scholarly journals The Associations of Periodontopathic Bacteria and Oral Candida with Periodontal Inflamed Surface Area in Older Adults Receiving Supportive Periodontal Therapy

Diagnostics ◽  
2021 ◽  
Vol 11 (8) ◽  
pp. 1397
Author(s):  
Hideo Shigeishi ◽  
Mariko Nakamura ◽  
Iori Oka ◽  
Cheng-Yih Su ◽  
Kanako Yano ◽  
...  
Keyword(s):  
Propensity Score ◽  
Surface Area ◽  
University Hospital ◽  
Double Positive ◽  
Epithelial Surface ◽  
Periodontopathic Bacteria ◽  
Oral Rinse ◽  
Periodontal Inflammation ◽  
Inflammatory Status ◽  
Supportive Periodontal Therapy

The periodontal inflamed surface area (PISA) has been proposed for assessment of the total periodontal inflammatory status in people with periodontitis. This study was performed to investigate the associations of periodontopathic bacteria and candida with PISA in older people. We enrolled 100 patients aged ≥ 60 years who visited Hiroshima University Hospital. PISA and periodontal epithelial surface area (PESA) were calculated in each patient. Oral rinse samples were collected for DNA extraction. Periodontopathic bacteria and candida were detected by polymerase chain reaction. The mean values of PISA and PESA were significantly greater in T.forsythia-positive patients than in T.forsythia-negative patients. T.forsythia/C. albicans double-positive patients exhibited significantly greater PISA values than did non-double-positive patients. Additionally, PISA values were significantly greater in T. forsythia//T. denticola/C. albicans triple-positive patients than in T. forsythia//T. denticola/C. albicans non-triple-positive patients (p = 0.02). Propensity score-matching was performed between periodontopathic bacteria-positive and -negative patients using propensity scores generated from clinical factors. Importantly, T.forsythia/T. denticola double-positive patients exhibited significantly greater PISA values than non-double-positive patients among 72 propensity score-matched patients. Our preliminary results highlight the importance of the presence of T.forsythia and T. denticola for periodontal inflammation severity in older Japanese people.

scholarly journals Microbiological and Clinical Effects of Sitafloxacin and Azithromycin in Periodontitis Patients Receiving Supportive Periodontal Therapy

2016 ◽  
Vol 60 (3) ◽  
pp. 1779-1787 ◽  
Author(s):  
Takako Nakajima ◽  
Takafumi Okui ◽  
Harue Ito ◽  
Mayuka Nakajima ◽  
Tomoyuki Honda ◽  
...  
Keyword(s):  
Medical Information ◽  
Periodontal Therapy ◽  
Clinical Isolates ◽  
University Hospital ◽  
Clinical Effects ◽  
Clinical Parameters ◽  
Content Type ◽  
Periodontopathic Bacteria ◽  
Supportive Periodontal Therapy ◽  
Registration Number

Sitafloxacin (STFX) is a newly developed quinolone that has robust antimicrobial activity against periodontopathic bacteria. We previously reported that oral administration of STFX during supportive periodontal therapy was as effective as conventional mechanical debridement under local anesthesia microbiologically and clinically for 3 months. The aim of the present study was to examine the short-term and long-term microbiological and clinical effects of systemic STFX and azithromycin (AZM) on active periodontal pockets during supportive periodontal therapy. Fifty-one patients receiving supportive periodontal therapy were randomly allocated to the STFX group (200 mg/day of STFX for 5 days) or the AZM group (500 mg/day of AZM for 3 days). The microbiological and clinical parameters were examined until 12 months after the systemic administration of each drug. The concentration of each drug in periodontal pockets and the antimicrobial susceptibility of clinical isolates were also analyzed. The proportions of red complex bacteria, i.e.,Porphyromonas gingivalis,Treponema denticola, andTannerella forsythia, which are the representative periodontopathic bacteria, were significantly reduced at 1 month and remained lower at 12 months than those at baseline in both the STFX and AZM groups. Clinical parameters were significantly improved over the 12-month period in both groups. An increase in the MIC of AZM against clinical isolates was observed in the AZM group. These results indicate that monotherapy with systemic STFX and AZM might be an alternative treatment during supportive periodontal therapy in patients for whom invasive mechanical treatment is inappropriate. (This study has been registered with the University Hospital Medical Information Network-Clinical Trials Registry [UMIN-CTR] under registration number UMIN000007834.)

