Regular Visits Research Articles

Medication-related osteonecrosis of the jaw in patients with cancer using zoledronic acid and denosumab: Single-center retrospective study.

Medication-related osteonecrosis of the jaw (MRONJ) is a rare but potentially severe condition that significantly affects the quality of life of patients with cancer. This study evaluated MRONJ in patients with cancer treated with zoledronic acid (ZOA) and denosumab (Dmab). The survey investigated patients who were diagnosed with MRONJ at the Department of Oral and Maxillofacial Surgery after receiving either ZOA or Dmab at the Saitama Medical Center, Saitama Medical University, between April 1, 2022, and March 31, 2023. Of 252 patients, 27 were ZOA users and 225 were Dmab users. MRONJ was not observed with ZOA. MRONJ was detected in 11 (4.9%) Dmab users, eight male and three female patients with a mean (± standard deviation) age of 74.6 (± 9.2) years (range 61-98 years). The total dose of Dmab was 2724 ± 1838 mg (range: 480-6360 mg). The time from Dmab administration to MRONJ onset was 28.0 ± 16.0 months (range 4.5-53.2 months). Of the 11 patients with MRONJ, four (36.4%) had visited a dentist within the last 12 months. One participant (9.1%) was informed about and understood MRONJ. MRONJ was only observed in Dmab users, with an incidence rate of 4.9%. The percentage of patients with MRONJ receiving regular dental check-ups was 36.4%, and only 9.1% of patients were aware of MRONJ, both of which are low rates. To reduce MRONJ in patients with cancer, face-to-face consultations with pharmacists could serve as a valuable opportunity to inform patients about MRONJ and encourage regular dental visits.

Enhancing Academic Performance in a Rural Private Primary School: Addressing COVID-19 Disruptions and Long-Term Challenges

This study aimed to analyze the trends in academic performance, establish the possible causes of the poor academic performance, and explore and implement some mitigation strategies for 5 years. After observing a sharp decline in the Grade seven national examination pass rate at one rural Private Primary School, the Department of Education committed itself to work in collaboration with the school administrators and teachers to improve the pass rate. Several trips were made to the Primary school to establish rapport, assess their needs, and establish the contributing causes of the sharp decline in the pass rates. In-depth interviews were carried out with key informants. The major factors identified to be contributing to the decline in pass rates were low motivation among both students and teachers. In addition, inadequate resources; particularly educational materials and basic needs for teachers such as water and food were also identified. A strategic plan was formulated with goals projected for the coming 4 years. Regular visits to the school were made by the department of Education at least once every school term. Special training programs were done in the third term of each year in preparation for writing final exams. The teachers and students were incentivized by provision of basic needs such as water and food and other basic commodities. Other motivational promises were made, such as prizes for the best-performing students and teachers. The results were recorded and compared every year. After the first year of implementing the strategies, there was a noticeable change in the academic performance. The pass rates were beginning to rise when COVID-19 pandemic broke out. The overall pass rate dropped from 42 % to 15% during the COVID-19 pandemic era. However, after the COVID-19 Pandemic the intervention strategies continued. Despite experiencing the drastic negative effects of the COVID-19 pandemic, the graph of academic performance rose, there was a sharp rise from 33% in 2022 to 52% in 2023. The study recommends that a detailed longitudinal study be carried out to investigate the impact of other strategies (such as encouraging parental involvement). If these strategies carried out in this study are implemented coupled with other strategies such as parental involvement, this may result in marked improvements in academic performance of the learners and very high pass rates.

