Asociación entre la autoevaluación y el estado clínico de salud oral en adultos, Paraguay.

Introduction: Oral health can be defined as the absence of pathologies and disorders that affect the stomatognathic system. Objetives: This study aimed to determine the characteristics of self-assessment oral health status, in the clinical experience of dental caries, periodontal status, periodontal fixation loss and to investigate the association between self-reported and clinical oral health status among Paraguayans adults during early 2017. Material and Methods: The design is cross-sectional. Two dentists carried out the oral examinations following the recommendations of the World Health Organization (WHO). Results: There were 333 adult participants with a mean age of 35 ± 13 years. Most (77.2%) of the participants were female. Missing teeth (5.32±6), filled teeth (3.56±4), and decayed teeth (2.55±3) were also detected. Almost half (48.0%) of participants had dental calculus, while 5.8% had a periodontal pocket and 48.6% periodontal fixation loss. The self-perception of oral health was poor in 12.3% of participants, fair in 29.8%, normal in 31.8%, good in 16.2%, and excellent in 9.9%. Oral health self-assessment was positive in 58.0% and negative in 42.0%. A statistically significant difference was found when comparing the DMFT index according to self-perception of oral health, the score being higher in those who had negative self-perception; obtaining similar results in the decayed component. Conclusion: Negative oral health self-perception was associated with a high DMFT index, of this, the decayed component was the only one that presented statistically significant differences.Introducción: La salud bucodental puede ser definida como la ausencia de patologías y trastornos que afectan el sistema estomatognático. Objetivos: Este estudio tuvo como objetivo determinar las características de la autoevaluación del estado de salud bucal, en la experiencia clínica de la caries dental, el estado periodontal, la fijación de la pérdida periodontal e investigar la asociación entre el estado de salud bucal autoinformado y clínico entre los adultos paraguayos a principios de 2017. Material y Métodos: El diseño es transversal. Dos odontólogos fueron calibrados para el examen bucal, siguiendo las recomendaciones de la Organización Mundial de la Salud (OMS). Resultados: Participaron 333 sujetos, el promedio de edad fue de 34.93 (DE=12.64) años, 77.2% eran mujeres. El 21.1% de las piezas dentarias estaban perdidas, el 12.2% obturadas y el 9.2% cariadas. El 48.0% presentó cálculo dental, 5.8% el bolsa periodontal y el 48.6% pérdida de fijación. La autopercepción de salud bucal fue para el 12.3% pobre, el 29.8% regular, el 31.8% normal, el 16.2% buena y el 9.9% excelente. Tuvieron una autoevaluación de su salud oral positiva el 58.0% y negativa el 42.0%. Se encontró diferencia estadísticamente significativa al comparar el DMFT index según la autopercepción de salud oral, siendo mayor el puntaje en los negativos; obteniéndose resultados similares con el componente cariado. Conclusión: La autopercepción de salud oral negativa se asoció con un elevado DMFT index, de este, el componente cariado fue el único que presentó diferencias estadísticamente significativas

Validación del Perfil de Impacto de Salud Oral en español para adultos paraguayos (OHIP-14Py).

