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Systemic Disorders (systemic + disorders)

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Medical Sciences	100%

Selected Abstracts

Systemic disorders in patients with periodontal disease

JOURNAL OF CLINICAL PERIODONTOLOGY, Issue 4 2003
Maria Lagervall
Abstract Background, aims: Over the past 10 years several studies have been published pointing towards a relationship between periodontal disease and various systemic disorders or diseases. The purpose of this retrospective study was to investigate the occurrence of self-reported systemic disorders in patients referred to a specialist clinic for periodontal treatment and to explore possible relationships between general health and periodontal disease severity in this population. Material and Methods: Data were collected from the dental records and the health questionnaires of 1006 subjects. Stepwise multiple linear regression analyses were adopted to calculate correlations between systemic disorders as independent variables and number of remaining teeth and the relative frequency of periodontal pockets of 5 mm or more, respectively, as the dependent variable. Results: The number of remaining teeth was significantly and positively correlated to the presence of cardiovascular disease, diabetes and rheumatoid disease after adjustment for age, sex and smoking. The relative frequency of diseased sites, however, was not significantly correlated to any one of the investigated systemic health disorders. Conclusion: No significant associations between investigated systemic disorders and periodontal disease severity were found if the relative frequency of deep periodontal pockets was used as the clinical parameter for periodontal disease severity. However, cardiovascular disease, diabetes and rheumatoid disease were found to be significantly correlated to number of lost teeth, which may represent one aspect of periodontal health. This result held true in nonsmokers only. Zusammenfassung Hintergrund: Während der letzten 10 Jahre wurden zahlreiche Studien publiziert, die auf einen Zusammenhang zwischen Parodontitis und verschiedenen systemischen Störungen und Erkrankungen hinweisen. Zielsetzung: Feststellung der Häufigkeit von selbst angegebenen systemischen Erkrankungen bei Patienten, die an eine parodontologische Spezialklinik zur Parodontitistherapie überwiesen worden waren, in einer retrospektiven Studie und Untersuchung möglicher Zusammenhänge zwischen allgemeiner Gesundheit und dem Schweregrad parodontaler Erkrankungen in dieser Bevölkerungsgruppe. Material und Methoden: Die Daten wurden aus den Behandlungsakten und Gesundheitsfragebögen von 1006 Personen gewonnen. Eine schrittweise multiple lineare Regressionsanalyse wurde verwendet, um Korrelationen zwischen systemischen Erkrankungen als unabhängigen Variablen und der Zahl verbliebener Zähne bzw. der relativen Häufigkeit parodontaler Taschen 5 mm als abhängigen Variablen zu berechnen. Ergebnisse: Nach Korrektur für Alter, Geschlecht und Rauchen war die Zahl verbliebener Zähne signifikant positiv mit Herz-Kreislauf-Erkrankungen, Diabetes und rheumatischen Erkrankungen korreliert. Die relative Häufigkeit erkrankter Stellen war allerdings mit keiner der untersuchten systemischen Erkrankungen korreliert. Schlussfolgerung: Wenn die relative Häufigkeit tiefer parodontaler Taschen als Maß für den Schweregrad parodontaler Erkrankung gewählt wurde, ließ sich keine Assoziation zwischen den untersuchten systemischen Erkrankungen und dem Parodontitisschweregrad zeigen. Allerdings waren Herz-Kreislauf-Erkrankungen, Diabetes und rheumatischen Erkrankungen signifikant mit der Zahl verlorener Zähne korreliert, die einen Aspekt parodontaler Gesundheit repräsentieren. Dieses Ergebnis ergab sich aber nur für Nichtraucher. Résumé Références et buts: Au cours des 10 dernières années, plusieurs études ont été publiées pour souligner une relation entre la maladie parodontale et diverses désordres ou maladies systémiques. Cette étude rétrospective se propose de rechercher l'apparition de désordres systémiques racontés par des patients adressés à une clinique spécialisée pour traitement parodontal et d'explorer de possibles relations entre la santé générale et la sévérité de la maladie parodontale dans cette population. Matériel et Méthodes: Les données furent récoltées des dossiers dentaires et des interrogatoires médicaux de 1006 sujets. Une analyse de régression multiple linéaire échelonnée a été utilisée pour calculer les corrélations entre les désordres systémiques en tant que variables indépendantes et le nombre de dents restantes et la fréquence relative de poches parodontales d'au moins 5mm, respectivement, comme variable dépendante. Résultats: le nombre de dents restantes était significativement et positivement corréléà la présence de maladies cardiovasculaires, de diabète et de maladie rhumatoïde après ajustement pour l'âge, le sexe, et le tabagisme. La relative fréquence de sites malades, cependant, n'était corrélée à aucun des désordres systémiques étudiés. Conclusion: Aucune association significative entre les désordres systémiques étudiés et la sévérité de la maladie parodontale ne fut trouvée lorsque la fréquence relative de poches parodontales profondes était utilisée comme paramètre clinique pour définir la sévérité de la maladie parodontale. Cependant, une maladie cardio-vasculaire, le diabète, une maladie rhumatoïde sont corrélées significativement au nombre de dents perdues qui peut être représentatif d'un aspect de santé parodontale. Ces résultats n'étaient valables que chez les non fumeurs. [source]

