Asociación entre alteraciones psicológicas y la presencia de Liquen plano oral, Síndrome boca urente y Estomatitis aftosa recividante

OBJETIVO: El propósito de este estudio fue determinar la relación existente entre el Liquen Plano Oral (LPO),Estomatitis Aftosa Recividante (EAR), Síndrome de Boca Urente (SBU) y las alteraciones psicológicas del paciente, tales como el estrés, la ansiedad y la depresión. DISEÑO DEL ESTUDIO : Fueron estudiados 18 pacientes con EAR , 9 pacientes con LPO y 7 pacientes con SBU, que presentaron la lesión en el momento del examen, más un grupo control de 20 pacientes sanos. Ambos grupos fueron extraídos de centros hospitalarios y docentes, donde el diagnóstico clínico fue realizado por un equipo de patólogos orales. A los pacientes se les aplicó dos instrumentos de medición del estado psicológico del individuo: el Test de Experiencia Reciente, para medir el grado de estrés y la escala HAD, para determinar el nivel de ansiedad y depresión; los puntajes entregados por ellos fueron analizados estadísticamente a través del test T de Student no pareado y el Anova Tukey. RESULTADOS : Nuestros resultados sugirieron que hay una asociación estadísticamente significativa entre estos desórdenes psicológicos y las patologías de la mucosa oral en estudio. Se estableció que el nivel de estrés es mayor en los pacientes con EAR y LPO. Por otro lado la ansiedad es mayor en los tres grupos de pacientes con patología oral y la depresión es particularmente alta en los pacientes con SBU, todos estos datos respecto al grupo control. CONCLUSIONES : Existe una relación positiva entre alteraciones psicológicas y la EAR , LPO y SBU La EAR y el LPO se asociaron a altos niveles de estrés y ansiedad, mientras que el SBU se relacionó con importantes grados de ansiedad y depresión. De acuerdo a lo observado por nosotros, en el mantenimiento del estado de salud de los tejidos orales, los factores psicológicos desempeñan un papel importante.OBJECTIVE: The aim of this study was to determine the existing relation between the Oral Lichen Planus (OLP), Recurrent Aphthous Stomatitis (RAS), Burning Mouth Syndrome (BMS) and psychological alterations of the patient, such as stress, anxiety and depression. DESIGN OF THE STUDY: 18 patients with RAS, 9 patients with OLP and 7 patients with BMS, that presented the condition at the moment of the examination, were studied, as well as a control group of 20 healthy patients. Both groups were extracted of hospitals and universitary centers, where the clinical diagnosis was made by a team of oral pathologists. Two measuring instruments were applied to them about their psychological condition: the Test of Recent Experience, to measure the stress level and scale H.A.D., to determine the level of anxiety and depression; the score given by them were statistically analyzed through T-test and the Anova Tukey test. RESULTS: Our results suggested a statistically significant association between these psychological disorders and the diseases of the oral mucosa in study. It was observed that the stress level is greater in patients with RAS and OLP, depression is particularly high in patients with BMS, and levels of anxiety are rised in the three groups, in comparison with the group control. CONCLUSIONS: A positive relationship can be established between psychological alterations and RAS, OLP and BMS. The RAS and the OLP stress and anxiety levels were considered as high, whereas the BMS was more related to important levels of anxiety and depression. According to these findings it is possible to assume that psychological factors should be taking into account when oral health wants to be maintain as normal

Increased nuclear β-catenin expression in oral potentially malignant lesions: a marker of epithelial dysplasia

Background: Deregulation of β-catenin is associated with malignant transformation; however, its relationship with potentially malignant and malignant oral processes is not fully understood. The aim of this study was to determine and compare the nuclear β-catenin expression in oral dysplasia and oral squamous cell carcinoma (OSCC). Material and Methods: Cross sectional study. Immunodetection of β-catenin was performed on 72 samples, with the following distribution: 21 mild dysplasia, 12 moderate dysplasia, severe dysplasia 3, 36 OSCC including 19 well differentiated, 15 moderately differentiated and 2 poorly differentiated. Through microscopic observation the number of positive cells per 1000 epithelial cells was counted. For the statistical analysis, the Kruskal Wallis test was used. Results: Nuclear expression of β-catenin was observed in all samples with severe and moderate dysplasia, with a median of 267.5, in comparison to mild dysplasia whose median was 103.75. Only 10 samples (27.7%) with OSCC showed nuclear expression, with statistically significant differences between groups ( p < 0.05). Conclusions: Our results are consistent with most of the reports which show increased presence of β-catenin in severe and moderate dysplasia compared to mild dysplasia; however the expression of nuclear β-catenin decreased after starting the invasive neoplastic process. This suggests a role for this protein in the progression of dysplasia and early malignant transformation to OSCC. Immunodetection of β-catenin could be a possible immune marker in the detection of oral dysplasi

Experiencia de transferencia tecnológica de la Consejería Telefónica para Cuidados Crónicos de Salud, a equipos de Atención Primaria.

