Poor Dentition Research Articles

Oral Cavity Cancer Secondary to Dental Trauma: A Scoping Review.

(1) Background: Oral cavity cancer represents the most common site of origin of head and neck mucosal malignancies. A few limited studies have suggested that chronic irritation, particularly in non-healing ulcers, and fibrotic tissue from poor dentition or ill-fitting dentures had a role in developing mouth cancer. This scoping review aims to evaluate the existing evidence concerning Oral Cavicty Cancer (OCC) in non-smokers/non-drinkers and the relationship with dental trauma. (2) Methods: A scoping review of the PubMed, Embase, and Web of Science databases was completed in adherence with the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews checklist. (3) Results: Of the 33 articles that met inclusion, in 6 of them authors discussed the role of topography in dental trauma, in 11 articles authors discussed the carcinogenesis mechanism involved in chronic mucosal trauma, in 17 articles data on ill-fitting dentures was included, 4 studies dealt with the effect of broken/sharp teeth on mucosal damage, and in 7 studies the role of oral hygiene was covered. Less frequently discussed topics included gender, risk of neck nodes, and the role of potentially malignant oral disorders. (4) Conclusions: The available literature suggests a potential connection between chronic dental trauma and the development of OCC. Studies have highlighted factors such as denture use and ill-fitting dental appliances as contributors to an increased risk of oral cancer. Interestingly, we still miss data to support the hypothesis that women, particularly those without toxic habits like smoking or alcohol consumption, appear to be disproportionately affected by oral cancer related to chronic dental trauma.

Pulmonary Actinomycosis in a 65-Year-Old Female with Poor Oral Dentition.

Pulmonary actinomycosis is an uncommon clinical entity that can be challenging to diagnose due to its non-specific symptomatology. Misdiagnosis and delayed treatment may result in invasive procedures and extended antimicrobial treatment courses. We report a case involving a 65-year-old female with poor oral dentition admitted for acute respiratory failure subsequently found to have a left-sided pleural effusion and perihepatic abscess formation. Cytopathology examination and microbiology studies confirmed the diagnosis of pulmonary actinomycosis.

The Prevalence of Dysphagia in Individuals Living in Residential Aged Care Facilities: A Systematic Review and Meta-Analysis.

Dysphagia commonly affects older adults, making them nutritionally vulnerable. There is significant variation in the reported prevalence of dysphagia in aged care. The aim of this systematic review and meta-analysis was to determine the prevalence of dysphagia in individuals living in residential aged care facilities using appropriate assessment methods, and in four subgroups at higher risk: individuals with nervous system diseases, dementia, malnutrition, and poor dentition. Scopus, Web of Science, Medline, and CINAHL Plus were searched, and study selection was conducted in Covidence. Meta-analysis using a random effects model was used to obtain the pooled prevalence of dysphagia. Seven studies were eligible for inclusion. Dysphagia prevalence ranged from 16 to 69.6%. The pooled prevalence of dysphagia was 56.11% (95% CI 39.363-72.172, p < 0.0001, I2 = 98.61%). Sensitivity analysis examining the prevalence of dysphagia using only the CSE indicated a pooled prevalence of 60.90% (95% CI 57.557-64.211, p = 0.9994, I2 = 0%). Only one study each reported on dysphagia prevalence in individuals with nervous system diseases (31%), poor dentition (92%), and dementia (68.4%), meaning that meta-analysis could not be completed. No studies reported on the prevalence of dysphagia in individuals with malnutrition. The prevalence of dysphagia is high amongst residents of aged care facilities. This evidence should be used to guide improvements in the health outcomes and quality of life of aged care residents. Future research should explore the prevalence in the subgroups at higher risk.