Clinical dental examinations of 357 donkeys in the UK.

EQUINE VETERINARY JOURNAL, Issue 4 2009
Part 2: Epidemiological studies on the potential relationships between different dental disorders, between dental disease, systemic disorders
Summary Reasons for performing study: Dental disease has been shown to be a risk factor for weight loss and colic in horses. No extensive clinical studies in donkeys have investigated the potential relationship between different dental disorders, or between dental disease and systemic disorders. Objectives: To determine possible associations between dental disease and body condition score, weight loss, the need for supplemental feeding and prevalence of colic in donkeys of all ages, and to gain a better understanding of the pathogenesis of dental disease by the determination of associations between different dental disorders. Methods: A prospective cross-sectional analysis of clinical dental examinations of 357 donkeys in The Donkey Sanctuary, Sidmouth was performed. Other epidemiological factors such as estimated age group, body condition score, weight loss, medical history and supplemental feeding were also recorded, and multiple regression analyses were performed to determine possible associations. Results: Donkeys from older age groups were more likely to have dental disease, poor body condition score and suffered previous colic episodes. The presence of dental disease was also significantly associated with weight loss, colic, low body condition score and the need for supplemental feeding. The presence of diastemata, periodontal disease, wave mouth, smooth mouth and step mouth are frequently associated with the presence of other dental disorders. Conclusions: In addition to oral-related pain, dental disease can cause significant systemic disorders and so has increased welfare implications in donkeys. Some dental disorders promote the development of other types of dental abnormalities and thus increase the severity of dental disease in individual animals. Potential significance: Effective treatment of dental disorders slows down the progression of dental disease and decreases the risk of developing some medical disorders such as colic and weight loss that are associated with dental disease. [source]

Etiology and Distribution of Headaches in Two Brazilian Primary Care Units

HEADACHE, Issue 3 2000
Marcelo E. Bigal MD
Objectives.,To determine (a) which patients seek primary care services with a complaint of headache, (b) the percentages of the various types of headache in this population, and (c) the impact of the care provided to these patients on the basic health care network. Background.,Headache is one of the most frequent symptoms reported in medical practice, resulting in significant medical services costs and loss of patient productivity, as well as reduced quality of life. Methods.,A prospective study was conducted in two towns (Ribeirão Preto and São Carlos) in the State of São Paulo, Brazil. The participants in the study consisted of 6006 patients (52.4% women) with highly varied acute symptoms. The patients ranged in age from 14 to 98 years. Results.,Headache as the main complaint was reported by 561 (9.3%) of the patients considered, with 312 (55.6%) of those patients presenting with primary headache, 221 (39.4%) with headaches secondary to systemic disorders, and 28 (5.0%) with headaches secondary to neurological disorders. Migraine, the most prevalent primary headache, accounted for 45.1% of patients reporting headache as the single symptom. The most frequent etiologies of headaches secondary to systemic disorders were fever, acute hypertension, and sinusitis. The most frequent headaches secondary to neurological disorders were posttraumatic headaches, headaches secondary to cervical disease, and expansive intracranial processes. Of the 26 cases of drug abuse, 20 were secondary to alcohol (hangover). Headaches secondary to systemic disorders were more frequent in the extreme age ranges. Conclusions.,Headache is a very frequent symptom among patients seen at primary health care units and should be considered a public health problem. The dissemination of the diagnostic criteria of the International Headache Society among primary health care physicians is urgently needed in order to avoid the repeated return of patients or their referral to more differentiated emergency units, which overburden an already insufficient health care network. [source]

