scholarly journals Influence of implant cover screw loosening on early peri-implant marginal bone loss: a retrospective evaluation of risk factors

Author(s):  
Yin Wuwei ◽  
Yang Yong ◽  
Wu Zhenzhen ◽  
Chen Pei ◽  
Yang Zinan ◽  
...  

Abstract Background: This study aimed to evaluate the risk factors of cover screw loosening (CSL) and its influence on peri-implant marginal bone during early bone healing process.Methods: A total of 91 implants in 90 patients (75 normal patients and 15 patients with CSL) were included in this study. Panoramic radiographs were taken for the measurement of peri-implant marginal bone loss (MBL). A piece of soft tissue above the cover screw during the second-stage surgery was taken for pathological examination. The differences between the two groups were evaluated and the possible risk factors associated with CSL were analyzed.Results: Increased frequency of CSL showed significant association with maxillary region (p=0.038). The mean MBL at implants with CSL was 0.82 ± 0.56 mm, and it was 0.22 ± 0.20 mm at normal implants (p<0.001). The inflammatory granulation tissue around the loose cover screws showed infiltration of a large number of inflammatory cells.Conclusions: CSL during healing process is associated with early peri-implant MBL. The location of the maxilla is considered as a significant risk factor for CSL.

2019 ◽  
Vol 147 (5-6) ◽  
pp. 295-300
Author(s):  
Vesna Brzacki ◽  
Bojan Mladenovic ◽  
Nenad Govedarovic

Introduction/Objective. The most important complication of gastroesophageal reflux disease (GERD) is Barrett?s esophagus (B?) and the development of esophageal adenocarcinoma. Prevalence of BE is 5?15% in patients with GERD symptoms. The aim of the study was to investigate the prevalence and risk factors for BE in patients with chronic reflux symptoms. A prospective study was conducted in the Clinic of Gastroenterology, Nis Clinical Center. Methods. We included 676 patients with chronic reflux symptoms, who underwent esophagogastroduodenoscopy. The biopsy specimens were obtained in a four-quadrant fashion at intervals of 2 cm from the circumferential endoscopic Barrett?s epithelium in the distal esophagus. BE was diagnosed by pathological examination. Results. Out of the total number patients with GERD, 92 were diagnosed with columnar-lined esophagus (CLE), the prevalence being 13.6%. Histological examination of biopsy from 92 patients with CLE revealed specialized intestinal metaplasia in 15 patients, with the prevalence of 2.22%. Compared to patients without BE, patients with BE were older and more commonly male. Univariable analyses showed that hiatal hernia and Helicobacter pylori infection were two significant risk factors for the onset of esophagitis. The age and the presence of reflux symptoms were associated with the presence of BE. Older age could be considered a significant risk factor for the development of BE and GERD. Conclusion. Prevalence of biopsy-proven BE and CLE in Serbia was 2.22% and 13.6%, respectively, in patients with GERD symptoms.


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Junya Arai ◽  
Jun Kato ◽  
Nobuo Toda ◽  
Ken Kurokawa ◽  
Chikako Shibata ◽  
...  

Abstract Background Impairment of activities of daily living (ADL) due to hemorrhagic gastroduodenal ulcers (HGU) has rarely been evaluated. We analyzed the risk factors of poor prognosis, including mortality and impairment of ADL, in patients with HGU. Methods In total, 582 patients diagnosed with HGU were retrospectively analyzed. Admission to a care facility or the need for home adaptations during hospitalization were defined as ADL decline. The clinical factors were evaluated: endoscopic features, need for interventional endoscopic procedures, comorbidities, symptoms, and medications. The risk factors of outcomes were examined with multivariate analysis. Results Advanced age (> 75 years) was a significant predictor of poor prognosis, including impairment of ADL. Additional significant risk factors were renal disease (odds ratio [OR] 3.43; 95% confidence interval [CI] 1.44–8.14) for overall mortality, proton pump inhibitor (PPIs) usage prior to hemorrhage (OR 5.80; 95% CI 2.08–16.2), and heart disease (OR 3.05; 95% CI 1.11–8.43) for the impairment of ADL. Analysis of elderly (> 75 years) subjects alone also revealed that use of PPIs prior to hemorrhage was a significant predictor for the impairment of ADL (OR 8.24; 95% CI 2.36–28.7). Conclusion In addition to advanced age, the presence of comorbidities was a risk of poor outcomes in patients with HGU. PPI use prior to hemorrhage was a significant risk factor for the impairment of ADL, both in overall HGU patients and in elderly patients alone. These findings suggest that the current strategy for PPI use needs reconsideration.


