RESUMO
Severe periodontitis is a risk factor for poor glycemic control. The appropriate medicaltreatment and plaque control of periodontitis positively affects blood-sugar control in diabetespatients. We aimed to identify the factors associated with glycemic control and examine theperiodontal treatment (PT) experience and oral health-related quality of life (OHQoL) for patientswith poor glycemic control in type 2 diabetes mellitus (T2DM). This multicenter case-control studyrecruited 242 patients with poor glycemic control and 198 patients with good glycemic control. Wecollected patients' information through face-to-face interviews using a structured questionnaire.The Oral Health Impact Profile-14 (OHIP-14) was used to measure OHQoL. Based on PT status, thepatients were classified into three groups: a non-periodontal disease group, a PT group, and a non-PT (NPT) group. Regression models were used to analyze the data. No interdental cleaning(adjusted odds ratio (aOR) = 1.78) and positive attitudes toward periodontal health (aOR = 1.11)were significantly more likely to be associated with poor glycemic control in patients with T2DM.The PT group had a significantly lower OHIP-14 score than the NPT group (6.05 vs. 9.02, p < 0.001),indicating a better OHQoL among patients with poorly controlled T2DM. However, the OHQoLdid not differ significantly in patients with well-controlled T2DM between the PT and NPT groups.This suggested that diabetic patients with poor glycemic control must improve periodontal carepractices and receive proper PT, if necessary, to improve their OHQoL.
Assuntos
Assistência Odontológica/métodos , Diabetes Mellitus Tipo 2/epidemiologia , Diabetes Mellitus Tipo 2/psicologia , Periodontite/epidemiologia , Periodontite/psicologia , Qualidade de Vida , Adulto , Glicemia , Estudos de Casos e Controles , Feminino , Humanos , Entrevistas como Assunto , Masculino , Pessoa de Meia-Idade , Saúde Bucal , Periodontite/terapia , Fatores de Risco , Índice de Gravidade de DoençaRESUMO
BACKGROUND: Obstructive sleep apnea (OSA) is associated with systemic inflammation and induces various comorbid medical diseases. To date, no study has explored the relationship between OSA and atopic dermatitis (AD), an inflammatory and autoimmune skin disorder. This study investigated the longitudinal risk for AD in patients with OSA. METHODS: A random sample of 1,000,000 individuals from Taiwan's National Health Insurance database was collected. From this sample, 1222 patients with newly-diagnosed OSA between 2000 and 2005 were identified and compared with a matched cohort of 18330 patients without OSA. All patients were tracked for 5.5 years from the index date in order to identify which patients subsequently developed AD. RESULTS: During the 5.5-year follow-up period, the incidence rates of AD in the OSA cohort and comparison groups were 9.81 and 6.21 per 1000 person-years, respectively. After adjustment for age, gender, diabetes, hypertension, coronary heart disease, obesity, allergy, allergic rhinitis, asthma, monthly income, and geographic location, patients with OSA were 1.5-times more likely to develop AD than patients without OSA (95% CI = 1.15-1.95, p = 0.0025). The hazard risk for AD was greater in male OSA patients and young OSA patients (0-18 and 19-34 years), adjusted HRs being 1.53 (95% CI = 1.14-2.06, p = 0.005), 4.01(95% CI = 1.57-10.26, p = 0.0038) and 1.75(95% CI = 1.00-3.04, p = 0.0483), respectively. The log-rank test indicated that OSA patients <35-years-old had significantly higher cumulative incidence rates of AD than those patient of the same age in the comparison group (p = 0.0001). CONCLUSION: Patients with OSA, especially male patients and younger patients, are at an increased risk for AD later in life.
Assuntos
Dermatite Atópica/etiologia , Apneia Obstrutiva do Sono/complicações , Adolescente , Adulto , Estudos de Casos e Controles , Criança , Pré-Escolar , Comorbidade , Dermatite Atópica/epidemiologia , Humanos , Incidência , Lactente , Recém-Nascido , Masculino , Pessoa de Meia-Idade , Risco , Apneia Obstrutiva do Sono/epidemiologia , Taiwan/epidemiologiaAssuntos
Lipomatose Simétrica Múltipla/tratamento farmacológico , Colesterol/sangue , Complicações do Diabetes/tratamento farmacológico , Complicações do Diabetes/etiologia , Dislipidemias/tratamento farmacológico , Dislipidemias/etiologia , Humanos , Inibidores de Hidroximetilglutaril-CoA Redutases/uso terapêutico , Hipoglicemiantes/uso terapêutico , Insulina/uso terapêutico , Lipomatose Simétrica Múltipla/complicações , Lipomatose Simétrica Múltipla/diagnóstico , Lipoproteínas HDL/sangue , Lipoproteínas LDL/sangue , Imageamento por Ressonância Magnética , Masculino , Pessoa de Meia-IdadeRESUMO
Diabetic muscle infarction (DMI) is a rare complication that often exists in long-standing diabetic patients. Clinically, it presents with pain, swelling and sometimes a palpable mass, and is often misdiagnosed as soft tissue infection. The athogenesis of DMI is uncertain. We present the case of a type 2 diabetic patient with liver cirrhosis who was diagnosed with muscle infarction after being treated with terlipressin for gastrointestinal bleeding. This 45-year-old male complained of increasing pain in his right posterior thigh after treatment with terlipressin for 2 days. He was initially diagnosed with soft tissue infection, but he responded poorly to antibiotic treatment. Magnetic resonance imaging suggested acute muscle infarction. We performed a muscle biopsy and the pathologist reported that the muscle was necrotic. After 5 days of bed rest, the patient was able to walk and was discharged uneventfully.
