scholarly journals Prophylactic and Therapeutic Antibiotic Patterns of Lebanese Dentists for the Management of Dentoalveolar Abscesses

2016 ◽  
Vol 17 (6) ◽  
pp. 425-433 ◽  
Author(s):  
Ghada Asmar ◽  
Dominique Cochelard ◽  
Jacques Mokhbat ◽  
Mohamed Lemdani ◽  
Ahmed Haddadi
Keyword(s):  
Antibiotic Prescription ◽  
Medical Condition ◽  
Local Treatment ◽  
Clinical Signs ◽  
Signs And Symptoms ◽  
Medical Community ◽  
Chi Square ◽  
Systemic Involvement ◽  
Increased Risk ◽  
General Dentists

ABSTRACT Introduction General dentists issue approximately 10% of antibiotic prescriptions across the global medical community consummation. The use of antibiotics for the management of dentoalveolar infections should be considered only in the presence of an increased risk of a systemic involvement or to prevent metastatic infections. This study aimed to investigate the prophylactic and therapeutic antibiotic prescription patterns of Lebanese dentists for the management of dentoalveolar abscesses. The aim was to evaluate the influence of the patients’ medical condition and clinical signs data on the patterns of antibiotics prescription. Materials and methods Only patients with a dentoalveolar abscess were included in the study. Age, medical history, reason for consultation, clinical signs and symptoms, diagnosis, type of local treatment, and type of antibiotherapy were collected for each patient attending dental clinics in Beirut. The data were analyzed with chi-square test and multivariate regression. Results Out of the 563 initial patients, 127 were selected for the study and received a local treatment. The patient's medical condition and age did not affect the decision to prescribe antibiotics 36.2% patients with pain and 11.8% patients with swelling were prescribed antibiotics. Pain and swelling contributed to a higher level of antibiotic prescription compared to other signs and symptoms. Antibiotics were prescribed inappropriately to 51.76 and 38.10% among patients with an acute or chronic dentoalveolar abscess respectively. The main prescribed antibiotic was amoxicillin. Conclusion This study showed that dentists often did not follow the current prophylactic and therapeutic antibiotic prescription guidelines. Clinical significance Antibiotics prescriptions in dentistry will be more pertinent, leading to a decrease in inadequacy of prescriptions, microbial resistance, and the development of multiresistant germs against antibiotics. How to cite this article Asmar G, Cochelard D, Mokhbat J, Lemdani M, Haddadi A, Ayoub F. Prophylactic and Therapeutic Antibiotic Patterns of Lebanese Dentists for the Management of Dentoalveolar Abscesses. J Contemp Dent Pract 2016;17(6):425-433.

Serology surveillance of anti-SARS-CoV-2 antibodies among asymptomatic healthcare workers in Malaysian healthcare facilities designated for COVID-19 care

2020 ◽  
Author(s):  
Yuan Liang Woon ◽  
Yee Leng Lee ◽  
Yoong Min Chong ◽  
Nor Aliya Ayub ◽  
Swarna Lata Krishnabahawan ◽  
...  
Keyword(s):  
Clinical Signs ◽  
Signs And Symptoms ◽  
Healthcare Setting ◽  
Public Hospitals ◽  
Control Measures ◽  
Infection Prevention And Control ◽  
Personal Protection Equipment ◽  
Strict Adherence ◽  
The Past ◽  
Increased Risk

