Management of Medically Compromised Prosthodontic Patients

The medical evaluation of patients considering prosthodontic treatment is a vital step in the treatment planning. The prosthodontist should be able to assess the inherent risks associated with the treatment of patients with systemic conditions. Many factors are associated with evaluating the patient’s health status and risk including the patient’s current and past medical and dental history, current and past use of medications, type of treatment, length of treatment, invasiveness of treatment, and degree of urgency of treatment. In this article, some of the systemic diseases like arthritis, cardiovascular diseases, endocrine disorders, hematologic and oncologic disease, neurologic disorders, bone disorders, pulmonary diseases, liver diseases, and chronic kidney disease that commonly affect aged individuals are reviewed. The prosthodontic considerations that should be taken care of while managing patients with these systemic conditions will also be discussed.

Impact of Injection Protocol Selection by Retina Specialists on Clinical Outcomes in Patients with Diabetic Macular Edema

Intravitreal anti-VEGF injections are the current gold standard for treating diabetic macular edema (DME). However, injection practice patterns of retina specialists have varied markedly based on physician discretion. This retrospective study analyzes the impact of injection protocol selection on change in best-corrected visual acuity (BCVA) and central macular thickness (CMT) in 170 eyes treated by 4 retina specialists practicing a pro re nata (PRN) strategy between 2010 and 2020. DME patients received an average of 7.25 injections every 6.24 weeks over 56.6 weeks. There were significant differences between retina specialists in mean number of injections (p = 0.0001) and mean length of treatment (p = 0.0007) but not in mean interval between injections. Over the treatment period, average change in BCVA was −0.053 logMAR, and average change in CMT was −51.1 µm, neither of which had significant differences between retina specialists. BCVA and CMT at initial visit were found to be significantly associated with improved BCVA and CMT over the treatment period (p < 0.001). Number of injections administered and interval between injections were not found to be significant factors affecting change in BCVA or CMT. Despite significant differences in injection dosing regimen, retina specialists achieved similar outcomes in change in BCVA and CMT over the treatment period.

Analisis Survival dengan Menggunakan Metode Kaplan Meier pada Penderita Penyakit Demam Berdarah Dengue (DBD)

The Kaplan Meier method is one of the methods in survival analysis that is used to find out how big the chances of survival of a person suffering from a certain disease. The Kaplan Meier method calculates the patient's life by providing a definite survival proportion. The purpose of this study was to determine the relationship between age and length of treatment and patient status. The life chances of DHF patients using the Kaplan Meier method at the Lasinrang District Hospital. Pinrang. The results showed that there was no relationship between age and length of treatment as well as the status of DHF patients in Lasinrang Hospital Kab. Pinrang. The conclusion of this study is that the chance of survival of DHF patients before a patient dies is 100%. However, the chance of patient survival after 1 patient died during the observation was 99.1%. It is recommended that clinical monitoring should always be carried out, to predict the correct diagnosis of Dengue Virus Infection. And sero-epidemiological studies should continue to be carried out in many island capitals in Indonesia.

Analisis Korelasi Faktor Resiko Kematian Di Ruang Isolasi Covid-19

Health workers and various other sectors are currently busy with handling world health cases of the Sars Cov-2 virus pandemic. The transmission of COVID-19 is very easy and dangerous, which is the cause of the increasing number of deaths. The large percentage of mortality rates for COVID-19 sufferers can be caused by internal factors and external factors. The purpose of this study was to analyze various factors that caused the death of COVID-19 sufferers. This scientific report uses observational analytics with a retrospective study design. The research target of Covid-19 patients in the isolation room of the Graha Medika hospital in August - December 2020 was 437 respondents. The research sample amounted to 305 respondents who were selected with simple random sampling technique. The instruments that the researchers used in data collection were writing instruments and medical records of patients in the COVID-19 isolation room. Most of the respondents were female, namely 161 respondents (52.8%), Almost half of the respondents aged >60 years, namely 119 respondents (39%), Almost all respondents underwent treatment for 1-5 days, namely 251 respondents (82.3% ), and most of the respondents had comorbidities, namely 228 respondents (74.8%). Factors of age, sex, comorbidities, had a statistical value (p<0.05) while the length of treatment was not related to the value (p>0.05). The most comorbid disease experienced by respondents was diabetes mellitus, and contributed to the death rate of 72 respondents (23.6%). Immediate handling and appropriate intervention for elderly COVID-19 sufferers of various genders and especially those with comorbidities to minimize the mortality rate of COVID-19 sufferers.