Author(s):  
Stephanie M. Cabral ◽  
Katherine E. Goodman ◽  
Natalia Blanco ◽  
Surbhi Leekha ◽  
Larry S. Magder ◽  
...  

Abstract Objective: To determine whether electronically available comorbidities and laboratory values on admission are risk factors for hospital-onset Clostridioides difficile infection (HO-CDI) across multiple institutions and whether they could be used to improve risk adjustment. Patients: All patients at least 18 years of age admitted to 3 hospitals in Maryland between January 1, 2016, and January 1, 2018. Methods: Comorbid conditions were assigned using the Elixhauser comorbidity index. Multivariable log-binomial regression was conducted for each hospital using significant covariates (P < .10) in a bivariate analysis. Standardized infection ratios (SIRs) were computed using current Centers for Disease Control and Prevention (CDC) risk adjustment methodology and with the addition of Elixhauser score and individual comorbidities. Results: At hospital 1, 314 of 48,057 patient admissions (0.65%) had a HO-CDI; 41 of 8,791 patient admissions (0.47%) at community hospital 2 had a HO-CDI; and 75 of 29,211 patient admissions (0.26%) at community hospital 3 had a HO-CDI. In multivariable regression, Elixhauser score was a significant risk factor for HO-CDI at all hospitals when controlling for age, antibiotic use, and antacid use. Abnormal leukocyte level at hospital admission was a significant risk factor at hospital 1 and hospital 2. When Elixhauser score was included in the risk adjustment model, it was statistically significant (P < .01). Compared with the current CDC SIR methodology, the SIR of hospital 1 decreased by 2%, whereas the SIRs of hospitals 2 and 3 increased by 2% and 6%, respectively, but the rankings did not change. Conclusions: Electronically available patient comorbidities are important risk factors for HO-CDI and may improve risk-adjustment methodology.


2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Harpreet Singh ◽  
Su Jin Cho ◽  
Shubham Gupta ◽  
Ravneet Kaur ◽  
S. Sunidhi ◽  
...  

AbstractIncreased length of stay (LOS) in intensive care units is directly associated with the financial burden, anxiety, and increased mortality risks. In the current study, we have incorporated the association of day-to-day nutrition and medication data of the patient during its stay in hospital with its predicted LOS. To demonstrate the same, we developed a model to predict the LOS using risk factors (a) perinatal and antenatal details, (b) deviation of nutrition and medication dosage from guidelines, and (c) clinical diagnoses encountered during NICU stay. Data of 836 patient records (12 months) from two NICU sites were used and validated on 211 patient records (4 months). A bedside user interface integrated with EMR has been designed to display the model performance results on the validation dataset. The study shows that each gestation age group of patients has unique and independent risk factors associated with the LOS. The gestation is a significant risk factor for neonates < 34 weeks, nutrition deviation for < 32 weeks, and clinical diagnosis (sepsis) for ≥ 32 weeks. Patients on medications had considerable extra LOS for ≥ 32 weeks’ gestation. The presented LOS model is tailored for each patient, and deviations from the recommended nutrition and medication guidelines were significantly associated with the predicted LOS.


Children ◽  
2021 ◽  
Vol 8 (2) ◽  
pp. 145
Author(s):  
Peter L. Stavinoha ◽  
Cody Solesbee ◽  
Susan M. Swearer ◽  
Steven Svoboda ◽  
Laura J. Klesse ◽  
...  