Antibiotic Prophylaxis Prior to Dental Procedures After Total Hip and Knee Arthroplasty Does Not Decrease the Risk of Periprosthetic Joint Infection

BackgroundPeriprosthetic joint infection (PJI) is a devastating complication after total hip and total knee arthroplasty (THA/TKA). While some guidelines no longer recommend routine use of prophylactic antibiotics for dental procedures, many surgeons continue to prescribe antibiotics for their THA/TKA patients. In a setting of increasing antibiotic resistance, it is important to reduce unnecessary antibiotic use. This study aims to evaluate antibiotics prior to dental procedures and the association between dental procedures and PJI. MethodsWe conducted a retrospective cohort study of patients who underwent THA/TKA between January 1, 2019 and December 31, 2020. The primary outcome was late-presenting PJI, occurring > 90 days after surgery. Patients were designated in the antibiotic group (2,000 mg of amoxicillin) or non-antibiotic group based on their surgeon’s prophylaxis protocol. Dental-associated PJIs were considered if the patient had evidence of poor dentition or a recent dental procedure prior to the onset of PJI symptoms. ResultsThere were 2,871 (26.4%) patients in the no antibiotics group and 8,023 (73.6%) patients in the antibiotics group. We found 27 (0.3%) late-presenting PJIs and 4 dental-associated PJIs. In the univariate and multivariable analyses, body mass index ≥-30 and revision surgery were the only variables that increased the odds of late-presenting PJI. All 4 dental-associated PJIs occurred in patients prescribed antibiotics. ConclusionsWe found a low rate of late-presenting PJI. Routine antibiotics prior to dental procedures were not shown to affect the risk of late-presenting PJI. These findings suggest that routine antibiotic prophylaxis before dental procedures is not necessary after THA/TKA.

1722 A Quality Improvement Project to improve MUST score and food chart completion on Frailty Wards

Abstract Introduction Nutrition is one of the cornerstones of healthy aging. As we age, there are many changes in our bodies including decreased appetite and poor dentition, that contribute to increasing malnutrition. The MUST (Malnutrition Universal Screening Tool) score is a quick and effective tool to assess this. In this project, we reviewed MUST score and food chart completion on the frailty wards at EDGH to attempt to improve the nutrition of elderly patients. Methods The charts of seventy-five patients were reviewed over a period of one month. Following this, a training program for all the nursing staff was put in place. Initial results were discussed and the importance of nutrition in the elderly was highlighted. The staff were shown how to fill in the MUST score and follow management guidelines. Also, a reminder was set up on Nervecentre (local electronic patient record) for all staff. Results Of the initial seventy-five patients: 1 – a MUST score was completed for only 64% on admission to the ward 2 – 41.3% of patients were eating 50% or less of their meals 3 – In only 27% the reasons why they were not eating were documented. In the second cycle, eighty patients were included, and the results were markedly improved. 1 – The percentage of MUST score completion on admission increased to 91.3% 2 – Management guidelines were followed in 92.5% of the cases 3 – 18.8% with a MUST score of two or more, were referred to dietitians at an early stage Conclusions Our quality improvement project significantly increased MUST score completion and prompted action at an early stage. The third cycle in our improvement project is to improve the documentation of patients' food charts and encourage staff to look for and document the reasons why patients are not eating.

Histopathological Features of Shell Teeth: A Case Report

Shell Teeth are a type of radiographic appearance of teeth seen in Dentinogenesis Imperfecta type II (DGI II). Radiographically, they are characterised by an enlarged pulp chamber enclosed by a thin layer of dentin. The clinical appearance of these teeth ranges from yellow to bluish-grey in colour. The histological features of shell teeth have not been updated in the literature, unlike clinical and radiographic appearance. These features are not available in the literature compared to other dental anomalies. Here, the authors present a case of an 18-year-old female who came with the complaint of poor aesthetic dentition. The dentition aligned with the clinical and radiographic features of shell teeth. Histopathological features of the present case included an irregular arrangement of the dentinal matrix and a few cellular inclusions. The final diagnosis was given as DGI type II. This developmental disorder requires prevention and early intervention of its dental implications, such as dental caries and attrition. The treatment usually requires a wellplanned multidisciplinary protocol involving endodontic and prosthodontic approaches. Histopathological features of shell teeth are required to aid in the identification of the precise pathogenesis and genetic mechanism behind this structural disorder of dentin. It also helps in the modification of certain treatment procedures to accommodate the structural abnormality. The case report aimed to bridge the literature gap on the histopathological features of shell teeth.

