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The Association of Periodontal Treatment and Decreased Pneumonia: A Nationwide Population-Based Cohort Study.

牙周治疗与肺炎减少的关系: 一项基于全国人群的队列研究。

  • 影响因子:2.81
  • DOI:10.3390/ijerph17010356
  • 作者列表:"Yang LC","Suen YJ","Wang YH","Lin TC","Yu HC","Chang YC
  • 发表时间:2020-01-05
Abstract

:Pneumonia is a common respiratory infectious disease that involves the inflammation of the pulmonary parenchyma. Periodontal disease is widespread and correlated with pneumonia. However, the relationship between periodontal treatment and clinical infectious outcomes in patients with pneumonia has remained undetermined. The aim of this study was to investigate the association between periodontal treatment and the risk of pneumonia events in the Taiwanese population. A nationwide population-based cohort study was conducted using data from the Taiwanese National Health Insurance Research Database (NHIRD). A total of 49,400 chronic periodontitis patients who received periodontal treatment from 2001 to 2012 were selected. In addition, 49,400 healthy individuals without periodontal diseases were picked randomly from the general population after propensity score matching according to age, gender, monthly income, urbanization, and comorbidities. The Cox proportional hazard regression analysis was adopted to assess the hazard ratio (HR) of pneumonia between the periodontal treatment cohort and the comparison cohort. The average ages of the periodontal treatment and comparison groups were 44.25 ± 14.82 years and 44.15 ± 14.5 years, respectively. The follow up durations were 7.66 and 7.41 years for the periodontal treatment and comparison groups, respectively. We found 2504 and 1922 patients with newly diagnosed pneumonia in the comparison cohort and the periodontal treatment cohort, respectively. The Kaplan-Meier plot revealed that the cumulative incidence of pneumonia was significantly lower over the 12 year follow-up period in the periodontal treatment group (using the log-rank test, p < 0.001). In conclusion, this nationwide population-based study indicated that the patients with periodontal treatment exhibited a significantly lower risk of pneumonia than the general population.

摘要

: 肺炎是一种常见的呼吸道传染病,涉及肺实质的炎症。牙周病广泛存在,并与肺炎相关。然而,肺炎患者的牙周治疗与临床感染结局之间的关系仍未确定。这项研究的目的是调查台湾人群中牙周治疗与肺炎事件风险之间的关系。使用台湾国民健康保险研究数据库 (NHIRD) 的数据,进行了一项基于人群的全国性队列研究。选择 2001-2012 年接受牙周治疗的慢性牙周炎患者 49,400 例。此外,按年龄、性别、月收入、城市化、合并症等因素进行倾向评分匹配后,从普通人群中随机抽取 49,400 例无牙周病的健康个体。采用Cox比例风险回归分析评估牙周治疗队列和对照队列之间肺炎的风险比 (HR)。牙周治疗组和对照组的平均年龄分别为 44.25 ± 14.82 岁和 44.15 ± 14.5 岁。牙周治疗组和对照组的随访时间分别为 7.66 年和 7.41 年。我们在对照队列和牙周治疗队列中分别发现了 2504 和 1922 例新诊断的肺炎患者。Kaplan-Meier图显示,在牙周治疗组的 12 年随访期内,肺炎的累积发生率显著降低 (使用时序检验,p <0.001)。总之,这项基于全国人群的研究表明,接受牙周治疗的患者患肺炎的风险显著低于普通人群。

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影响因子:14.71
发表时间:2020-02-01
来源期刊:Nature immunology
DOI:10.1038/s41590-019-0571-2
作者列表:["Adrover JM","Aroca-Crevillén A","Crainiciuc G","Ostos F","Rojas-Vega Y","Rubio-Ponce A","Cilloniz C","Bonzón-Kulichenko E","Calvo E","Rico D","Moro MA","Weber C","Lizasoaín I","Torres A","Ruiz-Cabello J","Vázquez J","Hidalgo A"]

METHODS::The antimicrobial functions of neutrophils are facilitated by a defensive armamentarium of proteins stored in granules, and by the formation of neutrophil extracellular traps (NETs). However, the toxic nature of these structures poses a threat to highly vascularized tissues, such as the lungs. Here, we identified a cell-intrinsic program that modified the neutrophil proteome in the circulation and caused the progressive loss of granule content and reduction of the NET-forming capacity. This program was driven by the receptor CXCR2 and by regulators of circadian cycles. As a consequence, lungs were protected from inflammatory injury at times of day or in mouse mutants in which granule content was low. Changes in the proteome, granule content and NET formation also occurred in human neutrophils, and correlated with the incidence and severity of respiratory distress in pneumonia patients. Our findings unveil a 'disarming' strategy of neutrophils that depletes protein stores to reduce the magnitude of inflammation.

