Goodbye Hartmann trial: a prospective, international, multicenter, observational study on the current use of a surgical procedure developed a century ago

Background: Literature suggests colonic resection and primary anastomosis (RPA) instead of Hartmann's procedure (HP) for the treatment of left-sided colonic emergencies. We aim to evaluate the surgical options globally used to treat patients with acute left-sided colonic emergencies and the factors that leading to the choice of treatment, comparing HP and RPA. Methods: This is a prospective, international, multicenter, observational study registered on ClinicalTrials.gov. A total 1215 patients with left-sided colonic emergencies who required surgery were included from 204 centers during the period of March 1, 2020, to May 31, 2020. with a 1-year follow-up. Results: 564 patients (43.1%) were females. The mean age was 65.9 ± 15.6 years. HP was performed in 697 (57.3%) patients and RPA in 384 (31.6%) cases. Complicated acute diverticulitis was the most common cause of left-sided colonic emergencies (40.2%), followed by colorectal malignancy (36.6%). Severe complications (Clavien-Dindo ≥ 3b) were higher in the HP group (P < 0.001). 30-day mortality was higher in HP patients (13.7%), especially in case of bowel perforation and diffused peritonitis. 1-year follow-up showed no differences on ostomy reversal rate between HP and RPA. (P = 0.127). A backward likelihood logistic regression model showed that RPA was preferred in younger patients, having low ASA score (≤ 3), in case of large bowel obstruction, absence of colonic ischemia, longer time from admission to surgery, operating early at the day working hours, by a surgeon who performed more than 50 colorectal resections. Conclusions: After 100 years since the first Hartmann's procedure, HP remains the most common treatment for left-sided colorectal emergencies. Treatment's choice depends on patient characteristics, the time of surgery and the experience of the surgeon. RPA should be considered as the gold standard for surgery, with HP being an exception

Estudio epidemiológico de caries dental en escolares del estado de Baja California, México, 2010 / 2010 Epidemiological Study of Dental Caries in Schoolchildren of the Baja California State, Mexico

Propósito: Determinar índices y prevalencia de caries dental en la población escolar del estado de Baja California, México, en el 2010. Métodos: Estudio de corte transversal realizado con los criterios y formato de encuesta de la Organización Mundial de la Salud (OMS), en tres grupos etarios (6, 12 y 15 años), en los cinco municipios del estado. Así mismo, se analizaron los resultados con relación al sexo y estrato socioeconómico. Los encuestadores fueron calibrados previamente (concordancia interexaminador kappa > 0,80). La asociación del sexo y el nivel de ocupación de los padres sobre los indicadores de caries se evaluaron mediante χ2 para frecuencias y Andeva para efectos medios. El análisis se realizó con el paquete SAS 9,2. Resultados: La prevalencia de caries en dentición temporal a los 6 años fue del 60 %; en dentición permanente a los 12 años fue del 39 % y del 52 % a los 15. No hubo diferencias estadísticamente significativas respecto al sexo (p > 0,05), pero sí respecto al tipo de ocupación de los padres. El índice ceo-d 6 años fue 2,58; el CPO-D 12 años, de 1,12, y de 1,88 a los 15. Conclusiones: La prevalencia de caries en dentición permanente pasó del 67,96 % en el 2001 al 39,53 % en el 2010. Según la OMS, el CPO-D de 1,12 a los 12 años sitúa a Baja California en índices muy bajos de caries; mientras que en el 2001 se hallaba en moderado, con CPO-D de 2,51. Hubo una mayor prevalencia de caries dental en los escolares con padres cuya ocupación requiere menor capacitación y estudio. Purpose: Determinate the prevalence and indexes of dental caries in the school population of the State of Baja California, Mexico, 2010. Methods: Cross-sectional study in schoolchildren carried out using the criteria and survey format provided by the World Health Organization (WHO), in three age groups (6, 12, and 15 years old), in the five municipalities of the state. Also, the results were analyzed in relation to sex and socioeconomic status of the school children. Interviewers were previously standardized (inter-examiner concordance kappa > 0.80). The associations between sex and parent occupation and dental caries indicators were analyzed with the χ2 test for frequencies and Anova for media effects (SAS 9.2 statistical package). Results: The prevalence of dental caries in primary teeth at age 6 years old was 60 %; it was 39 % in permanent dentition at age 12 and 52 % among 15 years old. No statistically significant association was found for the variable sex (p>0.05), but it was for the occupation of parents. The dmf-t index was 2.58 at 6 years of age, DMF-T 1.12 at 12 years, and 1.88 at age 15. Conclusions: The prevalence of dental caries in permanent teeth decreased from 67.96 % in 2001 to 39.53 % in 2010. According to the WHO, the DMF-T index 1.12 of 12 year-old schoolchildren from Baja California in 2010 is considered low, while it was moderate (DMF-T 2.51) in 2001. There was a higher prevalence of caries in schoolchildren with parents whose occupation requires lower education levels