Preliminary Safety and Efficacy of Venetoclax and Selinexor in Combination with Chemotherapy in Pediatric and Young Adult Patients with Relapsed or Refractory Acute Myeloid Leukemia: Selclax

Background: Survival rates for children and adolescent/young adults (AYAs) with relapsed or refractory acute myeloid leukemia (R/R AML) remain poor. Previous clinical trials have demonstrated that the selective inhibitor of nuclear export selinexor and the BCL2 inhibitor venetoclax are each safe and active when combined with chemotherapy in children with R/R AML (NCT02212561, NCT03194932). However, many patients are refractory to these combinations. Preclinical data indicate that selinexor and venetoclax are synergistic and that selinexor may abrogate resistance to venetoclax. We thus aimed to characterize the toxicity profile and explore preliminary activity of venetoclax and selinexor with chemotherapy in pediatric and AYA patients with R/R AML and report results from the dose escalation phase of the SELCLAX clinical trial (NCT04898894). Methods: SELCLAX is a Phase I and expansion cohort study of selinexor and venetoclax in combination with chemotherapy in pediatric and AYA patients with R/R AML. For the dose escalation phase, eligibility criteria included &amp;lt; 30 years of age, adequate organ function and performance status, primary refractory, early first relapse (&amp;lt; 12 months from initial diagnosis), relapsed and refractory to salvage, post-transplant relapse or second or greater relapse AML or acute leukemia of ambiguous lineage (ALAL). The primary endpoint was determination of the recommended phase 2 dose (RP2D) of venetoclax and selinexor with chemotherapy. In the dose level 1 (DL1) cohort, venetoclax was given at 360 mg/m 2 per dose (max 600 mg) on days 1-21 in combination with selinexor at 40 mg/m 2 on days 1, 8, 15. For dose level 2 (DL2), venetoclax was dosed as in DL1, and selinexor was dosed at 40 mg/m 2 twice weekly on days 1, 3, 8, 10, 15, 17. Chemotherapy (fludarabine 30 mg/m 2, cytarabine 2 g/m 2 ± granulocyte colony stimulating factor 5 mcg/kg [FLA(G)]) was given on days 16-20. Response was evaluated by blast percentage in day 8 and 15 peripheral blood and in day 15 and end-cycle bone marrow. Any patient with a two-log (100-fold) reduction in measurable residual disease (MRD) between baseline and Day 15 was designated an “exceptional responder” (ER). At the discretion of the treating physician, ER patients could continue venetoclax until day 28 with additional selinexor (DL1: day 22; DL2: day 22, 24); FLA(G) could either be omitted or given on days 30-34; omission of FLA(G) deemed a patient non-evaluable (NE) for dose-limiting toxicity (DLT). Evaluable patients were assessed for DLTs, and dosing was escalated according to a rolling-six design. Results: As of July 14, 2023, fifteen patients (aged 3-17 years) with R/R AML (n=14) or ALAL (n=1) were enrolled in the dose escalation phase ( Table 1). Nearly all patients had high-risk cytomolecular features: KMT2A-rearranged (n=5), NUP98-rearranged (n=5), -7/del(7) (n=3), or FUS::ERG (n=1). Seven patients were enrolled on DL1 (one NE, replaced); eight patients were enrolled on DL2 (two NE, replaced). In the DL1 cohort, one DLT was reported of grade 3 anorexia requiring nasogastric feeds; however, this was cofounded by a prior history of anorexia, mucositis, and poor dentition requiring extractions and restorations. At DL2, one patient experienced a hematologic DLT with failure to recover absolute neutrophil count above 500/uL and platelet count above 25,000/uL by day 43 from start of FLA(G). There were no DLTs in the other five evaluable patients in DL2 and no serious adverse events (AEs) reported. The most common Grade 3 or 4 AE was febrile neutropenia (16.7%). Of the evaluable patients, five of twelve (41.7%) achieved complete response (CR) or complete response with incomplete count recovery (CRi). One patient was an ER on Day 15 at DL2 and did not receive FLA(G); thus, this patient was not evaluable for DLT assessment. Six patients proceeded to hematopoietic cell transplant after protocol therapy, five of whom are alive to date. Conclusion: Venetoclax and selinexor with FLA(G) chemotherapy is a tolerable combination in pediatric and AYA patients with R/R AML. Early activity of this combination regimen was observed in some patients, including those with primary refractory or early first-relapsed AML. Enrollment of the dose expansion phase at DL2 is underway in two cohorts: venetoclax-naïve and venetoclax-exposed.

