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International Journal of Medical... 2019Direct oral anticoagulants (DOACs) are used in anticoagulant therapy. The purpose of this study was to evaluate the association of DOAC-induced gastrointestinal (GI) and...
Adverse reaction profiles of hemorrhagic adverse reactions caused by direct oral anticoagulants analyzed using the Food and Drug Administration Adverse Event Reporting System (FAERS) database and the Japanese Adverse Drug Event Report (JADER) database.
Direct oral anticoagulants (DOACs) are used in anticoagulant therapy. The purpose of this study was to evaluate the association of DOAC-induced gastrointestinal (GI) and nervous system hemorrhage using the FDA's Adverse Event Reporting System (FAERS) database and the Japanese Adverse Drug Event Report (JADER) database. We identified and analyzed the reports of hemorrhagic reactions between 2004 and 2016 from the FAERS and JADER databases, and calculated the adjusted reported odds ratio (ROR) using the multiple logistic regression method. Additionally, we used the time-to-onset analysis. In the FAERS database, the adjusted ROR of apixaban, rivaroxaban, and dabigatran for GI hemorrhage was 6.79 (5.84-7.91), 19.58 (18.85-20.34), and 14.51 (13.58-15.51), respectively. In the JADER database, the adjusted ROR of apixaban, rivaroxaban, edoxaban, and dabigatran for GI hemorrhage was 11.80 (9.50-14.64), 11.03 (9.18-13.26), 10.17 (6.95-14.88), and 9.85 (7.23-13.42), respectively. We found that the association of GI hemorrhage with DOACs was affected by sex (female). Additionally, 30% of GI hemorrhage was observed after 30 days. Hemorrhagic reactions of both GI and nervous systems were observed in both the spontaneous reporting system databases. We recommend that female patients who experience symptoms related to GI hemorrhage should be closely monitored and advised to adhere to an appropriate care plan. Additionally, our results show that patients should be closely monitored for hemorrhage even after a month.
Topics: Administration, Oral; Adult; Adverse Drug Reaction Reporting Systems; Anticoagulants; Female; Gastrointestinal Hemorrhage; Hemorrhage; Humans; Intracranial Hemorrhages; Japan; Logistic Models; Male; Middle Aged; Odds Ratio; United States; United States Food and Drug Administration
PubMed: 31588196
DOI: 10.7150/ijms.34629 -
BMC Oral Health Feb 2015The importance of oral health care in the management of patients with systemic diseases including chronic kidney disease (CKD) has been affirmed. Many CKD patients have... (Comparative Study)
Comparative Study
BACKGROUND
The importance of oral health care in the management of patients with systemic diseases including chronic kidney disease (CKD) has been affirmed. Many CKD patients have related oral lesions, however, attention to oral health care has been lacking, especially in the developing countries with higher burden of renal diseases.
METHODS
One hundred and eighty patients, 90 cases and 90 controls were recruited, interviewed and examined. Oral mucosa assessment was based on the WHO Guide to Epidemiology and Diagnosis of Oral Mucosal Diseases. Urinalysis and blood creatinine levels were determined. Glomerular filtration rate (GFR) of each patient was calculated from the blood creatinine using Cockcroft and Gault formula.
RESULTS
Oral lesions were present in 86 out of 90 (96.5%) CKD patients compared with 15 out of 90 (16.7%) controls (p < 0.001). Abnormal lip hyperpigmentation was the most frequently seen lesion in 81 out of 90 (90%) CKD patients. Other significant findings were gum bleeding, xerostomia, candidiasis, burning mouth and abnormal taste. In the controls (without CKD), the mean GFR was lower in subjects with oral lesions compared with those without oral lesions p < 0.001.
CONCLUSIONS
CKD and reduced GFR in subjects without CKD are risk factors for oral lesions. The higher prevalence of oral lesions in CKD patients necessitates mandatory oral screening to identify patients with deteriorating renal function. The management of such lesions will enhance the overall well-being of CKD patients in developing countries.
