scholarly journals Clinical considerations for medication-related osteonecrosis of the jaw: a comprehensive literature review

2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Mampei Kawahara ◽  
Shinichiro Kuroshima ◽  
Takashi Sawase
Keyword(s):  
Risk Factors ◽  
Literature Review ◽  
Dental Treatment ◽  
Treatment Strategies ◽  
Osteonecrosis Of The Jaw ◽  
High Dose ◽  
Exclusion Criteria ◽  
Clinical Recommendations ◽  
Pubmed Database ◽  
Clinical Considerations

Abstract Background Medication-related osteonecrosis of the jaw (MRONJ), which was first reported as bisphosphonate-related osteonecrosis of the jaw (BRONJ) in bisphosphonate users, is a rare but severe soft and hard tissue disease induced by several types of medications. There has been a deluge of information about MRONJ, such as epidemiology, risk factors, clinical recommendations for dental treatment to prevent it, and treatment strategies in medication-prescribed users. The aim of this study was to comprehensively review recent articles and provide the current scientific information about MRONJ, especially clinical considerations or recommendations for dental treatment to prevent its occurrence. Materials and methods The current literature review was mainly based on 14 systematic reviews with or without meta-analysis, 4 position papers, 1 consensus statement, 1 clinical guideline, and 2 clinical reviews regarding MRONJ after a PubMed database and manual searches according to inclusion and exclusion criteria. Moreover, 53 articles were selected by manual search in regard to all references from selected articles and other articles identified on the PubMed search, irrespective of publication date, and inclusion and exclusion criteria. Results The incidence and prevalence of MRONJ are relatively low, although they are clearly higher in cancer patients receiving high-dose antiresorptive agents or angiogenesis inhibitors rather than osteoporosis patients receiving oral bisphosphonates or denosumab. There are many types of local, systemic, and other risk factors for the development of MRONJ. Clinical recommendations are provided for each clinical situation of patients to prevent MRONJ. There are also treatment strategies for MRONJ in each stage. Conclusions General dentists should perform appropriate dental treatment to prevent MRONJ in the patients prior to or when receiving medications that could induce MRONJ. Moreover, there are treatment strategies for MRONJ in each stage that oral surgeons could follow. Adequate and updated clinical information regarding MRONJ based on scientific data is required whenever possible.

Recurrent Clostridium Difficile Disease: Epidemiology and Clinical Characteristics

1999 ◽  
Vol 20 (01) ◽  
pp. 43-50 ◽  
Author(s):  
Lynne V. McFarland ◽  
Christina M. Surawicz ◽  
Moshe Rubin ◽  
Robert Fekety ◽  
Gary W. Elmer ◽  
...  
Keyword(s):  
Risk Factors ◽  
Clostridium Difficile ◽  
Lifetime Cost ◽  
Treatment Strategies ◽  
New Combination ◽  
Controlled Clinical Trial ◽  
High Dose ◽  
Recurrence Rates ◽  
Disease Epidemiology ◽  
Multiple Episodes

AbstractObjective:To describe the epidemiology, diagnosis, risk factors, patient impact, and treatment strategies for recurrentClostridium difficile-associated disease (CDAD).Design:Data were collected as part of a blinded, placebo-controlled clinical trial testing a new combination treatment for recurrent CDAD. Retrospective data regarding prior CDAD episodes were collected from interviews and medical-chart review. Prospective data on the current CDAD episode, risk factors, and recurrence rates were collected during a 2-month follow-up.Settings:National referral study.Participants:Patients with recurrent CDAD.Interventions:Treatment with a 10-day course of low-dose (500 mg/d) or high-dose (2 g/d) vancomycin or metronidazole (1 g/d).Results:Recurrent CDAD was found to have a lengthy course involving multiple episodes of diarrhea, abdominal cramping, nausea, and fever. CDAD may recur over several years despite frequent treatment with antibiotics. Recurrence rates were similar regardless of the choice or dose of antibiotic. Recurrent CDAD is not a trivial disease: patients may have multiple episodes (as many as 14), may require hospitalization, and the mean lifetime cost of direct medical care was $10,970 per patient. Fortunately, the disease does not become progressively more severe as the number of episodes increase. Two risk factors predictive for recurrent CDAD were found: increasing age and a decreased quality-of-life score at enrollment.Conclusions:Recurrent CDAD is a persistent disease that may result in prolonged hospital stays, additional medical costs, and rare serious complications.

