Access to Dental Services among Hypertensive Elderly in Peru: Exploring Patterns and Implications

Background: This study was conducted to determine access to dental services in the elderly with hypertension in Peru. Methods: Observational, analytical, and cross-sectional design. Data used for analysis in this research was collected from the Demographic and Family Health Survey of Peru (ENDES) from 2019 to 2021. Results: A Poisson regression analysis was performed a weighted sample for calculating prevalence ratio (PR) with their 95% confidence intervals (95%CI). The multiple regression analysis did not find among the factors associated with the probability of using the dental health service, since neither the time less than two years of hypertension (PR=0.74, 95%CI 0.53 – 1.02); nor from 2 to 4 years (PR = 0.97, CI 95% 0.86 – 1.09); neither a time of hypertension from 5 years or more (PR = 0.94, CI 95% 0.85 – 1.03) were associated. Conclusion: The study concluded that hypertensive patient over 60 years of age, despite a previous diagnosis of hypertension or not, does not attend dental service, reflecting a lack of interest and a greater risk exposure to cardiovascular complications associated with oral health

Factors Associated with Knowledge, Attitudes, and Practices about Tuberculosis in Peruvians

Objective: To determine the factors associated with knowledge, attitudes, and practices (KAPs) about tuberculosis (TB) in the Peruvian population. Materials and Methods: A cross-sectional, analytical study was carried out by conducting a virtual survey. The instrument that was used consisted of 4 sections: sociodemographic variables (9 questions), knowledge (23 questions), attitudes (9 questions), and practices (8 questions) about tuberculosis. Univariate and bivariate analyses and the Poisson regression model with robust variance were used to obtain crude and adjusted prevalence ratios (PRa). Results: The sample consisted of 1284 participants. Regarding knowledge, attitudes, and practices about TB, an insufficient level was found in 47.97%, 50.3%, and 54.36% of the cases, respectively. The variables that increased the probability of having sufficient knowledge were sex, grade, area, family history, and history of having TB. While only the area and both antecedents were for attitudes. Finally, the age, degree, and history of TB were for the practices. Conclusion: There are insufficient KAPs in around half of the population studied. In addition, there are differences according to the epidemiological characteristics, such as sex, age, academic degree, area, and family history of TB and having had this disease. Therefore, the importance of research in this field should be emphasized in the face of a disease that is related to the differences in the levels of these variables between different strata of the general population

Diagnostic Accuracy of Anthropometric Markers of Obesity for Prediabetes: A Systematic Review and Meta-Analysis

Introduction: Prediabetes is a significant public health concern due to its high risk of progressing to diabetes. Anthropometric measures of obesity, including body mass index (BMI), waist circumference (WC), and waist-to-height ratio (WHtR) have been demonstrated as key risk factors in the development of prediabetes. However, there is a lack of clarity on the diagnostic accuracy and cut-off points of these measures. Objective: To determine the diagnostic accuracy of these anthropometric measures for their most effective use in identifying prediabetes. Methodology: A systematic review (SR) with metanalysis of observational studies was carried out. The search was conducted in four databases: Pubmed/Medline, SCOPUS, Web of Science, and EMBASE. For the meta-analysis, sensitivity and specificity, together with their 95% confidence intervals (CI 95%) were calculated. Results: Among all the manuscripts chosen for review, we had four cross-sectional studies, and three were classified as cohort studies. The forest plots showed the combined sensitivity and specificity for both cross-sectional and cohort studies. For cross-sectional studies, the values were as follows: BMI had a sensitivity of 0.63 and specificity of 0.56, WC had a sensitivity of 0.59 and specificity of 0.58, and WHtR had a sensitivity of 0.63 and specificity of 0.73. In the cohort studies, the combined sensitivity and specificity were: BMI at 0.70 and 0.45, WC at 0.68 and 0.56, and WHtR at 0.68 and 0.56, respectively. All values are provided with 95% confidence intervals. Conclusions: This systematic review and meta-analysis evaluated the diagnostic accuracy of BMI, WC, and WHtR in identifying prediabetes. The results showed variations in sensitivity and specificity, with WHtR having the highest specificity in cross-sectional studies and BMI having improved sensitivity in cohort studies

Elevated Lactate as a Mortality Factor in Poly Traumatised Patients: A Systematic Review and Meta-Analysis

Introduction: According to global health estimates from the World Health Organization (WHO) injuries represent 8% of world deaths. There are systematic reviews that relate lactate and mortality in trauma patients but do not focus on multiple trauma patients. Objective: To determine if elevated lactate is a mortality factor in multiple trauma patients. Methodology: A systematic review and meta-analysis of observational studies were carried out. The search was carried out in 4 databases: PUBMED, Embase, Scopus, and Web of Science. Data were pooled using a random effects model and summary statistics were calculated using odds ratios (ORs) with their respective 95% confidence intervals (95% CI). Results: Nine studies were included (n=5302). A significant association was found between elevated admission lactate with mortality (OR: 1.80; 95% CI 1.11 to 2.91) and 72-hour mortality (OR: 1.24; 95% CI 1.02 to 1.50). No statistically significant association was found for the analysis of elevated admission lactate and 28-day mortality (OR: 1.24; 95% CI 1.02 to 1.50). Finally, elevated admission lactate is associated with mortality regardless of time (OR: 1.34; 95% CI 1.19 to 1.50). Conclusion: Elevated admission lactate is associated with mortality and 72-hour mortality in multiple trauma patients. No significant association was found between elevated admission lactate and 30-day mortality. Elevated intake of lactate is associated with mortality independent of time