Eigenvector centrality defines hierarchy and predicts graduation in therapeutic community units

Introduction Therapeutic communities (TCs) are mutual aid based residential programs for the treatment of substance abuse and criminal behavior. While it is expected that residents will provide feedback to peers, there has been no social network study of the hierarchy through which feedback flows. Methods Data for this study was drawn from clinical records of peer corrections exchanged between TC residents in six units kept over periods of less than two to over eight years. Four of the units served men while two served women. Hierarchy position was measured using eigenvector centrality, on the assumption that residents who were more central in the network of corrections were lower in the hierarchy. It was hypothesized that residents would rise in the hierarchy over time. This was tested using Wilcoxon paired samples tests comparing the mean and maximum eigenvector centrality for time in treatment with those in the last month of treatment. It was also hypothesized that residents who rose higher in the hierarchy were more likely to graduate, the outcome of primary interest. Logistic regression was used to test hierarchy position as a predictor of graduation, controlling for age, race, risk of recidivism as measured by the Level of Services Inventory-Revised (LSI-R) and days spent in the program. Results Residents averaged a statistically significantly lower eigenvector centrality in the last month in all units, indicating a rise in the hierarchy over time. Residents with lower maximum and average eigenvector centrality both over the length of treatment and in the last month of treatment were more likely to graduate in four of the six units, those with lower maximum and average eigenvector centrality in the last month but not over the length of treatment were more likely to graduate in one of the six units, while eigenvector centrality did not predict graduation in one unit. However, this last unit was much smaller than the others, which may have influenced the results. Conclusion These results suggest that TC residents move through a social network hierarchy and that movement through the hierarchy predicts successful graduation.

May Mutation of SNP rs1800947 Affects Length of Stay Outcome of COVID-19 suspects?

Coronavirus disease 2019 (COVID-19) is a new type of respiratory infection that first emerged in December 2019 in Wuhan, Hubei, China. COVID-19 is caused by a new type of virus called severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). This study aims to determine the association of SNP CRP rs1800947 gene in suspected COVID-19 patients to length of stay at Al Ihsan Hospital, and Banten Hospital in June-November 2020. This study used data from 60 patients, all patients were suspect COVID-19. The subject was 29 COVID-19 people were confirmed, whereas 31 people were not. A statistics analysis due to pearson correlation and linear multi regretion. This study found a significant assosiation between the subject. The results of this study were the relationship between SNP rs1800947 and outcome, a fairly strong association level relationship was found in the SNP rs1800947 (p-value= 0.045, association= 0.537). The association between length of stay and CRP levels has a low level of association (p-value=0.015, association=0.378). The SNP genotype rs1800947 G had a longer treatment duration of 0.14778 days compared to the SNPrs1800947 C genotype. CRP levels showed that higher CRP levels increased the length of treatment compared to normal CRP levels. Where high CRP levels are at risk of 0.6330 days longer than normal CRP while very high CRP is at risk of 2.9561 days longer than Normal CRP levels. In general, the gene SNP rs1800947 and CRP levels, together affect the outcome of patients with suspected COVID-19.

Suitability of CPOT and BPS to Assess Pain Response in Intubated Mohammad Hoesin Hospital Intensive Care Patients

Background. Assessing pain in mechanically ventilated patients is an important thing for leads to improved outcome and better quality life of patients in the ICU. CPOT and BPS has been developed for measuring nonverbal patients. Aims. To validate suitability the use of CPOT and BPS in ICU RSMH. Methods. Observational analytic with cross sectional design was chosen for 50 samples conducted on July 2020 in ICU RSMH. Data was collected before and after pain procedure. Result. From 50 patients mostly 27(54%) male with age majority > 30 years old 39 (78%). The lowest GCS 2 and the highest 10. Length of treatment in ICU was 1 – 20 days. Bleeding variations was 0 - 1200 cc. BPS average before painful procedure was 2 – 5 and after panful procedure was 5 – 7. CPOT average before painful procedure was 1 – 6 and after painful procedure was 3 - 8. Kappa before painful procedure are moderate (kappa=0,435) and after painful procedure are fair (kappa=0,248) with strongly correlated in Pearson correlation (r = 0,644, r = 0,610) (p < 0,05). Conclusion. This study demonstrated that CPOT more detail than BPS for measuring pain in intubated patients.

