Management of Medically Compromised Prosthodontic Patients

The medical evaluation of patients considering prosthodontic treatment is a vital step in the treatment planning. The prosthodontist should be able to assess the inherent risks associated with the treatment of patients with systemic conditions. Many factors are associated with evaluating the patient’s health status and risk including the patient’s current and past medical and dental history, current and past use of medications, type of treatment, length of treatment, invasiveness of treatment, and degree of urgency of treatment. In this article, some of the systemic diseases like arthritis, cardiovascular diseases, endocrine disorders, hematologic and oncologic disease, neurologic disorders, bone disorders, pulmonary diseases, liver diseases, and chronic kidney disease that commonly affect aged individuals are reviewed. The prosthodontic considerations that should be taken care of while managing patients with these systemic conditions will also be discussed.

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CHRONIC KIDNEY DISEASE AND CARDIOVASCULAR DISEASES: FOCUS ON ATRIAL FIBRILLATION

Rational Pharmacotherapy in Cardiology ◽

10.20996/1819-6446-2015-11-2-196-201 ◽

2015 ◽

Vol 11 (2) ◽

pp. 196-201 ◽

Cited By ~ 3

Author(s):

V. N. Shishkova

Keyword(s):

Atrial Fibrillation ◽

Chronic Kidney Disease ◽

Cardiovascular Diseases ◽

Kidney Disease

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THE CLINICAL EPIDEMIOLOGY OF CARDIOVASCULAR DISEASES IN CHRONIC KIDNEY DISEASE: Clinical Epidemiology of Cardiovascular Disease in Chronic Kidney Disease Prior to Dialysis

Seminars in Dialysis ◽

10.1046/j.1525-139x.2003.16025.x ◽

2003 ◽

Vol 16 (2) ◽

pp. 101-105 ◽

Cited By ~ 160

Author(s):

Adeera Levin

Keyword(s):

Cardiovascular Disease ◽

Chronic Kidney Disease ◽

Cardiovascular Diseases ◽

Kidney Disease ◽

Clinical Epidemiology

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Possibilities of using fosinopril in treatment of patients with chronic kidney disease in combination with cardiovascular diseases and diabetes mellitus

Medical alphabet ◽

10.33667/2078-5631-2021-1-17-25 ◽

2021 ◽

pp. 17-25

Author(s):

E. Yu. Ebzeeva ◽

O. D. Ostroumova ◽

S. V. Batyukina ◽

N. A. Shatalova ◽

N. M. Doldo ◽

...

Keyword(s):

Diabetes Mellitus ◽

Chronic Kidney Disease ◽

Cardiovascular Diseases ◽

Kidney Disease ◽

Angiotensin Converting Enzyme ◽

Enzyme Inhibitor ◽

The Body ◽

Converting Enzyme ◽

Converting Enzyme Inhibitors ◽

Secondary Damage

Chronic kidney disease is one of the most common diseases in general medical practice, due to their secondary damage to the kidneys in arterial hypertension, chronic heart failure, and diabetes mellitus. The coexistence of hypertension and diabetes increases the likelihood of developing chronic kidney failure tenfold. In turn, chronic kidney disease is an important independent risk factor for the development of cardiovascular complications, including fatal ones, due to the direct relationship of the pathogenetic mechanisms of cardiorenal relationships. Approaches to the treatment of chronic kidney disease should be aimed both at preventing the risks of developing renal dysfunction, and at treating existing pathology. The multifactorial nature of the disease and the complex etiopathogenetic relationships determine the need to optimize existing approaches to the treatment of chronic kidney disease in multimorbidity patients with concomitance cardiovascular diseases and diabetes mellitus. This is also due to the fact that, unlike other target organs, compensation for background disease does not always prevent further deterioration of kidney function. According to the recommendations of the main scientific communities, in such cases, it is advisable to start therapy with the most effective angiotensin-converting enzyme inhibitors that combine nephro-and cardioprotective effects and have a dual route of elimination from the body, which is especially important in multimorbidity, the aim to prevent polypharmacy, reduce the risk of drug interactions and, consequently, side effects. This article reviews the literature data indicating the high efficacy and safety of the angiotensin converting enzyme inhibitor fosinopril in patients with chronic kidney disease in combination with cardiovascular diseases and diabetes mellitus.