Objetive: The objective of this study was to culturally adapt and validate the short version of the Oral Health Impact Profile (OHIP) instrument into Spanish for use by Paraguayan adults who attended dental clinics. Material and methods: The design was a cross-sectional observational study based on Classical Test Theory (CTT). The original English language version was subjected to a forward-backward translation processes; a calibration of the examiners and pilot test were performed. The questionnaire was applied by dentists through interviews; the same dentists also made the oral examination. The dimensionality of the questionnaire was evaluated using Confirmatory Factorial Analysis (CFA). The total and item-total internal consistencies were evaluated using Cronbach’s alpha. To evaluate the discriminating validity, the Mann-Whitney and Kruskal-Wallis tests were used. Spearman’s correlation analysis was used to measure convergent validity for total-dimension, self-assessment of oral health, and dental caries experience index with the DMFT Index. Results: Three-hundred-thirty-three patients participated in the study. The CFA indicates the Paraguayan’s OHIP (OHIP-14Py) is considered a multi-dimensional instrument. The Cronbach’s alpha values were appropriate for both the total (?=0.061) and for item total (?=0.80) correlation. The OHIP-14Py discriminated for the variable self-perception of oral health (p=0.001), symptoms of the temporomandibular joint (TMJ) (p=0.026), need of upper dental prosthesis (p=0.001), need of lower dental prosthesis (p=0.001), and ?20 teeth healthy (p=0.001). For measuring convergent validity, all coefficients of correlation were statistically significant (p=0.001). Conclusion: The OHIP-14Py is a reliable and valid questionnaire for the evaluation of oral health-related quality of life in Paraguayan adults.Objetivo: El objetivo del estudio fue adaptar culturalmente y validar el instrumento Perfil de Impacto de Salud Oral (OHIP) en la versión corta de 14 ítems en español, en adultos paraguayos que acudieron a consultorios odontológicos durante el primer trimestre del año 2017. Material y Métodos: El diseño del estudio fue transversal, basado en la Teoría Clásica de los Test (TCT). La versión original en inglés fue sometida al proceso de traducción-retraducción. Se realizó calibración de exa-minadores y prueba piloto. El cuestionario fue aplicado por odontólogos mediante entrevista, quienes además realizaron examen bucal. Se evaluó la dimensionalidad del cuestionario mediante el Análisis Factorial Confirmatorio (AFC). La consistencia interna fue evaluada mediante Alfa de Cronbach (?) para total e ítem-total. Se evaluó la validez discriminante utilizando las pruebas de Mann-Whitney y Kruskal-Wallis, validez convergente utilizando correlación de Spearman para total-dominio, autoevaluación del estado de salud oral e índice de experiencia de caries CPO-D. Resultados: Participaron del estudio 333 pacientes de 18 a 59 años. El AFC se consideró al instrumento multidimensional. Para el total ?=0,861 y para correlación ítem-total al suprimir cada elemento ?=0,80 siendo todos adecuados. Discriminó para las variables autoevaluación de salud bucal (p=0,001), síntomas de ATM (p=0,026), necesidad de prótesis superior (p=0,001) e inferior (p=0,001) y ?20 dientes sanos (p=0,001). Todos los coeficientes de correlación de Spearman resultaron estadísticamente significativos con p=0,001. Conclusión: El OHIP-14Py es un cuestionario fiable y válido para la evaluación de la calidad de vida relacionada con la salud oral en adultos paraguayos

Estudio transversal sobre nivel de severidad de caries dental en adultos.

