Impact of Early Childhood Caries and Maternal Behaviors on Oral Health-Related Quality of Life of Children

Objective: To evaluate the impact of early childhood caries, maternal behaviors and associated factors on the oral health-related quality of life (OHRQoL) of preschool children. Material and Methods: This cross- sectional study was conducted with 163 preschool children aged 3-4 old from Porto Alegre, Southern Brazil. Mothers completed the Brazilian version of the Early Childhood Oral Health Impact Scale (ECOHIS) and answered questions about sociodemographic and maternal behaviors characteristics. The severity of dental caries was assessed by ICDAS criteria for evaluated early childhood caries (ECC). A Poisson regression model was used to investigate the association of ECC and associated factors on OHRQoL. Results: A total of 91.4% of preschooler children was ECC (ICDAS ≥ 1). Mean ECOHIS function domain and parental anxiety domain scores were significantly higher in children with dental caries (p<0.05). The adjusted Poisson regression model showed that household income, maternal education, mother’s job status and breastfeeding time was significantly associated with ECOHIS scores. Regarding oral conditions, child caries experience was associated with worsening child and family quality of life (RR 2.21; 95% IC: 1.43-3.41). Conclusion: Our findings suggest that ECC, socioeconomic and maternal behaviors characteristics influence children’s OHRQoL

The Role of Mother’s Knowledge, Attitudes, Practices in Dental Caries on Vulnerably Preschool Children

Objective: To analyze the association between Early Childhood Caries (ECC) and mother´s knowledge, attitudes, and practices (KAP). Material and Methods: This cross-sectional  study  included  a  random sample of 163 preschool children aged 3-4 old in southern Brazil. The severity of dental caries and ECC was assessed by ICDAS criteria, while mothers completed the semi-structured  questionnaire  (KAP-ECC). Maternal behavior characteristics and answered questions about socioeconomic and demographic variables. Logistic regression was performed to evaluate the association of exploratory variables with ECC. For this approach, we calculated the odds ratio (OR) and 95% confidence intervals (95% IC). Results: Dental examinations revealed that 91.4% of children presented ECC (ICDAS = 3, 4, 5 or 6). Among those children, 31.9% presented cavities (ICDAS ≥ 3). Family income was significantly associated with the presence of ECC (OR 2.17; 95% CI: 1.41-3.36). Regarding KAP-ECC, mothers have knowledge related to ECC etiology, reported dental hygiene attitudes and practices that can prevent ECC but reported less healthy attitudes and practices regarding child’s diet, specifically with respect to bottle and breastfeeding habits (OR 0.52; 95% CI: 0.33-0.81). Conclusion: ECC was more frequent in children from low-income families and whose mothers reported the belief that milk with chocolate does not contribute to caries and that disagreed that it is normal that a 2-year-old baby wakes up during the night to suckle. That is, good knowledge toward health habits may impact on lower occurrence of ECC; however, this condition also depends on the socioeconomic level

Eficácia e segurança dos stents farmacológicos em pacientes com insuficiência renal crônica

Objectives. We sought to evaluate the safety and efficacy of Drug eluting stents (DES) in patients with significant CKD in a real world registry Background. Patients with chronic kidney disease (CKD) who undergo percutaneous coronary angioplasty have higher rates of target lesion revascularization (TLR) and mortality. DES are associated with a lower rate of restenosis compared to bare metal stents (BMS), although in patients with CKD data on DES efficacy and safety is limited. Methods. A total of 504 patients who underwent percutaneous coronary intervention with DES in two centers were included in this study. Outcomes were stratified on the basis of the presence of CKD, defined as a baseline glomerular filtration rate <60ml/min/1.73m². Results. The mean follow-up was 22.7 months. CKD was present in 165 patients (32.7%). Patients with CKD were older, had more hypertension and diabetes. CKD patients presented increased incidence of death (12.3% vs. 2.4%, p<0.001) and myocardial infarction (MI) (7.4% vs. 3.3%, p=0.04) compared to patients without CKD. TLR rates were similar between groups (4.8% vs. 5.6%, p=0.7, CKD and no CKD patients, respectively). Independent predictors of death were CKD (HR 6.93; 2.4 – 19.5, p<0.001), current smoking (HR 3.66; 1.20 – 11.10, p=0.02) and diabetes (HR 2.66; 1.03 – 6.60, p=0.045). Conclusion. In this real-world registry, coronary intervention with DES in patients with CKD was associated with similar TLR compared to patients without CKD, demonstrating the efficacy of DES in preventing in-stent restenosis in this patient population. CKD was related to significantly increased MI and mortality rates

