Systemic Diseases
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2021 ◽  
Vol 28 ◽  
Christian Zanza ◽  
Tatsiana Romenskaya ◽  
Duraiyah Thangathurai ◽  
Veronica Ojetti ◽  
Angela Saviano ◽  

Background: The digestive tract represents an interface between the external environment and the body where the interaction of a complex polymicrobial ecology has an important influence on health and disease. The physiological mechanisms that are altered during the hospitalization and in the intensive care unit (ICU) contribute to the pathobiota’s growth. Intestinal dysbiosis occurs within hours of being admitted to ICU. This may be due to different factors, such as alterations of normal intestinal transit, administration of variuos medications or alterations in the intestinal wall which causes a cascade of events that will lead to the increase of nitrates and decrease of oxygen concentration, liberation of free radicals. Objective: This work aims to report the latest updates on the microbiota’s contribution to developing sepsis in patients in the ICU department. In this short review were reviewed the latest scientific findings on the mechanisms of intestinal immune defenses performed both locally and systemically. In addition, we considered it necessary to review the literature to report the current best treatment strategies to prevent the infection spread which can bring systemic infections in patients admitted to ICU. Material and Methods: This review has been written to answer at three main questions: what are the main intestinal flora’s defense mechanisms that help us to prevent the risk of developing systemic diseases on a day-to-day basis? What are the main dysbiosis’ systemic abnormalities? What are the modern strategies that are used in the ICU patients to prevent the infection spread? Using the combination of following keywords: microbiota and ICU, ICU and gut, microbiota and critical illness, microbiota and critical care, microbiota and sepsis, microbiota and infection, gastrointestinal immunity,in the Cochrane Controlled Trials Register, the Cochrane Library, medline and pubmed, google scholar, ovid/wiley. Finally, we reviewed and selected 72 articles. We also consulted the site to find out studies that are recently conducted or ongoing. Results: The critical illness can alter intestinal bacterial flora leading to homeostasis disequilibrium. Despite numerous mechanisms, such as epithelial cells with calciform cells that together build a mechanical barrier for pathogenic bacteria, the presence of mucous associated lymphoid tissue (MALT) which stimulates an immune response through the production of interferon-gamma (IFN-y) and THN-a or by stimulating lymphocytes T helper-2 produces anti-inflammatory cytokines. But these defenses can be altered following a hospitalization in ICU and lead to serious complications such as acute respiratory distress syndrome (ARDS), health care associated pneumonia (HAP) and ventilator associated pneumonia (VAP), Systemic infection and multiple organ failure (MOF), but also in the development of coronary artery disease (CAD). In addition, the microbiota has a significant impact on the development of intestinal complications and the severity of the SARS-COVID-19 patients. Conclusion: The microbiota is recognized as one of the important factors that can worsen the clinical conditions of patients who are already very frailty in intensive care unit. At the same time, the microbiota also plays a crucial role in the prevention of ICU associated complications. By using the resources, we have available, such as probiotics, symbiotics or fecal microbiota transplantation (FMT), we can preserve the integrity of the microbiota and the GUT, which will later help maintain homeostasis in ICU patients.

Medine Gündogan ◽  
Soner Kiliç ◽  
Sertan Göktas ◽  
Esra Vural ◽  
Muhammed Rasit Sirem ◽  

Abstract Purpose To investigate whether there are retinal lesions associated with severe COVID-19. Methods We studied 232 symptomatic subjects aged 18 – 65 years who had severe COVID-19 and had received treatment. The evaluations included ophthalmological examinations, optical coherence tomography (OCT), imaging modalities with near infrared reflectance (NIR), fundus autofluorescence (FAF), and fundus photography (FP). Results The mean age of the patients was 49 years, and 67.6% of them were men. There were no findings of microhemorrhage, cotton wool spots (CWS), vitritis, or retinitis in the examination and imaging. Conclusions This study indicates that retinal involvement as a complication associated with COVID-19 is questionable, although some reports have demonstrated a relationship that may occur secondary to existing systemic diseases.

2021 ◽  
Vol 21 (1) ◽  
Sanam Faheem ◽  
Shahida Maqsood ◽  
Arshad Hasan ◽  
Fouzia Imtiaz ◽  
Faheem Shaikh ◽  