Role of regular medical visits in mitigating increased suicide risk during the early COVID-19 pandemic in Kobe, Japan

BackgroundJapan has one of the lowest COVID-19 death rates, while the annual suicide rate in 2020 has risen for the first time since 2007. This study aimed to identify high-risk populations and assess the impact of medical visits on suicide trends post-COVID-19 pandemic in Japan.MethodThis quasi-experimental study analyzed a population-based database from Hyogo Prefecture (2012–2022). Interrupted time-series analyses identified level and trend changes in monthly suicide rates per 1 million population during the exposure period (2020–2022) versus the control period (2012–2019). Regular visits to primary care and psychiatry stratified analysis.Results2181 cases were analyzed, with two-thirds male and a median age of 54. Primary care physicians and psychiatric history were present in 69% and 40% of patients. The study found significant level changes in suicide rates overall (4.14, 95% CI: 1.70, 6.58) among individuals without regular primary care physician visits (2.83, 95% CI: 1.35, 4.32) and without psychiatric visits (2.85, 95% CI: 0.56, 5.14). In contrast, no significant changes were observed in individuals with regular primary care (0.99, 95% CI: -0.78, 2.76) or regular psychiatric visits (0.59, 95% CI: -0.98, 2.16). The trend changes were not significant in any of the groups.ConclusionThis study suggests that a history of attending a medical institution may have prevented the rapid increase in suicides during the early stages of the COVID-19 pandemic.

A Cross-sectional Study Investigating the Oral Health Status of Adult and Elderly Swiss Community-Dwellers.

To evaluate the oral health status of community-dwellers ≥ 45 years of age in the canton of Bern, Switzerland. Data were collected using a questionnaire (including sociodemographic factors, medical history, oral health behaviour) and a clinical examination comprising caries, periodontal disease, oral hygiene, and prosthetic rehabilitation. χ2/Fisher's tests and Cochrane Armitage trend tests as well as a binary logistic regression were performed to assess the association between oral disease presence (i.e., periodontal disease [PSI (periodontal screening index) score 3-4] and/or active dental caries [ICDAS 4-6, root ICDAS 2]) and the independent variables. A total of 275 participants were included in the present study: 154 (56%) males and 121 (44%) females, with a mean age of 69.7 years (SD 11.6). The majority presented with good oral health behaviour; 221 (86%) brushed their teeth at least twice daily, 196 (79%) had regular dental visits. Nevertheless, 82 (32%) participants presented with an approximal plaque index of > 50%. The older age groups and participants with bleeding gums had higher odds of having active dental caries and/or periodontal disease (65-74 years - OR 2.88 [95% CI 1.33-6.25], ≥75 years - OR 2.60 [95% CI 1.17-5.78], bleeding gums OR 3.52 [95% CI 1.07-11.50]). The present study shows an association between age, oral hygiene, and the presence of active caries and periodontal disease. The study highlights the importance of good oral hygiene maintenance, especially in older adults.

Life With Classic Congenital Adrenal Hyperplasia Due to 21-Hydroxylase Deficiency: Challenges and Burdens.

Congenital adrenal hyperplasia (CAH) is an autosomal recessive genetic condition requiring daily medication(s) and attention to details. In addition to daily medications and regular visits with healthcare providers, families may live with perpetual angst regarding unpredictable occurrences of acute adrenal insufficiency. Despite numerous barriers and challenges imposed by this chronic condition, caregivers and healthcare professionals can empower our patients to achieve a good quality of life. CAH is a global condition for which access to health care widely varies depending on local resources. Major treatment aims include good health, good quality of life, and achievement of personal goals for affected persons. To achieve these aims, patients, caregivers, and healthcare professionals interact to promote health maintenance and encourage positive outcomes for individuals with CAH. This article describes aspects of daily living with CAH through the perspective of 1 family and their healthcare team living in the United States. A young adult patient, nurse educator, and physicians provide their perspectives regarding patient health care, general well-being, and safety emphasizing that patients with CAH can thrive. Nevertheless, remembering and recognizing that many individuals with CAH live in areas with limited resources and enduring sociocultural barriers is essential. With access to knowledgeable healthcare providers, sufficient resources, and psychosocial support, "children with CAH can thrive and live normal lives." The future challenge is securing mechanisms to decrease the financial, sociocultural, and health access barriers in other communities throughout the world.

