmisión de la tuberculosis en estudiantes de odontología y terapia respiratoria. Métodos. Estudio descriptivo realizado con 291 estudiantes de los programas de odontología y terapia respiratoria de una institución de educación superior de la ciudad de Medellín, quienes se encontraban en práctica clínica al momento del estudio. Ellos respondieron una encuesta que contenía información sociodemográfica, conocimientos y actitudes frente a la transmisión de la tuberculosis. Se realizó un análisis descriptivo y bivariado. Resultados. El 57,7% de los estudiantes de odontología y el 42,3% de los estudiantes de terapia respiratoria consideran que la tuberculosis es trasmitida por una bacteria, y respecto a si la tos es considerada un mecanismo de transmisión, el 89,2% de los estudiantes de odontología dijo que sí y el 10,8% de los estudiantes de terapia respondieron que no. Conclusiones. La mayoría de los estudiantes respondieron que el factor etiológico de la tuberculosis es una bacteria y en cuanto a la vacunación, la mayoría considera que es importante para la protección.

Introduction. Tuberculosis continues to be a major public health issue, affecting both workers and students of health, who must have adequate and solid knowledge to ensure adequate prevention and control of the disease. Objective. To evaluate the knowledge and attitudes on the transmission of tuberculosis in students of dentistry and respiratory therapy. Methods. A descriptive study was carried out with 291 students from the dentistry and respiratory therapy programs of a higher education institution in the city of Medellín, who were in clinical practice at the time of the study. They answered a survey based on sociodemographic information, knowledge and attitudes regarding the transmission of tuberculosis. A descriptive and bivariate analysis was carried out. Results. 57.7% of dentistry students and 42.3% of respiratory therapy students consider that tuberculosis is transmitted by a bacterium, and if cough is considered a transmission mechanism, 89.2% of dentistry students said that it was and 10.8% of the therapy students answered no. Conclusions. The majority of the students answered that the etiological factor of tuberculosis is a bacterium and regarding to vaccination, most of them consider it is important for protection.

Introdução. A tuberculose continua sendo um grande problema de saúde pública, afetando tanto os trabalhadores quanto os estudantes de saúde, que devem ter conhecimentos adequados e sólidos para garantir a prevenção e o controle adequados da doença. Objetivo. Avaliar os conhecimentos e atitudes sobre a transmissão da tuberculose em estudantes de odontologia e fisioterapia respiratória. Métodos. Foi realizado um estudo descritivo com 291 estudantes dos cursos de odontologia e fisioterapia respiratória de uma instituição de ensino superior da cidade de Medellín, que estavam em prática clínica na época do estudo. Eles responderam a uma pesquisa que continha informações sociodemográficas, conhecimentos e atitudes em relação à transmissão da tuberculose. Uma análise descritiva e bi-variada foi realizada. Resultados. 57,7% dos estudantes de odontologia e 42,3% dos estudantes de fisioterapia respiratória consideram que a tuberculose é transmitida por bactérias; com respeito a se a tosse é considerada um mecanismo de transmissão, 89 2% dos estudantes de odontologia disseram que sim e 10,8% dos estudantes de terapia responderam que não. Conclusões. A maioria dos estudantes respondeu que o fator etiológico da tuberculose é uma bactéria e a maioria considera a vacinação importante para a proteção.

Condición periodontal y su relación con variables sociodemográficas y clínicas en pacientes adultos de una institución docencia-servicio / Periodontal disease and its relationship with clinical and sociodemographic variables in adult patients treated in a service/teaching institution

