scholarly journals Risk Score Algorithm for Treatment of Persistent Apical Periodontitis

2014 ◽  
Vol 93 (11) ◽  
pp. 1076-1082 ◽  
Author(s):  
V.S. Yu ◽  
L.W. Khin ◽  
C.S. Hsu ◽  
R. Yee ◽  
H.H. Messer

Persistent apical periodontitis related to a nonvital tooth that does not resolve following root canal treatment may be compatible with health and may not require further intervention. This research aimed to develop a Deterioration Risk Score (DRS) to differentiate lesions requiring further intervention from lesions likely to be compatible with health. In this cross-sectional study, patient records (2003-2008) were screened for root-filled teeth with periapical radiolucency visible on periapical radiographs taken at treatment and at recruitment at least 4 yr later. The final sample consisted of 228 lesions in 182 patients. Potential demographic and treatment risk factors were screened against 3 categorical outcomes (improved/unchanged/deteriorated), and a multivariate independent multinomial probit regression model was built. A 5-level DRS was constructed by summing values of adjusted regression coefficients in the model, based on predicted probabilities of deterioration. Most lesions (127, 55.7%) had improved over time, while 32 (14.0%) remained unchanged, and 69 (30.3%) had deteriorated. Significant predictors of deterioration were as follows: time since treatment (relative risk [RR]: 1.11, 95% confidence interval [CI]: 1.01-1.22, p = .030, rounded beta value = 1, for every year increase after 4 yr), current pain (RR: 3.79, 95% CI: 1.48-9.70, p = .005, rounded beta value = 13), sinus tract present (RR: 4.13, 95% CI: 1.11-15.29, p = .034, rounded beta value = 14), and lesion size (RR: 7.20, 95% CI: 3.70-14.02, p < .001, rounded beta value = 20). Persistent apical periodontitis with DRS <15 represented very low risk; 15-20, low risk; 21-30, moderate risk; 31-40, high risk; and >40, very high risk. DRS could help the clinician identify persistent apical periodontitis at low risk for deterioration, and it would not require intervention. When validated, this tool could reduce the risk of overtreatment and contribute toward targeted care and better efficiency in the timely management of disease.

Author(s):  
Singam Sivasankar Reddy ◽  
Syeda Rahath ◽  
Rakshitha H N ◽  
Godson K Lal ◽  
Swathy S ◽  
...  

The objective of the study was to evaluate the risk of diabetes mellitus in elderlywith age above 20 years in a hospital setting using Indian Diabetes risk score and to provide patient counselling regarding their life style modifications and health related quality of life among participants with high risk of developing diabetes.A total of 125 non diabetic patients were interviewed with a pre designed selfstructured questionnaire (IDRS). Participants were chosen voluntarily and a written consent was obtained before the administration of the questionnaire from individual patients. In our study we observed that out of 125 patients,males 26[59%]and 18[41%] females were at high risk, males 39[58.2%] and 28[41.8%] females were at moderate risk, males 5[35.7%] and 9[64.3%] females were at low risk of developing diabetes mellitus.


Author(s):  
Basavaraj S. Mannapur ◽  
Bhagyalaxmi S. Sidenur ◽  
Ashok S. Dorle

Background: Diabetes is considered as a global emergency where a person dies from diabetes every 6 seconds and diabetes is seen on 1 in 11 adults. Identification of individuals who are at risk is very much necessary to prevent diabetes in India. IDRS could also help to detect people at risk of having prediabetes. The objective of the study were to estimate the prevalence of diabetes mellitus in the age group of >20 years in urban field practice area of S.N. Medical college, Bagalkot and to identify high risk subjects using Indian diabetes risk score (IDRS).Methods: A cross sectional study was done in urban field practice area of S.N. Medical College among adults >20 years of age with sample size of 207. Systematic random sampling was used to select the subjects. Data was collected using standardised questionnaire which included socio-demographic profile, standard glucometer was used to measure random blood glucose for all participants. IDRS was used to ascertain the risk of developing diabetes. Data was analysed using Pearson’s Chi square test and Fischer exact.Results: The overall prevalence of diabetes was 14.1%. Among 206 subjects, 4.8% were in low risk category. 39.6% and 55.1% were in moderate and high risk category respectively. Total of 11 subjects were newly diagnosed in our study. Among them 10 subjects were in the high risk category and 1 was in the low risk category. Sensitivity of IDRS was 90%, specificity 50%, positive predictive value 43.8% and negative predictive value 96.74%..Conclusions: This study estimates the usefulness of simplified Indian diabetes risk score for identifying high risk diabetic subjects in the community. It can be used routinely in commu­nity-based screening to find out high risk people for diabetes so that proper intervention can be done to reduce the burden of the disease. 