Topics: Adult; Aged; Burning Mouth Syndrome; Candidiasis, Oral; Case-Control Studies; Creatinine; Developing Countries; Female; Gingival Hemorrhage; Glomerular Filtration Rate; Humans; Hyperpigmentation; Kidney Failure, Chronic; Lip Diseases; Male; Middle Aged; Mouth Diseases; Nigeria; Oral Hygiene Index; Periodontal Index; Periodontitis; Renal Insufficiency, Chronic; Saliva; Taste Disorders; Urinalysis
PubMed: 25888327
DOI: 10.1186/s12903-015-0004-z -
Medicina Oral, Patologia Oral Y Cirugia... Sep 2016Blood presence in apical surgery can prevent the correct vision of the surgical field, change the physical properties of filling materials and reduce their sealing... (Review)
Review
BACKGROUND
Blood presence in apical surgery can prevent the correct vision of the surgical field, change the physical properties of filling materials and reduce their sealing ability.
OBJECTIVES
To describe which are the most effective and safest haemostatic agents to control bleeding in patients undergoing apical surgery.
MATERIAL AND METHODS
We carried out a systematic review, using Medline and Cochrane Library databases, of human clinical studies published in the last 10 years.
RESULTS
The agents that proved more effective in bleeding control were calcium sulphate (100%) and collagen plus epinephrine (92.9%) followed by ferric sulphate (60%), gauze packing (30%) and collagen (16.7%). When using aluminium chloride (Expasyl®), over 90% of the apical lesions improved, but this agent seemed to increase swelling. Epinephrine with collagen did not significantly raise either blood pressure or heart rate.
CONCLUSIONS
Despite the use of several haemostatic materials in apical surgery, there is little evidence on their effectiveness and safety. The most effective haemostatic agents were calcium sulphate and epinephrine plus collagen. Epinephrine plus collagen did not seem to significantly raise blood pressure or heart rate during surgery. Aluminium chloride did not increase postoperative pain but could slightly increase postoperative swelling. Randomized clinical trials are needed to assess the haemostatic effectiveness and adverse effects of haemostatic materials in apical surgery.
Topics: Bandages; Hemostatics; Humans; Oral Hemorrhage; Tooth Apex
PubMed: 27475689
DOI: 10.4317/medoral.21109 -
Indian Journal of Dental Research :... 2011Over the past decade, a growing body of scientific evidence has suggested an exquisite association between oral infection and systemic diseases (e.g. atherosclerosis,... (Comparative Study)
Comparative Study
CONTEXT
Over the past decade, a growing body of scientific evidence has suggested an exquisite association between oral infection and systemic diseases (e.g. atherosclerosis, cardiovascular diseases, premature or low birth weight babies, pulmonary diseases, etc.) and also between systemic diseases (e.g. arthritis, diabetes, HIV infection and osteoporosis) and oral and craniofacial diseases and disorders. Leptin is a hormone secreted by the adipocytes in varying quantities and regulates the body weight. The present study was undertaken in the context of knowing the role of leptin in the inflammatory process occurring in the gingiva as the disease progressed from gingivitis to periodontitis.
AIMS
The present study was done to correlate the concentrations of leptin and interleukin (IL)-6 within the gingiva in healthy, gingivitis and periodontitis groups of patients and to correlate gingival leptin and IL-6 concentrations with plasma leptin and IL-6 concentrations in the healthy, gingivitis and periodontitis groups of patients.
SETTINGS AND DESIGN
This was a cross-sectional study and was carried out on the patients from the out-patient department of Periodontics in A B Shetty Memorial Institute of Dental Sciences.
PATIENTS AND METHODS
Seventy-five patients in the age group of 18-60 years were selected and grouped based on the gingival index (Loe and Sillness) and their clinical attachment levels into healthy, gingivitis and periodontitis groups. Leptin and IL-6 levels were estimated within gingiva and the plasma of each subject using an enzyme-linked immunosorbent assay kit. The results of this study were tabulated and subjected to statistical analysis. Mean and the standard deviation were calculated using analysis of variance Fisher's F-test and then the results were subjected to Tukey's Honest significance difference method for multiple comparison among the three groups. Correlation among the three groups was estimated using Pearson's correlation analysis.
RESULTS
Results showed a statistically significant decrease in the concentration of gingival leptin and a statistically significant increase in the concentration of plasma leptin as the gingival disease progressed.
