Consumo de café como factor protector contra cáncer oral y faríngeo: análisis crítico de la literatura.

The high and unequal prevalence of oral and pharyngeal cancer, together with the high consumption of coffee worldwide, make studies to analyze how the consumption of these drinks containing methylxanthines contributes, in the risk of these neoplasms, although with contradictory results. The objective of the present study was to verify the validity and applicability of the results regarding the effectiveness of high coffee consumption in adults as a protective factor for oral and pharyngeal cancer and answer the following question: ¿can a high consumption of coffee in drink be a protective factor against oral and pharyngeal cancer? The article by Miranda et al (2017) was analyzed: “Coffee is protective against oral and pharyngeal cancer: a systematic review and meta-analysis”. A significant protective association was found between coffee consumption and the risk of oral cancer, and especially pharyngeal (z = 2.34, p = 0.019, OR = 0.72), inferring that the development of oral cancer in individuals who consume large amounts of coffee is 1.45 times lower than in individuals who consume small quantities or do not consume (OR = .69; 95% CI = .57-.84). However, with the methodological limitations of the primary studies included in the systematic review with meta-analysis, we do not consider the current moderate evidence sufficient to recommend the consumption of high quantities of the beverage of coffee to prevent oral or pharyngeal cancer in adults.La alta y desigual prevalencia de cáncer oral y faríngeo, junto al alto consumo de café a nivel mundial, hacen que se realicen estudios para analizar cómo contribuye el consumo de estas bebidas que contienen metilxantinas, en el riesgo de estas neoplasias, aunque con resultados contradictorios. El objetivo del presente estudio fue comprobar la validez y la aplicabilidad de los resultados con respecto a la efectividad del alto consumo de café en adultos como factor protector del cáncer oral y faríngeo y responder al siguiente interrogante: ¿puede un alto consumo del café en bebida ser un factor protector contra el cáncer oral y faríngeo? Se analizó el artículo de Miranda et al (2017): “El café es protector contra el cáncer oral y faríngeo: una revisión sistemática y meta-análisis". Se encontró una asociación protectora significativa entre el consumo de café y el riesgo de cáncer oral, y faríngeo especialmente (z=2.34, p=0.019, OR=0.72), infiriendo que el desarrollo del cáncer oral en individuos que consumen grandes cantidades de café es 1.45 veces menor que en individuos que consumen poca cantidad o no consumen (OR = .69; 95% IC=.57-.84). No obstante, con las limitaciones metodológicas de los estudios primarios incluidos en la revisión sistemática con metaanálisis, no consideramos suficiente la evidencia actual moderada para recomendar el consumo de altas cantidades de la bebida de café para prevenir cáncer oral o faríngeo en personas adultas

Relationship between the gingival biotype and the results of root covering surgical procedures : a systematic review

Tissue biotypes are related to the results of periodontal therapy, conventional prosthodontics, implant therapy and root covering procedures. We conducted a systematic review (SR) of the literature about the relationship between the gingival biotype and

The global, regional, and national burden of adult lip, oral, and pharyngeal cancer in 204 countries and territories:A systematic analysis for the Global Burden of Disease Study 2019

