Severe drug-induced gingival enlargement and periodontitis: A case series with clinical presentation and management

Gingival enlargement (GE) is a condition in which the size of the gingiva increases in response to inflammation, systemic disease, or certain medications including anticonvulsants, calcium-channel blockers, and immunosuppressants. This report describes the management of two cases involving severe gingival enlargement related to the use of an anti-hypertensive calcium-channel blocker and an immunosuppressant. Besides taking amlodipine, one patient had undergone a heart transplantation seven years prior and has been taking two immunosuppressant drugs, mycophenolate and tacrolimus. The extent of the destruction of periodontal support, aggravated by gingival enlargement, resulted in extensive tooth loss. Periodontitis and gingival enlargement exacerbate and accelerate one another and can result in loss of the entire dentition, severely affecting function and esthetics. The pharmacologic etiology sometimes cannot be altered and the patient has to be carefully managed and maintained with periodontal therapy. Physicians and dentists should be aware of these medications and be able to identify early changes in the oral cavity and to prevent, diagnose, and successfully manage the unwanted side effects of these drugs in patients

Inclusion and neighborhood properties of certain subclasses of p-valent functions of complex order defined by convolution

In this paper we introduce and investigate three new subclasses of $p$-valent analytic functions by using the linear operator $D_{\lambda,p}^m(f*g)(z)$. The various results obtained here for each of these function classes include coefficient bounds, distortion inequalities and associated inclusion relations for $(n,\theta)$-neighborhoods of subclasses of analytic and multivalent functions with negative coefficients, which are defined by means of a non-homogenous differential equation

Pooled Analysis of the Efficacy and Safety of Video Capsule Endoscopy in Patients with Implantable Cardiac Devices

© 2019 Rabih Tabet et al. Background. To date, video capsule endoscopy (VCE) is still contraindicated by the FDA and the main manufacturers of Cardiac Implantable Electronic Devices (CIED) in patients with CIED, given a theoretical electromagnetic interference and possible device malfunction. Objectives. The objective of this study was to assess the safety profile and efficacy of VCE in patients with implantable cardiac devices through analyzing the risk of mutual interference. Methods. A systematic review of PubMed, Web of Science, and Embase databases was conducted. Peer-reviewed original articles, published in the English language and containing capsule endoscopy AND pacemaker , defibrillator OR left ventricular assist device as keywords, were selected. Studies performed in vitro, isolated case reports, and abstracts/posters were excluded. Results. A total of 735 VCE procedures were performed in patients with cardiac devices in various clinical settings. Cardiac events were not seen in any case. Interference on capsule images transmission was noted in 5 cases (left ventricular assist device (LVAD)) where few images were lost when the capsule was closest to the device. Finally, interference between capsule and telemetry leads was noted in 6 cases (4 Permanent Pacemakers (PPM), 2 Implantable Cardioverter-Defibrillator (ICD)) leading to image artifacts. Discussion. Adverse cardiac events were not seen in any study. Loss of images occurred when the VCE was in proximity to the device (only with LVAD) or after telemetry leads installation without affecting the completion rate and diagnostic yield of VCE. Conclusion. VCE is safe and remains efficient in patients with cardiac devices. If cardiac monitoring is required, wired systems are preferable

Effects of Art Intervention on Pediatric Anxiety and Pain in the Medical Setting

Introduction: Hospitalization and illness can be a painful and stressful time for a child. There may be anxiety over procedures and inpatient stays disrupt normal routines. Previous research found that for pre-school aged children, having parents around, having the help of the hospital staff, and playing an active role in alleviating their fears were the most helpful in reducing anxiety. Another study found that visual creative expressions can be meaningful experiences for young adult cancer survivors. Additionally, there is abundant literature on formal art therapy and its favorable effects on children in the hospital, however, there are fewer studies investigating less standardized “art intervention” in the same population. The purpose of our project was to assess whether art intervention reduces anxiety and pain in inpatient and outpatient pediatric patients.https://scholarworks.uvm.edu/comphp_gallery/1224/thumbnail.jp

Anticholinergic Toxicity Secondary to Overuse of Topricin Cream, a Homeopathic Medication.

