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Effect of Smoking on Periodontal Clinical Parameters in Patients with Periodontitis
No full textRelevance of the problem and aim of the work. Periodontitis is a widespread disease in Lithuanian population and worldwide. Many factors contribute to the onset and progression of this disease. One of them is smoking. The aim of this study was to perform a cross-sectional clinical study to evaluate the effect of smoking on periodontal clinical parameters (probing depth, bleeding on probing, plaque index) in general and at different stages of periodontitis. Material and the methods. A cross-sectional clinical study was performed on the patients who arrived to the Department of Dental and Oral Pathology of the Hospital of Lithuanian University of Health Sciences Kauno klinikos for periodontal treatment over the period from 2018 May 1 until 2019 June 1. Patients were grouped as follows: i) by smoking habit and ii) by smoking habit and stage of periodontitis. The periodontal clinical parameters were compared between the groups, as well as the intra-oral distribution of probing pocket depth was evaluated. Results. A total of 77 patients with III-IV stage of periodontitis were included in the study (26 smokers and 51 non-smokers). The comparison of probing pocket depth of smoking and non-smoking patients revealed a statistically significant difference with on average 0.8 mm higher probing pocket depth of smoking patients than that of non-smokers. Smoking patients also had a statistically significantly higher plaque index, however bleeding on probing did not differ statistically significantly between the groups. The greatest negative impact of smoking was assessed in the following periodontal areas: palatal surfaces of maxillary anterior teeth, buccal surfaces of mandibular anterior teeth, lingual surfaces of maxillary premolars and molars. If in addition to smoking habit periodontitis stage is considered, the comparison of probing pocket depth of smoking and non-smoking patients revealed that differences are bigger for periodontitis stage III rather than stage IV patients. In the case of periodontitis stage III the greatest negative impact of smoking is on those intra-oral areas that are closest to cigarette smoke stream during smoking, whereas in the case of stage IV the impact of smoking on different intra-oral areas is not so much significant. Conclusions. Smoking has a negative effect on probing pocket depth and plaque index in patients with periodontitis stage III and IV. Moreover, smoking effect on probing pocket depth is higher for periodontitis stage III rather than stage IV patients. The greatest negative impact of smoking is on those intra-oral areas that are closest to cigarette smoke stream during smoking
Balance, Fall Risk and Risk Factor's Evaluation Among the Patient’s In Geriatric Unit
No full textAuthor: Tautvydas Joteika Title: Balance, Fall Risk And Risk Factor's Evaluation Among The Patient’s In Geriatric Unit Aim: To determine the relationships between patient balance, fall risk, and risk factors in the geriatric ward. Objectives: 1. To assess patients’ falls, fall risks and balance in the geriatric ward. 2. To determine the association between patients’ diseases, drug use, fall risks and balance in the geriatric ward. 3. To determine the association between patients’ geriatric syndromes, functional status, risks of cognitive functions and falls, balance in the geriatric ward. Methods: Patients of the Geriatrics Ward of Kaunas Clinical Hospital (KKL) were interviewed using a patient‘s questionnaire developed by the authors and standardized tests ("Stand up and Go", "Tandem Romberg test" (sharpened Romberg sample)) to assess the risk of falls and balance. The patients’ medical data was taken and analyzed from medical records (Form No. 003 / a), medication prescription sheets (Form No. 003-4 / a) and standardized tests. Patients’ functional status (Barthel index), cognitive functions (TPBT/ MMSE), medical diagnoses (according to ICD), geriatric syndromes and prescribed medications, evaluating the polypharmacy degree according to Veehof, were analyzed. The statistical data analysis was performed with IBM SPSS statistics 26.0. Descriptive statistics were performed and dependence of traits and the connection strength between them were evaluated. The data is statistically significant when the level of significance is p≤ 0.05. Participants: The patients of KKL Geriatrics Ward. Results: 270 patients