Introduction: Oral diseases affect some 3.9 billion people worldwide, the most prevalent are dental caries, gingivitis, and periodontitis. Untreated dental caries lesions affect 35% of the population. Objective: To determine the level of severity of dental caries lesions in adults treated at public dental services in the cities of Asunción and Pirayú, Paraguay, in 2017. Material and Methods: Sociodemographic and clinical variables of oral health status were evaluated by means of a cross-sectional study using consecutive sampling. Two dentists were calibrated to perform the oral examination. Caries experience was evaluated using the DMF-T index. The Chi square test and Fisher's exact test were applied, with a confidence level of 95%. Results: 333 subjects with a mean age of 35 years participated in the study, 77.2% were females, and 64.0% did not have access to private health care services. The DMF-T index was 11.43 (SD=6.7); 12.6% obtained a very low level, 35.7% low level, 41.7% had a medium level, and 9.9% had a high level in the DMF-T index. The DMF-T index was significantly higher in females (p=0.001), in the age range of 50 to 59 years (p<0.001), in those who did not have access to private health services (p=0.008), in those who reported a negative self-evaluation of their oral health (p=0.04), in those with a normal molar ratio (p=0.023) and a very severe aesthetic index (p<0.001). Conclusion: The general level of severity of global caries was medium and associated with sociodemographic and clinical variables.Introducción: Las enfermedades orales afectan a 3,9 billones de personas a nivel mundial, siendo las más prevalentes la caries dental, la gingivitis y periodontitis; afectando al 35% de la población las lesiones de caries dental no tratadas. Objetivo: Determinar el nivel de severidad de lesiones de caries dental en adultos que acuden a servicios odontológicos públicos en las ciudades de Asunción y Pirayú, en el Paraguay, en el año 2017. Material y Métodos: Estudio transversal donde se evaluaron variables sociodemográficas y clínicas del estado de salud oral. El muestreo fue de casos consecutivos. Dos odontólogos fueron calibrados para realizar el examen oral. La experiencia de caries fue evaluada mediante el índice CPO-D. Se aplicaron las pruebas Chi cuadrado y Test exacto de Fisher, con un nivel de confianza del 95%. Resultados: Participaron del estudio 333 sujetos, con edad promedio de 35 años, el 77,2% mujeres y el 64,0% no tenía acceso a servicios de salud privado. El índice CPO-D fue de 11,43 (DE = 6,7). El 12,6% obtuvo un nivel muy bajo, el 35,7% nivel bajo, el 41,7% tuvo nivel medio y el 9,9% nivel alto del CPO-D, siendo significativamente más elevado en mujeres (p=0,001), en la edad de 50 a 59 años (p<0,001), en aquellos que no cuentan con acceso a servicios de salud privado (p=0,008), los que relataron una autoevaluación negativa de su salud bucal (p=0,04), los que tenían una relación molar normal (p=0,023) e índice de estética muy grave (p<0,001). Conclusión: El nivel general de severidad de caries global fue medio, se asoció con variables sociodemográficas y clínicas

Impact of oral health on the quality of life of Paraguayan adults

Introduction: Alterations in the oral cavity can affect people’s quality of life, hence it is important to determine how the individual perceives their own health. Objective: To determine the oral health-related quality of life in adults who received dental care at establishments managed by the Ministry of Public Health and Social Welfare of Paraguay, the School of Dentistry of Universidad Nacional de Asunción, and the “Chacarita” Community Center, in Paraguay, in the first quarter of 2017. Material and Methods: A cross-sectional study was carried out. The Paraguayan version of the Oral Health Impact Profile (OHIP-14Py) was used. Spearman's correlation, Kruskal-Wallis, and Mann-Whitney tests were used to relate the impact of oral health with demographic, labor, educational, and clinical variables. Results: 333 subjects participated in the study. The most affected domains were physical pain, psychological distress, and psychological disability. The correlation between OHIP-14Py and DMF-T was positive but poor (r=0.236; p=<0.001). The oral health-related quality of life was significantly lower in subjects with abnormal oral mucosa (p=0.020), presence of TMJ symptoms (p=0.026), need for prostheses (p<0.001), higher level of severity of DMF-T (p<0.001), use of upper (p=0.004) and lower (p<0.001) prostheses, and absence of functional dentition (p<0.001). Conclusion: Primary and secondary preventive measures should be promoted since oral health status can negatively influence people’s quality of life and may even cause total inability to carry out daily activities

Guia per a la prevenció i control de la tuberculosi en el personal sanitari

Tuberculosi; Prevenció; Control; Personal sanitariTuberculosis; Prevención; Control; Personal sanitarioTuberculosis; Prevention; Control; Health staffLa Guia per a la prevenció de la tuberculosi en el personal sanitari recull tot el coneixement científic del moment actual en l’àrea de la prevenció de la tuberculosi i permet donar a conèixer la dedicació i el compromís de tots els professionals que han col·laborat en la realització d’aquesta guia. La revisió dels criteris comuns per investigar la infecció tuberculosa en el personal sanitari, establir els mecanismes de vigilància periòdica del personal amb risc d’infecció, així com sistemes de maneig de les situacions d’exposicions accidentals o de personal infectat, era necessària. Experts, investigadors i societats científiques hi han aportat el seu coneixement, experiència i expertesa amb la voluntat d’elaborar i consensuar unes recomanacions que han donat com a fruit els protocols més actualitzats i l’última evidència disponible en una àrea, la de la infecció i la malaltia tuberculosa en el personal sanitari, en la qual des de cap punt de vista s’ha d’abaixar la guàrdia, tot i els avenços realitzats els darrers anys