Eficácia e segurança dos stents farmacológicos em pacientes com insuficiência renal crônica

Objectives. We sought to evaluate the safety and efficacy of Drug eluting stents (DES) in patients with significant CKD in a real world registry Background. Patients with chronic kidney disease (CKD) who undergo percutaneous coronary angioplasty have higher rates of target lesion revascularization (TLR) and mortality. DES are associated with a lower rate of restenosis compared to bare metal stents (BMS), although in patients with CKD data on DES efficacy and safety is limited. Methods. A total of 504 patients who underwent percutaneous coronary intervention with DES in two centers were included in this study. Outcomes were stratified on the basis of the presence of CKD, defined as a baseline glomerular filtration rate <60ml/min/1.73m². Results. The mean follow-up was 22.7 months. CKD was present in 165 patients (32.7%). Patients with CKD were older, had more hypertension and diabetes. CKD patients presented increased incidence of death (12.3% vs. 2.4%, p<0.001) and myocardial infarction (MI) (7.4% vs. 3.3%, p=0.04) compared to patients without CKD. TLR rates were similar between groups (4.8% vs. 5.6%, p=0.7, CKD and no CKD patients, respectively). Independent predictors of death were CKD (HR 6.93; 2.4 – 19.5, p<0.001), current smoking (HR 3.66; 1.20 – 11.10, p=0.02) and diabetes (HR 2.66; 1.03 – 6.60, p=0.045). Conclusion. In this real-world registry, coronary intervention with DES in patients with CKD was associated with similar TLR compared to patients without CKD, demonstrating the efficacy of DES in preventing in-stent restenosis in this patient population. CKD was related to significantly increased MI and mortality rates

Impacto da insuficiência renal crônica na eficácia de stents farmacológicos: estudo de seguimento de longo prazo

FUNDAMENTO: Pacientes com Insuficiência Renal Crônica (IRC) submetidos à angioplastia coronária apresentam maiores taxas de revascularização da lesão alvo (RLA) e mortalidade. Os stents farmacológicos (SF) estão associados com taxas menores de reestenose, quando comparados aos stents não farmacológicos (SNF), embora em pacientes com IRC os dados da eficácia e segurança do SF sejam limitados. OBJETIVO: Buscamos avaliar a segurança e eficácia dos SF em pacientes com IRC significante, quando comparados a pacientes com função renal normal em um registro da "vida real". MÉTODOS: 504 pacientes submetidos à intervenção coronariana percutânea com SF em dois centros foram incluídos. Os desfechos foram estratificados baseados na presença de IRC, definida como taxa de filtração glomerular basal < 60 ml/min/1,73 m². RESULTADOS: O acompanhamento médio foi de 22,7 meses. A IRC estava presente em 165 pacientes (32,7%). Pacientes com IRC eram mais velhos, tinham mais hipertensão e diabete. Pacientes com IRC apresentaram maior incidência de morte (12,3% vs 2,4%, p < 0,001) e infarto do miocárdio (IM) (7,4% vs 3,3%, p = 0,04), quando comparados aos pacientes sem IRC. Taxas de RLA foram similares entre os grupos (4.8% vs 5.6%, p = 0,7, pacientes com e sem IRC, respectivamente). Preditores independentes de morte foram a IRC (HR 6,93; 2,4 - 19,5, p < 0,001), tabagismo atual (HR 3,66; 1,20 - 11,10, p = 0,02) e diabete (HR 2,66; 1,3 - 6,60, p = 0,045). CONCLUSÃO: Neste registro, a intervenção coronariana com SF em pacientes com IRC foi associada com RLA similar comparada aos pacientes sem IRC, demonstrando a eficácia dos FS na prevenção da reestenose intra-stent nessa população de pacientes. A IRC foi relacionada a um aumento significativo das taxas de IM e mortalidade