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Pediatric Annals Sep 2015The International Federation of Gynecology and Obstetrics and the American Congress of Obstetricians and Gynecologists support the use of new terminology for abnormal... (Review)
Review
The International Federation of Gynecology and Obstetrics and the American Congress of Obstetricians and Gynecologists support the use of new terminology for abnormal uterine bleeding (AUB) to consistently categorize AUB by etiology. The term AUB can be further classified as AUB/heavy menstrual bleeding (HMB) (replacing the term "menorrhagia") or AUB/intermenstrual bleeding (replacing the term "metrorrhagia"). Although many cases of AUB in adolescent women are attributable to immaturity of the hypothalamic-pituitary-ovarian axis, underlying bleeding disorders should be considered in women with AUB/HMB. This article reviews the new terminology for AUB, discusses important relevant features of history and examination, presents the laboratory evaluation of HMB, and describes hormonal (oral contraceptive pills, progestin-only methods, long-acting reversible contraceptives including intrauterine systems), hematologic (tranexamic acid and desmopressin), and surgical management options for AUB/HMB.
Topics: Adolescent; Antifibrinolytic Agents; Contraceptives, Oral, Hormonal; Disease Management; Female; Humans; Uterine Hemorrhage
PubMed: 26431240
DOI: 10.3928/00904481-20150910-09 -
The Chinese Journal of Dental Research 2018To evaluate the use of oral health services, the economic burden of oral diseases and related influential factors in China.
OBJECTIVE
To evaluate the use of oral health services, the economic burden of oral diseases and related influential factors in China.
METHOD
Using the multistage, stratified, equal proportion, random sampling method in the 4th National Oral Health Survey of China conducted in 2015 to 2016, residents aged 3 to 5 years, 12 to 15 years, 35 to 44 years, 55 to 64 years, and 65 to 74 years respectively were recruited, clinically examined and answered a questionnaire. Utilisation of oral health services were assessed in all the age groups and the economic burden of oral diseases in the past 12 months were assessed in the 3 to 5 years and 35 to 74 year-old groups. Chi-squared tests, t tests, correlation analysis and a one-way ANOVA were used to determine the relationships of different factors with utilisation of oral health services and the economic burden of oral diseases.
RESULTS
In the subject groups - 3 to 5 years, 12 to 15 years and 35 to 74 years - the prevalence of the utilisation of oral health services in the past 12 months was 14.6% (5,876/40,353), 23.6% (27,936/118,592), and 20.1% (2,708/13,461), respectively. In all three groups, receiving dental treatment was the most common reason for subjects' recent dental visit. The average dental cost in the past 12 months was 403.43 CNY (median = 100) for 3 to 5-year-old children and 850.83 CNY (median = 300) for adults aged 35 to 74 years old. Area, education and annual household income per person were the socio-economic influential factors. Oral health status, oral hygiene and attitudes to and knowledge of oral health affected the utilisation of oral health services and the economic burden of oral diseases.
CONCLUSION
The percentage of dental service utilisation was relatively low, and the economic burden was high. The related factors for both utilisation of oral health services and the economic burden of oral diseases included living in area, educational attainment, household income, perceived oral health status, and oral hygiene.
Topics: Adolescent; Adult; Aged; Child; Child, Preschool; China; DMF Index; Dental Devices, Home Care; Dental Health Services; Educational Status; Female; Gingival Hemorrhage; Health Care Costs; Health Knowledge, Attitudes, Practice; Health Status; Humans; Male; Middle Aged; Oral Health; Oral Hygiene; Rural Population; Toothbrushing; Urban Population
PubMed: 30264044
DOI: 10.3290/j.cjdr.a41086 -
Hematology/oncology Clinics of North... Oct 2016The vitamin K antagonists (VKAs) are associated with a significant rate of major and fatal bleeding complications. The new direct oral anticoagulants (DOACs), even... (Review)
Review
The vitamin K antagonists (VKAs) are associated with a significant rate of major and fatal bleeding complications. The new direct oral anticoagulants (DOACs), even though having a better bleeding profile than the VKAs, are still associated with serious bleeding. The anticoagulation induced by the VKAs can be reversed with both vitamin K and prothrombin complex concentrates, whereas the DOACs were developed without specific reversal agents. Although there is controversy around the necessity of a reversal agent, most clinicians agree that having a reversal agent for the DOACs would be beneficial. Three reversal agents are currently in development.
