The clinical course of chronic periodontitis. IV. Gingival inflammation as a risk factor in tooth mortality

e19556 Background: CD19 chimeric antigen receptor T cell therapy possesses unique side effects including cytokine release syndrome (CRS) and immune effector cell associated neurotoxicity syndrome (ICANS). Age is a major risk factor for ICANS. However, whether ICANS in older patients is different compared to younger patients is unknown. Herein, we report clinical course, outcomes and risk factors for ICANS in older patients with large B cell lymphoma (LBCL) treated with axicabtagene ciloleucel (axi-cel). Methods: We comprehensively reviewed detailed clinical courses of ICANS in 78 adult patients with LBCL treated with axi-cel between June 2016 and October 2020. Incidence, manifestation, risk factors, treatment, and outcomes of ICANS were compared between patients age ≥60 (n=32) and <60 (n=46) years old. Results: Baseline characteristics were comparable between older and younger patients except higher proportion of high international prognostic index and underlying cerebral microvascular disease in older patients. ICANS was observed in 16 patients in the older and 24 patients in the younger age group, with a 30-day incidence of 52% and 50%, respectively. Median time to CRS and ICANS were similar between 2 age groups. The most common initial neurological findings included aphasia, dysgraphia and encephalopathy in both age groups. Table summarizes the characteristics, clinical course and interventions of ICANS in older and younger patients. In Cox regression model, the presence of CRS was the only factor associated with ICANS in both age groups. Age, history of central nervous system involvement and cerebral microvascular disease were not associated with ICANS. Importantly, all patients had complete resolution of ICANS. No elderly patients in our cohort experienced seizure as a manifestation of ICANS. Conclusions: In our study, older age was not a risk factor for ICANS. CRS was the only factor associated with ICANS in both younger and older patients. Incidence, clinical course and neurological outcomes of ICANS in older patients treated with axi-cel were comparable to younger patients. [Table: see text]

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Falcotentorial Location of Dural Arteriovenous Fistulas Derived from the Neural Crest as a Risk Factor for Aggressive Clinical Course

Acta Neurochirurgica Supplement - Trends in the Management of Cerebrovascular Diseases ◽

10.1007/978-3-319-73739-3_18 ◽

2018 ◽

pp. 121-126

Author(s):

Michihiro Tanaka

Keyword(s):

Risk Factor ◽

Neural Crest ◽

Clinical Course ◽

Arteriovenous Fistulas ◽

Dural Arteriovenous Fistulas ◽

Aggressive Clinical Course

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Pulmonary Vascular Lipid Deposition After Administration of Intravenous Fat to Infants

PEDIATRICS ◽

10.1542/peds.79.1.99 ◽

1987 ◽

Vol 79 (1) ◽

pp. 99-102

Author(s):

Robert J. Shulman ◽

Claire Langston ◽

Richard J. Schanler

Keyword(s):

Risk Factor ◽

Lipid Emulsion ◽

Clinical Course ◽

Serum Triglyceride ◽

Peak Serum ◽

Lipid Deposition ◽

Fat Emulsion ◽

Intravenous Fat Emulsion ◽

Intravenous Lipid Emulsion ◽

The Relationship

The incidence of pulmonary vascular lipid deposits in infants who did or did not receive intravenous lipid emulsion was determined through a review of the pulmonary histopathology and clinical course of 39 neonates who died during a two-year period. The relationship between pulmonary vascular lipid deposits and the duration and amount of administered intravenous fat emulsion was assessed. In addition, the effect of monitored serum triglyceride levels on the development of pulmonary vascular lipid deposits was evaluated. The incidence of pulmonary vascular lipid deposits was greater in the group that received intravenous fat emulsion (P < .02). Both the amount (grams per kilogram per day) and duration (days) of intravenous fat emulsion infusion were correlated positively with severity (P < .05) in infants who had pulmonary vascular lipid deposits. No relationship was seen between peak serum triglyceride levels, the frequency of elevated triglycerides, and pulmonary vascular lipid deposits. Although administered fat emulsion was a risk factor for the development of pulmonary vascular deposits, two of 13 infants who had not received intravenous fat emulsion had such deposits.

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Recurrent Idiopathic Gingival Hyperplasia

Journal of Nepalese Society of Periodontology and Oral Implantology ◽

10.3126/jnspoi.v3i1.24827 ◽

2019 ◽

Vol 3 (1) ◽

pp. 35-37

Author(s):

Junima Rajkarnikar ◽

Bikash Veer Shrestha ◽

Santhosh Kumar

Keyword(s):

Patient Compliance ◽

Successful Treatment ◽

Oral Hygiene ◽

Chronic Periodontitis ◽

Common Type ◽

Gingival Hyperplasia ◽

Gingival Inflammation ◽

Orthodontic Therapy ◽

Gingival Enlargement

Increase in size of the gingiva is termed as gingival enlargement. Most common type of gingival enlargement is inflammatory, which his caused due to plaque accumulation and improper oral hygiene maintenance. Orthodontic therapy can often lead to failure to improve oral hygiene. This case describes a recurrent, progressive gingival enlargement of a 19 year old female orthodontic patient in which gingivectomy was performed and repeated, which subsequently failed. Hence modified Widman’s flap was performed with medical supplements. Periodic periodontal check up is required in orthodontic cases to control the gingival inflammation. Patient compliance is also very important in such cases. There should be proper co-operation between the Orthodontist and Periodontist for successful treatment of gingival hyperplasia. Patients with such conditions should be carefully monitored and checked to avoid the recurrence and avoid further progression into chronic periodontitis.