scholarly journals Estimation of periodontal pocket surface area in small to medium dogs: a proof-of-concept study

2022 ◽  
Vol 18 (1) ◽  
Author(s):  
Kazuya Tamura ◽  
Masako Tokuzen-Tai ◽  
Yasir Dilshad Siddiqui ◽  
Hitomi Tamura-Naito ◽  
Yoshiharu Nagahara ◽  
...  
Keyword(s):  
Body Weight ◽  
Periodontal Disease ◽  
Surface Area ◽  
Periodontal Pocket ◽  
Regression Equations ◽  
Serum Globulin ◽  
Pocket Depth ◽  
Epithelial Surface ◽  
Periodontal Inflammation ◽  
Systemic Health

Abstract Background Periodontal disease is the most common dental disease in dogs. Although the systemic effects of periodontal disease have not been clarified in veterinary science, it is necessary to evaluate the effects of periodontal disease in clinical trials in the future. There have been a few clinical attempts made, however, to assess the severity of periodontal inflammation and its impact on the systemic health of dogs. Meanwhile, in the field of dentistry for humans, the periodontal inflamed surface area (PISA) and periodontal epithelial surface area (PESA) have been used to quantitatively assess the degree of periodontal disease affecting a single tooth as well as the overall extent of periodontitis. Recent studies have also suggested the use of these assessments to examine the relationship between periodontal inflammation and systemic health. Results The estimation formula for a dog’s periodontal pocket surface area (PPSA), an alternative to PISA and PESA in humans, was established using body weight and periodontal pocket depth. Actual values were measured using extracted teeth from various dog breeds and sizes (2.3–25.0 kg of body weight) to obtain universal regression equations for PPSA. Altogether, 625 teeth from 73 dogs of 16 breeds were extracted and subsequently analyzed for morphological information. PPSA was measured in 61 dogs of 10 breeds with periodontal disease using the established estimation formulas, and the correlation between PPSA and preoperative blood chemistry data was analyzed accordingly. A strong correlation was found between PPSA and serum globulin (r = 0.71) while moderate correlations were found for C-reactive protein (r = 0.54) and serum albumin (r = -0.51). Conclusions Estimation formulas using body weight and the 6-point probing depth were established for determining PPSA. Direct correlations between PPSA and several blood test results were observed in the study sample. Taken together, these results suggest that PPSA could be useful for evaluating the effects of periodontitis on systemic conditions in dogs.

scholarly journals Periodontal inflammation mediates the link between homocysteine and high blood pressure

2021 ◽  
Author(s):  
João Botelho ◽  
Vanessa Machado ◽  
Yago Leira ◽  
Luís Proença ◽  
José João Mendes
Keyword(s):  
Blood Pressure ◽  
Surface Area ◽  
Mediation Analysis ◽  
Complete Blood Count ◽  
Serum Levels ◽  
Clinical Situation ◽  
Epithelial Surface ◽  
Surface Areas ◽  
Periodontal Inflammation ◽  
Reported Data

