scholarly journals The role of the dentist and orthodontist in recognizing oro-facial manifestations of acromegaly: a questionnaire-based study

Pituitary ◽  
2021 ◽  
Author(s):  
Giorgia Preo ◽  
Alberto De Stefani ◽  
Francesca Dassie ◽  
Alexandra Wennberg ◽  
Roberto Vettor ◽  
...  

Abstract Purpose Oro-facial manifestations of acromegaly are among the earliest signs of the disease and are reported by a significant number of patients at diagnosis. Despite this high prevalence of acromegaly oral manifestation, dentists do not play a pivotal role in acromegaly identification and diagnosis. The aim of our study was to evaluate the ability of dentists and orthodontists in the early recognition of the oro-facial manifestations of acromegaly. Methods A telematic questionnaire was administered to dentists and orthodontists. The questionnaire included photos with facial and oral-dental details and lateral teleradiography of acromegaly patients (ACRO). Results The study included 426 participants: 220 dentists and 206 orthodontists. Upon reviewing the photos, dentists most often observed mandibular prognathism and lips projection, while orthodontists also reported the impairment of relative soft tissue. Orthodontists, who usually use photos to document patients’ oral-facial characteristics, paid more attention to oral-facial impairment than dentists. During dental assessment, 90% of the participants usually evaluated tongue size and appearance, diastemas presence, and signs of sleep impairment (mainly orthodontists). Orthodontists were also more able to identify sella turcica enlargement at teleradiography. A total of 10.8% of the participants had ACRO as patients and 11.3% referred at least one patient for acromegaly suspicion. Conclusion The study highlighted dentists’ strategic role in identifying ACRO. Increasing dentists’ awareness about acromegaly clinical issues may improve early diagnosis, potentially resulting in an increased quality of life and decreased mortality among ACRO.

Author(s):  
Novita Dhewi Ikakusumawati ◽  
Dewi Magistasari ◽  
Novena Adi Yuhara ◽  
Tri Murti Andayani ◽  
Supanji Supanji ◽  
...  

Diabetic retinopathy (DR) is one of the microvascular complications of diabetes mellitus (DM) which incidence increases with the high prevalence of DM. The presence of these complications will affect quality of life, especially vision-related. The purpose of this study was to determine the quality of life in RD patients assessed using the VFQ-25 and EQ-5D questionnaires, and to determine the of quality of life based on the visual acuity (VA) severity. This study was an observational study in outpatient with diabetic retinopathy during October 2018 – Januari 2019 period, in RSUP dr. Sardjito and RS Mata Dr. YAP, Yogyakarta. The design of this study was cross sectional which observed quality of life and vision. Quality of life was measured by specific for vision instrument (NEI-VFQ-25)  and  generic instrument  (EQ-5D-5L). The number of patients in this study were 100 patients with an average age of 55 years, the most frequent type of RD was 84% proliferative RD. The average quality of life scores in RD patients measured using the VFQ-25 and EQ-5D utility questionnaires were 64.1 ± 16.2 and 0.61 ± 0.24, respectively. Based on VFQ-25, the most affected subscales were driving, dependence, and role difficulties subscale. Meanwhile, domains that have the most problems with the EQ-5D were pain / discomfort and anxiety / depression (78%). The total VFQ-25 score decreased with increasing visual severity, i.e. normal / mild (n = 19) 73.50 ± 15.08; moderate (n = 15) 68.14 ± 15.33; and severe (n = 66) 60.48 ± 15.64. The EQ-5D utility score showed a similar pattern, with scores of 0.66 ± 0.27 (normal / mild); 0.65 ± 0.22 (medium); and 0.59 ± 0.24 (severe); respectively. The higher severity of visual acuity so the quality of life become lower.


2021 ◽  
Vol 26 (5) ◽  
pp. 427-436
Author(s):  
Taylor S. Morris ◽  
Elizabeth B. Autry ◽  
Robert J. Kuhn

The management of pediatric patients with asthma continues to be a major health issue. For many patients, traditional therapies have been very effective, but for a large number of patients asthma remains poorly controlled. This leads to significant morbidity and impairment to quality of life. Recently, several new biologics, as well as new dosage forms of combination inhaled drugs, have been made available for use adding to the armamentarium of therapy for specific asthma phenotypes. Biologics have shown promise in the more difficult to manage asthma patient. Approved in children, omalizumab, an anti–immunoglobulin E (anti-IgE) antibody, has been available for several years. New agents, like mepolizumab and benralizumab, directed against interleukin (IL) 5, have indications for children >6 and >12 years of age, respectively. Dupilumab, an IL-4– and IL-13–directed antibody, has been studied as well in eosinophilic asthma, with positive results. A thorough understanding of the clinical data of these agents is key, as they may greatly improve the quality of life in children with difficult-to-manage asthma.


2020 ◽  
Author(s):  
Viktor Voros ◽  
Sandor Fekete ◽  
Tamas Tenyi ◽  
Zoltan Rihmer ◽  
Ilona Szili ◽  
...  

