No description available.

ABSTRACT Odontogenic abscesses and Ludwig’s angina are infections commonly seen by maxillofacial surgeons. Both infections have periapical or periodontal origin and caused by oral bacteria. Ludwig’s angina is an aggressive and fast spreading infection compared to odontogenic abscess. The origin and the responsible bacteria of these infections are similar but the development and response is different in patients. There is no comprehensive study that has investigated the bacterial and host factors involved in the development of there infections. The aim of this study was to compare the presence of bacteria and enzymes in to the pus samples collected from patients with odontogenic abscess and Ludwig’s angina. Furthermore, various haematological and immunological tests were also compared between the two study groups. Forty two patients presenting with localized odontogenic abscesses and 15 with Ludwig’s angina were selected. Patient was examined according to standard protocol and history was recorded. Bloods were collected for haematology and immunology tests and pus was collected for microbiology and enzymatic tests. The results showed that highly virulent bacteria such as Staphylococcus aureus and black pigmented bacteroides were prevalent, increase in c-reactive protein, white blood cell count, IL6 and decrease in urea, circulating immune complexes and IgE in patients with Ludwig’s angina. Development of Ludwig’s angina could be due to the aggressive bacteria, their byproducts and low immune response compared to the odontogenic abscesses.

INTRODUÇÃO: A proteína C-reativa de alta sensibilidade (PCR-as) é comumente utilizada na prática clínica para avaliar o risco cardiovascular. O seio coronário (SC) é considerado o local ideal para estudos de marcadores inflamatórios e circulação coronária, até o momento. A correlação entre os níveis séricos de PCR-as (valores absolutos) periférico versus (vs.) central ainda não foi feita. Avaliou-se a correlação entre os níveis séricos de PCR-as (mg/L) em veia periférica do antebraço esquerdo (VPAE) vs. SC, em pacientes portadores de doença arterial coronária (DAC) aterosclerótica com diagnóstico de angina estável (AE) ou angina instável (AI). Avaliou-se, também, se os níveis de PCR-as na VPAE e no SC diferem na AE e AI. MÉTODOS e RESULTADOS: 40 pacientes com DAC e estenose >= 70 % do diâmetro da luz vascular em uma das principais artérias coronárias foram incluídos no estudo e classificados em AE (n = 20) e, AI (n = 20). Coletaram-se amostras de sangue simultaneamente na VPAE e no SC, antes da angiografia coronária. A média dos níveis séricos absolutos de PCR-as na VPAE nos pacientes com AE foi de 2,97 ± 2,66, log 0,53 ± 1,24 e, com AI foi de 3,04 ± 3,29, log 0,67 ± 0,94, p = 0,689; e no SC, na AE foi de 2,71 ± 2,46, log 0,46 ± 1,18 e na AI, foi de 2,65 ± 3,08, log 0,41 ± 0,97, p = 0,898 e, portanto, não foram observadas diferenças significativas. A análise de correlação entre os níveis séricos de PCR-as em VPAE vs. SC mostrou uma forte correlação linear tanto para AE (r = 0,993, p < 0,001), para AI (r = 0,976, p < 0,001) e em toda amostra (r = 0,985, p < 0,001). CONCLUSÃO: Os nossos dados sugeriram uma forte correlação linear entre os níveis séricos de PCR-as na VPAE vs. SC na AE e AI; e esses níveis na VPAE e no SC na AE e AI foram semelhantes e não revelaram diferentes influências biológicas / BACKGROUND: The high-sensitivity C-reactive protein (hs-CRP) is commonly used in clinical practice to assess cardiovascular risk. The coronary sinus (CS) is considered the ideal location for studies of inflammatory markers and coronary circulation, until the moment. The correlation between peripheral versus (vs.) central serum levels of hs-CRP (absolute values) has not been done. We evaluated the correlation between serum levels of hs-CRP (mg/L) in the left forearm peripheral vein (LFPV) vs. CS in patients with atherosclerotic coronary artery disease (CAD) and diagnosis of stable angina (SA) or unstable angina (UA). We also evaluated whether the hs-CRP levels in LFPV and CS differ in SA and UA. METHODS and RESULTS: 40 patients with CAD and >= 70 % stenosis of the diameter of the vascular lumen in one of the main coronary arteries were included in the study and, classified into SA (n = 20) and, UA (n = 20). Blood samples from in the LFPV and CS were simultaneously collected before coronary angiography. The mean serum levels of hs-CRP in LFPV in the patients with SA was 2.97 ± 2.66, log 0.53 ± 1.24 and, in the UA was 3.04 ± 3.29, log 0.67 ± 0.94, p = 0.689. In CS in SA, it was 2.71 ± 2.46, log 0.46 ± 1.18 and in UA it was 2.65 ± 3.08, log 0.41 ± 0.97, p = 0.898; therefore, no significant differences were observed. The correlation analysis between the serum levels of hs-CRP in LFPV vs. CS showed a strong linear correlation in both for SA (r = 0.993, p < 0.001), for UA (r = 0.976, p < 0.001) and in the whole sample (r = 0.985, p < 0.001). CONCLUSIONS: Our data suggested that in SA as well as in UA there was a strong linear correlation between the serum levels of hs-CRP in LFPV vs. CS and, these levels in VPAE and SC in AE and AI were similar and did not reveal different biological influences

