Diagnostico de salud oral en personas mayores postradas inscritas en el Centro de Salud Dr. Jose Dionisio Astaburuaga de la comuna de Talca

68 p.Introducción: Actualmente la poblaci6n mayor de 60 anos ha ido en aumento, esto, trae consigo un aumento de las enfermedades degenerativas, cr6nicas y tumores. Producto de estas enfermedades es que aproximadamente un 4% de las personas mayores de 60 anos, se encuentra postrado. Objetivo: Conocer el estado de la salud oral de los pacientes adultos mayores postrados inscritos en el Centro de Salud Dr. José D. Astaburuaga. Método: Estudio descriptivo de corte transversal no probabilístico. La poblaci6n a estudiar correspondi6 al universo de pacientes inscritos en el programa de Atenci6n Domiciliaria del Paciente Postrado. Previo un consentimiento informado se realiz6 un examen bucal y una entrevista tanto a pacientes como cuidadores. Resultados: El sexo predominante fue femenino; edad promedio, 81 anos. El 53,33% s6lo tuvo acceso a la educaci6n básica, 21,66% presentaba pluripatologias, 53,84% era desdentada total y 44,23% desdentada parcial. El índice COPD fue 26,35. El 58,33% tenían pr6tesis y 57,69% requería de pr6tesis dental nueva. El cuidador result6 ser la hija, de 55 anos, con nivel educacional bajo. Conclusiones: Se encontr6 un estado de salud oral y practicas de higiene oral deficiente en este grupo

Modifying the minimum criteria for diagnosing amnestic MCI to improve prediction of brain atrophy and progression to Alzheimer’s disease

Mild cognitive impairment (MCI) is a heterogeneous condition with variable outcomes. Improving diagnosis to increase the likelihood that MCI reliably reflects prodromal Alzheimer's Disease (AD) would be of great benefit for clinical practice and intervention trials. In 230 cognitively normal (CN) and 394 MCI individuals from the Alzheimer's Disease Neuroimaging Initiative, we studied whether an MCI diagnostic requirement of impairment on at least two episodic memory tests improves 3-year prediction of medial temporal lobe atrophy and progression to AD. Based on external age-adjusted norms for delayed free recall on the Rey Auditory Verbal Learning Test (AVLT), MCI participants were further classified as having normal (AVLT+, above -1 SD, n = 121) or impaired (AVLT -, -1 SD or below, n = 273) AVLT performance. CN, AVLT+, and AVLT- groups differed significantly on baseline brain (hippocampus, entorhinal cortex) and cerebrospinal fluid (amyloid, tau, p-tau) biomarkers, with the AVLT- group being most abnormal. The AVLT- group had significantly more medial temporal atrophy and a substantially higher AD progression rate than the AVLT+ group (51% vs. 16%, p <0.001). The AVLT+ group had similar medial temporal trajectories compared to CN individuals. Results were similar even when restricted to individuals with above average (based on the CN group mean) baseline medial temporal volume/thickness. Requiring impairment on at least two memory tests for MCI diagnosis can markedly improve prediction of medial temporal atrophy and conversion to AD, even in the absence of baseline medial temporal atrophy. This modification constitutes a practical and cost-effective approach for clinical and research settings.Peer reviewe

Genetic and environmental influences on sleep quality in middle‐aged men: a twin study

Poor sleep quality is a risk factor for a number of cognitive and physiological age-related disorders. Identifying factors underlying sleep quality are important in understanding the etiology of these age-related health disorders. We investigated the extent to which genes and the environment contribute to subjective sleep quality in middle-aged male twins using the classical twin design. We used the Pittsburgh Sleep Quality Index to measure sleep quality in 1218 middle-aged twin men from the Vietnam Era Twin Study of Aging (mean age = 55.4 years; range 51-60; 339 monozygotic twin pairs, 257 dizygotic twin pairs, 26 unpaired twins). The mean PSQI global score was 5.6 [SD = 3.6; range 0-20]. Based on univariate twin models, 34% of variability in the global PSQI score was due to additive genetic effects (heritability) and 66% was attributed to individual-specific environmental factors. Common environment did not contribute to the variability. Similarly, the heritability of poor sleep-a dichotomous measure based on the cut-off of global PSQI>5-was 31%, with no contribution of the common environment. Heritability of six of the seven PSQI component scores (subjective sleep quality, sleep latency, sleep duration, habitual sleep efficiency, sleep disturbances, and daytime dysfunction) ranged from 0.15 to 0.31, whereas no genetic influences contributed to the use of sleeping medication. Additive genetic influences contribute to approximately one-third of the variability of global subjective sleep quality. Our results in middle-aged men constitute a first step towards examination of the genetic relationship between sleep and other facets of aging.Accepted manuscrip

Diagnostico de salud oral de primigestas que acuden a control prenatal al Consultorio Dr. Jose D. Astaburuaga, Talca-2004.

