RESUMEN
OBJECTIVE: This retrospective study was designed to assess the effects of the combination of pioglitazone and extended-release niacin on the lipid panel, particularly HDL-cholesterol, when used in patients with type 2 diabetes in an endocrinology specialty practice. METHODS: The electronic medical records of 434 adult patients with type 2 diabetes receiving extended-release niacin and pioglitazone were screened for review. Patients with type 2 diabetes and hyperlipidemia were included for review if they received the combination of pioglitazone at doses ≥ 15 mg/day and extended-release niacin (Niaspan) at doses ≥ 1000 mg/day for ≥6 months. Statistical analysis used paired t-tests with p < 0.05 as statistically significant. Both ANOVA and the Tukey-Kramer test for multiple comparisons (α = 0.05) were also used. RESULTS: A total of 47 patients, 83% were men with average age of 58, met all eligibility criteria for the study. Compared with baseline, a statistically significant increase in HDL-C (+ 25.13%, p < 0.0001) was observed at the conclusion of combination therapy. The HDL-C levels progressively increased with duration of combination treatment, and were not correlated with concomitant statin use. Significant decreases in total cholesterol and triglycerides were detected, and HbA1c decreased 0.84% during combination therapy for all therapies combined. CONCLUSION: The combination of pioglitazone and extended-release niacin in patients with type 2 diabetes and hyperlipidemia, used in commonly prescribed doses for at least 6 months, resulted in statistically significant improvements in HDL-C, total cholesterol, and triglycerides, and did not result in deteriorations in glycemic control.
Asunto(s)
HDL-Colesterol/efectos de los fármacos , Diabetes Mellitus Tipo 2/tratamiento farmacológico , Hipoglucemiantes/administración & dosificación , Hipolipemiantes/administración & dosificación , Niacina/administración & dosificación , Tiazolidinedionas/administración & dosificación , Análisis de Varianza , HDL-Colesterol/metabolismo , Preparaciones de Acción Retardada , Diabetes Mellitus Tipo 2/sangre , Quimioterapia Combinada , Femenino , Intolerancia a la Glucosa/prevención & control , Hemoglobina Glucada/metabolismo , Humanos , Masculino , Persona de Mediana Edad , Pioglitazona , Estudios Retrospectivos , Resultado del TratamientoRESUMEN
A case is described of self-inflicted oral injury in a 15-month-old infant. The child had a habit of posturing the mandible forwards and biting the gingiva lingual to the mandibular primary incisors with the maxillary incisors, causing marked ulceration. It is suggested that the habit may have been initiated by irritation from erupting mandibular primary canines. The habit was abandoned as the canines erupted and the ulcerated area healed completely.
Asunto(s)
Encía/lesiones , Conducta Autodestructiva , Erupción Dental , Diente Canino , Succión del Dedo , Hábitos , Humanos , Lactante , Masculino , MandíbulaRESUMEN
The importance of continued education for the general dental practitioner is being increasingly emphasized. This paper describes the review of a prosthetic dentistry course which endeavoured to involve local practitioners to increase its appeal and relevance.
Asunto(s)
Educación Continua en Odontología , Curriculum , Inglaterra , Humanos , Encuestas y CuestionariosRESUMEN
This case report of severe periodontitis concerns a young male patient with chronic idiopathic neutropenia seen between 1981 and 1983 by the School of Dental Medicine of Geneva and from 1984 to 1988 by the Eastman Dental Hospital of London. The patient was maintained by intermittent systemic antibiotics, subgingival chlorhexidine irrigation, conventional debridement, brushing, and wire-mesh and composite splinting of loose teeth. After leaving school, at the patient's express wish, the extreme downhill pattern of the periodontitis resulted in removal of affected teeth and overdenture construction. The extracted teeth and associated soft tissues were examined for relevant plaque and host response features. The intact morphotypes associated with the advancing front of the lesion were invariably Gram-negative or positive coccoid cells, or less commonly short rods, as in all documented forms of periodotitis. Connective tissue destruction was associated with a leucocyte accumulation comprising mainly polymorphonuclear neutrophils (PMN) and plasma cells. Both were observed degenerated more deeply than in routine adult periodontitis, including PMN lysosome loss and lymphocyte maturation within peripheral blood vessels. Only in one instance, one part of the superficial connective tissue of one block contained bacteria. It was concluded that the features of plaque and the lesion suggest a typical first line of defence response as in other forms of periodontitis. From the consideration of the 10 years clinical history of the patient, it is clear that non-surgical management is possible even in extreme cases, without any compromise of the patient's oral or systemic health, and in accord with the patient's wishes.
Asunto(s)
Agranulocitosis/complicaciones , Neutropenia/complicaciones , Periodontitis/patología , Adolescente , Resorción Ósea/patología , Enfermedad Crónica , Tejido Conectivo/ultraestructura , Placa Dental/ultraestructura , Gingivitis/patología , Humanos , Masculino , Microscopía Electrónica , Neutrófilos/ultraestructura , Periodontitis/etiología , Periodoncio/ultraestructura , PronósticoRESUMEN
Breast milk antibodies have been shown to persist in the mouths of neonates for some hours following feeding. The decrease in concentration following a feed probably reflects the flushing action of salivary flow combined with swallowing.