A Case of Foreign Body Aspiration Mimicking Asthma in Adult

Foreign body aspiration is uncommon in adults who have no known risk factors such as mental retardation, poor dentition, or advanced age. Adults with foreign body aspiration are commonly misdiagnosed with bronchial asthma, however, does not respond to standard bronchodilator treatment. A thorough history-taking, focused physical examination and a high index of suspicion is crucial in making the correct diagnosis. This paper reports an interesting case of a 41- year-old woman with an undetected 10-year long foreign body aspiration which was misdiagnosed as bronchial asthma.

116 Incidence of colic and lunar phase

Equine colic is defined as pain in the abdominal cavity; the etiology is commonly gastrointestinal. There is no known definitive cause, but conditions such as poor forage, poor dentition, parasites, or reduced water intake increase the risk of colic. Previous research on a small scale showed there is a weak but significant increase in the incidence of colic with the waxing gibbous and full moon. The objective of this study was to determine if the association between the incidence of colic and lunar phase was repeatable on a larger scale. Data on yearly equine admissions from Marion duPont Scott Equine Medical Center (2133 admissions) and Cornell University College of Veterinary Medicine Equine Hospital (1429 admissions) was aggregated, and the number of daily colic diagnoses was standardized into the number of daily colic diagnoses per 1000 yearly hospital admissions. Referred colic cases were confirmed by attending veterinarians. The corresponding moon phases were distributed into 3 levels: new moon + 2 d (n = 480), full moon + 2 d (n = 470) and remaining normal days (n = 1,850) and for each phase, the mean number of daily colic diagnoses per 1000 yearly admissions was foundto be 0.294 (SD = 0.478), 0.290 (SD = 0.463) and 0.304 (SD = 0.486), respectively. A priori power analysis showed the sample size was adequate to test the hypothesis (Statistical Power = 80%, α = 0.05). The data were strongly right skewed with multiple outliers, driving the decision to use the median and interquartile range (IQR) to represent the measure of center and dispersion and a Kruskal-Wallis H test for statistical analysis. The distribution of the number of colic cases per day were similar across all moon phases, as assessed by visual inspection of comparative boxplots. For all 3 lunar phases, the median number of daily colic diagnoses per 1000 yearly hospital admissions was 0 (IQR = 0.47). At the 0.05 significance level, there were no significant differences found in the median number of daily diagnoses per 1000 yearly admissions among the 3 lunar phases (χ2(2) = 0.261, P = 0.878). In conclusion, this data does not find an association between the incidence of referred colic cases and lunar phase.

Oral health and functional outcomes following mechanical thrombectomy for ischemic stroke

BackgroundAn association between poor dentition and the risk of ischemic stroke has previously been reported in the literature. In this study we assessed oral hygiene (OH), including tooth loss and...