e-CliniC ◽  
2017 ◽  
Vol 5 (2) ◽  
Author(s):  
Engelin E. Emor ◽  
Agnes L. Panda ◽  
Janry Pangemanan

Abstract: Atherosclerotic cardiovascular disease is caused by the accumulation of plaque on the artery wall causing dysfunction of anatomical and hemodynamic system of the heart and blood flow. There are many risk factors that cause atherosclerotic cardiovascular disease which are divided into modifiable and unmodifiable risk factors. Prevention of this disease can be achieved with early detection, such as prediction the risk level of 10 years ahead of atherosclerotic cardiovascular disease by using the Framingham Risk Score (FRS). This study was aimed to obtain the risk level of atherosclerotic cardiovascular disease in patients at Internal Medicine Polyclinic of Prof. Dr. R. D. Kandou Hospital Manado by using their medical records from September to October 2017. This was a descriptive study with a cross sectional design. There were 100 samples obtained by using conclusive sampling technique. Of the 100 patients, 42 (42%) patients had low risk, 27 (27%) patients had moderate risk, and 31 (31%) patients had high risk of atherosclerotic cardiovascular disease in 10 years ahead. Conclusion: In this study, the highest percentage was in patients with low risk, followed by patients with high risk, and moderate risk.Keywords: ASCVD, Framingham Risk Score, Risk of atherosclerotic cardiovascular sisease. Abstrak: Penyakit kardiovaskuler aterosklerotik adalah penyakit yang disebabkan oleh adanya timbunan plak pada dinding arteri sehingga menyebabkan gangguan fungsional, anatomis serta sistem hemodinamis jantung dan pembuluh darah. Terdapat banyak faktor risiko yang menyebabkan terjadinya penyakit kardiovaskuler aterosklerotik yang dibagi menjadi faktor risiko yang dapat dimodifikasi dan yang tidak dapat dimodifikasi. Pencegahan penyakit ini dapat dilakukan dengan deteksi dini, salah satunya yaitu dengan memrediksi tingkat risiko 10 tahun kedepan terjadinya penyakit kardiovaskuler aterosklerotik dengan menggunakan Framingham Risk Score. Penelitian ini bertujuan untuk mengetahui tingkat risiko penyakit kardiovaskuler ateroskerotik pada pasien di Poliklinik Penyakit Dalam RSUP Prof. Dr. R. D. Kandou Manado. Jenis penelitian ialah deskriptif dengan desain potong lintang menggunakan data rekam medik pasien Poliklinik Penyakit Dalam RSUP Prof. Dr. R. D. Kandou Manado periode September - Oktober 2017. Sampel penelitian berjumlah 100 orang dengan teknik pengambilan conclusive sampling. Terdapat 42 pasien (42%) dengan tingkat risiko rendah, 27 pasien (27%) dengan risiko sedang, dan 31 pasien (31%) dengan risiko tinggi terkena penyakit kardiovaskuler aterosklerotik 10 tahun kedepan. Simpulan: Pada studi ini, persentase tertinggi ialah pasien dengan tingkat risiko rendah terjadinya penyakit kardiovaskuler aterosklerotik, diikuti tingkat risiko tinggi dan risiko sedang.Kata kunci: ASCVD, Framingham Risk Score, tingkat risiko penyakit kardiovaskuler aterosklerotik


Author(s):  
Tamilarasan M. ◽  
Maniprabhu Selvaraju ◽  
Karthikeyan Kulothungan ◽  
Srirangathan T.

