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Clinical & Experimental Ophthalmology Aug 2021To describe ocular adverse events and retinal changes during fibroblast growth factor receptor (FGFR) inhibitor (AZD4547) anticancer therapy.
Increased interdigitation zone visibility on optical coherence tomography following systemic fibroblast growth factor receptor 1-3 tyrosine kinase inhibitor anticancer therapy.
BACKGROUND
To describe ocular adverse events and retinal changes during fibroblast growth factor receptor (FGFR) inhibitor (AZD4547) anticancer therapy.
METHODS
This is a sub-study examining ocular adverse effects from AZD4547 therapy (single-centre, open-label, single arm phase II clinical trial). Comprehensive ocular examinations were performed 3 weekly in 24 patients. Macular optical coherence tomography (OCT) scan (30 × 25 ) was obtained at each visit and OCT parameters [central 1 mm retinal thickness (CRT) and total macular volume in central 6 mm] extracted. OCT scans were subdivided into outer (ELM to RPE) and inner (ELM to ILM) layers to compare outer and inner retinal changes.
RESULTS
In 24 patients, AZD4547 was associated with eyelash elongation (n = 5, 21%) and punctate corneal erosion (n = 2, 8%). One patient developed clinically significant posterior capsular opacification during the study. OCT data were available in 23 patients, retinal changes ranged from an asymptomatic increased visibility of the interdigitation zone (IDZ) (n = 10, 43%) to multilobular subretinal fluid pockets (n = 5, 22%), which was associated with mild visual acuity loss. In a subset of patients (n = 9) with pre-AZD4547 dosing OCT baseline, CRT increased by mean (SD) of 9 (4) μm in those with IDZ change only compared with 64 (38) μm in those with other retinal changes. Retinal changes tended to be bilateral, self-limiting and improved over time without medical intervention.
CONCLUSIONS
The ocular signs and symptoms did not result in dose cessation. Posteriorly, FGFR inhibition leads to outer retinal changes ranging from increased visibility of IDZ to distinct, multiple fluid pockets.
Topics: Humans; Protein Kinase Inhibitors; Receptor, Fibroblast Growth Factor, Type 1; Retina; Tomography, Optical Coherence; Visual Acuity
PubMed: 33934469
DOI: 10.1111/ceo.13940 -
Journal of Family Medicine and Primary... Oct 2020The occupational environment influences oral health to a greater extent. The unique environment in the steel factory might influence oral health and oral health-related...
INTRODUCTION
The occupational environment influences oral health to a greater extent. The unique environment in the steel factory might influence oral health and oral health-related quality of life of its workers, especially those who are exposed to its environment.
AIM AND OBJECTIVES
To determine oral health status and Oral Health-Related Quality of Life among production line and administration workers of a steel factory and assess their relationship with occupation exposure.
METHOD
A cross-sectional study was conducted among 533 production line and 517 administration workers of the steel factory aged 31-60 years using simple random sampling. The collected data includes information on demographic factors, adverse habits of the study subjects, and oral health-related quality of life using Oral Health Impact Profile-14 (OHIP-14). The oral health status was assessed using the WHO oral health assessment form 2013.
STATISTICAL ANALYSIS
SPSS Version 20 was used for statistical analysis. A student -test was done to compare means.
RESULTS
The prevalence of dental caries is 62.5% in the production line and 74.9% in administration workers, and the prevalence of periodontal status is 91.6% and 74.8%, respectively. The mean of OHIP-14 was 2.13 ± 0.73 in the production line and 2.33 ± 0.77 in administration workers. All domains of OHIP-14 were found to have high statistical significance with dental caries, periodontal pocket depth, loss of attachment, oral mucosal lesions, dental erosion, and dental trauma in both study groups ( < 0.001).
CONCLUSION
OHIP-14 scores were related significantly with oral health status indicators in both study groups. The prevalence of the periodontal disease, oral mucosal lesions, and OHIP-14 scores was found to be significantly higher among production line workers.