Importance Lip, oral, and pharyngeal cancers are important contributors to cancer burden worldwide, and a comprehensive evaluation of their burden globally, regionally, and nationally is crucial for effective policy planning.Objective To analyze the total and risk-attributable burden of lip and oral cavity cancer (LOC) and other pharyngeal cancer (OPC) for 204 countries and territories and by Socio-demographic Index (SDI) using 2019 Global Burden of Diseases, Injuries, and Risk Factors (GBD) Study estimates.Evidence Review The incidence, mortality, and disability-adjusted life years (DALYs) due to LOC and OPC from 1990 to 2019 were estimated using GBD 2019 methods. The GBD 2019 comparative risk assessment framework was used to estimate the proportion of deaths and DALYs for LOC and OPC attributable to smoking, tobacco, and alcohol consumption in 2019.Findings In 2019, 370 000 (95% uncertainty interval [UI], 338 000-401 000) cases and 199 000 (95% UI, 181 000-217 000) deaths for LOC and 167 000 (95% UI, 153 000-180 000) cases and 114 000 (95% UI, 103 000-126 000) deaths for OPC were estimated to occur globally, contributing 5.5 million (95% UI, 5.0-6.0 million) and 3.2 million (95% UI, 2.9-3.6 million) DALYs, respectively. From 1990 to 2019, low-middle and low SDI regions consistently showed the highest age-standardized mortality rates due to LOC and OPC, while the high SDI strata exhibited age-standardized incidence rates decreasing for LOC and increasing for OPC. Globally in 2019, smoking had the greatest contribution to risk-attributable OPC deaths for both sexes (55.8% [95% UI, 49.2%-62.0%] of all OPC deaths in male individuals and 17.4% [95% UI, 13.8%-21.2%] of all OPC deaths in female individuals). Smoking and alcohol both contributed to substantial LOC deaths globally among male individuals (42.3% [95% UI, 35.2%-48.6%] and 40.2% [95% UI, 33.3%-46.8%] of all risk-attributable cancer deaths, respectively), while chewing tobacco contributed to the greatest attributable LOC deaths among female individuals (27.6% [95% UI, 21.5%-33.8%]), driven by high risk-attributable burden in South and Southeast Asia.Conclusions and Relevance In this systematic analysis, disparities in LOC and OPC burden existed across the SDI spectrum, and a considerable percentage of burden was attributable to tobacco and alcohol use. These estimates can contribute to an understanding of the distribution and disparities in LOC and OPC burden globally and support cancer control planning efforts

The global burden of adolescent and young adult cancer in 2019 : a systematic analysis for the Global Burden of Disease Study 2019

Background In estimating the global burden of cancer, adolescents and young adults with cancer are often overlooked, despite being a distinct subgroup with unique epidemiology, clinical care needs, and societal impact. Comprehensive estimates of the global cancer burden in adolescents and young adults (aged 15-39 years) are lacking. To address this gap, we analysed results from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019, with a focus on the outcome of disability-adjusted life-years (DALYs), to inform global cancer control measures in adolescents and young adults. Methods Using the GBD 2019 methodology, international mortality data were collected from vital registration systems, verbal autopsies, and population-based cancer registry inputs modelled with mortality-to-incidence ratios (MIRs). Incidence was computed with mortality estimates and corresponding MIRs. Prevalence estimates were calculated using modelled survival and multiplied by disability weights to obtain years lived with disability (YLDs). Years of life lost (YLLs) were calculated as age-specific cancer deaths multiplied by the standard life expectancy at the age of death. The main outcome was DALYs (the sum of YLLs and YLDs). Estimates were presented globally and by Socio-demographic Index (SDI) quintiles (countries ranked and divided into five equal SDI groups), and all estimates were presented with corresponding 95% uncertainty intervals (UIs). For this analysis, we used the age range of 15-39 years to define adolescents and young adults. Findings There were 1.19 million (95% UI 1.11-1.28) incident cancer cases and 396 000 (370 000-425 000) deaths due to cancer among people aged 15-39 years worldwide in 2019. The highest age-standardised incidence rates occurred in high SDI (59.6 [54.5-65.7] per 100 000 person-years) and high-middle SDI countries (53.2 [48.8-57.9] per 100 000 person-years), while the highest age-standardised mortality rates were in low-middle SDI (14.2 [12.9-15.6] per 100 000 person-years) and middle SDI (13.6 [12.6-14.8] per 100 000 person-years) countries. In 2019, adolescent and young adult cancers contributed 23.5 million (21.9-25.2) DALYs to the global burden of disease, of which 2.7% (1.9-3.6) came from YLDs and 97.3% (96.4-98.1) from YLLs. Cancer was the fourth leading cause of death and tenth leading cause of DALYs in adolescents and young adults globally. Interpretation Adolescent and young adult cancers contributed substantially to the overall adolescent and young adult disease burden globally in 2019. These results provide new insights into the distribution and magnitude of the adolescent and young adult cancer burden around the world. With notable differences observed across SDI settings, these estimates can inform global and country-level cancer control efforts. Copyright (C) 2021 The Author(s). Published by Elsevier Ltd.Peer reviewe

