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Several Complications (several + complications)

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Medical Sciences87%

Selected Abstracts

Labial piercing resulting in gingival recession.

JOURNAL OF CLINICAL PERIODONTOLOGY, Issue 10 2002
A case series
Abstract Several complications of oral piercing have been recently reported in the medical and dental literature. Even though few people have had problems related to oral piercing, dentists should familiarise themselves with the potential associated oral and dental problems. We present three cases of young people with gingival recession in the mandibular incisor area related to labial piercing. The clinical examination and the dental history of the three cases revealed the relationship between the gingival recession and the presence of labial piercing. In particular, a stud in the lower lip was held in place by a metal disk on the inner labial mucosa in each case. The metal disk was in close proximity to the mandibular front teeth and it would appear that it was responsible for local trauma and recession. This case series reinforces previously reported concerns regarding the practice of piercing and the role of the dentist, both in advising patients with oral or facial piercing and in the treatment of related oral, gingival and dental problems. Zusammenfassung Durchstochene Lippen führten zu einer Retraktion Gingiva. Eine Fallserie In jüngerer Zeit wurden in der allgemein- und zahnmedizinischen Literatur eine Reihe von Komplikationen nach Durchstechen des Mundgewebes berichtet. Obwohl nur wenige Menschen Probleme nach durchstochenen Lippen bekamen, sollten sich Zahnärzte dennoch mit den potentiell mit dieser Praxis verbundenen Zahnproblemen beschäftigen. Wir stellen hier drei Fälle von jungen Menschen mit einer Retraktion der Gingiva im Bereich der mandibulären Schneidezähne vor, die auf ein Durchstechen der Lippen zurückzuführen ist. Die klinische Untersuchung und die Zahnanamnese der drei Fälle zeigte eine Verbindung zwischen der Retraktion der Gingiva und den durchstochenen Lippen. In jedem der Fälle wurde ein Stecker in der Unterlippe durch eine an der inneren Schleimhaut der Unterlippe anliegende Metallscheibe festgehalten. Die Metallscheibe lag in der direkten Umgebung der mandibulären Schneidezähne und wir gehen davon aus, das diese Scheibe für das lokale Trauma und die Retraktion der Gingiva verantwortlich war. Diese Fallserie unterstützt an früherer Stelle ausgedrückte Besorgnisse in Bezug auf das Durchstechen der Lippen und die Rolle des Zahnarztes, sowohl bei der Beratung des Patienten in Bezug auf das Durchstechen der Lippen bzw. anderer Gesichtsteile, als auch bei der Behandlung damit verbundener oraler, gingivaler oder dentaler Probleme. Résumé Piercing labial entraînant une récession gingivale. Série de cas La littérature médicale et dentaire a récemment fait état de plusieurs complications dues au piercing buccal. Bien que peu de personnes aient eu des problèmes liés au piercing buccal, les dentistes devraient se familiariser avec les potentielles complications buccales et dentaires qui lui sont associées. Nous exposons les cas de trois jeunes personnes présentant une récession gingivale dans la région incisive mandibulaire, en relation avec un piercing labial. L'examen clinique et le passé dentaire des trois cas ont mis en évidence la relation entre la récession gingivale et la présence d'un piercing labial. En particulier, dans chaque cas, un clou placé dans la lèvre inférieure était maintenu en place par un disque métallique situé sur la muqueuse labiale interne. Ce disque était à proximité des dents mandibulaires antérieures, et il semblerait qu'il ait étéà l'origine d'un traumatisme local et d'une récession. Cette série de cas renforce les préoccupations déjàévoquées dans le passé sur la pratique du piercing, ainsi que sur le rôle du dentiste, à la fois pour conseiller les patients sur le piercing buccal et facial et pour traiter les problèmes dentaires buccaux et gingivaux associés. [source]

Rhabdomyolysis and brain ischemic stroke in a heroin-dependent male under methadone maintenance therapy

ACTA PSYCHIATRICA SCANDINAVICA, Issue 1 2009
W.-Y. Hsu
Objective:, There are several complications associated with heroin abuse, some of which are life-threatening. Methadone may aggravate this problem. Method:, A clinical case description. Results:, A 33-year-old man presented with rhabdomyolysis and cerebral ischemic stroke after intravenous heroin. He had used heroin since age 20, and had used 150 mg methadone daily for 6 months. He was found unconsciousness at home and was sent to our hospital. In the ER, his opiate level was 4497 ng/ml. In the ICU, we found rhabdomyolysis, acute renal failure and acute respiratory failure. After transfer to an internal ward, we noted aphasia and weakness of his left limbs. After MRI, we found cerebral ischemic infarction. Conclusion:, Those using methadone and heroin simultaneously may increase risk of rhabdomyolysis and ischemic stroke. Patients under methadone maintenance therapy should be warned regarding these serious adverse events. Hypotheses of heroin-related rhabdomyolysis and stroke in heroin abusers are discussed. [source]