ABSTRACTBackgroundHere, we assess the association between Hcy serum levels and periodontal status in a large representative sample of the National Health and Nutrition Examination Survey (NHANES).MethodsWe included 4,021 participants with a periodontal examination, medical self-reported data, BP and blood samples to determine complete blood count, C-reactive protein (CRP) and Hcy levels. We then calculated the periodontal inflamed surface area (PISA) and the periodontal epithelial surface area (PESA). Multivariable regression analysis explored the association between Hcy, periodontal measures and blood pressure. Mediation analysis was performed to understand the effect of age on the association of periodontitis with BP. Mediation analysis assessed the effect of PISA and PESA in the link between Hcy and BP.Results4,021 participants fulfilled the inclusion criteria. Hcy levels showed significant correlations with systolic BP, diastolic BP, PISA, PESA and age. PESA showed to be significantly associated with Hcy both for the crude and adjusted models (p<0.01), but not PISA (p>0.05). In the association of Hcy with systolic BP, PISA significantly mediated 17.4% and PESA 0.9%. In the association of Hcy with diastolic BP, PISA significantly mediated 16.3% and PESA 47.2%.ConclusionsThis report shows that Hcy and periodontitis are associated. Also, both PISA and PESA significantly mediated the association of Hcy with systolic BP and diastolic BP. Future studies shall deepen the mechanisms by which homocysteine levels increase in a clinical situation of periodontitis.One-sentence summary describing the key finding(s) from the studyHomocysteine and periodontitis are associated. The periodontal inflamed and epithelial surface areas significantly mediate the association of homocysteine with systolic and diastolic blood pressures.

scholarly journals Procedural times in early non-intubated VATS program - a propensity score analysis

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Isabella Metelmann ◽  
Johannes Broschewitz ◽  
Uta-Carolin Pietsch ◽  
Gerald Huschak ◽  
Uwe Eichfeld ◽  
...  
Keyword(s):  
Propensity Score ◽  
Surgical Procedure ◽  
Recovery Time ◽  
Propensity Score Analysis ◽  
Wedge Resection ◽  
University Hospital ◽  
Implementation Phase ◽  
Score Analysis ◽  
Significant Difference ◽  
Procedural Time

Abstract Background Non-intubated video-assisted thoracic surgery (NiVATS) has been introduced to surgical medicine in order to reduce the invasiveness of anesthetic procedures and avoid adverse effects of intubation and one-lung ventilation (OLV). The aim of this study is to determine the time effectiveness of a NiVATS program compared to conventional OLV. Methods This retrospective analysis included all patients in Leipzig University Hospital that needed minor VATS surgery between November 2016 and October 2019 constituting a NiVATS (n = 67) and an OLV (n = 36) group. Perioperative data was matched via propensity score analysis, identifying two comparable groups with 23 patients. Matched pairs were compared via t-Test. Results Patients in NiVATS and OLV group show no significant differences other than the type of surgical procedure performed. Wedge resection was performed significantly more often under NiVATS conditions than with OLV (p = 0,043). Recovery time was significantly reduced by 7 min (p = 0,000) in the NiVATS group. There was no significant difference in the time for induction of anesthesia, duration of surgical procedure or overall procedural time. Conclusions Recovery time was significantly shorter in NiVATS, but this effect disappeared when extrapolated to total procedural time. Even during the implementation phase of NiVATS programs, no extension of procedural times occurs.

scholarly journals The effect of vitamin K on prothrombin time in critically ill patients: an observational registry study

2021 ◽  
Vol 9 (1) ◽  
Author(s):  
Sofia Dahlberg ◽  
Ulf Schött ◽  
Thomas Kander
Keyword(s):  
Propensity Score ◽  
Prothrombin Time ◽  
Critically Ill ◽  
Vitamin K ◽  
Critically Ill Patients ◽  
International Normalized Ratio ◽  
University Hospital ◽  
Red Blood Cell Transfusion ◽  
Registry Study ◽  
Exclusion Criteria