Abstract IntroductionHealthcare workers (HCW) are presumed to be at increased risk of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection due to occupational exposure to infected patients. We aim to determine the prevalence of anti-SARS-CoV-2 antibodies among asymptomatic HCW.MethodsWe prospectively recruited HCW from the National Public Health Laboratory and two COVID-19 designated public hospitals in Klang Valley, Malaysia between April 13th and May 12th, 2020. Quota sampling was applied to ensure adequate representation of the HCW involved in provision of care for patients directly and indirectly. All participants had worked in the respective healthcare facility for at least 30 days prior study enrollment. HCW who were previously confirmed with COVID-19 infection or listed as “patient under investigation” were excluded. A self-administered questionnaire was used to capture sociodemographic information, history of contact with COVID-19 cases within the past month, clinical signs and symptoms and adherence to universal precautions. Blood samples were taken to test for anti-SARS-CoV-2 antibodies by surrogate virus neutralization test.ResultsA total of 400 HCW were recruited, comprising 154 (38.5%) nurses, 103 (25.8%) medical doctors, 47 (11.8%) laboratory technologists and others (23.9%). The mean age was 35±7.8 years, with females predominant (74%). A majority (68.9%) reported direct contact with COVID-19 patients, body fluids of COVID-19 patients and/or contaminated objects and surfaces in the past month within their respective workplaces. Nearly all claimed to adhere to personal protection equipment (PPE) guidelines (97%-100% adherence) and hand hygiene practice (91%-96% adherence). None (95% CI: 0, 0.0095) of the participants had anti-SARS-CoV-2 antibodies detected, despite 135 (33.8%) reporting respiratory symptoms one month prior to study recruitment. One hundred and fifteen (29%) participants claimed to have contact with known COVID-19 persons outside of the workplace.ConclusionOur finding of zero seroprevalence among asymptomatic HCW suggests a low risk of asymptomatic COVID-19 infection in our healthcare setting; which is at expected levels for a country with an incidence of 26 per 100,000. The adequacy of PPE equipment and strict adherence to infection prevention and control measures offers considerable protection during contact with COVID-19 cases and should be ensured to prevent future nosocomial transmission.

scholarly journals Clozapine-induced myocarditis: electronic health register analysis of incidence, timing, clinical markers and diagnostic accuracy

2021 ◽  
pp. 1-8
Author(s):  
Aviv Segev ◽  
Ehtesham Iqbal ◽  
Theresa A. McDonagh ◽  
Cecilia Casetta ◽  
Ebenezer Oloyede ◽  
...  
Keyword(s):  
Adverse Effects ◽  
Language Processing ◽  
Clinical Signs ◽  
Clinical Manifestations ◽  
Area Under The Curve ◽  
Signs And Symptoms ◽  
Diagnostic Value ◽  
Clinical Markers ◽  
Reactive Protein ◽  
Increased Risk

Background Clozapine is associated with increased risk of myocarditis. However, many common side-effects of clozapine overlap with the clinical manifestations of myocarditis. As a result, there is uncertainty about which signs, symptoms and investigations are important in distinguishing myocarditis from benign adverse effects of clozapine. Clarity on this issue is important, since missing a diagnosis of myocarditis or discontinuing clozapine unnecessarily may both have devastating consequences. Aims To examine the clinical characteristics of clozapine-induced myocarditis and to identify which signs and symptoms distinguish true myocarditis from other clozapine adverse effects. Method A retrospective analysis of the record database for 247 621 patients was performed. A natural language processing algorithm identified the instances of patients in which myocarditis was suspected. The anonymised case notes for the patients of each suspected instance were then manually examined, and those whose instances were ambiguous were referred for an independent assessment by up to three cardiologists. Patients with suspected instances were classified as having confirmed myocarditis, myocarditis ruled out or undetermined. Results Of 254 instances in 228 patients with suspected myocarditis, 11.4% (n = 29 instances) were confirmed as probable myocarditis. Troponin and C-reactive protein (CRP) had excellent diagnostic value (area under the curve 0.975 and 0.896, respectively), whereas tachycardia was of little diagnostic value. All confirmed instances occurred within 42 days of clozapine initiation. Conclusions Suspicion of myocarditis can lead to unnecessary discontinuation of clozapine. The ‘critical period’ for myocarditis emergence is the first 6 weeks, and clinical signs including tachycardia are of low specificity. Elevated CRP and troponin are the best markers for the need for further evaluation.

scholarly journals General Disturbances and their Correlation to the Eruption of Primary Dentition in Children between 5 and 30 Months Age Group of Belgaum City: An Epidemiological Study

2011 ◽  
Vol 2 (1) ◽  
pp. 39-43
Author(s):  
Shobha Deshpande ◽  
Santosh M Sholapurmath ◽  
Shigli L Anand
Keyword(s):  
Clinical Manifestation ◽  
Clinical Symptoms ◽  
Scientific Information ◽  
Clinical Signs ◽  
Signs And Symptoms ◽  
Chi Square ◽  
Number Of Children ◽  
Group A ◽  
Group B ◽  
Group D