Topics: Administration, Oral; Anticoagulants; Blood Coagulation Factors; Hemorrhage; Humans; Vitamin K
PubMed: 27637309
DOI: 10.1016/j.hoc.2016.05.006 -
Pediatric Dentistry Jan 2018The purpose of this systematic review was to verify whether child and adolescent oral health affected academic performance.
PURPOSE
The purpose of this systematic review was to verify whether child and adolescent oral health affected academic performance.
METHODS
A literature search conducted in March 2017 on PubMed, Lilacs, Web of Science, and Scopus databases identified 2,009 papers, six of which were included in the final review. Quality appraisal and risk of bias were evaluated using the quality assessment tool for observational cohort and cross-sectional studies.
RESULTS
Two papers were classified as being of good quality, one as fair, and three as poor. In four publications, oral health conditions were measured by taking only dental caries into account, while in two others treatment needs and dental trauma were also considered. Although four papers concluded that children's academic performance and poor oral health were associated, the results were not considered reliable because of the high risk of bias. The two papers classified as being of good quality did not show an association between oral health and academic performance, unless mediated by socioeconomic factors.
CONCLUSION
Further well-designed studies are required to demonstrate whether children's oral health can have a negative influence on their academic performance.
Topics: Academic Performance; Adolescent; Child; Dental Caries; Gingival Hemorrhage; Humans; Malocclusion; Oral Health; Socioeconomic Factors; Tooth Diseases; Tooth Injuries
PubMed: 29482676
DOI: No ID Found -
American Journal of Otolaryngology 2022In 2013, the FDA placed a black box warning on the usage of opioid pain medications in the post-operative setting after pediatric adenotonsillectomy. Since then,...
PURPOSE
In 2013, the FDA placed a black box warning on the usage of opioid pain medications in the post-operative setting after pediatric adenotonsillectomy. Since then, alternative pain management regimens have been employed. Some have advocated for post-operative oral steroids, in part due to the effectiveness of intraoperative intravenous steroids in reducing post-operative pain and nausea. The evidence regarding the efficacy and safety of post-operative oral steroids is not as clear. The purpose of this study was to examine whether post-tonsillectomy hemorrhage rates in pediatric patients were affected by post-operative oral steroid usage.
MATERIALS AND METHODS
Case-control retrospective chart review using a deidentified data set of patients undergoing tonsillectomy with or without adenoidectomy at a single academic medical center between June 2012 and November 2015.
RESULTS
A total of 1416 patients were included in the study, with 704 in the no post-operative oral steroids group and 712 in the group who did receive post-operative oral steroids. The rate of post-tonsillectomy hemorrhage in the post-operative oral steroid group was 3.1 % compared to 1.8 % in the group who did not receive post-operative oral steroids, however, this was not a statistically significant difference (P = .132).
CONCLUSIONS
Our study suggests that post-operative oral steroids are safe and do not increase the risk of post-operative hemorrhage after pediatric tonsillectomy.
Topics: Analgesics, Opioid; Child; Humans; Postoperative Hemorrhage; Retrospective Studies; Steroids; Tonsillectomy
PubMed: 35963105
DOI: 10.1016/j.amjoto.2022.103595 -
Erythema multiforme-like lip presentation in pemphigus vulgaris patients: a multicenter case series.BMC Oral Health Dec 2023Pemphigus vulgaris (PV) is a chronic autoimmune mucocutaneous blistering disease. Autoantibodies are directed against desmogleins, leading to the formation of...
Pemphigus vulgaris (PV) is a chronic autoimmune mucocutaneous blistering disease. Autoantibodies are directed against desmogleins, leading to the formation of intraepithelial bullae. PV, as with other autoimmune mucocutaneous disorders of the oral cavity, presents diagnostic and therapeutic challenges. Approximately 50-70% of cases present first with oral lesions. The lesions commonly start as vesicles or bullae that rapidly rupture, leading to erosions and ulcerations. The palatal, gingival, buccal, and labial mucosa are the most commonly affected sites. Oral PV can mimic several other diseases that cause mucosal erosions and/or ulcerations, including erythema multiforme (EM). EM is an acute, immune-mediated, self-limited hypersensitivity condition primarily associated with herpes simplex infection. Oral lesions can be variable, but a very characteristic presentation with labial hemorrhagic erosions, ulcerations and crusting is commonly seen. In this case series, we present six cases of PV: one male patient and five female patients whose ages ranged from 34 to 65 years old. All patients presented with hemorrhage and crusting of the lips in addition to multiple intraoral erosions and ulcerations. Three patients presented with oral and skin lesions. All patients underwent biopsies, and a diagnosis of PV was confirmed. All patients were treated with steroids (topical and systemic) and variable steroid-sparing agents. This case series emphasizes that oral PV may be misdiagnosed as EM in a subgroup of patients who present with persistent lip hemorrhage and crusting. Therefore, a comprehensive history, clinical examination and incisional biopsies should be considered in such patients.