RESUMEN: Objetivo: Determinar la prevalencia de enfermedad periodontal y los factores sociodemográficos y clínicos relacionados. Material y métodos: Se diseñó un estudio observacional, descriptivo y retrospectivo. Se incluyeron historias clínicas con los siguientes criterios: ≥ 35 años de edad, historia clínica y ficha periodontal completa y mínimo 10 dientes presentes en boca. Se analizaron variables sociodemográficas y clínicas periodontales y se estableció el diagnóstico periodontal de acuerdo con dos sistemas de clasificación (AAP y CDC-AAP). Se calculó el χ2 para analizar las diferencias entre variables sociodemográficas y clínicas con relación a la severidad de la periodontitis. Para variables cuantitativas se utilizó la prueba de la mediana. Resultados: La frecuencia de periodontitis fue 67.2% (periodontitis severa 43.2%) y gingivitis fue 32.8%. En 155 casos hubo acuerdo entre las dos clasificaciones cuando la periodontitis fue severa. La clasificación CDC-AAP produjo más casos de periodontitis moderada y sólo 47 casos en concordancia con el sistema AAP. Los pacientes con periodontitis presentaron mayor sangrado al sondaje, pérdida de inserción y bolsas periodontales (p < 0.001). Los pacientes con periodontitis perdieron más dientes que pacientes con gingivitis. La periodontitis fue más frecuente en hombres que en mujeres (p = 0.025). Los pacientes con periodontitis tuvieron un nivel educativo más bajo, enfermedades sistémicas, consumo de cigarrillo y alcohol y problemas de afiliación a la seguridad social. Conclusiones: La frecuencia de periodontitis en la población de estudio fue muy alta (60%) y se encontró relacionada con enfermedades sistémicas, cigarrillo, afiliación a la seguridad social y nivel educativo. La frecuencia de periodontitis se ve determinada por el sistema de clasificación que se utilice.

ABSTRACT: Objective: To determine prevalence of periodontal disease and related clinical and sociodemographic factors. Material and methods: An observational, descriptive and retrospective study was undertaken. Criteria to select patients were as follows: ≥ 35 years of age, full clinical history and periodontal chart and a minimum of ten teeth present in the mouth. Clinical periodontal and sociodemographic variables were examined; periodontal diagnosis was established according to two classification systems (AAP and CDC-AAP). χ2 was calculated in order to analyze differences among sociodemographic and clinical variables with respect to periodontitis severity. Median test was used for quantitative variables. Results: Periodontitis frequency was 67.2% (severe periodontitis 43.2%). Gingivitis frequency was 32.8%. In 155 cases there was concordance of two observers in cases of severe periodontitis. CDC-AAP classification established more cases of moderate periodontitis and only 47 cases in concordance with AAP system. Periodontitis patients exhibited greater bleeding upon probing, insertion loss and periodontal pockets (p < 0.001). Patients with periodontitis lost more teeth that patients with gingivitis. Periodontitis was more frequent in males than in females (p = 0.025). Patients with periodontitis exhibited lower educational levels, suffered systemic diseases, were addicted to tobacco and alcohol use and had encountered problems with their affiliation to social security services. Conclusions: Periodontitis frequency in studied population was high (60%), and found to be related to systemic diseases, tobacco use, affiliation to social security services and educational level. Periodontitis frequency was determined by used classification system.

Higiene bucal, caries dental y necesidades de tratamiento en escolares de 5, 7 y 12 años, municipio de Istmina, Chocó, Colombia (2013) / Oral Hygiene, Dental Caries and Treatment Needs in 5, 7 and 12 Year-Old School Children in the Village of Istmina, Chocó, Colombia (2013)

Antecedentes: Es necesario identificar la situación de salud bucal en grupos específicos para establecer programas efectivos. Objetivo: Describir el estado de higiene bucal, caries dental y de necesidades de tratamiento en escolares de 5, 7 y 12 años del municipio de Istmina (Chocó, Colombia). Métodos: Se realizó un estudio descriptivo en 294 escolares (48 % niñas), seleccionados por conveniencia, de 6 instituciones educativas oficiales. Por medio de encuesta y examen clínico se recogió información sociodemográfica, de uso de elementos de higiene bucal, grado de higiene bucal, índices ceo-d y COP-D (y sus componentes) y necesidades de tratamiento. Se efectuó análisis descriptivo univariado y bivariado e inferencia! mediante chi cuadrado. Resultados: Dos terceras partes de la población analizada tenían una higiene oral deficiente (mayor porcentaje en niños y en escolares de 7 años). El promedio ceo-d M fue de 2,5 ± 3,2, lo cual equivale a una prevalencia y experiencia de caries dental del 57 % y 59 % respectivamente. El promedio COP-D M file de 0,6 ± 1,2, con una prevalencia y experiencia de caries dental del 24 % y 28 % respectivamente. El índice de caries significativa fue de 1,9 ± 1,5. El 47 % requería obturaciones (promedio de 1,9 ± 1,5). Se presentaron diferencias significativas por edad y sexo tanto para caries dental como para necesidades de tratamiento. Conclusiones: Los indicadores de caries dental estaban en consonancia con las metas internacionales. Se identificaron algunas diferencias según factores sociodemográficos que requieren estudios a mayor profundidad desde la perspectiva de determinantes sociales.