Neurofibromatosis type 1 (NF1) is an autosomal disorder associated with numerous physical stigmata. Children with NF1 are at known risk for attention-deficit/hyperactivity disorder (ADHD), academic struggles, and significant social difficulties and adverse social outcomes, including bullying victimization. The primary aim of this study was to identify risk factors associated with bullying victimization in children with NF1 to better inform clinicians regarding targets for prevention and clinical intervention. Children and a parent completed questionnaires assessing the bully victim status, and parents completed a measure of ADHD symptoms. Analyses were completed separately for parent-reported victimization of the child and the child’s self-report of victimization. According to the parent report, results suggest ADHD symptoms are a significant risk factor for these children being a target of bullying. Findings for academic disability were not conclusive, nor were findings related to having a parent with NF1. Findings indicate the need for further research into possible risk factors for social victimization in children with NF1. Results provide preliminary evidence that may guide clinicians working with children with NF1 and their parents in identifying higher-risk profiles that may warrant earlier and more intensive intervention to mitigate later risk for bullying victimization.


2020 ◽  
Vol 148 ◽  
Author(s):  
Fei He ◽  
Hong mei Yang ◽  
Guo ming Li ◽  
Bing qing Zhu ◽  
Yating Zhang ◽  
...  

Abstract Teenagers are important carriers of Neisseria meningitidis, which is a leading cause of invasive meningococcal disease. In China, the carriage rate and risk factors among teenagers are unclear. The present study presents a retrospective analysis of epidemiological data for N. meningitidis carriage from 2013 to 2017 in Suizhou city, China. The carriage rates were 3.26%, 2.22%, 3.33%, 3.53% and 9.88% for 2013, 2014, 2015, 2016 and 2017, respectively. From 2014 to 2017, the carriage rate in the 15- to 19-year-old age group (teenagers) was the highest and significantly higher than that in remain age groups. Subsequently, a larger scale survey (December 2017) for carriage rate and relative risk factors (population density, time spent in the classroom, gender and antibiotics use) were investigated on the teenagers (15- to 19-year-old age) at the same school. The carriage rate was still high at 33.48% (223/663) and varied greatly from 6.56% to 52.94% in a different class. Population density of the classroom was found to be a significant risk factor for carriage, and 1.4 persons/m2 is recommended as the maximum classroom density. Further, higher male gender ratio and more time spent in the classroom were also significantly associated with higher carriage. Finally, antibiotic use was associated with a significantly lower carriage rate. All the results imply that attention should be paid to the teenagers and various measures can be taken to reduce the N. meningitidis carriage, to prevent and control the outbreak of IMD.


2021 ◽  
pp. 1-6

OBJECTIVE The aim of this study was to investigate the clinical and radiological factors associated with the rupture of a vertebral artery dissecting aneurysm (VADA) and to evaluate whether the stagnation sign is a significant risk factor for rupture of VADA. METHODS Clinical and radiological variables of 117 VADAs treated in a tertiary hospital from September 2008 to December 2020 were retrospectively reviewed. The stagnation sign is defined as the finding of contrast agent remaining in the lesion until the venous phase of angiography. Univariate and multivariate analyses were executed to reveal the associations between rupture status and VADA characteristics. RESULTS The rate of ruptured VADAs was 29.1% (34 of 117) and the stagnation sign was observed in 39.3% (46 of 117). Fusiform shape (OR 5.105, 95% CI 1.591–16.383, p = 0.006), irregular surface (OR 4.200, 95% CI 1.412–12.495, p = 0.010), posterior inferior cerebellar artery (PICA) involvement (OR 3.788, 95% CI 1.288–11.136, p = 0.016), and the stagnation sign (OR = 3.317, 95% CI 1.131–9.732, p = 0.029) were significantly related to rupture of VADA in multivariate logistic regression analysis. CONCLUSIONS This study showed that fusiform shape, irregular surface, PICA involvement, and the stagnation sign may be independent risk factors for the rupture of VADA. Therefore, when the potential risk factors are observed in unruptured VADA, more aggressive treatment rather than follow-up or medical therapy may be considered.


2018 ◽  
Vol 41 (5) ◽  
pp. 447-453 ◽  
Author(s):  
Frédéric Rafflenbeul ◽  
Catherine-Isabelle Gros ◽  
François Lefebvre ◽  
Sophie Bahi-Gross ◽  
Raphaëlle Maizeray ◽  
...  

