Search

Background: Overweight during pregnancy has increased in Chile. In the region of La Araucania it occurs in 67% of pregnancies, which exceeds the national indicators. Aim: To analyze the secular trend during eight years of the nutritional status at the beginning of gestation, the excessive weight gain during pregnancy, and its association with individual factors in pregnant women cared the public health system of two Southern Chilean neighboring cities. Material and Methods: This is an analytical observational study with a cross-sectional and longitudinal trend design. We used an anonymized database with 17,270 reproductive data of urban pregnant women who were cared between 2009 and 2016. Trend analysis was performed to evaluate secular changes (nptrend < 0.05) in nutritional indicators and logistic regression to determine the association with individual characteristics. Results: In the study period, overweight at the beginning of pregnancy increased by 13.1 percentage points. Forty percent of pregnant women with normal initial body mass index, were overweight or obese at the end of pregnancy. The excessive weight gain decreased slightly (z=-3.33, p = 0.001), but unevenly in both cities. Adolescent pregnancy, a low education and low socio-economic level of household together with previous overweight and a family or personal history of chronic diseases are associated with excessive gestational weight gain. Conclusions: The results show social inequality. Female malnutrition by excess is a problem that must be addressed through a robust public policy, centered on primary health care level and with a focus on social determinants. Prenatal care provides a window of opportunity to intervene.

Objective. To estimate the point prevalence and likely ranges of pregnancy-induced hypertension, preeclampsia, gestational diabetes, low birth weight and preterm delivery in Latin America and the Caribbean, and evaluate the heterogeneity of the estimates. Methods. We conducted a systematic review and meta-analysis of observational studies reporting the prevalence of maternal and perinatal adverse outcomes in populations in Latin American and the Caribbean published between 2000 and 2019 in English, Spanish, or Portuguese. We searched PubMed, Embase, and LILACS. We estimated the point prevalence and evaluated overall heterogeneity and, in sub-group analyses, heterogeneity by study design and level of bias. Results. Of 1087 records retrieved, 50 articles were included in the review: two on hypertensive disorders of pregnancy, 14 on pre-eclampsia, six on gestational diabetes, nine on low birth weight and 19 on preterm birth. No meta-analysis for hypertensive disorders of pregnancy could be done because of the small number of studies. Point prevalence estimates and 95% confidence intervals (CIs) for pre-eclampsia, gestational diabetes, low birth weight, and preterm birth were: 6.6% (95% CI: 4.9%, 8.6%), 8.5% (95% CI: 3.9%, 14.7%), 8.5% (95% CI: 7.2%, 9.8%), and 10.0% (95% CI: 8.0%, 12.0%), respectively. We observed substantial heterogeneity overall and by study design. No major differences in estimates were observed by level of bias. Conclusions. The results of this study provide updated estimates of some of the most prevalent adverse pregnancy and perinatal outcomes in Latin America and the Caribbean. They highlight that important heterogeneity exists in prevalence estimates, which may reflect the diversity of populations in the region. Objetivo. Estimar la prevalencia puntual y los rangos probables de hipertensión provocada por embarazo, preeclampsia, diabetes gestacional, peso bajo al nacer y parto prematuro en América Latina y el Caribe, y evaluar la heterogeneidad de las estimaciones. Métodos. Se llevó a cabo una revisión sistemática y metanálisis de los estudios de observación que notificaron la prevalencia de resultados adversos perinatales y maternos en poblaciones de América Latina y el Caribe, publicados entre los años 2000 y 2019 en inglés, español o portugués. Se realizaron búsquedas en PubMed, Embase y LILACS. Se estimó la prevalencia puntual y se evaluó la heterogeneidad general y, en los análisis de subgrupos, la heterogeneidad según el diseño del estudio y nivel de sesgo. Resultados. De 1 087 registros recuperados, se incluyeron 50 artículos en la revisión: 2 sobre los trastornos hipertensivos en el embarazo, 14 sobre preeclampsia, 6 sobre la diabetes gestacional, 9 sobre peso bajo al nacer y 19 sobre parto prematuro. No se pudo realizar ningún metanálisis de los trastornos hipertensivos del embarazo debido al número reducido de estudios. Las estimaciones de prevalencia puntual y los intervalos de confianza (IC) del 95% para la preeclampsia, la diabetes gestacional, el peso bajo al nacer y el parto prematuro fueron: 6,6% (IC de 95%: 4,9%, 8,6%), 8,5% (IC de 95%: 3,9%, 14,7%), 8,5% (IC de 95%: 7,2%, 9,8%) y 10,0% (IC de 95%: 8,0%, 12,0%), respectivamente. Se observó una heterogeneidad significativa en general, así como según el diseño del estudio. No se advirtieron grandes diferencias en las estimaciones según el nivel del sesgo. Conclusiones. Los resultados de este estudio ofrecen cálculos actualizados de algunos de los resultados adversos perinatales y del embarazo con mayor prevalencia en América Latina y el Caribe. Estos resultados ponen de manifiesto que existe una gran heterogeneidad en las estimaciones de prevalencia, que podría reflejar la diversidad de la población de la región. Objetivo. Estimar a prevalência pontual e os intervalos prováveis de hipertensão induzida pela gravidez, pré-eclâmpsia, diabetes gestacional, baixo peso ao nascer e parto prematuro na América Latina e no Caribe e avaliar a heterogeneidade das estimativas. Métodos. Realizou-se uma revisão sistemática com metanálise de estudos observacionais que relatam a prevalência de desfechos maternos e perinatais adversos em populações da América Latina e do Caribe, publicados entre 2000 e 2019 em inglês, espanhol ou português. Os bancos de dados PubMed, Embase e LILACS foram pesquisados. Estimou-se a prevalência pontual e avaliou-se a heterogeneidade geral, bem como, em análises de subgrupo, a heterogeneidade por delineamento do estudo e o nível de viés. Resultados. De 1 087 registros encontrados, 50 artigos foram incluídos na revisão: dois sobre distúrbios hipertensivos da gravidez, 14 sobre pré-eclâmpsia, seis sobre diabetes gestacional, nove sobre baixo peso ao nascer e 19 sobre parto prematuro. Não foi possível realizar metanálise para distúrbios hipertensivos da gravidez devido ao pequeno número de estudos. As estimativas de prevalência pontual e intervalos de confiança de 95% (IC) para pré-eclâmpsia, diabetes gestacional, baixo peso ao nascer e parto prematuro foram: 6,6%; (IC 95%: 4,9–8,6%), 8,5% (IC 95%: 3,9–14,7%), 8,5% (IC 95%: 7,2–9,8%) e 10,0% (IC 95%: 8,0– 12,0%), respectivamente. Observou-se heterogeneidade considerável, tanto em geral como por delineamento de estudo. Não foram observadas diferenças importantes nas estimativas por nível de viés. Conclusões. Os resultados deste estudo fornecem estimativas atualizadas de alguns dos desfechos gestacionais e perinatais adversos mais prevalentes na América Latina e no Caribe. Destacam a existência de uma importante heterogeneidade nas estimativas de prevalência, o que pode refletir a diversidade das populações da região.