Characterization and comparison of health-related utility in people with diabetes with various single and multiple vascular complications

DIABETIC MEDICINE, Issue 10 2006
C. Ll.
Abstract Aims To characterize and compare health-related utility in a large cohort of patients treated in hospital with diabetes and with single and multiple comorbidities. Methods The study was conducted in Cardiff and the Vale of Glamorgan, UK. Health-related utility was measured using the EQ5Dindex, a standardized instrument for measuring health outcome. Patients from the Health Outcomes Data Repository (HODaR) were surveyed by postal questionnaire 6 weeks post discharge for in-patients and during clinics for patients attending as out-patients between January 2002 and July 2005. Patients with diabetes were identified by a previous history of in-patient admission with diabetes or as an out-patient with diabetes recorded as a coexisting diagnosis. Results, We identified 4502 patients with diabetes. Mean ages were 65.4 and 64.2 years for males and females, respectively. Of these, 2003 (45%) had no recorded vascular complication. Overall, the EQ5Dindex was 0.584 (sd 0.325) for males and 0.533 (sd 0.351) for females. For those without any vascular complications the mean EQ5Dindex was 0.735 (sd 0.288). In a general linear model, the presence of single and multiple complications had a detrimental impact on the EQ5Dindex. Conclusion The results of this study provide an indication of the true impact of diabetes in terms of health-related utility. There was a decrease in the mean EQ5Dindex for those with vascular complications. Economic models of diabetes that have used additive or multiplicative methods to assess utility in individuals with several complications may be unreliable, and direct measurements, such as this, are recommended. [source]

Tricuspid Valve Malfunction and Ventricular Pacemaker Lead: Case Report and Review of the Literature

ECHOCARDIOGRAPHY, Issue 8 2006
Said B. Iskandar M.D.
Pacemaker implantation can be associated with several complications, including myocardial perforation with or without pericardial effusion, venous thrombosis, vegetations of the tricuspid valve (TV) or pacing lead, and tricuspid regurgitation (TR). The TR is thought to be derived from deformity or perforation of the TV by the pacing lead or secondary to atrioventricular discordance with asynchronous ventricular pacing. Severe TR can be deleterious to the patient because it raises the central venous pressure by increasing the right sided preload. Chronically, the increase in right sided blood volume can result in an increase in the right atrial pressure leading to a decrease in venous return and low cardiac output. Severe TR from leaflet adhesion to the pacemaker lead has not been reported before. With the aging of the population and the expanding use of pacemakers and implantable cardioverter defibrillators (ICD) in clinical practice, this complication may be seen more frequently. We present a patient diagnosed with severe TR, years after his pacemaker implantation. His TR was thought to be caused by adhesion of the tricuspid valve to his pacemaker lead. [source]

Internal algorithm variability and among-algorithm discordance in statistical haplotype reconstruction

MOLECULAR ECOLOGY, Issue 8 2009
ZU-SHI HUANG
The potential effectiveness of statistical haplotype inference makes it an area of active exploration over the last decade. There are several complications of statistical inference, including: the same algorithm can produce different solutions for the same data set, which reflects the internal algorithm variability; different algorithms can give different solutions for the same data set, reflecting the discordance among algorithms; and the algorithms per se are unable to evaluate the reliability of the solutions even if they are unique, this being a general limitation of all inference methods. With the aim of increasing the confidence of statistical inference results, consensus strategy appears to be an effective means to deal with these problems. Several authors have explored this with different emphases. Here we discuss two recent studies examining the internal algorithm variability and among-algorithm discordance, respectively, and evaluate the different outcomes of these analyses, in light of Orzack (2009) comment. Until other, better methods are developed, a combination of these two approaches should provide a practical way to increase the confidence of statistical haplotyping results. [source]

Strategies for the endodontic management of concurrent endodontic and periodontal diseases