scholarly journals Bisphosphonate Associated Osteonecrosis of the Jaw

2009 ◽  
Vol 36 (3) ◽  
pp. 478-490 ◽  
Author(s):  
ALIYA A. KHAN ◽  
GEORGE K.B. SÁNDOR ◽  
EDWARD DORE ◽  
ARCHIBALD D. MORRISON ◽  
MAZEN ALSAHLI ◽  
...  
Keyword(s):  
Patient Population ◽  
Low Dose ◽  
Treatment Strategies ◽  
Causal Link ◽  
Osteonecrosis Of The Jaw ◽  
Bisphosphonate Therapy ◽  
High Dose ◽  
Oncology Patient ◽  
Prevention And Treatment ◽  
Incidence Risk

In 2003, the first reports describing osteonecrosis of the jaw (ONJ) in patients receiving bisphosphonates (BP) were published. These cases occurred in patients with cancer receiving high-dose intravenous BP; however, 5% of the cases were in patients with osteoporosis receiving low-dose bisphosphonate therapy. We present the results of a systematic review of the incidence, risk factors, diagnosis, prevention, and treatment of BP associated ONJ. We conducted a comprehensive literature search for relevant studies on BP associated ONJ in oncology and osteoporosis patients published before February 2008.All selected relevant articles were sorted by area of focus. Data for each area were abstracted by 2 independent reviewers. The results showed that the diagnosis is made clinically. Prospective data evaluating the incidence and etiologic factors are very limited. In oncology patients receiving high-dose intravenous BP, ONJ appears to be dependent on the dose and duration of therapy, with an estimated incidence of 1%–12% at 36 months of exposure. In osteoporosis patients, it is rare, with an estimated incidence < 1 case per 100,000 person-years of exposure. The incidence of ONJ in the general population is not known. Currently, there is insufficient evidence to confirm a causal link between low-dose BP use in the osteoporosis patient population and ONJ. We concluded BP associated ONJ is associated with high-dose BP therapy primarily in the oncology patient population. Prevention and treatment strategies are currently based on expert opinion and focus on maintaining good oral hygiene and conservative surgical intervention.

scholarly journals RISK FACTOR OF ECTOPIC PREGNANCY BY USING LITERATURE REVIEW METHOD

2021 ◽  
Vol 5 (3) ◽  
pp. 277
Author(s):  
Winda Fatma Sari ◽  
Adityawarman Adityawarman ◽  
Budiono Budiono
Keyword(s):  
Risk Factors ◽  
Systematic Review ◽  
Risk Factor ◽  
Literature Review ◽  
Ectopic Pregnancy ◽  
Exclusion Criteria ◽  
Mortality And Morbidity ◽  
Pregnancy History ◽  
Major Predictor ◽  
History Of

Background: Ectopic pregnancy is a pregnancy outside the uterus, embryo could attached to thefallopian tube, ovary cervix or cervix. Around 85-90% incidence of ectopic pregnancy is found inmultigravid women. According to data from the Health Office, maternal mortality in 2017 tendsto increase in the last two years. Not only it is a major predictor of mortality and morbidity inpregnant women, but individuals with a history of ectopic pregnancy have a greater risk. Thepurpose of this research was to determine the risk factors that cause ectopic pregnancy by usingliterature studies review. Method:This study used a systematic review of articles that publishedbetween 2013-2020 in the Science Direct, Scopus and Google Scholar. 10 articles that meet theinclusion and exclusion criteria, included as a sample for further review. The results regarding torisk factors that caused ectopic pregnancy in each article were systematically synthesized. Results:Risk factors found to be significantly associated with the incidence of ectopic pregnancy in thearticle were age (2), infertility (2), IUD (3), PID (3), Ectopic Pregnancy History (5), Progestine Pills (2), History of Abortion (1), Smoking (3). Conclusions: age, infertility, IUD, PID, history of ectopic pregnancy, progestine pill, History of abortion, and smoking were risk factors that hadsignificant relationship with the incidence of ectopic pregnancy.