Abstract Background: Several studies demonstrated the role of depressive mood and cognitive impairment in the background of elevated mortality and decreased Quality of Life (QoL) of the elderly.Methods: In the framework of the ICT4Life project self-administered questionnaires and clinical screening tools were used to assess QoL, depressive symptoms and cognitive functions of 60 elderly over the age of 65.Results: Males found to be depressed and cognitively declined more frequently; and had higher scores on the depression and lower on the QoL scales. Depressed elderly had lower cognitive levels and their QoL was significantly poorer than that of the non-depressed subjects. Depressive disorders were detected in a quarter of the elderly, and the majority of them did not receive adequate antidepressant medication.Conclusions: Close correlation between depression and cognitive impairment was confirmed, as well as the key role of depression in the background of QoL decline. Results also highlighted the problems of recognition and adequate treatment of depression and cognitive decline in elderly, which can be further complicated by the common symptoms of depressive pseudo-dementia. Early recognition of depressive symptoms is important not only to treat the underlying mood disorder, but also to improve QoL of the elderly.


2022 ◽  
pp. 12-16
Author(s):  
Y. A. Kandrashkina ◽  
E. A. Orlova ◽  
A. A. Pribytkov

Atopic dermatitis is a chronic hereditary recurrent skin disease. One of the most pronounced symptoms of this dermatosis is itchy skin. Pruritus accompanies atopic dermatitis in more than 80% of cases. This review presents modern data on the mechanisms of pruritus formation in atopic dermatitis. The issues of etiological factors, neuroimmune interactions, peculiarities of skin dysfunction, as well as the role of stress are considered. The relevance of studying the topic is due to the high prevalence of atopic dermatitis among the population, a decrease in the quality of life and the lack of effective therapy. Analysis of the literature indicates the need for a comprehensive assessment of the pathogenetic mechanisms of the development of pruritus in atopic dermatitis. A more in-depth study of the mechanisms of neurogenic inflammation in atopic dermatitis will contribute to the development of new methods of diagnosis and treatment.


2021 ◽  
Author(s):  
Sonia Lech ◽  
Julie Lorraine O'Sullivan ◽  
Johanna Drewelies ◽  
Wolfram Herrmann ◽  
Robert Spang ◽  
...  

Abstract Background: General practitioners (GPs) play a key role in the care of people with dementia (PwD). However, the role of the German Dementia Guideline in primary care remains unclear. The main objective of the present study was to examine the role of guideline-based dementia care in general practices.Methods: A cross-sectional analysis of data obtained from the DemTab study was conducted. Descriptive analyses of sociodemographic and clinical characteristics for GPs (N = 28) and PwD (N = 91) were conducted. Adherence to the German Dementia Guideline of GPs was measured at the level of PwD. Linear Mixed Models were used to analyze the associations between adherence to the German Dementia Guideline and GP factors at individual (age, years of experience as a GP, frequency of utilization of guideline, perceived usefulness of guideline) and structural (type of practice, total number of patients seen by a participating GP, and total number of PwD seen by a participating GP) levels as well as between adherence to the German Dementia Guideline and PwD’s quality of life. Results: Self-reported overall adherence of GPs was on average 71% (SD = 19.4, range: 25 – 100). Adherence to specific recommendations varied widely (from 19.2% to 95.3%) and the majority of GPs (79.1%) reported the guideline as only partially or somewhat helpful. Further, we found lower adherence to be significantly associated with higher numbers of patients (γ10 = -5.58, CI = -10.97, -0.19, p = .04). No association between adherence to the guideline and PwD’s quality of life was found (γ10 = -.86, CI = -4.18, 2.47, p = .61). Conclusion: The present study examined the role of adherence to the German Dementia Guideline recommendations in primary care. Overall, GPs reported high levels of adherence. However, major differences across guideline recommendations were found. Findings highlight the importance of guidelines for the provision of care. Dementia guidelines for GPs need to be better tailored and addressed. Further, structural changes such as more time for PwD may contribute to a sustainable change of dementia care in primary care.Trial registration: The DemTab trial was prospectively registered with the ISRCTN registry (Trial registration number: ISRCTN15854413). Registered 01 April 2019, https://doi.org/10.1186/ISRCTN15854413


Author(s):  
Antonio Carlos Eber Mendes Sá

This work aims at critical reflection on the actions that determine a good level of oral health. Health promotion is a process that can positively affect the quality of life of a population. Dental problems have a low priority compared to diseases considered to be of social relevance. Prevention of oral diseases must be developed at three levels: primary, secondary and tertiary. Self-diagnosis is extremely important, because the sooner the problem is detected and prevention services are activated, the greater the chances of an effective treatment. Among oral health problems, dental caries is considered a damage that deserves higher priority due to its high prevalence. Oral cancer gained the second degree of priority, due to its severity, followed by periodontal diseases. Education in oral health has been increasingly required, taking into account the low cost and the possibilities of dental impact on public health. Therefore, the role of educating should not be the exclusive responsibility of the professional conventionally called teacher, but of any citizen.