Background There is a need to identify the oral health situation in every specific group in order to implement effective programs. Objective: To describe the oral hygiene status and treatment needs in 5, 7 and 12 year-old school children in the village of Istmina (Chocó, Colombia). Methods: A descriptive study was carried out in 294 school children (48% girls) selected for convenience reasons from six public schools. Clinical examinations were conducted, and surveys applied in order to gather information on sociodemographic, use of oral hygiene elements, oral hygiene level, ceo-d index and COP-d indexes (and its components), and treatment needs. A descriptive univariate analysis and an inferential bivariate analysis were conducted based on a Chi-square statistics. Results: Two thirds of the studied population had poor oral hygiene habits (a greater percentage was found in 7 year-old boys). The average ceo-d M index was 2.5 ± 3.2, which indicates a dental caries prevalence and experience of 57% and 59%, respectively. The average COP-DM index was 06 ± 1.2, with a dental caries prevalence and experience of 24% and 28%, respectively.The significant dental caries index was 1.9 ± 1.5; 47% of them required obturations (average: 1.9 ± 1.5). Signifi cant differences were found as per age and gender, both for dental caries and treatment needs. Conclusions: Dental caries indicators were similar to the expected international goals. Some differences were identified based on some sociodemographic factors, which requires more in-depth studies under a social determinant perspective.

Oral health-related quality of life in the elderly population receiving health care at the public hospital network in Medellín, Colombia, and its related factors.

Metrosalud is the largest public hospital network in the city of Medellin and one of the most important in Colombia providing health care to the most vulnerable population. The objective of the study was to determine the Oral HealthRelated Quality of Life (OHRQoL) and its related factors in the elderly population receiving health care at the public hospital network in Medellin (Colombia). A crosssectional design was used. Men and women ≥ 65 years old were considered for this research, selected from first consultation records by the institution's statistical unit for 2011, who accepted to participate after being contacted by telephone. Sampling was performed in two stages: simple random sampling for selecting Hospital Units HUand Health Centers HCthroughout the hospital network in the city, followed by random quota sampling in proportion to the number of elderly population assigned to each HU and HC. A total 342 patients (58.2% women) participated in the study. The project involved the use of a structured questionnaire and complete dental examination with information on sociodemographic data, selfperceived health variables (mental, general and oral), use of oral health services, Oral HealthRelated Quality of Life (OHRQoL as measured with GOHAI index), temporomandibular joint test, oral mucosa, soft tissue evaluation, periodontal, dental and prosthetic examination. Descriptive and bivariate analyses were conducted to determine statistically significant differences. Multivariate analysis was performed, using logistic regression, calculating crude and adjusted odds ratios (OR) with their 95% confidence intervals (95% CI). Impacts were found to be generated by education levels, differences in socioeconomic status and urban or rural housing conditions. The results of this research show low OHRQoL levels in the elderly population receiving health care services at the public hospital network in Medellin.