Abstract Background Previous studies have indicated that vitamin K deficiency is common in non-bleeding critically ill patients with slightly prolonged prothrombin time-international normalized ratio (PT-INR). It has never been investigated thoroughly whether the administration of vitamin K to these patients could affect their PT-INR. Therefore, the aim of this registry study was to evaluate changes in PT-INR in response to vitamin K in critically ill patients with PT-INR in the range of 1.3–1.9. Methods Patients admitted to a mixed 9-bed general intensive care unit at a University Hospital, between 2013 and 2019 (n = 4541) with a PT-INR between 1.3 and 1.9 at any time during the stay were identified. Patients who received vitamin K with appropriate sampling times for PT-INR and without exclusion criteria were matched with propensity score to patients from the same cohort who did not receive vitamin K (controls). PT-INR was measured at admission, within 12 h before vitamin K administration and 12–36 h following vitamin K administration. Exclusion criteria included pre-existing liver cirrhosis, any plasma or platelet transfusion, or > 1 unit red blood cell transfusion between PT-INR samplings. Results Propensity score matching resulted in two groups of patients with 129 patients in each group. PT-INR decreased in both groups (1.4 [1.3–1.4] in the vitamin K group and 1.4 [1.3–1.6] in the controls, p < 0.001 and p = 0.004, respectively). The decrease in PT-INR was slightly more pronounced in patients who received vitamin K (delta PT-INR − 0.10 [− 0.30 to − 0.10] in the vitamin K group and − 0.10 [− 0.20 to 0.10] in the controls, p = 0.01). Conclusion In critically ill patients with a PT-INR of 1.3–1.9, the administration of vitamin K resulted in a slightly larger decrease of PT-INR 12–36 h after administration compared to controls. Future studies should focus on identifying which patient populations may benefit most from vitamin K administration as well as whether vitamin K could be a better alternative than plasma or prothrombin complex concentrate to improve PT-INR before non-emergent invasive procedures.

scholarly journals Lipid, fatty acid, carnitine- and choline derivative profiles in rheumatoid arthritis outpatients with different degrees of periodontal inflammation

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Kathrin Beyer ◽  
Stein Atle Lie ◽  
Bodil Bjørndal ◽  
Rolf K. Berge ◽  
Asbjørn Svardal ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Fatty Acid ◽  
Mitochondrial Dysfunction ◽  
Inflammatory Diseases ◽  
Whole Body ◽  
Cross Sectional ◽  
Chronic Inflammatory Diseases ◽  
Periodontal Inflammation ◽  
Inflammatory Status ◽  
Lipid Fatty Acid

AbstractRheumatoid arthritis (RA) and periodontitis are chronic inflammatory diseases with several pathogenic pathways in common. Evidence supports an association between the diseases, but the exact underlying mechanisms behind the connection are still under investigation. Lipid, fatty acid (FA) and metabolic profile alterations have been associated with several chronic inflammatory diseases, including RA and periodontitis. Mitochondria have a central role in regulating cellular bioenergetic and whole-body metabolic homeostasis, and mitochondrial dysfunction has been proposed as a possible link between the two disorders. The aim of this cross-sectional study was to explore whole-blood FA, serum lipid composition, and carnitine- and choline derivatives in 78 RA outpatients with different degrees of periodontal inflammation. The main findings were alterations in lipid, FA, and carnitine- and choline derivative profiles. More specifically, higher total FA and total cholesterol concentrations were found in active RA. Elevated phospholipid concentrations with concomitant lower choline, elevated medium-chain acylcarnitines (MC-AC), and decreased ratios of MC-AC and long-chain (LC)-AC were associated with prednisolone medication. This may indicate an altered mitochondrial function in relation to the increased inflammatory status in RA disease. Our findings may support the need for interdisciplinary collaboration within the field of medicine and dentistry in patient stratification to improve personalized treatment. Longitudinal studies should be conducted to further assess the potential impact of mitochondrial dysfunction on RA and periodontitis.

scholarly journals Risk of Bleeding after Colorectal Endoscopic Resection in Patients with Continued Warfarin Use Compared to Heparin Replacement: A Propensity Score Matching Analysis

2021 ◽  
Vol 2021 ◽  
pp. 1-11
Author(s):  
Katsuaki Inagaki ◽  
Ken Yamashita ◽  
Shiro Oka ◽  
Fumiaki Tanino ◽  
Noriko Yamamoto ◽  
...  
Keyword(s):  
Propensity Score ◽  
Propensity Score Matching ◽  
Endoscopic Resection ◽  
Warfarin Therapy ◽  
Colorectal Neoplasia ◽  
Perioperative Period ◽  
University Hospital ◽  
Risk Of Bleeding ◽  
Warfarin Group ◽  
Clinical Records