Associations between metabolic phenotypes and diabetes risk: A systematic review and meta-analysis

Introduction: It seems that the risk of developing diabetes cannot be predicted solely based on weight or BMI. Metabolic phenotypes might offer a more precise tool for identifying patients at higher risk of diabetes, thus enabling more effective and targeted preventive interventions. Objective: To determine the association between these metabolic phenotypes and the risk of diabetes. Materials: Systematic Review (SR) with a meta-analysis of cohort studies. The search was carried out in four databases: Pubmed/Medline, SCOPUS, Web of Science, and EMBASE. Metabolic states were classified into six groups: Metabolically Healthy Normal Weight (MHNW), Metabolically Unhealthy Normal Weight (MUNW), Metabolically Healthy Overweight (MHOW), Metabolically Unhealthy Overweight (MUOW), Metabolically Healthy Obesity (MHO), and Metabolically Unhealthy Obesity (MUO). Association measures were presented as odds ratios (OR) and hazard ratios (HR) along with their 95 % confidence intervals (CI95%). Results: A total of six studies were evaluated. For the meta-analysis, only studies using OR as the measure of association were included. Compared with individuals with MHNW, a statistically significant association was found for MUNW (OR: 1.82; CI95% 1.62, 2.04), MHOW (OR: 1.19; CI95% 1.07, 1.32), MUOW (OR: 2.44; CI95% 2.19, 2.72), MHO (OR: 2.14; CI95% 1.52, 3.01), and MUO (OR: 3.94; CI95% 3.28, 4.74). Conclusions: Metabolic phenotypes are significantly associated with the risk of diabetes, regardless of BMI. Further research in this field is required, and should be conducted in other regions of the world where obesity and diabetes rates are rapidly increasing

Anthropometric measures of obesity as risk indicators for prediabetes. A systematic review and meta-analysis

Introduction: Several previous studies have provided evidence that obesity is a significant risk factor for the increase in prediabetes, but there are discrepancies regarding whether all the classic ways of measuring obesity, the body mass index (BMI), the waist circumference (WC) or the Waist to height ratio (WHtR) present the same level of risk. Objective: to carry out a systematic review (SR) with meta-analysis to determine the association between indicators of obesity and prediabetes. Methods: A systematic review (SR) with a meta-analysis of observational studies was performed. The search was conducted in four databases: Pubmed/Medline, SCOPUS, Web of Science, and EMBASE. Association measures were presented as odds ratios (OR), relative risk (RR), or hazard ratio (HR), together with their 95% confidence intervals (95% CI). Results: Of the total number of manuscripts chosen, 12 had an analytical cross-sectional design, and 4 were cohort studies. For the cross-sectional studies, together they presented a statistically significant association for BMI (OR: 1.99; 95% CI 1.65 – 1.34), WC (OR: 1.41; 95% CI 1.30 – 1.54), and WHtR (OR: 2.47 IC 95 % 1.50 – 4.06). In the meta-analysis of the cohort studies, an association was found with WC (RR: 4.95; 95% CI 3.42 – 7.17) but not with BMI (HR: 1.22; 95% CI 0.81 – 1.85). There were no studies with WHtR. Conclusions: According to the results, considering cohort studies, WC could be the best risk indicator for prediabetes. There is a high degree of heterogeneity between the studies about the way obesity is measured, including the cut-off points used, so further longitudinal studies are needed to evaluate the association and confirm the results found

Association of new obesity markers with symptoms of depression: Analysis of a 4-year Peruvian national survey

Introduction: Although body mass index (BMI) and waist circumference (WC) are the most commonly used obesity markers in clinical practice regarding depression, some studies suggest that other obesity markers such as waist-to-height ratio (WHtR), a body shape index (ABSI), body roundness index (BRI), and conicity index (CI) may be more accurate in identifying patients with depression. Objective: To determine the relationship between different markers of obesity and the presence of symptoms of depression. Methods: Analytical cross-sectional study. A secondary analysis was conducted on the Demographic and Family Health Survey (ENDES) from 2018 to 2021. The main variable of the present study was the depression score. Numerical variables were presented as mean and confidence interval at 95 % (CI 95 %). A generalized linear model of the Gaussian family and Identity link function was performed to evaluate the strength of association between the variables of interest. Results: The average depression score in the study population was 2.61 (95 % CI 2.56–2.65). In the multivariable analysis, the depression score increased for each unit that increased the BMI by 0.011 points (β = 0.011; 95 % CI 0.002–0.020), the WHtR by 0.207 points (β = 0.207; 95 % CI 0.145–0.267), the ABSI by 0.158 points (β = 0.158; IC95% 0.047–0.269), the BRI by 0.096 points (β = 0.096; IC95% 0.069–0.122), and the CI by 0.010 points (β = 0.010; IC95% 0.004–0.016). There was no statistically significant association for WC. Conclusions: The WHtR may be a better marker of obesity for identifying patients with depressive symptoms compared to other markers