Histologic Analysis of Buccal Graft Quality Stratified by Tobacco Use in Patients Undergoing Substitution Urethroplasty

To determine if there are histologic differences relative to tobacco exposure in buccal mucosa. Substitution urethroplasty outcomes may be worse in tobacco users and we investigate if the buccal graft is inherently damaged due to chronic tobacco exposure. Subjects undergoing substitution urethroplasty with buccal graft harvest were prospectively consented in this IRB approved study. Subjects with poor dentition were excluded. A detailed tobacco use history was obtained. Cotinine testing was performed day of surgery to confirm or exclude active tobacco use. Trimmed portions of harvested graft were sent for tissue processing. Standard hematoxylin and eosin staining was performed. A single blinded pathologist performed analysis of the slides. Using a scale of none, mild, moderate, or severe slides were analyzed for cytologic atypia, architectural complexity, inflammation, and keratinization. Evidence of vascular damage was noted and the type of inflammation if present was classified. Twenty-five buccal grafts were analyzed. No evidence of vascular damage or cytologic atypia were noted in any grafts. While mild architectural complexity and mild inflammation, typically lymphocytic, were noted in several of the buccal mucosa sections, this did not appear to correlate with tobacco exposure. The majority of grafts demonstrating increased keratinization correlated with significant tobacco exposure, but this was not consistently noted in all those with tobacco use. Buccal mucosa in patients with tobacco exposure did not show significant histologic alterations. Outcomes of substitution urethroplasty may be more impacted by persistent systemic exposure causing local ischemia as opposed to the graft tissue itself.

Abstract 13195: A Case of Ebstein Anomaly Diagnosed Following Tricuspid and Pulmonic Valve Infective Endocarditis in an Adult Patient

Background: We present a rare case of infective endocarditis (IE) involving both tricuspid (TV) and pulmonic valves (PV) in the setting of newly diagnosed Ebstein anomaly (EA) with isolated, small membranous VSD. Case: A 48 yo woman with no known medical history presented with two weeks of fever, flu-like symptoms, and dyspnea. Vitals showed fever, tachycardia, and tachypnea. Poor dentition, grade III systolic murmur, and S3 gallop were noted on physical exam. EKG showed sinus tachycardia and right bundle branch block. Laboratory studies showed leukocytosis and elevated CRP. A chest CT revealed bilateral lung infiltrates in a rounded configuration concerning for septic emboli. Blood cultures grew Streptococcus mitis , and IV antibiotics were initiated. TTE revealed 3.2cm apical displacement of the TV resulting in right ventricular atrialization, diagnostic for EA. TTE also found a 26x17mm vegetation on the septal and anterior leaflets of the TV with moderate tricuspid regurgitation and an 11x6mm vegetation on the PV, confirmed by TEE. Cardiac MRI also noted a focal aneurysm of the membranous interventricular septum with a hemodynamically insignificant shunt. Discussion: While interatrial communications are seen in a majority of EA patients (80-94% of cases), this patient presented solely with a small membranous VSD and absence of ASD and PFO. Moreover, this patient had no PDA to depend on for pulmonary flow. Remarkably, she had an asymptomatic course with EA until the development of endocarditis. It is believed the presence of an isolated VSD in this patient’s severe EA likely promoted forward pulmonic flow in an already inadequate right ventricle. Right-sided IE is itself rare (5-10% of cases) with isolated PV involvement being even rarer (2% of cases). This patient’s uncorrected EA with redundant TV and PV leaflet tissue likely contributed as a nidus for simultaneous infection of both valves.

Association of the number of natural teeth with dietary diversity and nutritional status in older adults: A cross-sectional study in China.