Missing data from air quality datasets is a common problem, but is much more severe in small cities or localities. This poses a great challenge for environmental epidemiology as high exposures to pollutants worldwide occur in these settings and gaps in datasets hinder health studies that could later inform local and international policies. Here, we propose the use of imputation methods as a tool to reconstruct air quality datasets and have applied this approach to an air quality dataset in Temuco, a mid-size city in Chile as a case-study. We attempted to reconstruct the database comparing five approaches: mean imputation, conditional mean imputation, K-Nearest Neighbor imputation, multiple imputation and Bayesian Principal Component Analysis imputation. As a base for the imputation methods, linear regression models were fitted for PM2.5 against other air quality and meteorological variables. Methods were challenged against validation sets where data was removed artificially. Imputation methods were able to reconstruct the dataset with good performance in terms of completeness, errors, and bias, even when challenged against the validations sets. The performance improved when including covariates from a second monitoring station in Temuco. K-Nearest Neighbor imputation showed slightly better performance than multiple imputation for error (25% vs. 27%) and bias (2.1% vs. 3.9%), but presented lower completeness (70% vs. 100%). In summary, our results show that the imputation methods can be a useful tool in reconstructing air quality datasets in a real-life situation.

Introduction Evidence concerning the interactions between human health and planetary health has grown extensively in recent years. In turn, the perceived importance of environmental sustainability within higher education is growing at a rapid rate. This paper provides a summary of key elements as they apply to dentistry, and provides an introduction to the reader of an early consensus of how sustainability could be included as part of the dental curriculum. Methods The consensus opinion within this paper largely centres around discussion at the ADEE sustainability workshop at the annual conference in Berlin (August 2019). In order to help inform discussions at the workshop, a brief scoping questionnaire was circulated to potential participants regarding their understanding and current teaching practices in sustainability. An infographic was designed to help delegates remember the important elements of sustainable dentistry. Delegates discussed the concept of sustainability alongside the infographic, and how they could link these with the Graduating European Dentist (GED) curriculum. Results The discussions within the workshop largely centred around 4 main themes: Disease prevention and health promotion, Patient education and empowerment, Lean service delivery and Preferential use of strategies with lower environmental impact. Discussion It is apparent that there is a widespread need for teaching materials relating to environmental sustainability; this includes specific learning outcomes relating to the 4 educational domains of the Graduating European Dentist curriculum, and methods for teaching and assessing these outcomes. Conclusion This paper reports consensus on the first phase of a pan‐European working group on Sustainability in dental education