Abstract Background Human beta defensin-3 (HβD-3) is an antimicrobial peptide present in saliva that protects tooth surfaces from microbial attack. These peptides are part of innate immunity so levels may be affected by different systemic diseases like anemia. Therefore, anemia may predispose an affected child to an increased risk of dental caries. The objectives of this study were to determine the association of early childhood caries (ECC) with HβD-3 levels and observe the association of HβD-3 levels with childhood anemia. Methods A total of 80 children admitted in a pediatric medical ward, age 48–71 months, of either sex were included in the study. The included children were categorized as cases (children with ECC n = 40) and controls (children without ECC n = 40). Children were further segregated into the anemic and non-anemic sub-groups based on the hospital record of hemoglobin level. The salivary concentration of HβD-3 was measured by Enzyme-Linked Immuno-sorbent assay (ELISA). IBM SPSS version 20 software was used for statistical analysis. Two sample t-test and one-way ANOVA were used to compare mean values while spearman was used for correlations at p < 0.05. Results The mean Salivary HβD-3 level in cases (8.87 ± 4.30) was significantly higher (p = 0.042) as compared to controls (7.23 ± 2.57). Salivary HβD-3 level in patients with caries and without anemia was highest (10.80 ± 4.50) whereas salivary HβD-3 level in the presence of caries and anemia was lowest (6.94 ± 3.13) amongst all groups. This difference was statistically significant (p = 0.001). Salivary HβD-3 level was found to be moderately correlated with cases (p = 0.002). An inverse correlation was found between salivary HβD-3 level and anemia (r = -0.479, p = 0.002). Conclusion Anemia may affect the innate immunity of children, and may result in a decreased level of salivary HβD3, thus increasing vulnerability to decay.

2021 ◽  
Vol 12 ◽  
Mi Yang ◽  
Qiwen Li ◽  
Chijun Deng ◽  
Gang Yao ◽  
Xue Bai ◽  

Introduction: Schizophrenia is a mental disease with a profound impact on human health. Patients with schizophrenia have poor oral hygiene, increasing their risk of systemic diseases, such as respiratory infections, and declining their quality of life. Therefore, this study aims to assess the oral health status of inpatients with schizophrenia, analyze its related factors, and thus provide scientific evidence for further exploration of corresponding control strategies.Methods: A total of 425 inpatients older than 50 years with a diagnosis of schizophrenia from two psychiatric hospitals (mean age 58.49 ± 5.72 years) were enrolled. The demographic data of the patients were checked on admission. Two independent dentists examined caries, missing teeth, and fillings. Mini-Mental State Examination (MMSE) and Global Deterioration Scale were performed as cognitive tests. Positive and Negative Syndrome Scale and Repeatable Battery for the Assessment of Neuropsychological Status rating scale were used to determine their mental status.Results: The average decayed, missing, and filled teeth index was 12.99 ± 8.86. Linear regression analysis showed that the decayed, missing, and filled teeth index had a significantly positive relationship with age (p &lt; 0.001) and smoking (p &lt; 0.001) and a negative relationship with MMSE (p = 0.029). The missing teeth index had a positive relationship with age (p &lt; 0.001), smoking (p &lt; 0.001), and Global Deterioration Scale (p = 0.014) and a negative relationship with MMSE (p = 0.004).Conclusion: The oral health of elderly patients with schizophrenia is poor, which may be related to the cognitive level of patients and affect their quality of life. The focus should be provided to the oral care of patients with schizophrenia, and investment in their specialized oral treatment should be increased.

Abdullah F. Al-Hussain ◽  
Yahya S. Aljabri ◽  
Khalid A. Sindi ◽  
Abdulaziz Y. Thobab ◽  
Abdullah A. Khormi ◽  

Increasing awareness about providing the necessary care of oral health is essential for patients with a removable prosthesis. The awareness is less interested in dental disorders, being busier with the systemic ones. Planning prosthetic management should only be done after a thorough evaluation of the underlying systemic conditions because the treatment plan might vary accordingly. Previous studies have demonstrated that many systemic diseases are associated with removable prosthesis (RP) procedures. We aim to discuss the feasibility and outcomes of the removable prosthesis for medically compromised patients, including many conditions as diabetes mellitus, cardiovascular, renal, hematological, pulmonary, gastrointestinal disorders and immunocompromised patients. Taking adequate care of oral hygiene practices is recommended for these patients. In addition, it is necessary to have frequent care, but short follow-up visits to make sure that the modalities are still valid for additional use, and to investigate for potential complications and adverse events. Adequate prophylaxis against some diseases might also be the only convenient solution. Therefore, proper management of the medical condition might be associated with the enhanced success of the modality with favorable outcomes and better quality of life. Making unified protocols to deal with these patients is also suggested to enhance the practice among the different clinical settings.

2021 ◽  
Vol 9 (9) ◽  
pp. 1925
Erica M. Lopes ◽  
Maicon R. Z. Passini ◽  
Luciano T. Kishi ◽  
Tsute Chen ◽  
Bruce J. Paster ◽  

Periodontal and Endodontic diseases are biofilm-related diseases. The presence of microorganisms in root canals (RCs) and the complex microbiota of periodontal pockets (PPs) contribute to the development of endodontic-periodontal diseases. This study performed a systemic analysis using state-of-the-art sequence data to assess the microbial composition of infected RCs and PPs to further assess the microbiota and verify the possibility of cross-infection between these sites. The microbiomes of these combined diseases were examined with a focus on the V3-V4 hypervariable region of the 16S rRNA gene. The number of species in PP was higher than in RC, and there was a predominance of obligate anaerobes and gram-negative bacteria. In the RCs, the genera Enterococcus, Parvimonas, Stomatobaculum predominated, in contrast, the PPs revealed a predominance of Enterococcus, Parvimonas, Stomatobaculum, Peptostreptococcus and Mogibacterium. The RC and PP microbiome was not similar with regards to the sharing of OTUs for phyla and genera (8 and 67, respectively). The evaluation of molecular markers revealed a large number of markers for resistance to antibiotics of the carbapenem and beta-lactam type (broad spectrum). Another relevant finding of this study was the markers related to systemic diseases related to cardiac muscle and rheumatology, among others. In conclusion, the RC microbiota was less complex and diverse than PP. Interactions between microbial communities were present. The shared genus can signal communication between the endodontic and periodontal microbiomes.