To investigate the association of the number of natural teeth with overall dietary diversity and nutritional status in a nationally representative study among older adults in China. A cross-sectional analysis was conducted among community-dwelling adults aged 65 years or older from the Chinese Longitudinal Healthy Longevity Study. According to the self-reported number of natural teeth, participants were categorized into ≥20, 10-19, 1-9 natural teeth, and edentulous. Dietary diversity score (DDS) was constructed based on intake frequencies of 10 food groups assessed by a simplified food frequency questionnaire. The geriatric nutritional risk index was used to measure the malnutrition status (i.e., normal, mild malnutrition, and moderate-to-severe malnutrition) among a subgroup of participants. Linear and multinomial logistic regression models were used to examine the corresponding associations. Among 54,796 study participants, the mean (SD) age was 87.86 (11.45) years, 82.7% had poor dentition (<20 natural teeth), and 27.3% wore dentures. After multivariable adjustment, participants with poor dentition had lower DDSs (βedentulous =-0.39, 95% confidence interval [CI], -0.48, -0.30; β1-9 teeth =-0.46, 95% CI, -0.55, -0.37; β10-19 teeth =-0.36, 95% CI, -0.46, -0.26) than those with 20 natural teeth or more. For individual food items, edentulous, 1-9 and 10-19 natural teeth were associated with lower odds of regular intake of fresh fruits, fresh vegetables, meat, fish and aquatic products, eggs, legumes, preserved vegetables, tea, and garlic, but higher odds of regular intake of sugar and sweets. Among participants with poor dentition, individuals without dentures had lower intake frequencies of most food groups than those wearing dentures. In addition, poor dentition was related to lower odds of normal nutritional status (odds ratio=0.49, 95% CI, 0.27, 0.89). Older adults with poor dentition had significantly lower dietary diversity and worse nutritional status. Future studies are warranted to identify effective interventions to improve the dietary quality and nutrition status among partially and fully edentulous individuals, including those with Stage IV periodontitis.

A rare case of 48, XXYY syndrome in Taiwan

A rare case of 48, XXYY syndrome in Taiwan

A Rare Foreign Body in a Patient with Poor Dentition: A Satay Skewer

Foreign body (FB) ingestion and impaction in the upper gastrointestinal tract is a common urgent referral to otorhinolaryngology. The types of FB are significantly different between children and adults, and it largely depends on the region, sociocultural influences and dietary habits of the patient. Rare FBs in adults should be suspected in certain groups of people with psychiatric illnesses and in patients with dental pathology who are unable to chew food properly before swallowing. In this report, we present a rare case of oesophageal impaction by a long satay skewer with sharp ends along with chicken meat in a 37-year-old man with poor dentition. It was successfully removed using rigid oesophagoscopy.

Vitamin C Deficiency in a Food Insecure Patient: A Rare Case Report

Introduction: Scurvy is rarely seen in developed countries and is characterized by deficiency of vitamin C, which can lead to symptoms including wound impairment, bleeding manifestations, and loss of teeth. Case Description: We present a case of a 53-year-old male with a right knee hemarthrosis after a fall. The patient also noted progressively enlarging spontaneous hematomas, denying any recent trauma except for the fall to the knee. He denied family history of bleeding and clotting disorders and endorsed aspirin use in the setting of a prior stroke. He actively resided at a local shelter with limited means of transportation for routine medical care. Physical exam revealed large, firm hematomas on his bilateral lower extremities, poor dentition with spontaneous gum bleeding, and scattered petechiae on his back and feet. The patient’s diet consisted entirely of fast-food meals; he denied intake of fruits or vegetables for almost a full year. Nutritional deficiencies including ascorbic acid remained higher on the differential. Vitamin C levels returned < 0.01 indicating severe deficiency (< 0.02 is diagnostic). A bleeding disorder was ruled out based on other labs. He was treated with vitamin C, iron, thiamine, and folate supplementation. His hematomas improved significantly during the hospitalization. He was discharged on a multivitamin regimen and recommended outpatient physical therapy. Discussion: Scurvy is rare in the adult population of developed countries, and while easily treatable with an excellent prognosis, the consequences are deadly if missed. Clinicians should maintain a broad differential and consider social determinants of health in high-risk groups.

