<p>Estudio de corte trasversal cuyo objetivo fue identificar presencia de barreras geográficas de acceso a salud y elaborar un inventario de prestadores de salud oral del departamento de Nariño, con información de 64 municipios. <em>Metodología: </em>se desarrolló un sistema de medida de distancia y tiempo, identificando el tiempo de viaje que toma el desplazamiento de un municipio hasta la capital en diferentes medios de transporte. Como determinante de barrera de acceso: tiempo de viaje mayor a cuatro horas y distancia mayor a 25 km. <em>Resultados: </em>se identificaron 305 prestadores públicos, 1062 privados; en salud oral 670 prestadores. Nariño cuenta con primer nivel de atención en todos los municipios, segundo en cuatro y tercero en Pasto. De los 64 municipios tres no tienen barrera de acceso. <em>Conclusiones: </em>el tiempo de viaje y el medio de transporte son determinantes de barrera de acceso a salud, especialmente en las áreas del Pacífico de Nariño. </p>
To estimate the degree of concordance and consistency in the radiographic and tomographic evaluation of the periapical area. A study of diagnostic tests was designed. Three blind evaluators analyzed radiographic images, which were selected at two different points in time. An oral radiologist and an endodontist determined the second observation moment. The degree of similarity and variability, concordance and consistency for each radiograph was set at 95% confidence. A Kappa coefficient (κ), for radiographic findings and a correlation coefficient of Lin (CCC) for tomographic measurements was established. 12 radiographies and 19 tomographs were evaluated. The intraobserver consistency determined a k= 1 (Almost Perfect) and a CCC from 0.42 to 0.95 (Poor to Substantial) for both observation times. For radiographies, the interobserver concordance did not show changes between the first and second observation. Values include a k= 0.56-0.80 (Moderate to Good) and a CCC with greater degree of agreement, after training, as follows: axial view: CCC 0.86, 95% of Confidence Interval (CI) 0.69-0.94, coronal view: CCC 0.90 95%CI 0.75-0.96, and sagittal view: CCC 0.96, 95%CI 0.90-0.98. The statistical tests estimated the consistency and concordance to observe radiographically and tomographically the periapical tissue in endodontics.
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