CONCLUSION
It was concluded that as the gingival disease progressed, the gingival leptin concentration decreased, whereas the plasma leptin concentration increased, indicating a possible correlation between leptin concentration in the gingiva and the risk of developing systemic disease like the cardiovascular disease.
Topics: Adolescent; Adult; Cross-Sectional Studies; Disease Progression; Forecasting; Gingiva; Gingival Hemorrhage; Gingivitis; Humans; Inflammation; Interleukin-6; Leptin; Middle Aged; Periodontal Attachment Loss; Periodontal Index; Periodontal Pocket; Periodontitis; Risk Factors; Young Adult
PubMed: 22124048
DOI: 10.4103/0970-9290.90292 -
PloS One 2024Conditions such as hypertension, cardiovascular diseases, and hypercholesterolemia, are a major public health challenge. This study investigates the influence of oral...
BACKGROUND AND AIM
Conditions such as hypertension, cardiovascular diseases, and hypercholesterolemia, are a major public health challenge. This study investigates the influence of oral health indicators, including gum bleeding, active dental caries, tooth mobility, and tooth loss, on their prevalence in Hungary, considering socioeconomic, demographic, and lifestyle factors.
MATERIALS AND METHODS
Data from the 2019 Hungarian European Health Interview Survey with 5,603 participants informed this analysis. Data were accessed from the records maintained by the Department of Health Informatics at the University of Debrecen between September and November 2023. Variable selection employed elastic net regularization and k-fold cross-validation, leading to high-performing predictors for weighted multiple logistic regression models. Sensitivity analysis confirmed the findings' validity.
RESULTS
Significant links were found between poor oral health and chronic cardiac conditions. Multiple teeth extractions increased hypertension risk (OR = 1.67, 95% CI: [1.01-2.77]); dental prosthetics had an OR of 1.45 [1.20-1.75]. Gum bleeding was associated with higher cardiovascular disease (OR = 1.69 [1.30-2.21]) and hypercholesterolemia risks (OR = 1.40 [1.09-1.81]).
CONCLUSIONS
Oral health improvement may reduce the risk of cardiac conditions. This underscores oral health's role in multidisciplinary disease management.
Topics: Humans; Oral Health; Dental Caries; Hypercholesterolemia; Gingival Hemorrhage; Hypertension; Research Design
PubMed: 38635852
DOI: 10.1371/journal.pone.0301466 -
International Journal of Environmental... Mar 2023The surgical dental treatment of subjects admitted for anticoagulants therapy represents a consistent risk for peri-operative bleeding. The aim of the present study was... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
The surgical dental treatment of subjects admitted for anticoagulants therapy represents a consistent risk for peri-operative bleeding. The aim of the present study was to investigate the clinical findings of dental surgery operative management of the patients under anticoagulants drugs protocol.
METHODS
The literature screening was performed using Pubmed/Medline, EMBASE and Cochrane library, considering only randomized clinical trials (RCTs) papers. No limitations about the publication's period, follow-up time or clinical parameters were considered.
RESULTS
A total of eight RCTs were included for the qualitative synthesis. No thromboembolic complications were reported in any studies. Several bleeding episodes associated with anticoagulant drugs in dental surgery were mild and generally happened on the first day after the treatment.
CONCLUSIONS
The use of local haemostatic measures is generally effective for bleeding control with no further pharmacological drug management or suspension.
Topics: Humans; Fibrinolytic Agents; Network Meta-Analysis; Hemorrhage; Anticoagulants; Thromboembolism
PubMed: 37047909
DOI: 10.3390/ijerph20075293 -
BMC Oral Health May 2022Studies using salivary inflammatory biomarkers for diagnosing and monitoring the progression of periodontal disease have garnered increased attention in recent years....
BACKGROUND
Studies using salivary inflammatory biomarkers for diagnosing and monitoring the progression of periodontal disease have garnered increased attention in recent years. The present study aimed to identify changes in clinical parameters and concentrations of salivary matrix metalloproteinases (MMPs) following 6 weeks of non-surgical periodontal therapy (NSPT).