Introducción: La angina variante por vasoespasmo coronario y el síndrome X han sido mencionados como responsables de angina en ausencia de lesión coronaria significativa. Sin embargo no todos los pacientes en esta situación clínica cumplen criterios para ser agrupados en estas entidades patológicas.Pacientes y Métodos: Se estudiaron 328 pacientes consecutivos divididos en 4 grupos: A: Angina vasoespástica (n:165). B: Síndrome X (SDX) [sin vasoespasmo (VSP) con prueba de esfuerzo (PE) positiva] (n:47). C: Angina de reposo o mixta, sin VSP y PE negativa (n:93) D: Angina de esfuerzo, sin VSP y PE negativa (n:23). Fueron excluidos del estudio aquellos pacientes con patología extracoronaria que justificase la angina. Se evaluaron antecedentes patológicos, factores de riesgo y características clínicas. Se realizó a todos una prueba de esfuerzo, con gammagrafía en 214 casos, y se analizó en el seguimiento a largo plazo (72±52meses) valorando la mortalidad y la aparición de eventos coronarios.Resultados: La prevalencia global de dislipemia fue elevada (67%) y no mostró diferencias significativa entre los grupos. La prevalencia del tabaquismo fue superior en los pacientes que presentaban VSP (62 vs 22%, p<0,001) y la de HTA fue superior en el SDX que en el resto de los grupos (51 vs 34%, P<0,05). Entre los pacientes vasoespásticos existía una mayor proporción con respuesta a NTG que en los no vasoespásticos (85 vs 54%,p<0,01). Un 43,2% de los pacientes de grupos C y D presentan defectos de perfusión reversibles. No existieron diferencias significativas entre los pacientes con y sin VSP en la aparición de cambios ECG (24,6 vs 29%, p:ns) ni defectos gammagráficos (53 vs 50%,p:ns) durante la PE. En el seguimiento se observó una reducida mortalidad (3%) y una baja incidencia de infarto de miocardio (5%) sin evidenciarse diferencias entre los grupos ni entre pacientes con (4,7%) o sin (7%) defectos gammagráficos de esfuerzo (p:ns).Conclusiones: Nuestros resultados indican que existe una proporción importante de pacientes anginosos sin lesiones coronarias significativas que no presentan vasoespasmo ni cambios en el ECG de esfuerzo. No obstante, casi la mitad de ellos presentan defectos de perfusión durante el esfuerzo, en su mayoría leves. Existe una baja incidencia de infarto de miocardio y de mortalidad cardiaca en el seguimiento a largo plazo. La aparición de defectos gammagráficos de esfuerzo no confiere empeoramiento en el pronóstico. / Introduction: Variant angina due to coronary spasm and syndrome X are known to be responsible for angina in the absence of significant coronary stenosis. However, not all patients in these clinical conditions meet the criteria to be labelled as these pathological entities.Patient and methods: We studied 328 consecutive patients in 4 different groups: A: vasospastic angina (n:165). B: Syndrome X (SDX) [without vasospasm (VSP) with a positive stress test (ST)] (n:47). C: Rest angina or mixed angina, without VSP and with a negative ST (n:93). D: stress angina without VSP and with negative ST (n:23). Those patients with non coronary cause of angina were excluded of this study. We evaluated pathological antecedents, risk factors and clinical characteristics. Stress tests were performed in all patients, 214 of them with scintigraphic perfusion analysis. We study incidence of mortality and coronary events in the long term follow up (72±52month).Result: The global prevalence of dislipidemia was high (67%) without significant differences between groups. The prevalence of smoking was higher in the vasospastic patients (62 vs 22%, p<0,001) and the hypertension's prevalence was higher in Group B than in the remaining groups (51 vs 34%, P<0,05). Among vasospastic patients we observed a greater proportion with response to nitroglicerine than no vasospastic patients (85 vs 54%, p<0,01). Forty tree patients from groups C and D presented reversible perfusion defects. There were not significant differences between patients with and without VSP in the ECG changes (24,6 vs. 29%, p:ns) nor in the scintigraphic defects (53 vs 50%,p:ns) during ST. In the follow-up we observed a low mortality rate (3%) and a low incidence of infarct (5%) without differences among the groups nor between patients with (4,7%) or without (7%) stress scintigraphic defects (p:ns) during ST.Conclusions: Our results indicate than there is an important proportions of patients with angina without significant coronary artery stenosis who do not nither present vasospasm nor ECG changes during ST. However, nearly a half of them present perfusion defects during ST, mild in most of them. There is a low incidence of myocardial infarct and cardiac mortality in the long-term follow-up. The presence of stress scintigraphic defects do not implicate worse prognosis.

No description available.

Thesis (MClinPharm)--University of South Australia, 1997

Angina pectoris (AP) is an important manifestation of chronic coronary heart disease, estimated to affect more than 10% of people aged over 60 years. Typically, AP is experienced as chest pain, induced by exertion and relieved by rest or medication. Despite contemporary medical management, people with chronic AP may experience symptoms during everyday activities. Accordingly, AP has significant potential to limit people's daily activities and participation in life roles. Yet there is a limited literature reporting the impact of AP on activities. The aim of this program of research was to describe the relationship between AP and limitation in people's activities and participation in life roles. The research comprised three studies. The first two studies were undertaken by secondary analysis of data from a large population study, the Australian Longitudinal Study of Ageing (ALSA). These studies answered research questions about the relationship between AP and activity limitation in a large sample of older Australians. The third study involved the collection of new data to explore how people of various ages perceive and manage the impact of AP on their activities and life roles. / PhD Doctorate

Ulm, Univ. Diss., 2006.

Thesis (doctoral)--Malmö, 1982.

Thesis (M.S.)--University of Wisconsin-Madison. / Typescript. eContent provider-neutral record in process. Description based on print version record. Includes bibliographical references (leaves 52-56).