Oral Mucosa Status and Saliva Parameters of Multimorbid Adult Patients Diagnosed with End-Stage Chronic Kidney Disease

There has been an increasing number of patients diagnosed with chronic diseases. Many of those diseases determine changes in patients’ social and even professional life. The aim of the present work was to analyze saliva and oral mucosa parameters in adult patients diagnosed with chronic diseases. A total of 228 patients took part in the research. A total of 180 patients were hemodialyzed in Diaverum dialysis stations, and there were 48 patients from the Conservative Dentistry with Endodontics Clinic of the Academic Centre of Dentistry of Silesian Medical University in Bytom and patients from the dentistry division of the Arnika Clinic in Zabrze not diagnosed with any such diseases. Selected saliva parameters (secretion, pH and buffer capacity) and mucosa status were examined. In order to obtain information regarding xerostomia, patients were given a questionnaire. Patients assigned to the control group rarely used water to make swallowing easier or used candies to lessen the feeling of oral cavity dryness. They also rarely suffered from eye dryness. The feeling of dryness also did not influence their social life. The amount of produced saliva was higher in the control group. There was a significantly lower percentage of patients with a low buffer capacity of saliva. There were no differences in terms of saliva pH values between the two groups of patients. A significantly lower number of patients were diagnosed with ecchymosis, candidiasis, scrotal tongue and mechanical damages. Patients diagnosed with chronic diseases need to be provided with long-term care.

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Compound Sarcopenia in Hospitalized Patients with Cirrhosis Worsens Outcomes with Increasing Age

Nutrients ◽

10.3390/nu13020659 ◽

2021 ◽

Vol 13 (2) ◽

pp. 659

Author(s):

Nicole Welch ◽

Amy Attaway ◽

Annette Bellar ◽

Hayder Alkhafaji ◽

Adil Vural ◽

...

Keyword(s):

Chronic Diseases ◽

Older Patients ◽

Hospitalized Patients ◽

Muscle Loss ◽

Term Care ◽

Old Patients ◽

Younger Patients ◽

Age Related ◽

Number Of Patients ◽

The Impact

Background: There are limited data on outcomes of older patients with chronic diseases. Skeletal muscle loss of aging (primary sarcopenia) has been extensively studied but the impact of secondary sarcopenia of chronic disease is not as well evaluated. Older patients with chronic diseases have both primary and secondary sarcopenia that we term compound sarcopenia. We evaluated the clinical impact of compound sarcopenia in hospitalized patients with cirrhosis given the increasing number of patients and high prevalence of sarcopenia in these patients. Design: The Nationwide Inpatients Sample (NIS) database (years 2010–2014) was analyzed to study older patients with cirrhosis. Since there is no universal hospital diagnosis code for “muscle loss”, we used a comprehensive array of codes for “muscle loss phenotype” in the international classification of diseases-9 (ICD-9). A randomly selected 2% sample of hospitalized general medical population (GMP) and inpatients with cirrhosis were stratified into 3 age groups based on age-related changes in muscle mass. In-hospital mortality, length of stay (LoS), cost of hospitalization (CoH), comorbidities and discharge disposition were analyzed. Results. Of 517,605 hospitalizations for GMP and 106,835 hospitalizations for treatment of cirrhosis or a cirrhosis-related complication, 207,266 (40.4%) GMP and 29,018 (27.7%) patients with cirrhosis were >65 years old, respectively. Muscle loss phenotype in both GMP and inpatients with cirrhosis 51–65 years old and >65 years old was significantly (p < 0.001 for all) associated with higher mortality, LoS, and CoH compared to those ≤50 years old. Patients >65 years old with cirrhosis and muscle loss phenotype had higher mortality (adjusted OR: 1.06, 95% CI [1.04, 1.08] and CoH (adjusted odds ratio (OR): 1.10, 95% confidence interval (CI) [1.04, 1.08])) when compared to >65 years old GMP with muscle loss phenotype. Muscle loss in younger patients with cirrhosis (≤50 years old) was associated with worse outcomes compared to GMP >65 years old. Non-home discharges (nursing, skilled, long-term care) were more frequent with increasing age to a greater extent in patients with cirrhosis with muscle loss phenotype for each age stratum. Conclusion: Muscle loss is more frequent in older patients with cirrhosis than younger patients with cirrhosis and older GMP. Younger patients with cirrhosis had clinical outcomes similar to those of older GMP, suggesting an accelerated senescence in cirrhosis. Compound sarcopenia in older patients with cirrhosis is associated with higher inpatient mortality, increased LoS, and CoH compared to GMP with sarcopenia.