PubMed: 33409207
DOI: 10.4103/jfmpc.jfmpc_877_20 -
HeartRhythm Case Reports Nov 2023
PubMed: 38023679
DOI: 10.1016/j.hrcr.2023.08.010 -
BMC Oral Health Apr 2024Mouth dryness increases the risk of some oral health-related conditions. Furthermore, it is unclear if patients with dry mouth engage in appropriate oral health-related...
BACKGROUND
Mouth dryness increases the risk of some oral health-related conditions. Furthermore, it is unclear if patients with dry mouth engage in appropriate oral health-related behaviours. The study examined oral health, related behaviours, and perceived stress in dry-mouth patients and compared them to matched controls without mouth dryness.
METHODS
Information about 182 dry-mouth patients and 302 age- and sex-matched subjects was retrieved. Three dry mouth groups: xerostomia, Sicca syndrome and Sjögren's syndrome, were formed based on patient self-reported and objectively assessed symptoms. The World Health Organization's Oral Health for Adults and Perceived Stress Scale (PSS-10) questionnaires inquired about sociodemographic characteristics, oral health-related behaviours, and self-perceived stress. Clinical oral health assessments included: caries experience measured as total numbers of decayed (DS), missing (MS), filled surfaces (FS), number of remaining teeth, erosive tooth wear and extent of periodontal pocketing. Data were analyzed using bivariate and multivariable tests.
RESULTS
The dry-mouth participants had higher mean (SD) DMFS scores than their matched controls: xerostomia patients vs. controls: 74.6 (34.4) and 66.3 (35.4), Sicca syndrome patients vs. controls: 88.3 (34.0) and 70.1 (33.9), and Sjögren's syndrome patients vs. controls: 95.7 (31.5) and 74 (33.2). In comparison to controls, individuals with Sicca and patients with Sjögren's syndromes had lower mean (SD) number of remaining teeth, 15.9 (10.1) vs. 21.7 (8.4) and 13.8 (10.0) vs. 20.1 (9.2), and a lower mean (SD) extent of periodontal pocketing, 20.7 (28.6) vs. 41.1 (31.0), and 21.2 (24.1) vs. 34.8 (34.2), respectively. Xerostomia, Sicca syndrome and Sjögren's syndrome patients had higher odds of using fluoridated toothpaste; OR 1.8 (95%CI 1.1-2.9), OR 5.6 (95%CI 1.7-18.3) and OR 6.9 (95%CI 2.2-21.3), respectively. Participants with Sjögren's syndrome had lower odds of the last dental visit being within the last year; OR 0.2 (95%CI 0.1-0.8).
CONCLUSIONS
Dry-mouth patients had higher caries experience and fewer teeth than comparison groups but a lower extent of periodontal pocketing. Even though more participants with dry mouth used fluoridated toothpastes, their oral health-related behaviours were not optimal.
Topics: Adult; Humans; Sjogren's Syndrome; Oral Health; Cross-Sectional Studies; Xerostomia; Periodontal Pocket; Dental Caries; Stress, Psychological; Psychological Tests; Self Report
PubMed: 38622697
DOI: 10.1186/s12903-024-04224-7 -
Anais Da Academia Brasileira de Ciencias 2022The majority of ornithogenic soils studied in Antarctica focus on the influence of penguins, wherever little reports evaluated the influence of flying birds on soil...
The majority of ornithogenic soils studied in Antarctica focus on the influence of penguins, wherever little reports evaluated the influence of flying birds on soil genesis. This study aimed to characterize the morphologic, chemic, physic, mineralogic, and micromorphologic ornithogenic soil pockets influenced by flying birds in Snow Island, Maritime Antarctica. Fifteen soil pockets were selected, described, sampled and analyzed, these sites constitute the main areas with intense long-term terrestrial biological activity in Snow Island. In order to investigate the impact of phosphatization, we compared the soil pockets with the surrounding soils and soils affected by penguins. Zone of phosphatization have a high concentration of P, K, and Ca. The XRD patterns for the clay fraction of ornithogenic soils show that phosphate minerals are the main crystalline phases (leucophosphite, minyulite, fluorapatite, and apatite). We show that even under typical periglacial conditions, sites influenced by flying birds present active chemical weathering processes. The phosphatization release exchangeable bases and accelerate mineralogical and micromorphological transformations in soils. Under the current global warming trend and expected sea-level rise, the ornithogenic environments are susceptible to accelerated erosion rates and a great part of these hotspots may be lost for the open sea.