The Japan Gastroenterological Endoscopy Society (JGES) guidelines recommend continued warfarin treatment during gastroenterological endoscopic procedures with a high risk of bleeding as an alternative to heparin replacement in patients on warfarin therapy. However, there is insufficient evidence to support the use of warfarin in colorectal endoscopic resection (ER). The present study is aimed at verifying the risk of bleeding after ER for colorectal neoplasia (CRN) in patients with continued warfarin use. This was a single-center retrospective cohort study using clinical records. We assessed 126 consecutive patients with 159 CRNs who underwent ER (endoscopic mucosal resection, 146 cases; endoscopic submucosal dissection, 13 cases) at Hiroshima University Hospital between January 2014 and December 2019. Patients were divided into two groups: the heparin replacement group (79 patients with 79 CRNs) and the continued warfarin group (47 patients with 80 CRNs). One-to-one propensity score matching was performed to compare the bleeding rate after ER between the groups. The rate of bleeding after ER was significantly higher in the heparin replacement group than in the continued warfarin group for both before (10.1% vs. 1.3%, respectively; P = 0.0178 ) and after (11.9% vs. 0%, respectively; P = 0.0211 ) propensity score matching. None of the patients experienced thromboembolic events during the perioperative period. The risk of bleeding after colorectal ER was significantly lower in patients with continued warfarin use than in those with heparin replacement. Our data supports the recommendations of the latest JGES guidelines for patients receiving warfarin therapy.

scholarly journals Alveolar epithelial surface area-volume relationship in isolated rat lungs

1999 ◽  
Vol 86 (6) ◽  
pp. 2026-2033 ◽  
Author(s):  
Daniel J. Tschumperlin ◽  
Susan S. Margulies
Keyword(s):  
Basement Membrane ◽  
Surface Area ◽  
Total Lung Capacity ◽  
Membrane Surface ◽  
Epithelial Surface ◽  
Alveolar Epithelial ◽  
Lung Capacity ◽  
Epithelial Basement Membrane ◽  
Rat Lungs ◽  
Epithelial Basement

In vitro studies of the alveolar epithelial response to deformation require knowledge of the in situ mechanical environment of these cells. Because of the presence of tissue folding and crumpling, previous measurements of the alveolar surface area available for gas exchange are not equivalent to the epithelial surface area. To identify epithelial deformations in uniformly inflated lungs representative of the in vivo condition, we studied isolated Sprague-Dawley rat lungs ( n = 31) fixed by perfusion with glutaraldehyde on deflation after cycling three times at high lung volume (10–25 cmH2O). The epithelial basement membrane in 45 electron micrographs (×12,000)/rat was traced, digitally scanned, and analyzed. Epithelial basement membrane surface area (EBMSA) was computed from a morphometric relationship. EBMSA was found to increase 5, 16, 12, and 40% relative to EBMSA at 24% total lung capacity at lung volumes of 42, 60, 82, and 100% total lung capacity, respectively. The increases in EBMSA suggest that epithelial cells undergo significant deformations with large inflations and that alveolar basement membrane deformation may contribute to lung recoil at high lung pressures.

scholarly journals Routine open abdomen treatment compared with on-demand open abdomen or direct closure following open repair of ruptured abdominal aortic aneurysms: A propensity score–matched study

2019 ◽  
Vol 7 ◽  
pp. 205031211983350 ◽  
Author(s):  
Kristian Smidfelt ◽  
Joakim Nordanstig ◽  
Urban Wingren ◽  
Göran Bergström ◽  
Marcus Langenskiöld
Keyword(s):  
Abdominal Aortic Aneurysm ◽  
Aortic Aneurysm ◽  
Propensity Score ◽  
Open Abdomen ◽  
Open Repair ◽  
Matched Control ◽  
University Hospital ◽  
Control Group ◽  
Ruptured Abdominal Aortic Aneurysm ◽  
Abdominal Aortic