were studied, males - 33%, females - 67%, the mean patients’ age were 80,83 ± 7,8 y.. Falls risk were evaluated using "Stand up and Go" test - 46,3% of the patient’s had high risk of falling, 30% - average, 23,7% - low risk. Falls risk and balance were evaluated using "Tandem Romberg test"- 73% of respondents had increased risk of falling and worsening balance, 27% - didn‘t have. There was statistically significant increase of risk and frequency (according to both tests) of falls in elderly patients (p<0,001, respectively). Patients, who had experienced falls during the last 12 months, had statistically significant increased risk of falls . The risks of falling were statistically significantly higher in women than in men, when the patients were tested for the risk of falls and the balance using "Tandem Romberg test" (p=0,001). There was statistically significant increased risk of falling in patients with eye, its accessory organ‘s, connective tissue and musculoskeletal system diseases (according to "Stand up and Go" test, p=0,041, p=0,027, respectively) and diseases of the circulatory system (according to "Tandem Romberg test", p=0,007). Any use of these drugs (calcium channel blockers, antipsychotics, antiparkinsonian and antiarrhythmics, p=0,039, p=0,037, p=0,028, p=0,030, respectively) and polypharmacy statistically significant increased patients‘ falling risks 6 (p=0,028). Patients with worsening cognitive functions and functional status, had statistically significant higher risk of falling (p<0,001, p<0,001, respectively). Higher risk of falling occurred in patients, who have been diagnosed with: urine, fecal incontinence, dementia, dizziness, malnutrition, depression, sleeping disorders. Patients who used wide range of mobility aids had statistically significant increased risk and frequency of falls (p<0,001). Conclusions: 1. Most geriatric patients had average or high risk of falling and disturbed balance. Higher risk of falling and frequency occurred in elderly patients and those, who experienced falls in the last 12 months. Females had higher risk of falling than males. 2. Patients with eye‘s and its accessory organs, connective tissue and musculoskeletal system, circulatory system diseases had higher risk of falling and disturbed balance more frequently in geriatric ward. Geriatric patients, who were treated with calcium channel blockers, antipsychotics, antiparkinsonian and antiarrhythmic drugs and those, who used 5 or more drugs, had increased risk of falling. Risk of falling and disturbed balance were associated with circulatory system diseases and usage of antipsychotic drugs, and proton pump inhibitors. 3. Patients with high risk of falling had been diagnosed with geriatric syndromes more often: urinary, fecal incontinence, dementia, dizziness, malnutrition, depression, sleeping disorder, - and they used mobility aids more often. High risk of falling and disturbed balance were associated with impaired cognitive functions and functional status. Practical recommendations: 1. When performing a comprehensive geriatric examination of a patient in a hospital, it is important to assess risk of falls. 2. Explain the importance of the movement function to the patient and his relatives with the help of team members: physiotherapists, occupational therapists and nurses. 3. When discharging a patient from the hospital, a memorandum “Fall Risk Factors” has to be prepared and recommended. 4. Provide/ recommend a safe environment to prevent falls in the geriatric ward and the patient's home
Intestinal Intussusception In Children: Peculiarities Of Ultrasound Diagnostics
No full textPurpose: To identify the characteristics of ultrasound in cases of children intussusception. Task: 1. To identify the age, sex and the types of intussusception in children that were hospitalized due to intussusception. 2. To determine the most common ultrasound characteristics of children with intussusception. 3. To compare the characteristics of ultrasound and X-ray in children with intussusception. 4. To identify the most relevant ultrasound changes of intussusception and compare it with tactics of the treatment. 