scholarly journals Is the Mandibular Condyle Involved in Medication-Related Osteonecrosis of the Jaw? Audit of a Single Tertiary Referral Center and Literature Review

2021 ◽  
Vol 15 (1) ◽  
pp. 769-777
Author(s):  
Giorgio Lo Giudice ◽  
Antonio Troiano ◽  
Carmelo Lo Faro ◽  
Mario Santagata ◽  
Marco Montella ◽  
...  
Keyword(s):  
Literature Review ◽  
Mandibular Condyle ◽  
Osteonecrosis Of The Jaw ◽  
Tertiary Referral Center ◽  
Site Distribution ◽  
Underlying Malignancy ◽  
Pubmed Database ◽  
Mandibular Body ◽  
Maxilla And Mandible ◽  
Surgery Department

Background: Medication-related osteonecrosis of the jaw (MRONJ) may manifest as exposed mandible bone. Recent reviews of the incidence of MRONJ report primarily as exposed cortical bone of the mandibular body, ramus, and symphysis with no reports of condylar involvement. Objective: The aim of this study is to analyze the topographical incidence of MRONJ, comorbidities, demographics data, and clinical characteristics of patients diagnosed with MRONJ between 2014 and 2019 in the Maxillo-Facial Surgery Department University of Campania “Luigi Vanvitelli”, and compare these results with published reports. Methods: Data on 179 patients were collected for the study, including gender, age, underlying malignancy, medical history, and specific lesion location-identifying premaxilla and posterior sectors area involvement for the maxilla and symphysis, body, ramus, and condyle area for the mandible. A literature review was performed in order to compare our results with similar or higher sample sizes and find if any condylar involvement was ever reported. The research was carried out on PubMed database identifying articles from January 2003 to November 2020, where MRONJ site distribution was discussed, and data were examined to scan for condylar localization reports. Results: 30 patients had maxillary MRONJ, 136 patients had mandibular MRONJ, and 13 patients had lesions located in both maxilla and mandible. None of the patients reported condylar involvement, neither as a single site nor as an additional localization. Literature review results were coherent to our findings showing no mention of condylar MRONJ. Conclusion: Results do not show reports of condylar involvement in MRONJ. Although the pathophysiology of the disease has not been fully elucidated, two possible explanations were developed: the first one based on the condyle embryogenetic origin; the second one based on the bisphosphonate and anti-resorptive medications effects on the different vascular patterns of the mandible areas.

scholarly journals Pengaruh Kafein terhadap Tekanan Intraokular

2021 ◽  
Vol 2 (2) ◽  
Author(s):  
Julian Juanito ◽  
Wenny P. Supit ◽  
Laya M. Rares
Keyword(s):  
Risk Factors ◽  
Intraocular Pressure ◽  
Literature Review ◽  
High Intensity ◽  
External Factors ◽  
Google Scholar ◽  
Caffeine Consumption ◽  
Exclusion Criteria ◽  
Data Bases ◽  
Review Study