The technology transfer process requires training future users in specific knowledge and skills, as well as performing administrative adjustments for an effective incorporation of innovation into the structure of the system and into the professional care. Pontificia Universidad Católica de Chile's School of Nursing developed a model of Technological Support for Health Self-Care, which includes the use of telephone counseling to help people who suffer from chronic diseases manage their condition and look after themselves by teaching them techniques which alleviate their disease. Here, we present an experience that was carried out to transfer this technology to professionals related to the Cardiovascular Health Program in Chilean Public Primary Healthcare Centers located in a low-income district of Chile's capital city, Santiago, so that the technology could be applied to patients with type 2 diabetes who had joined such program. This process was conducted in two stages: 1. Making of a theoretical-practical workshop to support health decision-making and motivational strategies for health behavior change (workshops and demonstrations); and 2. Field demonstration, and monitoring with supervision and meetings at local level. The professionals who participated in the technology transfer program succeeded in developing the skills expected in the Telephone Counseling Tool to Support Self-Management of People suffering from DM2. Finally, to enable telephone counseling in clinical practice, healthcare centers restructured their system of service provisions, incorporating such counseling into their professional duties.El proceso de transferencia tecnológica exige capacitar en conocimientos y habilidades específicas a los futuros usuarios, así como también, la realización de adecuaciones administrativas para la incorporación efectiva de la innovación en la estructura del sistema y en la atención profesional.La Escuela de Enfermería a la que pertenecen los autores, desarrolló un modelo de Apoyo Tecnológico para el Autocuidado en Salud, que incluye el uso de consejerías telefónicas para apoyar a personas con enfermedades crónicas en el automanejo,  y autocuidado de su condición. Se presenta a continuación la experiencia llevada a cabo para  transferir esta tecnología a profesionales del Programa de Salud Cardiovascular en Centros de Atención Primaria públicos de una comuna de bajos recursos en Chile, para su incorporación en la atención de pacientes con diabetes tipo 2 adscritos a dicho programa.Este proceso se realizó en dos etapas: 1. Realización de un taller teórico práctico en apoyo a la toma de decisiones en salud y estrategias motivacionales para el cambio de conducta en salud (talleres y demostraciones) y 2. Demostración en terreno, y  seguimiento con supervisión y reuniones a nivel local.Los profesionales que participaron del programa de transferencia tecnológica, lograron desarrollar las destrezas esperadas en la herramienta de Consejería Telefónica de Apoyo al Auto-Manejo de Personas con DM2. Finalmente, para  incorporar las consejerías telefónicas en la práctica clínica, los centros de salud reestructuraron el sistema de prestación de servicios, integrando así dichas  consejerías a su quehacer profesional

Oral metastasis of renal cell carcinoma : presentation of a case

The oral cavity constitutes a site of low prevalence for metastasis of malignant tumors. Nevertheless, it has a high prevalence for metastasis of renal origin. Besides the kidneys, there are other primary sites with high prevalence of metastasis to the oral mucosa, such as the lungs, skin and breasts. Metastasis is common in patients with a background of treated renal tumors, thereby, it is proper to determine the possibility of oral metastasis as part of the protocol of attention. However, it constitutes a diagnostic challenge when it presents in patients with no renal antecedents. It is in this type of patients that the diagnosis of carcinoma is achieved by means of a metastasis. Survival rate in these patients is short because at the time of the metastasis diagnosis, the general compromise is high. The following report describes a case referred from the Rheumatology Unit with an intraoral tumor, that was finally diagnosed as a Metastasic Renal Cell Carcinoma with multiple metastasis

Salivary gland dysfunction markers in type 2 diabetes mellitus patients

Background: Diabetes mellitus (DM) is a chronic disease of the carbohydrate metabolism that, when not rigorously controlled, compromises systemic and organ integrity, thereby causing renal diseases, blindness, neuropathy, arteriosclerosis, infections, and glandular dysfunction, including the salivary glands. The aim of this study was to determine the relationship between the qualitative and quantitative parameters of salivary alteration, which are indicators of salivary gland dysfunction, and the level of metabolic control of type 2 diabetes patients. Material and Methods: A convenience sample of 74 voluntary patients with type 2 DM was selected, each of whom donated a sample of unstimulated saliva. Salivary parameters such as salivary flow rate, protein concentration, pH, and xerostomia were studied. Results: There is a positive relationship between the level of metabolic control measured with HbA1 and the protein concentration in saliva (Spearman rho = 0.329 and p = 0.004). The same assay showed an inverse correlation between HbA1 and pH (Spearman rho = -0.225 and p = 0.05). Conclusions: The protein concentration in saliva and, to a lesser extent, the pH may be useful as glandular dysfunction indicators in DM2 patients

Determination of susceptibility to sensitization to dental materials in atopic and non-atopic patients