The global burden of cancer attributable to risk factors, 2010-19 : a systematic analysis for the Global Burden of Disease Study 2019

Background Understanding the magnitude of cancer burden attributable to potentially modifiable risk factors is crucial for development of effective prevention and mitigation strategies. We analysed results from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019 to inform cancer control planning efforts globally. Methods The GBD 2019 comparative risk assessment framework was used to estimate cancer burden attributable to behavioural, environmental and occupational, and metabolic risk factors. A total of 82 risk-outcome pairs were included on the basis of the World Cancer Research Fund criteria. Estimated cancer deaths and disability-adjusted life-years (DALYs) in 2019 and change in these measures between 2010 and 2019 are presented. Findings Globally, in 2019, the risk factors included in this analysis accounted for 4.45 million (95% uncertainty interval 4.01-4.94) deaths and 105 million (95.0-116) DALYs for both sexes combined, representing 44.4% (41.3-48.4) of all cancer deaths and 42.0% (39.1-45.6) of all DALYs. There were 2.88 million (2.60-3.18) risk-attributable cancer deaths in males (50.6% [47.8-54.1] of all male cancer deaths) and 1.58 million (1.36-1.84) risk-attributable cancer deaths in females (36.3% [32.5-41.3] of all female cancer deaths). The leading risk factors at the most detailed level globally for risk-attributable cancer deaths and DALYs in 2019 for both sexes combined were smoking, followed by alcohol use and high BMI. Risk-attributable cancer burden varied by world region and Socio-demographic Index (SDI), with smoking, unsafe sex, and alcohol use being the three leading risk factors for risk-attributable cancer DALYs in low SDI locations in 2019, whereas DALYs in high SDI locations mirrored the top three global risk factor rankings. From 2010 to 2019, global risk-attributable cancer deaths increased by 20.4% (12.6-28.4) and DALYs by 16.8% (8.8-25.0), with the greatest percentage increase in metabolic risks (34.7% [27.9-42.8] and 33.3% [25.8-42.0]). Interpretation The leading risk factors contributing to global cancer burden in 2019 were behavioural, whereas metabolic risk factors saw the largest increases between 2010 and 2019. Reducing exposure to these modifiable risk factors would decrease cancer mortality and DALY rates worldwide, and policies should be tailored appropriately to local cancer risk factor burden. Copyright (C) 2022 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license.Peer reviewe

Cancer Incidence, Mortality, Years of Life Lost, Years Lived With Disability, and Disability-Adjusted Life Years for 29 Cancer Groups From 2010 to 2019: A Systematic Analysis for the Global Burden of Disease Study 2019.

