scholarly journals Kandisiasis Mulut sebagai Indikator Penyakit Sistemik

2012 ◽  
Vol 19 (2) ◽  
pp. 162
Author(s):  
Satrya Ayu Erawatie Prayudha ◽  
Bernadeta Esti Chrismawaty ◽  
Dewi Agustina ◽  
Goeno Subagyo
Keyword(s):  
Diabetes Mellitus ◽  
Early Identification ◽  
Systemic Disease ◽  
Oral Candidiasis ◽  
Oral Lesion ◽  
Clinical Findings ◽  
Oral Health Education ◽  
Patient Reported ◽  
Polymorphic Type ◽  
Teeth Extraction

Latar belakang. Kandidiasis mulut disebabkan oleh infeksi Candida. Kondisi imunokompromais seperti DM merupakan salah satu faktor predisposisinya. Diabetes mellitus (DM) merupakan penyakit metabolik yang sering tidak disadari dan menjadikan penderitanya rentan infeksi. Tujuan. Penulisan ini bertujuan untuk melaporkan kandidiasis mulut polimorfik pada pasien yang sebelumnya tidak terdeteksi DM. Kasus dan penanganan. Seorang laki-laki 57 tahun datang ke Klinik Gigi dan Mulut, RSUP Dr. Sardjito mengeluhkan gangguan pengunyahan. Keluhan dirasakan sejak 1 bulan terakhir akibat gigi sebalah kiri atasnya goyah. Pasien menggunakan gigi tiruan sebagian lepasan (GTSL) sejak 5 tahun yang lalu. Sejak awal, GTSL susah dilepas sendiri oleh pasien. Akhir-akhir ini, terdapat keluhan mulutnya gatal dan nafas berbau. Dilaporkan adanya penurunan berat badan hingga 9 kg pada 3 bula terakhir. Ekstra-oral normal, intra-oral tampak plak putih pada dorsum lidah, area eritematus pada palatum berhadapan dengan plat GTSL, gigi avulsi, luksasi disertai resesi. Berdasar anamnesis dan pemeriksaan klinis, lesi mulut mengacu pada kandidiasis mulut dan pasien dicurigai menderita DM. Rencana perawatan meliputi Komunikasi, Informasi, dan Edukasi, terapi antifungal, ortopantomogram (OPG) dan konsultasi medis terkait kecurigaan DM. Penatalaksanaan lesi mulut meliputi debridasi dan Nystatin topikal. Dua minggu kemudian, lesi mulut menunjukkan perbaikan. Hasil OPG dan kadar glukosa darah (KGD) mengindikasikan latar belakang DM. Ekstraksi dilakukan setelah DM terkontrol diikuti pembuatan protesa. Fungsi mulut kembali normal dan diinstruksikan pengelolaan KGD. Kesimpulan. Temuan klinis kandidiasis mulut dapat digunakan sebagai indicator adanya gangguan sistemik, pada kasus ini adalah DM. Identifikasi dini lesi mulut terkait gangguan sistemik dapat membantu penderita untuk memperoleh perawatan sistemik lebih awal. Background. Oral candidiasis is caused bt Candida infection. Immunocompromise condition such as diabetes is one of its predisposition. Diabetes mellitus (DM) is metabolic disorder that is often not realized by the sufferer and makes the sufferer susceptible to infection. Purpose. This paper is intended to report the polymorphic type of oral candidiasis in patient with previously undetected DM. Case and management. A 57 years old man complained of impaired mastication due to teeth luxation since last month. Patient has wearing removable partial dentures since 5 years ago, which was hard to removed by himself. Lately the patient experienced prickly under dentures and halitosis. The patient reported about lost of weight as 9 kg in 3 months. No abnormality found extraorally, and intraorally it found some velvety white plaque on dorsum of the tongue, erythematous area on mucosal bearing dentures, avulsion and luxation of the teeth. Based on history taking and clinical examination, oral lesion regarded as oral candidiasis and the patient suspected to have DM. Treatment planning were oral health education, antifungal therapy, taking an OPG, medical consultation because of possibility of DM. Treatments comprises as oral debridement and topical nystatin. Two weeks later, oral lesion showed improvement. It revealed that OPG and Blood Glucosa Level (BGL) result were referred to DM. After his DM controlled, teeth extraction was done followed by construction of new denture. Normal oral function returned, and patient instructed to maintain BGL. Conclusion. Clinical findings as oral candidiasis can be used as an indicator of the existence of the systemic disease, in this case are DM. Early identification of oral lesion associated systemic disease could help the patient to obtain early treatment.