Summary Objectives The aim of this retrospective study was to assess in maxillary canine impaction cases both the prevalence of root resorption of adjacent teeth among untreated children and adolescents, and its associated risk factors. Subjects and methods Sixty subjects (mean age 12.2 years; SD 1.9; range 8–17 years) with 83 displaced maxillary canines and without any past or ongoing orthodontic treatment were included in this study. The presence of root resorption was evaluated on images from a single cone beam computed tomography (CBCT) unit. Potential risk factors were measured on the CBCT images and on panoramic reconstructions of the 3D data sets. The sample was characterized by descriptive statistics and multiple logistic regressions were performed to predict root resorption. Results Root resorption of at least one adjacent tooth was detected in 67.5 per cent of the affected quadrants. It was found that 55.7 per cent of the lateral incisors, 8.4 per cent of the central incisors, and 19.5 per cent of first premolars were resorbed. Of the detected resorptions, 71.7 per cent were considered slight, 14.9 per cent moderate, and 13.4 per cent severe. Contact between the displaced canine(s) and the adjacent teeth roots was the only identified statistically significant risk factor, all teeth being considered (odds ratio [OR] = 18.7, 95% confidence interval: 2.26–756, P < 0.01). An enlarged canine dental follicle, a peg upper lateral, or an upper lateral agenesis were not significantly associated with root resorption of adjacent teeth, nor were age nor gender. Conclusions Root resorption of adjacent teeth was detected in more than two-thirds of a sample of sixty untreated children and adolescents.


Author(s):  
K. Kokila ◽  
K. Chellavel Ganapathi

Background: Chronic kidney disease (CKD) is a silent epidemic. The true prevalence of CKD with in a population are very difficult to estimate, since early to moderate CKD were usually asymptomatic. ESRD in the consequence of CKD is one of the most expensive diseases to treat.Only way is to prevent it and Hence this was conducted to estimate the prevalence of CKD and its associated risk factors among adults in selected slums of Chennai.Methods: This is a cross sectional study done from May 2013 to June 2014 in selected slums of Chennai. The study population includes adult males and females. Multi stage sampling method used. Sample size covered was 400. A semi structured questionnaire used as tool. Based on the serum creatinine eGFR calculated using modified MDRD study equation and CKD prevalence was identified. The data was entered in MS excel and analyzed using SPSS version 21.Results: Total of 400 participants involved. Females were predominant in the study. Among them, 67 (16.8%) were diagnosed as CKD patients and Stage 1, 4.0% had stage 2, 3.6% had stage 3, 1.3% had stage 4 and 0.5% had stage 5 at the time of diagnosis.Conclusions: This study revealed prevalence of CKD among slum population was 16.8%. This study showed that old age, uncontrolled hypertension, uneducated, Diabetes with poor control, overuse of analgesics, H/o smoking, obesity, alcoholism, passive smoking, family H/o CKD and proteinuria were significant risk factor for CKD among study subjects. Slum population with risk factors should be regularly screened for CKD.


2015 ◽  
Vol 2015 ◽  
pp. 1-7 ◽  
Author(s):  
Joyce Siwila ◽  
Annette Olsen

Intestinal parasitic infections are common among children worldwide. This study was aimed at determining risk factors for infection with soil transmitted helminths, Cryptosporidium spp., and Giardia duodenalis, among children in preschools. The study was in two parts: a cross-sectional study in which data were collected from 403 children from 10 preschools and a longitudinal study in which 100 children from four preschools from the previous 10 were selected. Prevalence of Ascaris lumbricoides was 12.0%, while that of hookworm was 8.3%. Overall prevalence of Cryptosporidium and G. duodenalis was 28.0% and 29.0%, respectively. Low education level of parent/guardian was a significant risk factor for A. lumbricoides (OR = 2.35, 95% CI: 1.02–5.41; P=0.04), while roofing types other than corrugated iron sheets were found to be protective for G. duodenalis infection in both bivariate and multivariate analyses (multivariate: OR = 0.67, 95% CI: 0.45–0.99; P=0.04). Low socioeconomic level was found to be protective for Cryptosporidium spp. infection in multivariate analysis (OR = 0.59, 95% CI: 0.35–0.99; P=0.04). In the longitudinal study, none of the factors were associated with either infection. These findings may have implications for other preschools in other districts in Zambia.


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