The Global Burden of Diseases, Injuries, and Risk Factors Study 2019 (GBD 2019) provided systematic estimates of incidence, morbidity, and mortality to inform local and international efforts toward reducing cancer burden. To estimate cancer burden and trends globally for 204 countries and territories and by Sociodemographic Index (SDI) quintiles from 2010 to 2019. The GBD 2019 estimation methods were used to describe cancer incidence, mortality, years lived with disability, years of life lost, and disability-adjusted life years (DALYs) in 2019 and over the past decade. Estimates are also provided by quintiles of the SDI, a composite measure of educational attainment, income per capita, and total fertility rate for those younger than 25 years. Estimates include 95% uncertainty intervals (UIs). In 2019, there were an estimated 23.6 million (95% UI, 22.2-24.9 million) new cancer cases (17.2 million when excluding nonmelanoma skin cancer) and 10.0 million (95% UI, 9.36-10.6 million) cancer deaths globally, with an estimated 250 million (235-264 million) DALYs due to cancer. Since 2010, these represented a 26.3% (95% UI, 20.3%-32.3%) increase in new cases, a 20.9% (95% UI, 14.2%-27.6%) increase in deaths, and a 16.0% (95% UI, 9.3%-22.8%) increase in DALYs. Among 22 groups of diseases and injuries in the GBD 2019 study, cancer was second only to cardiovascular diseases for the number of deaths, years of life lost, and DALYs globally in 2019. Cancer burden differed across SDI quintiles. The proportion of years lived with disability that contributed to DALYs increased with SDI, ranging from 1.4% (1.1%-1.8%) in the low SDI quintile to 5.7% (4.2%-7.1%) in the high SDI quintile. While the high SDI quintile had the highest number of new cases in 2019, the middle SDI quintile had the highest number of cancer deaths and DALYs. From 2010 to 2019, the largest percentage increase in the numbers of cases and deaths occurred in the low and low-middle SDI quintiles. The results of this systematic analysis suggest that the global burden of cancer is substantial and growing, with burden differing by SDI. These results provide comprehensive and comparable estimates that can potentially inform efforts toward equitable cancer control around the world.Funding/Support: The Institute for Health Metrics and Evaluation received funding from the Bill & Melinda Gates Foundation and the American Lebanese Syrian Associated Charities. Dr Aljunid acknowledges the Department of Health Policy and Management of Kuwait University and the International Centre for Casemix and Clinical Coding, National University of Malaysia for the approval and support to participate in this research project. Dr Bhaskar acknowledges institutional support from the NSW Ministry of Health and NSW Health Pathology. Dr Bärnighausen was supported by the Alexander von Humboldt Foundation through the Alexander von Humboldt Professor award, which is funded by the German Federal Ministry of Education and Research. Dr Braithwaite acknowledges funding from the National Institutes of Health/ National Cancer Institute. Dr Conde acknowledges financial support from the European Research Council ERC Starting Grant agreement No 848325. Dr Costa acknowledges her grant (SFRH/BHD/110001/2015), received by Portuguese national funds through Fundação para a Ciência e Tecnologia, IP under the Norma Transitória grant DL57/2016/CP1334/CT0006. Dr Ghith acknowledges support from a grant from Novo Nordisk Foundation (NNF16OC0021856). Dr Glasbey is supported by a National Institute of Health Research Doctoral Research Fellowship. Dr Vivek Kumar Gupta acknowledges funding support from National Health and Medical Research Council Australia. Dr Haque thanks Jazan University, Saudi Arabia for providing access to the Saudi Digital Library for this research study. Drs Herteliu, Pana, and Ausloos are partially supported by a grant of the Romanian National Authority for Scientific Research and Innovation, CNDS-UEFISCDI, project number PN-III-P4-ID-PCCF-2016-0084. Dr Hugo received support from the Higher Education Improvement Coordination of the Brazilian Ministry of Education for a sabbatical period at the Institute for Health Metrics and Evaluation, between September 2019 and August 2020. Dr Sheikh Mohammed Shariful Islam acknowledges funding by a National Heart Foundation of Australia Fellowship and National Health and Medical Research Council Emerging Leadership Fellowship. Dr Jakovljevic acknowledges support through grant OI 175014 of the Ministry of Education Science and Technological Development of the Republic of Serbia. Dr Katikireddi acknowledges funding from a NHS Research Scotland Senior Clinical Fellowship (SCAF/15/02), the Medical Research Council (MC_UU_00022/2), and the Scottish Government Chief Scientist Office (SPHSU17). Dr Md Nuruzzaman Khan acknowledges the support of Jatiya Kabi Kazi Nazrul Islam University, Bangladesh. Dr Yun Jin Kim was supported by the Research Management Centre, Xiamen University Malaysia (XMUMRF/2020-C6/ITCM/0004). Dr Koulmane Laxminarayana acknowledges institutional support from Manipal Academy of Higher Education. Dr Landires is a member of the Sistema Nacional de Investigación, which is supported by Panama’s Secretaría Nacional de Ciencia, Tecnología e Innovación. Dr Loureiro was supported by national funds through Fundação para a Ciência e Tecnologia under the Scientific Employment Stimulus–Institutional Call (CEECINST/00049/2018). Dr Molokhia is supported by the National Institute for Health Research Biomedical Research Center at Guy’s and St Thomas’ National Health Service Foundation Trust and King’s College London. Dr Moosavi appreciates NIGEB's support. Dr Pati acknowledges support from the SIAN Institute, Association for Biodiversity Conservation & Research. Dr Rakovac acknowledges a grant from the government of the Russian Federation in the context of World Health Organization Noncommunicable Diseases Office. Dr Samy was supported by a fellowship from the Egyptian Fulbright Mission Program. Dr Sheikh acknowledges support from Health Data Research UK. Drs Adithi Shetty and Unnikrishnan acknowledge support given by Kasturba Medical College, Mangalore, Manipal Academy of Higher Education. Dr Pavanchand H. Shetty acknowledges Manipal Academy of Higher Education for their research support. Dr Diego Augusto Santos Silva was financed in part by the Coordenação de Aperfeiçoamento de Pessoal de Nível Superior - Brasil Finance Code 001 and is supported in part by CNPq (302028/2018-8). Dr Zhu acknowledges the Cancer Prevention and Research Institute of Texas grant RP210042

