scholarly journals Prevalence of erosive wear lesions in Gastro-Esophageal Reflux Disease patients – A case series

2021 ◽  
Vol 28 ◽  
pp. 1-7
Author(s):  
Prema Sukumaran ◽  
Siti Nurshakina Abdul Kamar ◽  
Nur Azwa Nadia M Zalani ◽  
Divya Nambiar ◽  
Rathna Devi Vaithilingam ◽  
...  
Keyword(s):  
Reflux Disease ◽  
Clinical Signs ◽  
Case Series ◽  
Erosive Wear ◽  
Clinical Findings ◽  
Esophageal Reflux ◽  
Anterior Teeth ◽  
Dental Practitioners ◽  
Tooth Surfaces ◽  
Mandibular Teeth

Extra esophageal manifestation of Gastro-esophageal reflux disease (GERD) include erosive wear dental lesions. Early erosive wear lesions in this group of patients can be easily missed as they are accompanied by few clinical signs and hardly any symptoms. This case series aims to report the prevalence and severity of erosive wear lesions amongst a sample of GERD patients in Malaysia. Eleven subjects with well characterized GERD, diagnosed based on modified Reflux Disease Questionnaire (RDQ) or via endoscopy, were included in this case series. A standardized intra oral clinical examination was performed to assess presence and severity of erosive wear lesions on tooth surfaces using Basic Erosive Wear Examination (BEWE) index. Majority of BEWE score 1 lesions were distributed in maxillary anterior teeth, followed by maxillary posterior and mandibular teeth. BEWE score 2 lesions were most prevalent in maxillary anterior teeth and there were no BEWE score 3 lesions observed. Based on the clinical findings, more erosive wear lesions were found on the buccal surfaces of maxillary and mandibular teeth in GERD patients. This case series further confirms the link between GERD and erosive wear lesions. The authors would like to highlight the need for both medical and dental practitioners to be aware of early clinical presentations of GERD and erosive wear lesions. Early diagnoses allow for intervention and conservative management of these conditions.

scholarly journals Clinical features of cats with aqueous tear deficiency: a retrospective case series of 10 patients (17 eyes)

2018 ◽  
Vol 21 (10) ◽  
pp. 944-950 ◽  
Author(s):  
Lisa K Uhl ◽  
Akihiko Saito ◽  
Hiroko Iwashita ◽  
David J Maggs ◽  
Jonathan P Mochel ◽  
...  
Keyword(s):  
Clinical Features ◽  
Ocular Surface ◽  
Clinical Signs ◽  
Case Series ◽  
Reference Interval ◽  
Clinical Findings ◽  
Response To Therapy ◽  
Ocular Surface Disease ◽  
Retrospective Case ◽  
Schirmer Tear Test

Objectives The aim of this study was to describe the clinical findings, diagnostic test results and response to therapy of cats with Schirmer tear test 1 (STT-1) values below the reference interval. Methods The medical records of three institutions were searched for cats with ocular surface disease and STT-1 values <9 mm/min, confirmed at two or more separate visits. Results Ten cats (17 eyes) were included. The mean ± SD (range) age and STT-1 values in affected eye(s) were 6.1 ± 5.7 (0.2–16) years and 2.4 ± 3.1 (0–8) mm/min, respectively. Concurrent ocular surface disease was bilateral in 5/10 cats. Clinical signs included conjunctivitis (14/17 eyes), corneal ulceration (6/17 eyes), non-ulcerative keratitis (4/17 eyes), symblepharon (4/17 eyes), eosinophilic keratitis (3/17 eyes), corneal sequestrum (3/17 eyes), corneal fibrosis (2/17 eyes) and meibomitis (2/17 eyes). Management included: topically applied lacrimomimetics, antiviral drugs, corticosteroids or immunomodulatory drugs; orally administered famciclovir; or surgical procedures, in various combinations. Response to therapy (defined as an increase in STT-1 value of ⩾5 mm/min) was transient (seen at a single reassessment) in 65% of eyes and sustained (seen at ⩾2 consecutive reassessments) in 18% of eyes. Conclusions and relevance Clinical features seen in cats with low STT-1 values are described, although the association between aqueous deficiency and the reported ocular changes is unknown at this time. We encourage clinicians to assess the tear film in cats with ocular surface disease, and initiate therapy with lacrimomimetics if STT-1 values are repeatedly below normal. Such information will further define aqueous tear deficiency in cats, providing a better understanding of disease prevalence, pathogenesis and treatment.

scholarly journals Opinions and Treatment Decisions for Dental Erosive Wear: A Questionnaire Survey among Icelandic Dentists