5. To compare the characteristics of ultrasound in children intussusception with other authors. Methods: Retrospective research method was applied in LSMU Children surgery clinic. All children who were treated from the intussusception in LSMU Children Surgery Clinic from 1st of January 2017 until 31st of December 2019 were selected for this research. The ages of the patients were between 0 and 18 years old. Results: The study included 92 children with intestinal intussusception. Most of them (69,57%) were boys, the average age was 3 years. The most common diagnosis was ileocolic intussusception. The total number of ultrasonography was 205 (all the patients undergo ultrasonography examination at least once). “Target” symptom was found 93 (81,58%) times and it was statistically significant (p<0,05) in different types of intussusception. The intraperitoneal fluid was found 64 times, enlarged mesenteric lymph nodes – 112 times. Ultrasound sensitivity was 98,84% and specificity was 75,63%. The tactics of the treatment were monitoring (30,43%), disinvagination with a control of X-ray (60,87%) or surgery (8,7%). All the cases of surgical treatment were performed after unsuccessful disinvagination with a control of X-ray. Conclusions: 1) 92 children that were hospitalized to LSMUL KK due to intestinal intussusception, boys were dominating, the average age was 3 years old and the most common type of intussusception was ileocolic. 2) The most common characteristics of intussusception found in ultrasound were “target” sign, intraperitoneal fluid and enlarged mesenteric lymph nodes. 3) US was used to diagnose and monitor patients with a diagnosis of intestinal intussusception. Roentgenology was performed as a form of management: using air or contrast to reduce an intussusception. 4) After a confirmed diagnosis of intestinal intussusception (e.g., finding of “target” sign) patients were monitored, disinvagination with a control of X-ray was performed or, if disinvagination was unsuccessful, patients undergo the surgery. 5) The sensitivity of ultrasound in children with intussusception that was treated at LSMUL KK was similar to other authors results, although the specificity of ultrasound was lower
Comparative analysis of the treatment methods of myofascial pain syndrome in the area of head and neck. A systematic review
No full textRelevance of the problem and aim of the work. Myofascial pain syndrome is an important health problem that affects more than three quarters of the population during their lifetime. This condition reduces functional status of musculoskeletal system and the quality of life [2]. Pathogenic trigger points often develop near traumatized, overloaded or overstressed muscle fibers and usually are the cause of spontaneous pain, as well as provoked pain. All the central nervous system is irritated during these pain paroxysms, especially the gray matter of the brain [3, 7]. Therefore, the main aim of this work is to evaluate and suggest the most effective and optimal treatment methods of myofascial pain syndrome in the area of head and neck. Materials and methods. This systematic review was conducted according to PRISMA criteria [8]. Information about clinical trials was found on PubMed/Medline and ScienceDirect. There was selected 25 articles studying the effectiveness of the treatment methods of myofascial pain syndrome. Results. There were evaluated a total of 17 pain management methods. All of them showed statistically significant results in reducing the intensity of the pain. But the ones with the biggest change in the area of head were: regional nerve block (a reduction mean of 6.40 scores in the ten-point Gracely scale) and a combination of occlusal appliance with intraoral drug (a reduction mean of 4.00 scores in the ten-point VAS scale). The ones with the biggest change in the area of neck were: topically applied drug (a reduction mean of 4.0525 VAS scores) and electrical stimulation (a reduction mean of 3.855 VAS scores). The methods that performed at the lowest rates were: the combination of occlusal appliance with dry needling (a reduction mean of 1.50 VAS scores) in the area of head and dry needling (a reduction mean of 1.325 VAS scores) in the area of neck. Conclusions. The most effective treatment methods in the area of head are regional nerve block (with a local anesthetic) or a combination of occlusal appliance (splint) and nonsteroidal anti-inflammatory drug (nimesulide). The most effective treatment methods in the area of neck are topically applied drugs (hot herbal compresses, lidocaine patches or topical diclofenac) or electrical stimulation (Transcutaneous Electrical Nerve Stimulation). It is ideal to choose the most effective treatment techniques for a long-term pain
Is there a connection between IL1RAP rs4624606, IL1RL1 rs1041973 polymorphisms and predisposition to optic neuritis?