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Fentanyl versus midazolam as additive to local anesthetic mixture for peribulbar block during posterior segment surgery in adult patients a prospective randomized double-blind study

Ain-Shams Journal of Anesthesiology ◽

10.1186/s42077-019-0036-8 ◽

2019 ◽

Vol 11 (1) ◽

Author(s):

Ahmed Abdalla Mohamed ◽

Tamer Fayez Safan

Keyword(s):

Postoperative Analgesia ◽

Local Anesthetic ◽

Posterior Segment ◽

Adult Patients ◽

The Other ◽

Control Group ◽

Double Blind ◽

Rescue Analgesia ◽

Number Of Patients ◽

Peribulbar Block

Abstract Objectives To evaluate analgesic and hemodynamic outcome of fentanyl or midazolam as additives to local anesthetic mixture (LAM) for peribulbar block (PBB) during posterior chamber surgery. Methods One hundred thirty-two ASA status I to III adult patients aged 50–75 years scheduled for posterior segment surgery (intraocular foreign body and elective vitrectomy) were enrolled in this prospective, randomized, double-blind trial from which 12 patients were excluded. After signing a written fully informed consent for study participation, patients were grouped into 3 groups (40 patients in each group); group C received local anesthetic mixture plus 1 ml plain saline, group F received local anesthetic mixture plus 25 μg fentanyl in 1 ml saline and group M received local anesthetic mixture plus 1 mg midazolam in 1 ml saline. The primary outcome was the onset time of eyelid and globe akinesia. Also, the duration of the block was assessed in the three studied groups. Intraoperative and postoperative hemodynamic measures were assessed. Postoperative analgesia was hourly-assessed using Visual analogue scale (VAS) and rescue analgesia was provided at visual analogue score of > 3. Results The number of patients who had fast eyelid and globe akinesia was significantly higher with significantly lower total 15-min score in group F than the other groups. Intraoperative and postoperative hemodynamic measures were non-significantly different between studied groups. Duration of the block was significantly longer in groups F and M than group C with significantly longer duration in group F. The number of patients who required postoperative rescue analgesia was significantly lower with significantly lower number of requests in group F than the other groups. Conclusion Additives to local anesthetic mixture during peribulbar block provided satisfactory anesthetic outcome than local anesthetic mixture alone. Fentanyl was superior to midazolam in terms of significantly speed up onset, longer block duration with significantly longer postoperative analgesia and lesser consumption of rescue analgesia. Both additives provided adjusted hemodynamic measures comparable to the control group. Trial registration Pan African Clinical Trials Registry (PACTR201708002496243) registered 03/08/2017 retrospectively.

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The effectiveness of the osteopathic correction in the complex treatment of adult patients with gastroesophageal reﬂux disease

Russian Osteopathic Journal ◽

10.32885/2220-0975-2021-1-69-79 ◽

2021 ◽

pp. 69-79

Author(s):

T. P. Naletova ◽

E. P. Udintsev ◽

A. Yu. Oreshko ◽

O. A. Chusovitina

Keyword(s):