Can a low-threshold check-up motivate older adults to schedule a dental visit? Study protocol for a randomized controlled trial

BackgroundMost oral diseases benefit from early detection by dental professionals. However, in the older population, regular dental attendance is low. This trial investigates whether a low-threshold check-up by a dental professional in a non-dental setting can motivate older persons to seek professional oral care.MethodsA total of 194 community-dwelling persons aged 65 years and older, without a dental check-up over the last 12 months, will be recruited for this randomized, controlled, two-arm, single-blinded, superiority trial with a 1:1 allocation ratio. The intervention group will receive an oral examination including tailored oral health information. They will also be informed about the importance of regular dental visits and will be provided with referral letters for the dental professional and the family physician and a list of nearby dentists. In the control group, the oral examination including tailored information will not be performed. This group will only receive flyers with general oral hygiene information and a list of nearby dentists. The primary outcome is whether or not the participants will contact a dental professional within four months after the intervention.DiscussionThis study examines the efficacy of a low-threshold dental check-up intervention to motivate older adults to contact a dental professional and reactivate them into primary oral care, addressing barriers to oral care such as low health literacy, subjective treatment need, and dental anxiety. Key strategies include enhancing oral health knowledge, identifying existing oral issues, and involving family physicians. The study, set to run from April 2024 to March 2025, aims to inform future evidence-based oral health promotion strategies for community-dwelling older adults.Trial registrationClinicalTrials.gov NCT06341959. Registered on 25 April 2024.

A Cross-Sectional Multivariable Analysis of the Quality of Hemodialysis Patients' Life in Lahore City, Pakistan.

Background/Objectives: Chronic kidney disease (CKD) is a severe health problem with dire consequences for the quality of life of millions of individuals and their families around the globe. This quantitative study analyzes the factors associated with hemodialysis patients' quality of life (QoL) in Lahore City, Pakistan. Methods: Primary data from a sample of 384 patients were collected through regular visits to the hospital. We employed proportional odds models (POMs) and structural equation models to identify factors associated with the QoL. Results: The results revealed significant associations between various factors and patients' quality of life. While gender showed no association with quality of life, younger age, single marital status, higher education, higher family income, and employment status were associated with a better QoL. Clinical variables such as the absence of diabetes and hypertension and specific laboratory parameters were protective against deteriorating QoL. Physical symptoms like muscle soreness, cramps, and shortness of breath significantly impacted QoL. Social and environmental factors adversely affected patient well-being, including family distress and financial issues. Psychological variables such as anxiety, depression, and fear of death also influenced QoL. Conclusions: The findings underscore the importance of holistic, patient-centered care approaches in renal failure management, highlighting the need for tailored interventions to address the diverse needs of dialysis patients and enhance their QoL. Further longitudinal research is recommended to validate these findings and guide the development of targeted interventions for improving patient well-being in hemodialysis settings.

Cinacalcet Improves Erythropoietin Resistance in Patients with Secondary Hyperparathyroidism Receiving Dialysis Treatment.

Chronic Kidney Disease (CKD) is recognized as a major global public health problem. Dialysis is the mainstay of treatment for patients with end-stage renal disease and can prolong survival in patients with CKD. As patient survival increases, the treatment of complications becomes more important. CKD-mineral and bone disorders (CKD-MBD) and renal anemia are common complications in patients with CKD. Cinacalcet is a calcimimetic for the treatment of Secondary Hyperparathyroidism (SHPT) in adult dialysis patients, which regulates the synthesis and secretion of parathyroid hormone by increasing the sensitivity of calcium-sensitive receptors. This retrospective study evaluated the efficacy of cinacalcet in dialysis patients. Forty-seven patients on dialysis with elevated parathyroid hormone were included. The selected patients have regular follow-up visits in our outpatient clinic and regular use of cinacalcet for no less than 6 months. During the 6-month efficacy evaluation phase, cinacalcet not only reduced the levels of the intact parathyroid hormone (iPTH, P ≤ 0.05), serum calcium (P ≤ 0.01), and Ca×P (P ≤ 0.05) but also reduced weekly erythropoietin dosage (P ≤ 0.01) and erythropoietin resistance index (ERI, P ≤ 0.05). While controlling SHPT in patients with CKD, cinacalcet reduced EPO resistance and improved renal anemia. In conclusion, cinacalcet not only decreased the levels of the iPTH, serum calcium, and Ca×P but also reduced weekly EPO dosage and ERI levels. Controlling SHPT in patients with CKD, cinacalcet also reduced ERI and improved renal anemia.

