OBJECTIVES

A growing body of evidence points to a positive association between periodontitis and
various systemic diseases, including cardiovascular diseases (CVD), hypertension, and rheumatoid arthritis. However,
there is limited data on the prevalence and odds of having systemic conditions among Filipino periodontal patients.
Thus, this study aimed to determine the association of periodontal disease with systemic conditions among Filipino
patients at a university dental clinic.

METHODS

The periodontal and medical charts of all patients who underwent periodontal consult at a university
dental clinic within two academic years were reviewed. Periodontal diagnoses which had originally been assigned
using the 1999 classification of periodontal diseases were reclassified based on the 2018 European Federation
of Periodontology-American Academy of Periodontology classification. Listed medical conditions in the patients’
charts were self-reported. The prevalence of various systemic conditions in 715 periodontitis cases was compared
to that of 834 control patients without periodontitis. Fisher’s exact test was performed to evaluate the difference
in the prevalence of comorbidities between groups, while adjusted odds ratios (AOR) were computed using logistic
regression analysis, accounting for age, sex, educational attainment, and smoking status.

RESULTS

The prevalence of having at least one systemic condition was significantly higher among periodontitis patients
(44.5%) compared to non-periodontitis patients (36.3%). Compared to controls, a significantly higher number of
periodontitis cases had two systemic comorbidities (P=0.001). The prevalence of hypertension (18.6% versus 5.04%),
CVD including hypertension (20.42% versus 6.95%), arthritis (9.37% versus 3.0%), and diabetes mellitus (5.73% versus
0.84%) were all significantly higher in patients with periodontitis compared to non-periodontitis controls.
The odds of having CVD (AOR=1.81), hypertension (AOR=2.14) and diabetes (AOR=3.05) were higher in periodontitis cases. Meanwhile, the prevalence of asthma (9.23% versus 5.31%), respiratory diseases including asthma (12.95% versus 8.25%), and allergies (18.82% versus 13.71%) were significantly higher in non- periodontitis patients compared to periodontitis cases.

CONCLUSION

Periodontitis patients were more likely to present with CVD, hypertension, and diabetes mellitus. On the other hand, no association was found between periodontitis and respiratory diseases, as well as between periodontitis and asthma.

Human ; Male ; Female ; Adolescent: 13-18 Yrs Old ; Young Adult: 19-24 Yrs Old ; Adult: 25-44 Yrs Old ; Middle Aged: 45-64 Yrs Old ; Aged: 65-79 Yrs Old ; Regression (psychology) ; Respiratory Tract Diseases ; Regression Analysis ; Periodontal Diseases ; Cardiovascular Diseases

Objective:To analyze the changes in the costs of hospital rehabilitation after the reform of health insurance payments in the past 6 years, and to identify relevant factors which can provide a reference for the reform of the health insurance payment system in rehabilitation department.Methods:Information on 16, 827 patients hospitalized in the rehabilitation department of The First Affiliated Hospital of Xi′an Jiaotong University between May 2018 and May 2024 was collected and subjected to non-parametric analysis.Results:The average hospitalization cost of rehabilitation department patients over the six years was Y14, 574.92±10, 524.79. During that time the proportion of the cost attributable to Western medicine decreased from 17.1% in 2018 to 7.6% in 2024. The proportion of the patients with hypertension was 51.94%, followed by diabetes mellitus (20.10%). Those with infections had the highest total hospitalization costs. Motor disorders were the most common dysfunction (59.02%), followed by speech disorders (17.45%). Patients with swallowing disorders had the highest hospitalization costs. After the payment system shifted from fee-for-service (FFS) to payment by diagnosis-related group (DRG) in 2023, the average daily inpatient expenditures for rehabilitation patients with all types of diseases gradually declined, reaching its lowest level in 2024.Conclusions:After the health insurance payments shifted from FFS to DRG, the proportion of in patients′ total drug costs decreased annually, and the average daily costs of patients with different types of diseases also decreased significantly, but the comprehensive service fee and diagnostic costs increased.

