Edema and gingival bleeding in anterior region have a negative influence on quality of life of adolescents

Abstract The aim of the present study was to verify if clinical signs of gingivitis such as color changes, edema, and bleeding in the anterior region influence the OHRQoL of adolescents. We followed a cross-sectional convenience sample of 67 adolescents aged 11 to 16 years receiving dental treatment at the Federal University of Santa Maria (UFSM), in southern Brazil. The participants were evaluated for the following clinical variables: edema, gingival color alteration, and marginal bleeding of the gingival tissues, collected at 6 sites per tooth in the anterior region of the mouth. Socioeconomic variables were collected through questionnaires and OHRQoL was evaluated through the Brazilian version of the Children Perception Questionnaire (CPQ 11-14) short form. A Poisson regression model was used to verify associations between clinical variables and general CPQ11-14 scores. In the unadjusted analysis, edema, color alterations, and marginal bleeding in the anterior region were associated with worse scores of OHRQoL. Edema and marginal bleeding remained associated after adjusting for clinical and sociodemographic variables. Adolescents with higher levels of marginal bleeding and edema in the anterior region had higher mean CPQ11-14 scores. Therefore, the presence of bleeding and gingival edema in the anterior region can be considered clinical signs of gingivitis that are associated with a worse OHRQoL in adolescents.

Does administering albumin to postoperative gastroschisis patients improve outcome?

OBJECTIVES: Newborns who undergo surgery for gastroschisis correction may present with oliguria, anasarca, prolonged postoperative ileus, and infection. New postoperative therapeutic procedures were tested with the objective of improving postoperative outcome. PATIENTS AND METHODS: One hundred thirty-six newborns participated in one of two phases. Newborns in the first phase received infusions of large volumes of crystalloid solution and integral enteral formula, and newborns in the second phase received crystalloid solutions in smaller volumes, with albumin solution infusion when necessary and the late introduction of a semi-elemental diet. The studied variables were serum sodium and albumin levels, the need for albumin solution expansion, the occurrence of anasarca, the length of time on parenteral nutrition, the length of time before initiating an enteral diet and reaching a full enteral diet, orotracheal intubation time, length of hospitalization, and survival rates. RESULTS: Serum sodium levels were higher in newborns in the second phase. There was a correlation between low serum sodium levels and orotracheal intubation time; additionally, low serum albumin levels correlated with the length of time before the initiation of an oral diet and the time until a full enteral diet was reached. However, the discharge weights of newborns in the second phase were higher than in the first phase. The other studied variables, including survival rates (83.4 percent and 92.0 percent, respectively), were similar for both phases. CONCLUSIONS: The administration of an albumin solution to newborns in the early postoperative period following gastroschisis repair increased their low serum sodium levels but did not improve the final outcome. The introduction of a semi-elemental diet promoted an increase in body weight at the time of discharge.

The Prevalence of Yersinia Infection in Adult Patients with Acute Right Lower Quadrant Pain / 대한소화기학회지

BACKGROUND/AIMS: Clinical manifestations of intestinal yersiniosis include enterocolitis, mesenteric adenitis, and terminal ileitis presenting with fever, right lower quadrant pain, and leukocytosis. According to a previous Korean study in 1997, Yersinia was revealed in two among 15 adult patients with mesenteric adenitis (13%). However, recent reports on the prevalence of Yersinia infection in adult patients are few. The aim of this study was to investigate the prevalence of Yersinia infection in adult patients with acute right lower quadrant pain. METHODS: Adult patients (>18 years) who visited Eulji medical center, due to acute right lower quadrant pain were enrolled prospectively from December 2007 to July 2009. Abdominal CT, stool culture, serologic test for Yersinia, and Widal test were performed. RESULTS: Among 115 patients, 5 patients were excluded due to positive Widal test or salmonella culture. In 110 patients, abdominal CT showed right colitis in 20 (18.2%), terminal ileitis in 16 (14.5%), mesenteric adenitis in 13 (11.8%), acute appendicitis in 10 (9.1%), acute diverticulitis in 7 (6.4%), non specific mucosal edema in 36 (32.7%) and no specific lesion in 8 (7.3%). Two (1.8%) of the 110 patients had antibodies to Yersinia. One patient showed acute enteritis and the other patient was diagnosed with acute appendicitis and underwent appendectomy. No Yersinia species were grown on stool or tissue culture. CONCLUSIONS: Nowadays, among adult Korean patients presenting with acute right lower quadrant pain, there have been few incidences of Yersinia infection.