Detection of endogenous lithium in neuropsychiatric disorders,a model for biological transmutation

HUMAN PSYCHOPHARMACOLOGY: CLINICAL AND EXPERIMENTAL, Issue 1 2002
Ravi Kumar Kurup
Abstract The human hypothalmus produces an endogenous membrane Na+ -K+ ATPase inhibitor, digoxin. A digoxin induced model of cellular/neuronal quantal state and perception has been described by the authors. Biological transmutation has been described in microbial systems in the quantal state. The study focuses on the plasma levels of digoxin, RBC membrane Na+ -K+ ATPase activity, plasma levels of magnesium and lithium in neuropsychiatric and systemic disorders. Inhibition of RBC membrane Na+ -K+ ATPase activity was observed in most cases along with an increase in the levels of serum digoxin and lithium and a decrease in the level of serum Mg++. The generation of endogenous lithium would obviously occur due to biological transmutation from magnesium. Digoxin and lithium together can produce added membrane Na+ -K+ ATPase inhibition. The role of membrane Na+ -K+ ATPase inhibition in the pathogenesis of neuropsychiatric and systemic disorders is discussed. The inhibition of membrane Na+ -K+ ATPase can contribute to an increase in intracellular calcium and a decrease in magnesium, which can result in a defective neurotransmitter transport mechanism, mitochondrial dysfunction and apoptosis, defective golgi body function and protein processing dysfunction, immune dysfunction and oncogenesis. Copyright © 2002 John Wiley & Sons, Ltd. [source]

Systemic disorders in patients with periodontal disease

Spontaneous nontraumatic intrasplenic pseudoaneurysm: Causes, sonographic diagnosis, and prognosis

JOURNAL OF CLINICAL ULTRASOUND, Issue 3 2003
Christian Görg MD
Abstract Purpose The aim of this study was to describe the incidence, causes, sonographic features, therapy, and prognosis of nontraumatic intrasplenic pseudoaneurysms (NTISPs), a rare complication of splenic infarction or infiltration by malignant systemic disorders or infectious diseases. Methods We retrospectively reviewed the medical and sonographic records of all patients seen at our clinic from July 1985 through December 2000 to identify patients with a sonographic diagnosis of spontaneous nontraumatic splenic rupture. We then examined the features of the resulting cases to identify patients in whom NTISPs were revealed by color Doppler sonography. Results In total, 41 patients were identified. Among those patients, 5 (12%) had NTISPs. Three of those 5 patients had an underlying malignant disorder (1 case of non-Hodgkin's lymphoma and 2 cases of chronic myelogenous leukemia), and the other 2 had an inflammatory disease (1 case of endocarditis and 1 case of pancreatitis). Three of the patients also had splenic infarctions. Three patients underwent splenectomy; in 2 of them, secondary delayed splenic rupture occurred before or during splenectomy. In 2 other patients, spontaneous thrombosis of the aneurysms occurred (after 16 hours in 1 and 15 days in the other). Conclusions NTISPs may occur in about 12% of patients with sonographically detected nontraumatic spontaneous splenic rupture. NTISPs appear to be associated with an increased risk of secondary delayed splenic rupture, although spontaneous thrombosis may occur. Short-term follow-up sonographic examinations, particularly with color Doppler imaging, are recommended for early recognition of progression of NTISPs, which can guide treatment decisions. © 2003 Wiley Periodicals, Inc. J Clin Ultrasound 31:129,134, 2003 [source]