Objective: To investigate whether a strategy of treatment with a primarily open abdomen improves outcome in terms of mortality and major complications in patients treated with open repair for a ruptured abdominal aortic aneurysm compared to a strategy of primary closure of the abdomen. Design: Retrospective cohort study. Methods: Patients treated with a primarily open abdomen at a centre where this strategy was routine in most ruptured abdominal aortic aneurysm patients were compared to a propensity score–matched control group of patients who had the abdomen closed at the end of the primary operation in a majority of the cases. Results: In total, 79 patients treated with a primarily open abdomen after open repair for ruptured abdominal aortic aneurysm at Sahlgrenska University Hospital were compared to a propensity score–matched control group of 148 patients. The abdomen was closed at the end of the procedure in 108 (73%) of the control patients. There was no difference in 30-day mortality between patients treated with a primarily open abdomen at Sahlgrenska University Hospital and the controls, 21 (26.6%) versus 49 (33.1%), p = 0.37. The adjusted odds ratio for mortality at 30 days was 0.66 (95% confidence interval: 0.35–1.25) in patients treated with a primarily open abdomen at Sahlgrenska University Hospital compared to the controls. No difference was observed between the groups regarding 90-day mortality, postoperative renal failure requiring renal replacement therapy, postoperative intestinal ischaemia necessitating bowel resection or postoperative bleeding requiring reoperation. Conclusions: The study did not show any survival advantage or difference in major complications between patients treated with a primarily open abdomen after open repair for ruptured abdominal aortic aneurysm and propensity-matched controls where the abdomen was primarily closed in a majority of the cases.

Postoperative Acute Kidney Injury: Focus on Renal Recovery Definitions, Kidney Disease Progression and Survival

2019 ◽  
Vol 49 (3) ◽  
pp. 175-185 ◽  
Author(s):  
Thorir E. Long ◽  
Solveig Helgadottir ◽  
Dadi Helgason ◽  
Gisli H. Sigurdsson ◽  
Tomas Gudbjartsson ◽  
...  
Keyword(s):  
Acute Kidney Injury ◽  
Kidney Disease ◽  
Propensity Score ◽  
Matched Control ◽  
Kidney Injury ◽  
Renal Recovery ◽  
University Hospital ◽  
Control Group ◽  
One Year ◽  
Definition Of

Background: The aim of this study was to examine different definitions of renal recovery following postoperative acute kidney injury (AKI) and how these definitions associate with survival and the development and progression of chronic kidney disease (CKD). Methods: This was a retrospective study of all patients who underwent abdominal, cardiothoracic, vascular, or orthopedic surgery at a single university hospital between 1998 and 2015. Recovery of renal function following postoperative AKI was assessed comparing 4 different definitions: serum creatinine (SCr) (i) < 1.1 × baseline, (ii) 1.1–1.25 × baseline, (iii) 1.25–1.5 × baseline, and (iv) > 1.5 × baseline. One-year survival and the development or progression of CKD within 5 years was compared with a propensity score-matched control groups. Results: In total, 2,520 AKI patients were evaluated for renal recovery. Risk of incident and progressive CKD within 5 years was significantly increased if patients did not achieve a reduction in SCr to < 1.5 × baseline (hazard ratio [HR] 1.50; 95% CI 1.29–1.75) and if renal recovery was limited to a fall in SCr to 1.25–1.5 × baseline (HR 1.32; 95% CI 1.12–1.57) within 30 days. The definition of renal recovery that best predicted survival was a reduction in SCr to < 1.5 × baseline within 30 days. One-year survival of patients whose SCr decreased to < 1.5 × baseline within 30 days was significantly better than that of a propensity score-matched control group that did not achieve renal recovery (85 vs. 71%, p < 0.001). Conclusions: These findings should be considered when a consensus definition of renal recovery after AKI is established.

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