Abstract: High intraocular pressure (IOP) is one of the risk factors of glaucoma or worsening of its prognosis. There are a lot of external factors that can affect IOP inter alia exercise, as well as some food and drinks. One of the drinks that could affect IOP is coffee that contains caffeine. This study was aimed to evaluate whether caffeine had an effect on IOP. This was a literature review study using 4 data bases, as follows: Clinical Key, Pub-med, Google Scholar, and Science Direct. The keywords were Caffeine OR Coffee OR Tea AND IOP OR Intraocular Pressure. Based on inclusion and exclusion criteria, 10 literatures were selected. The results showed that some literatures reported an increase in IOP after caffeine consumption, the others reported a decrease in IOP, meanwhile some others did not find any change of IOP. In conclusion, the effect of caffeine on IOP was acute. People who had high intensity of caffeine consumption had a more significant increase in IOP after consuming caffeine.Keywords: caffeine, intraocular pressure (IOP)  Abstrak: Peningkatan tekanan intraokular (TIO) merupakan salah satu faktor risiko untuk terjadinya glaukoma atau memperburuk prognosis glaukoma. Terdapat banyak faktor eksternal yang dapat memengaruhi TIO, antara lain olahraga, minuman, dan makanan. Salah satu minuman yang dapat memengaruhi TIO ialah kopi yang mengandung kafein. Penelitian ini bertujuan untuk mengetahui adanya pengaruh kafein pada tekanan intraokular. Jenis penelitian ialah literature review. Pencarian data menggunakan empat database yaitu Clinical key, PubMed, Google scholar, dan Science direct. Kata kunci yang digunakan yaitu Caffeine OR Coffee OR Tea AND IOP OR Intraocular Pressure. Seleksi data berdasarkan kriteria inklusi dan ekslusi mendapatkan 10 literatur. Hasil kajian mendapatkan bahwa beberapa penelitian melaporkan adanya peningkatan TIO setelah konsumsi kafein, penelitian lain melaporkan penurunan TIO, dan terdapat pula penelitian yang tidak menemukan perubahan apapun. Simpulan penelitian ini ialah pengaruh kafein pada TIO hanya berlangsung akut. Individu yang memiliki intensitas konsumsi kafein lebih tinggi menunjukkan peningkatan TIO yang lebih nyata setelah mengonsumsi kafein.Kata kunci: kafein, tekanan intraokular (TIO) 

Prognostic factors for response to second induction course in patients showing persistent disease after first course of standard induction chemotherapy for de novo acute myeloid leukemia (AML)

2007 ◽  
Vol 25 (18_suppl) ◽  
pp. 7056-7056
Author(s):  
J. Lee ◽  
S. Sym ◽  
S. Choi ◽  
J. Lee ◽  
Y. Lee ◽  
...  
Keyword(s):  
Risk Factors ◽  
Prognostic Factors ◽  
Induction Chemotherapy ◽  
De Novo ◽  
Chromosomal Abnormalities ◽  
Treatment Strategies ◽  
High Dose ◽  
Usual Practice ◽  
Persistent Disease ◽  
Resistant Disease

7056 Background: Standard induction chemotherapy for AML consists of cytarabine plus daunorubicin or idarubicin (‘7+3' regimen). For patients showing persistent leukemia after first induction course (IND1) of the induction, usual practice is to give a second course (IND2) of similar regimen (‘7+3' or 5+2'). This strategy, however, has not been well evaluated. We investigated prognostic factors for response to IND2. Methods: We performed a retrospective study in 110 patients with de novo AML. All patients received cytarabine (100 or 200 mg/m2/d) for 7 days plus daunorubicin (45–60 mg/m2/d) or idarubicin (12 mg/m2/d) for 3 days as IND1. Patients who showed persistent leukemia after IND1 were given the same doses and drugs as ‘5+2’ (n = 85) or ‘7+3’ (n = 25) for IND2. We collected the clinico-pathologic data of the patients at diagnosis and at IND2, and analyzed prognostic factors for response to IND2. Results: Sixty-one (55.5%) of 110 patients, who received IND2, achieved complete remission (CR). The causes of treatment failure were resistant disease in 35, complication of aplasia in 8, and indeterminated in 6. Five-year probabilities of overall and relapse-free survival were 25% and 21%, respectively. Multivariate analysis demonstrated that cellularity at interim BM biopsy > 30% (p = 0.015), blast percentage at interim BM aspiration > 30% (p = 0.031), presence of circulating blasts at IND2 (p = 0.011), and unfavorable chromosomal abnormalities (p = 0.014) were independent risk factors for failure to induce CR. The CR rates were significantly different according to the number of the risk factors: 73% for 0–1 factor, 48% for 2 factors, and 11% for 3–4 factors (p< 0.001). Conclusions: We identified 4 independent poor risk factors for CR in patients who showed persistent disease after standard induction chemotherapy and who received similar second induction course. Other treatment strategies such as high-dose cytarabine rather than standard regimens seem to be needed for the patients with 3–4 risk factors before IND2. No significant financial relationships to disclose.