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翻译标题与摘要 下载文献
影响因子:2.81
发表时间:2020-01-05
DOI:10.3390/ijerph17010356
作者列表:["Yang LC","Suen YJ","Wang YH","Lin TC","Yu HC","Chang YC"]

METHODS::Pneumonia is a common respiratory infectious disease that involves the inflammation of the pulmonary parenchyma. Periodontal disease is widespread and correlated with pneumonia. However, the relationship between periodontal treatment and clinical infectious outcomes in patients with pneumonia has remained undetermined. The aim of this study was to investigate the association between periodontal treatment and the risk of pneumonia events in the Taiwanese population. A nationwide population-based cohort study was conducted using data from the Taiwanese National Health Insurance Research Database (NHIRD). A total of 49,400 chronic periodontitis patients who received periodontal treatment from 2001 to 2012 were selected. In addition, 49,400 healthy individuals without periodontal diseases were picked randomly from the general population after propensity score matching according to age, gender, monthly income, urbanization, and comorbidities. The Cox proportional hazard regression analysis was adopted to assess the hazard ratio (HR) of pneumonia between the periodontal treatment cohort and the comparison cohort. The average ages of the periodontal treatment and comparison groups were 44.25 ± 14.82 years and 44.15 ± 14.5 years, respectively. The follow up durations were 7.66 and 7.41 years for the periodontal treatment and comparison groups, respectively. We found 2504 and 1922 patients with newly diagnosed pneumonia in the comparison cohort and the periodontal treatment cohort, respectively. The Kaplan-Meier plot revealed that the cumulative incidence of pneumonia was significantly lower over the 12 year follow-up period in the periodontal treatment group (using the log-rank test, p < 0.001). In conclusion, this nationwide population-based study indicated that the patients with periodontal treatment exhibited a significantly lower risk of pneumonia than the general population.

翻译标题与摘要 下载文献
影响因子:2.89
发表时间:2020-04-01
DOI:10.1016/j.ijid.2020.01.038
作者列表:["Ngocho JS","Horumpende PG","de Jonge MI","Mmbaga BT"]

METHODS:OBJECTIVE:To describe the treatment of community-acquired pneumonia (CAP) in children under five years in Tanzania. METHODS:Between January and December 2017, children aged 2-59 months with chest radiography-confirmed CAP were enrolled. The parents were interviewed to collect information on the patients and home-based medication. Clinical information was derived from the patient files. Nasopharyngeal swab and blood samples were collected for isolation of the causative pathogens. Swab samples were analysed by quantitative PCR whereas blood samples were tested using BacT/Alert 3D. RESULTS:Overall, 109 children with CAP were included in this analysis. Provision of care to most children was delayed (median = 4.6 days). A quarter (26.6%) were given unprescribed/leftover antibiotics at home. Only one child had positive bacterial culture. Referrals were associated with nasopharyngeal carriage of Streptococcus pneumoniae (p = 0.003) and Haemophilus influenzae (p = 0.004). Of all admitted children, more than a quarter (n = 29) did not need to be hospitalised and inappropriately received injectable instead of oral antibiotics. CONCLUSION:We found high rates of home treatment, particularly with antibiotics. Appropriate health care was delayed for most children because of home treatment. Efforts are needed at the community level to improve awareness of antimicrobial resistance.

翻译标题与摘要 下载文献
肺炎方向

肺炎是指终末气道、肺泡和肺间质的炎症。可由细菌、病毒、真菌、寄生虫等致病微生物,以及放射线、吸入性异物等理化因素引起。临床主要症状为发热、咳嗽、咳痰、痰中带血,可伴胸痛或呼吸困难等。

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