Decamethoxin and chlorhexidine bigluconate effect on the adhesive and biofilm-forming properties of Streptococcus mitis.

The aim of the study: Was to investigate the effect of antiseptics on the adhesive and biofilm-forming properties of clinical S.mitis isolates isolated from the oral cavity of patients with an infectious and inflammatory post-extraction complication. Materials and methods: Twenty four clinical isolates of S.mitis isolated from patients were studied. The studied antiseptics included 0.02% aqueous solution of decamethoxin and 0.05% solution of chlorhexidine bigluconate. Adhesion of clinical isolates under the action of decamethoxin and chlorhexidine bigluconate was determined by the method of V.I. Brillis. The biofilm-forming properties of clinical isolates were studied using the "microtiter plate test" according to G.D. Christensen. Results: The studied clinical isolates of S.mitis are classified as highly adherent microorganisms. Action of decamethoxin on clinical isolates decreases the adhesion index of the studied isolates in comparison with the adhesion index of the control culture. Action of chlorhexidine bigluconate on S.mitis isolates increases of adhession of the studied clinical isolates in comparison with the control. After the effect of decamethoxin, the optical density of clinical isolates decreased considering the optical density results of the control. The clinical isolates left an average film-forming capacity even after chlorhexidine bigluconate action. Conclusions: Clinical isolates of S.mitis are highly adherent microorganisms. The antiseptic decamethoxin decreases the adhesion index of these bacteria, while chlorhexidine bigluconate increases the adhesion index of clinical S.mitis isolates. Clinical S. mitis isolates have an average biofilm formation capacity index. The antiseptic decamethoxin inhibits the biofilm formation capacity of S.mitis from medium to low.

Sex differences in outcomes of transvenous lead extraction: insights from National Readmission Database.

BACKGROUND: With the growing use of implantable cardiac devices, the need for transvenous lead extraction has increased, which translates to increased procedural volumes. Sex differences in lead extraction outcomes are not well studied. OBJECTIVE: The present study aims at evaluating the impact of sex on outcomes of lead extraction. METHODS: We identified 71,754 patients who presented between 2016 and 2019 and underwent transvenous lead extraction. Their clinical data were retrospectively accrued from the National Readmission Database (NRD) using the corresponding diagnosis codes. We compared clinical outcomes between male and female patients. Odds ratios (ORs) for the primary and secondary outcomes were calculated, and multivariable regression analysis was utilized to adjust for confounding variables. RESULTS: Compared to male patients, female patients had higher in-hospital complications including pneumothorax (OR 1.26, 95% CI (1.07-1.4), P < 0.01), hemopericardium (OR 1.39, 95% CI (1.02-1.88), P = 0.036), injury to superior vena cava and innominate vein requiring repair (OR 1.88, 95% CI (1.14-3.1), P = 0.014; OR 3.4, 95% CI (1.8-6.5), P < 0.01), need for blood transfusion (OR 1.28, 95% CI (1.18-1.38), P < 0.01), and pericardiocentesis (OR 1.6, 95% CI (1.3-2), P < 0.01). Thirty-day readmission was also significantly higher in female patients (OR 1.09, 95% CI (1.02-1.17), P < 0.01). There was no significant difference regarding in-hospital mortality (OR 0.99, 95% CI (0.87-1.14), P = 0.95). CONCLUSION: In female patients, lead extraction is associated with worse clinical outcomes and higher 30-day readmission rate.

New-onset pericardial effusion during transvenous lead extraction: incidence, causative mechanisms, and associated factors.

PURPOSE: Pericardial effusion (PE) may occur during the lead extraction procedure (TLE). Little is known about the incidence, causes, and predictors of this complication. METHODS: From January 2009 to October 2016, TLE was attempted for 297 leads in 212 patients (age 69.3 ± 12.9 years, 169 male, BMI 27.2 ± 9.9 m²/kg, LVEF 43.4 ± 24.6%) for lead dysfunction (62.7%), upgrade (16.0%), infection (14.2%), or other (7.0%) indications. TLE was performed under general anesthesia with continuous invasive arterial blood pressure and transesophageal echocardiography (TEE) monitoring. For lead removal, the mechanical approach was first attempted, followed by the laser-assisted technique when needed. Severity of PE was defined by the presence of hemodynamically significant PE > 10 mm at TEE. RESULTS: Clinical success was achieved for 292 leads (98.3%). New-onset PE was observed in 14 patients (6.6%) [mild entity in 7 patients (3.3%) and severe in 7 (3.3%)]. In these latter patients, intra-procedural management included surgery (n = 3), pericardiocentesis (n = 2), or a conservative approach (n = 2). Right ventricular (RV) site lesions were treated with a simple fluid infusion. Laceration of the superior vena cava and other vessels resulted in rescue surgery. Lesions of the right atrial free wall (n = 1) and coronary sinus (n = 1) were treated with pericardiocentesis. NYHA III/IV, LVEF < 35%, renal impairment, right-sided implant, and ≥2 leads targeted for TLE were associated with new-onset PE. More than two factors identified a higher risk group (16.2%, 95% CI 6.2-32.0%, P = 0.02). CONCLUSIONS: New-onset PE is common during TLE and is associated with specific factors. PE severity and subsequent patient management depend on the site of injury.