Metrosalud es la Empresa Social del Estado (E.S.E.) y red hospitalaria pública más grande de la ciudad de Medellín y una de las más importantes del país en materia de atención en salud a la población más vulnerable. El objetivo de este estudio fue determinar la calidad de vida relacionada con salud bucal (CVRSB) en la población adulta mayor atendida en la red hospitalaria pública de Medellín (Colombia) y sus factores relacionados. Se realizó un estudio descriptivo trasversal. La muestra fue constituida por población adulta mayor de la ESE Metrosalud. Hombres y mujeres mayores de 65 años fueron considerados para esta investigación y fueron seleccionados de los registros de consulta de la unidad de estadística de la institución (año 2011) e invitados a participar a través de contacto telefónico. Se realizó un muestreo en dos etapas, en primer lugar se seleccionaron aleatoriamente los centros y unidades hospitalarias y en segundo lugar se realizó un muestreo por cuotas teniendo en cuenta la distribución de adultos mayores, uso del Índice GOHAI, examen de articulación temporomandibular, mucosa bucal, evaluación de tejidos blandos, examen periodontal, dental y protésico. Se realizaron análisis de 342 adultos mayores (58,2% mujeres) participaron en el estudio. El proyecto contempló la utilización de encuesta estructurada y examen odontológico completo, con información sobre datos sociodemográficos, variables de salud autopercibida (mental, general y bucal), utilización de servicios de salud bucal, calidad de vida relacionada con la salud bucal (CVRSB). Análisis descriptivos y bivariados fueron realizados para observar diferencias estadísticamente significativas. Se realizó análisis multivariado por regresión logística, calculando odds ratios (OR) crudas y ajustadas con sus intervalos de confianza al 95% (IC 95%). Los hallazgos indican impactos en la Calidad de Vida Relacionada con la Salud Bucal CVRSBgenerados por variables como los niveles de educación, las diferencias en niveles socioeconómicos y las condiciones de la vivienda urbana o rural. Los resultados de esta investigación muestran bajos niveles de CVRSB en la población adulta mayor vinculados a los servicios de la red de publica hospitalaria en la ciudad de Medellín.

Signos y síntomas de trastornos temporo-mandibulares en la población adulta mayor atendida en la red hospitalaria pública de Medellín (Colombia) / Signs and symptoms of temporomandibular joint disorders in elderly population treated within the public hospital network of Medellin (Colombia)

Resumen: Objetivo: Determinar la prevalencia de signos y síntomas de trastornos temporomandibulares en adultos mayores de Medellín y sus factores relacionados. Material y métodos: Estudio transversal en la red hospitalaria «Metrosalud¼. Participaron 342 adultos ≥ 65 años (57.8% mujeres). Variables: sociodemográficas y apoyo social (Duke-11); estrés autopercibido, salud mental, salud general autopercibida, satisfacción estado dental, salud bucal autopercibida, problemas bucales (últimos 30 días), número de dientes presentes, presencia de prótesis (superior/inferior); índice anamnésico de Helkimo y evaluación clínica. Se calculó la prevalencia de trastornos temporomandibulares-índice anamnésico de Helkimo según variables sociodemográficas y de salud y de trastornos temporomandibulares según evaluación clínica. Se estimó la asociación entre trastornos temporomandibulares-índice anamnésico de Helkimo e indicadores de salud y trastornos temporomandibulares clínicos mediante regresión logística calculando Odds Ratio crudas y ajustadas con intervalos de confianza al 95% (IC95%). Resultados: La prevalencia de síntomas severos fue mayor en hombres (32%) y de síntomas leves en mujeres (18%), con diferencias según factores sociodemográficos. Las personas que reportan síntomas tienden a reportar mayores prevalencias de malos indicadores de salud general y bucal. La mayor asociación se encontró para los problemas dentales en los últimos 30 días (ORa 3.57; IC95% 1.80-7.08) en el caso de las mujeres y para los hombres en mala salud mental (ORa 2.83; IC95% 1.31-6.09). Aunque las mujeres presentaron mayor riesgo de reportar problemas relacionados con la ATM (excepto para la presencia de ruidos articulares), no se encontraron asociaciones estadísticamente significativas. Conclusiones: Se requieren sistemas de vigilancia epidemiológica que permitan establecer con mayor claridad las asociaciones encontradas.