Endovascular Management of Ureteroarterial Fistula: Single Institution Experience and Systematic Literature Review

2018 ◽  
Vol 52 (4) ◽  
pp. 275-286 ◽  
Author(s):  
José D. Subiela ◽  
Andrea Balla ◽  
Jesús Bollo ◽  
Jaume F. Dilme ◽  
Begoña Soto Carricas ◽  
...  
Keyword(s):  
Risk Factors ◽  
Literature Review ◽  
Stent Graft ◽  
Systematic Literature Review ◽  
Pelvic Surgery ◽  
Retroperitoneal Abscess ◽  
Endovascular Management ◽  
Graft Placement ◽  
Ureteroarterial Fistula ◽  
Pubmed Database

Background: Ureteroarterial fistula (UAF) represents an uncommon complication after urological surgery; however, this is a well-documented condition in patients with predisposing risk factors. The aim of the present study is to report and analyze the endovascular management of a series of patients with UAF, treated in authors’ hospital, and to report and analyze the same data concerning patients retrieved from a systematic literature review. Methods: Authors conducted a retrospective analysis of prospectively collected data and a systematic literature review. The research was carried out through PubMed database searching the following keywords: “uretero arterial fistula” and “uretero iliac fistula.” It includes only articles reporting the endovascular management. Results: Forty-six articles were included in the present study for a total of 94 patients. Risk factors were as follows: chronic indwelling ureteral stents, pelvic surgery, radiotherapy, iliac artery pseudo-aneurysm, and chemotherapy. All patients had gross hematuria at presentation. Stent graft placement was performed in 89 patients, embolization in 5 patients, and iliac internal artery embolization combined with stent graft placement was performed in 24 patients. Four postprocedural complications were observed (4.2%). During a median follow-up of 8 months, 10 complications related to UAF were observed (10.6%): rebleeding (7 cases) and stent thrombosis (3 cases). Two patients died for causes related to UAF (2.1%): rebleeding (1) and retroperitoneal abscess (1). Conclusion: Based on the present data, endovascular treatment is feasible and safe with low postprocedural complications and mortality rate. Considering the increase in surgery and radiotherapy performed, UAF should be always debated in patients with massive hematuria.

scholarly journals Natural History and Treatment Strategies of Advanced PEComas: A Systematic Review

Cancers ◽  
2021 ◽  
Vol 13 (20) ◽  
pp. 5227
Author(s):  
Agathe Bourgmayer ◽  
Simon Nannini ◽  
Paul Bonjean ◽  
Jean-Emmanuel Kurtz ◽  
Gabriel G. Malouf ◽  
...  
Keyword(s):  
Risk Factors ◽  
Systematic Review ◽  
Natural History ◽  
Case Reports ◽  
English Literature ◽  
Treatment Strategies ◽  
Risk Category ◽  
Mesenchymal Tumors ◽  
Entire Cohort ◽  
Pubmed Database