Global burden of 288 causes of death and life expectancy decomposition in 204 countries and territories and 811 subnational locations, 1990–2021: a systematic analysis for the Global Burden of Disease Study 2021

BACKGROUND Regular, detailed reporting on population health by underlying cause of death is fundamental for public health decision making. Cause-specific estimates of mortality and the subsequent effects on life expectancy worldwide are valuable metrics to gauge progress in reducing mortality rates. These estimates are particularly important following large-scale mortality spikes, such as the COVID-19 pandemic. When systematically analysed, mortality rates and life expectancy allow comparisons of the consequences of causes of death globally and over time, providing a nuanced understanding of the effect of these causes on global populations. METHODS The Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2021 cause-of-death analysis estimated mortality and years of life lost (YLLs) from 288 causes of death by age-sex-location-year in 204 countries and territories and 811 subnational locations for each year from 1990 until 2021. The analysis used 56 604 data sources, including data from vital registration and verbal autopsy as well as surveys, censuses, surveillance systems, and cancer registries, among others. As with previous GBD rounds, cause-specific death rates for most causes were estimated using the Cause of Death Ensemble model-a modelling tool developed for GBD to assess the out-of-sample predictive validity of different statistical models and covariate permutations and combine those results to produce cause-specific mortality estimates-with alternative strategies adapted to model causes with insufficient data, substantial changes in reporting over the study period, or unusual epidemiology. YLLs were computed as the product of the number of deaths for each cause-age-sex-location-year and the standard life expectancy at each age. As part of the modelling process, uncertainty intervals (UIs) were generated using the 2·5th and 97·5th percentiles from a 1000-draw distribution for each metric. We decomposed life expectancy by cause of death, location, and year to show cause-specific effects on life expectancy from 1990 to 2021. We also used the coefficient of variation and the fraction of population affected by 90% of deaths to highlight concentrations of mortality. Findings are reported in counts and age-standardised rates. Methodological improvements for cause-of-death estimates in GBD 2021 include the expansion of under-5-years age group to include four new age groups, enhanced methods to account for stochastic variation of sparse data, and the inclusion of COVID-19 and other pandemic-related mortality-which includes excess mortality associated with the pandemic, excluding COVID-19, lower respiratory infections, measles, malaria, and pertussis. For this analysis, 199 new country-years of vital registration cause-of-death data, 5 country-years of surveillance data, 21 country-years of verbal autopsy data, and 94 country-years of other data types were added to those used in previous GBD rounds. FINDINGS The leading causes of age-standardised deaths globally were the same in 2019 as they were in 1990; in descending order, these were, ischaemic heart disease, stroke, chronic obstructive pulmonary disease, and lower respiratory infections. In 2021, however, COVID-19 replaced stroke as the second-leading age-standardised cause of death, with 94·0 deaths (95% UI 89·2-100·0) per 100 000 population. The COVID-19 pandemic shifted the rankings of the leading five causes, lowering stroke to the third-leading and chronic obstructive pulmonary disease to the fourth-leading position. In 2021, the highest age-standardised death rates from COVID-19 occurred in sub-Saharan Africa (271·0 deaths [250·1-290·7] per 100 000 population) and Latin America and the Caribbean (195·4 deaths [182·1-211·4] per 100 000 population). The lowest age-standardised death rates from COVID-19 were in the high-income super-region (48·1 deaths [47·4-48·8] per 100 000 population) and southeast Asia, east Asia, and Oceania (23·2 deaths [16·3-37·2] per 100 000 population). Globally, life expectancy steadily improved between 1990 and 2019 for 18 of the 22 investigated causes. Decomposition of global and regional life expectancy showed the positive effect that reductions in deaths from enteric infections, lower respiratory infections, stroke, and neonatal deaths, among others have contributed to improved survival over the study period. However, a net reduction of 1·6 years occurred in global life expectancy between 2019 and 2021, primarily due to increased death rates from COVID-19 and other pandemic-related mortality. Life expectancy was highly variable between super-regions over the study period, with southeast Asia, east Asia, and Oceania gaining 8·3 years (6·7-9·9) overall, while having the smallest reduction in life expectancy due to COVID-19 (0·4 years). The largest reduction in life expectancy due to COVID-19 occurred in Latin America and the Caribbean (3·6 years). Additionally, 53 of the 288 causes of death were highly concentrated in locations with less than 50% of the global population as of 2021, and these causes of death became progressively more concentrated since 1990, when only 44 causes showed this pattern. The concentration phenomenon is discussed heuristically with respect to enteric and lower respiratory infections, malaria, HIV/AIDS, neonatal disorders, tuberculosis, and measles. INTERPRETATION Long-standing gains in life expectancy and reductions in many of the leading causes of death have been disrupted by the COVID-19 pandemic, the adverse effects of which were spread unevenly among populations. Despite the pandemic, there has been continued progress in combatting several notable causes of death, leading to improved global life expectancy over the study period. Each of the seven GBD super-regions showed an overall improvement from 1990 and 2021, obscuring the negative effect in the years of the pandemic. Additionally, our findings regarding regional variation in causes of death driving increases in life expectancy hold clear policy utility. Analyses of shifting mortality trends reveal that several causes, once widespread globally, are now increasingly concentrated geographically. These changes in mortality concentration, alongside further investigation of changing risks, interventions, and relevant policy, present an important opportunity to deepen our understanding of mortality-reduction strategies. Examining patterns in mortality concentration might reveal areas where successful public health interventions have been implemented. Translating these successes to locations where certain causes of death remain entrenched can inform policies that work to improve life expectancy for people everywhere. FUNDING Bill & Melinda Gates Foundation

Desigualdades sociales de la mortalidad por cáncer oral en América Latina entre 2000 y 2017