Protocol for a 1-year randomised, controlled, parallel group, open-label trial on the effects and feasibility of time-restricted eating in individuals with type 2 diabetes- The Restricted Eating Time in the Treatment of Type 2 Diabetes (RESET2) trial.

Time-restricted eating (TRE) limits the time for food intake to typically 6-10 h/day without other dietary restrictions. The aim of the RESET2 (the REStricted Eating Time in the treatment of type 2 diabetes) trial is to investigate the effects on glycaemic control (HbA1c) and the feasibility of a 1-year TRE intervention in individuals with overweight/obesity and type 2 diabetes. The aim of the present paper is to describe the protocol for the RESET2 trial. RESET2 is a randomised, controlled, parallel-group, open-label trial. One hundred and sixty individuals with type 2 diabetes (HbA1c >53 mmol/mol (>7.0%)), and Body Mass Index ≥25 kg/m2 will be randomised to standard care plus TRE, or to standard care and habitual living. Both the intervention and control group will follow standard diabetes care including regular clinical visits 3-4 times/year. The intervention is divided into two periods: (1) a 3-month TRE period with a fixed eating window with a self-selected timing to obtain data from the participants' experiences with TRE and (2) a 9-month individually adjusted TRE period. Participants in the TRE group will be instructed to reduce their eating window by a minimum of 3 h/day compared to the habitual eating window and with an eating window of 8-10 h/day. Test days will be scheduled at baseline, after 3 months and after 1 year. The primary outcome is HbA1c (evaluated 3 months and 1 year after randomisation) and secondary outcomes are body weight, fat mass, continuous glucose monitoring derived time-in-range and use of antidiabetic medicine (evaluated 1 year after randomisation). Additionally, we will conduct a process evaluation to assess whether the TRE intervention functioned as hypothesised.

CYSTIC LESIONS OF THE SALIVARY GLANDS(Report of 3 cases)

At least one-third of cystic salivary gland lesions are neoplastic. Cystic lesion of the salivary gland requires only surgery, because regardless of the type and location, drug therapy is not possible with this diagnosis.. If the cystic neoplasm is localized in a hard-to-reach place and if it is localized in the parotid gland, the surgical manipulation is performed from the outside, it is removed simultaneously with the parenchyma of the salivary gland. The FNA specimens from salivary gland cystic lesions can be no informative very often, because FNA of these lesions demonstrates hypocellular mucinous material contents, possibly with inflammatory cells and also scant epithelial cells. For example, the presence of mucin and admixed lymphocytes in cyst fluid can be demonstrated both in the benign inflammatory cysts and cystic neoplasms. A definitive diagnosis of cystic neoplasms of the salivary glands is possible only through histological examination of the neoplastic tissue. Prevention of cystic neoplasms of the salivary gland consists of preventing injuries and inflammations of the oral cavity, careful hygiene and regular visits to the dentist. This article presents cases of the salivary glands cystic neoplasms, which are the clinical interest.

Denture care attitudes, hygiene levels and oral mucosal lesions in complete denture wearers from a single-institution cross‐sectional study