scholarly journals Gingival Pemphigus Vulgaris-Challenges and Solution : A Case Report

2020 ◽  
Vol 6 (2) ◽  
pp. 75-78
Author(s):  
Ira Gupta ◽  
Aastha Singh ◽  
Nidhi Gupta ◽  
Rohit Gupta
Keyword(s):  
Systemic Disease ◽  
Pemphigus Vulgaris ◽  
Clinical Findings ◽  
Chief Complaint ◽  
Histopathological Analysis ◽  
Patient Reported ◽  
Life Threatening ◽  
A Site ◽  
Oral Hygiene Instructions

Pemphigus vulgaris (PV) is a potentially life threatening and rare mucocutaneous disease that usually manifests first in the oral cavity and may later spread to the skin or other mucous membrane. Lesions may occur anywhere on the mucosa but it is unusual for PV to present over the gingiva as a primary site of involvement. A 64 year old female patient reported with a chief complaint of reddish, painful gums with burning sensation since 8 years. The diagnosis of PV is based on clinical findings (Nikolsky’s sign positive) and confirmed by histopathological analysis. Medications were prescribed as per indications and requirements. Oral hygiene instructions were given. No recurrence was observed at 1½ year of follow-up. Thus, this case serves to enhance our awareness of gingiva as a site at which systemic disease can manifests itself.

scholarly journals Deep Neck infections of Odontogenic Origin and Their Clinical Significance. A Retrospective Study from Hradec Králové, Czech Republic

2015 ◽  
Vol 58 (3) ◽  
pp. 86-91 ◽  
Author(s):  
Helena Doležalová ◽  
Josef Zemek ◽  
Luboš Tuček
Keyword(s):  
Diabetes Mellitus ◽  
Economic Status ◽  
Statistical Significance ◽  
Systemic Disease ◽  
University Hospital ◽  
Airway Patency ◽  
Significance Level ◽  
Socio Economic Status ◽  
Odontogenic Origin ◽  
The Mean

Introduction: Cellulitis remains a very serious disease even today. Mortality, which varied between 10–40%, has been reduced owing to the standard securing of airway patency and use of an appropriate surgical treatment approach. Materials and methods: A total of 195 patients were hospitalised for cellulitis at the University Hospital in Hradec Králové during 2007–2011. The following parameters were evaluated: age, gender, dependence of incidence of the disease on the season of the year, frequency of attacks of the particular areas and their clinical characteristics, aetiology of the inflammation, types of patient complaints, prevalence of current systemic diseases, results of microbiological and selected laboratory analyses, socio-economic status of the patients, and duration of patient stay at the hospital. Statistical analysis was performed by using Pearson’s correlation coefficient, the statistical significance level was p < 0.05. Results: The mean age of the patients was 39.8 years. The group of 195 patients included 108 (55%) males and 87 (45%) females. The mean time between the first symptoms of the disease and admission to the Department was 5 days. From among the 195 patients, 116 (59.5%) were working persons, 79 (40.5%) were non-working (children, students, unemployed persons, women on maternity leave, retired people). The odontogenic origin of the disease was verified in 173 (88.7%) patients. In total, 65 (33.3%) patients had no coinciding complicating systemic disease, 22 (11.3%) patients had diabetes mellitus. The most frequent symptom of cellulitis was painful swelling, found in 194 (99.5%) patients, followed by jaw contracture, found in 153 (78.5%) patients. Conclusion: The results are largely very similar to those of previous studies performed in other countries, except that we found no correlation between the prevalence of cellulitis and the socio-economic status, nor have we confirmed Klebsiella pneumoniae sp. as the cause of cellulitis in patients with diabetes mellitus.