2018 ◽  
Vol 2018 ◽  
pp. 1-9 ◽  
Author(s):  
Aida Mulic ◽  
Inga B. Árnadòttir ◽  
Torbjòrg Jensdottir ◽  
Simen E. Kopperud
Keyword(s):  
Erosive Wear ◽  
Treatment Decision ◽  
Treatment Decisions ◽  
Dental Erosion ◽  
Invasive Approach ◽  
Dietary History ◽  
Anterior Teeth ◽  
Dental Practitioners ◽  
Occlusal Surfaces ◽  
High Fluoride

Dental erosive wear (DEW) is common among children and adolescents, and a survey of Icelandic children showed that 30.7% of 15-year-olds were diagnosed with the condition. Objective. To gain knowledge about dental practitioners’ experiences, opinions, and treatment decisions. Materials and Methods. A precoded questionnaire, previously used among Norwegian dentists, was sent electronically to all dentists in Iceland (n = 341). Results. The response rate was 64.2%, and 58% of dentists were male. More than half of the clinicians (54%) thought that prevalence had increased the last 10–15 years, and 67% reported it to be more common in male. Most (96%) recorded presence of DEW, but only 4% used a detailed scoring system. Lesions were mostly on occlusal surfaces of first mandibular molars (73%), on palatal in upper anterior teeth (61%), and on occlusal of maxillary first molars (36%). Most dentists (74%) reported a probable cause, e.g., high consumption of carbonated beverages (98%), acidic juices (68%), sport drinks (58%), reflux (54%), and eating disorders (20%). Dietary history was often recorded by 38%, and 65% never measured saliva. Most of the dentists (88%) treated patients themselves, and half of them preferred prevention with high fluoride and resin sealants. While some dentists wanted to restore teeth more invasively, most considered to restore with a filling. Conclusion. Icelandic dentists seem to be well educated for diagnosis and treatment of dental erosion, and dentists are aware of a minimally invasive approach. Clinical Significance. It is challenging for dentists to make the best treatment decision for patients with DEW, both in a short perspective and long perspective. At present, little is known about their knowledge and treatment approach, and there is no standard treatment which can be recommended. Therefore, the present study investigated dental practitioners’ treatment decisions, as well as knowledge, experiences, and awareness of DEW.

scholarly journals Histologic identification of intraocular Cytauxzoon felis in three cats

2018 ◽  
Vol 4 (2) ◽  
pp. 205511691881324
Author(s):  
Jessica Meekins ◽  
Ada G Cino-Ozuna
Keyword(s):  
Blood Vessels ◽  
Clinical Signs ◽  
Case Series ◽  
Clinical Findings ◽  
Ocular Involvement ◽  
State University ◽  
Diagnostic Laboratory ◽  
Uveal Tract ◽  
Cytauxzoon Felis ◽  
Kansas State University

Case series summary A 5-month-old male intact domestic shorthair (DSH) cat (cat 1), a 1-year-old male neutered DSH cat (cat 2) and a 1.5-year-old female spayed DSH cat (cat 3) were submitted for gross necropsy after acute death, with the clinical suspicion of cytauxzoonosis. All three cats displayed signs of rapidly progressive clinical deterioration, including lethargy, anorexia, and hyper- or hypothermia. Cat 1 was euthanized owing to the grave prognosis for survival, whereas cats 2 and 3 were found dead 1–4 days after the onset of clinical signs. Remains were submitted to the Kansas State University Veterinary Diagnostic Laboratory for gross necropsy. In all three cats, general examination findings included icterus of the mucous membranes, multifocal pulmonary parenchymal hemorrhages, and splenic reddening and enlargement. Histologic examination revealed macrophages laden with protozoal schizonts diffusely distributed within blood vessels and vascular spaces of all affected organs, including the blood vessels of the uveal tract. The ciliary body within the anterior uveal tract was most affected. Relevance and novel information This is the first description of cytauxzoonosis affecting the eyes of infected cats. This report confirms involvement of ocular blood vessels similar to the classic lesions of the lungs, spleen and liver. In cats presenting with a history and clinical findings suggestive of cytauxzoonosis, complete ophthalmic examination is indicated to confirm or rule out ocular involvement.

scholarly journals Full mouth rehabilitation of a patients with gastro-oesophagealal reflux disease - A case report

2020 ◽  
Vol 11 (4) ◽  
pp. 6888-6891
Author(s):  
Preetham Prasad Nittla ◽  
Deepak Nallaswamy V
Keyword(s):  
Reflux Disease ◽  
Clinical Report ◽  
Esophageal Reflux ◽  
Stomach Acid ◽  
Metal Ceramic ◽  
Dental Rehabilitation ◽  
Full Mouth Rehabilitation ◽  
Natural Teeth ◽  
Mandibular Teeth ◽  
Common Manifestation