Gastroesophageal Reflux Disease ◽

Gastroesophageal Reflux ◽

Reflux Disease ◽

Clinical Symptoms ◽

Life Quality ◽

Adult Patients ◽

Control Group ◽

Complex Treatment ◽

Number Of Patients ◽

Therapy Effectiveness

Introduction. Gastroesophageal reﬂux disease (GERD) is now widespread throughout the world, with clear evidence of incidence increase in many countries. The importance of GERD is caused by the fact that it leads to a signiﬁcant decrease in the patient′s life quality, the appearance of extraesophageal symptoms (chest pain, persistent cough) and the risk of such complications as bleeding from ulcers and erosions, the development of peptic strictures, and esophageal adenocarcinoma. After stopping the medicine treatment, the relapse quickly occurs and it is the main risk factor for the development of Barrett′s esophagus — a precancerous pathology of the esophagus. Therefore, the search for additional, non-drug methods of treatment for increasing the standard therapy effectiveness is in demand. Osteopathic correction of somatic dysfunction can be one of these methods. To date, there is some evidence of the osteopathic correction effectiveness in children with GERD.The goal of research — to study the effectiveness of osteopathic correction in the complex treatment of adult patients with GERD.Materials and methods. The study involved 20 people, divided by simple randomization into two equal groups: control and main. The control group received standard treatment, the main group received additional osteopathic correction. At the beginning and at the end of the study, there were assessed the osteopathic status of patients and the severity of the disease using the GerdQ questionnaire. The obtained data were processed by methods of nonparametric statistics.Results. The inclusion of osteopathic correction in the complex treatment of patients with GERD is accompanied by a statistically signiﬁcant decrease in the number of local and regional somatic dysfunctions (SD), a signiﬁcant redistribution of the dominant SD structure, and a decrease in the severity of previously dominant SD in the neck and thoracic region. Compared with patients who did not receive osteopathic correction, there is a statistically signiﬁcantly more pronounced decrease in the severity of GERD clinical symptoms.Conclusion. Despite the relatively small number of patients who participated in the study, the obtained results make it possible to recommend the inclusion of osteopathic correction in the complex therapy of patients with GERD.

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Estimation of Proinflammatory Factors in the Saliva of Adult Patients with Cystic Fibrosis and Dental Caries

Medicina ◽

10.3390/medicina56110612 ◽

2020 ◽

Vol 56 (11) ◽

pp. 612

Author(s):

Tomasz Hildebrandt ◽

Anna Zawilska ◽

Agata Trzcionka ◽

Marta Tanasiewicz ◽

Henryk Mazurek ◽

...

Keyword(s):

Cystic Fibrosis ◽

Sialic Acid ◽

Dental Caries ◽

Total Protein ◽

Buffer Capacity ◽

Amylase Activity ◽

Diagnostic Methods ◽

Adult Patients ◽

Control Group ◽

Tnf Α

Introduction: The available literature lacks data regarding the levels of resistin, lysozyme, lactoferrin, α-amylase activity, pH, and saliva buffer capacity, as well as oral health and hygiene in the group of adult patients with cystic fibrosis (CF). The aim of the research was to assess the selected saliva parameters in patients diagnosed with cystic fibrosis. Materials and methods: Examined group was composed of 40 patients diagnosed with CF, while the control group of 40 healthy individuals. Both groups underwent the same scheme of the assessment (DMT index, salivary pH, buffer capacity, analysis of total sialic acid, total protein estimation, lysozyme levels estimation, lactofferin levels measurement, α-amylase activity, estimation of the levels of resistin and TNF-α). Results: In the examined group, there were higher values of decayed teeth as well as values of sialic acid, total protein, lactoferrin, α-amylase, and TNF-α. However, mean lysozyme, and resistin levels, as well as pH and buffer capacity of the saliva, were lower. Conclusions: New diagnostic methods, including the evaluation of selected salivary biochemical parameters, may indicate the existence of factors predisposing to severe tooth decay in the study group. Appropriate preventive treatment to combat dental caries in adult patients with CF will significantly improve their comfort and life expectancy.

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Reversible Uremic Deafness: Is it Correlated with the Degree of Anemia?

Annals of Otology Rhinology & Laryngology ◽

10.1177/000348949710600506 ◽

1997 ◽

Vol 106 (5) ◽

pp. 391-393 ◽

Cited By ~ 10

Author(s):

Faissal A. M. Shaheen ◽

Noor A. Mansuri ◽

Iftikhar A. Sheikh ◽

Abdullah A. Al-Khader ◽

Abdul Munaim Al-Shaikh ◽

...