Abstract: Objective: To determine prevalence of temporomandibular joint disorders signs and symptoms of elderly adults in Medellin as well as related factors. Material and methods: The present was a crosssectional study conducted at the «Metrosalud¼ hospital network. The study was composed of 342 adult patients ≥ 65 years, (57.8% females) Variables: Socio-demographical and social support (Duke- 11); Self-perceived stress, mental health, self-perceived general health, satisfaction with respect to dental circumstances, self-perceived oral health, oral problems (previous 30 days), number of teeth present, presence of prostheses (upper/lower), Helkimo Anamnestic Index and clinical assessment. Prevalence of temporomandibular joint disorders- Helkimo Anamnestic Index was assessed with respect to health and socio-demographic variables, temporomandibular joint disorders was assessed according to clinical evaluation. Association between temporomandibular joint disorders-Helkimo Anamnestic Index and health indicators was evaluated as well as clinical temporomandibular joint disorders by means of logistic regression calculating crude and adjusted Odds Ratio with 95% (CI95%) confidence intervals. Results: Prevalence of severe symptoms was higher in males (32%), females exhibited higher prevalence of mild symptoms (18.8%); differences were found according to socio-demographic factors. Subjects reporting symptoms tended to report higher prevalence of poor oral and general health indicators. Higher association was found for patients with dental problems in the previous 30 days. (aOR 3.57; CI95% 1.80-7.08) in the case of women and, for men, the indicator was poor mental health (aOR 2.83; CI95% 1.31-6.09) Even though females exhibited greater risk of reporting TMJ related problems (except for the presence of articular noises) no statistical significant associations were found. Conclusions: Further epidemiological surveillance systems are required in order to suitably and clearly establish associations found in the present study.

Ethnicity and Health in Colombia: What Do Self-Perceived Health Indicators Tell Us?

OBJECTIVE: To compare self-perceived health indicators between ethnic groups in Colombia. METHODS: Cross-sectional study with data from the 2007 National Public Health Survey (ENSP-2007). Data from 57,617 people ≥18 years were used. Variables included: belonging to an ethnic group (exposure); self-rated health; mental health problems, injuries for accidents/violence (outcomes); sex, age, education level and occupation (explicative/control). A descriptive study was carried out of the explicative variables, and the prevalence of the outcomes was calculated according to ethnicity, education level and occupation. The association between the exposure variable and the outcomes was estimated by means of adjusted odds ratios (OR) with 95% CI using logistic regression. Analyses were conducted separately for men and women. RESULTS: The prevalence of outcomes was higher in people reporting to belong to an ethnic group and differences were found by sex, ethnic groups and health outcomes. Women from the Palenquero group were more likely to report poor self-rated health (aOR 7.04; 95%CI 2.50-19.88) and injuries from accidents/violence (aOR 7.99; 95%CI 2.89-22.07). Indigenous men were more likely to report mental health problems (aOR 1.75; 95%CI 1.41-2.17). Gradients according to ethnicity, education, occupation and sex were found. CONCLUSIONS: Minority ethnic groups are vulnerable to reporting poor health outcomes. Political actions are required to diminish health inequalities in these groups.

Condiciones de salud oral y estado protésico de la población adulta mayor atendida en la red hospitalaria pública de Medellín (Colombia) / Oral health conditions and prosthetic status in elderly population assisted by the public hospital network of Medellin (Colombia)

Este estudio pretendió analizar las condiciones de salud oral y el estado protésico de la población adulta mayor atendida en la red hospitalaria pública de Medellín (Colombia). Se realizó un estudio transversal mediante muestreo bi-etápico en las unidades hospitalarias y centros de salud adscritos a esta red. Participaron 342 adultos de 65 y más años (58,2 % mujeres). Se recogió información a través de encuesta y examen clínico. Variables: Sociodemográficas: edad, sexo, estrato socioeconómico, nivel educativo, zona de residencia, apoyo social (Duke-11). Salud oral: Percepción de salud oral, presencia de problemas orales en el último mes. Indicadores clínicos: Índice COPD, dientes presentes, estado de prótesis dentales, problemas de la mucosa oral. Análisis univariado y bivariado y cálculo de pruebas Chi cuadrado para observar diferencias estadísticamente significativas entre las variables. Se encontró que las personas 75 años, los hombres, la población de estratos socioeconómicos y nivel educativo bajos, ubicados en área urbana y con apoyo social bajo tienden a reportar mala salud oral autopercibida. El promedio de dientes presentes en la población fue de 5,7 (±7,8), lo que implica un COPD promedio de 24,2 (±5,9), con diferencias de acuerdo a variables sociodemográficas. Más del 55 % de los hombres y las mujeres requieren cambio de prótesis inferior y un 70 % requieren cambio de prótesis superior. Se encontraron problemas de la mucosa oral: candidiasis (12 %), ulceras (7 %), leucoplasia (7 %), liquen plano (1 %). En conclusión se evidencian deficientes condiciones de salud oral que pueden ser explicadas por la situación de vulnerabilidad social que enfrenta esta población y barreras de acceso a servicios de salud oral preventivos y curativos.