What is the perception of biological risk by undergraduate nursing students?

to analyze undergraduate nursing students' perception of biological risk and its relationship with their prior practical training. a descriptive cross-sectional study was conducted among undergraduate nursing students enrolled in clinical practice courses in the academic year 2013-2014 at the School of Nursing at the University of Barcelona. Variables: sociodemographic variables, employment, training, clinical experience and other variables related to the assessment of perceived biological risk were collected. Both a newly developed tool and the Dimensional Assessment of Risk Perception at the worker level scale (Escala de Evaluación Dimensional del Riesgo Percibido por el Trabajador, EDRP-T) were used. Statistical analysis: descriptive and univariate analysis were used to identify differences between the perception of biological risk of the EDRP-T scale items and sociodemographic variables. students without prior practical training had weaker perceptions of biological risk compared to students with prior practical training (p=0.05 and p=0.04, respectively). Weaker perceptions of biological risk were found among students with prior work experience. practical training and work experience influence the perception of biological risk among nursing students

Qual a percepção do risco biológico tem os estudantes da Licenciatura em Enfermagem?

Objectivo: analisar a percepção do risco biológico nos estudantes da Licenciatura de Enfermagem e a sua ligação com a formação prática previa. Método: estudo descritivo transversal realizado na Escola de Enfermagem da Universidade de Barcelona, em estudantes da Licenciatura de Enfermagem matriculados em disciplinas práticas do curso académico 2013-2014 (N=78). Variáveis: sociodemográficas, laborais, de formação, clinicas e referidas na avaliação do risco biológico percebido. Foi utilizado um instrumento de elaboração própria e a escala EDRP-T. Analise estatístico: descritivo e univariante para detectar se existiam diferenças entre a percepção do risco biológico dos itens da escala EDRP-T e as variáveis sociodemográficas. Resultado: os estudantes sem formação prática previa tiveram menos percepção do conhecimento e menor percepção dos danos derivados do risco biológico em comparação com os estudantes com previa formação prática (p=0.0.5 e p=0.04 respectivamente). Detectou-se menor percepção do risco biológico em estudantes com experiencia laboral previa. Conclusão: a formação práticas e experiencia laboral influenciam na percepção do risco biológico em estudantes de Enfermagem. Faltam estudos que relacionem a percepção do risco com o uso das medidas de prevenção durante a formação pratica e os acidentes do tipo biológicos ocorridos.Objetivo: analizar la percepción del riesgo biológico en los estudiantes de Grado de Enfermería y su relación con la formación práctica previa. Método: estudio descriptivo transversal realizado en la Escuela de Enfermería de la Universidad de Barcelona en estudiantes de Grado de Enfermería matriculados en asignaturas prácticas del curso académico 2013-2014. Variables: sociodemográficas, laborales, de formación, clínicas y referidas a la evaluación del riesgo biológico percibido. Se utilizó un instrumento de elaboración propia y la escala Evaluación dimensional del Riesgo Percibido (EDRP-T). Análisis estadístico: descriptivo y univariante para detectar si habían diferencias entre la percepción de riesgo biológico de los ítems de la escala EDRP-T y las variables sociodemográficas. Resultados: los estudiantes sin formación práctica previa tenían menor percepción de conocimiento y menor percepción de daño derivado del riesgo biológico con respecto a los estudiantes con formación práctica previa (p=0.05 y p=0.04 respectivamente). Se detectó menor percepción del riesgo biológico en los estudiantes con experiencia laboral previa. Conclusión: la formación práctica y la experiencia laboral influyen en la percepción del riesgo biológico de los estudiantes de enfermería.Objective: to analyze undergraduate nursing students' perception of biological risk and its relationship with their prior practical training. Method: a descriptive cross-sectional study was conducted among undergraduate nursing students enrolled in clinical practice courses in the academic year 2013-2014 at the School of Nursing at the University of Barcelona. Variables: sociodemographic variables, employment, training, clinical experience and other variables related to the assessment of perceived biological risk were collected. Both a newly developed tool and the Dimensional Assessment of Risk Perception at the worker level scale (Escala de Evaluación Dimensional del Riesgo Percibido por el Trabajador, EDRP-T) were used. Statistical analysis: descriptive and univariate analysis were used to identify differences between the perception of biological risk of the EDRP-T scale items and sociodemographic variables. Results: students without prior practical training had weaker perceptions of biological risk compared to students with prior practical training (p=0.05 and p=0.04, respectively). Weaker perceptions of biological risk were found among students with prior work experience. Conclusion: practical training and work experience influence the perception of biological risk among nursing students