Keyword(s):

Renal Failure ◽

Pure Tone Audiometry ◽

Common Finding ◽

Control Group ◽

Sensitivity Index ◽

End Stage Renal Failure ◽

Pathogenic Factors ◽

Number Of Patients ◽

End Stage

Hearing loss is a common finding in patients with end-stage renal failure. Uremic toxins, ototoxins, and axonal uremic neuropathy appear to be likely pathogenic factors. We analyzed whether an improvement in hearing capacity can be achieved with an improvement of anemia by erythropoietin (EPO) administration. Fifty patients on long-term hemodialysis in a single center were examined audiologically by otoscopy, tympanometry, pure tone audiometry, and the short increment sensitivity index. Twenty-five patients were treated with EPO in a dose of 120 U/kg per week over a period of 5 to 8 months, and the remaining 25 patients were not treated with EPO (controls). Both groups were reexamined audiologically after the study period, and the results were compared. In the group treated with EPO, the hemoglobin level increased from 7 ± 0.9 to 11 ± 0.8 g/dL, as against the control group, whose hemoglobin increased from 7.1 ± 0.9 to 8 ± 0.8 g/dL. The audiologic tests were repeated at the end of the study period, and a significant improvement of hearing was found in the patients treated with EPO as compared with the control group (p < .001). Our study suggests that improvement of anemia in patients on long-term hemodialysis by administration of EPO is associated with an improvement in hearing capacity in a significant number of patients. Thus, anemia seems to be an important factor responsible for hearing disorders in patients with end-stage renal failure. Studies with larger numbers of patients are required to confirm this observation.

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Burnout of the Mind – Burnout of the Body?

Journal of Psychophysiology ◽

10.1027/0269-8803/a000182 ◽

2018 ◽

Vol 32 (1) ◽

pp. 30-42 ◽

Cited By ~ 2

Author(s):

Claudia Traunmüller ◽

Kerstin Gaisbachgrabner ◽

Helmut Karl Lackner ◽

Andreas R. Schwerdtfeger

Keyword(s):

Blood Pressure ◽

Allostatic Load ◽

Maslach Burnout Inventory ◽

The Body ◽

Lower Percentage ◽

Control Group ◽

Urinary Catecholamines ◽

Morning Cortisol ◽

The Mind ◽

Cortisol Increase

Abstract. In the present paper we investigate whether patients with a clinical diagnosis of burnout show physiological signs of burden across multiple physiological systems referred to as allostatic load (AL). Measures of the sympathetic-adrenergic-medullary (SAM) axis and the hypothalamic-pituitary-adrenal (HPA) axis were assessed. We examined patients who had been diagnosed with burnout by their physicians (n = 32) and were also identified as burnout patients based on their score in the Maslach Burnout Inventory-General Survey (MBI-GS) and compared them with a nonclinical control group (n = 19) with regard to indicators of allostatic load (i.e., ambulatory ECG, nocturnal urinary catecholamines, salivary morning cortisol secretion, blood pressure, and waist-to-hip ratio [WHR]). Contrary to expectations, a higher AL index suggesting elevated load in several of the parameters of the HPA and SAM axes was found in the control group but not in the burnout group. The control group showed higher norepinephrine values, higher blood pressure, higher WHR, higher sympathovagal balance, and lower percentage of cortisol increase within the first hour after awakening as compared to the patient group. Burnout was not associated with AL. Results seem to indicate a discrepancy between self-reported burnout symptoms and psychobiological load.

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The Use of Posterior Pericardiotomy Technique to Prevent Postoperative Pericardial Effusion in Cardiac Surgery

The Heart Surgery Forum ◽

10.1532/hsf98.20111128 ◽

2012 ◽

Vol 15 (2) ◽

pp. 84 ◽

Cited By ~ 4

Author(s):

Canturk Cakalagaoglu ◽

Cengiz Koksal ◽

Ayse Baysal ◽

Gokhan Alici ◽

Birol Ozkan ◽

...

Keyword(s):