Tesis para obtener el grado de Doctora en Ciencias de la SaludEl cáncer oral se ha convertido en un importante problema de salud pública dada su alta prevalencia, el hecho de que comparte factores de riesgo con otras enfermedades crónicas no transmisibles, y el impacto de condiciones socioeconómicas en su detección y tratamiento oportunos. Así, el objetivo de este estudio fue establecer las desigualdades sociales relacionadas con la mortalidad por cáncer oral en América Latina durante 2000 a 2017. La metodología se basó en un estudio ecológico mixto compuesto por series temporales y evaluación de grupos múltiples, con unidades de análisis 20 países de América Latina discriminados por sexos para el periodo de estudio. Así, se determinaron las tendencias de incidencia y mortalidad al interior de cada país para hombres y mujeres; para luego comparar éstas entre los grupos geográficos y frente a variables explicativas como la prevalencia de factores de riesgo como consumo de tabaco y alcohol y el impacto de las políticas públicas para su control, e indicadores como el Índice de Desarrollo Humano, entre otros. Los resultados mostraron que entre los países de mayor IDH, los hombres de Brasil y Cuba presentaron las más altas tasas de incidencia (ASR >7,5) y mortalidad (ASR >4,5). Haití fue el país más afectado entre los de menor IDH (ASR incidencia >4,1 y mortalidad >3,0). La relación Hombre:Mujer más alta fue en Paraguay (incidencia >3,5 y mortalidad >4,0).Las tendencias muestran que los descensos más importantes se presentan en los hombres de Brasil y en las mujeres de Panamá. Son pocas las tendencias al aumento, aunque éstas se evidencian especialmente entre las mujeres. La implementación de las medidas de control de factores de riesgo: tabaco, alcohol, infecciones virales, programas de detección temprana y tratamiento; muestra avances desiguales entre los países. Se observó una mayor relación entre la mortalidad por cáncer oral con: el consumo de tabaco en los contextos de menor implementación de las políticas; y el consumo de alcohol en los escenarios de mayor avance. A su vez, la mortalidad por cáncer oral, se relaciona de manera negativa con el IDH global (r:-0.80) y con los índices de salud (r:-0.83) e ingreso (r:-0.75) (p<0.05) en los países de menor IDH. En México, la mayor carga de la enfermedad se encontró en los hombres, especialmente en la región sureste: Campeche, Yucatán y Veracruz (IDH alto), con Colima como caso particular (ASR hombres: 3.52, mujeres: 1.92). Pero, la RMI más alta (> 0.65) se encontró entre los estados con el IDH más bajo (Oaxaca y Chiapas: IDH <0.700). El mejor modelo resultante explicó el (r2)59% [F (p): 0.000] de la variabilidad.Becarios Conacy

Evaluación a 72 meses de una estrategia de prevención en salud oral en escolares