Background: Various studies from the urban population shows people are more susceptible to develop type 2 diabetes mellitus. Since the cause of diabetes is multifactorial it is necessary to screen the population to identify high-risk individuals. The objective of the study was to estimate the risk of developing type 2 Diabetes Mellitus (T2DM) using the Indian diabetes risk score (IDRS) and its determinants in the urban field practicing area of the medical college in Perambalur district.Methods: A cross-sectional study was conducted in an urban field practicing area of Dhanalakshmi Srinivasan Medical College and Hospital in Perambalur district. 400 participants of age more than 20 years enrolled in this study. IDRS risk score and data on other risk factors were obtained for every individual. Data entry was done in Excel and statistical analysis was done with SPSS version 16.Results: In our study, the proportion of male and female were almost equal. One-third of the participants 124 (31%) had a high risk of developing type 2 diabetes mellitus. Similarly, half of them 188 (47%) were at moderate risk and 88 (22%) had a low risk for diabetes. Statistically, a significant association was seen between high risk for T2DM and increased age, positive family history, Low socioeconomic status, living as a nuclear family, habits of smoking/Alcohol, and sedentary lifestyle.Conclusions: The risk of developing type 2 diabetes mellitus among the urban population is rising trends. For effective screening of the general population, IDRS can be used.


2021 ◽  
Vol 4 (1) ◽  
pp. 10
Author(s):  
Gondo Mastutik ◽  
Alphania Rahniayu ◽  
Dwi Murtiastutik ◽  
Afria Arista ◽  
Trisniartami Setyaningrum ◽  
...  

Introduction: Condyloma acuminata that is also known as genital warts are one of the most common sexually transmitted that caused by infection of Human papillomavirus (HPV). Persistent infection of Low Risk (LR) or High risk (HR) HPV is a risk factor for progress into benign or malignant cancer. The objective is to analyze distribution of genotype LR-HPV and HR-HPV at condyloma acuminata in anogenital region. Methods: A cross sectional study using were 36 lesions from men and women of condyloma acuminata patients. All subject signed the informed consent and ethic obtained from our institution, number 382/Panke.KKE/V/2016. The specimen was used to histopathological examination and to identified 40 genotypes of HPV using a reverse line blot assay.Results: The All patients were diagnosed as condyloma acuminata, some with focus dysplasia and koilocytosis. All patients were positive for HPV, including LR-HPV were HPV 6, 11, 42, 54, 61, 81,87,89 and HR-HPV were HPV 18, 26, 45, 51, 52, 66, 67, 68B, 69, 82. The single infection of LR-HPV was 44.4%, multiple infection LR/LR-HPV was 13,9% and the multiple infection of LR/HR-HPV was 41.7%. The LR-HPV infected 70,6% and HR-HPV infected 29,4%.  Conclusion: LR-HPV is the major infection of condyloma acuminata, in single infection or multiple infection with HR-HPV. The most common infections were HPV 11, followed by HPV 6, HPV 18, HPV 51, and HPV 82. The determination of genotype of HPV can be used to predict the malignant transformation.


2020 ◽  
Vol 9 (12) ◽  
pp. 4066
Author(s):  
Nicola Capasso ◽  
Raffaele Palladino ◽  
Emma Montella ◽  
Francesca Pennino ◽  
Roberta Lanzillo ◽  
...  

Background. We compared the prevalence of SARS-CoV-2 IgG/IgM in multiple sclerosis (MS), low-risk, and high-risk populations and explored possible clinical correlates. Methods. In this cross-sectional study, we recruited MS patients, low-risk (university staff from non-clinical departments), and high-risk individuals (healthcare staff from COVID-19 wards) from 11 May to 15 June 2020. We used lateral flow immunoassay to detect SARS-CoV-2 IgG and IgM. We used t-test, Fisher’s exact test, chi square test, or McNemar’s test, as appropriate, to evaluate between-group differences. Results. We recruited 310 MS patients (42.3 ± 12.4 years; females 67.1%), 862 low-risk individuals (42.9 ± 13.3 years; females 47.8%), and 235 high-risk individuals (39.4 ± 10.9 years; females 54.5%). The prevalence of SARS-CoV-2 IgG/IgM in MS patients (n = 9, 2.9%) was significantly lower than in the high-risk population (n = 25, 10.6%) (p < 0.001), and similar to the low-risk population (n = 11, 1.3%) (p = 0.057); these results were also confirmed after random matching by age and sex (1:1:1). No significant differences were found in demographic, clinical, treatment, and laboratory features. Among MS patients positive to SARS-CoV-2 IgG/IgM (n = 9), only two patients retrospectively reported mild and short-lasting COVID-19 symptoms. Conclusions. MS patients have similar risk of SARS-CoV-2 infection to the general population, and can be asymptomatic from COVID-19, also if using treatments with systemic immunosuppression.


Author(s):  
Vidya K. R. ◽  
Lohit K. ◽  
Naveen Kumar P.