Topics: Animals; Antarctic Regions; Birds; Soil
PubMed: 35170669
DOI: 10.1590/0001-3765202220210595 -
Quintessence International (Berlin,... 2021The extraction of a tooth with root resorption can be a complicated procedure and can result in the removal of a significant amount of alveolar bone. In the anterior...
The extraction of a tooth with root resorption can be a complicated procedure and can result in the removal of a significant amount of alveolar bone. In the anterior maxilla, esthetic rehabilitation of damaged sites with implant-supported crown could require multiple surgeries. Patients often ask for an alternative, and minimally invasive treatments are generally preferred. In this paper, a clinical case of implant-supported crown in a site affected by root resorption is described. Immediate implant was placed leaving some root fragments in the osteotomy site, thus avoiding invasive extractive surgeries. A minimally invasive flapless technique with a computer-guided implant placement procedure was used. After ?8 years, clinical and radiologic data were stable, gingival tissues around the implant appeared healthy, no dark translucency appeared through marginal gingiva around the implant, and there was no pathologic probing pocket depth ?or bleeding on probing. In the presence of root resorption and ankylosis, computer-guided surgery could be helpful to prepare a precise implant site through various tissues, such as partially resorbed root remnants. (Quintessence Int 2021;52:132-137; doi: 10.3290/j.qi.a45432).
Topics: Computers; Crowns; Dental Implantation, Endosseous; Dental Implants; Dental Implants, Single-Tooth; Dental Prosthesis, Implant-Supported; Esthetics, Dental; Humans; Immediate Dental Implant Loading; Maxilla; Tooth Extraction; Treatment Outcome
PubMed: 33433079
DOI: 10.3290/j.qi.a45432 -
Journal of Cardiovascular... Apr 2024The implantation of a cardiac implantable electronic device (CIED) can have esthetic and psychological consequences on patients. We explore a heart team model for care...
INTRODUCTION
The implantation of a cardiac implantable electronic device (CIED) can have esthetic and psychological consequences on patients. We explore a heart team model for care coordination and discuss esthetic approaches for improved cosmetic outcomes in patients undergoing (CIED)-related procedures or de novo implantation.
METHODS
Patients undergoing CIED surgery for approved indications between June 2015 and June 2022 were identified. Patients were included when surgical care was provided by a collaborative relationship between the primary electrophysiologist and the plastic surgeon. Patient demographics, details of the surgical procedure, information on breast implants, complications, and outcomes related to cosmesis were recorded.
RESULTS
Twenty-two female patients were included in this study. The mean age was 50.2 ± 18.2 years. The mean follow-up duration was 2.2 ± 5.5 months. The top two indications for the procedure included CIED generator change (n = 9, 41%) and implantable cardioverter-defibrillator (ICD) implantation (n = 7, 32%). The most common reasons for involving plastic surgery in the procedure included surgery near breast implants (n = 10, 45%) and device displacement or discomfort (n = 8, 36%). CIED pocket position was prepectoral in 10 cases (45%), subpectoral in 11 patients (50%), and intramuscular in one patient (4.5%). The majority of the patients (20, 91%) had cosmetically acceptable results postprocedure. One patient (4.5%) had breast asymmetry on the CIED side, and another continued to have skin erosion over the CIED and leads.
CONCLUSION
A heart team approach incorporating the expertize of cardiac electrophysiology and plastic surgery is essential for providing optimal care for patients with breast implants and patients requesting esthetic appeal.