Relación entre los anticonceptivos orales y la incidencia de alveolitis. Revisión bibliográfica / Relationship between oral contraceptives and alveolitis incidence. A literature review

Introducción: La alveolitis es una complicación tras una exodoncia dental quecursa con dolor intenso, trismo y mal olor.Esta complicación se relaciona con el hábito tabáquico, la higiene oral, no seguirlas normas post extracción o la edad yel género del paciente. Otras causas potenciales que podrían desencadenar esteproceso son el ciclo menstrual en el casode las pacientes de género femenino o eltratamiento con anticonceptivos orales. Elobjetivo de esta revisión es comparar, según la literatura, la incidencia de alveolitisen mujeres en tratamiento con anticonceptivos orales respecto a las que no lostoman y respecto a los hombres.Métodos: Se realizó una búsqueda bibliográfica en las bases de datos PubMed/Medline, Science Direct, GoogleScholar y Scopus y se incluyeron artículos en inglés y en español relacionadoscon el tema a tratar. Las palabras claveutilizadas fueron: “alveolar osteitis” OR “fibrinolytic alveolitis” OR “localized osteomyelitis” OR “delayed extraction woundhealing” AND “contraceptives” OR “OC”OR “contraceptive pill”. Se incluyeron estudios sobre exodoncias en pacientes entratamiento con anticonceptivos o sin anticonceptivos o varones, según los gruposde control que se han propuesto estudiar,que registrasen casos de alveolitis.Resultados: Se observó una mayor incidencia media de alveolitis post extracciónen las pacientes en tratamiento con anticonceptivos (18,52%), respecto a otraspacientes que no lo estaban (6,78%) yrespecto a la población de género masculino (6,4%)...(AU)

Introduction: Alveolitis is a complicationafter dental extraction which courses withintense pain, trismus, and halitosis. This complication is associated with smoking,oral hygiene, not following post-extraction rules or the age and gender of the patient. However, other potential causes could trigger this process, such as the menstrual cycle in the case of female patients or the fact that they are under treatment with oral contraceptives. The objective of this review was to compare the incidence of alveolitis among patients treated with oral contraceptives with those who do not take them. Methods: A bibliographic search was carried out in the databases PubMed/Medline, Science Direct, Google Scholar and Scopus and articles in English and Spanish related to the topic were included.Keywords used were: “alveolar osteitis ”OR “fibrinolytic alveolitis” OR “localized osteomyelitis” OR “delayed extraction wound healing” AND “contraceptives”OR “OC” OR “contraceptive pill”. Studies on exodontia in patients treated with contraceptives with registered cases of alveolitis were included.Results: A higher mean incidence of alveolitis was observed in patients treated with contraceptives (18.52%),with respect to other patients who were not (6.78%) and with respect to male population (6.4%)...(AU)

Comparision between neocone, alvogyl and zinc oxide eugenol packing for the treatment of dry socket: a double blind randomised control trial.

OBJECTIVES: To prospectively evaluate and compare the effectiveness of Neocone, Alvogyl and Zinc Oxide Eugenol (ZOE) intra alveolar dressings for the management of dry socket and to study the epidemiological factors associated with the condition. STUDY DESIGN: All the patients who underwent extraction of teeth and who fulfilled our inclusion and exclusion criteria from 1st January 2012 to February 28th 2013 were included in our study. Patients who were diagnosed to suffer from dry socket were randomly allocated to three groups namely Group A (Alvogyl), Group B (ZOE), Group C (Neocone). Pain relief and healing of the socket were compared between these groups. The collected data were subjected to statistical analysis by Chi Square test, Z test of proportionality. RESULTS AND CONCLUSION: Alvogyl is superior to the other two medications for providing initial pain relief. Neocone provides complete pain relief and the healing was fastest with Neocone. Neocone emerged as the most suitable dressing material for the management of dry socket by virtue of shorter time required for complete pain relief, fewer visits and faster clinical healing.

Chronic swelling from entrapment of acrylic resin in a surgical extraction site.

When acrylic resin is inadvertently embedded in oral tissue, it can result in a pronounced chronic inflammatory response. This report describes a case in which temporary crown and bridge resin was forced into a surgical extraction site after the two adjacent teeth were prepared for a bridge immediately following extraction of a maxillary premolar. The patient experienced swelling at the extraction site over a ten month period despite treatment with antibiotics and anti-inflammatory drugs. After detection and removal of the foreign body, the symptoms resolved. The episode contributed to periodontal bone loss around an adjacent tooth. While morbidity of this nature is rare, this case reinforces the need to investigate persistent signs of inflammation and account for dental materials that are lost during the course of treatment.