Insuficiência cardíaca com fração de ejeção preservada e com disfunção sistólica na comunidade / Heart failure with preserved ejection fraction and systolic dysfunction in the community

FUNDAMENTO: Em países desenvolvidos, a insuficiência cardíaca com fração de ejeção preservada (ICFEP) é o modelo mais prevalente que a insuficiência cardíaca com disfunção sistólica (ICDS) na comunidade. No entanto, não está plenamente estabelecido se tal fato também é observado na nossa comunidade. OBJETIVO: Determinar o tipo mais prevalente de insuficiência cardíaca (ICFEP ou ICDS) e se a prevalência de ICFEP é elevada na comunidade. MÉTODOS: Estudo transversal de pacientes atendidos na comunidade com diagnóstico clínico de IC, de janeiro a dezembro de 2005. O ecodopplercardiograma foi realizado em todos os pacientes. O tipo de IC foi estratificado pela presença de anormalidades e pela fração de encurtamento ao ecodopplercardiograma. RESULTADOS: O estudo avaliou 170 pacientes (61,0±13,3 anos), a maioria mulheres e idosos. A ICFEP foi o tipo de IC mais prevalente (64,2 por cento, p<0,001) com tendência nas mulheres idosas (62 por cento, p=0,07), e o inverso na ICDS, nos homens idosos (63,6 por cento, p=0,07). Os pacientes sem IC representaram um terço dos casos (27,6 por cento). A ICDS apresentou mais edema de membros inferiores, doença coronariana, diabete, insuficiência renal crônica, re-internações e maior escore de Boston. O etilismo e o tabagismo estiveram mais presentes na ICDS. CONCLUSÃO: A ICFEP é o tipo de IC mais prevalente na comunidade, principalmente nas mulheres idosas, enquanto a ICDS, nos homens idosos, com maior gravidade clínica e acometimento dos principais fatores de risco e sem modificação nos hábitos de vida. Apesar dos sinais e dos sintomas de IC, em um terço dos casos a IC não foi confirmada.

BACKGROUND: In developed countries, heart failure with preserved ejection fraction (HFpEF) is more prevalent than heart failure with reduced ejection fraction (HFrEF) in the community. However, it has not been completely established if this fact is also observed within our community. OBJECTIVE: To determine the most prevalent form of heart failure (HFpEF or HFrEF) and whether the prevalence of HFpEF is higher in the community. METHODS: This is a cross-sectional study conducted with patients clinically diagnosed with HF who were seen in community-based health care centers from January to December 2005. Echodopplercardiograms were performed for all patients. The form of HF was stratified according to the presence of abnormalities and the shortening fraction observed on the echodopplercardiogram. RESULTS: The study evaluated 170 patients (61.0 ± 13.3 years of age), most of them women and elderly. HFpEF was the more prevalent form of HF (64.2 percent, p<0.001), affecting mostly elderly women (62 percent, p = 0.07), whereas the opposite condition, HFrEF, was observed mostly in elderly men (63.6 percent, p = 0.07). Patients with no HF represented one-third of the cases (27.6 percent). HFrEF patients had more lower-limb edema, coronary disease, diabetes, chronic renal failure, higher Boston scores and hospital readmissions. Use of alcoholic beverages and smoking were also more common among HFrEF patients. CONCLUSION: HFpEF is the most prevalent form of HF in the community especially among elderly women, whereas HFrEF affects mostly elderly men and is associated with greater clinical severity, main risk factors and no changes in lifestyle. Despite the signs and symptoms of HF, this condition was not confirmed for one-third of the cases.

Epidemic dropsy in Andhra Pradesh due to contaminated ghee.

An outbreak of epidemic dropsy in Andhra Pradesh was studied during August to September 1987. Thirty cases from 6 families were identified and examined. Ghee and one oil sample were found to be contaminated with the toxic compound sanguinarine. The affected families had purchased ghee from one vendor. The epidemic ended after alerting the villagers of the contaminated ghee, and stopping its further use.