Background: Prevalence of diabetes mellitus is increasing in an alarming way throughout the world. More than 50% of the diabetic subjects in India remain unaware of their diabetes status and screening for risk factors of diabetes mellitus enable us to initiate appropriate control measures. This study was undertaken to identify the people who are at risk of diabetes mellitus in rural area of Bengaluru.Methods: It was a community based cross sectional study in which 1750 study subjects were randomly selected using multi stage random sampling method. Selected individuals were examined and interviewed using a semi structured questionnaire. Indian diabetic risk score was used to assess risk of developing diabetes. Data entry and analysis was done using SPSS version 20.0.Results: According to IDRS, 46.2% of respondents were in the moderate risk group and 33.1% were in the high risk group. Family history of diabetes, low physical activity and abdominal obesity were found to associate with high risk group.Conclusions: The prevalence of high risk for diabetes according to IRDS was 33%. Primordial and primary preventive actions are very much necessary.


Author(s):  
Aditya Pandey ◽  
Amit Patel

Background: Diabetes mellitus is a major public health problem which affects all age groups and has now been identified in young. Indian diabetes risk score (IDRS), devised and developed by Mohan et al. at the Madras Diabetes Research Foundation, is a validated tool to identify individuals with high risk of developing type 2 diabetes mellitus.Methods: Present cross-sectional study was conducted among medical students of a medical college in Jhansi from June 2021 to September 2021. A semi-structured interview schedule for socio demographic details of subjects like age, gender, education/occupation of parents and physical activity. Written informed consent was taken. Statistical analysis used was SPSS trial version was used for data analysis. P<0.05 was considered as statistically significant.Results: A total of 300 medical students were included in the study. IDRS categorization revealed 10 (3.3%) respondents had score >60 (high risk) and 84 (28%) respondents had score between 30-50 (moderate risk). While 206 (68.6%) respondent had score <30 (low risk).Conclusions: Our study supports the use of IDRS method as screening of diabetes at mass level as it is cost effective as well as time saving procedure.


2021 ◽  
Vol 49 (11) ◽  
pp. 030006052110583
Author(s):  
Lawless Robert ◽  
Vickers Mark ◽  
Alawami Moayed ◽  
Appasamy Nivashen ◽  
Rajasingam Vinod ◽  
...  

Objective We aimed to assess prescribing practices, compliance with guidelines, and outcomes for patients who were admitted to the authors’ institution with community-acquired pneumonia (CAP). Methods We performed a single-center retrospective cross-sectional study of adults with CAP presenting during the 2019 influenza season. CAP severity was assessed using the CURB-65 risk score. The effect of CURB-65 risk score use on the rate of appropriate antimicrobial prescribing was assessed using the chi-square test and reported as odds ratio (OR). Fisher’s exact test was used to assess the relationship between prescribing appropriateness and patient outcomes. Results Patients with low-risk CAP were most likely to be inappropriately prescribed antimicrobials (OR: 4.77; 95% confidence interval: 2.44–10.47). In low-risk CAP, the most common prescribing error was overuse of ceftriaxone. In high-risk CAP, the most common errors were ceftriaxone underdosing and missed atypical coverage with azithromycin. Overall, 80% of patients were considered to have been inappropriately prescribed antimicrobials. No effect on mortality was observed. Conclusions In this study, we found low use of CAP risk scores and low adherence to antimicrobial prescribing guidelines for CAP at the authors’ institution.


Author(s):  
Ana Karina Marques Salge ◽  
Érika Lopes Rocha ◽  
Maria Aparecida Munhoz Gaíva ◽  
Thaíla Correa Castral ◽  
Janaína Valadares Guimarães ◽  
...  

Abstract OBJECTIVE Comparing foot length measurements of newborns in high and low risk pregnancies at a public hospital in Goiânia, GO, Brazil. METHOD A cross-sectional study carried out between April, 2013 and May, 2015, with a sample consisting of 180 newborns; 106 infants of women from high-risk pregnancies and 74 of women from low-risk pregnancies. Data were descriptively analyzed. Foot length measurement was performed using a stiff transparent plastic ruler, graduated in millimeters. The length of both feet was measured from the tip of the hallux (big toe) to the end of the heel. RESULTS A statistically significant relationship was found between the foot length and newborn’s weight, between the cephalic and thoracic perimeters in the high-risk group and between the cephalic perimeter in the control group. CONCLUSION There is a need for creating cut-off points to identify newborns with intrauterine growth disorders using foot length.


Sign in / Sign up

Export Citation Format

Share Document