scholarly journals A gyógyszer által indukált állcsontnecrosis-kockázat mértékének meghatározása az általános fogorvosi gyakorlatban

2019 ◽  
Vol 160 (7) ◽  
pp. 243-251
Author(s):  
Anna Zurányi ◽  
Enikő Vasziné Szabó ◽  
Zsuzsanna Tóth
Keyword(s):  
Risk Factors ◽  
Treatment Plan ◽  
Osteonecrosis Of The Jaw ◽  
Concomitant Disease ◽  
Antiresorptive Therapy ◽  
Periodontal Inflammation ◽  
Pubmed Database ◽  
Risk Patients ◽  
Favorable Case ◽  
Local Risk

Abstract: Medication-related osteonecrosis of the jaw may appear as adverse effect in antiresorptive therapy. Its successful treatment is challenging. We aimed to gather the systemic and local factors playing a role in etiology, published after its recognition. Risk factors were collected from the PubMed database 1998–2018. The three main groups of risk patients are: patients starting, patients having antiresorptive therapy, osteonecrosis diagnosed patients. The dentist must recognize risk factors, determine appropriate treatment plan and frequency of check-ups. Oncological disease treated intravenously means the greatest risk. Further systemic risk factors are: supportive therapies, concomitant disease, way of life, individual factors. Local risk factors may be: dentoalveolar surgery, periapical and periodontal inflammation, ill-fitting denture, presence of some anatomical structures. The accumulation of risk factors determines the probability of the manifestation of osteonecrosis. The most favorable case is patient starting antiresorptive therapy with a dental status needing no treatment. Orv hetil. 2019; 160(7): 243–251.

scholarly journals Osteonecrosis of the Jaw Beyond Bisphosphonates: Are There Any Unknown Local Risk Factors?

2021 ◽  
Vol Volume 13 ◽  
pp. 21-37
Author(s):  
Johann Lechner ◽  
Volker von Baehr ◽  
Bernd Zimmermann
Keyword(s):  
Risk Factors ◽  
Osteonecrosis Of The Jaw ◽  
Local Risk

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.

Influence of osteoporosis risk factors on extensive suppression of bone metabolism during antiresorptive therapy

2014 ◽  
Author(s):  
Tijana Icin ◽  
Jovanka Novakovic-Paro ◽  
Bojan Vukovic ◽  
Ivana Bajkin ◽  
Milica Medic-Stojanoska
Keyword(s):  
Risk Factors ◽  
Bone Metabolism ◽  
Antiresorptive Therapy ◽  
Osteoporosis Risk Factors ◽  
Osteoporosis Risk

Behavioral Emergencies and Crises

2010 ◽  
pp. 739-762
Author(s):  
Phillip M. Kleespies ◽  
Justin M. Hill
Keyword(s):  
Mental Health ◽  
Risk Factors ◽  
High Risk ◽  
Work Environment ◽  
Emotional Impact ◽  
High Risk Patients ◽  
Risk Patients ◽  
Life Threatening ◽  
Behavioral Emergencies ◽  
And Training

This chapter illustrates the mental health clinician’s relationship with behavioral emergencies. The chapter begins by distinguishing the terms behavioral emergency and behavioral crisis, and underlying themes among all behavioral emergencies are identified. Given that most clinicians will face a behavioral emergency in their careers, the importance of enhancing the process of educating and training practitioners for such situations far beyond the minimal training that currently exists is highlighted. The chapter continues by exploring various aspects of evaluating and managing high-risk patients (i.e., those who exhibit violent tendencies toward themselves or others, and those at risk for victimization). It includes a discussion of the benefits and limitations to estimating life-threatening risk factors and specific protective factors. The chapter concludes by discussing the emotional impact that working with high-risk patients has on clinicians, and an emphasis is placed on the importance of creating a supportive work environment.

scholarly journals Risk Factors for Oral Health in Anorexia Nervosa: Comparison of a Self-Report Questionnaire and a Face-to-Face Interview

2021 ◽  
Vol 18 (8) ◽  
pp. 4212
Author(s):  
Hélène Rangé ◽  
Alice Pallier ◽  
Aminata Ali ◽  
Caroline Huas ◽  
Pierre Colon ◽  
...  
Keyword(s):  
Risk Factors ◽  
Anorexia Nervosa ◽  
Oral Health ◽  
Statistical Tests ◽  
The Self ◽  
Self Report ◽  
Short Version ◽  
Oral Diseases ◽  
Face To Face ◽  
Local Risk

