The effect of nonsurgical periodontal treatment on serum and gingival crevicular fluid markers in patients with atherosclerosis

Background and Aims: The aim of this study is to compare patients with atherosclerosis and chronic periodontitis and patients who are systemically healthy and chronic periodontitis using alteration of adrenomedullin (ADM), chemokine (C-C motif) ligand 28 (CCL-28), white blood cell levels, platelet levels, high-density lipoprotein, low-density lipoprotein, high-sensitivity C-reactive protein, creatinine, and fibrinogen. Materials and Methods: Totally, 40 patients were involved in study; a test group of 20 patients with atherosclerosis-chronic periodontitis and a control group of 20 patients who were nonatherosclerosis-chronic periodontitis. Nonsurgical periodontal treatment was offered to all patients, in whom systemic markers of atherosclerosis were measured in serum; ADM and CCL-28 biomarkers were measured in gingival crevicular fluid. Results: Systemic markers of atherosclerosis, ADM, and CCL-28 levels have changed significantly in the test group compared to the control group after nonsurgical periodontal treatment. Conclusions: Treatment of local inflammation and reduction of systemic inflammatory markers are believed to lower the diagnostic criteria for atherosclerosis as well. It is possible to conclude that nonsurgical periodontal treatment of chronic periodontitis, which is a risk factor for atherosclerosis, has a positive effect on the atherosclerosis prognosis

chronic periodontitis and atherosclerosis

This study was carried out to compare individuals diagnosed with atherosclerosis and periodontal periodontitis based on the degree of change in the human beta-defensins (HBD) HBD-2, HBD-3, and calprotectin. Atherosclerosis is the most frequently observed cardiovascular disease. Dental and periodontal infections are known to provide a considerable basis for atheroma plaque formation. The study group consists of a total number of 40 subjects, with 20 patients diagnosed with atherosclerosis and chronic periodontitis and 20 systemically healthy patients diagnosed with chronic periodontitis. Clinical periodontal and blood parameters and HBD-2, HBD-3, and calprotectin biomarkers in the gingival crevicular fluid were measured. In both groups, following clinical periodontal treatment, a statistically significant decrease in white blood cells (WBC), low-density lipoproteins (LDL), fibrinogen, creatinine, and platelets (PLT), a statistically significant increase in high-density lipoproteins (HDL) in blood samples, statistically meaningful decrease in HBD-2, HBD-3, and calprotectin in the gingival crevicular fluid were achieved. Blood values and HBD-2, HBD-3, calprotectin amounts in the gingival crevicular fluid were increased significantly in the test group compared to the control group. A positive correlation was observed between decreases in HBD-2, HBD-3, calprotectin, and clinical periodontal indices. Regression in systemic inflammation was observed after clinical periodontal treatment. It is concluded that nonsurgical periodontal treatment of chronic periodontitis positively affects atherosclerosis prognosis.C1 [Taspinar, Mehmet] Aksaray Univ, Fac Med, Aksaray, Turkey.[Taspinar, Mehmet] Yuzuncu Yil Univ, Fac Med, Van, Turkey.[Bozoglan, Alihan] Firat Univ, Fac Dent, Dept Periodontol, Elazig, Turkey.[Bozoglan, Alihan] Yuzuncu Yil Univ, Fac Dent, Dept Periodontol, Van, Turkey.[Ertugrul, Abdullah Seckin] Izmir Katip Celebi Univ, Fac Dent, Dept Periodontol, Izmir, Turkey.[Elmas, Levent] Pamukkale Univ, Fac Med, Denizli, Turkey

Elevated insulin resistance in patients with recurrent aphthous stomatitis

Objectives The role of glucose metabolism disorders in periodontal diseases including recurrent aphthous stomatitis (RAS) is currently attracting attention. The aim of this study is to investigate insulin resistance (IR) in patients with RAS in otherwise healthy individuals

Ribavirin for Crimean-Congo hemorrhagic fever: systematic review and meta-analysis

Background Crimean-Congo Hemorrhagic Fever epidemics often occur in areas where health services are limited, and are associated with case fatality rates of 5-40%. Besides intensive care, ribavirin is often recommended. A solid evidence base for the use of this drug will help justify assuring access to the drug in areas where epidemics are common. Methods We carried out a systematic review of observational and experimental studies of people with suspected or confirmed Crimean-Congo Haemorrhagic Fever that included comparisons between patients given ribavirin and those not. We extracted data on mortality, hospital stay, and adverse events. Risk of bias was assessed using a standard checklist, and data were presented in meta-analytical graphs, stratified by study design, and summary estimates were assessed using the GRADE method. Results Twenty-one unique studies, including one randomised controlled trial of ribavirin, were included. Quality of the evidence was very low, with a Down and Black median score of 4 (maximum possible 33). Ribavirin treatment was not shown to be superior to no ribavirin treatment for mortality rate in a single RCT (RR: 1.13, 95%CI: 0.29 to 4.32, 136 participants, GRADE= low quality evidence); but ribavirin was associated with reduced mortality by 44% when compared to no ribavirin treatment in the pooled observational studies (RR: 0.56, 95%CI: 0.35 to 0.90, 955 participants; GRADE=very low quality evidence). Adverse events were more common with the ribavirin patients, but no severe adverse events were reported. No difference in length of hospital stay was reported. Conclusions No clear message of benefit is available from the current data on ribavirin as observational data are heavily confounded, and the one trial carried out has limited power. However, ribavirin could potentially have large benefits in this condition and these results very clearly indicate a pragmatic, randomised controlled trial in the context of good quality supportive care is urgently needed and ethically justified

Insulin resistance is increased in alopecia areata patients

Increased insulin resistance (IR) has been found in androgenetic alopecia in several studies. However, IR has not been investigated in alopecia areata (AA). We aimed to investigate IR in AA patients and the controls. Anthropometric and demographic data were obtained from 51 AA patients and 36 controls. We measured insulin, c-peptide and blood glucose and HOMA-IR. Demographic characteristics of the two groups were similar. AA group had higher insulin [12.5 +/- 7.01 vs. 8.3 +/- 3.9 mu IU/mL, p = 0.001], c-peptide [2.7 +/- 1.07 vs. 2.1 +/- 0.6 ng/mL, p = 0.007] and HOMA-IR levels [2.8 +/- 1.6 vs. 1.9 +/- 0.9, p = .004] than the controls. Patient and control groups were also similar regarding lipid profiles. In this study, we found increased IR in AA patients for the first time in literature. Increased inflammatory cytokines and hypothalamic-pituitary-adrenal axis activation may be responsible for this finding. Further studies with larger sample sizes may give additional information for IR in AA