Introduction: Some studies report that atopic patients have a greater frequency of delayed-type sensitization than non-atopic patients. Objective: To determine the influence of the atopic condition on delayed sensitization to dental materials. Design: cross-sectional study. Methods: Forty (40) atopic subjects and forty (40) non-atopic subjects, of both sexes, between 20 and 65 years of age were included. The determination of delayed sensitization to dental materials was performed using patch test. An oral exam was also carried out to check for lesions of the oral mucosa. Results: 61.25% of the patients were positive for delayed-type sensitization to one or more allergens, being palladium chloride (21.25%), ammoniated mercury (20%), benzoyl peroxide (12.5%) and amalgam (10%) the most frequent. The frequency of sensitization was 67.5% in the group of atopic patients, compared to 55% in the non atopic group (p>0.05). The materials with the greatest difference of sensitization in atopic compared to non-atopic patients were ammoniated mercury, benzoyl peroxide, amalgam and Bisphenol A Dimethacrylate (BIS-GMA). Conclusion: The atopic condition is not related to a higher frequency of delayed sensitization to a battery of dental materials. © Medicina Oral

De las notas de campo a la reflexión de la práctica pedagógica en Educación Parvularia. Una experiencia innovadora de investigación-acción

Favorecer el desarrollo de competencias investigativas y de reflexión sobre la propia práctica docente en educación parvularia. Se utilizó el registro de notas de campo de las experiencias pedagógicas ejecutadas durante la práctica profesional. Se reflejó la importancia de los aspectos actitudinales, conceptuales y metodológicos en la práctica pedagógica, evidenciando desafíos y oportunidades para la educadora en formación. El ambiente socioemocional al interior del aula influyó en la calidad del desempeño pedagógico. El rol de la educadora guía y las estrategias de retroalimentación de la práctica docente, fueron factores relevantes que influyeron en la sensación de seguridad y confianza al ejercer el rol pedagógico

Registro electrónico de enfermería en la valoración de las heridas

The wound assessment record, is the written and photographic documentation of their development and involves a process of observation, data collection and evaluation. With the advance of computer technology, have implemented various electronic record systems in the area of wound care. This literature review aims to describe the usefulness of electronic records as a support tool in the assessment area of the wounds. We conducted a thorough review of literature, the COCHRANE LIBRARY databases MEDLINE, PUBMED, Proquest NURSING &amp; ALLIED HEALTH SOURCE. Articles published from 1998 to 2010. Among the main results suggest that having an excellent documentation of assessment of injury, is essential due to medical reasons, legal, research, teaching, administration and human resources and communication with different members of health team. There are many benefits in using the use of electronic registration system (ERS), but there is no consensus whether the ERS or the manual registration system is the best way to record the activities of nursing. We recommend creating a user-friendly electronic format, with the participation of professionals working in the area of information technology, along with nursing professionals to define exactly what should be recorded in the assessment of injuries.El registro de la valoración de una herida, es la documentación escrita y fotográfica de su evolución y conlleva un proceso de observación, recolección de datos y evaluación. Con el avance de la informática, se han implementado diversos sistemas de registro electrónico en el área del cuidado de las heridas. La presente revisión de literatura tiene por objetivo describir la utilidad de los registros electrónicos como herramienta de apoyo en el área de la valoración de las heridas. Se realizó una exhaustiva revisión de literatura, de las bases de datos COCHRANE LIBRARY MEDLINE, PUBMED, PROQUEST NURSING &amp; ALLIED HEALTH SOURCE. Se incluyeron artículos publicados desde el año 1998 hasta el 2010. Dentro de los principales resultados se desprende que el contar con una óptima documentación de valoración de las heridas, es fundamental debido a razones clínicas, legales, de investigación, de docencia, de administración de recursos materiales y humanos y de comunicación con los diferentes miembros del equipo de salud. Existen variados beneficios en la utilización del uso del sistema de registro electrónico (SRE), sin embargo no existe consenso si el SRE o el sistema de registro manual, es la mejor manera de registrar las actividades de enfermería. Se recomienda la creación de un formato electrónico amigable, contando con la participación de profesionales relacionados al área de la informática, junto a profesionales de enfermería, para definir en forma exacta lo que debe registrarse en la valoración de las heridas. Palabras clave: registros, enfermería, registros electrónicos, manejo de heridas

Illness Experience and Quality of Life in Sjögren Syndrome Patients

Sjögren’s syndrome (SS) is a disease with autoimmune features that affects mainly women and compromises the health-related quality of Life (HRQoL); it is important to evaluate illness experience for a better understanding of the life situation of the patient. The aim of the study was to summarize the individual life experiences and determine the impact of HRQoL and oral health-related quality of life (OHRQoL) and their correlation with health self-assessment in women with SS. The life experiences evaluation employed a concept mapping design to structure qualitative content obtained from semi-structured interviews. Hierarchical cluster analysis was used to analyze the patient’s experiences. EQ-5D-5L and OHIP-14Sp were used. The correlation between appreciation of the general health status and OHIP-14 was evaluated. The experience classification by patients were analyzed and a dendrogram was obtained, identifying 10 clusters of disease experiences of SS, being limitations, pain and difficulties, coping and attitudes towards treatment the most common. Pain/discomfort in EQ-5D-5L and physical pain and psychological discomfort in OHIP-14 were the most affected dimensions in the patients. The results support the theoretical perspective that the experience of illness is relevant to describing the main difficulties of patients with SS and how it affects their quality of life