METHODS
A 6-week NSPT program was applied to 51 adults aged ≥ 20 years. The program involved scaling, root planing, and professional toothbrushing for healthy participants and those with periodontal disease. Patients with periodontal disease underwent professional toothbrushing during all three visits. Periodontal pocket depth (PD) and gingival bleeding were assessed at week 0, week 3, and week 6, and saliva samples were collected to measure the concentrations of MMP-3, -8, and -9.
RESULTS
All clinical parameters were improved in the periodontal disease groups following the NSPT course. Compared with healthy participants, the patients with periodontal disease showed increased concentrations of salivary MMP-3, -8, and -9. During the 6-week program, patients with periodontal disease also showed significant reductions in PD and gingival bleeding during the third week; no significant reduction was found during the sixth week. Significant reductions in the concentrations of salivary MMP-3, -8, and -9 were also noted in the periodontal disease group at week 3. The sensitivity and specificity of MMP-3 for predicting periodontitis were 81.8% and 55.5%, respectively.
CONCLUSION
The present study found that NSPT resulted in reductions of salivary MMP-3, -8, and -9, and identified the potential of MMP-3 as a biomarker in the diagnosis of periodontal disease. These findings may serve as foundational data for future studies into the development of diagnostic kits for periodontal disease.
Topics: Adult; Biomarkers; Gingival Crevicular Fluid; Gingival Hemorrhage; Humans; Matrix Metalloproteinase 3; Matrix Metalloproteinase 8; Matrix Metalloproteinase 9; Periodontal Diseases; Periodontal Index; Periodontal Pocket
PubMed: 35562715
DOI: 10.1186/s12903-022-02185-3 -
Brazilian Oral Research 2018The aims of this study were to describe the self-reported oral hygiene habits, dental visit frequency, and gingival bleeding perception in adult populations from three...
The aims of this study were to describe the self-reported oral hygiene habits, dental visit frequency, and gingival bleeding perception in adult populations from three South American cities, and also to assess the association of these variables with sociodemographic data and with the clinical presence of plaque and gingival inflammation. Five-hundred and fifty adult subjects from each city (Porto Alegre, Brazil; Tucumán, Argentina; Santiago, Chile) received full mouth examinations to determine visible plaque and gingival index. A structured questionnaire on demographics, habits, attitudes and knowledge of oral health was also administered. The data were analyzed according to dental visit frequency, toothbrushing frequency, interproximal tooth cleaning frequency, subjects' perception of gum bleeding, and proportion of subject sites with VP and bleeding sites. Analysis of the association among the variables was performed using either a chi-square test or Fischer's exact test. Toothbrushing twice a day or more was reported by 84.2% of the subjects, but only 17.7% reported daily interdental cleaning, and 60.2% reported visiting a dental clinic only in an emergency. Only 2.97% had no bleeding sites, whereas 33.7% had 50% or more bleeding sites. Regular interdental self-cleaning and a dental visit every 3-6 months was associated with less plaque and less gingival bleeding. More than 12 years of education was associated with healthier habits, less bleeding and plaque scores. In conclusion, the oral health behavior of South American adult subjects from these cities is below the international recommendations, especially in relation to interdental cleaning and regular dental visits.
Topics: Adolescent; Adult; Age Distribution; Age Factors; Argentina; Brazil; Chile; Cities; Cross-Sectional Studies; Dental Health Surveys; Dental Plaque; Educational Status; Female; Gingival Hemorrhage; Health Behavior; Humans; Male; Middle Aged; Oral Health; Oral Hygiene; Self Report; Sex Distribution; Sex Factors; Toothbrushing; Young Adult
PubMed: 29723334
DOI: 10.1590/1807-3107bor-2018.vol32.0022 -
PloS One 2016There is little knowledge about how oral and respiratory health is interrelated even though the mucosa of the oral cavity and airways constitutes a continuum and the...
BACKGROUND
There is little knowledge about how oral and respiratory health is interrelated even though the mucosa of the oral cavity and airways constitutes a continuum and the exposures to these are partly similar.
AIMS
To investigate whether gum bleeding is related to asthma, respiratory symptoms and self-reported COPD.