ABSTRACT Background and objective The effect of teething on infants health has been debated for at least 5000 years and traditional beliefs on issue have still not been entirely supplemented by scientific finding. This study has tried to gather scientific information of systemic/clinical signs and symptoms in scientific manner. The objectives of this study were: (1) To describe the most frequent objective clinical manifestation during the eruption of primary teeth, e.g. fever, diarrhea, drooling, fever-drooling, fever-diarrhea, drooling-diarrhea. (2) To assess the correlation between systemic symptoms and eruption of various group of teeth, e.g. incisor, canine, molar. Methods The survey was conducted in 500 children between 5 and 30 months and registered at child development center, KLES's Hospital and Medical Research Center, Nehru Nagar, Belgaum, Karnataka. A specially structured questionnaire was applied with face-to-face interview. Information was relayed in yes or no manner of objective manifestation during eruption of primary incisor, canine and molar which included drooling, diarrhea, fever and combination of these symptoms. Data were analyzed by descriptive statistic and Chi-square analyses. Results The study showed more number of children in group A (less than 12 months) manifested drooling symptoms. As the ages advances with group B (between 12 and 18 months), group C (between 18 and 24 months) and group D (above 24 months), clinical manifestation of saliva found to be reduced. The results of study showed that 87.78%; 57.8%; 57.55%; 25.7%; of children with erupting teeth demonstrated general clinical symptoms like drooling, diarrhea and fever. The presence of fever-diarrhea in this study within group A, group B, group C and group D showed highest number of children by the manifestation than any other codes evaluated in the study. Interpretation and conclusion Present data demonstrate association between fever-diarrhea observed in all group consistently when marked numerically. As the age advances the fever-diarrhea from group C (between 18 and 24 months) and group D (above 24 months) rank second and third. This ranking in group A (less than 12 months) and group B (between 12 and 18 months) at its highest position and attributable to lower immunity of infants. Further, virology study should be conducted on subjects to demonstrate any possible occurrence of systemic disturbances.

CD30+ Lymphoproliferative Disorder/Lymphomatoid Papulosis - A Regression Caused by Mistletoe Therapy.

Blood ◽  
2005 ◽  
Vol 106 (11) ◽  
pp. 4779-4779
Author(s):  
Georg Seifert ◽  
Christoph Tautz ◽  
Karl Seeger ◽  
Guenter Henze ◽  
Alfred Laengler
Keyword(s):  
Clinical Signs ◽  
Immunohistochemical Analysis ◽  
Skin Lesions ◽  
High Risk Group ◽  
The Body ◽  
Topical Steroids ◽  
Malignant Lymphomas ◽  
Lymphomatoid Papulosis ◽  
Systemic Involvement ◽  
Increased Risk

Abstract Lymphomatoid papulosis (LyP) is a CD30+ cutaneous lymphoma according to the WHO classifications and regarded as a condition of uncertain malignant potential. The incidence of LyP in children is relatively low compared to that in adults. It is correlated with malignant lymphomas in 5–20% of adult LyP-patients. In children, an increased risk for the development of a malignant lymphoma is observed. The clinical course is often chronic. Most common treatment for LyP is topical steroids, antibiotics, phototherapy and low-dose methotrexate. Prognosis is excellent with a survival of 100% even for patients with malignant lymphomas. Case-report: An 8-years old boy suffered from reddish nodules (maximum 7 cm in diameter) on his right forearm and his left leg. Immunohistochemical analysis identified a CD30+large-T-cell-type-NHL of the skin. Topic steroids were effective but six months later he showed axillar lymph-node swelling. Immunohistochemically it was classified as anaplastic large cell T-type-lymphoma (ALCL) without signs of systemic involvement. Combination chemotherapy according to the European ALCL-trial (high-risk-group) was given for six months. All nodules (cutaneous and lympoid/axilla) resolved within a few weeks. Two months after cessation of chemotherapy a new skin-nodule on the left forearm appeared. The immunohistochemical diagnosis was now LyP. No specific therapy was given. In the following two months he developed two further solid and painful skin-lesions. In this situation we decided to start a therapeutic approach with subcutaneous mistleote (MT), which was injected close to one of these lesions. The skin-nodules decreased after the first dose and MT injections into all nodules were continued. Within the following two weeks the skin-lesions resolved completely and subcutaneous MT therapy was continued. Two months later, he developed two new nodules responding within a few days to increased dose of MT. While continuation therapy with MT the boy was without clinical signs both of the LvP and ALCL for nearly two years. Subsequently MT therapy was terminated. Three weeks after cessation the cutaneus LyP generally reactivated all over the body with typical nodules (maximum 1 cm in diameter). Subcutaneus MT therapy was restarted and the cutnaneus LyP regressed within 2 weeks completely without additional therapy.