A Review of Risk Factors and Predictors for Hemorrhagic Transformation in Patients with Acute Ischemic Stroke

Acute ischemic strokes (AIS) and hemorrhagic strokes lead to disabling neuropsychiatric and cognitive deficits. A serious and fatal complication of AIS is the occurrence of hemorrhagic transformation (HT). HT is cerebral bleeding that occurs after an ischemic event in the infarcted areas. This review summarises how specific risk factors such as demographic factors like age, gender, and race/ethnicity, comorbidities including essential hypertension, atrial fibrillation, diabetes mellitus, congestive heart failure, and ischemic heart disease along with predictors like higher NIHSS score, larger infarction size, cardioembolic strokes, systolic blood pressure/pulse pressure variability, higher plasma glucose levels, and higher body temperature during ischemic event, lower low-density lipoprotein and total cholesterol, early ischemic changes on imaging modalities, and some rare causes make an individual more susceptible to developing HT. We also discuss few other risk factors such as the role of blood-brain barrier, increased arterial stiffness, and globulin levels in patients postreperfusion using thrombolysis and mechanical thrombectomy. In addition, we discuss the implications of dual antiplatelet therapy and the length of treatment in reference to the incidence of developing HT. Current research into inflammatory mediators and biomarkers such as Cyclooxygenase-2, matrix metalloproteinases, and soluble ST2 and their potential role as treatment options for HT is also briefly discussed. Finally, this review calls for more research into use of dual antiplatelet and the timing of antiplatelet and anticoagulant use in reference to hemorrhagic transformation.

Use of antidepressants in the clinical nursing team: a prospective transversal observational study

Currently, with the perspective of becoming the second leading cause of disease in the world, depression is seen as a disease of modern society, affecting even health professionals such as nurses, nursing technicians, and nursing assistants. Based on this, this work aims to survey data on the use of antidepressants in the clinical nursing staff – nurses, technicians, and assistants who work at night at the ABHU. A questionnaire was designed to understand the reason for using antidepressants in the clinical nursing staff – nurses, technicians, and assistants. In addition, the questionnaire also aims to confirm hypotheses such as, whether the use of antidepressants by health professionals is related to the length of experience in the area, the use of antidepressants is related to stress, physical and emotional exhaustion, the length of treatment with antidepressants with a perception of improvement, it is related to the time of use, whether there is a relationship between the use of antidepressants and gender and whether the treatment with antidepressants is carried out with monitoring of professionals.

Gambaran Tingkat Kecemasan Keluarga Dengan Pasien Stroke : Literature Review

Families of stroke patients, who care for patients, will experience negative impacts, such as emotional stress, decreased health, and financial burden. It can be worsened by the severity of the stroke, the length of treatment, and the uncertain situations. This causes psychological problems in the patient's family, such as anxiety.To describe the level of anxiety of families with stroke patients.This research was descriptive. The method used in this study was a literature review from PubMed sources and the Garuda portal. There were articles/journals that matched the research inclusion criteria and could be analyzed further. Those articles were published in 2015-2020.The results showed that the anxiety levels in families of stroke patients were described as followed: No Anxiety (5.38% or 7 respondents), mild anxiety (31.54% or 41 respondents), moderate anxiety (40.77% or 53 respondents), severe anxiety (19.23% or 25 respondents) and panicked level (3.08% or 4 respondents).It can be concluded that most respondents feel moderate anxiety. Therefore, the nurses are expected to be able to help reduce anxiety and provide comfort for the patient's family.Keywords: family, stroke patient, anxiety level. AbstrakKeluarga pasien stroke yang merawat pasien akan mengalami dampak negative, seperti tekanan emosional, penurunan kesehatan dan beban keuangan. Hal tersebut diperparah oleh keparahan stroke, lama perawatan dan situai yang tidak menentu. Hal tersebut menyebabkan masalah psikologis pada keluarga pasien, salah satunya keluarga akan mengalami kecemasan. Untuk mendeskripsikan tingkat kecemasan keluarga dengan pasien stroke. Penelitian ini merupakan penelitian Deskriptif. Metode yang digunakan dalam penelitian ini literature review dari sumber pubmeddan portal garuda. Hasil penelusuran didapatkan 5 artikel/ jurnal yang sesuai dengan criteria inklusi penelitian dan dapat dianalisis lebih jauh, hasil penelitian 2015-2020. Hasil data tingkat kecemasan pada keluarga pasien stroke yaitu :Tidak Cemas 7 responden (5,38%), kecemasan ringan 41 responden (31,54%), kecemasan sedang 53 responden (40,77%), kecemasan berat 25 responden (19,23%) dan panik 4 responden (3,08%). Hasil literatur review menunjukkan bahwa mayoritas responden merasakan kecemasan sedang. Perawat berusaha membantu mengurangi kecemasan dan dapat memberikan kenyamanan bagi keluar gapasien.Kata Kunci : Keluarga; Paienstroke;Tingkat kecemasan.