METHODS
A postal questionnaire including questions about respiratory and oral health was sent to general population samples in seven Northern European centres. In 13,409 responders, gum bleeding when brushing teeth was reported always/often by 4% and sometimes by 20%. Logistic regressions accounted for age, smoking, educational level, centre and gender. Effects of BMI, cardio-metabolic diseases, early life factors, gastro-oesophageal reflux, dental hygiene, nasal congestion, and asthma medication were addressed.
RESULTS
Gum bleeding always/often was significantly associated with ≥ 3 asthma symptoms (OR 2.58, 95% CI 2.10-3.18), asthma (1.62 [1.23-2.14]) and self-reported COPD (2.02 [1.28-3.18]). There was a dose-response relationship between respiratory outcomes and gum bleeding frequency (≥ 3 symptoms: gum bleeding sometimes 1.42 [1.25-1.60], often/always 2.58 [2.10-3.18]), and there was no heterogeneity between centres (p(heterogeneity) = 0.49). None of the investigated risk factors explained the associations. The observed associations were significantly stronger among current smokers (p(interaction) = 0.004).
CONCLUSIONS
A consistent link between gum bleeding and obstructive airways disease was observed, not explained by common risk factors or metabolic factors. We speculate that oral pathogens might have unfavourable impact on the airways, and that the direct continuity of the mucosa of the oral cavity and the airways reflects a pathway that might provide novel opportunities for interventions.
Topics: Asthma; Europe; Female; Gingival Hemorrhage; Humans; Male; Middle Aged; Pulmonary Disease, Chronic Obstructive
PubMed: 26808490
DOI: 10.1371/journal.pone.0147518 -
BMC Oral Health May 2020Gingivitis is a common oral health problem, and untreated gingivitis can progress to periodontitis. The objectives of this study were to (1) explore associated factors...
BACKGROUND
Gingivitis is a common oral health problem, and untreated gingivitis can progress to periodontitis. The objectives of this study were to (1) explore associated factors of gingival bleeding and calculus among 12-year-old adolescents; (2) find predictive models for gingivitis management.
METHODS
Four thousand five hundred twenty-five subjects aged 12 in Sichuan Province were investigated. The questionnaire and clinical examination were applied in schools, and two-level logistic regression models were constructed to interpret the effect of individual and contextual factors on Chinese adolescents' gingival bleeding and calculus.
RESULTS
46.63% (95%CI: 40.71, 51.60) and 66.94% (95%CI: 56.85, 67.45) of the subjects presented gingival bleeding and calculus, respectively. For the gingival bleeding cases, the model showed the significant associated indicators were hukou (OR = 0.61, 95% CI: 0.52-0.72), family size (OR = 1.41, 95% CI: 1.19-1.68), parental educational level (father: OR = 0.53, 95% CI: 0.45-0.63; mother: OR = 0.71, 95% CI: 0.59-0.86), tooth-brushing frequency (OR = 0.35, 95% CI: 0.26-0.48), dental floss use (OR = 0.58, 95% CI: 0.41-0.83), sugar-containing drink consumption (OR = 2.11, 95% CI: 1.80-2.49), and dental visit (OR = 1.44, 95% CI: 1.19-1.74). It also confirmed that gender (OR = 1.32, 95% CI: 1.13-1.54), hukou (OR = 0.69, 95% CI: 0.59-0.82), family size (OR = 1.34, 95% CI: 1.12-1.59), parental educational level (father: OR = 0.46, 95% CI: 0.39-0.54; mother: OR = 0.65, 95% CI: 0.59-0.82), tooth-brushing frequency (OR = 0.57, 95% CI: 0.42-0.78), dental floss use (OR = 0.66, 95% CI: 0.48-0.90) and sugar-containing drink consumption (OR = 1.30, 95% CI: 1.11-1.53) were associated factors for dental calculus.
CONCLUSIONS
Gingival bleeding and calculus were common in western Chinese adolescents. Socio-demographic factors including gender, hukou and family factors are strong determinants of gingival health in Chinese adolescents. In addition, health-related lifestyle behaviors such as healthy diet, good hygiene care and more dental visits are good predictors of better gingival status.
Topics: Asian People; Child; Dental Calculus; Female; Gingival Hemorrhage; Gingivitis; Humans; Male; Multilevel Analysis; Oral Health
PubMed: 32429918
DOI: 10.1186/s12903-020-01125-3