Cutaneous gene transfer for skin and systemic diseases

JOURNAL OF INTERNAL MEDICINE, Issue 1 2002
P. A. KHAVARI
This article is partially based on the findings presented at a symposium on Cutaneous Gene Therapy, held in Uppsala, September 2001, and abstracted in Acta Derm Venereol 81: 227,239. Abstract.,Khavari PA, Rollman O, Vahlquist A (Stanford University School of Medicine, Stanford, CA, USA; and Department of Medical Sciences, Dermatology, Uppsala University, Uppsala, Sweden). Cutaneous gene transfer for skin and systemic diseases (Review). J Intern Med 2002; 252: 1,10. Recent progress in molecular genetics has illuminated the basis for a wide variety of inherited and acquired diseases. Gene therapy offers an attractive therapeutic approach capitalizing upon these new mechanistic insights. The skin is a uniquely attractive tissue site for development of new genetic therapeutic approaches both for its accessibility as well as for the large number of diseases that are amenable in principle to cutaneous gene transfer. Amongst these opportunities are primary monogenic skin diseases, chronic wounds and systemic disorders characterized by low or absent levels of circulating polypeptides. For cutaneous gene therapy to be effective, however, significant progress is required in a number of domains. Recent advances in vector design, administration, immune modulation, and regulation of gene expression have brought the field much nearer to clinical utility. [source]

Oral manifestation of chronic mucocutaneous candidiasis: seven case reports

JOURNAL OF ORAL PATHOLOGY & MEDICINE, Issue 9 2007
Xiaosong Liu
Background:, Chronic mucocutaneous candidiasis (CMC) is a rare disorder characterized by persistent or recurrent candidal infections of the skin, nails and mucous membranes or by a variable combination of endocrine failure as well as immunodeficiency. Oral clinicopathological features of CMC have seldom been described in detail. Methods:, Seven patients with CMC were reported in the study. The clinical and histological findings, etiological Candida species, immunological evaluation, and therapeutic pattern of oral lesions, were analyzed. Results:, Long-standing whitish hyperplastic and nodule-like lesions with exaggerated deep fissure were the typical and characteristic oral manifestations presented by all patients. The tongue was the most common site affected. Histologically, no obvious distinction was found between CMC and other forms of candidal infection. Abnormal proportions of T-lymphocyte subsets and positive titers of autoantibody were observed in three subjects (42.9%) and one patient (14.3%) respectively. Meanwhile, four subjects (57.1%) showed decreased albumin and increased globulin, three cases (42.9%) had high levels of ESR. But no iron deficiency was found. Candida albicans was the microorganism isolated from these patients. Conclusions:, Multiple and widespread candidal infectious lesions can be observed on the oral cavity of CMC patients. Hyperplastic and nodule-like lesion with irremovable whitish patches and deep fissure are the most common oral manifestations of these patients. Dentists, otolaryngologists and pediatricians should be familiar with the clinical appearances of CMC to make an accurate diagnosis. Potential systemic disorders should be concerned to avoid the reoccurrence of oral candidiasis. [source]

PREVALENCE AND RISK FACTORS IN CHRONIC POLYNEUROPATHY IN THE ELDERLY

JOURNAL OF THE PERIPHERAL NERVOUS SYSTEM, Issue 1 2002
E. Scarpini
The elderly are a population at high risk of polyneuropathy because there is a correlation between age and impairment of the peripheral nervous system and because the number of agents that can damage peripheral nerves, including chronic systemic disorders and neurotoxic drugs, increases with age. The Italian Longitudinal Study on Aging (ILSA), a multicenter project designed to study age-associated diseases, collected data from 8 Italian municipalities. For this study, the definition of peripheral neuropathy by P.J. Dyck (1982) was used. However, only peripheral neuropathies with distal and symmetrical involvement of lower limbs were considered. Diagnosis was articulated in two phases: Phase 1 or screening, administered to all participants. The criteria were: a) self reported diagnosis; b) presence of at least one neurological symptom; and c) presence of at least one positive test at short neurological evaluation. A validation of the screening instruments was performed. Phase 2 or clinical confirmation by a neurologist, based on: a) review of the clinical records; b) a neurological examination; c) a clinical history of the disease; and, d) when available, EMG, blood and spinal fluid examination, and a sural nerve biopsy. Three diagnostic categories were identified: possible, probable and definite DSNLL. The neuropathy was classified as definite only when confirmation by a positive EMG was available. A random sample of 5632 subjects aged 65,84 years was evaluated. A total number of 337 DSNLL were identified (possible, probable, defined). The prevalence is 6.5% (95% C.I. 5.8,7.2) in men and women; the rates by age, geographic area, and clinical severity are described, and the prevalence in the different groups of diabetic patients and non-diabetic subjects is analyzed. The prevalence obtained in our study is slightly lower than that in a similar recent multicentric study (IGPSG, 1995), but the diagnostic criteria were different. Diabetes is the most common associated disorder with the 20.8% of association, followed by toxic/drug exposure (5% of association). [source]