71 p.El embarazo constituye una etapa de importantes cambios fisiológicos en la mujer, no sólo a nivel general sino también en los tejidos orales que junto a cambios de conducta en este período, pueden iniciar patologías bucodentales o agravar las ya establecidas. Siendo las más prevalentes a nivel oral la caries y la enfermedad periodontal. Basándose en la alta prevalencia de éstas patologías orales y del rol de la madre como fuente de transmisión principal de caries para sus hijos y, considerando que el Plan Nacional de Salud Bucodental del Ministerio de Salud a integrado como Compromiso de Gestión a primigestas, se hace necesario la realización de este estudio epidemiológico en Talca. Objetivo General: Conocer el estado de salud bucal de las primigestas que asisten a control prenatal en el consultorio Dr. J. D. Astaburuaga. Método: Estudio descriptivo, con una muestra de 80 embarazadas en control prenatal, entre los meses de Julio a Septiembre de 2004. Tras previo consentimiento informado se les realizó un examen bucal y una entrevista predeterminada para el estudio. Resultados: La edad promedio de las primigestas fue de 20 años ± 4.01. La prevalencia de caries correspondió a un 81.2% y todas presentaban algún tipo de enfermedad periodontal. El COPD promedio fue de 8.26 ± 3.81. Más de la mitad de las embarazadas (51 %) presentó dentición completa. El 29% nunca había recibido instrucción de higiene oral. El 55 % no tenía control odontológico al momento del examen. Conclusión: Los resultados de este estudio epidemiológico revelan que la atención odontológica prenatal, si bien a mejorado, sigue siendo insuficiente. Por ello, es importante seguir desarrollando y reforzando programas que operan en el ministerio de salud destinado a este grupo prioritario. Palabras Claves: Salud Pública – Chile, Salud Bucal Primigestas – Chile, Diagnóstico Embarazadas- Chile

Underdiagnosis of mild cognitive impairment: A consequence of ignoring practice effects

INTRODUCTION: Longitudinal testing is necessary to accurately measure cognitive change. However, repeated testing is susceptible to practice effects, which may obscure true cognitive decline and delay detection of mild cognitive impairment (MCI). METHODS: We retested 995 late-middle-aged men in a ∼6-year follow-up of the Vietnam Era Twin Study of Aging. In addition, 170 age-matched replacements were tested for the first time at study wave 2. Group differences were used to calculate practice effects after controlling for attrition effects. MCI diagnoses were generated from practice-adjusted scores. RESULTS: There were significant practice effects on most cognitive domains. Conversion to MCI doubled after correcting for practice effects, from 4.5% to 9%. Importantly, practice effects were present although there were declines in uncorrected scores. DISCUSSION: Accounting for practice effects is critical to early detection of MCI. Declines, when lower than expected, can still indicate practice effects. Replacement participants are needed for accurately assessing disease progression.Published versio

Should 16-Year-Olds Be Allowed to Donate Blood? A Vermont Perspective

Introduction: Supplying adequate blood for transfusions is an ongoing challenge for blood collection agencies. One potential source of increased Whole Blood (WB) supply is among 16-17 year-olds, whose donation rates are still quite low. In 2010, donors aged 16-18 years-old provided 14% of all WB collected by the American Red Cross. Young donors may represent an opportunity to establish a committed, long-term blood donation base as they are more likely to return after first donation and donate at a higher yield rate than older donors. However, younger donors also have higher rates of adverse events during donation. Currently, 38 states allow 16 year-olds to donate blood with parental consent but Vermont is not among them. Our study examines the public’s comfort with 16 year-olds donating blood. As blood donation is a voluntary system, ascertaining the perspective of the general population regarding this issue could contribute to a policy debate surrounding the minimum age of donation.https://scholarworks.uvm.edu/comphp_gallery/1065/thumbnail.jp

A test for common genetic and environmental vulnerability to depression and diabetes

Molecular genetic research has provided some evidence for the association between depression and metabolic disorders. We sought to determine if molecular findings are reflected in twin analyses testing if common genetic and environmental risk factors contribute to the co-occurrence of diabetes and depression. Data to derive depression and diabetes were collected from 1,237 male-male twins who participated in the 2005 Vietnam Era Twin Study of Aging (VETSA). The 1,237 twins were comprised of 347 MZ pairs, 3 MZ singletons, 267 DZ pairs and 6 unpaired twins. Depression was defined as a score below 46 on the Short Form-36 mental component summary score. Diabetes was defined by self report, use of anti-diabetic medications and insulin. Twin models were fit to estimate the correlation of genetic and environmental contributions to depression and diabetes. Consistent with other studies these data support the association between depression and diabetes (OR = 1.7; 95%CI: 1.1–2.7). Genetic vulnerability accounted for 50% (95%CI: 32%–65%) of the variance in risk for depression and 69% (95%CI: 52%–81%) of the variance in risk for diabetes. The genetic correlation between depression and diabetes was r = 0.19 (95%CI: 0–0.46) and the non-shared environmental correlation was r = 0.09 (95% CI: 0–0.45). Overall there is little evidence that common genetic and environmental factors account for the co-occurrence of depression and diabetes in middle aged men. Further research in female twins and larger cohorts is warranted

Mediators of the Effect of Childhood Socioeconomic Status on Late Midlife Cognitive Abilities : A Four Decade Longitudinal Study

Peer reviewe

IGEMS : The Consortium on Interplay of Genes and Environment Across Multiple Studies - An Update

The Interplay of Genes and Environment across Multiple Studies (IGEMS) is a consortium of 18 twin studies from 5 different countries (Sweden, Denmark, Finland, United States, and Australia) established to explore the nature of gene-environment (GE) interplay in functioning across the adult lifespan. Fifteen of the studies are longitudinal, with follow-up as long as 59 years after baseline. The combined data from over 76,000 participants aged 14-103 at intake (including over 10,000 monozygotic and over 17,000 dizygotic twin pairs) support two primary research emphases: (1) investigation of models of GE interplay of early life adversity, and social factors at micro and macro environmental levels and with diverse outcomes, including mortality, physical functioning and psychological functioning; and (2) improved understanding of risk and protective factors for dementia by incorporating unmeasured and measured genetic factors with a wide range of exposures measured in young adulthood, midlife and later life.Peer reviewe