Estudio epidemiológico de caries dental en escolares del estado de Baja California, México, 2010 / 2010 Epidemiological Study of Dental Caries in Schoolchildren of the Baja California State, Mexico

Propósito: Determinar índices y prevalencia de caries dental en la población escolar del estado de Baja California, México, en el 2010. Métodos: Estudio de corte transversal realizado con los criterios y formato de encuesta de la Organización Mundial de la Salud (OMS), en tres grupos etarios (6, 12 y 15 años), en los cinco municipios del estado. Así mismo, se analizaron los resultados con relación al sexo y estrato socioeconómico. Los encuestadores fueron calibrados previamente (concordancia interexaminador kappa > 0,80). La asociación del sexo y el nivel de ocupación de los padres sobre los indicadores de caries se evaluaron mediante χ2 para frecuencias y Andeva para efectos medios. El análisis se realizó con el paquete SAS 9,2. Resultados: La prevalencia de caries en dentición temporal a los 6 años fue del 60 %; en dentición permanente a los 12 años fue del 39 % y del 52 % a los 15. No hubo diferencias estadísticamente significativas respecto al sexo (p > 0,05), pero sí respecto al tipo de ocupación de los padres. El índice ceo-d 6 años fue 2,58; el CPO-D 12 años, de 1,12, y de 1,88 a los 15. Conclusiones: La prevalencia de caries en dentición permanente pasó del 67,96 % en el 2001 al 39,53 % en el 2010. Según la OMS, el CPO-D de 1,12 a los 12 años sitúa a Baja California en índices muy bajos de caries; mientras que en el 2001 se hallaba en moderado, con CPO-D de 2,51. Hubo una mayor prevalencia de caries dental en los escolares con padres cuya ocupación requiere menor capacitación y estudio. Purpose: Determinate the prevalence and indexes of dental caries in the school population of the State of Baja California, Mexico, 2010. Methods: Cross-sectional study in schoolchildren carried out using the criteria and survey format provided by the World Health Organization (WHO), in three age groups (6, 12, and 15 years old), in the five municipalities of the state. Also, the results were analyzed in relation to sex and socioeconomic status of the school children. Interviewers were previously standardized (inter-examiner concordance kappa > 0.80). The associations between sex and parent occupation and dental caries indicators were analyzed with the χ2 test for frequencies and Anova for media effects (SAS 9.2 statistical package). Results: The prevalence of dental caries in primary teeth at age 6 years old was 60 %; it was 39 % in permanent dentition at age 12 and 52 % among 15 years old. No statistically significant association was found for the variable sex (p>0.05), but it was for the occupation of parents. The dmf-t index was 2.58 at 6 years of age, DMF-T 1.12 at 12 years, and 1.88 at age 15. Conclusions: The prevalence of dental caries in permanent teeth decreased from 67.96 % in 2001 to 39.53 % in 2010. According to the WHO, the DMF-T index 1.12 of 12 year-old schoolchildren from Baja California in 2010 is considered low, while it was moderate (DMF-T 2.51) in 2001. There was a higher prevalence of caries in schoolchildren with parents whose occupation requires lower education levels