No full textIntroduction: Acute optic neuritis (ON) is an inflammatory disease of the optic nerve, which typicaly presents with subacute monocular visual loss and is one of the most common neurological optic nerve conditions that affects young adults. Both IL1RAP and IL1RL1 play an important role in IL33/ST2 signaling pathway which is important in inflammatory processes. Since IL1RAP rs4624606 and IL-1RL1 rs1041973 polymorphisms are located at the promoter regions of IL1RAP and IL1RL1 genes, they are critical in the expression of these genes. Aim: To evaluate the connection between IL1RAP rs4624606, IL1RL1 rs1041973 polymorphisms and development of ON. Methods: Our study was conducted in the Department of Ophthalmology and Institute of Neuroscience of Lithuanian University of Health Sciences. Patients with an acute ON episode and healthy control (HC) subjects were included in the study. DNA extraction was performed from the venous blood of ON patient and HC groups. Genotyping of IL1RAP rs4624606, IL1RL1 rs1041973 was performed using RT-PCR. SNPs were determined using TaqMan® Genotyping assays. Results: Case control association analysis on 80 ON patients and 146 HC subjects was performed. It was observed that the IL1RL1 rs1041973 A/C genotype was associated with a 1.8-fold increase of ON development under the overdominant (p=0.04) model. ILRAP rs4624606 genotype variations did not show any significantly higher odds of developing ON. Conclusions: Our study results revealed that IL1RL1 rs1041973 A/C genotype was associated with 1.8-fold increased risk of developing ON compared to the HC group
Quantification of endogenous brain tissue displacement imaging by radiofrequency ultrasound
No full textThe purpose of this paper is a quantification of displacement parameters used in the imaging of brain tissue endogenous motion using ultrasonic radiofrequency (RF) signals. In a preclinical study, an ultrasonic diagnostic system with RF output was equipped with dedicated signal processing software and subject head-ultrasonic transducer stabilization. This allowed the use of RF scanning frames for the calculation of micrometer-range displacements, excluding sonographer-induced motions. Analysis of quantitative displacement estimates in dynamical phantom experiments showed that displacements of 55 µm down to 2 µm were quantified as confident according to Pearson correlation between signal fragments (minimum p ≤ 0.001). The same algorithm and scanning hardware were used in experiments and clinical imaging which allows translating phantom results to Alzheimer's disease patients and healthy elderly subjects as examples. The confident quantitative displacement waveforms of six in vivo heart-cycle episodes ranged from 8 µm up to 263 µm (Pearson correlation p ≤ 0.01). Displacement time sequences showed promising possibilities to evaluate the morphology of endogenous displacement signals at each point of the scanning plane, while displacement maps-regional distribution of displacement parameters-were essential for tissue characterization
The analysis of the skin changes due to the influence of the hypothyroidism in canines in small animals clinic “X”
No full textHypothyroidism is a clinical syndrome cause of thyroid hormone deficiency. It is one of the most common endocrinopathies in dogs, which are the main symptoms – skin lesions. Hypothyroidism does not exhibit specific symptoms therefore they are easy to mix with other diseases with similar skin lesions. The purpose of this thesis is to evaluate the influence of hypothyroidism on the development of canine skin lesions, to analyze the symptoms of this disease and discuss possible methods of diagnosis and treatments. The research was performed in small animal clinic \"X” in 2019 years. All patients with skin problems (n = 311) who were brought to clinic been analyzed during 01.01.2017 – 07.09.2019 period by giving special attention to patients with suspected hypothyroidism (n=65). Of the 65 patients with suspected hypothyroidism, 39 of them were diagnosed of this disease. More detailed studies performed for those canines: anamnesis, clinical symptoms, age, gender, thyroid hormone concentration in blood serum. Analysis of the results of thyroid hormone tests in patients and their comparison with clinical manifestations. The most common clinical symptom of hypothyroidism associated with skin lesions is symmetrical alopecia (82,05 %) (p=0,005, HR = 1,124). Less common signs are hyperpigmentation (51,28%), dry skin (53,85%), sensitive /itchy skin (46,15%), easy hairs plucking from damaged areas (46,15%). Hypothyroidism is most commonly diagnosed in dogs older than 7 years (p >0,05). No gender predisposition. The most common breed who is sick – french bulldog (15,38 proc.). (p>0,05) T4 and fT4 levels reduction were observed in blood serum. T4 (average 0,444 0,17 ng/ml.) in 84,6% of dogs, fT4 (0,416 0,24 ng/dl) in 89,7% of dogs. TT3 was found to be within normal limits in most dogs (average 1,495 0,71 µg/dl). Only 12 of them were slightly below the normal range (30,1%), that is why thyroxine is not a valid indicator for the diagnosis of hypothyroidism
Ultrasonography results of dogs with diarrhea