ABSTRACT Background: Given the high prevalence of caries and periodontal disease globally, and its cumulative process from an early age, effective strategies are required to influence healthy habits that are formed in a sustainable manner, taking advantage of common spaces such as school. The objective was to evaluate for 72 months an oral health prevention strategy in schoolchildren. Methods: This quasi-experimental study considered an initial sample of 350 students with similar cultural and socioeconomic conditions, which was later reduced to 220, after the 72 months. The tooth brushing practice was carried out at school daily; with teacher motivation and leader in oral health formation. Intervention was supervised all time long. to At the beginning and end of the 72 months, the following epidemiological indexes were taken: Silness-Loe plaque index, Loe-Silness Gingival index, brushing skill index by Simmons Smith & Gelbie (ISSG), and the MEDI-MED index that dichotomically considered: healthy permanent teeth, health of the gums and good attitude towards dental health. The statistical analysis included measures of central tendencies. The difference in averages of the indices was determined by the Mann-Whitney U test. Results: The average of the indices: initial (II) and final (IF) registered as follows: gingival (II: 0.63-IF: 0.27) and bacterial plaque (II: 0.99-IF: 0.41) with a difference p <0.05. The index (ISSG) indicated a dental plaque removal of 82.18%.MEDI-MED index “healthy permanent teeth” (II: 91% - IF: 59%); Gum (II: 14% - IF: at 85%) and the “Mind” component (II: 96% - IF: 87%). Conclusions: The preventive strategy evaluated significantly reduced the rates of bacterial and gingival plaque. The MEDI-MED index indicated decreased in healthy permanent teeth and a positive attitude towards dentistry.RESUMEN Fundamentos: Dada la alta prevalencia de caries y enfermedad periodontal a nivel global, y su proceso acumulativo desde temprana edad, se requieren estrategias efectivas para incidir en hábitos saludables que se formen de manera sostenible, aprovechando espacios comunes como la escuela. El objetivo de este estudio fue evaluar a 72 meses una estrategia de prevención en salud oral en escolares. Métodos: Esta investigación cuasi-experimental, longitudinal consideró una muestra inicial de 350 escolares con condiciones culturales y socioeconómicas similares, que después de 72 meses se redujo a 220. La práctica de cepillado dentro de la escuela se realizó diariamente, con motivación de sus maestros y formación de líderes de salud oral. Durante todo el tiempo la intervención estuvo supervisada. Al inicio y a los 72 meses, se tomaron los índices epidemiológicos: de Placa de Silness y Loe, Gingival de Loe y Silness, cepillado de Simmons Smith y Gelbie (ICSG), y el índice MEDIMED que consideró dicotómicamente: dientes permanentes sanos, salud de la encía y buena actitud hacia la odontología. El análisis estadístico incluyó medidas de tendencia central. La diferencia de promedios de los índices se determinó con la prueba U de Mann Whitney. Resultados: Los promedios de los índices iniciales (II) y finales (IF) registraron así: gingival (II: 0,63-IF: 0,27) y placa bacteriana (II: 0,99-IF: 0,41) con una diferencia p<0,05. El índice (ICSG) indicó una remoción de placa dental del 82,18%. El índice MEDIMED: “dientes permanentes sanos” (II: 91% - IF: 59%); encía (II: 14% - IF: a 85%) y el componente “Mente” (II: 96 % - IF: 87%). Conclusiones: La estrategia preventiva evaluada disminuyó los índices de placa bacteriana y gingival en forma significativa. El índice MEDIMED indicó disminucion en dientes permanentes sanos y disminución de una actitud positiva hacia la odontología