Behavioral, nutritional, and local risk factors for oral health are frequent in people with anorexia nervosa. However no self-report questionnaire is available for screening in clinical practice or for research purposes. The objective of this study was to design a questionnaire to identify risk factors and symptoms of oral diseases and to test its reliability as a self-report form among people with anorexia nervosa. A 26-item questionnaire was designed based on a sound literature review performed by a group of dentists, psychiatrists, and epidemiologists specialized in the field of eating disorders. Sixty-nine anorexia nervosa inpatients (mean age 18.72 ± 5.1) were included from four specialized units. The questionnaire was first self-reported by the patients, then the same questionnaire was administrated by a dentist during a structured face-to-face interview as the gold standard. The concordance between the two forms was evaluated globally and item per item using Cohen’s kappa statistical tests. The overall concordance between the self-report questionnaire and the face-to-face structured interview was 55%. Of the 26 items, 19 showed significant concordance. Items relating to water intake, extracted teeth, gingival status, and oral hygiene had the best concordance (all kappa coefficients > 0.4). A questionnaire that identifies risk factors and symptoms of oral diseases in anorexia nervosa was developed and tested. The 26-item form of the questionnaire (long version) is moderately reliable as a self-reported form. A short version of the questionnaire, including the 10 most reliable items, is recommended for oral risk assessment in patients with anorexia nervosa. The clinical value of the self-administered questionnaire remains to be evaluated.

scholarly journals Development of a prognostic tool: based on risk factors for tooth loss after active periodontal therapy

2021 ◽  
Author(s):  
Sonja Rahim-Wöstefeld ◽  
Dorothea Kronsteiner ◽  
Shirin ElSayed ◽  
Nihad ElSayed ◽  
Peter Eickholz ◽  
...  
Keyword(s):  
Risk Factors ◽  
Decision Making ◽  
Tooth Loss ◽  
Treatment Plan ◽  
Periodontal Therapy ◽  
Outcome Variable ◽  
Individual Treatment ◽  
Risk Indicator ◽  
Related Factors ◽  
Prognostic Tool

Abstract Objectives The aim of this study was to develop a prognostic tool to estimate long-term tooth retention in periodontitis patients at the beginning of active periodontal therapy (APT). Material and methods Tooth-related factors (type, location, bone loss (BL), infrabony defects, furcation involvement (FI), abutment status), and patient-related factors (age, gender, smoking, diabetes, plaque control record) were investigated in patients who had completed APT 10 years before. Descriptive analysis was performed, and a generalized linear-mixed model-tree was used to identify predictors for the main outcome variable tooth loss. To evaluate goodness-of-fit, the area under the curve (AUC) was calculated using cross-validation. A bootstrap approach was used to robustly identify risk factors while avoiding overfitting. Results Only a small percentage of teeth was lost during 10 years of supportive periodontal therapy (SPT; 0.15/year/patient). The risk factors abutment function, diabetes, and the risk indicator BL, FI, and age (≤ 61 vs. > 61) were identified to predict tooth loss. The prediction model reached an AUC of 0.77. Conclusion This quantitative prognostic model supports data-driven decision-making while establishing a treatment plan in periodontitis patients. In light of this, the presented prognostic tool may be of supporting value. Clinical relevance In daily clinical practice, a quantitative prognostic tool may support dentists with data-based decision-making. However, it should be stressed that treatment planning is strongly associated with the patient’s wishes and adherence. The tool described here may support establishment of an individual treatment plan for periodontally compromised patients.

scholarly journals The effects of a preoperative multidisciplinary conference on outcomes for high-risk patients with challenging surgical treatment options: a retrospective study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Masayoshi Koike ◽  
Mie Yoshimura ◽  
Yasushi Mio ◽  
Shoichi Uezono
Keyword(s):  
Patient Safety ◽  
Retrospective Study ◽  
High Risk ◽  
Treatment Plan ◽  
Treatment Options ◽  
High Risk Patients ◽  
Appropriate Treatment ◽  
Risk Patients ◽  
Treatment Plans ◽  
Multidisciplinary Conference