Impact of the Introduction of a Two-Step Laboratory Diagnostic Algorithm in the Incidence and Earlier Diagnosis of Clostridioides difficile Infection

Our aim was to determine changes in the incidence of CD infection (CDI) following the introduction of a two-step diagnostic algorithm and to analyze CDI cases diagnosed in the study period. We retrospectively studied CDI (January 2009 to July 2018) in adults diagnosed by toxin enzyme immunoassay (EIA) (2009-2012) or toxin-EIA + polymerase chain reaction (PCR) algorithm (2013 onwards). A total of 443 patients with a first episode of CDI were included, 297 (67.1%) toxin-EIA-positive and 146 (32.9%) toxin-EIA-negative/PCR-positive were only identified through the two-step algorithm including the PCR test. The incidence of CDI increased from 0.9 to 4.7/10,000 patient-days (p < 0.01) and 146 (32.9%) toxin-negative CDI were diagnosed. Testing rate increased from 24.4 to 59.5/10,000 patient-days (p < 0.01) and the percentage of positive stools rose from 3.9% to 12.5% (p < 0.01). CD toxin-positive patients had a higher frequency of severe presentation and a lower rate of immunosuppressive drugs and inflammatory bowel disease. Mortality (16.3%) was significantly higher in patients with hematological neoplasm, intensive care unit admission and complicated disease. Recurrences (14.9%) were significantly higher with proton pump inhibitor exposure. The two-step diagnostic algorithm facilitates earlier diagnosis, potentially impacting patient outcomes and nosocomial spread. CD-toxin-positive patients had a more severe clinical presentation, probably due to increased CD bacterial load with higher toxin concentration. This early and easy marker should alert clinicians of potentially more severe outcomes

What is the perception of biological risk by undergraduate nursing students?

Podeu consultar la versió en castellà a http://hdl.handle.net/2445/106568Objective: to analyze undergraduate nursing students' perception of biological risk and its relationship with their prior practical training. Method: a descriptive cross-sectional study was conducted among undergraduate nursing students enrolled in clinical practice courses in the academic year 2013-2014 at the School of Nursing at the University of Barcelona (N=78). Variables: sociodemographic variables, employment, training, clinical experience and other variables related to the assessment of perceived biological risk were collected. Both a newly developed tool and the EDRP-T scale were used. Statistical analysis: descriptive and univariate analysis were used to identify differences between the perception of biological risk of the EDRP-T scale items and sociodemographic variables. Results: students without prior practical training had weaker perceptions of biological risk compared to students with prior practical training (p=0.05 and p=0.04, respectively). Weaker perceptions of biological risk were found among students with prior work experience. Conclusion: practical training and work experience influence the perception of biological risk among nursing students. There are few studies linking the perception of risk with the use of preventive measures during students' practical training and the occurrence of biological accidents

Aïllament epicàrdic de les venes pulmonars amb ultrasons d'alta intensitat per al tractament quirúrgic de la fibril·lació auricular no primària

Aquest és un estudi prospectiu observacional de cohorts de 59 malalts amb fibril·lació auricular no primària tractats amb ablació epicàrdica de venes pulmonars amb ultrasons