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Serum ionised calcium as a prognostic risk factor in the clinical course of pancreatitis in cats

Journal of Feline Medicine and Surgery ◽

10.1177/1098612x14564203 ◽

2014 ◽

Vol 17 (12) ◽

pp. 984-990 ◽

Cited By ~ 8

Author(s):

Claúdia Dias ◽

L Miguel Carreira

Keyword(s):

Risk Factor ◽

Clinical Course ◽

Ionised Calcium

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Explaining why childhood abuse is a risk factor for poorer clinical course in bipolar disorder: a path analysis of 923 people with bipolar I disorder

Psychological Medicine ◽

10.1017/s0033291719002411 ◽

2019 ◽

Vol 50 (14) ◽

pp. 2346-2354 ◽

Cited By ~ 1

Author(s):

Steven Marwaha ◽

Paul M. Briley ◽

Amy Perry ◽

Phillip Rankin ◽

Arianna DiFlorio ◽

...

Keyword(s):

Bipolar Disorder ◽

Risk Factor ◽

Anxiety Disorders ◽

Path Analysis ◽

Childhood Abuse ◽

Clinical Features ◽

Clinical Course ◽

Rapid Cycling ◽

Bipolar I Disorder ◽

Affective Instability

AbstractBackgroundChildhood abuse is a risk factor for poorer illness course in bipolar disorder, but the reasons why are unclear. Trait-like features such as affective instability and impulsivity could be part of the explanation. We aimed to examine whether childhood abuse was associated with clinical features of bipolar disorder, and whether associations were mediated by affective instability or impulsivity.MethodsWe analysed data from 923 people with bipolar I disorder recruited by the Bipolar Disorder Research Network. Adjusted associations between childhood abuse, affective instability and impulsivity and eight clinical variables were analysed. A path analysis examined the direct and indirect links between childhood abuse and clinical features with affective instability and impulsivity as mediators.ResultsAffective instability significantly mediated the association between childhood abuse and earlier age of onset [effect estimate (θ)/standard error (SE): 2.49], number of depressive (θ/SE: 2.08) and manic episodes/illness year (θ/SE: 1.32), anxiety disorders (θ/SE: 1.98) and rapid cycling (θ/SE: 2.25). Impulsivity significantly mediated the association between childhood abuse and manic episodes/illness year (θ/SE: 1.79), anxiety disorders (θ/SE: 1.59), rapid cycling (θ/SE: 1.809), suicidal behaviour (θ/SE: 2.12) and substance misuse (θ/SE: 3.09). Measures of path analysis fit indicated an excellent fit to the data.ConclusionsAffective instability and impulsivity are likely part of the mechanism of why childhood abuse increases risk of poorer clinical course in bipolar disorder, with each showing some selectivity in pathways. They are potential novel targets for intervention to improve outcome in bipolar disorder.

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The Clinical Course of Chronic Periodontitis: V. Predictive Factors in Periodontal Disease

Primary Dental Care ◽

10.1308/135576109788634395 ◽

2009 ◽

Vol os16 (3) ◽

pp. 102-102

Author(s):

M Schätzle ◽

MJ Faddy ◽

GJ Seymour ◽

NP Lang ◽

W Bürgin

Keyword(s):

Periodontal Disease ◽

Predictive Factors ◽

Chronic Periodontitis ◽

Clinical Course

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Is the presence ofHelicobacter pyloriin the Dental Plaque of Patients with Chronic Periodontitis a Risk Factor for Gastric Infection?

Canadian Journal of Gastroenterology ◽

10.1155/2009/950527 ◽

2009 ◽

Vol 23 (3) ◽

pp. 177-179 ◽

Cited By ~ 40

Author(s):

Mohammed Al Asqah ◽

Nawaf Al Hamoudi ◽

Sukumaran Anil ◽

Abdulrahman Al jebreen ◽

Waleed Khalid Al-hamoudi

Keyword(s):

Risk Factor ◽

Chronic Periodontitis ◽

Dental Plaque ◽

Group Versus ◽

Periodontal Pocket ◽

Upper Gastrointestinal Endoscopy ◽

Peptic Ulcers ◽

H Pylori ◽

Upper Gastrointestinal ◽

Test Result

BACKGROUND:Helicobacter pyloriis considered to be a pathogen responsible for gastritis and peptic ulcers, and a risk factor for gastric cancer. A periodontal pocket in the teeth of individuals with chronic periodontitis may function as a reservoir forH pylori.OBJECTIVE: The present study was undertaken to evaluate whether the presence ofH pyloriin the dental plaque of patients with and without periodontitis correlates with gastric involvement.METHODS: A total of 101 patients with dyspepsia were included in the present study. Subjects were divided into periodontitis and non-periodontitis groups. For the detection ofH pyloriin dental plaque, samples were collected from two teeth using a periodontal curette. Subgingival plaque was obtained by inserting two sterile paper points into periodontal pockets for 20 s. This was followed by an upper gastrointestinal endoscopy and antral biopsies.RESULTS: Sixty-five per cent of patients had dental plaque positive forH pyloriand more than 50% harboured the bacteria in their stomach. Periodontitis patients had a significantly higher percentage ofH pyloriin their dental plaque (79% versus 43%; P<0.05) and the stomach (60% versus 33%; P<0.05) than patients with no periodontitis. Additionally, 78% of patients from the periodontitis group versus only 30% from the nonperiodontitis group had a positive test result for the coexistence ofH pyloriin both dental plaque and the stomach.CONCLUSION: Patients with poor oral hygiene have a higher prevalence ofH pyloriin dental plaque and in the stomach. This finding suggests that the oral cavity may be a reservoir forH pylori,and potentially a source of transmission or reinfection.

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