Predicted burden of venous disease

2016 ◽  
Vol 31 (1_suppl) ◽  
pp. 74-79 ◽  
Author(s):  
Sarah Onida ◽  
Alun Huw Davies
Keyword(s):  
Varicose Veins ◽  
Clinical Signs ◽  
Signs And Symptoms ◽  
Chronic Venous Disease ◽  
Venous Disease ◽  
Venous Ulceration ◽  
Increased Risk ◽  
Future Burden ◽  
Clinical Signs And Symptoms

Chronic venous disease is a common condition with clinical signs and symptoms ranging from spider veins, to varicose veins, to active venous ulceration. Both superficial and deep venous dysfunction may be implicated in the development of this disease. Socio-economic factors are shaping our population, with increasing age and body mass index resulting in significant pressure on healthcare systems worldwide. These risk factors also lead to an increased risk of developing superficial and/or deep venous insufficiency, increasing disease prevalence and morbidity. In this chapter, the authors review the current and future burden of chronic venous disease from an epidemiological, quality of life and economic perspective.

Comparison of conventional testing to polymerase chain reaction in detection of Trichomonas vaginalis in indigenous women living in remote areas

2005 ◽  
Vol 16 (12) ◽  
pp. 811-815 ◽  
Author(s):  
K S Smith ◽  
S N Tabrizi ◽  
K A Fethers ◽  
J B Knox ◽  
C Pearce ◽  
...  
Keyword(s):  
Polymerase Chain Reaction ◽  
Trichomonas Vaginalis ◽  
Hiv Transmission ◽  
Clinical Signs ◽  
Signs And Symptoms ◽  
Chain Reaction ◽  
Remote Areas ◽  
Increased Risk ◽  
Polymerase Chain ◽  
Conventional Methods

There are high rates of Trichomonas vaginalis in remote areas of Central Australia. Conventional tests for T. vaginalis have low sensitivity in this setting. Aims of the study were to estimate the prevalence of T. vaginalis, to assess the presence of clinical signs and symptoms, to compare a T. vaginalis polymerase chain reaction (PCR) test with conventional methods of diagnosis, and to compare the PCR from different samples, including self-collected swabs (SCS). Of 205 women recruited, the prevalence of T. vaginalis was 24%. The prevalence of T. vaginalis was higher in women under 25 years (33%), compared with those who were 25–34 years (26%) and those over 35 years (15%, P < 0.05). The sensitivity of T. vaginalis PCR detection from SCS (94%) was not statistically different from a practitioner-collected HVS (96%), but was superior to urine PCR (74%) and conventional methods. After multivariate analysis, those women with high pH were almost three times more likely to be positive for T. vaginalis (odds ratio = 2.71 with 95% confidence interval 1.06–6.93, P = 0.037). Superior assays such as PCR should be a diagnostic option to adequately screen and treat women with T. vaginalis, in order to reduce complications, including the increased risk of HIV transmission.

Self-reported Causes of Weight Gain: Among Prebariatric Surgery Patients

2013 ◽  
Vol 74 (4) ◽  
pp. 189-192 ◽  
Author(s):  
Sarah Ferguson ◽  
Layla Al-Rehany ◽  
Cathy Tang ◽  
Lorraine Gougeon ◽  
Katie Warwick ◽  
...  
Keyword(s):  
Bariatric Surgery ◽  
Weight Gain ◽  
Medical Condition ◽  
Weight Maintenance ◽  
Retrospective Chart Review ◽  
Health Condition ◽  
Living Environment ◽  
Medical Community ◽  
Environment Change ◽  
Chi Square