This study aimed to analyze oral health conditions and prosthetic status in elderly population assisted by the public hospital network in Medellin (Colombia). A cross sectional study was conducted by means a two-stage sampling in hospital units and health centers attached to this network. 342 adults aged 65 and over (58.2 % women) participated and the information was collected through survey and clinical examination. Variables: Sociodemographic: age, sex, socioeconomic status, educational level, place of residence, social support (Duke-11). Oral Health: Self-perceived Oral health, presence of oral problems in the last month. Clinical indicators: DFMT Index, present teeth, state of dentures, oral mucosa problems. Univariate and bivariate analysis and calculation of chi-square tests were carried out to observe statistically significant differences among different variables. As main findings people 75 years, men, people of socioeconomic and educational level lower, located in urban areas and with low social support tend to report poor self-perceived oral health. The average teeth in the population was 5.7 (±7.8), implying a 24.2 average DFMT (±5.9), differing according to demographic variables. Over 55 % of men and women require lower denture change and 70 % of them require change of upper prostheses. Main oral mucosa problems were observed: Candidiasis (12 %), ulcers (7 %), leukoplakia (7 %), lichen planus (1 %). As a conclusion poor oral health conditions was observed and they can be explained on the situation of social vulnerability faced o this population and barriers to preventive and curative oral health care.

Salud bucal y género en relación a la población adulta mayor atendida en la red hospitalaria pública de Medellín: Los puntos de vista del personal de salud / Oral health and gender in relation to the elderly population assisted by the public hospital network of Medellin: The health personnel points of view

Objetivo: Explorar las percepciones sobre salud bucal y género con relación a la población adulta mayor que consulta la red hospitalaria pública de Medellín desde la perspectiva de los prestadores de servicios de salud. Materiales y métodos: Estudio cualitativo con perspectiva etnográfica mediante 34 entrevistas semi-estructuradas en personal que presta servicios de salud en la Empresa Social del Estado -E.S.E- Metrosalud. Las entrevistas se transcribieron textualmente y se realizó análisis de contenido según categorías propias de los discursos de los participantes. Resultados: Se encontraron tres categorías principales: 1) Necesidades y problemas de salud general y bucal y sus determinantes; 2) Símbolos y significados de la población adulta mayor; 3) Perspectiva y roles de género y su relación con las prácticas sociales en salud bucal. En general, los prestadores perciben alta carga de enfermedad y barreras de acceso a los servicios de salud. Se percibieron diferencias de género relacionadas con los roles que asumen las personas, las prácticas de autocuidado, y los perfiles de utilización de los servicios de salud. Conclusiones: Los prestadores entrevistados perciben como la población adulta mayor que consulta a la red prestadora de servicios pública de Medellín se encuentra en situación de vulnerabilidad social que impacta en las condiciones de salud bucal. De igual manera, se perciben diferencias de género relacionadas. Se requieren políticas sociales que garanticen equidad para este grupo poblacional.

Objective: To explore the perceptions about oral health and gender in relation to the elderly population assisted by the public hospital network of Medellin from the health personnel perspective. Materials and methods: A qualitative and ethnographic study was conducted through 34 semi-structured interviews in health personnel in the State Social Enterprise E.S.E Metrosalud. Interviews were transcribed and a content analysis was carried out according to categories from the participants' discourses. Results: Three main categories were found: 1) Needs and problems of general and oral health and their determinants; 2) Symbols and significances of the elderly; 3) Perspectives and gender roles and its relationship with social practices on oral health. In general terms, participants perceived high disease burden and barriers of access to health services. In addition, gender differences were perceived related to the roles that people assume, self-care practices and health services utilization profiles. Conclusions: Interviewed providers perceived that the elderly population assisted by the public hospital network of Medellin is exposed to social vulnerability that affects oral health conditions. In addition, gender related differences were found. Social policies that ensure equity in this population group are required.