Review article: oral ulcers and its relevance to systemic disorders

ALIMENTARY PHARMACOLOGY & THERAPEUTICS, Issue 4 2005
S. R. Porter
Summary Oral ulceration is a common problem, and is sometimes a marker of gastroenterological disease. Patients with signs or symptoms of oral ulcers are sometimes referred to gastroenterology clinics, however, in most instances the ulcers does not reflect gastrointestinal disease. Indeed, a spectrum of disorders other than those of the gut can give rise to oral mucosal ulcers ranging from minor local trauma to significant local disease such as malignancy or systemic illness. This present article reviews aspects of the aetiology, diagnosis and management of common ulcerative disorders of the oral mucosa. [source]

The Impact of Neurodegenerative Disorders on Ageing: an Overview of the Sydney Older Persons Study

AUSTRALASIAN JOURNAL ON AGEING, Issue 1 2001
H. Creasey
This paper reviews the Sydney Older Persons Study, a longitudinal study following an initial cohort of 630 subjects aged 75 and over, community living in the inner west region of Sydney, carried out over seven years in four waves from 1991. We discuss the epidemiology of neurodegenerative disorders (NDDs) in relation to: each other, systemic disorders, death, lifestyle, risk factors and their impact on quality of life, service use and carers. [source]

Vasculitic neuropathy , electrodiagnostic findings and association with malignancies

ACTA NEUROLOGICA SCANDINAVICA, Issue 6 2007
S. A., ivkovi
Background,,, Vasculitic neuropathies occur in the context of systemic disorders or in isolation. Histopathologic evaluation remains the gold standard for diagnosis, but certain electrodiagnostic findings may heighten suspicion of vasculitic neuropathy and improve the yield of nerve and muscle biopsy. Aim of the study,,, Description of electrodiagnostic patterns associated with vasculitic neuropathies, and a report of a possible association with malignancies. Methods,,, Retrospective review of medical records of patients with histopathologically proven vasculitic and non-vasculitic axonal neuropathies evaluated at the University of Pittsburgh Medical Center from November 1995 to November 2003. Results,,, The most distinctive electrodiagnostic patterns associated with vasculitic neuropathy were mononeuritis multiplex (27.5% vs 4% in controls; P = 0.003) and axonal sensorimotor polyneuropathy with side-to-side amplitude asymmetry (50% vs 32%, P > 0.05). Additionally, six patients (15% vs 2%; P = 0.034) developed various malignancies within 2 years of onset of vasculitic neuropathy. Conclusions,,, While generalized polyneuropathy was the most common presentation of nerve vasculitis, our study affirms side-to-side amplitude asymmetry and mononeuritis multiplex as the most distinctive electrodiagnostic features. The frequent occurrence of malignancies suggests a possible association with the vasculitic neuropathy and warrants additional investigation. [source]

Systemic disease associations of familial and sporadic glaucoma: the Glaucoma Inheritance Study in Tasmania