This study investigated denture care attitudes, dental visit habits, oral mucosal lesions, and hygiene levels in 118 complete denture users treated at a university dentistry faculty. Data on demographics, smoking, denture use duration, dentist visits, and hygiene habits were collected via a questionnaire. A specialist examined mucosal lesions and assessed denture hygiene level using the Budtz-Jorgensen and Bertram method. Categorical data were analyzed with Yates’s correction, Pearson’s chi-square, and Fisher–Freeman–Halton tests; multiple comparisons used the Bonferroni Corrected Z Test. Participants’ mean age was 51.61. Most were non-smokers (55.1%), visited dentists only for complaints (44.9%), cleaned dentures daily (70.3%), and removed them at night (56.8%). Good hygiene was observed in 40.68%. Females cleaned dentures more frequently than males, and 96.3% of those with poor hygiene reported bad denture odor. This study revealed significant deficiencies in denture care habits and inadequate hygiene practices of participants in a university dentistry faculty clinic. Most participants visited dentists only for complaints and had bad habits such as sleeping with their dentures at night and using inappropriate denture hygiene habits. Promoting proper denture hygiene habits and emphasizing the importance of regular dental visits can contribute to better oral health.

Retrospective Study of the Impact of SARS-CoV-2 Infection on Asthma Control in Children.

Asthmatic children who tested positive for COVID-19 experienced changes in lung function and persistent symptoms following SARS-CoV-2 infection, even for several months after diagnosis, and with the same features as in an acute phase. This study aimed to analyze a pediatric age group (between 0 and 17 years old) diagnosed with asthma, and SARS-CoV-2 infection attending regular monitoring visits in a Pediatric Department of a Regional Tertiary Hospital (Filantropia Clinical Municipal Hospital Craiova, Romania) during the COVID-19 pandemic and post-pandemic time interval (i.e., March 2020-July 2024), and identify how the infection influenced their long-term symptoms and treatment. Materials and Methods. The following variables were recorded: demographic data (gender, age group, residence), data related to allergies (allergic rhinitis, atopic dermatitis, and food allergies), the presence of exacerbations, the fraction of exhaled nitric oxide, the ventilatory function, the asthma phenotype (allergic or non-allergic), as well as the GINA assessment of asthma control at clinical visits were analyzed. SARS-CoV-2 infections were evaluated in terms of year of infection, symptoms, cough presence and persistence, and modifications of the asthma treatment during and after COVID-19 disease. The data were statistically analyzed with SPSS, using the Mann-Whitney U, Kruskal-Wallis H, and Chi-Square tests. Results. A lower incidence of COVID-19 cases was recorded in the first pandemic of asthmatic patients (2020 and 2021), but an increase in the rate of cases was observed at the beginning of the second pandemic, in 2022. The nitric oxide values in asthmatic children who were infected with SARS-CoV-2 were statistically significantly increased (p < 0.0005), especially for children with persistent cough for more than 4 weeks. A significant increase in the number of exacerbations was also observed in patients who tested positive for SARS-CoV-2 infection (p < 0.0005). Ventilatory function values were statistically significantly different in asthmatic children with and without SARS-CoV-2 infection (p < 0.05). Conclusions. The persistence of cough after the acute phase of SARS-CoV-2 infection as well as the changes in ventilatory tests emphasize the need of periodic medical check-ups, as well as the implementation of a therapeutic regimen appropriate for each pediatric patient.

Association between equivalized annual household income and regular medical visits for hypertensive patients since the COVID-19 outbreak.

Previous studies have shown an increase in blood pressure during the coronavirus disease 2019 (COVID-19) pandemic even among patients receiving antihypertensive treatment. This study aims to evaluate the association between equivalized annual household income and refraining from regular medical visits for hypertensive patients since the COVID-19 outbreak. We analyzed data from the Japan COVID-19 and Society Internet Survey (JACSIS), including 2832 hypertensive patients aged 20-79 years from the 2020 survey and at least one survey between 2021 and 2023. They were categorized into lower-income (<median of ¥3,182,000) and higher-income (≥median) groups. Refraining from regular medical visits was defined as not attending scheduled medical visits for hypertension in the past two months. Poisson regression or generalized linear mixed models were used, inverse probability weighted for Internet survey selection. After weighting, the mean age was 64.8 ± 10.3 years and 63.7% were men. In 2020, the proportion of hypertensive patients refraining from regular medical visits after weighting was 19.6% in the lower-income group and 8.8% in the higher-income group, with an adjusted proportion ratio (95% confidence interval) of 1.86 (1.13-3.06) for the lower-income group compared with the higher-income group. After 2020, the proportion of those refraining from regular medical visits declined in all income groups, and the income-related differences disappeared. During the social restrictions due to the COVID-19 pandemic, hypertensive patients with lower equivalized annual household incomes were more likely to refrain from regular medical visits. Strategies to reduce income-related inequities in medical care utilization may be necessary for future public health crises. A nationwide Internet survey in Japan revealed hypertensive patients with lower equivalized annual household incomes were significantly more likely to refrain from regular medical visits in 2020, during the social restrictions due to the COVID-19 pandemic. Addressing income-related inequities in medical care utilization is crucial for future public health crises.