Topics: Humans; Female; Adult; Middle Aged; Aged; Pacemaker, Artificial; Defibrillators, Implantable; Breast Implants; Cardiac Surgical Procedures; Retrospective Studies
PubMed: 38361241
DOI: 10.1111/jce.16196 -
Journal of Cardiovascular Development... Mar 2022We reported the novel use of a taurolidine-containing antimicrobial solution in the successful salvage of a partially exposed and polymicrobially infected cardiac...
We reported the novel use of a taurolidine-containing antimicrobial solution in the successful salvage of a partially exposed and polymicrobially infected cardiac implantable electronic device pulse generator in a frail patient unfit for lead extraction. The old, salvaged device was entirely internalized, and there were no signs of recurrent infection at 9 months follow-up.
PubMed: 35323629
DOI: 10.3390/jcdd9030081 -
Spinal Cord Series and Cases Nov 2023Intrathecal baclofen (ITB) therapy is an effective method of treating spasticity in persons with spasticity due to spinal cord injury (SCI), but complications are not...
INTRODUCTION
Intrathecal baclofen (ITB) therapy is an effective method of treating spasticity in persons with spasticity due to spinal cord injury (SCI), but complications are not rare and can include spinal fluid leaks, infection, and catheter/pump malfunction.
CASE PRESENTATION
This study presents information related to an adult male patient with traumatic SCI and a history of two prior ITB pump pocket infections that required removal due to pump infection. The patient then developed skin erosion over the third pump, and the fluid around the pump grew methicillin-sensitive Staphylococcus aureus, diphtheroids, and Candida parapsilosis. The patient was initially treated with antibiotics and anti-fungal medication without removal of the ITB pump. The ITB pump was eventually removed 27 months later, and the fourth pump was implanted 10 months later.
DISCUSSION
ITB pumps can be an effective treatment modality for spasticity in people with SCI; however, complications, including infection, can occur and require pump removal. This case illustrates a case of possible Candida colonization of the ITB pump, which was eventually removed.
Topics: Adult; Humans; Male; Baclofen; Muscle Relaxants, Central; Candida parapsilosis; Cervical Cord; Infusion Pumps, Implantable; Spinal Cord Injuries; Muscle Spasticity
PubMed: 38036498
DOI: 10.1038/s41394-023-00610-5 -
BMJ Open Aug 2020The 2008 financial crisis had a particularly severe impact on Greece. To contain spending, the government capped public health expenditure and introduced increased...
OBJECTIVES AND SETTING
The 2008 financial crisis had a particularly severe impact on Greece. To contain spending, the government capped public health expenditure and introduced increased cost-sharing. The Greek case is important for studying the impact of recessions on health systems. This study analysed changes in household health expenditure in Greece over the economic crisis and explored whether the impact differed across socioeconomic groups.
PARTICIPANTS
We used data from the Greek Household Budget Survey for the years 2004 and 2008-2017. The dataset comprised 51 654 households, with a total of 128 111 members.
DESIGN
We compared pre-crisis and post-crisis trends in Greek household out-of-pocket payments for healthcare from 2004 to 2017 using an interrupted time series analysis. This study explored spending in euros and as a share of total household purchases.
RESULTS
Our results indicated that the population level trend in household health spending was reversed after the crisis began (pre-crisis trend: €0.040 decrease per quarter (95% CI: -0.785 to -0.022), post-crisis trend: €0.315 increase per quarter (95% CI: -0.004 to 0.635)). We also found that spending on inpatient services and pharmaceuticals has been increasing since the start of the crisis, whereas outpatient services expenditure has been decreasing. Across all households, out-of-pocket payments incurred a greater financial burden after the crisis relative to pre-existing trends, but the poorest households incurred a disproportionately higher burden.
CONCLUSIONS
This was the first study to use an interrupted time series analysis to assess the impact of the economic crisis on household health expenditure in Greece. Our findings suggest that there was an erosion of financial protection for Greek households as a consequence of the economic crisis. This effect was particularly pronounced among poorer households, which is indicative of a regressive financing system.
Topics: Economic Recession; Family Characteristics; Greece; Health Expenditures; Humans; Interrupted Time Series Analysis
PubMed: 32784261
DOI: 10.1136/bmjopen-2020-038158