AUSTRALIAN DENTAL JOURNAL, Issue 2009
PV Abbott
Abstract Endodontic and periodontal diseases can provide many diagnostic and management challenges to clinicians, particularly when they occur concurrently. As with all diseases, a thorough history combined with comprehensive clinical and radiographic examinations are all required so an accurate diagnosis can be made. This is essential since the diagnosis will determine the type and sequence of treatment required. This paper reviews the relevant literature and proposes a new classification for concurrent endodontic and periodontal diseases. This classification is a simple one that will help clinicians to formulate management plans for when these diseases occur concurrently. The key aspects are to determine whether both types of diseases are present, rather than just having manifestations of one disease in the alternate tissue. Once it is established that both diseases are present and that they are as a result of infections of each tissue, then the clinician must determine whether the two diseases communicate via the periodontal pocket so that appropriate management can be provided using the guidelines outlined. In general, if the root canal system is infected, endodontic treatment should be commenced prior to any periodontal therapy in order to remove the intracanal infection before any cementum is removed. This avoids several complications and provides a more favourable environment for periodontal repair. The endodontic treatment can be completed before periodontal treatment is provided when there is no communication between the disease processes. However, when there is communication between the two disease processes, then the root canals should be medicated until the periodontal treatment has been completed and the overall prognosis of the tooth has been reassessed as being favourable. The use of non-toxic intracanal therapeutic medicaments is essential to destroy bacteria and to help encourage tissue repair. [source]

Mycophenolate mofetil in uveitis

ACTA OPHTHALMOLOGICA, Issue 2009
P NERI
Purpose To review the current Literature and to describe the experience of a tertiary referral centre on the use of mycophenolate mofetil (MMF) treatment in uveitis. Methods The current literature is reviewed and the experience of a tertiary referral centre is reported. Results The long-lasting remission in several systemic diseases, such as Crohn's disease, severe atopic dermatitis, Wegener's granulomatosis and microscopic polyangioitis, rheumatoid arthritis, pemphigus vugaris, and psoriasis, have been proven. Recent publications have have recently confirmed the satisfactory control of uveitis with MMF in a large cohort of patients. Moreover, the long-term control of cystoid macular oedema (CMO) unresponsive to the traditional therapy has been described, as well as for the choroidal neovascularization (CNV). Conclusion Non-infectious uveitis is one of the leading causes of visual impairment in ophthalmology. Steroids can control such disease, even though a long-term treatment is not recommended: several complications, such as high blood sugar level, osteoporosis, blood cell abnormalities, cataract and glaucoma, can occur. MMF is a reversible, non competitive, selective inhibitor of the de-novo pathway of purine synthesis; mycophenolic acid has a strong effect to Type II isoform of inosine monophosphate dehydrogenase enzyme, providing a stronger cytostatic effect on lymphocytes than on other cells types, with minor action to Type I expressed in most other cells. The specific action of MMF on selected targets makes it a promising drug for the control of non-infectious intraocular inflammations. [source]

HIGH-DOSE TAURINE SUPPLEMENTATION INCREASES SERUM PARAOXONASE AND ARYLESTERASE ACTIVITIES IN EXPERIMENTAL HYPOTHYROIDISM

CLINICAL AND EXPERIMENTAL PHARMACOLOGY AND PHYSIOLOGY, Issue 9 2007
Melahat Dirican
SUMMARY 1Hypothyroidism is accompanied by hyperlipidaemia and oxidative stress and is associated with several complications, such as atherosclerosis. Paraoxonase activity has been reported to decrease in several situations associated with atherosclerosis and oxidative stress. In the present study, the effects of different doses of taurine on serum paraoxonase and arylesterase activities, as well as on the serum lipid profile, were investigated in hypothyroid rats. 2Forty male Sprague-Dawley rats were randomly divided into five groups as follows: Group 1, rats received normal rat chow and tap water; Group 2, rats received standard rat chow + 0.05% propylthiouracil (PTU) in the drinking water; and Groups 3,5, taurine-supplemented PTU groups (standard rat chow + 0.5, 2 or 3% taurine in the drinking water, respectively, in addition to PTU). Paraoxon or phenylacetate were used as substrates to measure paraoxonase and arylesterase activity, respectively. Plasma and tissue malondialdehyde (MDA) levels, indicators of lipid peroxidation, were determined using the thiobarbituric-acid reactive substances method. Serum triglyceride, total cholesterol and high-density lipoprotein,cholesterol (following precipitation with dextran sulphate,magnesium chloride) were determined using enzymatic methods. 3Serum paraoxonase and arylesterase activities were increased and plasma and tissue MDA levels and serum triglyceride levels were reduced in a dose-dependent manner in taurine-treated hypothyroid rats. Taurine concentrations were positively correlated with enzyme activities and negatively correlated with MDA and triglyceride levels. 4Further studies are needed to investigate the role of taurine supplementation in hypothyroidism in human subjects. [source]