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991.
Background: Ferritin, an acute‐phase reactant, has been found to be elevated in many chronic inflammation‐related diseases. The aim of the present study is to investigate differences in concentrations of serum ferritin in patients with and without periodontal disease before and after non‐surgical periodontal therapy and correlate these values with clinical variables associated with periodontal disease. Methods: Forty‐two individuals were included in this study, 20 with chronic periodontitis (CP) and 22 classified as periodontally healthy. Serum ferritin concentrations, hemoglobin levels, and periodontal parameters (probing depth [PD], clinical attachment level, gingival index, bleeding on probing, and plaque index) were recorded at baseline and 3 months after non‐surgical periodontal therapy. Results: Patients with CP showed higher concentrations of serum ferritin than periodontally healthy controls (P <0.01). After adjustment for confounders, a positive and significant correlation was observed between serum ferritin levels and the number of sites with PD ≥6 mm at baseline (P <0.01). Regression analyses revealed association between deep pockets and serum ferritin levels at baseline (R2 = 0.823). Significant reductions in serum ferritin levels were observed at the 3‐month assessment after periodontal treatment (P <0.01), and the post‐treatment serum ferritin values were comparable to those of controls (P >0.05). Furthermore, the post‐treatment degree of change in the serum ferritin level was positively and significantly associated with improvement in PD (R2 = 0.213, P <0.05). Conclusion: Serum ferritin levels are raised in patients with CP and decrease to control levels post‐treatment.  相似文献   
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Medication nonadherence is a multifactorial and complex problem that poses an enormous health and economic burden. Medication nonadherence related to medication side effects, referred to as rational nonadherence is increasingly seen in patients. This article discusses rational nonadherence with an exemplar of osteoporosis patients discontinuing their medication, mainly bisphosphonates, for fear of complications such as osteonecrosis of jaw. Also, the possible role of dental professionals in overcoming medication nonadherence in general is outlined.  相似文献   
994.
Imbalanced bone remodelling associated with osteopaenic or osteoporotic conditions can lead to a net bone loss throughout the skeleton, including the oral cavity, possibly leading to tooth mobility. This study investigated possible associations between systemic bone mineral density and both tooth mobility and periodontal status in peri-menopausal women. Subjects comprised 119 dentate, peri-menopausal Indian women between 40 and 54 years old. Clinical parameters recorded were systemic bone mineral density (BMD), tooth mobility in terms of Periotest value (PTV score), clinical attachment loss (CAL), pocket depth (PD), plaque index (PI) and sulcular bleeding index (SBI). Statistical analysis was performed to assess correlations between PTV score and T-score. PTV score correlated significantly (P < 0.05) with T-score, PD and CAL. The partial correlation coefficient between PTV score and T-score after adjusting for confounders was -0.3676 (P < 0.05). Results of one-way analysis of variance showed a significant difference between mean PTV scores for osteoporotic, osteopaenic and normal patients. In this population of peri-menopausal women, systemic bone mineral density represented an independent factor associated with tooth mobility.  相似文献   
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Objectives:The digital rectal examination (DRE) may be underutilized. We assessed the frequency of DREs among a variety of providers and explored factors affecting its performance and utilization.Methods:A total of 652 faculty, fellows, medical residents, and final-year medical students completed a questionnaire about their use of DREs.Results:On average, 41 DREs per year were performed. The yearly number of examinations was associated with years of experience and specialty type. Patient refusal rates were lowest among gastroenterology (GI) faculty and highest among primary-care doctors. Refusal rates were negatively correlated with comfort level of the physician in performing a DRE. More gastroenterologists used sophisticated methods to detect anorectal conditions, and gastroenterologists were more confident in diagnosing them. Confidence in making a diagnosis with a DRE was strongly associated with the number of DREs performed annually.Conclusions:The higher frequencies of performing a DRE, lower refusal rate, degree of comfort, diagnostic confidence, and training adequacy were directly related to level of experience with the examination. Training in DRE technique has diminished and may be lost. The DRE's role in medical school and advanced training curricula needs to be re-established.  相似文献   
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Cancer is a leading cause of death and disability in sub-Saharan Africa and will eclipse infectious diseases within the next several decades if current trends continue. Hematologic malignancies, including non-Hodgkin lymphoma, leukemia, Hodgkin lymphoma, and multiple myeloma, account for nearly 10% of the overall cancer burden in the region, and the incidence of non-Hodgkin lymphoma and Hodgkin lymphoma is rapidly increasing as a result of HIV. Despite an increasing burden, mechanisms for diagnosing, treating, and palliating malignant hematologic disorders are inadequate. In this review, we describe the scope of the problem, including the impact of endemic infections, such as HIV, Epstein-Barr virus, malaria, and Kaposi sarcoma-associated herpesvirus. We additionally describe current limitations in hematopathology, chemotherapy, radiotherapy, hematopoietic stem cell transplantation, and supportive care and palliation. We review contemporary treatment and outcomes of hematologic malignancies in the region and outline a clinical service and research agenda, which builds on recent global health successes combating HIV and other infectious diseases. Achieving similar progress against hematologic cancers in sub-Saharan Africa will require the sustained collaboration and advocacy of the entire global cancer community.  相似文献   
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