scholarly journals Sleep Tracking and Exercise in Patients With Type 2 Diabetes Mellitus (Step-D): Pilot Study to Determine Correlations Between Fitbit Data and Patient-Reported Outcomes (Preprint)

2017 ◽  
Author(s):  
James Weatherall ◽  
Yurek Paprocki ◽  
Theresa M Meyer ◽  
Ian Kudel ◽  
Edward A Witt
Keyword(s):  
Physical Activity ◽  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Pilot Study ◽  
Patient Reported Outcomes ◽  
Sleep Problems ◽  
Health Data ◽  
Patient Reported

BACKGROUND Few studies assessing the correlation between patient-reported outcomes and patient-generated health data from wearable devices exist. OBJECTIVE The aim of this study was to determine the direction and magnitude of associations between patient-generated health data (from the Fitbit Charge HR) and patient-reported outcomes for sleep patterns and physical activity in patients with type 2 diabetes mellitus (T2DM). METHODS This was a pilot study conducted with adults diagnosed with T2DM (n=86). All participants wore a Fitbit Charge HR for 14 consecutive days and completed internet-based surveys at 3 time points: day 1, day 7, and day 14. Patient-generated health data included minutes asleep and number of steps taken. Questionnaires assessed the number of days of exercise and nights of sleep problems per week. Means and SDs were calculated for all data, and Pearson correlations were used to examine associations between patient-reported outcomes and patient-generated health data. All respondents provided informed consent before participating. RESULTS The participants were predominantly middle-aged (mean 54.3, SD 13.3 years), white (80/86, 93%), and female (50/86, 58%). Use of oral T2DM medication correlated with the number of mean steps taken (r=.35, P=.001), whereas being unaware of the glycated hemoglobin level correlated with the number of minutes asleep (r=−.24, P=.04). On the basis of the Fitbit data, participants walked an average of 4955 steps and slept 6.7 hours per day. They self-reported an average of 2.0 days of exercise and 2.3 nights of sleep problems per week. The association between the number of days exercised and steps walked was strong (r=.60, P<.001), whereas the association between the number of troubled sleep nights and minutes asleep was weaker (r=.28, P=.02). CONCLUSIONS Fitbit and patient-reported data were positively associated for physical activity as well as sleep, with the former more strongly correlated than the latter. As extensive patient monitoring can guide clinical decisions regarding T2DM therapy, passive, objective data collection through wearables could potentially enhance patient care, resulting in better patient-reported outcomes.

Phase I study of autolytic immunotherapy of metastatic neuroendocrine tumors using intralesional rose bengal disodium.

2021 ◽  
Vol 39 (15_suppl) ◽  
pp. 4115-4115
Author(s):  
Timothy Jay Price ◽  
Gabby Cehic ◽  
Eric Andrew Wachter ◽  
Ian D. Kirkwood ◽  
Jessica Reid ◽  
...  
Keyword(s):  
Disease Control ◽  
Rose Bengal ◽  
Treatment Cycle ◽  
Phase 1 ◽  
Systemic Disease ◽  
Symptom Control ◽  
Objective Response ◽  
Neuroendocrine Neoplasms ◽  
Contrast Enhanced Ct ◽  
Patient Reported