935 Case of Bad Breath in a Child

Abstract 4-year-old girl with a two-year history of speech and language delay was referred to the Speech and Language Therapy Service by her health visitor. Additionally, she had a history of asthma, recurrent glue ears, head lice, poor dentition, a persistent malodorous nasal discharge, and halitosis. Her hyper-nasal speech sounds indicated soft palate dysfunction. Subsequent assessment in the cleft clinic resulted in a diagnosis of non-cleft velopharyngeal insufficiency. At the time of her elective pharyngoplasty, the anaesthetist and surgeon were overwhelmed by the foul smell emanating from her nose and mouth. As such, an intraoperative nasal endoscopy was undertaken to examine her vestibules. A calcified cigarette filter (Figure 1) was found impacted deep within the patient's right nostril and was removed prior to the pharyngoplasty. It was later discovered that the malodorous nasal discharge and halitosis had plagued the child since the age of 18 months. Moreover, she had undergone a number of clinical assessments within the primary care setting. However, the combination of head lice, foul smell, and her uncooperative demeanour made examination difficult, and her symptoms were inappropriately attributed to tooth decay and periodontal disease.

Retrospective Review of the Clinical Outcomes of Surgically Managed Patients with Intracranial Abscesses: A Single-Center Review

This study analyzed patient, radiologic, and clinical factors associated with operative brain abscesses and patients' functional outcomes. A retrospective analysis was conducted of neurosurgical cases of brain abscesses from 2009 to 2019 at a Canadian center. Functional outcome was recorded as Modified Rankin Scale score and Extended Glasgow Outcome Scale score. Multivariate analysis was conducted to identify relevant prognostic factors. We identified 139 patients managed surgically for brain abscesses. Resection alone was performed in 64% of patients, whereas 26.6% underwent aspiration alone. Most were adults (93.2%) and male (68.3%). Immunocompromise risk factors included diabetes (24.5%), cancer (23.7%), and immunosuppressive therapy (11.5%). Likely sources were postoperative (17.3%), systemic spread (16.5%), and poor dentition (12.9%). Microorganisms cultured from abscess samples were mixed growth (28%), Streptococcus anginosus (24.5%), and Staphylococcus aureus (7.9%). Disposition was home (42.4%) or repatriation to a home hospital (50.4%). By Extended Glasgow Outcome Scale, 25.2% had an unfavorable outcome including a mortality of 11.5%. Factors on multivariate analysis associated with poor outcome included diabetes (odds ratio, 2.8; 95% confidence interval [CI], 1.2-5.0) and ventricular rupture (odds ratio, 5.0; 95% CI, 1.7-13.5; hazard ratio, 12; 95% CI, 3.9-37.0). Supratentorial superficial eloquently located abscess was also associated with poor outcome (hazard ratio, 5.5; 95% CI, 1.8-16.7). Outcomes were similar with surgical excision and aspiration. Ventricular rupture and diabetes are significant risk factors for poor outcomes in intraparenchymal brain abscesses. No clear difference in outcomes was found between surgical excision or aspiration in our retrospective cohort.

Abstract #1151796: Hypophosphatasia and Microcephalic Osteodysplastic Primordial Dwarfism type II: Diagnosing patients with minor symptoms

Hypophosphatasia (HPP) and Microcephalic Osteodysplastic Primordial Dwarfism type II (MOPD II) are rare inherited diseases which arise from the ALPL gene and PCNT gene respectively. HPP has nonspecific alkaline phosphatase (TNSALP) deficiency which causes the manifestations of skeletal deformities, fractures, nephrocalcinosis, seizures, respiratory failure and poor dentition. While in MOPD typically presents with bone, vascular and hematological abnormalities. Both of these diseases have a variety of symptoms which can vary in severity which can make the diagnosis difficult but important to avoid future complications.

Subdural Empyema Due to Poor Dentition

Subdural Empyema Due to Poor Dentition