Cardiac Surgery ◽

Heart Surgery ◽

Artery Bypass ◽

Pericardial Tamponade ◽

Anxiety Level ◽

Control Group ◽

Echocardiographic Study ◽

Number Of Patients ◽

Hospital Stays

Aim: The goal was to determine the effectiveness of the posterior pericardiotomy technique in preventing the development of early and late pericardial effusions (PEs) and to determine the role of anxiety level for the detection of late pericardial tamponade (PT).Materials and Methods: We divided 100 patients randomly into 2 groups, the posterior pericardiotomy group (n = 50) and the control group (n = 50). All patients undergoing coronary artery bypass grafting surgery (CABG), valvular heart surgery, or combined valvular and CABG surgeries were included. The posterior pericardiotomy technique was performed in the first group of 50 patients. Evaluations completed preoperatively, postoperatively on day 1, before discharge, and on postoperative days 5 and 30 included electrocardiographic study, chest radiography, echocardiographic study, and evaluation of the patient's anxiety level. Postoperative causes of morbidity and durations of intensive care unit and hospital stays were recorded.Results: The 2 groups were not significantly different with respect to demographic and operative data (P > .05). Echocardiography evaluations revealed no significant differences between the groups preoperatively; however, before discharge the control group had a significantly higher number of patients with moderate, large, and very large PEs compared with the pericardiotomy group (P < .01). There were 6 cases of late PT in the control group, whereas there were none in the pericardiotomy group (P < .05). Before discharge and on postoperative day 15, the patients in the pericardiotomy group showed significant improvement in anxiety levels (P = .03 and .004, respectively). No differences in postoperative complications were observed between the 2 groups.Conclusion: Pericardiotomy is a simple, safe, and effective method for reducing the incidence of PE and late PT after cardiac surgery. It also has the potential to provide a better quality of life.

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MAIN DIRECTIONS OF PREVENTION OF INCREASED WEATHER SENSITIVITY AND TREATMENT OF WEATHER-DEPENDENT PATIENTS

"Medical & pharmaceutical journal "Pulse" ◽

10.26787/nydha-2686-6838-2020-22-11-45-48 ◽

2020 ◽

pp. 45-48

Author(s):

Kolyagina N.M. ◽

Berezhnova T.A. ◽

Klepikov O.V. ◽

Kulintsova Ya.V.

Keyword(s):

Chronic Diseases ◽

Climatic Factors ◽

Weather Factors ◽

Educational Work ◽

Pathological Effect ◽

Term Care ◽

Cardiovascular Pathology ◽

Therapeutic Work ◽

Weather Sensitivity ◽

Voronezh Region

Currently, and over the past decade, intensive research is being conducted in the field of organizational, preventive and therapeutic work with weather-sensitive and weather-dependent patients suffering from cardiovascular pathology. One of the most discussed issues in practical medicine is the application of climate conditions, with a fixed frequency and time of exposure. Conditions of influence of climatic factors, in some cases, can exceed the limits of the norm and, accordingly, have a pathological effect on the functional state of a person. Thus, we used data from statistically reliable results of 928 questionnaires processed and analyzed, reflecting the medical and social characteristics of patients with cardiovascular pathology. Direct results were evaluated by analyzing changes in the dynamics of indicators. According to a questionnaire survey, 62% of patients who have chronic diseases and seek medical help for diseases of the cardiovascular system believe that weather factors have a significant impact on their health. of the patients who do not have chronic diseases, 38% gave positive answers to the question about the weather sensitivity of their health. As part of the pilot project to create a system of long-term care for elderly and disabled citizens in the Voronezh region, patients are informed about the sources of obtaining specialized medical weather forecasts in the region; interaction between the parties is organized to conduct sanitary and educational work; medical examinations are organized and conducted; training sessions are organized for relatives of citizens who have lost the ability to self-service. Further organizational, preventive and therapeutic work with weather-sensitive and weather-dependent patients in the Voronezh region is characterized by an increase in the quality of medical care for patients with cardiovascular diseases.

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Comparative analysis of polymorphic variants of IL-17A and MMP-1 genes with the risk of developing chronic periodontitis in petrochemical workers

Russian Journal of Occupational Health and Industrial Ecology ◽

10.31089/1026-9428-2020-60-10-687-693 ◽

2020 ◽

Vol 60 (10) ◽

pp. 687-693

Author(s):

Iskander I. Zaidullin ◽

Denis O. Karimov ◽

Lilija K. Karimova ◽

Milyausha F. Kabirova ◽

Rasima R. Galimova ◽

...