Consumo de café como factor protector contra cáncer oral y faríngeo: análisis crítico de la literatura

The high and unequal prevalence of oral and pharyngeal cancer, together with the high consumption of coffee worldwide, make studies to analyze how the consumption of these drinks containing methylxanthines contributes in the risk of these neoplasms, although with contradictory results. The objective of the present study was to verify the validity and applicability of the results regarding the effectiveness of high coffee consumption in adults as a protective factor for oral and pharyngeal cancer and answer the following question: ¿can a high consumption of coffee in drink be a protective factor against oral and pharyngeal cancer? The article by Miranda et al. (2017) was analyzed: “Coffee is protective against oral and pharyngeal cancer: a systematic review and meta-analysis”. A significant protective association was found between coffee consumption and the risk of oral cancer, and especially pharyngeal (z=2.34; p=0.019; OR=0.72), inferring that the development of oral cancer in individuals who consume large amounts of coffee is 1.45 times lower than in individuals who consume small quantities or do not consume (OR=0.69; 95%CI=0.57–0.84). However, with the methodological limitations of the primary studies included in the systematic review with meta-analysis, we do not consider the current moderate evidence sufficient to recommend the consumption of high quantities of the beverage of coffee to prevent oral or pharyngeal cancer in adults.La alta y desigual prevalencia de cáncer oral y faríngeo, junto al alto consumo de café a nivel mundial, hacen que se realicen estudios para analizar cómo contribuye el consumo de estas bebidas que contienen metilxantinas, en el riesgo de estas neoplasias, aunque con resultados contradictorios. El objetivo del presente estudio fue comprobar la validez y la aplicabilidad de los resultados con respecto a la efectividad del alto consumo de café en adultos como factor protector del cáncer oral y faríngeo y responder al siguiente interrogante: ¿puede un alto consumo del café en bebida ser un factor protector contra el cáncer oral y faríngeo? Se analizó el artículo de Miranda et al (2017): “El café es protector contra el cáncer oral y faríngeo: una revisión sistemática y meta-análisis". Se encontró una asociación protectora significativa entre el consumo de café y el riesgo de cáncer oral, y faríngeo especialmente (z=2.34, p=0.019, OR=0.72), infiriendo que el desarrollo del cáncer oral en individuos que consumen grandes cantidades de café es 1.45 veces menor que en individuos que consumen poca cantidad o no consumen (OR = .69; 95% IC=.57-.84). No obstante, con las limitaciones metodológicas de los estudios primarios incluidos en la revisión sistemática con metaanálisis, no consideramos suficiente la evidencia actual moderada para recomendar el consumo de altas cantidades de la bebida de café para prevenir cáncer oral o faríngeo en personas adultas