Objective:To analyze the changes in the costs of hospital rehabilitation after the reform of health insurance payments in the past 6 years, and to identify relevant factors which can provide a reference for the reform of the health insurance payment system in rehabilitation department.Methods:Information on 16, 827 patients hospitalized in the rehabilitation department of The First Affiliated Hospital of Xi′an Jiaotong University between May 2018 and May 2024 was collected and subjected to non-parametric analysis.Results:The average hospitalization cost of rehabilitation department patients over the six years was Y14, 574.92±10, 524.79. During that time the proportion of the cost attributable to Western medicine decreased from 17.1% in 2018 to 7.6% in 2024. The proportion of the patients with hypertension was 51.94%, followed by diabetes mellitus (20.10%). Those with infections had the highest total hospitalization costs. Motor disorders were the most common dysfunction (59.02%), followed by speech disorders (17.45%). Patients with swallowing disorders had the highest hospitalization costs. After the payment system shifted from fee-for-service (FFS) to payment by diagnosis-related group (DRG) in 2023, the average daily inpatient expenditures for rehabilitation patients with all types of diseases gradually declined, reaching its lowest level in 2024.Conclusions:After the health insurance payments shifted from FFS to DRG, the proportion of in patients′ total drug costs decreased annually, and the average daily costs of patients with different types of diseases also decreased significantly, but the comprehensive service fee and diagnostic costs increased.

Use of benzodiazepine (BZD) receptor agonists for delirious or elderly patients has occasionally been found as a result of inappropriate instructions for insomnia or restlessness, according to research of the dementia and delirium support team (DDST), which manages instructions on admission and during hospital rounds. We believe that one reason for this is the lack of hospital guidelines for managing insomnia and restlessness. When changing electronic medical record vendors, we took the opportunity to establish proper drug usage instructions. The percentage of available instructions for insomnia and restlessness at the time of admission and the prescribed medications were surveyed and compared before and after the vendor change. The prescription rate for insomnia was 88.6% (1,779/2,007) before and 91.9% (1,902/2,069) after the change, showing a significant increase. The prescription rate of benzodiazepine receptor agonist use was 47.7% (848/1,779) before and 41.6% (792/1,902) after the change, showing a significant decrease. The prescription rate for restlessness was 71.2% (1,429/2,007) before and 85.6% (1,771/2,069) after the change, showing a significant increase. The recommended drug usage instructions affected prescriptions for insomnia and restlessness at admission and prescriptions of BZD receptor agonist usage at admission. Our findings seem to suggest that setting drug usage instructions for insomnia and restlessness when changing the electronic medical record vendor will be useful for promoting proper medication use.

HISTOPATHOLOGICAL GRADING OF MENINGIOMA IN ASSOCIATION WITH THE HORMONAL CONTRACEPTIVES’ USAGE The high incidence of meningiomas in women indicates the role of female sex hormones in the growth of meningiomas. The use of hormonal contraceptives has been associated with an increased risk of meningiomas. Prior studies have reported an association between hormonal contraceptive use and the expression of certain hormonal receptors in meningioma tissues in which expression of progesterone and estrogen receptors have been associated with histopathological grading of meningiomas. There have been no previous studies about the association between hormonal contraceptive use and the histopathological grading of meningiomas. The aim of this study was to evaluate the association between hormonal contraceptive use and histopathological grading of meningioma. This study was an analytic cross-sectional study conducted at Mohammad Hoesin General Hospital Palembang and enrolled female meningioma patients with a history of hormonal contraceptive use from January 1st, 2018, to December 31st, 2020. Data were collected from medical records and in person or by phone interview. From 220 meningioma patients, 72 subjects were included in this study with 79.2% were low grade meningioma and 20.8% were high grade meningioma. Among the current users, 66.7% had high-grade meningioma, while 60.0% of combined hormonal contraceptives, and another 60.0% long-term users had high-grade meningioma, respectively. The status of hormonal contraceptive uses (p = 0.038) and the type of hormonal contraceptive (p = 0.001) had a significant association with the histopathological grading of meningioma and became the most significant independent variables according to multivariate logistic regression (p = 0.034; OR: 4.433 and p = 0.001; OR: 9.686) while there was no association between duration of use and histopathological grading of meningioma (p = 0.180). Current users and combination contraceptives (estrogen and progesterone) increased the risk of high-grade meningioma.

Aneurysms and pseudoaneurysm are commonly encountered with arteriovenous vascular access for haemodialysis. They are difficult complications to manage. Due to the limited number of vascular centers available, patients were unable to seek treatment until further complications arise. The technique of partial aneurysmectomy and primary repair was adopted as the method of repair in this study. A total of 20 cases underwent the surgery from 2019 to 2020. Among the 20 cases, one patient had two pseudoaneurysms at different location which requires her to undergo the procedure twice. The successful cannulation rate post repair was 70% whereas the overall complication rate was 35% which might be attributed to the small sample size. Overall, this study demonstrated that AVF aneurysm and pseudoaneurysm can be safely treated with this approach and can be done effectively in non-vascular centers by general surgeons.