PEComas is a family of rare mesenchymal tumors. This systematic review aims to better understand the natural history of advanced PEComas. After a search on the PubMed database and main oncology meeting libraries according to the PRISMA guidelines, 88 articles reported in the English literature were included. Data on clinical and histological features, treatments and outcomes were collected. To identify risk factors, univariate and multivariate analyses were performed. Seven cohorts of patients and 124 individual patients were identified. Focusing on case reports, most patients were metastatic, and the median overall survival (OS) of the entire cohort was 60 months (95%CI 33; NA). Risk factors significantly associated with OS in the multivariate analysis were the presence of metastasis at diagnosis (HR: 2.59, 95%CI 1.06;6.33, p = 0.036) and the grouped-Bleeker’s risk category (HR: 4.66; 95%CI 1.07;20.19; p = 0.039). In the metastatic population, only the presence of lymph node metastasis was associated with OS (HR: 3.11; 95%CI 1.13;8.60, p < 0.05). Due to a lack of events, it was not possible to conclude on other factors. This review of the literature highlights the heterogeneity of literature data and shows the great diversity of clinical management strategies.

scholarly journals ADOLESCENTES AUTORES DE HOMICÍDIO: revisão sistemática dos fatores de risco

2021 ◽  
Vol 7 (1) ◽  
pp. 131-148
Author(s):  
Sthefanny Meira Moreira ◽  
Roberta Sasha Guedes Vieira ◽  
Elisabete Agrela de Andrade
Keyword(s):  
Risk Factors ◽  
Literature Review ◽  
Systematic Literature Review ◽  
Scientific Literature ◽  
Preventive Measures ◽  
Single Factor ◽  
Biological Factors ◽  
Exclusion Criteria ◽  
Factors Associated

The current research analyzed the risk factors associated with committing homicide in adolescence. This research is a systematic literature review of the scientific literature. The databases that were used are: Scielo, Pubmed and CAPES journals. Only 10 articles met the inclusion and exclusion criteria and the removal of duplicates. Social, behavioral, psychological, psychopathological and biological factors associated with homicide in adolescence were found. No single factor was found to be decisive for the adolescent to commit homicide. The importance of preventive measures for this phenomenon is highlighted.

Neuroleptic malignant syndrome: Case report and literature review

2017 ◽  
Vol 41 (S1) ◽  
pp. S564-S564
Author(s):  
R. Martín Gutierrez ◽  
R. Medina Blanco ◽  
P. Suarez Pinilla ◽  
R. Landera Rodriguez ◽  
M. Juncal Ruiz ◽  
...  
Keyword(s):  
Literature Review ◽  
Neuroleptic Malignant Syndrome ◽  
Life Support ◽  
Clinical Symptoms ◽  
Altered Mental Status ◽  
Antipsychotic Treatment ◽  
High Dose ◽  
Neuroleptic Treatment ◽  
Pubmed Database ◽  
Competing Interest

IntroductionNeuroleptic malignant syndrome (NMS) is an uncommon but potentially fatal adverse effect of neuroleptic, both classic and atypical drugs.ObjectiveTo review the incidence, clinical characteristics, diagnosis and treatment of NMS.AimWe have described the case of a man of 32 years of age diagnosed with bipolar disorder treated with lithium. He precised high-dose corticosteroids after having tonsillitis. Then, he presented manic decompensation requiring neuroleptic treatment (oral risperidone). After 72 hours, he presented an episode characterized by muscular rigidity, fever, altered mental status and autonomic dysfunction. Life support measures and suspension of neuroleptic treatment were required.MethodsA literature review of the NMS was performed using the PubMed database.ResultsThe frequency of NMS ranges from 0.02 to 2.4%. The pathophysiology is not clearly understood but the blockade of dopamine receptors seems to be the central mechanism. Some of the main risk factors described are: being a young adult, the concomitant use of lithium and metabolic causes, among others. NMS occurs most often during the first week of treatment or after increasing the dosage of the neuroleptic medication. Some issues of NMS are those related with diagnosis, treatment and reintroduction of antipsychotic treatment or not.ConclusionsNMS can be difficult to diagnose due to the variability in the clinical symptoms and presentation. Because of it diagnosis is of exclusion, clinicians should always take it into consideration when a patient is treating with neuroleptic, especially when the dosage has been recently increased. NMS is a clinical emergency.Disclosure of interestThe authors have not supplied their declaration of competing interest.

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