Antecedentes hereditarios, personales y estado bucal en pacientes con lesiones estomatológicas. Estudio comparativo

Las lesiones estomatológicas de la mucosa bucal son multifactoriales. Pueden ser de origen primario o secundario, según sean propias de enfermedades bucales o parte del cuadro clínico de enfermedades del sistema nervioso, cardiovascular, endocrino, dermatológico y digestivo. La salud bucal impacta sobre la calidad de vida de la población. En relación al cáncer bucal, tabaco y alcohol son los factores de riesgo más estudiados, sin embargo existen otros, llamados emergentes como la irritación mecánica crónica y un estado bucal deficiente, entre otros. Objetivo: comparar la prevalencia de factores hereditarios, personales y estado bucal en pacientes con lesiones estomatológicas en los períodos 1995 - 2004 (P1) (SAIO 2009) y 2009 - 2018 (P2) Material y métodos: análisis retrospectivo de 3183 historias clínicas de pacientes que asistieron al Servicio de Estomatología, FO-UNC. Se analizaron factores generales como cáncer, diabetes, hipertensión y factores locales como irritación mecánica crónica, consumo de tabaco, alcohol y estado bucal. Se calcularon las frecuencias absolutas y relativas. Resultados: en el P1 predominaron diabetes, cáncer e hipertensión: 15%, 14% y 17% respectivamente. En tanto que en P2 fue de 1%, 4% y 10%. Respecto al consumo de tabaco, 49% fumaba en P1 y 47% en P2. En relación al consumo de alcohol en exceso, se observó en 7% en P1 y 3% en P2. En el 27% de los casos se registró irritación dentaria y/o protética en el P1 y 37% en P2. Conclusiones: Los resultados indican que los porcentajes del consumo de tabaco, fueron similares en ambos períodos y que hubo una leve disminución del hábito de consumo de alcohol, lo que difiere de los registros nacionales. Se observó mayor porcentaje de irritación mecánica crónica en el P2., lo que plantearía la discusión si este factor aumentó o la forma de realizar el registro es más adecuada.Fil: Massaia, Camila. Universidad Nacional de Córdoba. Facultad de Odontología; Argentina.Fil: Isaia, Tatiana. Universidad Nacional de Córdoba. Facultad de Odontología; Argentina.Fil: Caciva, Ricardo Crhistian. Universidad Nacional de Córdoba. Facultad de Odontología. Cátedra de Estomatología A; Argentina.Fil: Criscuolo, María Inés. Universidad Nacional de Córdoba. Facultad de Odontología. Cátedra de Estomatología B; Argentina.Fil: Zapata, Marcelo Javier. Universidad Nacional de Córdoba. Facultad de Odontología. Cátedra de Estomatología B; Argentina.Fil: Robledo, Graciela Marta. Universidad Nacional de Córdoba. Facultad de Odontología. Cátedra de Estomatología B; Argentina.Otras Ciencias de la Salu

Effect of once-yearly zoledronic acid on the spine and hip as measured by quantitative computed tomography: results of the HORIZON Pivotal Fracture Trial.

Changes in bone mineral density and bone strength following treatment with zoledronic acid (ZOL) were measured by quantitative computed analysis (QCT) or dual-energy X-ray absorptiometry (DXA). ZOL treatment increased spine and hip BMD vs placebo, assessed by QCT and DXA. Changes in trabecular bone resulted in increased bone strength. INTRODUCTION: To investigate bone mineral density (BMD) changes in trabecular and cortical bone, estimated by quantitative computed analysis (QCT) or dual-energy X-ray absorptiometry (DXA), and whether zoledronic acid 5 mg (ZOL) affects bone strength. METHODS: In 233 women from a randomized, controlled trial of once-yearly ZOL, lumbar spine, total hip, femoral neck, and trochanter were assessed by DXA and QCT (baseline, Month 36). Mean percentage changes from baseline and between-treatment differences (ZOL vs placebo, t-test) were evaluated. RESULTS: Mean between-treatment differences for lumbar spine BMD were significant by DXA (7.0%, p < 0.01) and QCT (5.7%, p < 0.0001). Between-treatment differences were significant for trabecular spine (p = 0.0017) [non-parametric test], trabecular trochanter (10.7%, p < 0.0001), total hip (10.8%, p < 0.0001), and compressive strength indices at femoral neck (8.6%, p = 0.0001), and trochanter (14.1%, p < 0.0001). CONCLUSIONS: Once-yearly ZOL increased hip and spine BMD vs placebo, assessed by QCT vs DXA. Changes in trabecular bone resulted in increased indices of compressive strength

The surgical safety checklist and patient outcomes after surgery: a prospective observational cohort study, systematic review and meta-analysis

© 2017 British Journal of Anaesthesia Background: The surgical safety checklist is widely used to improve the quality of perioperative care. However, clinicians continue to debate the clinical effectiveness of this tool. Methods: Prospective analysis of data from the International Surgical Outcomes Study (ISOS), an international observational study of elective in-patient surgery, accompanied by a systematic review and meta-analysis of published literature. The exposure was surgical safety checklist use. The primary outcome was in-hospital mortality and the secondary outcome was postoperative complications. In the ISOS cohort, a multivariable multi-level generalized linear model was used to test associations. To further contextualise these findings, we included the results from the ISOS cohort in a meta-analysis. Results are reported as odds ratios (OR) with 95% confidence intervals. Results: We included 44 814 patients from 497 hospitals in 27 countries in the ISOS analysis. There were 40 245 (89.8%) patients exposed to the checklist, whilst 7508 (16.8%) sustained ≥1 postoperative complications and 207 (0.5%) died before hospital discharge. Checklist exposure was associated with reduced mortality [odds ratio (OR) 0.49 (0.32–0.77); P\u3c0.01], but no difference in complication rates [OR 1.02 (0.88–1.19); P=0.75]. In a systematic review, we screened 3732 records and identified 11 eligible studies of 453 292 patients including the ISOS cohort. Checklist exposure was associated with both reduced postoperative mortality [OR 0.75 (0.62–0.92); P\u3c0.01; I2=87%] and reduced complication rates [OR 0.73 (0.61–0.88); P\u3c0.01; I2=89%). Conclusions: Patients exposed to a surgical safety checklist experience better postoperative outcomes, but this could simply reflect wider quality of care in hospitals where checklist use is routine

Critical care admission following elective surgery was not associated with survival benefit: prospective analysis of data from 27 countries

This was an investigator initiated study funded by Nestle Health Sciences through an unrestricted research grant, and by a National Institute for Health Research (UK) Professorship held by RP. The study was sponsored by Queen Mary University of London