The course and treatment tactics of oral mucosal diseases in pregnant women

Oral mucosal diseases during pregnancy, such as pregnancy gingivitis, pyogenic granulomas, oral candidiasis, and herpes simplex virus infections, are common due to hormonal and immune changes. These conditions can cause discomfort and complications for both mother and fetus. Prevention through good oral hygiene, regular dental visits, and proper nutrition is essential. Treatment strategies focus on safe, non-invasive therapies, including antimicrobial agents and antifungal treatments. Timely management ensures both maternal and fetal health during pregnancy.

Longitudinally persisting KCNA2-autoantibodies in mild amnestic dementia with Alzheimer´s pathology - Report and literature review.

Neural autoantibodies are being increasingly detected in conjunction with neurodegenerative dementias such as Alzheimer's disease dementia (AD), yet their significance is not well clarified. In this case report, we report the previously unreported long-lasting persistence of potassium voltage-gated channel subfamily A member 2 (KCNA2) antibodies in biomarker-supported AD. We report on a 77-year-old, male patient evaluated in our outpatient memory clinic of the Department of Psychiatry and Psychotherapy, University Medical Center Göttingen. Neuropsychological test results and autoantibody testing in serum over a period of 4-5 years is provided. Our patient exhibited mild dementia syndrome and was diagnosed with AD on the basis of a prototypical biomarker profile (reduced Aβ42/40 ratio and elevated p-tau181 protein in cerebrospinal fluid). Within a 5-year follow-up with regular visits to our memory clinic, we observed a nearly stable neuropsychological profile of mild, amnestic variant dementia that did not noticeably progress. KCNA2 autoantibodies were also detectable in serum over 4 years with increasing titers over time. Combined anti-dementia therapy with donepezil, multimodal therapy including non-pharmacological cognitive therapy, and immunotherapy with intravenous methylprednisolone was carried out as an individual treatment approach. KCNA2 autoantibody persistence in biomarker-supported AD does not necessarily trigger a poor outcome in the long-term, as cognitive impairment did not progress subsequently. At the same time, mild immunotherapy did not result in less immunoreactivity in conjunction with the detection of KCNA2 autoantibodies. This detection of KCNA2 autoantibodies in AD could provide indices of a potentially benign long-term AD course that should be further evaluated in studies.

Physician-Visit Frequency and Its Impact on Glycemic Control in People With Type 2 Diabetes: Quantifying Care Acceptance Parameters From Retrospective Electronic Health Record Data.