Topics: Humans; Male; Female; Adult; Middle Aged; Aged; Pemphigus; Blister; Lip; Erythema Multiforme; Oral Ulcer; Chronic Disease; Hemorrhage
PubMed: 38041037
DOI: 10.1186/s12903-023-03665-w -
BMC Oral Health Aug 2022Vitamin D deficiency has been associated with autoimmune diseases and oral health. Knowledge about the association between vitamin D status and oral conditions in JIA is...
BACKGROUND
Vitamin D deficiency has been associated with autoimmune diseases and oral health. Knowledge about the association between vitamin D status and oral conditions in JIA is limited. We aimed to investigate vitamin D status in a cohort of Norwegian children and adolescents with JIA and possible associations between serum vitamin D levels, clinical indicators of oral health, and JIA disease characteristics.
METHODS
This multi-center, cross-sectional study, included individuals with JIA aged 4-16 years from three geographically spread regions in Norway. Demographic data, age at disease onset, disease duration, JIA category, disease status, medication, and vitamin D intake were registered. One blood sample per individual was analyzed for 25(OH) vitamin D, and the level of insufficiency was defined as < 50 nmol/L. A clinical oral examination was performed applying commonly used indices in epidemiological studies of dental caries, dental erosion, enamel defects, gingival bleeding, and oral hygiene. Serum vitamin D was used as exposure variable in multivariable regression analyses to estimate the associations between insufficient vitamin D level, JIA disease status, and oral conditions, with adjustments for age, sex, geographical region, BMI, seasonal blood sampling, and parental education.
RESULTS
Among the 223 participants with JIA, 97.3% were Caucasians, 59.2% were girls, and median age was 12.6 years. Median disease duration was 4.6 years, and 44.4% had oligoarticular JIA. Mean serum vitamin D level was 61.4 nmol/L and 29.6% had insufficient levels. Vitamin D levels did not differ between sexes, but between regions, iso-BMI categories, age groups, and seasons for blood sampling. Insufficient vitamin D levels were associated with dentin caries (adjusted OR 2.89, 95% CI 1.43-5.86) and gingival bleeding (adjusted OR 2.36, 95% CI 1.10-5.01). No associations were found with active JIA disease or more severe disease characteristics.
CONCLUSION
In our study, nearly 30% had vitamin D insufficiency, with a particularly high prevalence among adolescents. Vitamin D insufficiency was associated with dentin caries and gingival bleeding, but not with JIA disease activity. These results point to the need for a multidisciplinary approach in the follow-up of children with JIA, including an increased focus on vitamin D status and oral health.
Topics: Adolescent; Arthritis, Juvenile; Child; Cross-Sectional Studies; Dental Caries; Female; Gingival Hemorrhage; Humans; Male; Oral Health; Vitamin D; Vitamin D Deficiency
PubMed: 35941635
DOI: 10.1186/s12903-022-02349-1 -
The Neuroradiology Journal Jun 2022Intractable nasal and oropharyngeal hemorrhage may be treated with endovascular embolization, but limited data are available. We sought to evaluate the efficacy, safety,...
BACKGROUND
Intractable nasal and oropharyngeal hemorrhage may be treated with endovascular embolization, but limited data are available. We sought to evaluate the efficacy, safety, and factors associated with rebleeding.
METHODS
A retrospective analysis of consecutive embolizations for nasal and oropharyngeal hemorrhage over a 10-year period at a single institution was performed. Outcomes included procedural success (defined as cessation of hemorrhage in the immediate postoperative period), rebleeding requiring an additional intervention, and procedural complications.
RESULTS
A total of 47 embolizations on 39 patients were included. The mean age was 60 years (standard deviation 16.1), 23.1% of patients were women, and 21 (53.8%) patients had a previously diagnosed head/neck malignancy. Bleeding sites were the nose in 20 patients and oropharynx in 21 (two patients presented with both nasal and oral bleeding). Immediate procedural success was achieved in 45 (95.7%) embolizations. Rebleeding requiring an additional intervention occurred after 11 (23.4%) embolizations at a median of one day after the procedure. In the multivariate analysis, preoperative hypotension (odds ratio 4.78, 95% confidence interval 1.04-24.61) and the use of coils (odds ratio 6.09, 95% confidence interval 1.24-46.69) were associated with rebleeding requiring repeat intervention. Complications included two watershed strokes that were anticipated due to occlusion of the internal carotid artery.