No full textThe aim of the study was to detect structural lesions in dogs with acute and chronic diarrhea by ultrasound. The study was conducted in 2018 - 2019 in “X” Small Animal Clinic. 30 dogs with diarrhea were enrolled in this study, of which 20 had acute diarrhea and 10 had chronic diarrhea. Subjects were grouped by breed, age, diet type and weight. Pet owners were interviewed for the type of diet and duration of diarrhea they experienced. Dogs underwent a complete blood count test. Ultrasound was used to evaluate duodenum, jejunum, colon wall thickness and its layers. The echograms also assessed the echogenicity and structural changes of the gut wall layers. Acute and chronic diarrhea were commonly found in small breed dogs. Acute diarrhea was most common in 4 - 8 years old dogs and chronic in 11 - 18 years old dogs. Dogs who were fed dry commercial foods were more likely to develop acute diarrhea. Chronic diarrhea was more common in dogs who were fed dry commercial foods and mixed foods. Hyperechogenic bands were detected in the duodenal mucosa of five dogs weighing up to 15 kg. Of those, 3 patients developed chronic diarrhea. All dogs with acute and chronic diarrhea had a greater thickness of intestinal wall and layers than healthy dogs. There was no significant difference in the thickness of the duodenal, jejunum and colon walls of dogs who were fed dry commercial foods and mixed foods (p>0.05). Moderate positive correlations were found between WBC count and duodenal wall and mucosal thickness (r=0.601, r=0.601, p=0.001)
Canine blood transfusion. The recipient‘s blood morphology changes after blood transfusion
No full textDog blood transfusion – a procedure that is often performed in veterinary clinics. In many cases, this procedure is inseparable from the clinical practice with animals, that is why it is important to not only understand in what kind of cases it is performed, but also it is important to know what kind of morphological blood changes we can expect after blood transfusion procedures. In this research, we analyzed how dogs‘blood morphology changed after one and three days after blood transfusion procedure. Blood morphology tests were performed with Mindray Vet 2800 analyzer and the collected data was analyzed with „Microsoft Excel 2013“and „SPPS for Windows“statistical analyze programs. This study is provided with data about 25 dogs‘blood morphology changes, to which was performed hemotransfusion, that was monitored in „X veterinary clinic“during 2018 year October until 2019 year May. After one day after the procedure, the blood sample was taken from the dogs that survived the procedure, and we found out that there was significant rise of erythrocytes, hemoglobin, hematocrit and less significant rise of leucocytes and trombocrit count in the blood. The third day after the procedure, it is noticeable that count of leucocytes is getting lower but level of erythrocytes, hemoglobin, hematocrit and trombocrit is steadily increasing. The biggest part of the hemotransfusions was performed to the dogs that were infected with babesiosis (72 % of the total amount of the patients that blood transfusion was performed), also for the dogs that were intoxicated with second generation indirect exposure anticoagulants (bromadiolon, all 20 % of the patients that blood transfusions was performed). For the internal bleeding that was caused by the other etiology (spleen ruptures after car accidents, uterine horns’ bleeding during the surgery, and multiple traumas after falling down from high height) the hemotransfusion was performed for 8 % of the dogs, that were treated with performed blood transfusion
Primary prevention of cardiovascular risk in Lithuania – results from EUROASPIRE V survey
No full textBackground and Objectives: Cardiovascular disease (CVD) prevention guidelines define targets for lifestyle and risk factors for patients at high risk of developing CVD. We assessed the control of these factors, as well as CVD risk perception in patients enrolled into the primary care arm of the European Action on Secondary and Primary Prevention by Intervention to Reduce Events (EUROASPIRE V) survey in Lithuania. Materials and Methods: Data were collected as the part of the EUROASPIRE V survey, a multicenter, prospective, cross-sectional observational study. Adults without a documented CVD who had been prescribed antihypertensive medicines and/or lipid-lowering medicines and/or treatment for diabetes (diet and/oral antidiabetic medicines and/or insulin) were eligible for the survey. Data were collected through the review of medical records, patients’ interview, physical examination and laboratory tests. Results: A total of 201 patients were enrolled. Very few patients reached targets for low-density lipoprotein cholesterol (LDL-C) (4.5%), waist circumference (17.4%) and body mass index (15.4%). Only 31% of very high CVD risk patients and 52% of high-risk patients used statins. Blood pressure target was achieved by 115 (57.2%) patients. Only 21.7% of patients at very high actual CVD risk and 27% patients at high risk correctly estimated their risk. Of patients at moderate actual CVD risk, 37.5% patients accurately self-assessed the risk. About 60%–80% of patients reported efforts to reduce the intake of sugar, salt or alcohol; more than 70% of patients were current nonsmokers. Only a third of patients reported weight reduction efforts (33.3%) or regular physical activity (27.4%). Conclusions: The control of cardiovascular risk factors in a selected group of primary prevention patients was unsatisfactory, especially in terms of LDL-C level and body weight parameters. [...]