Type 2 diabetes is a metabolic disorder characterized by insulin resistance and hyperglycemia affecting many individuals worldwide. For effective management, adherence to recommended physician visits is important, along with lifestyle modification and pharmacological interventions. Regular doctor visits can improve adherence and help prevent complications. This study examined how doctor-visit frequency impacts blood glucose (BG) control in people with type 2 diabetes. This retrospective, single-center study included adults with type 2 diabetes who had at least two visits and two hemoglobin A1c (HbA1c) values recorded at least 90 days apart between March 2019 and November 2023. Visit per quarter ratio (VQR) and the standardized delta HbA1c (ΔHbA1c) were defined. Data were analyzed for descriptive statistics and compared for significance between the groups. Statistical differences among the groups were determined using the Kruskal-Wallis test and Dwass-Steel-Critchlow-Fligner pairwise comparisons. Five hundred seventy-seven participants with type 2 diabetes were analyzed, with a mean age of 53.9 years (±12.7). The HbA1c outcome was significantly lower in the good compliance group (7.3%) than in the poor (7.7%). The high VQR group had a significantly lower HbA1c outcome (7.4%) than the low VQR group (7.7%); 50.98% (n = 104) in the low VQR group, 65.54% (n = 97) in the medium VQR group, and 60.44% (n = 136) in the high VQR group achieved HbA1c below the target. The mean ΔHbA1c was significantly lower in the good compliance group compared to the poor compliance group. The average follow-up durations were 11.22 quarters (±4.11) for low VQR, 9.75 quarters (±4.69) for medium VQR, and 5.50 quarters (±4.84) for high VQR. Ahigher frequency of follow-up may be needed to encourage people with type 2 diabetes mellitus to visit their doctor regularly. The frequency of doctor visits has a positive impact on BG control. Regular visits enable timely adjustment of therapy and ensure high compliance with prescribed treatment. These findings have significant implications for mitigating nonadherence in chronic conditions like type 2 diabetes mellitus and warrant further investigation.

Gingivitis: The Contributing Roles of Dentist, Nursing, and Medical Documentation System-An Updated Review

Background: Gingivitis is an inflammatory condition affecting the gingival tissues, primarily caused by microbial plaque accumulation, and is the most prevalent periodontal disease. It is characterized by gingival redness, swelling, and bleeding, although it is often asymptomatic in its early stages. The disease is classified into several forms, with plaque-induced gingivitis being the most common. Aim: The purpose of this review is to examine the roles of dentists, nurses, and medical documentation systems in the management and prevention of gingivitis, with a focus on effective interventions and clinical outcomes. Methods: A comprehensive review of the literature was conducted to evaluate the etiology, pathophysiology, clinical presentation, and treatment of gingivitis. The roles of healthcare providers, including dental professionals and nursing staff, in managing the disease were analyzed, along with the significance of accurate medical documentation systems in patient care. Results: Gingivitis is primarily caused by bacterial plaque, although nutritional deficiencies, hormonal changes, and drug use can also contribute. Management typically involves mechanical plaque removal, oral hygiene education, and professional scaling. Nurses and dentists work collaboratively to assess symptoms, educate patients, and monitor progress. Medical documentation systems play a critical role in tracking patient history, treatment plans, and outcomes. Conclusion: Gingivitis can be effectively managed through early intervention, proper oral hygiene, and regular dental visits. Accurate medical documentation is essential for tracking the disease's progression and ensuring appropriate treatment. The combined efforts of dentists, nursing staff, and robust documentation systems are crucial in improving patient outcomes and preventing complications.

Clinical profile and molecular genetic analysis of alport syndrome in children: a single center experience

BackgroundAlport syndrome (AS) is a multifaceted condition that primarily affects the basement membranes of the kidneys, ears, and eyes. AS is considered the second most common cause of hereditary renal failure, exhibiting varied clinical manifestations across different lifespans. The aim of this study is to investigate the clinical features and genetic profile of AS and to elucidate the genotype-phenotype correlation of AS.MethodThe clinical and genetic data of ten children with AS treated at the General Hospital of Ningxia Medical University between January 2021 and May 2024 were retrospectively analyzed.ResultsTen children with AS, six male and four female patients, with a mean age of 9 years (ranging from 3 to 15 years) were reported. Hematuria was observed in all individuals, with six cases exhibiting microscopic hematuria and four cases exhibiting macroscopic hematuria. Furthermore, extra-renal manifestations were noted in five cases, encompassing ocular abnormalities (n = 2) and hearing impairment (n = 3). In total, eight cases displayed mutations in COL4A5 indicating XLAS, while two cases manifested mutations in COL4A4 indicating ADAS. Nine different variants were detected, with 3 mutations identified as novel. Two cases underwent histopathological analysis, revealing a thin basement membrane and mild to moderate mesangial proliferation. Three cases were lost to follow-up, while the remaining seven maintained regular visits to our hospital. As of August 1st, 2024, the median follow-up time was 30 (range 24–36) months, and the renal function of the children under observation remained within normal parameters.ConclusionIn this study, the most commonly observed mutation was glycine substitution. Additionally, patients exhibiting severe mutations showed an increased vulnerability to complications, including proteinuria, ocular lesions, and hearing impairment. Genetic testing emerged as a critical resource for diagnosing AS. Furthermore, early diagnosis is crucial for implementing an appropriate management plan and assessing the prognosis.