2021 ◽  
Vol 27 ◽  
Clodoveo Ferri ◽  
Dilia Giuggioli ◽  
Vincenzo Raimondo ◽  
Massimo L’Andolina ◽  
Lorenzo Dagna ◽  

Background: The Covid-19 pandemic may have a deleterious impact on patients with autoimmune systemic diseases (ASD) due to their deep immune-system alterations. Objective: To investigate the prevalence of symptomatic Covid-19 and its correlations with both organ involvement and ongoing treatments in a large series of Italian ASD patients during the first wave of pandemic. Method: Our multicenter telephone 6-week survey included 3,029 unselected ASD patients enrolled at 36 tertiary referral centers of northern, central, and southern Italian macro-areas with different diffusion of pandemic. Symptomatic SARS-CoV-2 infection was classified as definite Covid-19 (presence of symptoms plus positive oral/nasopharyngeal swabs) or highly suspected Covid-19 (highly suggestive symptoms, in absence of a swab testing). Results: A significantly higher prevalence of definite plus highly suspected Covid-19 compared to Italian general population was detected in the whole ASD series (p=.000), as well as in patients from the three macro-areas (p=.000 in all). Statistically higher prevalence of Covid-19 was also found in connective tissue diseases compared to chronic arthritis subgroup (p=.000) and in ASD patients with pre-existing interstitial lung involvement (p=.000). Patients treated with either conventional disease modifying anti-rheumatic drugs (DMARDs) and/or biological DMARDs showed a significantly lower prevalence of Covid-19 (p=.000 in both). Finally, scleroderma patients undergoing low-dose aspirin showed significantly lower rate of Covid-19 compared to those without (p=0.003). Conclusion: The higher prevalence of Covid-19 in ASD patients along with the significant correlations with important clinical features and therapeutic regimens suggests the need to develop targeted prevention/management strategies during the current pandemic wave.

Metabolites ◽  
2021 ◽  
Vol 11 (9) ◽  
pp. 587
Eelis Hyvärinen ◽  
Minttu Savolainen ◽  
Jopi J. W. Mikkonen ◽  
Arja M. Kullaa

Saliva is a useful biological fluid and a valuable source of biological information. Saliva contains many of the same components that can be found in blood or serum, but the components of interest tend to be at a lower concentration in saliva, and their analysis demands more sensitive techniques. Metabolomics is starting to emerge as a viable method for assessing the salivary metabolites which are generated by the biochemical processes in elucidating the pathways underlying different oral and systemic diseases. In oral diseases, salivary metabolomics has concentrated on periodontitis and oral cancer. Salivary metabolites of systemic diseases have been investigated mostly in the early diagnosis of different cancer, but also neurodegenerative diseases. This mini-review article aims to highlight the challenges and possibilities of salivary metabolomics from a clinical viewpoint. Furthermore, applications of the salivary metabolic profile in diagnosis and prognosis, monitoring the treatment success, and planning of personalized treatment of oral and systemic diseases are discussed.

2021 ◽  
Vol 23 (3) ◽  
pp. 291-300
Álvaro Franco-Giraldo

Introducción: A pesar de la implementación de diversas estrategias para atender la problemática en salud bucal, aun esta adolece de una visión de integralidad del ser humano y la práctica sanitaria. Objetivo: Analizar desde una perspectiva interpretativa y crítica la salud bucal, con énfasis en el caso colombiano, como práctica sanitaria y profesional, siguiendo la lógica de su relación con la salud sistémica y la salud pública. Materiales y métodos: Se realizó una revisión narrativa de tipo documental, mediante la búsqueda en las bases de datos Pubmed y Google escolarship (GS) en los últimos 5 años con los términos booleanos (periodontitis or oral pahology) and (systemic diseases), para la pregunta guía: ¿Cómo la patología bucal influye en las enfermedades crónicas no transmisibles? Resultados: Se identificaron asociaciones de la patología bucal con la salud sistémica, con las ECNT (diabetes, enfermedades cardiovasculares, embarazo y eclampsia, enfermedad perinatal, alzheimer), entre otras. Conclusiones: Es consistente en la literatura la relación biunívoca de la enfermedad periodontal con las enfermedades crónicas no transmisibles, aunque no se concluye sobre relaciones de causalidad. Se proponen algunas estrategias de salud pública y articulación de la práctica sanitaria interprofesional.

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