ACTA OPHTHALMOLOGICA, Issue 1 2010
Alex W. Hewitt
Abstract. Background:, This aim of this study was to compare the prevalence of various disease-associated and potentially modifiable risk factors between people with familial and sporadic forms of primary open angle glaucoma (OAG). Methods:, A cross-sectional, retrospective study design was utilized. A detailed questionnaire enquiring about knowledge of family history, demographic data, current medications, and medical history of systemic disorders was administered. Where possible, living relatives were examined for signs of OAG. Results:, A total of 3,800 potential patients with OAG were identified, of whom 2062 were examined. One thousand twelve (59.5%) subjects were found to have familial OAG, and 688 (40.5%) subjects had no known or identified relative with OAG (sporadic glaucoma). One thousand forty-two unaffected family members examined. A past history of migraine was found more often with familial OAG (OR: 1.67 95% CI: 1.15,2.42). This effect was primarily driven by patients who had a first-degree relative also affected by OAG. Following adjustment for male gender and the age at review, the presence of atherosclerosis was also found to be more common in patients with familial glaucoma than in people with sporadic disease (OR: 1.42 95% CI: 1.05,1.92). No significant difference in the prevalence of hypertension, Raynaud's phenomenon, diabetes mellitus or thyroid disease was identified. Conclusions:, Patients with a known relative affected by OAG were statistically significantly more likely to have a past history for migraine or presence of atherosclerosis compared to people with no known affected relative. An understanding of such differences and systemic comorbidities will be useful for further work investigating the underlying molecular mechanisms of this disease. [source]

Association of exfoliation syndrome and central retinal vein occlusion: an ultrastructural analysis

ACTA OPHTHALMOLOGICA, Issue 1 2010
Robert Ritch
Abstract. Purpose:, To evaluate prospectively the frequency with which exfoliation syndrome (XFS) occurs in patients with central retinal vein occlusion (CRVO) by clinical examination and ultrastructural examination of conjunctival biopsy specimens. Methods:, Prospective observational case series. Thirty-six eyes of 36 consecutive patients with CRVO were investigated for XFS by slit-lamp examination and conjunctival biopsy when XFS was not clinically visible on examination. Results:, A clinical diagnosis of XFS or a positive biopsy result for exfoliation material (XFM) was present in 22 of the 36 patients (61%; 95% confidence interval 45,75%). Twelve of these 22 patients (54%) had a clinical diagnosis of XFS. Aggregates of XFM were identified ultrastructurally in the biopsy specimens in 10 of 24 patients with no clinical signs of XFS (42%). Patients with and without XFS had similar distribution of age, gender, race and prevalence of systemic disorders. Twelve of the 22 (54%) XFS patients had neither glaucoma nor ocular hypertension prior to the CRVO. Conclusion:, In accordance with previous retrospective and histological studies, this prospective, in vivo study suggests that CRVO is commonly associated with XFS. [source]

Choroidal Langerhans' cell histiocytosis

ACTA OPHTHALMOLOGICA, Issue 1 2000
In Taek Kim
ABSTRACT. Purpose: To report a patient with choroidal Langerhans' cell histiocytosis. Methods: A solitary tumor was found in the left eye of a 49-year-old male who had no definite history of systemic disorders, but had observed visual disturbances for a period of 1 month. Ultrasonography, fluorescein angiography, and indocyanine green angiography were performed and the eyeball was enucleated. We prepared the specimen for microscopic examinations. Results: Fluorescein angiographic findings of the lesion were mottled hyperfluorescence in the arteriovenous phase and strong hyperfluorescence in the late phase. Hypofluorescence in both early and late phases showed on indocyanine green angiogram. The lesion of choroid was widely infiltrated by histiocytes, though no extraocular invasion was found. Immunohistochemical studies including S-100 and CD 68 staining revealed characteristic features of Langerhans' cell histiocytosis. Electron microscopic examination of the histiocytes showed histiocytosis X body (Birbeck granule) in the cytoplasm and indented nucleus. Conclusion: We consider that this is a case of choroidal Langerhans' cell histiocytosis with no evidence of systemic lesions. [source]

An unusually extensive case of cutaneous anthrax in a patient with type II diabetes mellitus

CLINICAL & EXPERIMENTAL DERMATOLOGY, Issue 6 2005
E. Erkek
Summary Naturally acquired anthrax infection remains an important public-health problem in developing countries. Turkey is one of the countries in which the zoonotic form of anthrax may still be encountered. The most frequent portal of entry for anthrax spores is the skin. Although cutaneous anthrax is usually self-limiting, complications may arise in untreated cases. Underlying systemic disorders such as diabetes mellitus may confound the clinical picture and lead to atypical presentations. We present an unusually extensive case of cutaneous anthrax in a patient with newly diagnosed diabetes mellitus. [source]