A case report of adenomyosis-induced spontaneous rupture in an unscarred and unpregnant uterus.

Spontaneous uterine rupture, although rare, is a life-threatening obstetric emergency with a high maternal and fetal mortality rate. It can occur without warning, leading to severe complications, including hemorrhage, shock, and fetal demise. The risk factors contributing to uterine rupture are diverse and include a history of uterine surgery (such as cesarean section), trauma to the uterus, abnormal uterine contractions during labor, and underlying conditions like adenomyosis. Identifying and understanding these risk factors are crucial for early detection, timely intervention, and improved outcomes in affected pregnancies. Here, we report an exceptionally rare case of spontaneous uterine rupture triggered by adenomyosis in a 34-year-old unmarried and nulliparous woman with no prior scarring or pregnancy. Physical examination revealed abdominal distension, with the uterine fundus at the level of the umbilicus, exhibiting hardness, tenderness upon palpation, and rebound tenderness. Ultrasonography and computerized tomography scans suggested adenomyosis and uterine rupture. During surgery, a rupture was discovered in the left basal layer of the uterus, with a rupture diameter of approximately 3 cm. Additionally, there were multiple internal endometrial lesions in the uterorectal pouch. Adenomyosis-induced spontaneous uterine rupture. The procedures performed included excision of adenomyotic lesions, repair of the uterine rupture, and electrocoagulation of endometriotic lesions in the pelvic cavity. At the 1-month post-surgery follow-up examination, the patient showed good recovery, with no signs of complications. She was able to resume normal daily activities without difficulty. The surgical site was healing well, with no signs of infection or abnormal scarring. Ultrasound and clinical assessments confirmed the resolution of pelvic fluid accumulation, and uterine function appeared to be intact. The patient was advised to continue regular follow-up visits to monitor her recovery and ensure long-term well-being. First, uterine rupture caused by adenomyosis in a nonpregnant, scarless uterus is extremely rare but still possible. When patients with severe adenomyosis present with abdominal pain and pelvic fluid, obstetricians and gynecologists should consider the possibility of uterine rupture. Second, ultrasound examination can quickly and accurately diagnose both adenomyosis and uterine rupture.

THE INFLUENCE OF DIABETES IN PEDIATRIC DENTISTRY

Pediatric diabetes presents significant challenges in dental treatment, requiring a tailored approach to minimize the risks associated with oral complications. Optimal glycemic control is fundamental before any intervention, and close collaboration with the diabetologist is essential to stabilize glucose levels. Local anesthesia should be used with caution, preferring solutions with low adrenaline concentrations, especially in patients with inadequate glycemic control. Dental treatment in children with diabetes involves a specialized approach due to the increased risks of oral complications and the peculiarities associated with this condition. Stable glycemic control is essential before any dental intervention, and collaboration with the diabetologist is crucial for adjusting the treatment. Local anesthesia should be administered with caution, using solutions with low adrenaline concentrations, especially in patients with unstable glycemic control. Educating patients and families about oral hygiene, diet, and the importance of regular visits to the dentist play a fundamental role in preventing dental complications. Children with diabetes are at increased risk of gum disease, such as gingivitis and periodontitis, so prompt management of these conditions through scaling and regular evaluations is vital. Rigorous oral hygiene should be encouraged to prevent infections and complications associated with compromised immune response. Interdisciplinary collaboration between dentists, diabetologists and other health professionals is essential for developing a coordinated and effective treatment plan.