CONCLUSIONS
In our experience endovascular embolization was a safe and effective treatment option for stopping oral and nasal hemorrhage. However, rebleeding was present after 23.4% of treatments and was associated with preoperative hypotension and the use of coils. Further study in a large multi-institutional cohort is warranted.
Topics: Embolization, Therapeutic; Female; Hemorrhage; Humans; Hypotension; Male; Middle Aged; Oropharynx; Retrospective Studies; Treatment Outcome
PubMed: 34477042
DOI: 10.1177/19714009211042893 -
Swiss Medical Weekly Feb 2023Oral anticoagulants (antivitamin K, direct oral anticoagulants) are routinely prescribed for the prevention or treatment of thromboembolic events, and many patients are... (Review)
Review
Oral anticoagulants (antivitamin K, direct oral anticoagulants) are routinely prescribed for the prevention or treatment of thromboembolic events, and many patients are now on long-term anticoagulant therapy. However, this complicates the management of urgent surgical conditions or major bleeding. Various strategies have been developed to reverse the anticoagulant effect and this narrative review provides an overview of the wide range of therapies currently available.
Topics: Humans; Anticoagulants; Hemorrhage; Thromboembolism; Administration, Oral
PubMed: 36800887
DOI: 10.57187/smw.2023.40036 -
BMC Oral Health Feb 2024To investigate the effects of combinations of mechanical (brushing and flossing) and chemotherapeutic regimens which included essential oils (EO) non-alcohol and... (Randomized Controlled Trial)
Randomized Controlled Trial
BACKGROUND
To investigate the effects of combinations of mechanical (brushing and flossing) and chemotherapeutic regimens which included essential oils (EO) non-alcohol and alcohol-containing mouthrinses compared to brushing only in the prevention and reduction of plaque, gingivitis, and gingival bleeding.
METHODS
This was a randomized, virtually supervised, examiner blind, controlled clinical trial. Following informed consent and screening, subjects (N = 270) with gingivitis were randomly assigned to one of the following regimens: (1) Brush Only (B, n = 54); (2) Brush/Rinse (EO alcohol-containing mouthrinse) (BA, n = 54); (3) Brush/Rinse (EO non-alcohol containing mouthrinse) (BZ, n = 54); (4) Brush/Floss (BF, n = 54); (5) Brush/Floss/Rinse (EO non-alcohol containing mouthrinse) (BFZ, n = 54). Unflavored waxed dental floss (REACH unflavored waxed dental floss), and fluoridated toothpaste (Colgate Cavity Protection) were used. Examinations included oral hard and soft tissue, plaque, gingivitis, gingival bleeding, probing depth and bleeding on probing.
RESULTS
After 12 weeks, both BA and BZ and the BFZ group were superior in reducing interproximal plaque (30.8%, 18.2%, 16.0%, respectively), gingivitis (39.0%, 36.9%, 36.1%, respectively), and bleeding (67.8%, 73.6%, 79.8%, respectively) compared to B. The BF group did not provide significant reductions in interproximal plaque but did reduce interproximal gingivitis (5.1%, p = 0.041) at Week 4 and bleeding at Weeks 4 and 12 (34.6%, 31.4%, p < 0.001 respectively) compared to B. The BFZ group did not significantly reduce interproximal plaque, gingivitis or bleeding compared to BZ.
CONCLUSIONS
This study demonstrated that the addition of EO non-alcohol containing mouthrinse to the manual toothbrushing and flossing regimen further reduces plaque, gingivitis and bleeding showing that addition of EO mouthrinses (alcohol or non-alcohol containing) to the oral hygiene regimen provides sustained reductions in plaque to help maintain gingival health after a dental prophylaxis. Dental professional recommendation of the addition of an EO non-alcohol containing mouthrinse to daily oral hygiene routines of brushing or brushing and flossing should be considered to aid supragingival plaque control and improve gingivitis prevention.
STUDY REGISTRY NUMBER
NCT05600231.
Topics: Humans; Mouthwashes; Dental Devices, Home Care; Dental Plaque; Toothbrushing; Gingivitis; Oils, Volatile; Gingival Hemorrhage; Dental Plaque Index
PubMed: 38310236
DOI: 10.1186/s12903-024-03924-4