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Comorbid diseases as predictors of survival of primary total hip and knee replacements: a nationwide register-based study of 96 754 operations on patients with primary osteoarthritis

Annals of the Rheumatic Diseases ◽

10.1136/annrheumdis-2012-202064 ◽

2012 ◽

Vol 72 (12) ◽

pp. 1975-1982 ◽

Cited By ~ 41

Author(s):

Esa Jämsen ◽

Mikko Peltola ◽

Antti Eskelinen ◽

Matti U K Lehto

Keyword(s):

Cardiovascular Diseases ◽

Psychotic Disorders ◽

Pulmonary Diseases ◽

Cox Regression Analysis ◽

Total Hip ◽

Prosthesis Survival ◽

Early Revision ◽

Combining Data ◽

Knee Replacements ◽

Comorbid Diseases

ObjectivesTo examine how comorbid diseases (cardiovascular diseases, hypertension, diabetes, cancer, pulmonary diseases, depression, psychotic disorders and neurodegenerative diseases) affect survival of hip and knee replacements.MethodsData for this register-based study were collected by combining data from five nationwide health registers. 43 747 primary total hip and 53 007 primary total knee replacements performed for osteoarthritis were included. The independent effects of comorbid diseases on prosthesis survival were analysed using multivariate Cox regression analysis.ResultsOccurrence of one or more of the diseases analysed was associated with poorer survival of hip (HR for revision 1.16, 95% CI 1.08 to 1.23) and knee replacements (1.23, 1.16 to 1.30). Cardiovascular diseases and psychotic disorders were associated with increased risk of revision after both hip (1.19, 1.06 to 1.34 and 1.41, 1.04 to 1.91, respectively) and knee replacement (1.29, 1.14 to 1.45 and 1.41, 1.07 to 1.86, respectively). Hypertension and diabetes were associated with early revision (0–5 years after primary operation) after knee replacements (1.14, 1.01 to 1.29 and 1.27, 1.08 to 1.50, respectively). Cancer was associated with poorer survival of hip replacements (1.27, 1.05 to 1.54) and late revision (>5 years) of knee replacements (2.21, 1.31 to 3.74). Depression affected the risk of early revision after hip replacement (1.50, 1.02 to 2.21). Neurodegenerative and pulmonary diseases did not affect prosthesis survival.ConclusionsComorbid diseases may play an important role in predicting survival of primary hip and knee replacements. The mechanisms underlying these findings and their effect on cost-effectiveness of joint replacements, merit further research.

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The role of inflammation in chronic kidney disease

10.1093/med/9780199592548.003.0110 ◽

2015 ◽

Author(s):

Juan Jesús Carrero ◽

Peter Stenvinkel

Keyword(s):

Chronic Kidney Disease ◽

Kidney Disease ◽

Endocrine Disorders ◽

Low Grade ◽

Protein Energy Wasting ◽

Protein Levels ◽

Reactive Protein ◽

Protein Energy ◽

Persistent Inflammation ◽

Clinical Consequences

Low-grade persistent inflammation is a common feature of chronic kidney disease. This chapter provides an overview of the pathogenesis and clinical consequences of elevated pro-inflammatory cytokines in the uraemic milieu with an emphasis on dialysis stages. It reviews the multifactorial dialysis- and non-dialysis-related causes of inflammation and its purported role in the development of protein energy wasting, vascular calcification, endocrine disorders, and depression. The chapter also discusses the use and the need of monitoring C-reactive protein levels regularly in the clinical setting and comments on possible therapeutic approaches to reduce inflammation in these patients.

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