Gastro esophageal reflux disease(GERD) is a chronic digestive disease caused by backwash (reflux) of stomach acid or contents into the esophagus or the oral cavity. Erosion of the teeth and subsequent wear is a common manifestation of GERD. This clinical report describes the dental rehabilitation of eroded maxillary and mandibular teeth along with other dental complaints in a 45-year-old female GERD patient. Full mouth rehabilitation of natural teeth together with metal-ceramic fixed partial dentures was selected as a treatment modality. Ideal occlusion, optimum esthetics, maintainable oral hygiene were all ensured for a favorable prognosis.

scholarly journals Atypical Clinical Presentation of Laryngopharyngeal Reflux: A 5-Year Case Series

2021 ◽  
Vol 10 (11) ◽  
pp. 2439
Author(s):  
Jerome R. Lechien ◽  
Stéphane Hans ◽  
Francois Bobin ◽  
Christian Calvo-Henriquez ◽  
Sven Saussez ◽  
...  
Keyword(s):  
Clinical Presentation ◽  
Laryngopharyngeal Reflux ◽  
Case Series ◽  
Clinical Findings ◽  
Aerodigestive Tract ◽  
Common Disease ◽  
Upper Aerodigestive Tract ◽  
Suppurative Otitis Media ◽  
Adequate Treatment ◽  
Atypical Clinical Presentation

Background: Laryngopharyngeal reflux (LPR) is a common disease in otolaryngology characterized by an inflammatory reaction of the mucosa of the upper aerodigestive tract caused by digestive refluxate enzymes. LPR has been identified as the etiological or favoring factor of laryngeal, oral, sinonasal, or otological diseases. In this case series, we reported the atypical clinical presentation of LPR in patients presenting in our clinic with reflux. Methods: A retrospective medical chart review of 351 patients with LPR treated in the European Reflux Clinic in Brussels, Poitiers and Paris was performed. In order to be included, patients had to report an atypical clinical presentation of LPR, consisting of symptoms or findings that are not described in the reflux symptom score and reflux sign assessment. The LPR diagnosis was confirmed with a 24 h hypopharyngeal-esophageal impedance pH study, and patients were treated with a combination of diet, proton pump inhibitors, and alginates. The atypical symptoms or findings had to be resolved from pre- to posttreatment. Results: From 2017 to 2021, 21 patients with atypical LPR were treated in our center. The clinical presentation consisted of recurrent aphthosis or burning mouth (N = 9), recurrent burps and abdominal disorders (N = 2), posterior nasal obstruction (N = 2), recurrent acute suppurative otitis media (N = 2), severe vocal fold dysplasia (N = 2), and recurrent acute rhinopharyngitis (N = 1), tearing (N = 1), aspirations (N = 1), or tracheobronchitis (N = 1). Abnormal upper aerodigestive tract reflux events were identified in all of these patients. Atypical clinical findings resolved and did not recur after an adequate antireflux treatment. Conclusion: LPR may present with various clinical presentations, including mouth, eye, tracheobronchial, nasal, or laryngeal findings, which may all regress with adequate treatment. Future studies are needed to better specify the relationship between LPR and these atypical findings through analyses identifying gastroduodenal enzymes in the inflamed tissue.

Diagnosis and management of hook of hamate fractures

2017 ◽  
Vol 43 (5) ◽  
pp. 539-545 ◽  
Author(s):  
Assaf Kadar ◽  
Allen T. Bishop ◽  
Marissa A. Suchyta ◽  
Steven L. Moran
Keyword(s):  
Case Series ◽  
Clinical Results ◽  
Clinical Findings ◽  
Advanced Imaging ◽  
Level Of Evidence ◽  
Historical Case ◽  
Treatment Groups ◽  
Diagnosis And Management ◽  
Time To Diagnosis ◽  
Hook Of Hamate

The purpose of this study was to evaluate the time to diagnosis and management of hook of hamate fractures in an era of advanced imaging. We performed a retrospective study of 51 patients treated for hook of hamate fractures. Patients were sent a quickDASH questionnaire regarding the outcomes of their treatment. Hook of hamate fractures were diagnosed with advanced imaging at a median of 27 days. Clinical findings of hook of hamate tenderness had better sensitivity than carpal tunnel-view radiographs. Nonunion occurred in 24% of patients with non-operative treatment and did not occur in the operative group. Both treatment groups achieved good clinical results, with a grip strength of 80% compared with the non-injured hand and a median quickDASH score of 2. Advanced imaging improved the time to diagnosis and treatment compared to historical case series. Nonunion is common in patients treated non-operatively. Level of evidence: IV

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