4115 Background: Metastatic neuroendocrine neoplasms (mNEN) originating in the gastrointestinal tract are frequently slow growing yet both symptom and disease control remain important. Treatment options include resection, systemic somatostatin analogues (SSA), and systemic peptide receptor radionuclide therapy (PRRT). Additional options are needed; we have explored intralesional (IL) rose bengal disodium (PV-10), an investigational autolytic immunotherapy that can yield immunogenic cell death and disease-specific functional adaptive immunity. Methods: This phase 1 study evaluated safety, tolerability and impact on symptoms and biochemical markers resulting from IL PV-10 administered percutaneously to hepatic lesions in patients (pts) with progressive mNEN not amenable to resection or other potentially curative therapy. Eligible lesion(s) were 1.0 - 3.9 cm in longest diameter with amount of PV-10 administered proportional to size. Cohort 1 (n = 6 pts) received PV-10 to a single lesion per treatment cycle; Cohort 2 (n = 6) could receive injection to multiple lesions per treatment cycle. Pts could receive further PV-10 ≥6 weeks after prior injection. The primary endpoint was safety. Secondary endpoints included objective response rate (ORR) assessed by contrast enhanced CT (RECIST 1.1) and 68Ga-DOTATATE PET, biochemical response (CgA) and patient-reported outcome (EORTC QLQ-C30 and GI.NET21 QOL instruments). Results: Twelve pts were enrolled, 50% male, median age 66 yrs (range 47-79). Primary sites: 7 small bowel, 2 pancreas, 1 caecal, 2 unknown; grade: Gd1 = 5, Gd2 = 7. All pts had received SSA and PRRT as part of previous therapy and all had symptomatic, progressive disease. Median CgA was 1585 (range 35-10370). One lesion was injected per cycle for all 12 pts; none were suitable for multiple injections. One pt received 4 sequential PV-10 treatment cycles, 3 received 2 cycles, and 8 received 1 cycle. Toxicity was consistent with experience in other hepatic malignancies: post-procedure pain was reported by most pts; grade 3 photosensitivity reaction occurred in 1 pt; and grade 1 elevation of hepatic enzymes attributed to PV-10 occurred in 2 pts, resolving by day 7. Additionally, carcinoid flare occurred in 1 pt. ORR of injected lesions was 42%; patient-level disease control was 84%. Estimated PFS was 9.2 months; median OS was 22.5 months. CgA remained stable in 10 pts and upregulation of NK and activated CD4+ T lymphocytes was observed post-injection. QOL data at months 1 and 3 showed stable or improved carcinoid symptoms and global health status in 9 pts. Conclusions: PV-10 elicited no safety concerns with encouraging evidence of both local and systemic disease and symptom control in a heavily pre-treated population. Multiple cycles were delivered safely in suitable patients. Adaptive immune upregulation is consistent with other solid tumors and supports potential systemic benefit. Clinical trial information: NCT02693067.

Sarcoidosis

2013 ◽  
pp. 1434-1441
Author(s):  
Joachim Müller-Quernheim ◽  
Gernot Zissel ◽  
Antje Prasse
Keyword(s):  
Tumour Necrosis ◽  
Systemic Disease ◽  
Organ Damage ◽  
Immunosuppressive Agent ◽  
Clinical Findings ◽  
Immunosuppressive Regimen ◽  
Cytokine Network ◽  
Symptomatic Disease ◽  
Resistant Disease ◽  
Necrosis Factor

Sarcoidosis is a systemic disease characterized by non-necrotizing granulomata and manifestations in almost any organ. Diagnosis relies on the exclusion of other granulomatous disorders and a compatible pattern of symptoms and clinical findings. Inflammatory lesions and granulomata may undergo spontaneous resolution or persist in chronic disease with eventual fibrosis and permanent organ damage. Immunological disease mechanisms are linked to severe derangements of the cytokine network. In systemic resolution or under prednisolone therapy of symptomatic disease pro-inflammatory cytokines are downregulated and histological lesions may completely vanish. Corticosteroid-resistant disease, however, requires treatment with an immunosuppressive regimen consisting of prednisolone and an immunosuppressive agent or anti-tumour necrosis factor (TNF) monoclonal antibodies.

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