Author(s):  
Lorenza Mattia ◽  
Irene Samperi ◽  
Salvatore Monti ◽  
Vincenzo Toscano ◽  
Giuseppe Pugliese ◽  
...  

Background: The improvement of beta thalassaemia treatments has led to an increase in life expectancy. This implies the emergence of new comorbidities. Amongst others, endocrine glands are extremely sensitive to iron overload. Objective: We aimed to understand the burden of the endocrine conditions on the patient’s quality of life (QOL). Results: Hypogonadism may present with lack or delay of pubertal development, sexual dysfunctions and impaired fertility, which impact QOL in both sexes. Early recognition and treatment, as well as choosing the most appropriate therapy, according to patient’s needs (fertility, pubertal development, psychological concerns, comorbidities) are advisable. Osteoporosis affects QOL irrespective of symptoms. Growth hormone deficiency may occur both in childhood and in adulthood, and it affects different aspects of QOL. In adults, it could be difficult to examine if the symptoms are due to GHD, and a trial of GH replacement could be useful to identify benefits and needs. Glucose metabolism impairment is common in thalassaemic patients and early recognition is mandatory because long-term complication can have a detrimental impact on QOL (as blindness or dialysis). Although the incidence of adrenal insufficiency seems to be rare in thalassaemic patients, when it occurs, it has a severe impact on QOL. Conclusion: Limited data is available on QOL in thalassaemic patients, and even less related to endocrinopathies. We can speculate that endocrinopathies have an impact on everyday life. More studies are needed to allow our patients to achieve not just a longer life but also a better quality of life.


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Sonia Lech ◽  
Julie L. O’Sullivan ◽  
Johanna Drewelies ◽  
Wolfram Herrmann ◽  
Robert P. Spang ◽  
...  

Abstract Background General practitioners (GPs) play a key role in the care of people with dementia (PwD). However, the role of the German Dementia Guideline in primary care remains unclear. The main objective of the present study was to examine the role of guideline-based dementia care in general practices. Methods A cross-sectional analysis of data obtained from the DemTab study was conducted. Descriptive analyses of sociodemographic and clinical characteristics for GPs (N = 28) and PwD (N = 91) were conducted. Adherence to the German Dementia Guideline of GPs was measured at the level of PwD. Linear Mixed Models were used to analyze the associations between adherence to the German Dementia Guideline and GP factors at individual (age, years of experience as a GP, frequency of utilization of guideline, perceived usefulness of guideline) and structural (type of practice, total number of patients seen by a participating GP, and total number of PwD seen by a participating GP) levels as well as between adherence to the German Dementia Guideline and PwD’s quality of life. Results Self-reported overall adherence of GPs was on average 71% (SD = 19.4, range: 25–100). Adherence to specific recommendations varied widely (from 19.2 to 95.3%) and the majority of GPs (79.1%) reported the guideline as only partially or somewhat helpful. Further, we found lower adherence to be significantly associated with higher numbers of patients (γ10 = − 5.58, CI = − 10.97, − 0.19, p = .04). No association between adherence to the guideline and PwD’s quality of life was found (γ10 = −.86, CI = − 4.18, 2.47, p = .61). Conclusion The present study examined the role of adherence to the German Dementia Guideline recommendations in primary care. Overall, GPs reported high levels of adherence. However, major differences across guideline recommendations were found. Findings highlight the importance of guidelines for the provision of care. Dementia guidelines for GPs need to be better tailored and addressed. Further, structural changes such as more time for PwD may contribute to a sustainable change of dementia care in primary care. Trial registration The DemTab trial was prospectively registered with the ISRCTN registry (Trial registration number: ISRCTN15854413). Registered 01 April 2019.


2020 ◽  
Vol 1 (2) ◽  
pp. 157
Author(s):  
Hasan Bastomi

<p class="AbstrakAGC"><strong>Purpose - </strong> This study aims to investigate the optimization of the role of religious instructors in the midst of the COVID-19 pandemic.</p><p class="AbstrakAGC"><strong>Method -</strong> This research is a type of library research, namely, by recording all findings and integrating all findings, both theories and new findings about the religious extension, analyzing all findings from various reading and providing critical ideas about optimizing the role of religious instructors in the midst of the COVID-19 pandemic.</p><p class="AbstrakAGC"><strong>Result</strong> - The results of the study show that various issues in all sectors emerged as a result of the outbreak of the COVID-19 pandemic, it is necessary to optimize the role of religious instructors who play a very strategic role in the framework of mental, moral, and value development devotion of the people and also contribute to improving the quality of life of the people in various fields both in the field of religion and development amid COVID-19 pandemic by carrying out informative and educative functions, consultative functions, and advocacy functions.</p><p class="AbstrakAGC"><strong>Implications -</strong> To optimize the role, several things need to be done by religious instructors.</p><p><strong>Originality - </strong>The framework of mental development with optimization of religious extension role in the midst of COVID-19 pandemic.</p>


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