A survival rate of oral squamous cell carcinoma patients treated for the first time in cancer centers between 2000 and 2011, Medellín-Colombia * / Supervivencia de los pacientes con cáncer escamocelular bucal, tratados por primera vez, en centros oncológicos en el periodo 2000 a 2011, Medellín-Colombia

ABSTRACT Introduction: the goal of this study is to determine the survival rate of patients white oral squamous cell carcinoma (OSCC) who were treated for the first time in 9 cancer centers over a period of 12 years. Methods: analysis of survival rate based on a retrospective sample of 630 cases of oral squamous cell carcinoma (OSCC), according to individual and clinical variables. Relevant life tables were created in order to identify some of the characteristics related to patient survival time; the Kaplan-Meier method, the log Rank test, and the Cox proportional hazards model were used to assess survival significance in relation to relevant variables. Results: average patient age at the time of diagnosis was 63.5 years (SD = 13.6 years). 28.1% (177) of them died as a direct consequence of oral cancer, according to death certificates filled out by doctors on duty. Median survival rate was 6.1 years, and when discriminated by sex, age groups, and stage of disease, the median was higher in women, in patients under 50 years of age, and in those who were diagnosed with OSCC in stage I and received surgery as single treatment. Conclusions: the survival rate of OSCC patients who were treated for the first time in nine cancer centers of the city of Medellín in a 12-year period was 6.1 years. The authors recommend implementing a surveillance program allowing early diagnosis in order to decrease the sequelae and mortality from this disease.

RESUMEN Introducción: el objetivo de este estudio fue determinar la supervivencia de los pacientes con cáncer escamocelular bucal (CEB) que fueron tratados por primera vez en 9 centros oncológicos en un periodo de 12 años. Métodos: se hizo un análisis de supervivencia basado en una cohorte dinámica retrospectiva de 630 casos de cáncer escamocelular bucal (CEB), según variables de personas y clínicas. Con el fin de identificar algunas características relacionadas con el tiempo de supervivencia de los pacientes, se construyeron las tablas de vida pertinentes; en la valoración de la significación de la supervivencia con respecto a variables de interés, se utilizó el método de Kaplan-Meier, el test de log Rank y el modelo de riesgos proporcionales de Cox. Resultados: la edad promedio de los pacientes al momento del diagnóstico fue 63,5 años (DE=13,6 años). El 28,1% (177) de éstos falleció por causa directa del cáncer bucal, de acuerdo con el certificado de defunción diligenciado por el médico de turno. La mediana de supervivencia fue de 6,1 años, y cuando esta se discriminó por sexo, grupos de edad y estadio de la enfermedad, la mediana fue mayor en mujeres, en menores de 50 años, en quienes estaban diagnosticados con CEB en el estadio I y cuyo único tratamiento fue la cirugía. Conclusiones: la supervivencia de los pacientes con CEB que fueron tratados por primera vez en nueve centros oncológicos de la ciudad de Medellín en un periodo de 12 años fue de 6,1 años. Se recomienda implementar un programa de vigilancia epidemiológica que permita hacer un diagnóstico precoz con el fin de disminuir las secuelas y la mortalidad por esta enfermedad.

A Multilevel Approach on Self-Reported Dental Caries in Subjects of Minority Ethnic Groups: A Cross-Sectional Study of 6440 Adults.

Regional contextual factors and dental caries using multilevel modeling related to adults in minority ethnic groups have been scantily explored. The influence of the socioeconomic context on self-reported dental caries (SRDC) in individuals of minority ethnic groups (IEG) in Colombia was studied. Data from the 2007 National Public Health Survey were collected in 34,843 participants of the population. The influence of different factors on SRDC in IEG was investigated with logistic and multilevel regression analyses. A total of 6440 individuals belonged to an ethnic group. Multilevel analysis showed a significant variance in SRDC that was smaller in IEG level than between states. Multilevel multivariate analysis also associated SRDC with increasing age, lower education level, last dental visit >1 year, unmet dental need and low Gross Domestic Product (GDP). Minority ethnic groups were at risk to report higher dental caries, where low GDP was an important variable to be considered.