Adverse reactions from over-the-counter medications present a challenge to physicians. Homeopathic medicine is an alternative practice, originating in Germany and gaining popularity in the United States. It utilizes dilute preparations of substances in order to treat and cure disease. Patients may potentially suffer serious effects from the use of these products as the contents and concentrations are often unclear. Here, we describe a case of suspected atropine toxicity due to the overuse of a topical homeopathic cream, Topricin, which contains belladonna, a plant containing atropine

2-[(2-Meth­oxy­eth­yl)sulfan­yl]-4-(2-methyl­prop­yl)-6-oxo-1,6-dihydro­pyrimidine-5-carbonitrile

In the title compound, C12H17N3O2S, the 4-methyl-2-methyl­sulfanyl-6-oxo-1,6-dihydro­pyrimidine-5-carbonitrile part of the mol­ecule is almost planar (r.m.s deviation = 0.062 Å). In the crystal, mol­ecules form centrosymmetric dimers via pairs of N—H⋯O hydrogen bonds

Dorsal GPi/GPe Stimulation Induced Dyskinesia in a Patient with Parkinson’s Disease

Clinical vignette: A 68-year-old man with Parkinson’s disease (PD) had bilateral GPi DBS placed for management of his motor fluctuations. He developed stimulation-induced dyskinesia (SID) with left dorsal GPi stimulation. Clinical dilemma: What do we know about SID in PD patients with GPi DBS? What are the potential strategies used to maximize the DBS therapeutic benefit and minimize the side effects of stimulation? Clinical solution: Avoiding the contact implicated in SID and programming more ventral contacts, using lower voltage, frequency and pulse width and programming in bipolar configuration all appear to help minimize the SID and provide appropriate symptomatic motor control. Gap in knowledge: Little is known about SID in patients with PD who had GPi DBS therapy. More studies using volume of tissue activated and diffusion tensor imaging MRI are needed to localize specific tracts in or around the GPi that may be implicated in SID

Responding to Climate Change: The Economy and Economics - Part of the Problem and Solution

The Climate Change Starter’s Guide provides an introduction and overview for education planners and practitioners on the wide range of issues relating to climate change and climate change education, including causes, impacts, mitigation and adaptation strategies, as well as some broad political and economic principles. The aim of this guide is to serve as a starting point for mainstreaming climate change education into school curricula. It has been created to enable education planners and practitioners to understand the issues at hand, to review and analyse their relevance to particular national and local contexts, and to facilitate the development of education policies, curricula, programmes and lesson plans. The guide covers four major thematic areas: 1. the science of climate change, which explains the causes and observed changes; 2. the social and human aspects of climate change including gender, health, migration, poverty and ethics; 3. policy responses to climate change including measures for mitigation and adaptation; and 4. education approaches including education for sustainable development, disaster reduction and sustainable lifestyles. A selection of key resources in the form of publication titles or websites for further reading is provided after each of the thematic sections

Degradation and Removal Methods for Perfluoroalkyl and Polyfluoroalkyl Substances in Water

Several perfluoroalkyl and polyfluoroalkyl substances (PFASs) have been identified as chemicals of concern in the environment due to their persistence, global ubiquity, and classification as reproductive and developmental toxicants, endocrine disrupters, and possible carcinogens. Multiple PFASs are often found together in the environment due to product manufacturing methods and abiotic and biotic transformations. Treatment methods are needed to effectively sequester or destroy a variety of PFASs from groundwater, drinking water, and wastewater. This review presents a comprehensive summary of several categories of treatment approaches: (1) sorption using activated carbon, ion exchange, or other sorbents, (2) advanced oxidation processes, including electrochemical oxidation, photolysis, and photocatalysis, (3) advanced reduction processes using aqueous iodide or dithionite and sulfite, (4) thermal and nonthermal destruction, including incineration, sonochemical degradation, sub- or supercritical treatment, microwave-hydrothermal treatment, and high-voltage electric discharge, (5) microbial treatment, and (6) other treatment processes, including ozonation under alkaline conditions, permanganate oxidation, vitamin-B_(12) and Ti(III) citrate reductive defluorination, and ball milling. Discussion of each treatment technology, including background, mechanisms, advances, and effectiveness, will inform the development of cost-effective PFAS remediation strategies based on environmental parameters and applicable methodologies. Further optimization of current technologies to analyze and remove or destroy PFASs below regulatory guidelines is needed. Due to the stability of PFASs, a combination of multiple treatment technologies will likely be required to effectively address real-world complexities of PFAS mixtures and cocontaminants present in environmental matrices