Keyword(s):

Ethylene Oxide ◽

Chronic Periodontitis ◽

Periodontal Diseases ◽

Clinical Manifestations ◽

Control Group ◽

Periodontal Tissues ◽

Dental Examination ◽

Number Of Patients ◽

Increased Risk ◽

Harmful Substances

The susceptibility to the development and progression of inflammatory periodontal diseases, which depends on genetic and external factors (smoking, stress, oral hygiene), varies widely. In the development of these diseases, an important role is played not only by the presence of periodontal pathogenic microorganisms, but also by the presence of congenital or acquired immunodeficiency, immunoregulatory defects. The immune system plays a key role in the physiological and pathological processes of periodontal tissues. In this regard, IL17, produced by CD4+ Th cells, which has both Pro-inflammatory and protective activity, is of particular interest in the pathogenesis of periodontitis. The aim of study was to identify the relationship between polymorphic loci of the IL-17A (rs2275913) and MMP-1 (rs1799750) genes and clinical manifestations of chronic periodontitis in petrochemical workers. Dental examination was performed in 92 ethylene oxide production workers with chronic periodontitis and 74 patients with chronic periodontitis who did not come into contact with chemical factors (control group). Genotyping of polymorphisms rs2275913 of the IL17A gene and rs1799750 of the MMP1 gene was performed by allele-specific real-time polymerase chain reaction (PCR). Hygienic assessment of the degree of air pollution of the working area with harmful substances was carried out by gas chromatography according to the guidelines for the determination of harmful substances in the air № 5098-89, № 3119-84. When comparing the results of studies of both groups, there were no statistically significant differences in the frequency distributions of allelic variants and genotypes of the IL-17A and MMP-1 genes. The AA/AG genotypes of the IL-17A gene were associated with an increased risk of severe disease compared to the GG genotype in workers in the main group (OR=6.1; 95% CI 1.33-28.5; p=0.021) and in the control group (OR=7.26; 95% CI 1.34-39.25; p=0.016). Carriers of the A allele in the control group increased the risk of severe chronic periodontitis by 2.4 times compared to carriers of the G allele (OR=2.41; 95% CI 1.19-4.87; p=0.014). During the dental examination of employees of the ethylene oxide plant, the clinical course of periodontal diseases was more severe in comparison with the control group, and the number of patients with severe periodontitis was twice as high. It was found that the AA/AG genotypes of the IL-17A gene and the carrier of the A allele are associated with increased susceptibility to the development of severe chronic periodontitis. The association between the MMP-1 gene polymorphism and the risk of severe forms of chronic periodontitis has not been established. A risk factor for the development of inflammatory periodontal diseases in employees of the petrochemical complex is a complex of harmful production factors.

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STUDY THE CHANGES IN MORPHOLOGY AND LEFT VENTRICULAR FUNCTION IN OVERWEIGHT-OBESE CHILDREN 5-15 YEARS OLD WHO VISITED CHILDREN'S HOSPITAL IN CAN THO

Journal of Medicine and Pharmacy ◽

10.34071/jmp.2011.6.4 ◽

2011 ◽

pp. 36-42

Author(s):

Hung Viet Bui ◽

Thi Cu Nguyen

Keyword(s):

Left Ventricular Function ◽

Ventricular Function ◽

Left Ventricular ◽

Left Ventricular Ejection ◽

Control Group ◽

Obese Children ◽

Ventricular Ejection Fraction ◽

Children's Hospital ◽

Number Of Patients ◽

Children’S Hospital

Objective: In Vietnam, obesity is increasing particularly in many large cities. Adult cardiovascular diseases are often derived from cardiovascular disorders during the children period. The implementation of early measures to prevent atherosclerosis, such as weight control, better lipid control will reduce the cardiovascular complications, such as hypertension (HTA), coronary heart diseases and some other diseases. Materials and Methods: Overweight - obese children from 5 to 15 years old who visited the Children's Hospital in Can Tho from May 2009 to May 2010. Total number of patients were chosen as 50 children. Method: Descriptive cross-sectional. Children in the study underwent Doppler ultrasound exam to evaluate cardiac morphology and cardiac function. Results: There were increases in left ventricular systolic diameter, left ventricular diastolic diameter, LV mass in overweight-obese children in the study compared with controls at all ages (p <0.05 ). Left ventricular ejection fraction in overweight-obese children in the study was lower than the control group at all ages (p> 0.05). The average rate of left ventricular shortening of overweight-obese children in the study was 34.8 ± 4.5(%). There was no difference in the rate of shortening of the left ventricle in overweight-obese children in the study compared with controls (p>0.05). There was no relationship between variation in morphology and left ventricular function with the degree of overweight-obesity in this study. Conclusion: The study showed that disturbances in morphology and left ventricular function in overweight-obese children but did not find a strong association with the disorder degree of overweight-obesity.

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