Temuco is a city heavily impacted by residential wood-burning, which causes strong episodes of air pollution, particularly in winter. Little is known about the spatial distribution of wood-burning ...

The spatial model development of particle distribution are necessary for studying the chronic health impacts of particulate air pollution due to residential wood- burning. The spatial variability o...

Background/aim In Latin America and Caribe, the most common cause of mortality is hypertensive disorders in pregnancy (HDP). Some researchers found that air pollution increase the risk of HDP. However, the evidence regarding to preeclampsia has not been conclusive. In Temuco, PM2.5 exceeds daily and annual standards due to the use of wood as fuel. We aimed to estimate associations between preeclampsia and PM2.5. Methods Temuco and Padre Las Casas are located in the south of Chile (39.7°E; 73.0°S). During the colds months increase the use of residential heating. PM2.5 was collected from 2009 to 2014 from Las Encinas air pollution monitoring station. Meteorological data (temperature (°C), wind speed (kn), relative humidity (%)) were obtained from the Chilean Meteorological Office. Reproductive data from pregnant women attending the Hospital were obtained from the databases compiled by the Obstetric Service. Data were descriptively analysed according to their distribution using mean, median, percentiles and their respective dispersion measure, depending on the variable distribution. We performed bivariate and multivariate analysis. We used STATA (version 13) to perform all the statistical analyses. Results The prevalence of preeclampsia is 3.8%. Around 63.5% of cases are 20–34 years-old, 53.1% obese at last prenatal control, 6.7% has gestational or pregestational diabetes. We found differences between educational level, nutritional status, presence of maternal morbidities, multiple pregnancies (p Conclusion The results indicate that the prevalence of preeclampsia is high. Temuco has high PM2.5 concentrations, over the national standards, attributable to wood burning.

La población de adultos mayores ha aumentado en los últimos años y se hace imprescindible determinar su estado de salud oral con el objetivo de orientar la atención de salud con base científica epidemiológica para brindarles una mejor calidad de vida. El objetivo de este trabajo fue evaluar el estado de la salud oral de los pacientes adultos mayores postrados. Se realizó un estudio descriptivo de corte transversal no probabilístico. Los datos fueron obtenidos del universo de pacientes inscritos en el programa de Atención Domiciliaria del Paciente Postrado de un centro de atención primaria. La tasa de respuesta obtenida fue 90%. El sexo predominante fue femenino; la media de edad fue 80 años; 60,9% sólo tuvo acceso a la educación primaria. La prevalencia de caries fue 100% y COPD de 25,6. El 40,6% se encontraba completamente edentulo y el 54,7% era portador de prótesis dental. El 32,8% presentaba restos radiculares. El 64,7% era capaz de cepillar sus dientes por sí mismo. El 79,4% consideraba tener una pobre salud oral. El cuidador resultó ser la hija, de aproximadamente 53 años, con nivel educacional bajo. Los adultos mayores son un grupo con gran daño odontológico, con escasos dientes remanentes y deficientes prácticas de higiene oral. Son cuidados por familiares con bajo nivel educacional.

Objective To determine whether there is a relationship between the use of dental services and caries experience in adults and older adults from central Chile. Materials and methods A sample of 453 adults, 35–44 years of age, and 438 older adults, 65–74 years of age, was interviewed and examined using World Health Organisation (WHO) methods. Sociodemographic variables were also registered. Caries experience was assessed using the Decayed, Missing and Filled teeth (DMFT) index. Multiple linear regression models were used to determine whether there was an association between the independent variables and caries experience. Results Caries prevalence was 99.6% for adults [DMFT score = 14.89 (±6.16)] and 99.8% for older adults [DMFT score = 25.68 (±6.49)]. Less than half of the population – 41.7% of adults and 31.5% of older adults – received dental care. Regardless of the age group, there were no differences in the DMFT score between those who received and those who did not receive attention (P > 0.05). When the DMFT findings were analysed in greater detail, people who received dental care and urban participants had more fillings (P