Purpose: Bariatric surgery is accepted by the medical community as the most effective treatment for obesity; however, weight regain after surgery remains common. Long-term weight loss and weight maintenance may be aided when dietitians who provide perioperative care understand the causes of weight gain leading to bariatric surgery. In this study, the most common causes for weight gain were examined among prebariatric surgery patients. Methods: A retrospective chart review was conducted for 160 patients enrolled in a bariatric surgery program. Data were collected for 20 variables : puberty, pregnancy, menopause, change in living environment, change in job/career, financial problems, quitting smoking, drug or alcohol use, medical condition, surgery, injury affecting mobility, chronic pain, dieting, others’ influence over diet, abuse, mental health condition, stress, death of a loved one, divorce/end of a relationship, and other causes. Frequency distribution and chi-square tests were performed using SPSS. Results: Sixty-three percent of participants selected stress as a cause of weight gain, while 56% selected dieting. Significant differences existed between women and men in the selection of dieting and change in living environment. Conclusions: This information may allow dietitians to better identify causes for weight gain leading to bariatric surgery, and to address these causes appropriately before and after surgery.

First-use Reactions: A Potential Hazard for Referral Centers

1989 ◽  
Vol 12 (11) ◽  
pp. 688-691 ◽  
Author(s):  
R.J. Caruana
Keyword(s):  
Renal Failure ◽  
Tertiary Care ◽  
Clinical Signs ◽  
Signs And Symptoms ◽  
Potential Hazard ◽  
End Stage Renal Failure ◽  
Increased Risk ◽  
Dialysis Facility ◽  
Clinical Signs And Symptoms ◽  
End Stage

First-use reactions comprise a spectrum of adverse clinical signs and symptoms occurring in end-stage renal failure patients during hemodialysis treatments. This report describes four patients experiencing first-use reactions in the context of being referred to or from a tertiary care inpatient dialysis facility. Theories on the pathogenesis of first-use reactions are reviewed and recommendations for identifying patients at increased risk for this problem are proposed.

scholarly journals Venous Thromboembolism Prophylaxis and Treatment in Patients With Cancer: ASCO Clinical Practice Guideline Update

2020 ◽  
Vol 38 (5) ◽  
pp. 496-520 ◽  
Author(s):  
Nigel S. Key ◽  
Alok A. Khorana ◽  
Nicole M. Kuderer ◽  
Kari Bohlke ◽  
Agnes Y.Y. Lee ◽  
...  
Keyword(s):  
Venous Thromboembolism ◽  
Medical Condition ◽  
Oral Anticoagulants ◽  
Direct Oral Anticoagulants ◽  
Signs And Symptoms ◽  
Cochrane Library ◽  
Thromboembolism Prophylaxis ◽  
Vte Prophylaxis ◽  
Patients With Cancer ◽  
Increased Risk

PURPOSE To provide updated recommendations about prophylaxis and treatment of venous thromboembolism (VTE) in patients with cancer. METHODS PubMed and the Cochrane Library were searched for randomized controlled trials (RCTs) and meta-analyses of RCTs published from August 1, 2014, through December 4, 2018. ASCO convened an Expert Panel to review the evidence and revise previous recommendations as needed. RESULTS The systematic review included 35 publications on VTE prophylaxis and treatment and 18 publications on VTE risk assessment. Two RCTs of direct oral anticoagulants (DOACs) for the treatment of VTE in patients with cancer reported that edoxaban and rivaroxaban are effective but are linked with a higher risk of bleeding compared with low-molecular-weight heparin (LMWH) in patients with GI and potentially genitourinary cancers. Two additional RCTs reported on DOACs for thromboprophylaxis in ambulatory patients with cancer at increased risk of VTE. RECOMMENDATIONS Changes to previous recommendations: Clinicians may offer thromboprophylaxis with apixaban, rivaroxaban, or LMWH to selected high-risk outpatients with cancer; rivaroxaban and edoxaban have been added as options for VTE treatment; patients with brain metastases are now addressed in the VTE treatment section; and the recommendation regarding long-term postoperative LMWH has been expanded. Re-affirmed recommendations: Most hospitalized patients with cancer and an acute medical condition require thromboprophylaxis throughout hospitalization. Thromboprophylaxis is not routinely recommended for all outpatients with cancer. Patients undergoing major cancer surgery should receive prophylaxis starting before surgery and continuing for at least 7 to 10 days. Patients with cancer should be periodically assessed for VTE risk, and oncology professionals should provide patient education about the signs and symptoms of VTE. Additional information is available at www.asco.org/supportive-care-guidelines .

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