Abstract Background Surgical options for patients vary with age and comorbidities, advances in medical technology and patients’ wishes. This complexity can make it difficult for surgeons to determine appropriate treatment plans independently. At our institution, final decisions regarding treatment for patients are made at multidisciplinary meetings, termed High-Risk Conferences, led by the Patient Safety Committee. Methods In this retrospective study, we assessed the reasons for convening High-Risk Conferences, the final decisions made and treatment outcomes using conference records and patient medical records for conferences conducted at our institution from April 2010 to March 2018. Results A total of 410 High-Risk Conferences were conducted for 406 patients during the study period. The department with the most conferences was cardiovascular surgery (24%), and the reasons for convening conferences included the presence of severe comorbidities (51%), highly difficult surgeries (41%) and nonmedical/personal issues (8%). Treatment changes were made for 49 patients (12%), including surgical modifications for 20 patients and surgery cancellation for 29. The most common surgical modification was procedure reduction (16 patients); 4 deaths were reported. Follow-up was available for 21 patients for whom surgery was cancelled, with 11 deaths reported. Conclusions Given that some change to the treatment plan was made for 12% of the patients discussed at the High-Risk Conferences, we conclude that participants of these conferences did not always agree with the original surgical plan and that the multidisciplinary decision-making process of the conferences served to allow for modifications. Many of the modifications involved reductions in procedures to reflect a more conservative approach, which might have decreased perioperative mortality and the incidence of complications as well as unnecessary surgeries. High-risk patients have complex issues, and it is difficult to verify statistically whether outcomes are associated with changes in course of treatment. Nevertheless, these conferences might be useful from a patient safety perspective and minimize the potential for legal disputes.

scholarly journals A Narrative Review of the Risk Factors for Cancer and the Preventive Opportunities: Current Status, Future Perspectives, and Implications for India

2021 ◽  
Author(s):  
Vinod K. Ramani ◽  
Ganesha D. V. ◽  
Radheshyam Naik
Keyword(s):  
Risk Factors ◽  
Lung Cancer ◽  
Air Pollution ◽  
Cancer Prevention ◽  
Assessment Tools ◽  
Biologically Active ◽  
Pubmed Database ◽  
Risk Of Cancer ◽  
Google Search ◽  
The Impact

Abstract Introduction Clinical cancer can arise from heterogenous pathways through various genetic mutations. Although we cannot predict the timeline by which an individual will develop cancer, certain risk assessment tools can be used among high-risk groups for focusing the preventive activities. As primary level of cancer prevention, healthy lifestyle approach is being promoted. The etiological factors for lung cancer include by-products of industrialization and air pollution. We need to factor the increase in household air pollution as well. Methods “PubMed” database and Google search engines were used for searching the relevant articles. Search terms with Boolean operators used include “Cancer prevention,” “Missed opportunities in cancer causation,” and “incidence of risk factors.” This review includes 20 studies and other relevant literature that address the opportunities for cancer prevention. Body The narrative describes the association between many of the risk factors and development of cancer. This includes tobacco, alcohol, infections, air pollution, physical inactivity, diet, obesity, screening and preventive strategies, chemoprevention, biomarkers of carcinogenesis, and factors that prolong the diagnosis of cancer. Discussion Reports from basic science research provide evidence on the potential of biologically active food components and pharmacological agents for mitigating the risk of cancer and its progression. However, some reports from observational studies and randomized trials have been inconsistent. We need to recognize the impact of sociodemographic factors such as age, sex, ethnicity, culture, and comorbid illness on preventive interventions. Spiral computed tomographic scan is a robust tool for early detection of lung cancer. Conclusion Infectious etiology for specific cancers provides opportunities for prevention and treatment. The complex interplay between man and microbial flora needs to be dissected, for understanding the pathogenesis of relevant malignancies. For reducing the morbidity of cancer, we need to focus on prevention as a priority strategy and intervene early during the carcinogenic process.

scholarly journals Problem-Orientated Antenatal Notekeeping: A Useful Primary Health Care Tool

Curationis ◽  
1978 ◽  
Vol 1 (3) ◽  
Author(s):  
J.V. Larsen
Keyword(s):  
Risk Factors ◽  
South Africa ◽  
Health Care ◽  
Primary Health Care ◽  
High Risk ◽  
Significant Risk ◽  
Obstetric Care ◽  
Antenatal Screening ◽  
Primary Health ◽  
Risk Patients

It has recently been demonstrated that about 56 percent of patients delivering in a rural obstetric unit had significant risk factors, and that 85 percent of these could have been detected by meticulous antenatal screening before the onset of labour. These figures show that the average rural obstetric unit in South Africa is dealing with a large percentage of high risk patients. In this work, it is hampered by: 1. Communications problems: i.e. bad roads, long distances. and unpredictable telephones. 2. A serious shortage of medical staff resulting in primary obstetric care being delivered by midwives with minimal medical supervision.

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